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4. European Association of Urology Biochemical Recurrence Risk Classification as a Decision Tool for Salvage Radiotherapy—A Multicenter Study

Author

Preisser, Felix, Abrams-Pompe, Raisa S., Stelwagen, Piter Jan, Böhmer, Dirk, Zattoni, Fabio, Magli, Alessandro, Rivas, Juan Gómez, Dilme, Roser Vives, Sepulcri, Matteo, Eguibar, Aritz, Heidegger, Isabel, Arnold, Christoph, Fankhauser, Christian D., Chun, Felix K.-H., van der Poel, Henk, Gandaglia, Giorgio, Wiegel, Thomas, van den Bergh, Roderick C.N., and Tilki, Derya more...

Published
2024
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5. Multi-institutional Development and External Validation of a Machine Learning Model for the Prediction of Distant Metastasis in Patients Treated by Salvage Radiotherapy for Biochemical Failure After Radical Prostatectomy

Author

Sabbagh, Ali, Tilki, Derya, Feng, Jean, Huland, Hartwig, Graefen, Markus, Wiegel, Thomas, Böhmer, Dirk, Hong, Julian C., Valdes, Gilmer, Cowan, Janet E., Cooperberg, Matthew, Feng, Felix Y., Mohammad, Tarek, Shelan, Mohamed, D'Amico, Anthony V., Carroll, Peter R., and Mohamad, Osama more...

Published
2024
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6. Development and External Validation of a Machine Learning Model for Prediction of Lymph Node Metastasis in Patients with Prostate Cancer

Author

Sabbagh, Ali, Washington, Samuel L., 3rd, Tilki, Derya, Hong, Julian C., Feng, Jean, Valdes, Gilmer, Chen, Ming-Hui, Wu, Jing, Huland, Hartwig, Graefen, Markus, Wiegel, Thomas, Böhmer, Dirk, Cowan, Janet E., Cooperberg, Matthew, Feng, Felix Y., Roach, Mack, 3rd, Trock, Bruce J., Partin, Alan W., D'Amico, Anthony V., Carroll, Peter R., and Mohamad, Osama more...

Published
2023
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8. Management, risk factors and prognostic impact of checkpoint-inhibitor pneumonitis (CIP) in lung cancer – A multicenter observational analysis

Author

Frost, Nikolaj, Unger, Kristina, Blum, Torsten Gerriet, Misch, Daniel, Kurz, Sylke, Lüders, Heike, Olive, Elisabeth, Raspe, Matthias, Hilbrandt, Moritz, Koch, Myriam, Böhmer, Dirk, Senger, Carolin, Witzenrath, Martin, Grohé, Christian, Bauer, Torsten, Modest, Dominik P., and Kollmeier, Jens more...

Published
2023
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10. Recurrence patterns and impact of brain metastases in synchronous single organ oligometastatic lung cancer following local ablative treatment – A multicenter analysis

Author

Frost, Nikolaj, Roeper, Julia, Velthaus, Janna-Lisa, Raspe, Matthias, Olive, Elisabeth, Schmittel, Alexander, Schmidt, Bernd, Wasilewski, David, Onken, Julia, Lüders, Heike, Witzenrath, Martin, Senger, Carolin, Böhmer, Dirk, Loges, Sonja, Griesinger, Frank, Modest, Dominik P., and Grohé, Christian more...

Published
2022
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13. Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries: A survey of the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society (DKG-ARO)

Author

Shelan, Mohamed, Aebersold, Daniel M., Albrecht, Clemens, Böhmer, Dirk, Flentje, Michael, Ganswindt, Ute, Höcht, Stefan, Hölscher, Tobias, Müller, Arndt-Christian, Niehoff, Peter, Pinkawa, Michael, Schmidt-Hegemann, Nina-Sophie, Sedlmayer, Felix, Wolf, Frank, Zamboglou, Constantinos, Zips, Daniel, Wiegel, Thomas, and Ghadjar, Pirus more...

Published
2021
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15. Radiotherapy in nodal oligorecurrent prostate cancer

Author

Pinkawa, Michael, Aebersold, Daniel M., Böhmer, Dirk, Flentje, Michael, Ghadjar, Pirus, Schmidt-Hegemann, Nina-Sophie, Höcht, Stefan, Hölscher, Tobias, Müller, Arndt-Christian, Niehoff, Peter, Sedlmayer, Felix, Wolf, Frank, Zamboglou, Constantinos, Zips, Daniel, and Wiegel, Thomas more...

