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M Bamberg

Publications and source records attributed to M Bamberg.

At least 235 records · Page 13Linked to original sources
PubMed1978

[Low-dose x-ray treatment of 44 haemangiomas of the lid (author's transl)].

An extent knowledge of different haemangioma forms is the prerequisite of any treatment of haemangioma. Only the blastomatous haemangioma, because of its histological substrate, has a marked sensitivity to x-radiation. The tendency towards spontaneous regression among haemangiomas is an important factor which must be taken into consideration in any treatment plan. The blastomatous haemangiomas are most radiation-sensitive during the growth phase. For this reason such treatment should be undertaken in the first two years of life and under quite specific indications. The results of low-dose radiotherapy was assessed five years after the end of treatment on 157 patients with haemangiomas (of these, 44 were of the lid). Very good to satisfactory results had been achieved in 95.5% of blastomatous haemangiomas. Radiotherapy was only little effective in juveniles and adults. These results indicate that radiotherapy is the treatment of choice for blastomatous haemangiomas.

Age Factors↗
PubMed1978

Relationship between curative radiation therapy of paravertebral tumors and the incidence of radiation myelitis.

The literature about radiation damage to the spinal cord is reviewed and 4 of own cases are presented. It is pointed out that in curative radiation therapy the risk of myelitis that accompanies higher spinal cord doses must be weighed against the therapeutic gains. However, in view of the lack of information about radiation damage to the spinal cord, this may be quite difficult.

Adult↗
PubMed1978

[The role of large portal- and shielding-techniques in radiotherapy (author's transl)].

Since electron linear accelerators with energies up to 20 MeV were introduced to radiotherapy it has become easier to irradiate large portals than was previously possible with 60Co unites or betatrons. The reasons for this are: 1) More favourable depth dose distribution resulting in better field homogeneity 2) Considerably smaller penumbra 3) Higher and more constant dose rates 4) Larger portals. The indications for the following large portal techniques are discussed: 1) Total nodal irradiation 2) Total lung irradiation 3) Abdominal bath 4) Irradiation of larger segments of the extremities 5) Whole body irradiation.

Humans↗
PubMed1978

[Radiotherapy of blastomatous hemangiomas - under special consideration of 44 eyelid hemangiomas (author's transl)].

The propriety of blastomatous hemangiomas to show spontaneous regression is underlined. Under certain indications, above all in case of eyelid hemangiomas, a radiotherapy is indicated. The moment of manifestation lies within the first three months of life, and the female sex is affected two times more frequently. The head represents the predilection spot within the distribution scheme of hemangiomas. 44 patients with eyelid hemangiomas who had been treated between 1968 and 1972 by the described irradiation method had check-up appointments five years later. The therapeutical results were evaluated according to certain criteria. 95,5% of the blastomatous hemangiomas showed a very good or satisfactory regression. Only 4,5% did not present any satisfactory success. In an advanced age of the patients, the hemangiomas do not always respond favourably to radiotherapy. In case of a strictly executed indication and a faultless irradiation technique, irradiation damages can be avoided. Our results show that, with regard to the spontaneous regression of blastomatous hemangiomas, total doses of 1000 to 1500 rd are sufficient. Finally the authors cite the standpoints of radiotherapy concerning the treatment of blastomatous hemangiomas and give recommendations for dosage principles.

Age Factors↗
PubMed1976

[Epidemiologic and etiologic factors in cancer of the breast. Catamnestic investigations on 749 patients of the Department of Radiology at Essen (author's transl)].

