26 results on '"Timmermann, Beate"'
Search Results
2. Meningioma risk following treatment for childhood cancer : A pooled analysis
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Timmermann, Beate and Kortmann, Rolf-Dieter
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Oncology ,Medizin ,Radiology, Nuclear Medicine and imaging - Published
- 2022
3. The European Particle Therapy Network (EPTN) consensus on the follow-up of adult patients with brain and skull base tumours treated with photon or proton irradiation
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De Roeck, Laurien, van der Weide, Hiska L, Eekers, Daniëlle B P, Kramer, Miranda C, Alapetite, Claire, Blomstrand, Malin, Burnet, Neil G, Calugaru, Valentin, Coremans, Ida E M, Di Perri, Dario, Harrabi, Semi, Iannalfi, Alberto, Klaver, Yvonne L B, Langendijk, Johannes A, Romero, Alejandra Méndez, Paulsen, Frank, Roelofs, Erik, de Ruysscher, Dirk, Timmermann, Beate, Vitek, Pavel, Weber, Damien C, Whitfield, Gillian A, Nyström, Petra Witt, Zindler, Jaap, Troost, Esther G C, Lambrecht, Maarten, work package 1 of the taskforce 'European Particle Therapy Network' of ESTRO, UCL - (SLuc) Centre du cancer, and UCL - (SLuc) Service de radiothérapie oncologique
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Adult ,Consensus ,Toxicity ,Skull base tumour ,Follow-up ,Medizin ,Particle therapy ,Brain ,Brain tumour ,Hematology ,Skull Base Neoplasms ,Oncology ,Central nervous system ,European Particle Therapy Network ,Proton Therapy ,Humans ,Radiology, Nuclear Medicine and imaging ,Protons ,610 Medicine & health ,Follow-Up Studies - Abstract
PURPOSE Treatment-related toxicity after irradiation of brain tumours has been underreported in the literature. Furthermore, there is considerable heterogeneity on how and when toxicity is evaluated. The aim of this European Particle Network (EPTN) collaborative project is to develop recommendations for uniform follow-up and toxicity scoring of adult brain tumour patients treated with radiotherapy. METHODS A Delphi method-based consensus was reached among 24 international radiation-oncology experts in the field of neuro-oncology concerning the toxicity endpoints, evaluation methods and time points. RESULTS In this paper, we present a basic framework for consistent toxicity scoring and follow-up, using multiple levels of recommendation. Level I includes all recommendations that are considered minimum of care, whereas level II and III are optional evaluations in the advanced clinical or research setting, respectively. Per outcome domain, the clinical endpoints and evaluation methods per level are listed. Where relevant, the organ at risk threshold doses for recommended referral to specific organ specialists are defined. CONCLUSION These consensus-based recommendations for follow-up will enable the collection of uniform toxicity data of brain tumour patients treated with radiotherapy. With adoptation of this standard, collaboration will be facilitated and we can further propel the research field of radiation-induced toxicities relevant for these patients. An online tool to implement this guideline in clinical practice is provided at www.cancerdata.org.
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- 2022
4. Pre-operative radiotherapy is associated with superior local relapse-free survival in advanced synovial sarcoma
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Scheer, Monika, Hallmen, Erika, Vokuhl, Christian, Fuchs, Joerg, Tunn, Per-Ulf, Muenter, Marc, Timmermann, Beate, Bauer, Sebastian, Henssen, Anton George, Kazanowska, Bernarda, Niggli, Felix, Ladenstein, Ruth, Ljungman, Gustaf, Eggert, Angelika, Klingebiel, Thomas, and Koscielniak, Ewa
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Cancer Research ,Soft tissue sarcoma ,Cancer och onkologi ,Radiotherapy ,Medizin ,General Medicine ,Local therapy ,Synovial sarcoma ,Scheduling of radiotherapy ,Oncology ,Cancer and Oncology ,Chemotherapy ,Pre-operative radiotherapy ,Surgery ,Maintenance therapy - Abstract
Purpose Optimization of local therapies in synovial sarcoma (SS) considered unresectable at diagnosis is needed. We evaluated the effects of neoadjuvant versus adjuvant radiation versus surgery only on long-term outcomes. Methods Patients with macroscopic SS tumors before chemotherapy (IRS-group-III) in the trials CWS-81, CWS-86, CWS-91, CWS-96, CWS-2002-P and SoTiSaR-registry were analyzed. Local therapies were scheduled after 3 neoadjuvant chemotherapy cycles. Results Median age of 145 patients was 14.5 years. 106 survivors had median follow-up of 7.0 years. Tumor site was 96 extremities, 19 head–neck, 16 shoulder/hip, 14 trunk. Tumors were 10 cm in 34 patients. In a secondary resection during chemotherapy, R0-status was accomplished in 82, R1 in 30, R2 in 21 (12 missing). Radiotherapy was administered to 115 (R0 61, R1 29, R2 20, missing 5), thereof 57 before and 52 after tumor resection. 23 were treated with surgery only. For all patients, 5 year event-free (EFS) and overall survival (OS) was 68.9% ± 7.6 (95%CI) and 79.1% ± 6.9. To establish independent significance, tumor site, size, surgical results and sequencing of local therapies were analyzed in a Cox regression analysis. Variables associated with EFS and OS are site, size and sequencing of local therapies. Variables associated with local recurrence are site, surgical results and sequencing of local therapies. The only variable associated with suffering metastatic recurrence is tumor size. Conclusion Differences in sequencing of local therapy procedures are independently associated with outcomes. Best local control is achieved when tumors are irradiated pre-operatively and undergo R0 or R1 resection thereafter.
