Rainer J Klement

Rainer J Klement
Leopoldina Hospital, Schweinfurt · Radiotherapy and Radiation Oncology

PhD

About

153
Publications
258,305
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2,538
Citations
Additional affiliations
November 2012 - present
Leopoldina Hospital, Schweinfurt
Position
  • Medical Professional
January 2011 - present
University of Wuerzburg
January 2011 - October 2012
University of Wuerzburg
Position
  • Medical Professional

Publications

Publications (153)
Article
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We have searched for and detected stellar streams or moving groups in the solar neighborhood, using the data provided by the first RAVE public data release. This analysis is based on distances to RAVE stars estimated from a color-magnitude relation calibrated on Hipparcos stars. Our final sample consists of 7015 stars selected to be within 500 pc o...
Article
The majority of radiobiological models about prediction of tumor control probability (TCP) does not account for the fact that many events could remain unobserved because of censoring.
Article
Background and purpose The radiobiological parameters for liver and lung metastases treated with stereotactic body radiation therapy (SBRT) are poorly defined. This project aimed at estimating these parameters from published tumor control probability (TCP) data, and separately for metastases with colorectal cancer (CRC) and non-CRC histology. Mate...
Article
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Background: Obesity and low muscle mass are associated with worse outcomes of breast cancer patients. We conducted a controlled trial to study the impact of a ketogenic diet (KD) based on natural foods versus an unspecified standard diet (SD) on body composition in breast cancer patients undergoing radiotherapy. Methods: Patients with non-metast...
Article
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Aim: To clarify the high variability in COVID-19-related deaths during the first wave of the pandemic, we conducted a modeling study using publicly available data. Materials and methods: We used 13 population- and country-specific variables to predict the number of population-standardized COVID-19-related deaths in 43 European countries using gene...
Article
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Purpose Patients with head and neck cancer (HNC) are at risk of malnutrition, especially during radiochemotherapy. We aimed to study the impact of a ketogenic diet (KD) versus an unspecified standard diet (SD) on body composition and survival in HNC patients undergoing radio(chemo)therapy. Methods As part of a controlled clinical trial, non-metast...
Research Proposal
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The study investigates whether the World Economic Forum (WEF) might have played a role in mandating non-pharmaceutical interventions (NPIs) during the first year of the Covid-19 pandemic. If this was the case, it would have done so by its generic and unique placement as a world-wide network of high-profile actors on the economic and political platf...
Article
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The performance of diagnostic tests crucially depends on the disease prevalence, test sensitivity, and test specificity. However, these quantities are often not well known when tests are performed outside defined routine lab procedures which make the rating of the test results somewhat problematic. A current example is the mass testing taking place...
Article
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PurposeInterest in ketogenic diets (KDs) as complementary nutritional treatments for cancer patients is rising, although some skepticism about their safety exists. We, therefore, studied the effects of KDs on quality of life and blood parameters in rectal cancer patients undergoing radio-chemotherapy. MethodsEORTC-QLQ30 questionnaire scores and dif...
Article
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Background and purpose The standard treatment of glioblastoma patients consists of surgery followed by normofractionated radiotherapy (NFRT) with concomitant and adjuvant temozolomide chemotherapy. Whether accelerated hyperfractionated radiotherapy (HFRT) yields comparable results to NFRT in combination with temozolomide has only sparsely been inve...
Preprint
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Objective: to answer the question: Why do people consent to being vaccinated with novel vaccines against SARS-CoV2? Design: Representative survey Setting: Online panel Participants: 1032 respondents of the general German population Method: a representative survey among German citizens in November/December 2021 which resulted in 1032 complete res...
Preprint
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Background and purpose The standard treatment of glioblastoma (GB) patients consists of surgery followed by normofractionated radiotherapy (NFRT) with concomitant and adjuvant temozolomide chemotherapy. Whether accelerated hyperfractionated radiotherapy (HFRT) yields comparable results to NFRT in combination with temozolomide has only sparsely been...
Conference Paper
Purpose/Objective(s) Recent studies suggest improved local control (LC) of early-stage non-small cell lung cancer (NSCLC) treated with SBRT regimens with biologically equivalent dose (BED10) > 150 Gy. It is unclear if this association is histology dependent. Multiple groups have shown lower LC rates after SBRT for squamous cell carcinoma (SCC), com...
Article
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Background: COVID-19 vaccines have had expedited reviews without sufficient safety data. We wanted to compare risks and benefits. Methods: We calculated the Number Needed to Vaccinate (NNTV) to prevent one death from a large Israeli field study. We accessed the Adverse Drug Reactions database of the Dutch National Register (Lareb) to extract the nu...
