Roland Guttenberger

University of Freiburg, Freiburg, Baden-Württemberg, Germany

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Publications (39)99.22 Total impact

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    ABSTRACT: Catheter-based coronary brachytherapy with beta- and gamma-radiation is an evidence-based method to prevent restenosis after percutaneous transluminal coronary angioplasty (PTCA) and stent implantation, but the outcome may be subject to improvements. Physiological studies suggest that most of the target cells of brachytherapy in coronary arteries after PTCA are hypoxic. A lack of oxygen decreases the effect of low LET (linear energy transfer) irradiation. The authors assumed that reoxygenation of hypoxic human coronary smooth muscle cells (HCSMCs) improves the results of coronary brachytherapy. The expression of hypoxia-inducible factor 1alpha (HIF-1alpha) gene, and the rates of growth and apoptosis of hypoxic and reoxygenated HCSMCs after gamma-irradiation were therefore analyzed. An in vitro model of megacolonies of HCSMCs was developed. After exposure to chronic hypoxia the HCSMCs were irradiated with graded doses of 2, 4, 8, and 16 Gy using a (60)Co source either under hypoxia (pO(2) < 3 mmHg) or after reoxygenation (pO(2) approximately 150 mmHg). RT-PCR (reverse transcription-polymerase chain reaction) analysis was used to quantify HIF-1alpha gene expression and the growth of HCSMC megacolonies was measured serially. The oxygen enhancement ratio (OER) was calculated from the specific growth delay. Apoptosis of HCSMCs was quantified by counting cells with specific DNA strand breaks using the TUNEL assay. HIF-1alpha gene expression was markedly suppressed in reoxygenated cells versus hypoxic cells 30 min after gamma-irradiation at all radiation doses (158 +/- 46% vs. 1,675 +/- 1,211%; p < 0.01). Apoptosis was markedly increased in reoxygenated HCSMCs. The OER was 1.8 (95% CI [confidence interval] 1.3-2.4). Therefore, reoxygenated HCSMCs require 44% less radiation dose to achieve the equivalent biological radiation effect compared to hypoxic HCSMCs. Reoxygenation of coronary smooth muscle cells should be considered an option to increase efficacy of coronary brachytherapy. This could be used to reduce radiation dose and associated late side effects.
    Strahlentherapie und Onkologie 01/2006; 182(1):16-21. · 4.16 Impact Factor
  • Strahlentherapie Und Onkologie - STRAHLENTHER ONKOL. 01/2006; 182(1):16-21.
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    ABSTRACT: Xerostomia is an important chronic side effect of radiotherapy in the head and neck area. The authors investigated the efficacy of different artificial saliva compounds in patients with postirradiation xerostomia. In 120 patients with xerostomia after radiotherapy for head and neck cancer, four different saliva substitute compounds (gel, carmellose spray, oil, mucin spray) were tested in a prospective crossover design. Xerostomia at baseline and under treatment with each compound was measured with a questionnaire approved in a pilot trial. All compounds significantly improved xerostomia when compared to baseline situation (p < 0.0001). The gel was rated best, the carmellose spray was rated worst by the patients, but the single compounds did not differ significantly in their effects. In spite of this result, most patients chose the carmellose spray as their favorite compound. This is due to its good taste and easy handling, which play an important role for the acceptance of the products. Big individual differences in the preference of the single compounds were found. For most patients considerable relief from xerostomia can be reached by saliva substitutes. Thus, every patient with xerostomia should be given different artificial saliva compounds for a test period. This will help to find the individually best way to cope with the dry mouth.
    Strahlentherapie und Onkologie 04/2005; 181(4):231-6. · 4.16 Impact Factor
  • Strahlentherapie Und Onkologie - STRAHLENTHER ONKOL. 01/2005; 181(4):231-236.