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- 2023
5. Inter-observer variation in target delineation and dose trade-off for radiotherapy of paediatric ependymoma
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Toussaint, Laura, Brandal, Petter, Embring, Anna, Engellau, Jacob, Evensen, Morten Egeberg, Griskeviskius, Romualdas, Hansen, Jolanta, Hietala, Henna, Johansson, Gun Wickart, J��rgensen, Morten, Kramer, Paul-Heinz, Kristensen, Ingrid, Lehtio, Kaisa, Magelssen, Henriette, Maraldo, Maja Vestm��, Marienhagen, Kirsten, Martinsson, Ulla, Nilsson, Kristina, Peters, Sarah, Plaude, Sandija, Seiersen, Klaus, Sendiuliene, Daiva, Smulders, Bob, Edvardsen, Tone, S��bstad, Johan Martin, Taheri, Zarah, Vaalavirta, Leila, Vestergaard, Anne, Timmermann, Beate, and Lassen-Ramshad, Yasmin
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Observer Variation ,Oncology ,Ependymoma ,Radiotherapy Planning, Computer-Assisted ,Radiation Oncology ,Medizin ,Humans ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine ,Child - Abstract
Inter-observer variation in target delineation and dose trade-off for radiotherapy of paediatric ependymoma
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- 2021
6. CD9- and CD81-positive extracellular vesicles provide a marker to monitor glioblastoma cell response to photon-based and proton-based radiotherapy
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Jennrich, Sara, Pelzer, Martin, Tertel, Tobias, Koska, Benjamin, Vüllings, Melanie, Thakur, Basant Kumar, Jendrossek, Verena, Timmermann, Beate, Giebel, Bernd, and Rudner, Justine
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Cancer Research ,Oncology ,Medizinische Fakultät » Universitätsklinikum Essen » Zentrum für Kinder- und Jugendmedizin » Klinik für Kinderheilkunde III ,Medizin ,ddc:610 ,Medizinische Fakultät » Universitätsklinikum Essen » Institut für Transfusionsmedizin ,radiotherapy with photons -- radiotherapy with protons -- glioblastoma -- extracellular vesicles -- exosomes -- microvesicles -- prognostic marker ,Medizinische Fakultät » Universitätsklinikum Essen » Institut für Zellbiologie (Tumorforschung) ,Medizinische Fakultät » Universitätsklinikum Essen » Westdeutsches Protonentherapiezentrum (WPE) ,Medizinische Fakultät » Universitätsklinikum Essen » Westdeutsches Tumorzentrum Essen (WTZ) - Abstract
Glioblastoma multiforme (GBM) is the most aggressive tumor of the central nervous system with a poor prognosis. In the treatment of GBM tumors, radiotherapy plays a major role. Typically, GBM tumors cannot be cured by irradiation because of intrinsic resistance machanisms. An escalation of the irradiation dose in the GBM tumor is difficult due to the high risk of severe side effects in the brain. In the last decade, the development of new irradiation techniques, including proton-based irradiation, promised new chances in the treatment of brain tumors. In contrast to conventional radiotherapy, irradiation with protons allows a dosimetrically more confined dose deposition in the tumor while better sparing the normal tissue surrounding the tumor. A systematic comparison of both irradiation techniques on glioblastoma cells has not been performed so far. Despite the improvements in radiotherapy, it remains challenging to predict the therapeutical response of GBM tumors. Recent publications suggest extracellular vesicles (EVs) as promising markers predicting tumor response. Being part of an ancient intercellular communication system, virtually all cells release specifically composed EVs. The assembly of EVs varies between cell types and depends on environmental parameters. Here, we compared the impact of photon-based with proton-based radiotherapy on cell viability and phenotype of four different glioblastoma cell lines. Furthermore, we characterized EVs released by different glioblastoma cells and correlated released EVs with the cellular response to radiotherapy. Our results demonstrated that glioblastoma cells reacted more sensitive to irradiation with protons than photons, while radiation-induced cell death 72 h after single dose irradiation was independent of the irradiation modality. Moreover, we detected CD9 and CD81-positive EVs in the supernatant of all glioblastoma cells, although at different concentrations. The amount of released CD9 and CD81-positive EVs increased after irradiation when cells became apoptotic. Although secreted EVs of non-irradiated cells were not predictive for radiosensitivity, their increased EV release after irradiation correlated with the cytotoxic response to radiotherapy 72 h after irradiation. Thus, our data suggest a novel application of EVs in the surveillance of anti-cancer therapies. OA Förderung 2022
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- 2022
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7. Dosimetric Feasibility of Moderately Hypofractionated/dose Escalated Radiation Therapy for Localised Prostate Cancer With Intensity-modulated Proton Beam Therapy Using Simultaneous Integrated Boost (SIB-IMPT) and Impact of Hydrogel Prostate-rectum Spacer
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Ahmad Khalil, Dalia, Jazmati, Danny, Geismar, Dirk, Wulff, Jörg, Bäumer, Christian, Kramer, Paul Heinz, Steinmeier, Theresa, Schulze Schleitthoff, Stefanie, Plaude, Sandija, Bischoff, Martin, Tschirdewahn, Stephan, Hadaschik, Boris, and Timmermann, Beate
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Male ,Oncology ,Radiotherapy Planning, Computer-Assisted ,Medizin ,Prostate ,Proton Therapy ,Rectum ,Feasibility Studies ,Humans ,Prostatic Neoplasms ,Hydrogels ,Radiology, Nuclear Medicine and imaging - Abstract
Purpose To examine the dosimetric feasibility of hypofractionated/dose escalated radiation therapy in patients with localized prostate carcinoma using simultaneous integrated boost intensity-modulated proton beam therapy (SIB-IMPT) in absence or presence of prostate-rectum spacer. Methods IMPT technique was implemented in 23 patients with intermediate- and high-risk prostate cancer treated at West German Proton Therapy Centre from March 2016 till June 2018, using SIB technique prescribing 60 GyRBE and 72 GyRBE in 30 fractions to PTV1 (prostate and seminal vesicle) and PTV2 boost (prostate and proximal seminal vesicle), respectively. In 15 patients, a transperineal injection of hydrogel was applied prior to radiotherapy to increase the distance between prostate and rectum. Planning and all treatments were performed with a 120 ml fluid-filled endorectal balloon customised daily for each patient. For each patient, 2 lateral IMPT beams were implemented taking a field-specific range uncertainty (RU) into account. Dose volume histograms (DVH) were analyzed for PTV2, PTV2 with range uncertainty margin (PTV2RU), rectum, bladder, right/left femoral heads, and penile bulb. For late rectal toxicities, the normal tissue complication probabilities (NTCP) were calculated using different biological models. A DVH- and NTCP-based dosimetric comparison was carried out between non-spacer and spacer groups. Results For the 23 patients, high-quality plans could be achieved for target volume and for other organs at risk (OARs). For PTV2, the V107% was 0% and the Dmax did not exceed 106.2% of the prescribed dose. The volume PTV2RU covered by 95% of the dose ranged from 96.16 to 99.95%. The conformality index for PTV2RU was 1.12 ± 0.057 and the homogeneity index (HI) was 1.04 ± 0.014. Rectum Dmax and rectal volume receiving 73–50 Gy could be further reduced for the spacer-group. Significant reductions in mean and median rectal NTCPs (stenosis/necrosis, late rectal bleeding ≥ 2, and late rectal toxicities ≥ 3) were predicted for the spacer group in comparison to the non-spacer group. Conclusion Hypofractionated/dose escalated radiotherapy with SIB-IMPT is dosimetrically feasible. Further reduction of the rectal volumes receiving high and medium dose levels (73–50 Gy) and rectal NTCP could be achieved through injection of spacers between rectum and prostate.
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- 2021
8. GCT-02. Imaging response assessment for Central Nervous System Germ Cell Tumours: consensus recommendations from the European Society for Paediatric Oncology Brain Tumour Group (SIOPE-BTG) and North American Children’s Oncology Group (COG)
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Morana, Giovanni, Shaw, Dennis, MacDonald, Shannon, Alapetite, Claire, Ajithkumar, Thankamma, Bhatia, Aashim, Brisse, Hervé, Jaimes, Camilo, Czech, Thomas, Dhall, Girish, Fangusaro, Jason, Faure-Conter, Cecile, Fouladi, Maryam, Hargrave, Darren, Harreld, Julie, Mitra, Dipayan, Nicholson, James, Souweidane, Mark, Timmermann, Beate, Calaminus, Gabriele, Bartels, Ute, Bison, Brigitte, and Murray, Matthew
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
BACKGROUND: Central nervous system (CNS) germ cell tumours (GCT) comprise a heterogeneous and relatively rare group of neoplasms. Improving the ability to conduct international clinical trials for CNS GCT requires use of homogeneous, common objective disease assessments and standardised response criteria. Currently, different criteria are employed between European and North American protocols for assessing radiological disease response. METHODS: An international working group of the European Society for Paediatric Oncology (SIOPE) Brain Tumour Group (BTG) and North American Children’s Oncology Group (COG) was therefore established to develop consensus recommendations for imaging response assessment for CNS GCT. The working group first reviewed existing literature and current practices and identified major challenges regarding imaging assessment. RESULTS: New clinical imaging standards were defined for the most common sites of intracranial GCT disease (suprasellar/pineal/bifocal), as well as for definition of loco-regional extension. In particular, clear standards were highlighted for definition of partial response (PR) and complete response (CR) to induction chemotherapy at different sites. Furthermore, growing teratoma syndrome (GTS) was clearly defined [apparent radiological increase in non-germinomatous GCT (NGGCT) size during induction chemotherapy despite normalising/normalised AFP/HCG markers – requiring surgery], to avoid such potential cases being classified as progressive disease (PD). CONCLUSION: This consensus will allow more consistent prospective neuroradiological evaluation of response to therapy for patients with CNS GCT and facilitate direct comparison of treatment outcomes across international studies. Ultimately, it may allow international trials to be developed and undertaken across a larger group of collaborating nations, which will be essential to answer many of the remaining questions for this rare but diverse group of tumours.