Morbidity- and morality statistics of cancer of the breast show a clear increase in almost all countries. The numbers of patients who died increased particularly in countries situated around the north-sea. It appears that unmarried women run a greater risk, as reported by many authors. On further risks we could not confirm that those women with few children predominated. Our results correspond to numbers calculated for abortions. More children increase the danger of breast cancer. These evaluations cannot be separated from the impact of shortened breast-feeding and sociologic factors which also influence the risk in an ill-defined manner. Breast-cancer is doubly to five times as common in female relatives of patients as shown in Anglo-american and our own materials. Age distribution among 742 patients shows, rather like that of some Scandinavian authors, peaks between 45 and 49 and between 56 and 63 years. This again raises the question of a post-menopausal stimulus. In our material there is an average delary of 4 1/2 months between first symptoms and start of treatment. The causes arise both from patients and doctors and, age apart, are responsible for the undue delay. Delay, invasion of lymph nodes and size of tumor establish a correlation between delay and stage of tumor. As to the site of the tomor the left breast was more often involved than the right in our patients. The upper lateral quadrant predominated. To extend the period of survival we shall have to reduce delay and develop further special techniques of treatment.

Attitude to Health↗
PubMedDate not supplied

Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89.

UNLABELLED: Malignant non-germinomatous intracranial germ cell tumors (MNGGCTs) are a heterogenous group of neoplastic lesions. Their treatment concept follows a multimodal concept that may include tumor resection for local tumor control, craniospinal irradiation to cover leptomenigeal tumor spread and chemotherapy to eliminate systemic tumor dissemination. A Platinum-based chemotherapy proven to be highly effective in testicular and non-testicular malignant germ cell tumors in adults as well as in children has also been chosen for intracranial sites. While therapeutic concepts have been thoroughly evaluated for children and adolescents with extracranial nongonadal GCTs, no such detailed long term follow-up data are available for intracranial MNGGCTs. This paper reports on the long-term outcome of 41 patients with intracranial malignant non-germinomatous GCTs enrolled into the German prospective protocol MAKEI 89. The analysis focuses on the impact of surgery, radio- and chemotherapy. PATIENTS AND METHODS: Between January 1989 and January 1994, 41 patients with malignant intracranial non-germinomatous GCTs were registered. Patients were compared in respect to protocol (n = 27) and non-protocol treatment (n = 14). Estimated were with chi (2) and Fisher exact test the impact of surgery, chemotherapy and irradiation on outcome. RESULTS: The estimated (Kaplan-Meier) 5-year event free survival (EFS) of patients treated according to protocol recommendations was 0.59 +/- 0.06 (n = 27), compared to an EFS of 0.37 +/- 0.33 for patients with different treatments (n = 14) (p = 0.70, log-rank). The 5-year relapse-free survival rate (RFS) was 0.74 +/- 0.06 in protocol patients and 0.38 +/- 0.33 in non-protocol patients (median observation time of 112 months after diagnosis for surviving patients) (p = 0.14, log-rank). Surgery, complete or incomplete had no significant impact on survival (p = 0.12). Radiotherapy, in terms of craniospinal irradiation had a significant influence on survival (p = 0.035) as well as a cumulative cisplatin dose >/= 400 mg/m (2) (p = 0.002). CONCLUSION: Cisplatin chemotherapy and craniospinal irradiation with tumor boost are of significant influence on long term survival in patients with MNGGCTs. The exclusion of major surgery at diagnosis using modern advances in neurosurgery or related tumor resection after neoadjuvant chemotherapy will allow a further reduction of treatment related mortality and long lasting morbidity. The analysis reveals that, given effective treatment, intracranial malignant non-germinomatous GCTs should not longer carry a poor prognosis.

Adolescent↗
PubMedDate not supplied

[Improved prognosis of intracranial germ cell tumors by intensified therapy: results of the MAKEI 89 therapy protocol].