Published
2021
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20. Assessing the Role and Optimal Duration of Hormonal Treatment in Association with Salvage Radiation Therapy After Radical Prostatectomy: Results from a Multi-Institutional Study

Author

Fossati, Nicola, Robesti, Daniele, Karnes, R. Jeffrey, Soligo, Matteo, Boorjian, Stephen A., Bossi, Alberto, Coraggio, Gabriele, Di Muzio, Nadia, Cozzarini, Cesare, Noris Chiorda, Barbara, Gandaglia, Giorgio, Scarcella, Simone, Bartkowiak, Detlef, Böhmer, Dirk, Shariat, Shahrokh, Goldner, Gregor, Battaglia, Antonino, Joniau, Steven, Haustermans, Karin, De Meerleer, Gert, Fonteyne, Valérie, Ost, Piet, Van Poppel, Hein, Montorsi, Francesco, Wiegel, Thomas, and Briganti, Alberto more...

Published
2019
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21. Local ablative treatment for synchronous single organ oligometastatic lung cancer—A propensity score analysis of 180 patients

Author

Frost, Nikolaj, Tessmer, Antje, Schmittel, Alexander, van Laak, Vincent, Raspe, Matthias, Ruwwe-Glösenkamp, Christoph, Brunn, Matthias, Senger, Carolin, Böhmer, Dirk, Ochsenreither, Sebastian, Temmesfeld-Wollbrück, Bettina, Furth, Christian, Schmidt, Bernd, Neudecker, Jens, Rückert, Jens-Carsten, Suttorp, Norbert, Witzenrath, Martin, and Grohé, Christian more...

Published
2018
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25. Use of androgen deprivation and salvage radiation therapy for patients with prostate cancer and biochemical recurrence after prostatectomy

Author

Ghadjar, Pirus, Aebersold, Daniel M., Albrecht, Clemens, Böhmer, Dirk, Flentje, Michael, Ganswindt, Ute, Höcht, Stefan, Hölscher, Tobias, Sedlmayer, Felix, Wenz, Frederik, Zips, Daniel, Wiegel, Thomas, and Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party Radiation Oncology of the German Cancer Society (DKG-ARO) more...

Published
2018
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26. Salvage Radiotherapy for Relapsed Prostate Cancer after Radical Prostatectomy Is Associated with Normal Life Expectancy.

Author

Lohm, Gunnar, Knörnschild, Franz, Neumann, Konrad, Budach, Volker, Schwartz, Stefan, Burock, Susen, and Böhmer, Dirk

Subjects
BIOCHEMISTRY, RADICAL prostatectomy, LIFE expectancy, PHENOMENOLOGICAL biology, CANCER relapse, COMPARATIVE studies, SURVIVAL analysis (Biometry), DESCRIPTIVE statistics, SALVAGE therapy, PROSTATE-specific antigen, PROSTATE tumors, LONGITUDINAL method, TUMOR grading
Abstract

Simple Summary: Radiotherapy is a treatment option for prostate cancer patients who have increasing prostate-specific antigen values after prostatectomy. However, this treatment has never been compared directly in a single study with the course of untreated relapsed prostate cancer. We analyzed the course of prostate-specific antigen values before and after radiotherapy by calculating prostate-specific antigen doubling times. Prolongation of these values after radiotherapy indicated slower progression with this treatment. The survival analysis also suggests the advantages of salvage radiotherapy. In our analysis, when comparing our cohort with an age-matched cohort from life tables, it was observed that patients had a normal life expectancy after radiotherapy for recurrent prostate cancer following prostatectomy. In patients with prostate cancer (PCa), salvage radiotherapy (SRT) for biochemical progression (BP) after radical prostatectomy (RP) improves PCa-specific survival. However, no prospective randomized trials have compared the effect of SRT with untreated patients. In this analysis of 151 patients who received SRT for post-RP BP, we compared their overall survival (OS) with virtual, age-matched controls (n = 151,000) retrieved from government life tables. We also investigated the risk factors associated with BP and OS and compared the prostate-specific antigen (PSA) doubling times (DTs) before and after SRT for patients with BP. The median follow-up was 9.3 years for BP and 17.4 years for OS. The risk factors significantly affecting BP were Gleason score (p < 0.001), pre-SRT PSA (p = 0.003), and negative surgical margins (p = 0.003). None of these risk factors were associated with OS. In 93 patients with BP after SRT, the median PSADT was significantly prolonged compared with pre-SRT values (3.7 vs. 8.3 months, p < 0.001). The OS did not differ between patients and controls (p = 0.112), and life expectancy was similar, likely due to the survival benefit of SRT. The prolonged PSADT after SRT further supports the beneficial role of SRT in this patient population. However, subsequent treatments were not systematically recorded, which may have affected the results. [ABSTRACT FROM AUTHOR] more...

