@article{vonBuerenOehlerShalabyetal.2011,
  author    = {von Bueren, Andr{\´e} O. and Oehler, Christoph and Shalaby, Tarek and von Hoff, Katja and Pruschy, Martin and Seifert, Burkhardt and Gerber, Nicolas U. and Warmuth-Metz, Monika and Stearns, Duncan and Eberhart, Charles G. and Kortmann, Rolf D. and Rutkowski, Stefan and Grotzer, Michael A.},
  title     = {c-MYC expression sensitizes medulloblastoma cells to radio- and chemotherapy and has no impact on response in medulloblastoma patients},
  series = {BMC Cancer},
  volume    = {11},
  journal   = {BMC Cancer},
  number    = {74},
  doi       = {10.1186/1471-2407-11-74},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-134185},
  pages     = {1-11},
  year      = {2011},
  abstract  = {Background: To study whether and how c-MYC expression determines response to radio-and chemotherapy in childhood medulloblastoma (MB). Methods: We used DAOY and UW228 human MB cells engineered to stably express different levels of c-MYC, and tested whether c-MYC expression has an effect on radio-and chemosensitivity using the colorimetric 3-(4,5-dimethylthiazol- 2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium inner salt (MTS) assay, clonogenic survival, apoptosis assays, cell cycle analysis, and western blot assessment. In an effort to validate our results, we analyzed c-MYC mRNA expression in formalin-fixed paraffin-embedded tumor samples from well-documented patients with postoperative residual tumor and compared c-MYC mRNA expression with response to radio-and chemotherapy as examined by neuroradiological imaging. Results: In DAOY -and to a lesser extent in UW228 -cells expressing high levels of c-MYC, the cytotoxicity of cisplatin, and etoposide was significantly higher when compared with DAOY/UW228 cells expressing low levels of c-MYC. Irradiation-and chemotherapy-induced apoptotic cell death was enhanced in DAOY cells expressing high levels of c-MYC. The response of 62 of 66 residual tumors was evaluable and response to postoperative radio-(14 responders (CR, PR) vs. 5 non-responders (SD, PD)) or chemotherapy (23 CR/PR vs. 20 SD/PD) was assessed. c-MYC mRNA expression was similar in primary MB samples of responders and non-responders (Mann-Whitney U test, p = 0.50, ratio 0.49, 95\% CI 0.008-30.0 and p = 0.67, ratio 1.8, 95\% CI 0.14-23.5, respectively). Conclusions: c-MYC sensitizes MB cells to some anti-cancer treatments in vitro. As we failed to show evidence for such an effect on postoperative residual tumors when analyzed by imaging, additional investigations in xenografts and larger MB cohorts may help to define the exact function of c-MYC in modulating response to treatment.},
  language  = {en}
}
@article{DietlSchwinnDietletal.2016,
  author    = {Dietl, Sebastian and Schwinn, Stefanie and Dietl, Susanne and Riedl, Simone and Deinlein, Frank and Rutkowski, Stefan and von Bueren, Andre O. and Krauss, J{\"u}rgen and Schweitzer, Tilmann and Vince, Giles H. and Picard, Daniel and Eyrich, Matthias and Rosenwald, Andreas and Ramaswamy, Vijay and Taylor, Michael D. and Remke, Marc and Monoranu, Camelia M. and Beilhack, Andreas and Schlegel, Paul G. and W{\"o}lfl, Matthias},
  title     = {MB3W1 is an orthotopic xenograft model for anaplastic medulloblastoma displaying cancer stem cell- and Group 3-properties},
  series = {BMC Cancer},
  volume    = {16},
  journal   = {BMC Cancer},
  number    = {115},
  doi       = {10.1186/s12885-016-2170-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145877},
  year      = {2016},
  abstract  = {Background Medulloblastoma is the most common malignant brain tumor in children and can be divided in different molecular subgroups. Patients whose tumor is classified as a Group 3 tumor have a dismal prognosis. However only very few tumor models are available for this subgroup. Methods We established a robust orthotopic xenograft model with a cell line derived from the malignant pleural effusions of a child suffering from a Group 3 medulloblastoma. Results Besides classical characteristics of this tumor subgroup, the cells display cancer stem cell characteristics including neurosphere formation, multilineage differentiation, CD133/CD15 expression, high ALDH-activity and high tumorigenicity in immunocompromised mice with xenografts exactly recapitulating the original tumor architecture. Conclusions This model using unmanipulated, human medulloblastoma cells will enable translational research, specifically focused on Group 3 medulloblastoma.},
  language  = {en}
}
@article{SabelFleischhackTippeltetal.2016,
