Rainer J Klement

Leopoldina Hospital, Schweinfurt · Radiotherapy and Radiation Oncology

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.

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...

The phase-space structure of our Galaxy holds the key to understand and reconstruct its formation. The Lambda-CDM model predicts a richly structured phase-space distribution of dark matter and (halo) stars, consisting of streams of particles torn from their progenitors during the process of hierarchical merging. While such streams quickly loose the...

Background Ketogenic diets (KDs) are high-fat diets with putatively anti-tumor effects. The aim of this study was to synthesize the evidence for anti-tumor effects of KDs in mice, with a focus on their possible synergism with chemotherapy (CT), radiotherapy (RT) or targeted therapies (TT). Materials and methods Relevant studies were retrieved from...

Krebs ist die Pandemie der neuen Zeit und in vielen Ländern bereits Todesursache Nummer Eins. Ist Krebs nun Schicksal oder vermeidbar? Und welche Rolle spielt unsere moderne Lebensweise? In diesem Buch werden sowohl für Experten als auch für Laien anschaulich Ursachen, Entstehung und evolutionäre Hintergründe von Krebs erklärt und daraus logisch na...

Purpose Obesity and insulin resistance appear to worsen prognosis of breast cancer patients. We conducted a feasibility study to test a 5:2 fasting regime in breast cancer patients undergoing radiotherapy. The intervention was rated as beneficial if it would be able to reduce fat mass while significantly improving insulin sensitivity. Methods A to...

Franchi and Tomsic (2023) correctly note that our review (Kämmerer et al., 2023) “has a clear focus on the technical aspect of RT-PCR, which is only one piece of the COVID-19 puzzle” and they ask for a more comprehensive discussion beyond our focus on the laboratory assay. They point to the lack of a specific definition of COVID-19 disease and conc...

Over the past two decades, it has been established that cancer patients with oligometastases, i.e., only a few detectable metastases confined to one or a few organs, may benefit from an aggressive local treatment approach such as the application of high-precision stereotactic body radiotherapy (SBRT). Specifically, some studies have indicated that...

Purpose To describe the case of successful radiotherapeutic treatment of a woman suffering from Brooke–Spiegler syndrome who had multiple disfiguring cylindromas on the entire scalp and further tumors on the trunk. Methods After decades of treatment with conventional therapies including surgery and topically applied salicylic acid, the 73-year-old...

For the first time in medical history, the result of a laboratory assay (RT-qPCR) was used as the sole criterion to diagnose a disease (Covid-19) without any rating of clinical symptoms and to justify the implementation of population-wide non-pharmaceutical interventions during virus season. The aim of this study is (1) to evaluate a robust RT-qPCR...

Background & aims Body composition plays a crucial role in therapy adherence and the prognosis of cancer patients. The aim of this work was to compare four measurement methods for determining body composition regarding their validity, reliability and practicability in order to be able to draft a practical recommendation as to which method is most...

In a recent modeling study Watson et al. (Lancet Infect Dis 2022;3099:1–10) claim that Covid-19 vaccinations have helped to prevent roughly 14-20 million deaths in 2021. This conclusion is based on an epidemiological susceptible-exposed-infectious-recovered (SEIR) model trained on partially simulated data and yielding a reproduction number distribu...

Introduction: Anxiety, burnout and depression cause a substantial psychological and social burden. Bioenergetic Meditation (BM) was developed by Viktor Philippi as a method to strengthen psychological and physical health. This work presents the results of four feasibility studies investigating the effects of BM developed by Viktor Philippi as a su...

Available at SSRN: https://ssrn.com/abstract=4248632

Objectives In a recent paper, Hardy et al. (2022, Journal of Human Evolution 162: 103105) claim that the physiological Neanderthal requirement for plant carbohydrates may have reached 50%–60% of caloric intake, inferred from modern dietary guidelines and a putative need for high carbohydrate intake in pregnant/breastfeeding women and athletes. The...

Background The World Economic Forum (WEF) has spawned a global network of elites called Young Global Leaders (YGLs) with significant influence on large corporations, politics, academia, and media. This article scrutinizes the idea that through this network, the WEF had a significant influence on the scale and scope of the non-pharmaceutical interve...

In this systematic review and meta-analysis of clinical controlled trials (CCTs) we aimed to investigate the efficacy of KDs as an adjuvant therapy on cardiometabolic outcomes in patient with cancer compared to conventional non-ketogenic diets. Only CCTs involving cancer patients that were assigned to either a KD or a standard diet control group we...

In a recent modeling study Watson et al. (Lancet Infect Dis 2022;3099:1-10) claim that Covid-19 vaccinations have helped to prevent roughly 14-20 million deaths in 2021. This conclusion is based on an epidemiological susceptible-exposed-infectious-recovered-susceptible (SEIRS) model trained on partially simulated data and extrapolated to a hypothet...

This article scrutinizes the idea that the World Economic Forum (WEF) had a significant influence on the scale and scope of the non-pharmaceutical pandemic interventions (NPIs) implemented in response to the COVID-19 crisis. We tested for associations between the country-level distribution of an alumni network of high-level decision makers who have...

In the interesting study by Barrea et al. [1] 260 women with overweight or obesity had completed a very low-calorie ketogenic diet (VLCKD) for 31 days. Before and after this intervention, high-sensitive CRP (hs-CRP), bioelectrical phase angle (PhA) and body weight was measured. Spearman’s rank-order correlation between changes of PhA (ΔPhA) and hs-...

Objective To answer the question: Why do people consent to being vaccinated with novel vaccines against SARS-CoV-2? 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 that resulted in 1032 complete resp...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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....

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...

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...

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,...

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...

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...

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...

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...

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...

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,...

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...

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...

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...

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...

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...

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...

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 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...

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...

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...

: 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)....

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.

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...

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...

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...

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...

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...