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- 2022
9. MEDB-38. Significance of CSF cytology and neurologic deterioration in relapsed medulloblastomas in the German HIT-REZ-97/-2005 Studies and the HIT-REZ-Register
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Tschirner, Sebastian, Adolph, Jonas E, Gaab, Christine, Tippelt, Stephan, Mikasch, Ruth, Mynarek, Martin, Rutkowski, Stefan, Pietsch, Thorsten, Bison, Brigitte, Warmuth-Metz, Monika, Pfister, Stefan M, Milde, Till, Pajtler, Kristian, Witt, Olaf, Frühwald, Michael, Kramm, Christof, Schlegel, Paul-Gerhardt, Kortmann, Rolf-Dieter, Dietzsch, Stefan, Timmermann, Beate, and Fleischhack, Gudrun
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
BACKGROUND: Follow-up examinations are an essential part of the aftercare of patients with brain tumours. We investigated survival in relation to neurological impairment and positive CSF findings at first relapse/progression of medulloblastomas. METHODS: We collected data from patients with relapsed medulloblastoma from the German HIT-REZ studies (HIT-REZ-1997, HIT-REZ-2005, HIT-REZ-Register, n=342). Survival differences dependent on tumour cell-positive and -negative CSF cytology as well as on new onset or worsening of neurological impairment (i.e. headache, nausea/vomiting, ataxia, seizures and others) were analysed. RESULTS: 247 patients with a recurrent medulloblastoma were evaluable for CSF cytology at first relapse/progression (positive n=97, negative n=150). Patients with tumour cell-positive CSF results showed a significantly shorter median PFS and OS time compared to patients with negative CSF cytology [PFS: 9.1 (CI: 5.3-12.9) vs. 16.8 (CI: 13.8-19.8) months, plog rank test=0.001; OS: 14.4 (CI: 12.3-16.4) vs. 41.8 (CI: 33.3–50.4) months, plog rank test
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- 2022
10. ATRT-05. Infants and newborns with atypical teratoid/rhabdoid tumors (ATRT) and extracranial malignant rhabdoid tumors: a unique and challenging population
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Nemes, Karolina, Johann, Pascal D, Steinbügl, Mona, Gruhle, Miriam, Bens, Susanne, Kachanov, Denis, Teleshova, Margarita, Peter, Hauser, Simon, Thorsten, Tippelt, Stephan, Eberl, Wolfgang, Chada, Martin, Lopez, Vicente Santa-Maria, Grigull, Lorenz, Hernáiz-Driever, Pablo, Eyrich, Matthias, Pears, Jane, Milde, Till, Reinhard, Harald, Leipold, Alfred, de Wetering, Marianne v, João Gil-da-Costa, Maria, Ebetsberger-Dachs, Georg, Kerl, Kornelius, Lemmer, Andreas, Boztug, Heidrun, Furtwängler, Rhoikos, Kordes, Uwe, Siebert, Reiner, Vokuhl, Christian, Hasselblatt, Martin, Bison, Brigitte, Kröncke, Thomas, Melchior, Patrick, Timmermann, Beate, Gerss, Joachim, and Frühwald, Michael C
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
INTRODUCTION: Malignant rhabdoid tumors (MRT) predominantly affect infants. Patients below six months represent a particularly challenging group: intensity of therapy is limited by toxicity to developing organs. Information on prognostic factors, toxicity and long term outcome is sparse. METHODS: Clinical, genetic, and treatment data of 100 patients (less than 6 months at diagnosis) from 13 European countries were analyzed (2005-2020). Tumors and matching blood samples were examined for SMARCB1 mutations using FISH, MLPA and Sanger sequencing. DNA-methylation subgroups (ATRT-TYR, ATRT-SHH, and ATRT-MYC) were determined using DNA methylation arrays. RESULTS: A total of 45 patients presented with ATRT, 29 with extracranial, extrarenal (eMRT) and 9 with renal rhabdoid tumors (RTK). Seventeen patients demonstrated synchronous tumors (SYN). Distant metastases at diagnosis (M+) were present in 27% (26/97). A germline mutation (GLM) was detected in 55% (47/86). Methylation subgroup status was available in 50% (31/62) of ATRT or SYN (SHH=13, TYR=13, MYC=4, SHH+TYR=1). The 5-year overall- (OS) and event free survival (EFS) rates were 23.5±4.6% and 19±4.1%, respectively. Male sex (11±5% vs. 35.8±7.4%), M+ (6.1±5.4% vs. 36.2±7.4%), presence of SYN (7.1±6.9% vs. 26.6±5.3%) and -GLM (7.7±4.2% vs. 45.7±8.6%) were significant prognosticators of 5-year OS, in univariate analysis. Molecular subgroup and survival analyses confirmed the previously described survival advantage of ATRT-TYR. In an adjusted multivariate model clinical factors that influence prognosis were: male sex [HR: 2.1 (1.2 – 3.6)], M+ [3.3 (1.8 – 6)], GLM [HR: 2 (1.1 – 3.6)] and maintenance therapy [HR: 0.3 (0.1 – 0.8)]. CONCLUSION: In this large cohort of homogenously treated infants with MRT, significant predictors of outcome were sex, M+, GLM and maintenance therapy. We confirm the need to stratify which patient group benefits from multimodal treatment, and which patients need novel therapeutic strategies. Biomarker-driven tailored trials may be a key option.
