Franz-Josef Prott

Publications of Franz-Josef Prott

• [Radiotherapy in painful gonarthrosis. Results of a national patterns-of-care study].

  Authors: Ralph Mücke, M Heinrich Seegenschmiedt, Reinhard Heyd, Ulrich Schäfer, Franz-Josef Prott, Michael Glatzel, Oliver Micke

  Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]. 01/2010; 186(1):7-17.

  After a patterns-of-care study (PCS) in 2003/2004 addressing benign disorders in general, the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD) conducted several multicenterAfter a patterns-of-care study (PCS) in 2003/2004 addressing benign disorders in general, the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD) conducted several multicenter cohort studies including the use of radiotherapy (RT) in painful gonarthrosis (GNA). From 2006 to 2008, a PCS for GNA was conducted in all German RT institutions using a standardized structured questionnaire. Patient accrual, patient number, pretreatment, pain record, treatment indications, RT technique, and target volume concepts for painful GNA were assessed. In addition, the long-term functional and subjective outcomes were evaluated. 238/248 institutions (95.9%) returned the questionnaire: 50 (21%) reported no clinical experience with RT in GNA, while 188 (79%) institutions treated 4,544 patients annually (median 15; range one to 846 cases per institution). Indications for treatment were acute pain symptoms in 18.9%, chronic pain in 95.3%, and treatment-refractory pain in 81.1%. The median total dose was 6 Gy (range 3-12 Gy), with a median single dose of 1 Gy (0.25-3 Gy). 40.4% of the institutions applied two fractions and 51.4% three fractions weekly. RT was delivered with orthovoltage units (25%), linear accelerators (79.6%), and cobalt-60 units (8.3%). 42 institutions evaluated the long-term clinical outcome in a total of 5,069 cases. Median pain reduction for at least 3 months was reported in 60% (5-100%), median pain reduction for at least 12 months in 40% (10-100%), and median persistent pain reduction in 27.8% (10-85%) of the treated patients. In 30% of patients (7-100%), a second RT series was applied for inadequate pain response or early pain recurrence. No radiogenic acute or chronic side effects were observed. This PCS comprises the largest number of cases reported for RT in painful and refractory GNA. Despite variations in daily RT practice, high response and low toxicity for this treatment in a very large number of painful and refractory GNA cases renders low-dose RT an effective conservative therapy which can be applied prior to surgical procedures.

• A randomized trial comparing hypofractionated and conventionally fractionated three-dimensional external-beam radiotherapy for localized prostate adenocarcinoma : a report on acute toxicity.

  Authors: Darius Norkus, Albert Miller, Juozas Kurtinaitis, Uwe Haverkamp, Sergey Popov, Franz-Josef Prott, Konstantinas Povilas Valuckas

  Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]. 11/2009; 185(11):715-21.

  PURPOSE: To compare acute gastrointestinal (GI) and genitourinary (GU) toxicity between patient groups with localized prostate adenocarcinoma, treated with conventionally fractionated (CFRT) andPURPOSE: To compare acute gastrointestinal (GI) and genitourinary (GU) toxicity between patient groups with localized prostate adenocarcinoma, treated with conventionally fractionated (CFRT) and hypofractionated (HFRT) three-dimensional conformal external-beam radiotherapy (3D-CRT). PATIENTS AND METHODS: 91 patients were enrolled into a randomized study with a minimum follow-up of 3 months. 44 men in the CFRT arm were irradiated with 74 Gy in 37 fractions at 2 Gy per fraction for 7.5 weeks. 47 men in the HFRT arm were treated with 57 Gy in 17 fractions for 3.5 weeks, given as 13 fractions of 3 Gy plus four fractions of 4.5 Gy. The clinical target volume (CTV) included the prostate and the base of seminal vesicles. The CTV-to-PTV (planning target volume) margin was 8-10 mm. Study patients had portal imaging and/or simulation performed on the first fractions and repeated at least weekly. RESULTS: No acute grade 3 or 4 toxicities were observed. The grade 2 GU acute toxicity proportion was significantly lower in the HFRT arm: 19.1% versus 47.7% (chi(2)-test, p = 0.003). The grade 2 GU acute toxicity-free survival was significantly better in the HFRT arm (log-rank test, p = 0.008). The median duration of overall GI acute toxicity was shorter with HFRT: 3 compared to 6 weeks with CFRT (median test, p = 0.017). CONCLUSION: In this first evaluation, the HFRT schedule is feasible and induces acceptable or even lower acute toxicity compared with the toxicities in the CFRT schedule. Extended follow-up is needed to justify this fractionation schedule's safety in the long term.

