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Search Results: 1 - 10 of 933 matches for " Katja Lindel "
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Long-term outcome and patterns of failure in patients with advanced head and neck cancer
Henrik Hauswald, Christian Simon, Simone Hecht, Juergen Debus, Katja Lindel
Radiation Oncology , 2011, DOI: 10.1186/1748-717x-6-70
Abstract: Between 1992 and 2005 127 patients (median age 55 years, UICC stage III n = 6, stage IV n = 121) with primarily inoperable, advanced HNSCC were treated with definite platinum-based radiochemotherapy (median dose 66.4 Gy). Analysed end-points were overall survival (OS), disease-free survival (DFS), loco-regional progression-free survival (LPFS), development of distant metastases (DM), prognostic factors and causes of death.The mean follow-up time was 34 months (range, 3-156 months), the 3-, 5- and 10-year OS rates were 39%, 28% and 14%, respectively. The median OS was 23 months. Forty-seven patients achieved a complete remission and 78 patients a partial remission. The median LPFS was 17 months, the 3-, 5- and 10-year LPFS rates were 41%, 33% and 30%, respectively. The LPFS was dependent on the nodal stage (p = 0.029). The median DFS was 11 months (range, 2-156 months), the 3-, 5- and 10-year DFS rates were 30%, 24% and 22%, respectively. Prognostic factors in univariate analyses were alcohol abuse (n = 102, p = 0.015), complete remission (n = 47, p < 0.001), local recurrence (n = 71, p < 0.001), development of DM (n = 45, p < 0.001; median OS 16 months) and borderline significance in nodal stage N2 versus N3 (p = 0.06). Median OS was 26 months with lung metastases (n = 17). Nodal stage was a predictive factor for the development of DM (p = 0.025). Cause of death was most commonly tumor progression.In stage IV HNSCC long-term survival is rare and DM is a significant predictor for mortality. If patients developed DM, lung metastases had the most favourable prognosis, so intensified palliative treatment might be justified in DM limited to the lungs.The incidence of oropharyngeal cancer in German men in 2004 was 16.3 per 100.000 [1]. Smoking and alcohol consumption were known risk factors for the development of head and neck squamous cell carcinoma (HNSCC)[2,3]. New and optimized treatment methods increase loco-regional progression-free survival (LPFS) and disease-free
The transcriptional regulator gene E2 of the Human Papillomavirus (HPV) 16 influences the radiosensitivity of cervical keratinocytes
Lindel Katja,Rieken Stefan,Daffinger Sigrid,Weber Klaus J
Radiation Oncology , 2012, DOI: 10.1186/1748-717x-7-187
Abstract: Background Clinical studies have demonstrated that HPV induced tumors constitute a specific subclass of cancer with a better response to radiation treatment. The purpose of this study was to investigate meaning of viral E2-gene for radiosensitivity. Methods W12 cells contain episomal HPV 16 genomes, whereas S12 cells, which derive from the W12 line, contain HPV DNA as integrated copies. Clonogenic survival was analyzed using 96-well in vitro test. Using flow cytometry cell cycle analyses were performed. Expression of pRb and p53 were analyzed using intracellular staining. Results W12 cells (intact E2 gene) showed a lower survival fraction than S12 cells. W12 cells developed a G2/M block 24 h after irradiation with 2 Gy whereas S12 showed no G2/M bloc. After irradiation S12 cells developed polyploidy and pRb-positive cells decreased. W12 cells showed no change of pRb-positive cells. Conclusions Depending on E2 gene status differences in cell cycle regulation might cause radioresistance. The E2/E7/pRb pathway seems to influence HPV-induced radiosensitivity. Our experiments demonstrated an effect of HPV on radiosensitivity of cervical keratinocytes via viral transcription regulator E2 pathway.