Article
Background: COVID-19 vaccines have had expedited reviews without sufficient safety data. We wanted to compare risks and benefits. Method: We calculated the number needed to vaccinate (NNTV) from a large Israeli field study to prevent one death. We accessed the Adverse Drug Reactions (ADR) database of the European Medicines Agency and of the Dutch N...
Article
Background & Aims Obesity and low muscle mass are associated with worse outcomes of colorectal cancer patients. We conducted a controlled trial to study the impact of a ketogenic diet (KD) based on natural foods versus an unspecified standard diet (SD) on body composition in rectal cancer patients undergoing radiotherapy. Methods Patients with non...
Article
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Vitamin D 3 (cholecalciferol) is a secosteroid and prohormone which is metabolized in various tissues to the biologically most active vitamin D hormone 1,25(OH) 2 D 3 (calcitriol). 1,25(OH) 2 D 3 has multiple pleiotropic effects, particularly within the immune system, and is increasingly utilized not only within prophylaxis, but also within therapy...
Article
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Background: Chronic stress has become a central problem of our modern society. It appears plausible that our Paleolithic ancestors were more exposed to acutely life-threatening stress stimuli than chronically enduring psychosocial stressors. The aim of this study was to test whether it is possible to reduce physiological and psychological stress pa...
Article
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Breast cancer (BC) patients often ask for a healthy diet. Here, we investigated a healthy standard diet (SD), a low carb diet (LCD), and a ketogenic diet (KD) for BC patients during the rehabilitation phase. KOLIBRI was an open-label non-randomized one-site nutritional intervention trial, combining inpatient and outpatient phases for 20 weeks. Fema...
Article
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To report outcome (freedom from local progression: FFLP, overall survival: OS, and toxicity) after stereotactic, palliative, or highly conformal fractionated (> 12) radiotherapy (SBRT, Pall‐RT, 3DCRT/IMRT) for adrenal metastases in a retrospective multicenter cohort within the framework of the German Society for Radiation Oncology (DEGRO). Adrenal...
Article
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Introduction The use of cranial re-irradiation is growing with improving overall survival and the advent of high-precision radiotherapy techniques. Still the value of re-irradiation needs careful evaluation regarding safety and efficacy. We analyzed dosimetric and clinical data of patients receiving cranial re-irradiation using EQD2 sum plans. Met...
Article
Background & Aims: Ketogenic diets (KDs) have been proposed as complementary nutritional treatments for cancer patients. Because it is important to gain knowledge about the safety of KDs adopted during cancer therapy, we studied the effects of KDs on quality of life and blood parameters in women with early-stage breast cancer undergoing radiotherap...
Preprint
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Background:: After submitting our review report on Corman et al. (referred hereinafter as CD-report) and republishing it on a scientific preprint server (http://doi.org/10.5281/zenodo.4298004) and Researchgate.net we offered the report for public discussion at cormandrostenreview.com on 27th November 2020. The scientific community provided addition...
Preprint
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After submitting our review report on Corman et al. (referred hereinafter as CD-report) andrepublishing it on a scientific preprint server [50] and Researchgate.net [51] we offered thereport for public discussion at cormandrostenreview.com on 27th November 2020. Thescientific community provided additional literature, references, and analyses concer...
Article
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Evolutionary principles are rarely considered in clinical oncology. We here aimed to test the feasibility and effects of a dietary and physical activity intervention based on evolutionary considerations in an oncological setting. A total of 13 breast cancer patients referred to our clinic for curative radiotherapy were recruited for this pilot stud...
Article
Background: Vitamin D has been shown to be associated with reduced risk and severity of COVID-19 and exerts regulating effects on all hallmarks of cancer. The goal of this study was to analyze the vitamin D status of a cancer patient cohort from our clinic in the Franconian region, Germany. Methods: 25-hydroxyvitamin D concentrations were availa...
Preprint
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This extensive review report has been officially submitted to Eurosurveillance editorial board on 27th November 2020 via their submission-portal, enclosed to this review report is a retraction request letter, signed by all the main & co-authors. First and last listed names are the first and second main authors. All names in between are co-authors....
Preprint
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There is a high variability in Covid-19 related deaths whose origin is unclear. We used three variables, percent test-standardized number of SARS-CoV-2-cases in a country, influenza-vaccination coverage in the elderly in a country and number of non-pharmaceutical interventions, to predict the number of population standardized Covid-19 related death...
