Biomedical subjects

C von Briel

Publications and source records attributed to C von Briel.

8 recordsLinked to original sources

PubMed2006

Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study.

The aim was to investigate the efficacy of neoadjuvant docetaxel-cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m-2 (day 1) plus cisplatin 40 or 50 mg m-2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel-cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.

Adult↗

PubMed2000

Prognostic relevance of Masaoka and Müller-Hermelink classification in patients with thymic tumors.

BACKGROUND: To compare the prognostic relevance of Masaoka and Müller-Hermelink classifications. METHODS: We treated 71 patients with thymic tumors at our institution between 1980 and 1997. Complete follow-up was achieved in 69 patients (97%) with a mean follow up-time of 8.3 years (range, 9 months to 17 years). RESULTS: Masaoka stage I was found in 31 patients (44.9%), stage II in 17 (24.6%), stage III in 19 (27.6%), and stage IV in 2 (2.9%). The 10-year overall survival rate was 83.5% for stage I, 100% for stage IIa, 58% for stage IIb, 44% for stage III, and 0% for stage IV. The disease-free survival rates were 100%, 70%, 40%, 38%, and 0%, respectively. Histologic classification according to Müller-Hermelink found medullary tumors in 7 patients (10.1%), mixed in 18 (26.1%), organoid in 14 (20.3%), cortical in 11 (15.9%), well-differentiated thymic carcinoma in 14 (20.3%), and endocrine carcinoma in 5 (7.3%), with 10-year overall survival rates of 100%, 75%, 92%, 87.5%, 30%, and 0%, respectively, and 10-year disease-free survival rates of 100%, 100%, 77%, 75%, 37%, and 0%, respectively. Medullary, mixed, and well-differentiated organoid tumors were correlated with stage I and II, and well-differentiated thymic carcinoma and endocrine carcinoma with stage III and IV (p < 0.001). Multivariate analysis showed age, gender, myasthenia gravis, and postoperative adjuvant therapy not to be significant predictors of overall and disease-free survival after complete resection, whereas the Müller-Hermelink and Masaoka classifications were independent significant predictors for overall (p < 0.05) and disease-free survival (p < 0.004; p < 0.0001). CONCLUSIONS: The consideration of staging and histology in thymic tumors has the potential to improve recurrence prediction and patient selection for combined treatment modalities.

Adult↗

PubMed1998

[Predictive significance of reflex otalgia in local radical radiotherapy of oropharyngeal carcinomas].

BACKGROUND: Patients with carcinomas of the upper aero-digestive tract often suffer from ear pain as a tumor associated syndrome. This prospective study examines the predictive and prognostic value of this symptom. PATIENTS AND METHODS: Ninety-six consecutive patients who completed a locally radiotherapy of a carcinoma of the oropharynx were prospectively evaluated and followed. Forty-nine out of 96 patients stated the symptom, either spontaneously or after questioning. The 2 groups showed no difference regarding TNM-classification, histology and total dose. Overall survival, local control and disease specific survival were calculated according to Kaplan-Meier and compared by the log-rank test. RESULTS: A clinically complete remission was obtained in significantly fewer patients with reflex-otalgia as compared to patients without reflex-otalgia, 61.2% versus 89.3%, p < 0.002. Local control of patients with reflex-otalgia was significantly less with 49%, mean follow-up 564 days, in comparison to local control in patients without reflex-otalgia, mean follow-up 613 days, p = 0.01. Disease specific survival was significantly worse for patients with reflex-otalgia, p < 0.012. The probability of local control of T1/T2 tumors with reflex-otalgia was similar to T3/T4 tumors without reflex-otalgia. Local control for all tumor categories combined is 74% for patients without reflex-otalgia versus 49% for patients with reflex-otalgia. CONCLUSION: In our patients, reflex-otalgia is a new and statistically significant parameter for the probability of local control and disease specific survival.

Adult↗

PubMed1998

[Progress in surgical therapy of bronchus carcinoma].

Surgical progresses in the treatment of lung cancer are not only related to technical details of surgery itself, but rely much upon an interdisciplinary approach before and after the operation. This will improve patient selection, multimodality treatment concepts and morbidity and mortality with overall improvement of quality of life in these patients.

Carcinoma, Bronchogenic↗

PubMed1998

[Is preoperative chemotherapy in locally advanced non-small-cell bronchial carcinoma of value?].

Although surgeons are able to resect completely locally advanced non-small cell lung cancer with mediastinal lymph node involvement (stage IIIA), the majority of patients succumb from metastatic disease. Therefore, neoadjuvant therapy was introduced in the management of this disease in order to eradicate distant metastases at an early stage. Phase II trials with preoperative chemotherapy in stage IIIA patients have shown that the pathological response (amount of tumour necrosis) and the clearance of mediastinal lymph node correlate with a better survival and is the best predictor for eradication of distant metastases. Indeed, three small randomised phase III studies have demonstrated a survival advantage for preoperative chemotherapy compared to surgery alone. Further studies are required to determine the best neoadjuvant regimen inducing the largest amount of tumour necrosis.

Carcinoma, Non-Small-Cell Lung↗

PubMed1998

[Curative radiotherapy in locally advanced non-small-cell bronchial carcinoma (NSCLC)].

Radiation is a standard treatment for patients with locally advanced non-small cell lung cancer. Only 5% of patients are alive after 5 years. Improvement of local control and survival time have been yielded using knowledge in radiobiology and technical innovations, especially three dimensional planning on the basis of CT and MRI. Further improvement could be reached by performing combination of radio- and chemotherapy. However, the best sequence of chemo- and radiotherapy could not be defined yet.

Carcinoma, Bronchogenic↗

PubMed1996

Combined surgical and X-ray treatment for angiosarcoma of the scalp: report of a case with a favourable outcome.

Classic angiosarcoma is an uncommon malignant neoplasm of vascular differentiation which is highly aggressive. The diagnosis is often delayed and, since the response to treatment mainly depends on the size of the tumour, the prognosis is usually poor. Here we report a 76-year-old man in whom an extensive angiosarcoma of the scalp was treated by excision followed by wide-field radiotherapy. More than 4 years later there are no signs of local recurrence or of metastasis.

Aged↗

PubMed1994

[Special endobronchial palliative measures].

Inoperable pulmonary malignancies can present with local stenoses of the central airways either at the time of diagnosis or later on. Depending on their localization, these obstructions cause progressive dyspnea, postobstructive atelectasis and/or pneumonia. The patient's general condition will deteriorate, and at the tracheal level life-threatening dyspnea can develop. If central airways stenosis is suspected, fiberbronchoscopy is mandatory to decide whether local endobronchial palliation is a feasible treatment modality. Usually, local palliation is combined with chemo-and/or radiotherapy. Laser resection using the Nd-YAG laser is performed for obstructions caused by endoluminal tumour growth and leads to an immediate effect after a single session. Brachytherapy means local, endobronchial irradiation with a short depth of penetration. The active probe is placed with the aid of the fiberbronchoscope. Brachytherapy can be used alone, but is often combined with an initial laser resection for the consolidation of the treatment effect. The principal of photodynamic therapy consists of photosensitization of tumour cells followed by local laser light application which leads to cell death. In selected cases this treatment can be curative. Extrinsic stenoses which are caused by external compression of the airways or by thickening of the airway walls through submucosal tumour spread must be treated by dilatation and insertion of stents (endoprostheses) to maintain airway patency. These stents--mostly self-expanding silicone or metal devices--are usually inserted with the rigid bronchoscope. Again, endobronchial and/or percutaneous radiotherapy is added to obtain longer local tumour control.

Airway Obstruction↗