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- 2022
11. NFB-13. Rhabdoid Tumor Predisposition Syndrome (RTPS) – Finding Evidence by systematic Analyses
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Nemes, Karolina, Bens, Susanne, Johann, Pascal D, Steinbügl, Mona, Gruhle, Miriam, Kachanov, Denis, Teleshova, Margarita, Hauser, Peter, Simon, Thorsten, Tippelt, Stephan, Eberl, Wolfgang, Woessmann, Wilhelm, Kratz, Christian, Abbink, Floor, Hernáiz-Driever, Pablo, Eyrich, Matthias, Sumerauer, David, Milde, Till, Reinhard, Harald, Leipold, Alfred, de Wetering, Marianne v, Gil-da-Costa, Maria João, Ebetsberger-Dachs, Georg, Marques, Carmen Hernandez, Bauer, Nina, Biassoni, Veronica, Meneses, Clarice Franco, Knirsch, Stephanie, Lauten, Melchior, Gerber, Nicolas U, Chada, Martin, Kerl, Kornelius, Lemmer, Andreas, Heidrun, Boztug, Kuhlen, Michaela, Furtwängler, Rhoikos, Kordes, Uwe, Schneppenheim, Reiner, Vokuhl, Christian, Hasselblatt, Martin, Kröncke, Thomas, Bison, Brigitte, Melchior, Patrick, Timmermann, Beate, Gerss, Joachim, Siebert, Reiner, and Frühwald, Michael C
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
BACKGROUND: Individuals with rhabdoid tumor predisposition syndrome (RTPS1 – SMARCB1, RTPS2 – SMARCA4) have a propensity to develop malignant rhabdoid tumors (MRT). Affected patients typically present < age 12 months with synchronous tumors (SYN) exhibiting an unusually aggressive clinical behavior. Due to the rarity of RTPS, standards for management are evolving. METHODS: Clinical, genetic, and treatment data of 90 patients with RTPS from 16 countries were analyzed (2004 – 2020). Therapy followed the EU-RHAB recommendations. Tumors and matching blood samples were investigated for SMARCB1 and/or SMARCA4 mutations using FISH, MLPA and sequencing. DNA-methylation subgroups were determined using DNA methylation arrays. RESULTS: The median age at diagnosis of 52 girls and 38 boys was 5.5 months (0 – 203). 55.5% (50/90) of patients presented with an atypical teratoid/rhabdoid tumor (ATRT), 23.5% (21/90) demonstrated SYN, and 21% (19/90) extracranial MRT. RTPS1 was present in 84-, RTPS2 in six patients. In 77% (65/84) complete data on SMARCB1 mutational status were generated. Methylation subgroup status was available in 59% (40/68) of ATRT or SYN. The 5-year overall- (OS) and event free survival rates of patients with RTPS1 were 19.8 ± 4.8% and 15 ± 4.2%, respectively. Age < 1 year at diagnosis (10.1±4.3% vs. 46.7±11.1%), presence of SYN (5.3±5.1% vs. 24.8±6%), histological diagnosis (ATRT vs. eMRT/RTK/SYN) (26.8±7.1% vs. 11.9±5.6%), localized disease (34.5±8 vs. 8.3±4.6%), and presence of PGV at C-terminal (33±8.6% vs. 9.4±5.3%) were significant prognostic factors for 5-year OS in univariate analysis. INTERPRETATION: In the largest cohort of patients with RTPS, predictors significant for positive outcome could be detected: age > 1 year, absence of SYN, histological diagnosis ATRT, localized disease and PGV located at C-terminal. In our research project, we aim to characterize the complete pheno- and genotype of patients with RTPS to develop a risk score including surveillance recommendation.
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- 2022
12. RONC-16. Proton therapy for patients with embryonal tumor with multilayered rosettes in early childhood – results of the prospective KiProReg Study
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Peters, Sarah, Frisch, Sabine, Merta, Julien, Bäumer, Christian, Blase, Christoph, Tippelt, Stephan, von Zezschwitz, Barbara, Johann, Pascal, von Hoff, Katja, Geismar, Dirk, and Timmermann, Beate
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
OBJECTIVES: Embryonal tumors with multilayered rosettes (ETMR) are rare malignancies of the central nervous system occurring predominantly in early childhood. Little is known about optimal time point and target volume of radiotherapy for the respective patients. The aim of this analysis was to evaluate treatment outcome in pediatric patients with ETMR treated with Proton Therapy (PT). METHODS: Between May 2016 and August 2021, 15 patients (9 male /6 female) with ETMR received PT in our institution and were enrolled in the prospective registry study KiProReg. Patient characteristics, treatment and outcome according to standardized follow-up data were descriptively analyzed by summarizing frequencies due to small sample size. RESULTS: Median age at PT was 3.0 years (range, 1.6-4.0 years). Three patients presented with metastatic disease (M1 n=1; M2 n=1; M2/3 n=1). Eight patients were treated with salvage PT at tumor progression or recurrence. Residual disease was present in three patients at start of PT. Tumor site was infratentorial (n=3) or supratentorial (n=12). All patients received Chemotherapy (CTX) prior to PT including high dose CTX (n=9) and intrathecal CTX (n=3). Concomitant CTX with temozolomide was administered in one patient. Patients received local PT (n=8) or craniospinal irradiation (CSI) followed by a local boost (n=7). Median dose was 54.0 Gy(RBE) (range, 3.6 -59.4 Gy(RBE)). PT was terminated prematurely in one patient due to cerebral edema and disease progression. Median follow-up after diagnosis was 16.3 months (range, 6.6-65.7 months) and 5.1 months (range, 0-62.4 months) after PT. Four patients treated for salvage experienced disease progression within three months after PT, three of them deceased. CONCLUSION: Preliminary results suggest promising outcomes for childhood ETMR after PT, especially in patients treated at initial diagnosis. Longer follow-up and larger cohorts are desirable to assess long-term survival and necessity of CSI.
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- 2022
13. RARE-09. Treatment of childhood-onset craniopharyngioma patients using proton beam therapy versus photon-based radiation therapy in the prospective KRANIOPHARYNGEOM 2007 trial
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Friedrich, Carsten, Boekhoff, Svenja, Sowithayasakul, Panjarat, Eveslage, Maria, Bison, Brigitte, Timmermann, Beate, and Müller, Hermann L
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
BACKGROUND: Proton beam therapy (PBT) compared to photon-based radiotherapy (XRT) offers the benefit to administer lower radiation doses to critical organs thereby possibly minimizing the risk of sequelae in patients with residual craniopharyngiomas (CP) after hypothalamus-sparing surgery. The validation in large CP patient cohorts is still pending. PATIENTS AND METHODS: Of 290 childhood-onset CP patients included 2007-2019 in the prospective multicenter trial KRANIOPHARYNGEOM 2007, 99 (34%) received external RT (65% PBT, 35% XRT). Outcome was compared between the different groups in terms of overall (OS) and event-free survival (EFS), quality of life (QoL using PEDQOL), functional capacity (FMH), and auxological data (BMI and height SDS) one, three and five years after irradiation/CP diagnosis. RESULTS: PBT became the predominant irradiation technique during the study period (used in 23% and 77% of all irradiated patients registered within the first and second half of the enrollment period, respectively). PBT as well as XRT were associated with high (p
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- 2022
14. Value of adjuvant radiotherapy in patients with localized Ewing sarcoma at the extremities: Report from the Ewing 2008 trial
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Heesen, Philip, Ranft, Andreas, Bhadri, Vivek, Brichard, Bénédicte, Collaud, Stephane, Cyprova, Sona, Eich, Hans-Theodor, Ek, Torben, Gelderblom, Hans, Havemann, Lianne, Hauser, Peter, Juergens, Heribert, Kanerva, Jukka, Kuehne, Thomas, Raciborska, Anna, Rascon, Jelena, Streitbuerger, Arne, Timmermann, Beate, Uhlenbruch, Yasmine, and Dirksen, Uta
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Cancer Research ,Oncology ,Medizin - Abstract
11531 Background: In patients with Ewing Sarcoma (EWS), adjuvant radiotherapy is often performed after surgery that could not obtain wide margins or after poor histological response to surgery. However, the benefit of adjuvant radiotherapy needs further investigation. Therefore, we compared event-free survival (EFS) between surgery (SX) alone and SX combined with radiation therapy (RT), performed a subgroup analysis and identified independent prognostic factors. Methods: The data from localized EWS patients with tumors at the extremities that were treated in the Ewing 2008 trial from 2009-2018 were included in this analysis. Patients received induction chemotherapy according to the protocol and then underwent local therapy. Patients receiving SX or adjuvant RT (combined SX/RT) were included in this analysis. Hazard ratios (HRs) (95% Confidence Intervals (CIs)) were calculated using Cox regression. Results: 360 out of 863 patients (41.7%) presented with an EWS at the extremities with 81 tumors at the upper extremity, and 279 tumors at the lower extremity. Most patients were treated with surgery only (223, 61.94%), while 125 patients (34.72%) were treated with SX plus RT. Adjuvant radiotherapy was conducted after a median time of 69 days (1st quartile, 3rd quartile; 54, 109). Median EFS at 5-years for all patients was 0.74 (0.69, 0.80), 0.76 (0.70, 0.83) for patients after surgery only, and 0.73 (0.64, 0.83) after combined RT/SX. After adjusting for sex, age, tumor volume, histological response and surgical margins, the HR for combined RT/SX vs SX alone was 0.69 (0.37, 1.26), p = 0.22. In patients with poor histological response to surgery (≥10% vital tumor cells) and with high tumor volume (≥ 200mL), additional radiotherapy did not decrease the hazards of any event, HR 0.72 (0.25, 2.06), p = 0.54. We identified high tumor volume, poor histological response to surgery as well as intralesional resection of the tumor as independent prognostic factors after adjusting for other known prognostic factors with HRs of 1.73 (1.04, 2.90), p = 0.03; 2.79 (1.69, 4.62), p < 0.0001 and 215.9 (13.17, 3538.61), p = 0.0002, respectively. Surgical complication was not a prognostic factor after adjusting for above mentioned variables, HR 0.85 (0.31, 2.34), p = 0.75. Conclusions: In our cohort, adjuvant radiotherapy was not superior compared to surgery alone in all patients with localized EWS at the extremities and neither in a subgroup of patients with high-risk factors. Poor histological response, intralesional tumor resection as well as high tumor volume were identified as independent negative prognostic factors. Clinical trial information: NCT00987636.