  author    = {Sabel, Magnus and Fleischhack, Gudrun and Tippelt, Stephan and Gustafsson, G{\"o}ran and Doz, Fran{\c{c}}ois and Kortmann, Rolf and Massimino, Maura and Navajas, Aurora and von Hoff, Katja and Rutkowski, Stefan and Warmuth-Metz, Monika and Clifford, Steven C. and Pietsch, Torsten and Pizer, Barry and Linnering, Birgitta},
  title     = {Relapse patterns and outcome after relapse in standard risk medulloblastoma: a report from the HIT-SIOP-PNET4 study},
  series = {Journal of Neurooncology},
  volume    = {129},
  journal   = {Journal of Neurooncology},
  number    = {3},
  organization    = {SIOP-E Brain Tumour Group},
  doi       = {10.1007/s11060-016-2202-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-187498},
  pages     = {515-524},
  year      = {2016},
  abstract  = {The HIT-SIOP-PNET4 randomised trial for standard risk medulloblastoma (MB) (2001-2006) included 338 patients and compared hyperfractionated and conventional radiotherapy. We here report the long-term outcome after a median follow up of 7.8 years, including detailed information on relapse and the treatment of relapse. Data were extracted from the HIT Group Relapsed MB database and by way of a specific case report form. The event-free and overall (OS) survival at 10 years were 76 +/- 2 \% and 78 +/- 2 \% respectively with no significant difference between the treatment arms. Seventy-two relapses and three second malignant neoplasms were reported. Thirteen relapses (18 \%) were isolated local relapses in the posterior fossa (PF) and 59 (82 \%) were craniospinal, metastatic relapses (isolated or multiple) with or without concurrent PF disease. Isolated PF relapse vs all other relapses occurred at mean/median of 38/35 and 28/26 months respectively (p = 0.24). Late relapse, i.e. > 5 years from diagnosis, occurred in six patients (8 \%). Relapse treatment consisted of combinations of surgery (25 \%), focal radiotherapy (RT 22 \%), high dose chemotherapy with stem cell rescue (HDSCR 21 \%) and conventional chemotherapy (90 \%). OS at 5 years after relapse was 6.0 +/- 4 \%. In multivariate analysis; isolated relapse in PF, and surgery were significantly associated with prolonged survival whereas RT and HDSCR were not. Survival after relapse was not related to biological factors and was very poor despite several patients receiving intensive treatments. Exploration of new drugs is warranted, preferably based on tumour biology from biopsy of the relapsed tumour.},
  language  = {en}
}
@article{GaabAdolphTippeltetal.2022,
  author    = {Gaab, Christine and Adolph, Jonas E. and Tippelt, Stephan and Mikasch, Ruth and Obrecht, Denise and Mynarek, Martin and Rutkowski, Stefan and Pfister, Stefan M. and Milde, Till and Witt, Olaf and Bison, Brigitte and Warmuth-Metz, Monika and Kortmann, Rolf-Dieter and Dietzsch, Stefan and Pietsch, Torsten and Timmermann, Beate and Str{\"a}ter, Ronald and Bode, Udo and Faldum, Andreas and Kwiecien, Robert and Fleischhack, Gudrun},
  title     = {Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 Study},
  series = {Cancers},
  volume    = {14},
  journal   = {Cancers},
  number    = {3},
  issn      = {2072-6694},
  doi       = {10.3390/cancers14030471},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-254809},
  year      = {2022},
  abstract  = {Recurrent medulloblastomas are associated with survival rates <10\%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) dependent on patient, disease, and treatment characteristics. The median age at the first recurrence was 10.1 years (IQR: 6.9-16.1). Median PFS and OS, at first recurrence, were 7.9 months (CI: 5.7-10.0) and 18.5 months (CI: 13.6-23.5), respectively. Early relapses/progressions (<18 months, n = 30/93) found mainly in molecular subgroup 3 were associated with markedly worse median PFS (HR: 2.34) and OS (HR: 3.26) in regression analyses. A significant survival advantage was found for the use of volume-reducing surgery as well as radiotherapy. Intravenous chemotherapy with carboplatin and etoposide (ivCHT, n = 28/93) showed improved PFS and OS data and the best objective response rate (ORR) was 66.7\% compared to oral temozolomide (oCHT, n = 47/93) which was 34.8\%. Intraventricular (n = 43) as well as high-dose chemotherapy (n = 17) at first relapse was not related to a significant survival benefit. Although the results are limited due to a non-randomized study design, they may serve as a basis for future treatment decisions in order to improve the patients' survival.},
  language  = {en}
}
@article{PetersFrischStocketal.2022,