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    ABSTRACT: Hypoxic human coronary smooth muscle cells (HCSMCs) are possible targets for brachytherapy to prevent restenosis after percutaneous transluminal coronary angiography. It is unclear whether growth kinetics and gene expression of these cells undergoing gamma-irradiation are changed by reoxygenation. Hypoxic (H) and hypoxia-reoxygenated (H-R) HCSMCs were irradiated with gamma-radiation at single doses of 4, 8, and 16 Gy using a 60Co-source. Vascular endothelial growth factor gene expression of HCSMCs was dramatically suppressed in H-R versus H cells independent of the radiation dose (15+/-7% versus 2183+/-2023%, P<0.01, H-R versus H cells). An oxygen enhancement ratio of 1.8 was calculated after irradiation from the retarded growth of H-R versus hypoxic HCSMCs. Production of reactive oxygen species by HCSMCs after irradiation increased by 15+/-2% in H-R cells versus 7+/-1% in H cells (P<0.05). Reoxygenation of hypoxic HCSMCs markedly amplifies growth-retarding effects of ionizing irradiation. On the basis of these findings, oxygenating radiosensitizers should be analyzed with regard to suitability for coronary brachytherapy to prevent restenosis.
    Circulation 03/2004; 109(8):1036-40. · 15.20 Impact Factor
  • Felix Momm, Gerhild Becker, Susanne Bartelt, Roland Guttenberger
    Journal of Pain and Symptom Management 02/2004; 27(1):3-4. · 2.60 Impact Factor
  • Johannes Lutterbach, Willi Sauerbrei, Roland Guttenberger
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    ABSTRACT: To identify prognostic factors for overall survival in patients with newly diagnosed glioblastoma undergoing radiation therapy. From January 1980 to June 2000, we treated 432 consecutive patients with glioblastoma at out institution. 17 patients were excluded from the analysis for various reasons. Mean age of the 415 patients who were included in the study was 59 years (19-81 years), Karnofsky performance status (KPS) was > or = 70 in 280 patients. 343 patients underwent resection, 72 had a biopsy. Various fractionation schemes were used (conventional fractionation, n = 112; hypofractionation, n = 94; accelerated hyperfractionation, n = 209). Survival probabilities were estimated using the method of Kaplan and Meier. Multivariate analysis was done with a Cox regression model. By July 2001, 406 patients had died. Medial overall survival was 8.2 months. Of ten factors considered in a proportional hazards model stratified for treatment (fractionation scheme and type of surgery), significant variables in a multivariate model were age (50-64 years vs < 50 years [RR 1.35; 95% CI 1.02-1.78], > or = 65 years vs < 50 years [RR 2.08; 95% CI 1.54-2.81]), performance status (KPS < 70 vs > or = 70 [RR 1.53; 95% CI 1.23-1.90]), and central tumor location (yes vs no [RR 1.39; 95% CI 1.04-1.87]). Blood hemoglobin (Hb) values were available in 318 patients and serum lactate dehydrogenase (LDH) levels in 234 patients. 89 patients were anemic (Hb men < 13 g/dl, women < 12 g/dl), in 80 patients the LDH level was raised beyond the upper limit of the normal range (> 240 U/l). By including the three significant variables, both parameters had an additional significant effect with an estimated relative risk of about 1.4 in their corresponding subgroups. Besides established prognostic factors, anemia and raised serum LDH levels may negatively influence outcome in glioblastoma patients. Our results from data-dependent modeling have to be confirmed by independent studies.