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- 2022
15. RONC-17. Feasibility of proton therapy with and without simultaneous chemotherapy in CNS malignancies of children and adolescents
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Schuermann, Eicke, Tippelt, Stephan, Zeller, Julia, Geismar, Dirk, Jazmati, Danny, Peters, Sarah, Timmermann, Beate, Mikasch, Ruth, and Fleischhack, Gudrun
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Cancer Research ,Oncology ,Medizin ,Neurology (clinical) - Abstract
BACKGROUND: Proton therapy (PT) is a valuable alternative to photon radiotherapy in treatment of CNS tumors in children and adolescents. The aim of this study was to investigate the feasibility of recent treatment strategies with a particular focus on the acute toxicity of a simultaneous radiotherapy and chemotherapy (sRCT). PATIENTS AND METHODS: We investigated 199 patients (116 male, 83 female, median age 7.4 years) who received in total 200 cycles of PT (60.5% at new diagnosis, 39.5% at relapse) from September 2013 to February 2017. Entities included ependymomas (34%), medulloblastomas (16%), low grade gliomas (13%), ATRTs (12%), craniopharyngiomas (9%), germ cell tumors (6%), and other entities (10%). SRCT was administered in 52 (26%) treatment cycles. The target tumor was predominantly localized infratentorial (53%), supratentorial (23.5%) and supra-/intrasellar (18%). 38 patients received additional CSI and 8 patients a boost to metastases. Data were collected retrospectively based on patient records. Toxicity was documented according to CTCAE version 4.03. RESULTS: Severe adverse events (SAE ≥ grade 3) occurred in 33.5% of all patients, in particular in form of hematotoxicity (64.1%) and infections (26.8%). In-patient treatment for unexpected SAEs was necessary in 33 patients (16.5%). In the group treated with sRCT 15 out of 52 (28.8%) patients couldn’t receive the recommended dose or time schedule of planned chemotherapy due to SAEs. Comparing the SAE frequency in both groups, the children who have been treated with sRCT had a significantly higher risk of SAEs than the patients who have received proton therapy only (63.5% vs. 23.0%, p=0.001). CONCLUSIONS: PT and concomitant chemotherapy are feasible, but require an interdisciplinary team with continuous out-/inpatient management of patients, as the risk of toxicity is significantly increased. Risk-adapted adjustment of simultaneous chemotherapy is necessary to reduce relevant interruptions of radiotherapy. Funded by the German Childhood Cancer Foundation
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- 2022
16. Proton Beam Therapy for Children With Neuroblastoma: Experiences From the Prospective KiProReg Registry
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Jazmati, Danny, Butzer, Sarina, Hero, Barbara, Ahmad Khalil, Dalia, Merta, Julien, Bäumer, Christian, Plum, Gina, Fuchs, Jörg, Koerber, Friederike, Steinmeier, Theresa, Peters, Sarah, Doyen, Jerome, Thole, Theresa, Schmidt, Matthias, Blase, Christoph, Tippelt, Stephan, Eggert, Angelika, Schwarz, Rudolf, Simon, Thorsten, and Timmermann, Beate
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Cancer Research ,Medizinische Fakultät » Universitätsklinikum Essen » Zentrum für Kinder- und Jugendmedizin » Klinik für Kinderheilkunde III ,Medizin ,proton beam therapy (PBT) ,survival ,Medizinische Fakultät » Universitätsklinikum Essen » Westdeutsches Protonentherapiezentrum (WPE) ,Medizinische Fakultät » Universitätsklinikum Essen » Westdeutsches Tumorzentrum Essen (WTZ) ,neuroblastoma ,Oncology ,childhood cancer ,ddc:610 ,radiotherapy—adverse effects ,pediatric radiation oncology ,retroperitoneal tumor - Abstract
Objective: Radiotherapy (RT) is an integral part of the interdisciplinary treatment of patients with high-risk neuroblastoma (NB). With the continuous improvements of outcome, the interest in local treatment strategies that reduce treatment-related side effects while achieving optimal oncological results is growing. Proton beam therapy (PBT) represents a promising alternative to conventional photon irradiation with regard to the reduction of treatment burden. Method: Retrospective analysis of children with high or intermediate risk NB receiving PBT of the primary tumor site during first-line therapy between 2015 and 2020 was performed. Data from the prospective in-house registry Standard Protonentherapie WPE – Kinder- (KiProReg) with respect to tumor control and treatment toxicity were analyzed. Adverse events were classified according to CTCAE Version 4 (V4.0) before, during, and after PBT. Results: In total, 44 patients (24 male, 20 female) with high (n = 39) or intermediate risk NB (n = 5) were included in the analysis. Median age was 3.4 years (range, 1.4–9.9 years). PBT doses ranged from 21.0 to 39.6 Gray (Gy) (median 36.0 Gy). Five patients received PBT to the MIBG-avid residual at the primary tumor site at time of PBT according to the NB-2004 protocol. In 39 patients radiation was given to the pre-operative tumor bed with or without an additional boost in case of residual tumor. After a median follow-up (FU) of 27.6 months, eight patients developed progression, either local recurrence (n = 1) or distant metastases (n = 7). Four patients died due to tumor progression. At three years, the estimated local control, distant metastatic free survival, progression free survival, and overall survival was 97.7, 84.1, 81.8, and 90.9%, respectively. During radiation, seven patients experienced higher-grade (CTCAE ≥ °3) hematologic toxicity. No other higher grade acute toxicity occurred. After PBT, one patient developed transient myelitis while receiving immunotherapy. No higher grade long-term toxicity was observed up to date. Conclusion: PBT was a well tolerated and effective local treatment in children with high and intermediate risk NB. The role of RT in an intensive multidisciplinary treatment regimen remains to be studied in the future in order to better define timing, doses, target volumes, and general need for RT in a particularly sensitive cohort of patients. OA Förderung 2021
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- 2021
17. The EPTN consensus-based atlas for CT- and MR-based contouring in neuro-oncology
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Eekers, Daniëlle Bp, In T Ven, Lieke, Roelofs, Erik, Postma, Alida, Alapetite, Claire, Burnet, Neil G., Valentin CALUGARU, Compter, Inge, Coremans, Ida E. M., Høyer, Morton, Lambrecht, Maarten, Nyström, Petra Witt, Méndez Romero, Alejandra, Paulsen, Frank, Perpar, Ana, Ruysscher, Dirk, Renard, Laurette, Timmermann, Beate, Vitek, Pavel, Weber, Damien C., Weide, Hiske L., Whitfield, Gillian A., Wiggenraad, Ruud, Troost, Esther G. C., Estro, 'european Particle Therapy Network' Of, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Radiotherapie, Promovendi ODB, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de radiothérapie oncologique, and Radiotherapy