Published
2024
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32. Ultrahypofractionation of localized prostate cancer

Author

Wolf, Frank, Sedlmayer, Felix, Aebersold, Daniel, Albrecht, Clemens, Böhmer, Dirk, Flentje, Michael, Ganswindt, Ute, Ghadjar, Pirus, Höcht, Stefan, Hölscher, Tobias, Müller, Arndt-Christian, Niehoff, Peter, Pinkawa, Michael, Schmidt-Hegemann, Nina-Sophie, Zamboglou, Constantinos, Zips, Daniel, and Wiegel, Thomas more...

Subjects
Male, Clinical Trials as Topic, SBRT, Treatment Outcome, Radiotherapy, Prostate, Hypofractionation, Humans, Prostatic Neoplasms, Radiation Dose Hypofractionation, Review Article, Extreme hypofractionation, SABR
Abstract

Due to its low fractionation sensitivity, also known as “alpha/beta ratio,” in relation to its surrounding organs at risk, prostate cancer is predestined for hypofractionated radiation schedules assuming an increased therapeutic ratio compared to normofractionated regimens. While moderate hypofractionation (2.2–4 Gy) has been proven to be non-inferior to normal fractionation in several large randomized trials for localized prostate cancer, level I evidence for ultrahypofractionation (>4 Gy) was lacking until recently. An accumulating body of non-randomized evidence has recently been strengthened by the publication of two randomized studies comparing ultrahypofractionation with a normofractionated schedule, i.e., the Scandinavian HYPO-RT trial by Widmark et al. and the first toxicity results of the PACE‑B trial. In this review, we aim to give a brief overview of the current evidence of ultrahypofractionation, make an overall assessment of the level of evidence, and provide recommendations and requirements that should be followed before introducing ultrahypofractionation into routine clinical use. more...

Published
2020

34. Management of the Contralateral Neck in Unilateral Node-Positive Oral Squamous Cell Carcinoma.

Author

Doll, Christian, Mrosk, Friedrich, Freund, Lea, Neumann, Felix, Kreutzer, Kilian, Voss, Jan, Raguse, Jan-Dirk, Beck, Marcus, Böhmer, Dirk, Rubarth, Kerstin, Heiland, Max, and Koerdt, Steffen

Subjects
MOUTH tumors, NECK surgery, RETROSPECTIVE studies, LYMPH nodes, METASTASIS, PROGNOSIS, COMPARATIVE studies, DISEASE prevalence, DESCRIPTIVE statistics, RADIOTHERAPY, SQUAMOUS cell carcinoma, DISEASE management, LONGITUDINAL method
Abstract