    Strahlentherapie und Onkologie 01/2003; 179(1):8-15. · 4.16 Impact Factor
  • Roland Guttenberger, Gerlo Witucki
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    ABSTRACT: Physician workload directly influences the ability of an institution to provide high standards in radiotherapy services. Data of 189 radiotherapy units of the DEGRO survey 2000 complemented and corrected (Table 1) are analyzed with simple and multiple linear regression (models in Table 2). In 21 private radiotherapy facilities actual numbers of physicians split up in 0.19 for every 1,000 megavoltage courses per year, 1.8 per megavoltage unit, 0.68 for every ten beds for inpatients minus 0.67 or plus 1.2 physicians per facility providing radiotherapy only or combined with other services, respectively. Radiotherapy units in hospitals were analyzed in two groups, i. e. radiotherapy only (n = 69) or in combination with other services (n = 59). In the latter, reported numbers of physicians split up in 3.2 for every 1,000 megavoltage courses per year, minus 0.13 per megavoltage unit, 0.87 for every ten beds for inpatients, plus 2.2 per facility. Units providing radiotherapy only had 0.86 physicians for every 1,000 megavoltage courses per year plus 1.0 per megavoltage unit plus 0.97 for every ten beds plus 1.0 per facility. In 36 radiotherapy university clinics actual numbers of physicians split up in 2.4 for every 1,000 megavoltage courses per year, 1.7 per megavoltage unit, 0.86 for every ten beds for inpatients, plus 1.5 per clinic. For confidence limits see Table 3, for results of univariate analysis Figure 1 and 2. In German radiotherapy facilities, physician workload varies considerably. It exceeds that reported for the USA by a substantial margin.
    Strahlentherapie und Onkologie 01/2003; 178(12):688-700. · 4.16 Impact Factor
  • Felix Momm, Roland Guttenberger
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    ABSTRACT: The goals of this work were to investigate the effect of a mucin-containing spray on chronic xerostomia after radiotherapy in the head and neck region and to lean about the influence of age on the results of this treatment. A total of 73 patients with xerostomia following radiotherapy for various malignant disease in the head and neck region tested a bottle of the mucin spray (SALIVA-medac) and filled ina questionnaire about xerostomia. In all, 59 questionnaires were completed and returned. All patients had had some form of prior treatment for xerostomia, which was applied an average (mean) of 16 times per day (median 15 times per day). The mucin spray had to be used less frequently, i.e. 11 times daily (median 5 times per day) (P<0.001, Wilcoxon rank test). Also, the patients reported sleeping significantly better when using the mucin spray [2.9 against 3.9 (P<0.00 I by Wilcoxon rank test) in the German school marking system, where 1=very good and 6=poor]. As far as the frequency of saliva substitute use is concerned, on average older patients had a benefit from using the spray. However, older patients had a clear benefit seen in the individual improvement in the reported quality of sleep when using the mucin spray. The slope of improvement in sleep quality (school-type points) over age (years) was 0.3 points/10 years. In this explorative study the mucin spray was found to be useful against xerostomia in irradiated patients. Older patients seem to derive especial benefit from its use.
    Supportive Care Cancer 09/2002; 10(6):505-8. · 2.65 Impact Factor
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    ABSTRACT: The objectives of the present study were (a) to validate the prognostic classification derived from recursive partitioning analysis (RPA) of the Radiation Therapy Oncology Group (RTOG); (b) to identify prognostic factors in class 3; (c) to examine the impact of treatment related variables on the prognosis in class 3. Nine hundred and sixteen patients with brain metastases had resection and whole brain radiotherapy (WBRT, n = 257) or WBRT alone (n = 659) at our institution from 1985 to 2000. Patients were grouped into RPA classes 1, 2, and 3 (n = 67, 441, and 408, respectively). Median survival of the whole group was 3.4 months. Median survival in classes 1, 2, and 3 was 8.2, 4.9, and 1.8 months, respectively. In class 3, age (<65 years vs. > or =65 years, relative risk (RR) 0.75), status of the primary tumor (controlled vs. uncontrolled, RR 0.86), and the number of brain metastases (single vs. multiple, RR 0.76) were independent prognostic variables. We defined three prognostic subgroups: class 3a (n = 51): age <65 years, controlled primary tumor, single brain metastasis; class 3c (n = 44): age > or =65 years, uncontrolled primary tumor, multiple brain metastases; class 3b (n = 313): all other patients. Median survival in classes 3a, 3b, and 3c was 3.2, 1.9, and 1.2 months, respectively (P < 0.0001). Intra-class comparisons showed that resection followed by WBRT yielded significantly better survival compared with WBRT alone. Our results validate the RTOG RPA classification for patients with brain metastases. The variables age, status of the primary, and number of brain metastases allow the division of class 3 into prognostic subgroups. Even class 3 patients may benefit from more aggressive treatment strategies.
