Biomedical subjects

Stephan Gripp

Publications and source records attributed to Stephan Gripp.

4 recordsLinked to original sources

PubMed2005

[Thymoma].

Thymoma is a rare epithelial tumor of the thymus, but the most common malignancy in the anterior mediastinum. A unique feature is its association with paraneoplastic syndromes, in particular myasthenia gravis. According to the WHO classification 6 histologic types of thymic epithelial tumors can be discriminated. Tumor stage according to MASAOKA is the most important prognostic factor. Non-invasive tumors (stage I) are usually completely resected and no further therapy is warranted. For incompletely resected tumors and locally advanced invasive thymomas (stage Ill-IV) postoperative radiotherapy with 50-60 Gy is advisable. Chemotherapy, preferably with Cisplatinum, is indicated with inoperable thymomas or metastatic disease. In general thymomas have a fair prognosis even in advanced stage. Long term follow-up is mandatory up to 10 years.

Drug Therapy↗

PubMed2004

Coverage of anterior fossa in whole-brain irradiation.

PURPOSE: Whole-brain irradiation is indispensable in the treatment of several brain tumors and requires coverage of the entire subarachnoid space. Retrospective studies have revealed frequent recurrences in the frontobasal fossa above the cribriform plate (CP). We sought to determine how accurately the latter could actually be identified on lateral radiographs such as those used for radiotherapy planning. METHODS AND MATERIALS: The CP was localized by five radiation oncologists and five radiologists on lateral radiographs of 30 human skulls from an anatomic collection. Reference radiographs were acquired under identical conditions except for lead markers pointing to the CP and the ethmoid cells. The targeting accuracy was analyzed. RESULTS: In 39% (n = 116), the location of the CP was correctly estimated within 2 mm. Mislocations of 2-5, 5-10, and >10 mm were noted in 34% (n = 102), 20% (n = 61), and 7% (n = 21), respectively. Neither specialty nor experience (years of training) exerted a significant influence on targeting accuracy. If the roofs of the ethmoid cells formed prominent bony edges, they were mistaken for the CP in 37%. CONCLUSION: Lateral radiographs provide insufficient information to locate the CP accurately in whole brain irradiation. Additionally, localization was significantly impaired by prominent ethmoid cells.

Adult↗

PubMed2003

Remission rates in breast cancer treated with preoperative chemotherapy and radiotherapy.

PURPOSE: Evaluation of remission rates after neoadjuvant chemotherapy alone or followed by preoperative radiotherapy. PATIENTS AND METHODS: 194 women with 198 biopsy-proven breast tumors were evaluated in this retrospective study. Of the 198 cases evaluated, 64 received neoadjuvant chemotherapy followed by surgery and adjuvant irradiation (CT group). In 134 cases, sequential preoperative chemo-/radiotherapy (CT-RT group) was given. In both groups, endocrine treatment was initiated in case of positive hormone receptor status after chemotherapy. The whole breast was homogeneously irradiated using 2-Gy fractions up to a total dose of 50 Gy, followed by a boost of 6-11 Gy to the tumor. RESULTS: A histologically proven complete remission (pCR) was achieved in 3% (2/64) in the CT and in 42% (56/134) in the CTRT group. The logistic regression analysis, including clinical tumor category (cT), lymph node (cN) and metastasis status (cM), grading (G), hormone receptor status (HRS), number of preoperative chemotherapy cycles, preoperative tumor volume, and preoperative radiotherapy, revealed that HRS (p = 0.0232) and radiotherapy (p < 0.0001) were significant factors for achieving pCR. CONCLUSION: Combination of neoadjuvant chemo-/radiotherapy results in significantly higher rates of complete remission than neoadjuvant chemotherapy alone. The significance for tumor-free and overall survival has to be evaluated.

Adult↗

PubMed2002

Radiotherapy in age-related macula degeneration.

PURPOSE: To ascertain the benefit from radiotherapy in age-related macula degeneration in a single-arm longitudinal study. METHODS AND MATERIALS: From 1997 to 1998, 39 patients with occult and 33 patients with classic choroidal neovascularization (CNV) were irradiated with 16 Gy. Fluorescein angiography and measurements of visual acuity were performed before and 3, 6, and 12 months after irradiation. RESULTS: Complete follow-up data for 1 year were available from 69 patients. The mean patient age was 72 years (range 49-92). Vision decreased in 43, was stable in 18, and improved in 8 cases. The mean vision deteriorated significantly (p = 0.02, Wilcoxon test), particularly within the first 3 months. Patients with occult CNV did significantly better than did those with classic CNV (p = 0.03). The proportion of patients retaining vision > or = 0.2 fell from 65% to 42% (p <0.01), for classic and occult CNV from 50% to 23%, and for occult CNV from 77% to 56% (p < 0.02), respectively. CNV size increased in 30 patients and was stable in 38. Neither age (p = 0.17) nor gender (p = 0.21, chi-square test) influenced prognosis. Four patients reported transitional complaints. CONCLUSION: Low-dose fractionated radiotherapy with 16 Gy is well tolerated. However, vision and reading ability were not preserved in most patients.

Aged↗