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Organs at Risk ,Neuro oncology ,medicine.medical_treatment ,Tomography, X-Ray Computed/methods ,Medizin ,030218 nuclear medicine & medical imaging ,Magnetic Resonance Imaging/methods ,0302 clinical medicine ,NECK-CANCER ,European Particle Therapy Network ,NASOPHARYNGEAL CARCINOMA ,Proton Therapy ,Radiation oncologist ,Contouring ,NEUROCOGNITIVE FUNCTION ,medicine.diagnostic_test ,Manchester Cancer Research Centre ,Brain Neoplasms ,Atlas for neuro-oncology ,Hematology ,Magnetic Resonance Imaging ,CRANIAL IRRADIATION ,Organs at risk ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Radiology, Nuclear Medicine and Medical Imaging ,WHOLE-BRAIN RADIOTHERAPY ,Consensus ,PROTON THERAPY ,Brain Neoplasms/radiotherapy ,Particle therapy ,Heavy Ion Radiotherapy ,03 medical and health sciences ,Atlas (anatomy) ,medicine ,Journal Article ,Humans ,Radiology, Nuclear Medicine and imaging ,RADIATION ONCOLOGISTS GUIDE ,HEAD ,Radiometry ,Proton therapy ,Radiotherapy Planning, Computer-Assisted/methods ,Cancer och onkologi ,business.industry ,Radiotherapy Planning, Computer-Assisted ,ResearchInstitutes_Networks_Beacons/mcrc ,HEARING-LOSS ,Magnetic resonance imaging ,Sagittal plane ,INTENSITY-MODULATED RADIOTHERAPY ,Cancer and Oncology ,Radiologi och bildbehandling ,business ,Nuclear medicine ,Tomography, X-Ray Computed - Abstract
PURPOSE: To create a digital, online atlas for organs at risk (OAR) delineation in neuro-oncology based on high-quality computed tomography (CT) and magnetic resonance (MR) imaging. METHODS: CT and 3 Tesla (3T) MR images (slice thickness 1 mm with intravenous contrast agent) were obtained from the same patient and subsequently fused. In addition, a 7T MR without intravenous contrast agent was obtained from a healthy volunteer. Based on discussion between experienced radiation oncologists, the clinically relevant organs at risk (OARs) to be included in the atlas for neuro-oncology were determined, excluding typical head and neck OARs previously published. The draft atlas was delineated by a senior radiation oncologist, 2 residents in radiation oncology, and a senior neuro-radiologist incorporating relevant available literature. The proposed atlas was then critically reviewed and discussed by European radiation oncologists until consensus was reached. RESULTS: The online atlas includes one CT-scan at two different window settings and one MR scan (3T) showing the OARs in axial, coronal and sagittal view. This manuscript presents the three-dimensional descriptions of the fifteen consensus OARs for neuro-oncology. Among these is a new OAR relevant for neuro-cognition, the posterior cerebellum (illustrated on 7T MR images). CONCLUSION: In order to decrease inter- and intra-observer variability in delineating OARs relevant for neuro-oncology and thus derive consistent dosimetric data, we propose this atlas to be used in photon and particle therapy. The atlas is available online at www.cancerdata.org and will be updated whenever required. ispartof: RADIOTHERAPY AND ONCOLOGY vol:128 issue:1 pages:37-43 ispartof: location:Ireland status: published
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- 2018
18. Tumour volume reduction after neoadjuvant chemotherapy impacts outcome in localised embryonal rhabdomyosarcoma
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Dantonello, Tobias M, Stark, Monika, Timmermann, Beate, Fuchs, Jörg, Selle, Barbara, Linderkamp, Christin, Handgretinger, Rupert, Hagen, Rudolf, Feuchtgruber, Simone, Kube, Stefanie, Kosztyla, Daniel, Kazanowska, Bernarda, Ladenstein, Ruth, Niggli, Felix, Ljungman, Gustaf, Bielack, Stefan S, Klingebiel, Thomas, Koscielniak, Ewa, University of Zurich, and Dantonello, Tobias M
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and Child Health ,Oncology ,10036 Medical Clinic ,2720 Hematology ,Medizin ,610 Medicine & health ,2730 Oncology ,2735 Pediatrics, Perinatology and Child Health ,Hematology ,Pediatrics ,Perinatology - Published
- 2015
19. Recommendations for the organisation of care in paediatric radiation oncology across Europe: a SIOPE–ESTRO–PROS–CCI-Europe collaborative project in the framework of the JARC.
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Janssens, Geert O., Timmermann, Beate, Laprie, Anne, Mandeville, Henry, Padovani, Laetitia, Chargari, Cyrus, Journy, Neige, Kameric, Lejla, Kienesberger, Anita, Brunhofer, Melanie, Kozhaeva, Olga, Gasparotto, Chiara, Kearns, Pamela, Boterberg, Tom, Lievens, Yolande, and Vassal, Gilles
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HEALTH services accessibility , *HEALTH status indicators , *INTERPROFESSIONAL relations , *MEDICAL care , *EVALUATION of medical care , *MEDICAL quality control , *MEDICAL societies , *ONCOLOGY , *PATIENT education , *PATIENTS , *PEDIATRICS , *RADIOTHERAPY , *TUMORS in children , *TUMOR treatment - Abstract
Disparities in survival and long-term side-effects from paediatric cancer are observed across European Society for Paediatric Oncology (SIOPE)–affiliated countries. The Joint Action on Rare Cancers (JARC) is a project supported by the European Union and member states aiming to formulate recommendations on rare cancers, including paediatric malignancies, to reduce inequalities and to improve health outcomes. Most paediatric cancers are treated by a combination of systemic agents, surgery and/or radiotherapy. Radiotherapy for children is becoming increasingly complex because of the growing availability of new modalities and techniques and the evolution in molecular biology. These added challenges have the potential to enhance disparities in survival and side-effects between countries, but also among centres in the same country. To tackle radiotherapy-related inequalities, representatives of SIOPE, European SocieTy for Radiotherapy and Oncology, Paediatric Radiation Oncology Society and Childhood Cancer International–Europe defined 'standard' and 'optional' levels to deliver Good Clinical Practice–compliant treatment in paediatric radiation oncology with a focus on patient-related care, education and training. In addition, more than 250 paediatric radiotherapy centres across the SIOPE-affiliated countries have been mapped. For a better understanding of resources in paediatric radiotherapy, JARC representatives are working on an online survey for paediatric radiation oncologists of each centre in SIOPE-affiliated countries. The outcome of this survey will give an insight into the strengths and weaknesses of paediatric radiotherapy across SIOPE-affiliated countries and can be relevant for European Reference Networks in terms of collaboration pathways and referrals in paediatric radiotherapy. • Across European Society for Paediatric Oncology–affiliated countries, disparities in childhood cancer survival are a fact. • Radiotherapy for children is becoming increasingly complex. • The Joint Action on Rare Cancers aims to formulate appropriate recommendations to reduce inequalities. • Recommendations focus on patient care, education and training, and clinical research. [ABSTRACT FROM AUTHOR]
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- 2019
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20. Study protocol of the German "Registry for the Detection of Late Sequelae after Radiotherapy in Childhood and Adolescence" (RiSK).