    Radiotherapy and Oncology 06/2002; 63(3):339-45. · 4.52 Impact Factor
  • Roland Guttenberger, Gerlo Witucki
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    ABSTRACT: Hintergrund: Die aktuelle Ausstattung der strahlentherapeutischen Einrichtungen mit rztlichem Personal wird hinsichtlich verschiedener Einflussgren analysiert. Material und Methoden: Die Daten aus dem DEGRO-Verzeichnis der Abteilungen und Praxen fr Strahlentherapie in Deutschland (Stand: 2000) werden auf Plausibilitt getestet, ergnzt und korrigiert. Die Daten von 189 Einrichtungen werden mit einfacher und multipler linearer Regression analysiert. Ergebnisse: In den 21 auswertbaren Praxen werden fr 1000 Megavolt-Serien pro Jahr 0,19 plus 1,8 rzte pro Megavolt-Gert vorgehalten. Dazu kommen 0,68 rzte pro zehn betreute Betten plus 1,2 rzte pro Praxis bzw. minus 0,67 rzte bei rein strahlentherapeutischen Praxen. Die 128 Abteilungen ffentlicher oder privater Trger werden getrennt in rein strahlentherapeutische (n = 69) und radiologische (mit Diagnostik und/oder Nuklearmedizin) Abteilungen analysiert. Auf 1000 Megavolt-Serien pro Jahr kommen bei Letzteren 3,2 rzte minus 0,13 rzte pro Megavolt-Gert. Zustzlich gibt es 0,87 rzte pro zehn betreute Betten plus 2,2 rzte pro Klinik. Rein strahlentherapeutisch ausgerichtete Abteilungen haben 0,86 rzte pro 1000 Megavolt-Serien plus 1,0 rzte pro Megavolt-Gert und zustzlich 0,97 rzte pro zehn betreute Betten plus 1,0 rzte pro Klinik. An den 36 strahlentherapeutischen Universittskliniken stehen pro 1000 Megavolt-Serien im Jahr 2,4 rzte zur Verfgung. Dazu kommen zustzlich 0,86 rzte pro zehn Betten und weitere 1,7 rzte fr jedes Megavolt-Gert plus 1,5 rzte pro Universittsklinik. Schlussfolgerung: Die personelle Ausstattung mit rzten an strahlentherapeutischen Einrichtungen in Deutschland unterliegt einer erheblichen Variabilitt, die durch die erfassten Leistungen nur zum Teil erklrt ist. Verglichen mit den Strahlentherapeuten in den USA besteht eine deutlich hhere Arbeitsbelastung. Background: Physician workload directly influences the ability of an institution to provide high standards in radiotherapy services. Material and Methods: Data of 189 radiotherapy units of the DEGRO survey 2000 complemented and corrected (Table 1) are analyzed with simple and multiple linear regression (models in Table 2). Results: In 21 private radiotherapy facilities actual numbers of physicians split up in 0.19 for every 1,000 megavoltage courses per year, 1.8 per megavoltage unit, 0.68 for every ten beds for inpatients minus 0.67 or plus 1.2 physicians per facility providing radiotherapy only or combined with other services, respectively. Radiotherapy units in hospitals were analyzed in two groups, i. e. radiotherapy only (n = 69) or in combination with other services (n = 59). In the latter, reported numbers of physicians split up in 3.2 for every 1,000 megavoltage courses per year, minus 0.13 per megavoltae unit, 0.87 for every ten beds for inpatients, plus 2.2 per facility. Units providing radiotherapy only had 0.86 physicians for every 1,000 megavoltage courses per year plus 1.0 per megavoltage unit plus 0.97 for every ten beds plus 1.0 per facility. In 36 rdiotherapy university clinics actual numbers of physicians split up in 2.4 for every 1,000 megavoltage courses per year, 1.7 per megavoltage unit, 0.86 for every ten beds for inpatients, plus 1.5 per clinic. For confidence limits see Table 3, for results of univariate analysis Figure 1 and 2. Conclusion: In German radiotherapy facilities, physician workload varies considerably. It exceeds that reported for the USA by a substantial margin.