Germ cell tumors of the central nervous system are histological identical to the extracranial tumor sites. According to the localisation germ cell tumors of the CNS are different in symptoms, diagnostic approaches, kind and location of metastases and stratification of therapy. Since 1986 patients with intracranial germ cell tumors are registered in the ongoing study for non-testicular germ cell tumors (MAKEI) of the German Society of Pediatric Oncology and Hematology, and are treated in accordance to therapy guidelines for extracranial sites. In MAKEI 89 therapy strategy was revised with a reduction of radiotherapy and an increased cumulative cisplatinum dose from 200 mg/m2 to 400 mg/m2. Patients with germinoma receive after histologic diagnosis radiotherapy consisting of 30 Gy craniospinal irradiation and 15 Gy tumorboost. Malignant non-germinoma receive after diagnosis by tumor marker in CSF and/or serum 2 courses bleomycin 15 mg/m2 day 1-3, Etoposide 150 mg/m2 day 1 + 2 and cisplatinum 20 mg/m2 days 4-8 (BEP), continued by 2 courses Vinblastine 3 mg/m2 day 1 + 2, Ifosfamide 1500 mg/m2 days 1-5 and cisplatinum 20 mg/m2 days 1-5 (VIP), followed by 30 Gy craniospinal irradiation and 20 Gy tumor boost. In teratoma first line therapy is complete resection. In incomplete resected cases adjuvant chemotherapy according to histological grading is administered. Until 31st January, 1993 101 patients (pts) were registered, containing 69 protocol pts. Diagnosis in protocol pts was teratoma in 8 cases, 2 pts died postnatal because of extended disease, 2/8 pts relapsed, but were salvaged by chemotherapy. 40 pts offered germinomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[BEP/VIP in children and adolescents with malignant non-testicular germ cell tumors. A comparison of the results of treatment of therapy studies MAKEI 83/86 and 89P/89].

The treatment regimen of the ongoing cooperative study for non testicular germ cell tumors (MAKEI 89 of the German Society of Pediatric Oncology and Hematology), was stratified as in MAKEI 83 and 86 according to histology, localisation and stage. In the 1989 study, vinblastine was replaced by etoposide, resulting in a chemotherapeutic regimen of 3 to 4 courses BEP and 3 to 4 courses VIP in patients with stage I to IV. Total chemotherapy was reduced for 25%. In children under 1 year of age, bleomycin was omitted and bleomycin dose was reduced to 50%. In children up to 2 years because of two toxic deaths due to bleomycin who were registered in MAKEI 89 Pilot phase. Until Jan. 31, 1993, 230 patients were registered in the MAKEI 89 pilot study and the MAKEI 89 study, containing 186 protocol and 44 follow-up patients (patients with intracranial tumors are excluded for the review). 78 of the registered patients had a teratoma, 9 of these 78 patients suffered from a relapse. In 7 of 9 patients a lasting second remission has been achieved. 12 patients offered with germinoma. 1 of 12 patients had a recurrence but is in second remission. 47 patients had malignant non germinomatous germ cell tumors with an event free survival of 91 +/- 0.4%. 2 of the 47 patients relapsed and died. Toxicity was mainly hematologic without evidence of long term effects. Bleomycin induced pulmotoxicity (WHO grade IV) was documented in 1 protocol patient (see above). Nephrotoxicity with a grade III (WHO) decrease of creatinine clearance was found in 25% of the documented patients with a fast return to normal values after the end of therapy in most of the children. For the follow-up MAKEI 93 study, different topics are defined. 1. The value of chemotherapy for immature teratoma has to be discussed. 2. In invasive immature teratoma in children over 1 year of age, the effectiveness of chemotherapy should be proved. 3. Germinomas show high platinum sensitivity, therefore a platinum based chemotherapy has to be examined for this risk group. 4. The value of a wait and see strategy similar to the proved regimen in the French germ cell tumor protocol has to be verified in patients with stage I non germinomatous germ cell tumors. 5. An intensification of chemotherapy in patients with malignant stage III and IV non germinomatous germ cell tumors has to be examined as a new therapeutic approach for this risk group.

Adolescent↗
PubMedDate not supplied

[Non-testicular germ cell tumors: analysis of the therapy study MAKEI 83/86 anc changes in the protocol for the follow-up study].