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Bolling, Tobias, Schuck, Andreas, Pape, Hildegard, Rube, Christian, Pollinger, Barbara, Timmermann, Beate, Kortmann, Rolf D., Dieckmann, Karin, and Willich, Normann
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RADIOTHERAPY ,CHILDHOOD cancer ,CANCER in adolescence ,ONCOLOGY ,HEMATOLOGY - Abstract
Background: Late effects after radiotherapy in childhood and adolescence have mainly been characterized retrospectively with small patient numbers. However, these analyses are limited due to little information regarding organ dose levels in many cases. To overcome this limitation, the German Group of Paediatric Radiation Oncology (APRO) established the „Registry for the evaluation of late side effects after radiation in childhood and adolescence" (RiSK). The study protocol and the documentation forms are given in this publication. Methods/Design: Radiation parameters including detailed organ doses as well as toxicity evaluations are collected prospectively from centres all over Germany. Standardized documentation forms are used. These forms are given in an English and German version as additional files to this publication. Documentation is planned for all children who receive radiotherapy in one of the therapy trials of the "German Society of Paediatric Oncology and Haematology (GPOH)". The study started in a pilot phase in June 2001 in few centres. Since 2004 documentation has been performed all over Germany and is still on-going. Discussion: To our knowledge, "RiSK" is the only multi-centre study that evaluates radiation associated side effects prospectively with detailed information about organ dose levels. With ongoing recruitment and prolongation of follow-up powerful data will be obtained in a few years. A broad use and international cooperation are welcome. [ABSTRACT FROM AUTHOR]
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- 2008
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21. Spot-scanning proton therapy for malignant soft tissue tumors in childhood: First experiences at the Paul Scherrer Institute
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Timmermann, Beate, Schuck, Andreas, Niggli, Felix, Weiss, Markus, Lomax, Antony Jonathan, Pedroni, Eros, Coray, Adolf, Jermann, Martin, Rutz, Hans Peter, and Goitein, Gudrun
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CANCER radiotherapy complications , *CHILDHOOD cancer , *SOFT tissue tumors , *ONCOLOGY - Abstract
Purpose: Radiotherapy plays a major role in the treatment strategy of childhood sarcomas. Consequences of treatment are likely to affect the survivor’s quality of life significantly. We investigated the feasibility of spot-scanning proton therapy (PT) for soft tissue tumors in childhood. Methods and Materials: Sixteen children with soft tissue sarcomas were included. Median age at PT was 3.3 years. In 10 children the tumor histology was embryonal rhabdomyosarcoma. All tumors were located in the head or neck, parameningeal, or paraspinal, or pelvic region. In the majority of children, the tumor was initially unresectable (Intergroup Rhabdomyosarcoma Study [IRS] Group III in 75%). In 50% of children the tumors exceeded 5 cm. Fourteen children had chemotherapy before and during PT. Median total dose of radiotherapy was 50 cobalt Gray equivalent (CGE). All 16 children were treated with spot-scanning proton therapy at the Paul Scherrer Institute, and in 3 children the PT was intensity-modulated (IMPT). Results: After median follow-up of 1.5 years, local control was achieved in 12 children. Four children failed locally, 1 at the border of the radiation field and 3 within the field. All 4 children died of tumor recurrence. All 4 showed unfavorable characteristic either of site or histopathology of the tumor. Acute toxicity was low, with Grade 3 or 4 side effects according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria occurring in the bone marrow only. Conclusions: Proton therapy was feasible and well tolerated. Early local control rates are comparable to those being achieved after conventional radiotherapy. For investigations on late effect, longer follow-up is needed. [Copyright &y& Elsevier]
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- 2007
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22. Consensus Report From the Stockholm Pediatric Proton Therapy Conference
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Indelicato, Daniel J., Merchant, Thomas, Laperriere, Normand, Lassen, Yasmin, Vennarini, Sabina, Wolden, Suzanne, Hartsell, William, Pankuch, Mark, Brandal, Petter, Law, Chi-Ching K., Taylor, Roger, Laskar, Siddhartha, Okcu, Mehmet Fatih, Bouffet, Eric, Mandeville, Henry, Bjork-Eriksson, Thomas, Nilsson, Kristina, Nystrom, Hakan, Constine, Louis Sandy, Story, Michael, Timmermann, Beate, Roberts, Kenneth, and Kortmann, Rolf-Dieter
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medicine.medical_specialty ,Cancer Research ,Consensus ,MODULATED RADIATION-THERAPY ,Consensus Development Conferences as Topic ,MEDLINE ,Medizin ,CHILDREN ,Cancer Care Facilities ,Radiation Dosage ,030218 nuclear medicine & medical imaging ,Central Nervous System Neoplasms ,03 medical and health sciences ,Craniopharyngioma ,0302 clinical medicine ,Neoplasms ,Rhabdomyosarcoma ,medicine ,Proton Therapy ,Humans ,Radiology, Nuclear Medicine and imaging ,Pituitary Neoplasms ,Intensive care medicine ,Cerebellar Neoplasms ,Child ,Proton therapy ,RISK ,Photons ,Radiation ,business.industry ,Brain Neoplasms ,Glioma ,Oncology ,Ependymoma ,Radiology Nuclear Medicine and imaging ,030220 oncology & carcinogenesis ,business ,Medulloblastoma - Full Text
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23. Management of vertebral radiotherapy dose in paediatric patients with cancer: consensus recommendations from the SIOPE radiotherapy working group.