    Strahlentherapie und Onkologie 01/2002; 178(12):688-700. · 4.16 Impact Factor
  • J Lutterbach, R Guttenberger, A Pagenstecher
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    ABSTRACT: Gliosarcomas are rare biphasic neoplasms of the central nervous system composed of a glioblastoma multiforme (GBM) admixed with a sarcomatous component. There are conflicting reports regarding their clinical aggressiveness. Four hundred and twenty-two consecutive patients with GBM were treated at our hospital between 1980 and 1999, among them 12 gliosarcomas. The goal of this study was to examine clinical features, treatment, survival and patterns of failure of gliosarcoma patients and to compare them with the entire group of GBM patients. This comparison was refined by a matched pair analysis with a group of 12 GBM patients selected for age, Karnofsky performance status, resection status, fractionation scheme and total dose (control GBM group). Seven gliosarcoma patients were male, five female, with a median age of 56 years (range 37-76 years). The median tumor size was 4.5 cm (range 3-8 cm). The locations, all supratentorial, included temporal in six, parietal in five, frontal in four and occipital in one patient. All patients underwent tumor resection followed by postoperative radiation therapy. Median survival was 11.5 months for the gliosarcoma group, 8.1 months for the entire GBM group (log rank test, P=0.16) and 11.0 months for the control GBM group (log rank test, P=0.36). All gliosarcoma patients had local tumor recurrences and died due to neurologic causes within 19.3 months after radiation therapy. With regard to clinical features, survival and patterns of failure, gliosarcomas and GBM cannot be distinguished clinically. Therefore, the same principles should be applied for the treatment of these tumors.
    Radiotherapy and Oncology 11/2001; 61(1):57-64. · 4.52 Impact Factor
  • F Momm, M Müller, A Tsekos, R Guttenberger
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    ABSTRACT: After radiotherapy (XRT) for head and neck tumors, xerostomia is observed as a chronic side effect. We investigated whether the topical use of a mucin-containing spray can help patients to cope with this problem. A total of 73 patients with xerostomia post XRT received a bottle of the mucin spray (Saliva medac) and a questionnaire, 59 of which were completed and returned. All patients had received some form of prior treatment, which had been applied 16 times/day on average (median: 15 times/day). The mucin spray had to be used less frequently, i.e., 11 times/day (median: 5 times/day), (p < 0.001, Wilcoxon's rank test). Additionally, they reported being able to sleep significantly better when using the mucin spray (2.9 vs 3.9 in the German school grading system: 1 = very good, 6 = poor; p < 0.001, Wilcoxon's rank test). The spray was well accepted by the patients. The spray was useful against xerostomia in irradiated patients.
    HNO 10/2001; 49(10):831-6. · 0.42 Impact Factor
  • F Pajonk, S Schlessmann, R Guttenberger, M Henke
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    ABSTRACT: In this study amplification of cytokeratin-19 mRNA by Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect circulating tumor cells in the peripheral blood of patients with cancer of the head and neck before, during and after radiation therapy. Detection of cytokeratin-19-positive cells coincided with local failure, distant metastasis and anemia.