205 patients with germ cell tumors were entered into the GPO Cooperative Study MAKEI 83/86 and classified as follows: 97 teratomas, 66 yolk sac tumors, 22 dysgerminomas, 17 embryonal carcinomas and three choriocarcinomas; 20% of all tumors were classified as mixed histology. Predominant primary sites were the ovaries (91 pts), the saccrococcygeal region (74 pts), the mediastinum (12 pts), the peritoneal cavity (10 pts) and other sites (18 pts). The treatment of teratomas was primarily surgery. Localised dysgerminomas received radiotherapy following surgery, in advanced stages (III, IV) four courses of chemotherapy vinblastine 3 mg/m2/day (days 1 + 2), bleomycin 15 mg/m2/day (days 1-3) and cisplatinum 20 mg/m2/day (days 4-8) (VBC) were applied. The other fully malignant tumors received four courses of VBC chemotherapy, in extragonadal primary tumors and advanced stages of all sites additional four courses of VP16 100 mg/m2/day (days 1-3), ifosfamide 1500 mg/m2/day (days 1-5) and cisplatin 20 mg/m2/day (days 1-5) (VPIC) were administered. To avoid mutilating surgery in advanced disease, four courses of VBC chemotherapy were administered prior to resection. The relapse-free survival according to Kaplan-Meier for protocol patients with teratomas is 0.97 +/- 0.01, for dysgerminomas 0.73 +/- 0.09 and for other fully malignant histologic entities 0.81 +/- 0.02 with a median period of observation of 31 months. The toxicity mainly consisted of myelosuppression during VPIC chemotherapy in 39 of 62 pts resulting in twelve incidents of sepsis with lethal outcome in two pts. Impaired renal function was reported in 14 pts, the incidence of neuropathy, ototoxicity and pulmonary toxicity was negligible. For the follow-up study a reduction in chemotherapy seems justified in patients with favourable prognosis. The substitution of VP16 for vinblastine may result in reduced toxicity.

Adolescent↗
PubMedDate not supplied

[Treatment of non-testicular germ cell tumors in children and adolescents with BEP and VIP: initial results of the MAKEI 89 therapy study].

The pilot protocol of the German Society of Pediatric Oncology for treatment of non testicular germ cell tumors was initiated in November 1987. The final protocol was started at 1. 1. 89. Different therapy was administered depending on histology, primary localisation or stage of tumors. Patients with malignant germ cell tumors such as dysgerminomas, embryonal carcinomas, yolk sac tumors or chorio carcinomas received BEP (Bleomycin 15 mg/m2/days 1-3, Etoposide 100 mg/m2/days 4-8, Cisplatinum 20 mg/m2/days 4-8), followed by VIP (Vinblastine 3 mg/m2/days 1 + 2, Ifosfamide 1500 mg/m2/days 1-5 including Mesna uroprotection and Cisplatinum 20 mg/m2/days 1-5). Patients with ovary tumors of stage 1 were treated with 3 courses of BEP, patients with ovary tumors stage II and extragonadal localisation received 3 courses of VIP in addition to 3 courses of BEP. In cases of extended tumors 4 courses of BEP were followed by delayed resection of tumors and 4 courses of VIP. Patients with intracranial germinomas were treated with 30 Gy of craniospinal radiation therapy and additional 15 Gy as a tumor boost. Since some cases of spinal extension were reported a spinal radiation therapy seems to be indispensable. Patients with intracranial embryonal carcinomas, yolk sac tumors or chorio carcinomas tumors were given 2 courses of BEP and VIP followed by 30 Gy of craniospinal radiation therapy and additional 20 Gy as a tumor boost. Patients with immature teratomas of the ovary grade 1-3 and grade 3 of tumors with extragonadal localisation were treated with 3 courses of BEP after resection of tumors. Until 1. 1. 1991 92 patients were reported to the study--27 with intracranial and 65 with extracranial primary localisation of tumors. 43 patients suffered from teratomas (including 20 immature teratomas grade 1-3), 18 from germinomas (seminomas/dysgerminomas) and 31 from malignant non-seminomatous germ cell tumors. After an observation period of 29 months disease-free survival rate was 80% (79/92 patients, Kaplan-Meier Statistics). Outcome of intracranial tumors was death or relapse in 2/9 patients with malignant non-seminomatous germ cell tumors, in 2/14 patients with intracranial germinomas, in 2/4 patients with teratomas. Patients with extracranial localisation of tumors suffered from death or relapse in 1/21 cases with non-seminomatous tumors, in 0/4 cases with dysgerminomas and 5/39 cases with teratomas. During pilot study one infant with a malignant non-seminomatous germ cell tumor died of a pneumopathia. Therefore infants treated according to the final protocol did not receive Bleomycin.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMedDate not supplied

[Intracranial germ cell tumors: analysis of the therapy study MAKEI 83/86 and changes in protocol for the follow-up study].