Major combined electrolyte deficiency during therapy with low-dose Cisplatin, 5-Fluorouracil and Interferon alpha: report on several cases and review of the literature [ISRCTN62866759]
Katrin Hoffmann, Angela Marten, Katja Lindel, Stefan Fritz, Dirk Jager, Markus W Buchler, Jan Schmidt
BMC Cancer , 2006, DOI: 10.1186/1471-2407-6-128
Abstract: A patient with resected adenocarcinoma of the pancreas was treated with adjuvant radio-chemo-immunotherapy using a combination of low-dose Cisplatin, 5-Fluorouracil and Interferon alpha together with external beam radiation. Severe hypocalcaemia without signs of acute renal failure or electrolyte disturbance occurred within 2 days at the 4th week of treatment and required intensive care treatment.Combination of biological and cytotoxic therapies may increase the incidence of severe hypocalcaemia in pancreatic cancer. Oncologists should remain attentive of this problem as more highly active regimes become available.Hypocalcaemia is a known side-effect in high-dose Cisplatin chemotherapy of solid tumors [1,2]. In the classic case, hypocalcaemia is caused by excessive urinary loss and decreased renal up-take during high-dose Cisplatin treatment. Proximal tubular damage leads to decreased reabsorption of cations. Acute nephrotoxicity presents with increased creatinine and persistent protein and electrolyte losses. Chronic nephrotoxicity is characterized by a decrease of glomerular filtration rate and a slightly elevated but persistent magnesium, potassium and calcium excretion [3]. Hypomagnaesemic induced hypocalcaemia is caused by inhibition of parathyroid hormone secretion, impaired calcium release from the bones and low tissue responses to PTH due to low magnesium levels. Cisplatin associated hypocalcaemia and hypercalciuria can not be influenced by calcium supplementation. Correction of magnesium blood levels usually should improve the hypocalcaemia [4]. Hypocalcaemia may be associated with tetany, depression, carpopedal spasm, neuromuscular excitability, cardiac arrythmias with prolonged Q-T interval and sudden death, making it a true oncological emergency [5].Outside cytotoxic therapy hypocalcaemia has been observed after thyroid and parathyroid surgery, chronic renal failure, acute rhabdomyolysis and pancreatitis [6-9]. Cisplatin is often used in combinations wit
Targeting ανβ3 and ανβ5 inhibits photon-induced hypermigration of malignant glioma cells
Stefan Rieken, Daniel Habermehl, Angela Mohr, Lena Wuerth, Katja Lindel, Klaus Weber, Jürgen Debus, Stephanie E Combs
Radiation Oncology , 2011, DOI: 10.1186/1748-717x-6-132
Abstract: Eight μm pore size membranes were coated with vitronectin (VN), collagen I and collagen IV. U87 and Ln229 glioma cells were analysed in migration experiments with and without radiotherapy (RT), serum stimulation and addition of monoclonal antibodies directed to human integrins ανβ3 and ανβ5. Quantitative FACS analysis of integrins was performed in U87 and Ln229 glioma cells following RT. Statistical analysis was performed using Student's t-test.Glioma cell migration is serum-dependent and can be increased by photon RT which leads to enhanced expression of Vn receptor integrins. Blocking of either ανβ3 or ανβ5 integrins by antibodies inhibits Vn-based migration of both untreated and photon-irradiated glioma cells.Peripheral glioma cells are at risk of attraction into the adjacent healthy brain by serum components leaking through the blood brain barrier (BBB). Radiation therapy is associated with upregulation of Vn receptor integrins and enhanced glioma cell migration at sublethal doses. This effect can be inhibited by specific integrin blockade. Future therapeutical benefit may be derived from pharmacological integrin inhibition in combination with photon irradiation.Despite continuously evolving therapy regimes including extensive neurosurgery, multiagent chemotherapy, and dose-escalated conformal radiotherapy, primary brain tumors have not ceased to account for high lethality after short periods of time in most patients. Deep locoregional tumor cell infiltration that eludes modern imaging techniques and hampers complete local resection was accounted responsible for early relapse and spread of disease throughout the brain. Current glioma therapy involves surgical tumor resection followed by adjuvant radiotherapy combined with concomitant and adjuvant chemotherapy [1].As opposed to the tissue they originate from, most tumor cells, including malignant glioma cells, possess the unique ability to migrate and adhere to various surfaces, displaying polyligand-induced moti
Phase II study evaluating consolidation whole abdominal intensity-modulated radiotherapy (IMRT) in patients with advanced ovarian cancer stage FIGO III - The OVAR-IMRT-02 Study
Nathalie Rochet, Meinhard Kieser, Florian Sterzing, Sonja Krause, Katja Lindel, Wolfgang Harms, Michael H Eichbaum, Andreas Schneeweiss, Christof Sohn, Juergen Debus
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-41
Abstract: Ovarian cancer is a radiosensitive tumor, so that the use of whole abdominal radiotherapy (WAR) as a consolidation therapy would appear to be a logical strategy. WAR used to be the standard treatment after surgery before the chemotherapy era; however, it has been almost totally excluded from the treatment of ovarian cancer during the past decade because of its high toxicity. Modern intensity-modulated radiation therapy (IMRT) has the potential of sparing organs at risk like kidneys, liver, and bone marrow while still adequately covering the peritoneal cavity with a homogenous dose.Our previous phase I study showed for the first time the clinical feasibility of intensity-modulated WAR and pointed out promising results concerning treatment tolerance. The current phase-II study succeeds to the phase-I study to further evaluate the toxicity of this new treatment.The OVAR-IMRT-02 study is a single-center one arm phase-II trial. Thirty seven patients with optimally debulked ovarian