  author    = {Peters, Sarah and Frisch, Sabine and Stock, Annika and Merta, Julien and B{\"a}umer, Christian and Blase, Christoph and Schuermann, Eicke and Tippelt, Stephan and Bison, Brigitte and Fr{\"u}hwald, Michael and Rutkowski, Stefan and Fleischhack, Gudrun and Timmermann, Beate},
  title     = {Proton beam therapy for pediatric tumors of the central nervous system — experiences of clinical outcome and feasibility from the KiProReg study},
  series = {Cancers},
  volume    = {14},
  journal   = {Cancers},
  number    = {23},
  issn      = {2072-6694},
  doi       = {10.3390/cancers14235863},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-297489},
  year      = {2022},
  abstract  = {As radiotherapy is an important part of the treatment in a variety of pediatric tumors of the central nervous system (CNS), proton beam therapy (PBT) plays an evolving role due to its potential benefits attributable to the unique dose distribution, with the possibility to deliver high doses to the target volume while sparing surrounding tissue. Children receiving PBT for an intracranial tumor between August 2013 and October 2017 were enrolled in the prospective registry study KiProReg. Patient's clinical data including treatment, outcome, and follow-up were analyzed using descriptive statistics, Kaplan-Meier, and Cox regression analysis. Adverse events were scored according to the Common Terminology Criteria for Adverse Events (CTCAE) 4.0 before, during, and after PBT. Written reports of follow-up imaging were screened for newly emerged evidence of imaging changes, according to a list of predefined keywords for the first 14 months after PBT. Two hundred and ninety-four patients were enrolled in this study. The 3-year overall survival of the whole cohort was 82.7\%, 3-year progression-free survival was 67.3\%, and 3-year local control was 79.5\%. Seventeen patients developed grade 3 adverse events of the CNS during long-term follow-up (new adverse event n = 7; deterioration n = 10). Two patients developed vision loss (CTCAE 4°). This analysis demonstrates good general outcomes after PBT.},
  language  = {en}
}
@article{DietzschBraesigkSeideletal.2022,
  author    = {Dietzsch, Stefan and Braesigk, Annett and Seidel, Clemens and Remmele, Julia and Kitzing, Ralf and Schlender, Tina and Mynarek, Martin and Geismar, Dirk and Jablonska, Karolina and Schwarz, Rudolf and Pazos, Montserrat and Weber, Damien C. and Frick, Silke and Gurtner, Kristin and Matuschek, Christiane and Harrabi, Semi Ben and Gl{\"u}ck, Albrecht and Lewitzki, Victor and Dieckmann, Karin and Benesch, Martin and Gerber, Nicolas U. and Obrecht, Denise and Rutkowski, Stefan and Timmermann, Beate and Kortmann, Rolf-Dieter},
  title     = {Types of deviation and review criteria in pretreatment central quality control of tumor bed boost in medulloblastoma—an analysis of the German Radiotherapy Quality Control Panel in the SIOP PNET5 MB trial},
  series = {Strahlentherapie und Onkologie},
  volume    = {198},
  journal   = {Strahlentherapie und Onkologie},
  number    = {3},
  issn      = {0179-7158},
  doi       = {10.1007/s00066-021-01822-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307812},
  pages     = {282-290},
  year      = {2022},
  abstract  = {Purpose In Germany, Austria, and Switzerland, pretreatment radiotherapy quality control (RT-QC) for tumor bed boost (TB) in non-metastatic medulloblastoma (MB) was not mandatory but was recommended for patients enrolled in the SIOP PNET5 MB trial between 2014 and 2018. This individual case review (ICR) analysis aimed to evaluate types of deviations in the initial plan proposals and develop uniform review criteria for TB boost. Patients and methods A total of 78 patients were registered in this trial, of whom a subgroup of 65 patients were available for evaluation of the TB treatment plans. Dose uniformity was evaluated according to the definitions of the protocol. Additional RT-QC criteria for standardized review of target contours were elaborated and data evaluated accordingly. Results Of 65 initial TB plan proposals, 27 (41.5\%) revealed deviations of target volume delineation. Deviations according to the dose uniformity criteria were present in 14 (21.5\%) TB plans. In 25 (38.5\%) cases a modification of the RT plan was recommended. Rejection of the TB plans was rather related to unacceptable target volume delineation than to insufficient dose uniformity. Conclusion In this analysis of pretreatment RT-QC, protocol deviations were present in a high proportion of initial TB plan proposals. These findings emphasize the importance of pretreatment RT-QC in clinical trials for MB. Based on these data, a proposal for RT-QC criteria for tumor bed boost in non-metastatic MB was developed.},
  language  = {en}
}