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Hoeben, Bianca A, Carrie, Christian, Timmermann, Beate, Mandeville, Henry C, Gandola, Lorenza, Dieckmann, Karin, Ramos Albiac, Monica, Magelssen, Henriette, Lassen-Ramshad, Yasmin, Ondrová, Barbora, Ajithkumar, Thankamma, Alapetite, Claire, Balgobind, Brian V, Bolle, Stephanie, Cameron, Alison L, Davila Fajardo, Raquel, Dietzsch, Stefan, Dumont Lecomte, Delphine, van den Heuvel-Eibrink, Marry M, and Kortmann, Rolf D
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ONCOLOGY , *PEDIATRICS , *RADIATION doses , *RADIOTHERAPY , *TUMORS - Abstract
Inhomogeneities in radiotherapy dose distributions covering the vertebrae in children can produce long-term spinal problems, including kyphosis, lordosis, scoliosis, and hypoplasia. In the published literature, many often interrelated variables have been reported to affect the extent of potential radiotherapy damage to the spine. Articles published in the 2D and 3D radiotherapy era instructed radiation oncologists to avoid dose inhomogeneity over growing vertebrae. However, in the present era of highly conformal radiotherapy, steep dose gradients over at-risk structures can be generated and thus less harm is caused to patients. In this report, paediatric radiation oncologists from leading centres in 11 European countries have produced recommendations on how to approach dose coverage for target volumes that are adjacent to vertebrae to minimise the risk of long-term spinal problems. Based on available information, it is advised that homogeneous vertebral radiotherapy doses should be delivered in children who have not yet finished the pubertal growth spurt. If dose fall-off within vertebrae cannot be avoided, acceptable dose gradients for different age groups are detailed here. Vertebral delineation should include all primary ossification centres and growth plates, and therefore include at least the vertebral body and arch. For partial spinal radiotherapy, the number of irradiated vertebrae should be restricted as much as achievable, particularly at the thoracic level in young children (<6 years old). There is a need for multicentre research on vertebral radiotherapy dose distributions for children, but until more valid data become available, these recommendations can provide a basis for daily practice for radiation oncologists who have patients that require vertebral radiotherapy. [ABSTRACT FROM AUTHOR]
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- 2019
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24. QUARTET: A SIOP Europe project for quality and excellence in radiotherapy and imaging for children and adolescents with cancer.
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Kelly, Sarah M., Effeney, Rachel, Gaze, Mark N., Bernier-Chastagner, Valérie, Blondeel, Anne, Clementel, Enrico, Corning, Coreen, Dieckmann, Karin, Essiaf, Samira, Gandola, Lorenza, Janssens, Geert O., Kearns, Pamela R., Lacombe, Denis, Lassen-Ramshad, Yasmin, Merks, Hans, Miles, Elizabeth, Padovani, Laetitia, Scarzello, Giovanni, Schwarz, Rudolf, and Timmermann, Beate
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CLINICAL trials , *NEUROBLASTOMA , *HEALTH services accessibility , *RHABDOMYOSARCOMA , *TUMORS in children , *DIAGNOSTIC imaging , *BRAIN tumors , *NEPHROBLASTOMA , *QUALITY assurance , *KIDNEY tumors , *DESCRIPTIVE statistics , *RADIOTHERAPY , *ONCOLOGY , *LONGITUDINAL method , *SARCOMA - Abstract
The European Society for Paediatric Oncology (SIOPE) Radiation Oncology Working Group presents the QUARTET Project: a centralised quality assurance programme designed to standardise care and improve the quality of radiotherapy and imaging for international clinical trials recruiting children and adolescents with cancer throughout Europe. QUARTET combines the paediatric radiation oncology expertise of SIOPE with the infrastructure and experience of the European Organisation for Research and Treatment of Cancer to deliver radiotherapy quality assurance programmes for large, prospective, international clinical trials. QUARTET-affiliated trials include children and adolescents with brain tumours, neuroblastoma, sarcomas including rhabdomyosarcoma, and renal tumours including Wilms' tumour. With nine prospective clinical trials and two retrospective studies within the active portfolio in March 2022, QUARTET will collect one of the largest repositories of paediatric radiotherapy and imaging data, support the clinical assessment of radiotherapy, and evaluate the role and benefit of radiotherapy quality assurance for this cohort of patients within the context of clinical trials. • High-quality, protocol compliant radiotherapy is essential in clinical trials. • QUARTET is a platform for centralised prospective radiotherapy quality assurance. • QUARTET facilitates a strong collaborative network for paediatric radiation oncology. • QUARTET improves equity in access to paediatric radiotherapy expertise across Europe. • QUARTET supports central review of diagnostic imaging for treatment failure analysis. [ABSTRACT FROM AUTHOR]
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- 2022
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25. Imaging response assessment for CNS germ cell tumours: consensus recommendations from the European Society for Paediatric Oncology Brain Tumour Group and North American Children's Oncology Group.
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Morana, Giovanni, Shaw, Dennis, MacDonald, Shannon M, Alapetite, Claire, Ajithkumar, Thankamma, Bhatia, Aashim, Brisse, Hervé, Jaimes, Camilo, Czech, Thomas, Dhall, Girish, Fangusaro, Jason, Faure-Conter, Cecile, Fouladi, Maryam, Hargrave, Darren, Harreld, Julie H, Mitra, Dipayan, Nicholson, James C, Souweidane, Mark, Timmermann, Beate, and Calaminus, Gabriele
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PEDIATRIC oncology , *GERM cells , *BRAIN tumors , *AMERICANS , *TUMORS , *ONCOLOGY , *BRAIN tumor treatment , *GERM cell tumors , *CONSENSUS (Social sciences) , *DIAGNOSTIC imaging , *TREATMENT effectiveness , *NORTH Americans ,CENTRAL nervous system tumors - Abstract
Homogeneous and common objective disease assessments and standardised response criteria are important for better international clinical trials for CNS germ cell tumours. Currently, European protocols differ from those of North America (the USA and Canada) in terms of criteria to assess radiological disease response. An international working group of the European Society for Paediatric Oncology Brain Tumour Group and North American Children's Oncology Group was therefore established to review existing literature and current practices, identify major challenges regarding imaging assessment, and develop consensus recommendations for imaging response assessment for patients with CNS germ cell tumours. New clinical imaging standards were defined for the most common sites of CNS germ cell tumour and for the definition of locoregional extension. These new standards will allow the evaluation of response to therapy in patients with CNS germ cell tumours to be more consistent, and facilitate direct comparison of treatment outcomes across international studies. [ABSTRACT FROM AUTHOR]
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- 2022
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26. Radiation dose constraints for organs at risk in neuro-oncology; the European Particle Therapy Network consensus.
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Lambrecht, Maarten, Eekers, Daniëlle B.P., Alapetite, Claire, Burnet, Neil G., Calugaru, Valentin, Coremans, Ida E.M., Fossati, Piero, Høyer, Morten, Langendijk, Johannes A., Romero, Alejandra Méndez, Paulsen, Frank, Perpar, Ana, Renard, Laurette, de Ruysscher, Dirk, Timmermann, Beate, Vitek, Pavel, Weber, Damien C., van der Weide, Hiske L., Whitfield, Gillian A., and Wiggenraad, Ruud
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RADIATION , *ONCOLOGY , *PARTICLES , *ORGANS (Anatomy) , *TISSUES - Abstract
Purpose For unbiased comparison of different radiation modalities and techniques, consensus on delineation of radiation sensitive organs at risk (OARs) and on their dose constraints is warranted. Following the publication of a digital, online atlas for OAR delineation in neuro-oncology by the same group, we assessed the brain OAR-dose constraints in a follow-up study. Methods We performed a comprehensive search to identify the current papers on OAR dose constraints for normofractionated photon and particle therapy in PubMed, Ovid Medline, Cochrane Library, Embase and Web of Science. Moreover, the included articles’ reference lists were cross-checked for potential studies that met the inclusion criteria. Consensus was reached among 20 radiation oncology experts in the field of neuro-oncology. Results For the OARs published in the neuro-oncology literature, we summarized the available literature and recommended dose constraints associated with certain levels of normal tissue complication probability (NTCP) according to the recent ICRU recommendations. For those OARs with lacking or insufficient NTCP data, a proposal for effective and efficient data collection is given. Conclusion The use of the European Particle Therapy Network-consensus OAR dose constraints summarized in this article is recommended for the model-based approach comparing photon and proton beam irradiation as well as for prospective clinical trials including novel radiation techniques and/or modalities. [ABSTRACT FROM AUTHOR]
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- 2018
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