    Radiotherapy and Oncology 06/2001; 59(2):213-7. · 4.52 Impact Factor
  • F. Momm, M. Müller, A. Tsekos, R. Guttenberger
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    ABSTRACT: Zusammenfassung Hintergrund und Fragestellung. Nach Strahlentherapie im Kopf-Hals-Bereich tritt als chronische Nebenwirkung in vielen Fällen eine Xerostomie auf. Wir untersuchten die topische Anwendung eines mucinhaltigen Sprays. Das Ausmaß der erreichten Linderung wurde quantifiziert. Patienten und Methoden. An insgesamt 73 Patienten, die in unserer Nachsorgeambulanz über Mundtrockenheit berichteten, wurde jeweils eine Sprayflasche SALIVA medac zusammen mit einem Fragebogen ausgehändigt. Die folgenden Ergebnisse basieren auf 59 auswertbaren Fragebögen. Ergebnisse. Alle Patienten hatten eine Vormedikation [Kaugummi, Bonbons, große Trinkmenge, Speichelersatzspray ohne Mucin (n=13)]. Das mucinhaltige Spray musste mit signifikant geringerer Frequenz angewendet werden als die Vormedikation [durchschnittlich 11-mal/Tag (Median: 5-mal/Tag) gegen 16-mal/Tag (Median: 15-mal/Tag); p
    HNO 01/2001; 49(10):831-836. · 0.42 Impact Factor
  • J. Lutterbach, R. Guttenberger
    European Journal of Cancer - EUR J CANCER. 01/2001; 37.
  • J Lutterbach, R Guttenberger
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    ABSTRACT: A strong association between hemoglobin levels and tumor control exists in head and neck cancer treated with radiotherapy. This retrospective study has been performed to determine whether or not this association can also be found in the surgical setting. Between January 1970 and December 1990, 258 patients with glottic SCC received conventional surgery only (T1/T2/T3/T4 n = 188/31/37/2, respectively). Locoregional control was calculated by the Kaplan-Meier method. The influence of hemoglobin, T stage, age, gender, performance/nutritional status, and grading was evaluated using a Cox model. Five-year locoregional control for T1a/T1b/T2/T3/T4 tumors was 91%/85%/76%/62%/0%, respectively (log-rank test, p < 0.0001). Anemia (male < 13, female < 12 g/dL hemoglobin) was present in 27 patients. It was associated with significantly worse 5-year locoregional control, i.e., 60% vs. 85% (log-rank test, p = 0.003). In multivariate analysis stratified for T stage, two variables were of influence: positive margins (relative risk [RR], 3.8; 95% confidence interval [CI], 1.7-8.4), anemia (RR, 3.0; 95% CI, 1.4-6.2). The largest subgroup consisted of 162 patients characterized by male gender, T1, and complete resection. In this subgroup, the significant variables were T stage (T1b vs. T1a; RR, 3.5; 95% CI, 0.96-12.4) and hemoglobin with a RR of 1.4 (95% CI, 1.0-2.1) per g/dL less analyzed as a continuous variable. Anemia is associated with a high risk of treatment failure in surgically treated glottic cancer. Hemoglobin levels might be predictive even within the normal range as indicated by subgroup analysis.
    International Journal of Radiation OncologyBiologyPhysics 12/2000; 48(5):1345-50. · 4.52 Impact Factor
  • M Henke, C Bechtold, F Momm, W Dörr, R Guttenberger
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    ABSTRACT: To evaluate the influence of blood hemoglobin concentration on the radiosensitivity of acutely reacting normal tissues. Weekly scores (EORTC/RTOG criteria) for acute reactions of skin and mucosa are available for 60 patients with cancer of the head and neck undergoing a standard conventional radiotherapy. The prognostic significance of blood hemoglobin levels on the development of acute reactions is studied by multivariate analysis (Cox Proportional Hazards Model). Further, the incidence and the time to development of these reactions is looked at in cohorts of patients with different mean blood hemoglobin concentrations during radiotherapy. Patients are therefore classified into a "severely anemic group" (hemoglobin < 11.0 g/100 mL), and into a cohort with a blood hemoglobin value equal or above 11.0 g/100 mL. Normal tissue scoring and monitoring of blood hemoglobin levels allows for a detailed analysis of possible correlations. A decrease in the mean blood hemoglobin value of 1 g/100 mL predicts a reduced risk to develop a skin reaction of Grade 2 or 3 (RR = 0.9; p = 0.08; RR = 0.8; p = 0.26, respectively) or a mucosa reaction of Grade 3 (RR = 0.8; p = 0.16), independent from the radiation dose, the treatment time and from previous surgery within the radiation volume (multivariate analysis). Likewise, patients with severe anemia develop grade 3 mucositis or dermatitis less often (0%; 13%) as compared to those with blood hemoglobin concentrations equal or above 11.0 g/100 mL (21%; 19%). Skin and mucosa reactions further tend to occur later in the course of radiation. The observations are not statistically significant and possible reasons will be discussed. A decreased blood hemoglobin concentration may-perhaps by an impaired tissue oxygenation-reduce the radiosensitivity of normal tissue such as skin and mucosa. However, the data is preliminary and needs further confirmation.