Article
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We investigate the epistemological consequences of a positive polymerase chain reaction SARS-CoV test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questio...
Article
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We here express our concern about a general decree to let patients wear face masks in radiation oncology clinics. We believe that potential risks associated with wearing masks, such as the risk of confounding patients, outweigh any benefits of such a policy for which evidence of protection from COVID-19 is generally weak. For asymptomatic patients,...
Article
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Background and aim Ketogenic diets (KDs) have gained interest as a complementary treatment for cancer patients. Here we present first results of our ongoing KETOCOMP study (NCT02516501) concerning body composition changes among rectal, breast and head & neck cancer (HNC) patients who consumed a KD during curative radiotherapy (RT). Experimental pr...
Article
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Reductionism is ubiquitous in Medicine. In this paper, I argue that the current SARS-CoV-2 crisis is also a crisis of reductionism, with a narrow view on a virus without consideration of interdependencies between virology, epidemiology, immunity, economics and a diversity of other scientific disciplines. For optimal management of this crisis, syste...
Article
Background There exists large variation regarding prescription and dose inhomogeneity in the practice of stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) The aim of this modeling study was to identify which dose metric correlates best with local tumor control probability (TCP) in order to make recommendation...
Preprint
Full-text available
Background: Breast Cancer (BC) patients often ask for a healthy diet. Here, we compared three different diets which could support BC patients during the rehabilitation process: a healthy standard diet (SD), a low carb diet (LCD) and a ketogenic diet (KD). Patients and Methods: KOLIBRI was a one-site nutritional intervention trial, combining inpatie...
Preprint
Full-text available
We investigate the epistemological consequences of a positive SARS-CoV-2 test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the sole cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questions regarding each h...
Preprint
Full-text available
We investigate the epistemological consequences of a positive SARS-CoV-2 test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the sole cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questions regarding each h...
Article
Background Calorie restriction (CR) over 20% has been hypothesized to aid cancer prevention and treatment. Yet, there is a lack of reported studies in humans describing tolerance, adherence, or efficacy, and unpublished and incomplete dietary studies may indicate lack of tolerability and compliance. Objective Due to the lack of published studies,...
Article
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Preclinical data provide evidence for synergism between ketogenic diets (KDs) and other oncological therapies. The aim of this systematic review was to summarize data from clinical studies that have tested KDs along with other treatments used within medical oncology. The PubMed database was searched using the key words "ketogenic" AND ("cancer" OR...
Article
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Background: Current standard of treatment for newly diagnosed patients with glioblastoma (GBM) is surgical resection with adjuvant normofractionated radiotherapy (NFRT) combined with temozolomide (TMZ) chemotherapy. Hyperfractionated accelerated radiotherapy (HFRT) which was known as an option from randomized controlled trials before the temozolom...
Article
Purpose: To identify frequency, clinical relevance and risk factors for vertebral compression fracture (VCF) after spine stereotactic body radiation therapy (SBRT) with long-term follow up (FU). Methods: From 2012 to 2015, 61 lesions (56 patients) were treated within a prospective multicenter phase 2 study (NCT01594892) of SBRT for painful verte...
Article
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In his book “Medical Philosophy: Conceptual issues in Medicine”, Mario Bunge provides a unique account of medical philosophy that is deeply rooted in a realist ontology he calls “systemism”. According to systemism, the world consists of systems and their parts, and systems possess emergent properties that their parts lack. Events within systems may...
Article
Background: High-dose hypofractionated radiotherapy should theoretically result in a deviation from the typical linear-quadratic shape of the cell survival curve beyond a certain threshold dose, yet no evidence for this hypothesis has so far been found in clinical data of stereotactic body radiotherapy treatment (SBRT) for early-stage non-small ce...
Article
Introduction: Studies have consistently identified an increased risk of pancreatic cancer in diabetics, yet the role hyperglycemia may play in predicting prognosis is less clear. This work aims to evaluate the impact of glycemic state and antidiabetics on outcomes after systemic and local treatment for locoregionally advanced pancreatic cancer. M...
Preprint
Full-text available
In his book “Medical Philosophy: Conceptual issues in Medicine“, Mario Bunge provides a unique account of medical philosophy that is deeply rooted in a realist ontology he calls “systemism”. According to systemism, the world consists of systems and their parts, and systems possess emergent properties that their parts lack. Events within systems may...