As part of the Cooperative Germ Cell Tumors Studies MAKEI 83/86 of the German Society of Pediatric Oncology, 37 patients with intracranial germ cell tumors were registered. Based on histological criteria and tumor markers, 26 were classified as germinomas, 9 as fully malignant non-germinomatous germ cell tumors (2 yolk sac tumors, 1 embryonal carcinoma, 1 choriocarcinoma, 5 mixed type germ cell tumors), and 2 were mature teratomas. Of 26 patients with germinomas, 14 received radiotherapy only, all patients are surviving disease-free, median period of observation: 2 years, 10 patients were treated with both chemotherapy and radiotherapy, 8 of these patients are surviving disease-free. Of the 2 patients who received chemotherapy only, none is surviving. Of 9 patients with fully malignant non-germinomatous germ cell tumors, 4 are surviving following surgery, cisplatinum-based chemotherapy and radiotherapy more than 2 years following diagnosis, 1 of these 4 patients with stable disease. Of 2 patients with mature teratomas, 1 is surviving disease-free. Based on these data, recommendations for diagnostic evaluation and therapy of intracranial germ cell tumors are outlined.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Suppression of heterotopic ossification: single-dose versus fractionated irradiation--animal study].

Periarticular ossification is one of the main problems of total hip replacement. Irradiation with megavolt photons is known to be a well recognized means of prevention of heterotopic ossification. So far only little scientific basis exists about the most favourable way of radiotherapy for prevention of ectopic ossification. In this study two theoretically equivalent doses are compared. Allogeneic bone matrix was implanted into both thighs of 50 adult male Wistar rats for experimental induction of heterotopic ossification. Immediately after operation the thigh implants were irradiated with a single dose of 7 Gy or a total dose of 10 Gy given in 5 fractions of 2 Gy each. In the model of matrix-induced osteogenesis in rats fractionated irradiation by 5 x 2 Gy leaded to a highly-significant (p = 0.001) better suppression of ectopic ossification compared to irradiation by 1 x 7 Gy. Once-only irradiation with 1 x 7 Gy leads to a reduction of the calcium contents by 27.5%, split irradiation by 5 x 2 Gy obtained a reduction by 66.9% compared to the calcium contents of thigh implants not exposed to radiation. In view of experimentally proven better effects, fractionated irradiation has to be preferred to single dose radiation also considering less side effects in split radiation.

Animals↗
PubMedDate not supplied

Advances in treatment techniques and time/dose schedules in external radiation therapy of brain tumours in childhood.

Recent advances in radiotherapy techniques seek to improve the therapeutic ratio in childhood brain tumours by adding potentially more effective treatment in ways that will increase tumour control and limit radiation toxicity. Stereotactic irradiation techniques in conjunction with rigid head fixation systems comprising single high-dose delivery ("radiosurgery"), fractionated convergence therapy and three dimensional conformal therapy focus the dose to tumour while sparing surrounding normal tissue. Although these techniques are well established in adults data for childhood central nervous system malignancies are scarce. Preliminary data reveal low acute toxicity and promising results in recurrent tumours as well as in primary treatment. Whether stereotactic radiation therapy with either of the latter techniques will add substantially to disease control and preserve neurologic function remains to be established and should be part of future investigations. The introduction of quality control procedures assures precise radiotherapy of the tumour site, whole brain and craniospinal axis and is a prerequisite to improve survival and to reduce potential adverse effects. Hyperfractionated radiotherapy has the potential of increasing dose to tumour more safely theoretically sparing children some of the late effects while in particular in craniospinal irradiation. Pilot studies revealed excellent tumour control in medulloblastoma with acceptable acute toxicity. The strategy is part of the subsequent HIT '98 trial both for low and high risk patients. In conclusion, there is considerable enthusiasm among all those caring for children with brain tumours to study modifications of radiation delivery that may result in improved treatment. Rapid accrual to an increasing number of cooperative prospective trials is expected to provide the body of data supporting the selection of novel radiation therapy modalities in the future.