    International Journal of Radiation OncologyBiologyPhysics 10/2000; 48(2):339-45. · 4.52 Impact Factor
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    ABSTRACT: Purpose: To evaluate the influence of blood hemoglobin concentration on the radiosensitivity of acutely reacting normal tissues.Methods and Materials: Weekly scores (EORTC/RTOG criteria) for acute reactions of skin and mucosa are available for 60 patients with cancer of the head and neck undergoing a standard conventional radiotherapy. The prognostic significance of blood hemoglobin levels on the development of acute reactions is studied by multivariate analysis (Cox Proportional Hazards Model). Further, the incidence and the time to development of these reactions is looked at in cohorts of patients with different mean blood hemoglobin concentrations during radiotherapy. Patients are therefore classified into a “severely anemic group” (hemoglobin Results: Normal tissue scoring and monitoring of blood hemoglobin levels allows for a detailed analysis of possible correlations. A decrease in the mean blood hemoglobin value of 1 g/100 mL predicts a reduced risk to develop a skin reaction of Grade 2 or 3 (RR = 0.9; p = 0.08; RR = 0.8; p = 0.26, respectively) or a mucosa reaction of Grade 3 (RR = 0.8; p = 0.16), independent from the radiation dose, the treatment time and from previous surgery within the radiation volume (multivariate analysis). Likewise, patients with severe anemia develop grade 3 mucositis or dermatitis less often (0%; 13%) as compared to those with blood hemoglobin concentrations equal or above 11.0 g/100 mL (21%; 19%). Skin and mucosa reactions further tend to occur later in the course of radiation. The observations are not statistically significant and possible reasons will be discussed.Conclusions: A decreased blood hemoglobin concentration may—perhaps by an impaired tissue oxygenation—reduce the radiosensitivity of normal tissue such as skin and mucosa. However, the data is preliminary and needs further confirmation.
    Fuel and Energy Abstracts 09/2000; 48(2):339-345.
  • M Henke, R Guttenberger
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    ABSTRACT: The therapeutic potential of erythropoietin gains increasing attention among radiation oncologists because the prognosis is better for patients with high blood hemoglobin levels following radiotherapy. However, there is still a debate on how hemoglobin affects radiotherapy. Further, the means to manipulate the hemoglobin level, their indication and administration need to be clarified. Available experimental and clinical data on hypoxia, anemia and on their treatment with erythropoietin have been extensively discussed at an international conference in Freiburg, Germany, in June 1999. This report gives a summary reviewing the topic.
    Oncology 03/2000; 58(2):175-82. · 2.17 Impact Factor

Publication Stats

387 Citations
99.22 Total Impact Points

Institutions

  • 1999–2006
    • University of Freiburg
      • Department of Internal Medicine
      Freiburg, Baden-Württemberg, Germany
  • 2000
    • Universitätsklinikum Freiburg
      Freiburg an der Elbe, Lower Saxony, Germany
    • Carl Gustav Carus-Institut
      Pforzheim, Baden-Württemberg, Germany
  • 1997
    • Freie Universität Berlin
      • Institute of Social and Cultural Anthropology
      Berlín, Berlin, Germany