Cover Page
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Cover page of Medicina, Volume 55, Issue 4 (April 2019). Cover story: Western diets and modern lifestyle have led to a significant reduction of gut microbial diversity, which is linked to many non-communicable diseases (NCDs) including cancer. This paper reviews the effects of some of the most popular "cancer-specific" diets on microbiota composit...
Article
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An increasing amount of evidence suggests that migraines are a response to a cerebral energy deficiency or oxidative stress levels that exceed antioxidant capacity. The ketogenic diet (KD), a diet mimicking fasting that leads to the elevation of ketone bodies (KBs), is a therapeutic intervention targeting cerebral metabolism that has recently shown...
Cover Page
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An increasing amount of evidence points towards migraine being a response to cerebral energy deficiency or oxidative stress levels that exceed antioxidant capacity. The ketogenic diet (KD), a diet mimicking fasting that leads to the elevation of ketone bodies (KBs), is a therapeutic intervention targeting cerebral metabolism that has recently shown...
Article
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: Diet is frequently considered as a food regimen focused on weight loss, while it is actually the sum of food consumed by the organism. Western diets, modern lifestyle, sedentary behaviors, smoking habits, and drug consumption have led to a significant reduction of gut microbial diversity, which is linked to many non-communicable diseases (NCDs)....
Article
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This editorial introduces a total of five extended abstracts from the 6th symposium of the Society for Evolutionary Medicine and Health that were published in a special issue of the Journal of Evolution and Health.
Article
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Purpose The aim of our study was an external validation of the extracranial prognostic score predicting survival of patients with brain metastases receiving cranial irradiation on data from a single institution. Materials and Methods A retrospective analysis of 524 patients with brain metastases treated with cranial radiotherapy in a single tertiar...
Article
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Background: The aim of this analysis was to model the effect of local control (LC) on overall survival (OS) in patients treated with stereotactic body radiotherapy (SBRT) for liver or lung metastases from colorectal cancer. Methods: The analysis is based on pooled data from two retrospective SBRT databases for pulmonary and hepatic metastases from...
Article
PURPOSE OF REVIEW: Altered glucose metabolism in cancer cells is an almost ubiquitous observation, yet hardly exploited therapeutically. However, ketogenic diets have gained growing attention in recent years as a nontoxic broad-spectrum approach to target this major metabolic difference between normal and cancer cells. Although much research still...
Article
Abdel-Rahman [1] analyzed the overall survival-rate and disease-free survival of T1-2 N1 breast cancer patients after mastectomy, who were adjuvantly treated with various modern chemotherapeutic drugs (anthracyclines, taxanes) in 3 prospective phase III chemotherapy trials. His analysis suggested no potential benefits of an additional adjuvant post...
Article
Purpose To report the development of an ultimately fatal occurrence of Fournier’s gangrene in a rectal cancer patient undergoing neoadjuvant radiotherapy without chemotherapy. Methods A 53-year-old male patient with G2 cT3 cN1a cM0 stage IIIB adenocarcinoma of the lower rectum and several comorbidities including ulcerative colitis was treated with...
Article
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The growing interest in the alterations of tumor cell metabolism and their possible therapeutic exploitation also spurred new complementary and integrative approaches such as treating patients with a ketogenic diet (KD). KDs aim at inhibiting glycolytic tumor metabolism and growth, and have therefore been proposed as adjuncts not only to standard-o...
Article
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Background: Ketogenic therapy in the form of ketogenic diets or calorie restriction has been proposed as a metabolic treatment of high grade glioma (HGG) brain tumors based on mechanistic reasoning obtained mainly from animal experiments. Given the paucity of clinical studies of this relatively new approach, our goal is to extrapolate evidence fro...
Article
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We here describe two apparent paradoxes concerning high CRP levels and NCD risk. One has emerged from observational studies in the Amazon region showing that the indigenous Tsimane in Bolivia appear protected against non-communicable diseases (NCDs) such as obesity, type 2 diabetes, and cardiovascular diseases despite increased inflammatory markers...
Article
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Introduction: Epidemiologic data indicate diabetes confers an augmented risk of lung cancer development, yet the relationship between hyperglycemia, metabolic agents, and prognosis is unclear. We analyzed the impact of hyperglycemia, anti-diabetic agents, and statins on outcomes in non-small cell lung cancer (NSCLC) patients undergoing chemoradiati...
Preprint
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Background: Ketogenic therapy (KT) in the form of ketogenic diets (KDs) and/or supplements that induce nutritional ketosis have gained interest as a complementary treatment for cancer patients. Besides putative anti-tumor effects, preclinical and preliminary clinical data indicate that KT could induce favorable changes in body composition of the tu...