Therapy-Associated Late Effects after Irradiation of Malignant Diseases in Childhood and Adolescence. Feasibility Analyses of a Prospective Multicenter Register Study

Bölling, Tobias; Schuck, Andreas; Rübe, Christian; Hesselmann, Stefan; Pape, H.; Dieckmann, Karin; Pöllinger, Barbara; Kortmann, Rolf‐Dieter; Speiser-Held, Irene; Meyer, F.; Martini, Carmen; Asadpour, Branka; Timmermann, Beate; Beck, J. D.; Langer, Thor﻿s﻿ten; Paulides, Marios; Schmidt, Bernhard; Willich, Normann

doi:10.1007/s00066-006-1517-9

Cited by 37 publications

(36 citation statements)

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“…Morphological and physiological studies have identified the renal tubule system as the site of maximum radiation damage [3,6,10,11,14,28,[31][32][33]. According to the results of our study, tubular toxicity induced by 6-Gy irradiation was seen over a period of 6 months.…”

Section: Discussionmentioning

confidence: 71%

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Amifostine Use in Radiation-Induced Kidney Damage

et al. 2008

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Section: Discussionmentioning

confidence: 71%

“…Kidneys are probably the most radiosensitive abdominal organs; a tolerance dose of 20 Gy has been proposed [18,19,23]. Radiation nephropathy includes increased vascular permeability, perfusion disturbance, inflammatory reactions, and fibrosis [3,7].…”

Section: Introductionmentioning

confidence: 99%

Amifostine Use in Radiation-Induced Kidney Damage

et al. 2008

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“…After the end of the EF-radiotherapy, simulation and verification films of every individual patient as well as the treatment data were analysed by an expert panel. One important achievement of this retrospective quality control was to show that deviations of radiation treatment portals and radiation doses from prospective treatment prescriptions proved to be unfavourable prognostic factors for patients with early-stage HL (Figure1) [5][6][7][8][9][10].…”

Section: Clinical Results In Early-favourable Stages From a Single Ramentioning

confidence: 99%

Current Role and Future Developments of Radiotherapy in Early-stage Favourable Hodgkin's Lymphoma

Eich

Müller

2007

Strahlenther Onkol

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Strahlentherapie und Onkologie Supplement Article IntroductionThe radiosensibility of Hodgkin's lymphoma (HL) is well established since 1902, when Pusey [1] was one of the first to publish about radiotherapeutical treatment of a HL.In the early years, radiotherapy was the only curative treatment for this systemic disease, but the reports of Kaplan and Rosenberg [2] and Peters [3] in the fifties and seventies showed that irradiation of involved lymph node regions only resulted in high local and distant recurrences.The introduction of linear accelerator based high dose extended field (EF)-radiotherapy by Kaplan in Stanford was a milestone in the evolution of definitive curative radiotherapy strategies. The application of the mantle field for supradiaphragmatic and the inverted Y (with or without including the spleen or splenic pedicle) for infradiaphragmatic disease resulted in a dramatic improvement of survival rates in the early stages I and II (Ann Arbor) from 25-30 % in the sixties to 65-80 % in the eighties [4]. Kaplan reported about a close relationship between radiation dose and cure rates in the case of definitive radiotherapy. A dose of at least 40 Gy resulted in local recurrences below 5% and is today the standard dose for radiotherapy only outside protocols. Despite complete remission rates after radiotherapy of 90-100%, the overall recurrence rate (including in-field, marginal and distant relapses) was between 20 and 30%. Analysis of the relapses revealed some stage migrating risk factors: large mediastinal mass, extra nodal involvement, number of involved lymph node areas (> 3) and high ESR.The possibility of more accurate staging by using new imaging techniques like ultrasonography, CT and MRI as well as PET in the recent years resulted e.g. in the definition of early-favourable, early-unfavourable (intermediate) and high risk stages and more specific, risk adapted treatment strategies.The objective of this article is to show recent achievements and developments in the management of early-stage favourable HL exemplified by the strategy of the German Hodgkin Study Group (GHSG), where radiotherapy still is an integral part within combined modality treatment.

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“…The structure of "RiSK" as well as detailed information about documentation procedures has recently been published [4,5]. In short, documentation forms including evaluation of treatment period, fractionation schedule, target volume, radiation technique and dose including detailed information about organ dose levels were established.…”

Section: Methodsmentioning

confidence: 99%