• Whole blood selenium levels (WBSL) in patients with prostate cancer (PC), benign prostatic hyperplasia (BPH) and healthy male inhabitants (HMI) and prostatic tissue selenium levels (PTSL) in patients with PC and BPH.

  Authors: Ralph Muecke, Theodor Klotz, Josef Giedl, Jens Buentzel, Guenther Kundt, Klaus Kisters, Franz-Josef Prott, Oliver Micke

  Acta oncologica (Stockholm, Sweden). 10/2008;

  Background. The aim of this exploratory study was to evaluate whether significant differences exist between whole blood selenium levels (WBSL) in patients with prostate cancer (PC), benign prostaticBackground. The aim of this exploratory study was to evaluate whether significant differences exist between whole blood selenium levels (WBSL) in patients with prostate cancer (PC), benign prostatic hyperplasia (BPH), healthy male inhabitants (HMI) in northern Bavaria and the normal value. Furthermore, we investigated whether differences exist between prostatic tissue selenium levels (PTSL) in patients with PC, BPH and the benign tissue surrounding the PC. Material and methods. We prospectively evaluated WBSL in 24 patients with PC, 21 patients with BPH, and 21 HMI. Measurements of PTSL were performed in 17 patients with PC and 22 patients with BPH. In 9 cases with PC, measurements were also done in the benign tissue surrounding the carcinoma. Measurements were performed using automated graphite furnace atomic absorption spectrophotometry. Results. In patients with PC, there is a significantly lower WBSL in comparison to HMI (p=0.04). There is no significant difference in WBSL between BPH-patients and HMI (p=0.13) and between PC- and BPH-patients (p=0.67). In all patients and the HMI, there is a significantly lower WBSL in comparison to the recommended normal value of 85 - 162 microg/l (p<0.01). There is no significant difference in PTSL between PC and BPH (p=0.49), and between PC and the tissue compartment surrounding the PC (p=0.56). PTSL seemed to be reduced in the compartment surrounding the PC in comparison to BPH (p=0.03). In PC-patients, there is no significant correlation between WBSL and prostate specific antigen (PSA) (rho=-0.20; p=0.36), Gleason score (rho=0.32, p=0.13), and T-stage (rho=0.22; p=0.23). Conclusion. Since the WBSL measured in all men with PC and BPH, and in HMI participating in our study were significantly lower than the recommended normal range, our findings may support the recommendation of selenium supplementation.

• Demographic, clinical and treatment related predictors for event-free probability following low-dose radiotherapy for painful heel spurs - a retrospective multicenter study of 502 patients.

  Authors: Ralph Muecke, Oliver Micke, Berthold Reichl, Rainer Heyder, Franz-Josef Prott, M Heinrich Seegenschmiedt, Michael Glatzel, Oliver Schneider, Ulrich Schäfer, Guenther Kundt

  Acta oncologica (Stockholm, Sweden). 01/2007; 46(2):239-46.