Adult↗
PubMedDate not supplied

Preradiation chemotherapy of children and young adults with malignant brain tumors: results of the German pilot trial HIT'88/'89.

BACKGROUND: Preradiation chemotherapy could be beneficial in malignant brain tumors, because the blood-brain tumor-barrier is disrupted after surgery, bone marrow recovery--essential for intense chemotherapy--is still intact, and CNS toxicity and ototoxicity of active drugs are lower before irradiation of a child's brain. PATIENTS AND METHODS: A neoadjuvant phase 2 and a single arm pilot trial were initiated to investigate the efficacy and toxicity of an intense multidrug regimen before radiotherapy in 147 patients aged between 3 and 29; 9 years with medulloblastoma (94), malignant glioma (22), ependymoma (21), and stPNET (10). They were treated with one or two cycles consisting of procarbazine, ifosfamide/mesna with etoposide, high dose methotrexate/CF, and cisplatin with cytarabine. RESULTS: Radiation therapy was delayed for 17-30 weeks (median 23 weeks) in 112 patients who received two cycles. Chemotherapy was well tolerated. Serious infections were observed in 20 patients, with one fatal fungal septicemia. In 69 high risk patients with a residual tumor and/or solid CNS metastases an objective response (CR plus PR) was achieved in 67% medulloblastoma, 57% stPNET, 55% anaplastic ependymoma and 25% malignant glioma. Progression-free survival (PFS) at 5 years was 57% in 14 high risk patients with medulloblastoma, who achieved a complete response (CR). After a less than CR the PFS was 20% (p = 0.01). Overall survival at 5 years was 57% in medulloblastoma, 62% in ependymoma, 36% in malignant glioma and 30% in stPNET. CONCLUSION: The HIT'88/'89 regimen was well tolerated and efficacious in regard to response rates and early PSF particularly in medulloblastoma and anaplastic ependymoma. Based on these results the prospectively randomized trial HIT'91 was designed to investigate the optimal timing of chemotherapy. Preradiation chemotherapy according to the HIT'88/'89 regimen was compared with the standard regimen using CCNU, cisplatin, and vincristine after radiation therapy. Additionally, strict quality control of the three treatment modalities was instituted to help improve the survival rates in both trial arms.

Adolescent↗
PubMedDate not supplied

Cystosarcoma phyllodes malignum: a case report of a successive triple modality treatment.

This paper reports on a woman with a rapidly growing recurrent cystosarcoma phyllodes malignum after two major attempts of surgery. In this situation, neoadjuvant hyperfractionated radiotherapy, superficial hyperthermia and ifosfamide were administered. Toxicity was mild. Resection of the tumour bed revealed a pathologically complete response with an actual disease free follow-up of 48 months.

Antineoplastic Agents, Alkylating↗
PubMedDate not supplied

An on-line phase measurement system for quality assurance of the BSD 2000. Part I: technical description of the measurement system.

The hyperthermia system BSD 2000 with the ring applicator Sigma 60 utilizes the principle of a phase controlled group radiation source. The accuracy of the phase relationship between the four receiving HF signals is crucial for the position of the electric field inside the applicator. Therefore, essential significance falls to the phase control of the system. An automatic phase measuring technique has been developed to register immediately the phase position of the four channels of the BSD 2000 with respect to a reference signal. The system improves the insurance of the technical safeguarding. In the first part of this work, the technical realization of the measurement system is described and first measurements with the system are given. In the second part, results with respect to the quality assurance of the BSD 2000 system are presented.

Humans↗