Simple Summary: Elective management of the contralateral neck in lateralized oral squamous cell carcinoma remains a matter of debate, and current guidelines provide only little guidance in this regard. Especially patients with ipsilateral cervical lymph node metastasis are of interest since several studies showed a higher risk for contralateral metastasis in these cases. The present study is a retrospective analysis of this cohort over a 10-year period at a high-volume tumor center in Germany. The results of this study show that the prevalence of occult contralateral neck metastases is low, and that contralateral elective neck dissection should not be performed routinely in this cohort. Introduction: In lateralized oral squamous cell carcinoma (OSCC) with ipsilateral cervical lymph node metastasis (CLNM), the surgical management of the unsuspicious contralateral neck remains a matter of debate. The aim of this study was to analyze this cohort and to compare the outcomes of patients with and without contralateral elective neck dissection (END). Material and Methods: A retrospective analysis of patients with lateralized OSCC, ipsilateral CLNM (pN+) and contralateral cN0-stage was performed. Patients were divided into two groups according to the surgical management of the contralateral neck: I: END; and II: no END performed. Adjuvant radiotherapy was applied bilaterally in both groups according to individual risk. Results: A total of 65 patients (group I: 16 (24.6%); group II: 49 (75.4%)) with a median follow-up of 28 months were included. Initially, there was no case of contralateral CLNM after surgery. During follow-up, 6 (9.2%) patients presented with recurrent CLNM. In 5 of these cases (7.7%), the contralateral neck (group I: 3/16 (18.8%); group II: 2/49 (4.1%)) was affected. Increased ipsilateral lymph node ratio was associated with contralateral CLNM (p = 0.07). END of the contralateral side showed no significant benefit regarding OS (p = 0.59) and RFS (p = 0.19). Conclusions: Overall, the risk for occult contralateral CLNM in patients with lateralized OSCC ipsilateral CLNM is low. Our data suggest that END should not be performed routinely in this cohort. Risk-adapted radiotherapy of the contralateral neck alone seems to be sufficient from the oncological point of view. [ABSTRACT FROM AUTHOR] more...

Published
2023
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36. Treatment strategies to prevent and reduce gynecomastia and/or breast pain caused by antiandrogen therapy for prostate cancer : Statement from the DEGRO working group prostate cancer

Author

Ghadjar, Pirus, Aebersold, Daniel M., Albrecht, Clemens, Böhmer, Dirk, Flentje, Michael, Ganswindt, Ute, Höcht, Stefan, Hölscher, Tobias, Müller, Arndt-Christian, Niehoff, Peter, Pinkawa, Michael, Sedlmayer, Felix, Zips, Daniel, Wiegel, Thomas, and Prostate Cancer Expert Panel Of The German Society Of Radiation Oncology (DEGRO) And The Working Party Radiation Oncology Of The German Cancer Society (DKG-ARO) more...

Subjects
Male, Oncology, medicine.medical_treatment, 030232 urology & nephrology, Breast pain, Antiandrogen therapy, Review Article, law.invention, Tosyl Compounds, Prostate cancer, 0302 clinical medicine, Estrogen Receptor Modulators, Randomized controlled trial, law, Anilides, Antiandrogen Therapy, 610 Medicine & health, skin and connective tissue diseases, Randomized Controlled Trials as Topic, Gynecomastia, 030220 oncology & carcinogenesis, Androgens, medicine.symptom, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, medicine.drug, medicine.medical_specialty, Neoplasms, Hormone-Dependent, Antineoplastic Agents, Hormonal, Anastrozole, Adenocarcinoma, Dizziness, Drug Administration Schedule, 03 medical and health sciences, Meta-Analysis as Topic, Internal medicine, Nitriles, Flushing, medicine, Humans, Radiology, Nuclear Medicine and imaging, business.industry, Prostatic Neoplasms, Androgen Antagonists, Off-Label Use, medicine.disease, Treatment, Radiation therapy, Tamoxifen, Dose Fractionation, Radiation, business, Mastodynia
Abstract

Aim To provide an overview on the available treatments to prevent and reduce gynecomastia and/or breast pain caused by antiandrogen therapy for prostate cancer. Methods The German Society of Radiation Oncology (DEGRO) expert panel summarized available evidence published and assessed the validity of the information on efficacy and treatment-related toxicity. Results Eight randomized controlled trials and one meta-analysis were identified. Two randomized trials demonstrated that prophylactic radiation therapy (RT) using 1 × 10 Gy or 2 × 6 Gy significantly reduced the rate of gynecomastia but not breast pain, as compared to observation. A randomized dose-finding trial identified the daily dose of 20 mg tamoxifen (TMX) as the most effective prophylactic dose and another randomized trial described that daily TMX use was superior to weekly use. Another randomized trial showed that prophylactic daily TMX is more effective than TMX given at the onset of gynecomastia. Two other randomized trials described that TMX was clearly superior to anastrozole in reducing the risk for gynecomastia and/or breast pain. One comparative randomized trial between prophylactic RT using 1 × 12 Gy and TMX concluded that prophylactic TMX is more effective compared to prophylactic RT and furthermore that TMX appears to be more effective to treat gynecomastia and/or breast pain when symptoms are already present. A meta-analysis confirmed that both prophylactic RT and TMX can reduce the risk of gynecomastia and/or breast pain with TMX being more effective; however, the rate of side effects after TMX including dizziness and hot flushes might be higher than after RT and must be taken into account. Less is known regarding the comparative effectiveness of different radiation fractionation schedules and more modern RT techniques. Conclusions Prophylactic RT as well as daily TMX can significantly reduce the incidence of gynecomastia and/or breast pain. TMX appears to be an effective alternative to RT also as a therapeutic treatment in the presence of gynecomastia but its side effects and off-label use must be considered. more...

