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Feyer P.C.,Klinik fur Strahlentherapie und Radioonkologie | Steingraeber M.,Gemeinschaftspraxis fur Strahlentherapie und Radioonkologie
Breast Care

Bone metastases (BM) represent the most frequent indication for palliative radiotherapy in patients with breast cancer. BM increase the risk of skeletalrelated events defined as pathological fractures, spinal cord compression, and, most frequently, bone pain. The therapeutic goals of palliative radiotherapy for BM are pain relief, recalcification, and stabilization, reducing spinal cord compression and minimizing the risk of paraplegia. In advanced tumor stages radiotherapy may also be used to alleviate symptoms of generalized bone metastasis. This requires an individual approach including factors, such as life expectancy and tumor progression at different sites. Side effects of radiation therapy of the middle and lower spine may include nausea and emesis requiring adequate antiemetic prophylaxis. Irradiation of large bone marrow areas may cause myelotoxicity making monitoring of blood cell counts mandatory. Radiotherapy is an effective tool in palliation treatment of BM and is part of an interdisciplinary approach. Preferred technique, targeting, and different dose schedules are described in the guidelines of the German Society for Radiooncology (DEGRO) which are also integrated in 2012 recommendations of the Working Group Gynecologic Oncology (AGO). © 2012 S. Karger GmbH, Freiburg. Source

Kriz J.,Universitatsklinikum Munster | Eich H.T.,Universitatsklinikum Munster | Bruns F.,Klinik fur Strahlentherapie und Spezielle Onkologie | Heyd R.,Goethe University Frankfurt | And 5 more authors.
Radiation Oncology

Introduction: Langerhans Cell Histiocytosis (LCH) represents a rare benign disorder, previously designated as " Histiocytosis X" , " Type II Histiocytosis" or " Langerhans Cell Granulomatosis" Clinical presentation includes osteolysis, ulcerations of skin and soft tissues but also involvement of the CNS is described.Because treatment concepts are not well defined the German Cooperative Group on Radiotherapy for Benign Diseases performed a retrospective analysis.Methods and material: Eight closely cooperating centres collected patients' data of the past 45 years. As study endpoints disease free survival, recurrent disease, death and therapy related side effects were defined.Results: A total of 80 patients with histologically proven LCH were irradiated within the past 45 years. According to the LCH classification of Greenberger et al. 37 patients had stage Ia, 21 patients stage Ib, 13 patients stage II and 9 patients stage IIIb and the median age was 29 years. The median Follow up was 54 months (range 9-134 months). A total of 39 patients had a surgical intervention and 23 patients a chemotherapy regimen.Radiation treatment was carried out with a median total dose of 15 Gy (range 3-50.4 Gy). The median single fraction was 2 Gy (range 1.8-3 Gy).Overall, 77% patients achieved a complete remission and 12.5% achieved a partial remission. The long-term control rate reached 80%. Within an actuarial overall 5-year survival of 90% no radiogenic side and late effects ≥EORTC/RTOG II° were observed.Conclusion: In the present study a large collective of irradiated patients was analysed. Radiotherapy (RT) is a very effective and safe treatment option and even low RT doses show sufficient local control. © 2013 Kriz et al.; licensee BioMed Central Ltd. Source

Buntzel J.,Klinik fur Hals Nasen Ohren Heilkunde und Abteilung fur Interdisziplinare Palliativmedizin | Buntzel H.,Klinik fur Hals Nasen Ohren Heilkunde und Abteilung fur Interdisziplinare Palliativmedizin | Micke O.,Klinik fur Strahlentherapie und Radioonkologie

Context: At the end of life the majority of patients and their relatives are looking for complementary treatment approaches. Special acceptance is seen in methods of communicative and patient-focussed medicine. Techniques unrelated to health sciences (e.g. sports, laughter therapy and art therapy) are important as well as classical therapies (e.g. speech therapy and occupational therapy). Basal stimulation and aroma therapy are also established components of modern palliative care. Objective: The integration of herbal therapy is explained using the example of treatment of inflammation of the oral mucosa. Finally, spiritual care is shown as an essential part of modern palliative medicine in order to support the patient and to protect the professional care giver. Material and methods: Research of literature and interview of patients as well as their relatives using a questionaire. © 2013 Springer-Verlag Berlin Heidelberg. Source

Kriz J.,Universitatsklinikum Munster | Eich H.T.,Universitatsklinikum Munster | Haverkamp U.,Universitatsklinikum Munster | Bruns F.,Klinik fur Strahlentherapie und Spezielle Onkologie | Micke O.,Klinik fur Strahlentherapie und Radioonkologie
Oncology Research and Treatment

Background: Desmoids (aggressive fibromatosis) are defined as benign neoplasms of the connective tissue that arise from the deep muscle fascia, aponeurosis, tendons, and scar tissue. Recurrence rates between 40 and 80% were reported after surgery alone. We addressed the impact of radiation therapy (RT) in the management of aggressive fibromatosis. Patients and Methods: A large literature review was performed, and the data was compared with the results of a multicenter study of the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD). Results: This analysis included 52 patients treated with RT. 37 patients received postoperative RT (20 patients after R2 resection and 17 patients after R1 resection). 15 patients received RT alone (6 patients with inoperable primary tumor and 9 patients with inoperable recurrent tumor). In the case of postoperative RT, a median dose of 50 Gy (range 50-60 Gy) was used; for definitive RT, a median dose of 55 Gy (range 55-65 Gy) was used. The local control rate was 79% for the whole group. The median follow-up was 44 month (range 8-62 months). Conclusion: Given the large number of patients, these data show that RT is highly effective in the treatment of desmoid tumors. RT is an attractive alternative to mutilating surgery. © 2014 S. Karger GmbH, Freiburg. Source

Neu B.,Klinik fur Radioonkologie und Strahlentherapie | Sautter V.,Klinik fur Radioonkologie und Strahlentherapie | Momm F.,University Hospital Freiburg | Melcher U.,Klinik fur Radioonkologie und Strahlentherapie | And 3 more authors.
Strahlentherapie und Onkologie

Background: Gynecomastia is a frequent side effect of antiandrogen therapy for prostate cancer and may compromise quality of life. Although it has been successfully treated with radiotherapy (RT) for decades, the priority of RT as a preferred treatment option has recently been disputed as tamoxifen was also demonstrated to be effective. The aim of the present paper is to provide an overview of indications, frequency, and technique of RT in daily practice in Germany, Switzerland, and Austria. Patients and Methods: On behalf of the DEGRO-AG GCG-BD (German Cooperative Group on Radiotherapy of Benign Diseases) a standardized questionnaire was sent to 294 RT institutions. The questionnaires inquired about patient numbers, indications, RT technique, dose, and - if available - treatment results. Moreover, the participants were asked whether they were interested in participating in a prospective study. Results: From a total of 294 institutions, 146 replies were received, of which 141 offered RT for gynecomastia. Seven of those reported prophylactic RT only, whereas 129 perform both preventive and symptomatic RT. In 110 of 137departments, a maximum of 20 patients were treated per year. Electron beams (76%) were used most often, while 24% of patients received photon beams or orthovolt x-rays. Total doses were up to 20 Gy for prophylactic and up to 40 Gy for therapeutic RT. Results were reported by 19 departments: prevention of gynecomastia was observed in 60-100% of patients. Only 13 institutions observed side effects. Conclusion: Prophylactic and symptomatic RT is widely used in the German-speaking countries, but patient numbers are small. The clinical results indicate that RT is a highly effective and well-tolerated treatment. © 2011 Urban & Vogel. Source

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