  A total of 502 patients treated between 1990 and 2002 with low-dose radiotherapy (RT) for painful heel spurs were analysed for prognostic factors for long-term treatment success. The median follow-upA total of 502 patients treated between 1990 and 2002 with low-dose radiotherapy (RT) for painful heel spurs were analysed for prognostic factors for long-term treatment success. The median follow-up was 26 months, ranging from 1 to 103 months. Events were defined as (1) slightly improved or unchanged pain after therapy, or (2) recurrent pain sensations during the follow-up period. Overall 8-year event-free probability was 60.9%. Event-free probabilities of patients with one/two series (414/88) were 69.7%/32.2% (p<0.001); >58/ < or = 58 years (236/266), 81.3%/47.9% (p=0.001); high voltage/orthovoltage (341/161), 67.9%/60.6% (p=0.019); pain anamnesis < or = 6 months/ >6 months (308/194), 76.3%/43.9% (p=0.001); single dose 0.5/1.0 Gy (100/401), 86.2%/55.1% (p=0.009); without/with prior treatment (121/381), 83.1%/54.9% (p=0.023); men/women (165/337), 61.2%/61.5% (p=0.059). The multivariate Cox regression analysis with inclusion of the number of treatment series, age, photon energy, pain history, single-dose and prior treatments revealed patients with only one treatment series (p<0.001), an age >58 years (p=0.011) and therapy with high voltage photons (p=0.050) to be significant prognostic factors for pain relief. Overall low-dose RT is a very effective treatment in painful heel spurs.

• Long-term alterations of oral mucosa in radiotherapy patients.

  Authors: Franz-Josef Prott, Jörg Handschel, Oliver Micke, Cord Sunderkötter, Ulrich Meyer, Josef Piffko

  International journal of radiation oncology, biology, physics. 10/2002; 54(1):203-10.

  PURPOSE: The aim of this investigation was to describe the alterations in oral mucosa after radiotherapy. METHODS AND MATERIALS: Biopsies were taken from patients before irradiation, at 60 Gy, andPURPOSE: The aim of this investigation was to describe the alterations in oral mucosa after radiotherapy. METHODS AND MATERIALS: Biopsies were taken from patients before irradiation, at 60 Gy, and 6-12 months after radiotherapy. Histomorphological evaluation of the vessels was performed, and endothelial expression of ICAM-1, VCAM-1, and E-selectin was also evaluated, as well as distribution of LFA-1-, Mac-1-, VLA-4-, RM3/1-, 27E10-, and 25F9-bearing cells in the subepithelial tissue. RESULTS: The expression of ICAM-1 was downregulated after radiotherapy, whereas the percentage of LFA-1- and VLA-4-bearing cells increased. VCAM-1 remained at low levels. The subepithelial infiltration was still dominated by RM3/1-positive macrophages. The number of vessels decreased, while the lumina of the remaining vessels in the deeper connective layer increased. CONCLUSIONS: The late effects of radiotherapy are characterized by a decreased number of blood vessels and by significantly different expression patterns of the adhesion molecules studied, and of integrins and macrophage subpopulations compared to the conditions before irradiation and at 60 Gy.

• Up-front centralized data review and individualized treatment proposals in a multicenter pediatric Hodgkin's disease trial with 71 participating hospitals: the experience of the German-Austrian pediatric multicenter trial DAL-HD-90.

  Authors: Karin Dieckmann, Richard Pötter, Wolfgang Wagner, Franz Josef Prott, Isabel Hörnig-Franz, Bettina Rath, Günther Schellong

  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 02/2002; 62(2):191-200.