Published
2020
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38. The Treatment of Metastatic, Hormone-Sensitive Prostatic Carcinoma.

Author

Merseburger, Axel S., Krabbe, Laura-Maria, Krause, Bernd Joachim, Böhmer, Dirk, Perner, Sven, and von Amsberg, Gunhild

Abstract

Background: For many years, the standard treatment of metastatic, hormone-sensitive prostatic carcinoma (mHSPC) was androgen deprivation therapy (ADT) alone. By lowering the testosterone level into the castration range, ADT deprives the tumor of a key growth factor. Methods: For this article, we evaluated the treatment recommendations contained in national and international guidelines (German S3 guidelines and those of the European Society for Medical Oncology [ESMO], European Association of Urology [EAU], and National Comprehensive Cancer Network [NCCN]), as well as pertinent publications revealed by a PubMed search and the congress abstracts of the ESMO and of the American Society of Clinical Oncology [ASCO]. Results: The past few years have witnessed fundamental changes in the treatment of mHSPC. Treatment intensification with docetaxel or with the new drugs directed against the androgen receptor signal pathway (abiraterone, apalutamide and enzalutamide) has been found to lower mortality by 19-40% and is now an integral component of first-line therapy. Relevant new findings have also been obtained with threefold combinations of ADT, docetaxel, and abiraterone or darolutamide. For patients with a light tumor burden, local radiotherapy of the primary tumor improves the probability of survival at 3 years by 8% (45.4 versus 49.1 months, difference 3.6 months; 95% confidence interval, 1.0 to 6.2 months). Conclusion: The treatment of mHSPC is constantly changing. Phase III trials that are now in the recruitment stage, as well as our continually improving understanding of the underlying molecular-pathological mechanisms, will be altering the treatment landscape still further in the years to come. [ABSTRACT FROM AUTHOR] more...

Published
2022
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42. German S3 Evidence-Based Guidelines on Focal Therapy in Localized Prostate Cancer: The First Evidence-Based Guidelines on Focal Therapy.

Author

Borkowetz, Angelika, Blana, Andreas, Böhmer, Dirk, Cash, Hannes, Ehrmann, Udo, Franiel, Tobias, Henkel, Thomas-Oliver, Höcht, Stefan, Kristiansen, Glen, Machtens, Stefan, Niehoff, Peter, Penzkofer, Tobias, Pinkawa, Michael, Radtke, Jan Philipp, Roth, Wilfried, Witzsch, Ullrich, Ganzer, Roman, Schlemmer, Heinz Peter, Grimm, Marc-Oliver, and Hakenberg, Oliver W. more...

Subjects
PROSTATE cancer, HIGH-intensity focused ultrasound, EXPERT evidence
Abstract

Background: Focal therapy (FT) is an option to treat localized prostate cancer (PCa) and preserve healthy prostate tissue in order to reduce known side effects from primary whole-gland treatment. The available FT modalities are manifold. Until now, national and international PCa guidelines have been cautious to propose recommendations regarding FT treatment since data from prospective controlled trials are lacking for most FT modalities. Moreover, none of the international guidelines provides a separate section on FT. In this purpose, we provide a synopsis of the consensus-based German S3 guidelines for a possible international use. Summary: The recently published update of the German S3 guidelines, an evidence- and consensus-based guideline, provides a section on FT with recommendations for diagnostic work-up, indications, modalities, and follow-up. This section consists of 12 statements and recommendations for FT in the treatment of localized PCa. Key Message: The German S3 guidelines on PCa are the first to incorporate recommendations for FT based on evidence and expert consensus including indication criteria for FT, pretreatment, and follow-up diagnostic pathways as well as an extended overview of FT techniques and the current supportive evidence. [ABSTRACT FROM AUTHOR] more...

Published
2022
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