cancer stage FIGO III having a complete remission after chemotherapy will be treated with intensity-modulated WAR as a consolidation therapy.A total dose of 30 Gy in 20 fractions of 1.5 Gy will be applied to the entire peritoneal cavity including the liver surface and the pelvic and para-aortic node regions. Organ at risk are kidneys, liver (except the 1 cm-outer border), heart, vertebral bodies and pelvic bones.Primary endpoint is tolerability; secondary objectives are toxicity, quality of life, progression-free and overall survival.Intensity-modulated WAR provides a new promising option in the consolidation treatment of ovarian carcinoma in patients with a complete pathologic remission after adjuvant chemotherapy. Further consequent studies will be needed to enable firm conclusions regarding the value of consolidation radiotherapy within the multimodal treatment of advanced ovarian cancer.Clinicaltrials.gov: NCT01180504Ovarian cancer has the highest mortality rate of all gynaecologic cancer i
Long-term survival of cancer patients compared to heart failure and stroke: A systematic review
Vasileios Askoxylakis, Christian Thieke, Sven T Pleger, Patrick Most, Judith Tanner, Katja Lindel, Hugo A Katus, Jürgen Debus, Marc Bischof
BMC Cancer , 2010, DOI: 10.1186/1471-2407-10-105
Abstract: Records for our study were identified by searches of Medline via Pubmed. We focused on observed and relative age- and sex-adjusted 5-year survival rates for cancer in general and for the four most common malignancies in developed countries, i.e. lung, breast, prostate and colorectal cancer, as well as for heart failure and stroke.Twenty studies were identified and included for analysis. Five-year observed survival was about 43% for all cancer entities, 40-68% for stroke and 26-52% for heart failure. Five-year age and sex adjusted relative survival was 50-57% for all cancer entities, about 50% for stroke and about 62% for heart failure. In regard to the four most common malignancies in developed countries 5-year relative survival was 12-18% for lung cancer, 73-89% for breast cancer, 50-99% for prostate cancer and about 43-63% for colorectal cancer. Trend analysis revealed a survival improvement over the last decades.The results indicate that long term survival and prognosis of cancer is not necessarily worse than that of heart failure and stroke. However, a comparison of the prognostic impact of the different diseases is limited, corroborating the necessity for further systematic investigation of competing risks.The facts that multiple diseases are present in many patients and that this trend is expected to increase in the future due to population ageing reveal the necessity for a better understanding of competing risks. Among the diseases with high mortality cancer, heart failure and stroke represent major global healthcare problems.Cancer is the second most common cause of death after cardiovascular diseases. According to the World Health Organization (WHO), more than 10 million people are diagnosed with cancer yearly. The disease is responsible for 6 million deaths per year accounting for up to 12% of all cases. Fifty six percent of newly diagnosed cancer patients are >65 years, while about 70% of cancer deaths are in this age group. The median age of cancer patie
Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function
Christian Simon, Cem Bulut, Philippe A Federspil, Marc W Münter, Katja Lindel, Zazie Bergmann, Serkan Sertel, Sarah Leitzbach, Peter K Plinkert
Radiation Oncology , 2011, DOI: 10.1186/1748-717x-6-109
Abstract: 21 patients were treated between 2005 and 2010 in a single institution (17 male, 4 female) for salvage (10/21), palliation (4/21), or functional rehabilitation (7/21). Overall 23 flaps were performed of which 8 were free flaps. Major recipient site complications were observed in only 4 pts. (19%) (1 postoperative haemorrhage, 1 partial flap loss, 2 fistulas) and major donor site complications in 1 pt (wound dehiscence). Also 2 minor donor site complications were observed. The overall complication rate was 33%. There was no free flap loss. Assessment of pre- and postoperative KPS revealed improvement in 13 out of 21 patients (62%). A decline of KPS was noted in only one patient.We conclude that within this (chemo)radiated patient population surgical interventions for salvage, palliation or improve function can be safely performed once vascularised grafts are used.Surgery after (chemo)radiation (RCTX/RTX) therapy is felt to be plagued with a high incidence of wound complications as the consequence of radiation induced wound bed changes [1]. Major peri- and postoperative complications upon surgery after RCTX or RTX are reported to be up to 73% for i.e. salvage laryngectomies [2]. The use of regional and free tissue transfer appears to decrease these complications. However studies on the incidence of major peri-and postoperative complications after procedures that include using vascularized tissue transfer still display highly variable rates that range between 10% [3] and 66% (for doubly irradiated patients) [4]. For salvage laryngectomies with reinforcement of the pharyngeal closure using vascularized tissue transfer the incidence of fistula formation is reported to be between 18% [5] and 29% [6] and there is still debate whether or not flaps help to decrease the incidence of such fistulas [7-10]. Thus, there remains a question on the safety of performing surgical procedures on (chemo)radiated patients and the role of vascularized tissue transfer within this patient po
Remembering the Shipyard Strike
Karin S. Lindel?f
Baltic Worlds , 2012,
Abstract: This article focus on how the Gdańsk shipyard strike and the formation of Solidarity have been remembered and observed afterwards, especially in connection with the 30th anniversary in August 2010. The author explores how people create meaning in past events in relation to current interests, and how the depiction of a shared history is constantly recast and used.