  BACKGROUND AND PURPOSE: A systematic procedure for up-front centralized data review and the set-up of individualized treatment proposals was integrated prospectively into the German-AustrianBACKGROUND AND PURPOSE: A systematic procedure for up-front centralized data review and the set-up of individualized treatment proposals was integrated prospectively into the German-Austrian multicenter trial DAL-HD-90 for pediatric Hodgkin's disease (HD) in order to introduce local radiotherapy according to the individual patient's spread of disease within a combined-modality treatment. This paper investigates the feasibility of such a procedure and its impact on the final definition of the extent and stage of disease as well as on the choice of treatment. PATIENTS AND METHODS: Between October 1990 and July 1995, 578 children and adolescents <18 years (259 girls, 319 boys, median age 12.9 years) with HD were enrolled into the HD-90 trial. After clinical and pathological staging (66.4/33.6%), patients were allocated to treatment groups (TG) 1 'early stage', TG2 'intermediate stage', or TG3 'advanced stage'. All groups underwent two cycles of OPPA (vincristine, prednisone, procarbazine, doxorubicin) (girls) or OEPA (E, etoposide) (boys) for induction chemotherapy. TG2 and TG3 continued on as two or four cycles, respectively, of COPP (C, cyclophosphamide). Low-dose local radiotherapy was given to the initially involved sites, with radiation doses of 25 Gy in TG1/TG2, and 20 Gy in TG3. All documentation forms, radiographs, and chest and abdominal computed tomography (CT) scans were centrally reviewed, addressing in particular the individual patient's extent and stage of disease. This review and the set-up of individualized treatment proposals were in the hands of the study coordinator, one additional pediatrician and two radiation oncologists and radiologists at the study center. During a time slot of at least 8 weeks (two cycles of standard chemotherapy in all three TGs) the individualized treatment proposals were to be sent to the participating hospital. RESULTS: Complete sets of documentation from 564/578 patients (97.6%) were submitted sufficiently early to the study center. A total of 285 out of 574 chest radiographs, 468 out of 553 chest CT scans and 421 out of 548 abdominal CT scans were available from 71 hospitals. A total of 564 individualized treatment proposals were worked out by the review group and sent to the hospitals before radiotherapy began. Re-analysis of images and documentation forms, including laboratory and clinical data, resulted in a revision of stage in 115/571 patients (20.1%) and of TG in 76/571 patients (13.3%). A total of 67/76 patients were shifted into a higher TG, 60 patients on account of additionally detected extralymphatic involvement, five patients because of additionally detected lymph node involvement and two patients due to clinical data which had to be classified as B-symptoms. A total of 9/76 patients were shifted into a lower TG; in three patients extranodal disease and in six patents local lymph node involvement could not be confirmed. CONCLUSIONS: The up-front centralized review of patient data and consecutive set-up and delivery of individualized treatment proposals for almost every patient are feasible within a large multicenter trial. Sufficient time and manpower at the study center are needed for the review process and the set-up of individualized treatment proposals. Such a procedure has a significant impact on the homogeneity of stage definition, allocation to TG, and individualized treatment proposals.

• The impact of squamous cell carcinoma (SCC) antigen in patients with advanced cancer of uterine cervix treated with (chemo-)radiotherapy.

  Authors: Oliver Micke, Frank Bruns, Ulrich Schäfer, Franz-Josef Prott, Normann Willich

  Anticancer research. 25(3A):1663-6.

  The impact of squamous cell carcinoma antigen (SCC) in the follow-up of patients with advanced cervical cancer treated with (chemo-) radiotherapy in primary and postoperative settings was evaluated.The impact of squamous cell carcinoma antigen (SCC) in the follow-up of patients with advanced cervical cancer treated with (chemo-) radiotherapy in primary and postoperative settings was evaluated. One hundred and forty-one patients with histologically proven squamous cell carcinoma of the uterine cervix were treated at the department of radiotherapy and radiation oncology. The serum level of SCC before treatment was elevated in 72% of the patients (cut-off level: 2.0 ng/ml). The course of SCC levels during (chemo-)radiotherapy reflects the tumor response: those patients, who had no significant decline of tumor marker values, had a lower response rate and worse outcome (p<0.001). Patients with a SCC level below the median of 7.2 U/ml had a significantly better prognosis and a better treatment response than those above the median (p=0.001). After treatment, 98% of patients with complete remission and 87% of patients with partial remission had a serum level below the cut-off In the case of recurrent disease, 82% of patients had a significant increase of SCC serum levels (p <0.001) before clinical manifestation of relapse. The lead- time ranged between one and 16 months (median: 4.5 months). We concluded that SCC is an essential tumor marker for monitoring treatment response and detecting recurrences in patients with squamous cell carcinoma of the uterine cervix undergoing (chemo-) radiotherapy. In this retrospective analysis, the value of SCC correlated with prognosis in patients with carcinoma of the cervix treated with (chemo-)radiotherapy.