Focal dose escalation using FDG-PET-guided intensity-modulated radiation therapy boost for postoperative local recurrent rectal cancer: a planning study with comparison of DVH and NTCP
Keiichi Jingu, Hisanori Ariga, Tomohiro Kaneta, Yoshihiro Takai, Ken Takeda, Lindel Katja, Kakutaro Narazaki, Takahiro Metoki, Keisuke Fujimoto, Rei Umezawa, Yoshihiro Ogawa, Kenji Nemoto, Masashi Koto, Masatoshi Mitsuya, Naruhiro Matsufuji, Shoki Takahashi, Shogo Yamada
BMC Cancer , 2010, DOI: 10.1186/1471-2407-10-127
Abstract: First, we performed conventional radiotherapy with 40 Gy/20 fr. (CRT 40 Gy) for 12 patients with postoperative local recurrent rectal cancer, and then we performed FDG-PET/CT radiotherapy planning for those patients. We defined the regions with SUV > 2.0 as biological target volume (BTV) and made three boost plans for each patient: 1) CRT boost plan, 2) IMRT without dose-painting boost plan, and 3) IMRT with dose-painting boost plan. The total boost dose was 20 Gy. In IMRT with dose-painting boost plan, we increased the dose for BTV+5 mm by 30% of the prescribed dose. We added CRT boost plan to CRT 40 Gy (summed plan 1), IMRT without dose-painting boost plan to CRT 40 Gy (summed plan 2) and IMRT with dose-painting boost plan to CRT 40 Gy (summed plan 3), and we compared those plans using DVHs and NTCP.Dmean of PTV-PET and that of PTV-CT were 26.5 Gy and 21.3 Gy, respectively. V50 of small bowel PRV in summed plan 1 was significantly higher than those in other plans ((summed plan 1 vs. summed plan 2 vs. summed plan 3: 47.11 ± 45.33 cm3 vs. 40.63 ± 39.13 cm3 vs. 41.25 ± 39.96 cm3(p < 0.01, respectively)). There were no significant differences in V30, V40, V60, Dmean or NTCP of small bowel PRV.FDG-PET-guided IMRT can facilitate focal dose-escalation to regions with SUV above 2.0 for postoperative local recurrent rectal cancer.Although positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) has become widely used for diagnosis of various malignant tumors, the spatial resolution of PET images alone is not high and it is difficult to determine anatomical sites in detail. However, this problem has been solved by the use of a combined PET/CT system, which enables both PET and CT images to be obtained at almost the same time and at the same position.Local recurrence rates of rectal cancer after surgery including dissection of lateral nodes have been reported to be about 9~12% in Japan [1-3], and the prognosis after local recurrence is poor. In the case of local r
Investigating a comorbid pattern of ill-health among late adolescents in relation to transdiagnostic processes: A prospective community study  [PDF]
Katja Boersma, Maria Tillfors
Health (Health) , 2013, DOI: 10.4236/health.2013.511247
Abstract: An increase in anxiety, depressed mood and sleep problems has been observed among adolescents. These symptoms have high rates of comorbidity and shared psychological processes have been proposed as maintaining factors. This study examined the occurrence and development of individual profiles of depressive symptoms, anxiety and sleeps problems and investigated them in relation to catastrophic thinking and cognitive avoidance. We used longitudinal data from a community sample of 379 senior high school students at two time points, one year apart. Five clusters were identified: a low scores cluster, a sleep problems cluster, a comorbidity cluster (high on all variables), a low mood cluster and a cluster with elevation on anxiety and depressed mood (“distress”). In general, the clusters showed stability across time. However, for the low mood and “distress” cluster, there was also an increased odds of developing sleep problems. The comorbidity and the “distress” cluster displayed the highest levels of catastrophic thinking. In conclusion, symptom patterns differed among adolescents and were stable over time. Anxiety and/or depressive symptoms were a risk factor for the development of sleep problems. Symptom constellations were related to differences in catastrophic thinking and cognitive avoidance and this may explain maintenance and exacerbation of problems over time.
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