@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{LorenzMusacchioKunstmannetal.2022, author = {Lorenz, Delia and Musacchio, Thomas and Kunstmann, Erdmute and Grauer, Eva and Pluta, Natalie and Stock, Annika and Speer, Christian P. and Hebestreit, Helge}, title = {A case report of Sanfilippo syndrome - the long way to diagnosis}, series = {BMC Neurology}, volume = {22}, journal = {BMC Neurology}, number = {1}, doi = {10.1186/s12883-022-02611-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300465}, year = {2022}, abstract = {Background Mucopolysaccharidosis type III (Sanfilippo syndrome) is a lysosomal storage disorder, caused by a deficiency in the heparan-N-sulfatase enzyme involved in the catabolism of the glycosaminoglycan heparan sulfate. It is characterized by early nonspecific neuropsychiatric symptoms, followed by progressive neurocognitive impairment in combination with only mild somatic features. In this patient group with a broad clinical spectrum a significant genotype-phenotype correlation with some mutations leading to a slower progressive, attenuated course has been demonstrated. Case presentation Our patient had complications in the neonatal period and was diagnosed with Mucopolysaccharidosis IIIa only at the age of 28 years. He was compound heterozygous for the variants p.R245H and p.S298P, the latter having been shown to lead to a significantly milder phenotype. Conclusions The diagnostic delay is even more prolonged in this patient population with comorbidities and a slowly progressive course of the disease.}, language = {en} } @article{MerkelLindnerGaberetal.2022, author = {Merkel, Helena and Lindner, Dirk and Gaber, Khaled and Ziganshyna, Svitlana and Jentzsch, Jennifer and Mucha, Simone and Gerhards, Thilo and Sari, Sabine and Stock, Annika and Vothel, Felicitas and Falter, Lea and Qu{\"a}schling, Ulf and Hoffmann, Karl-Titus and Meixensberger, J{\"u}rgen and Halama, Dirk and Richter, Cindy}, title = {Standardized classification of cerebral vasospasm after subarachnoid hemorrhage by digital subtraction angiography}, series = {Journal of Clinical Medicine}, volume = {11}, journal = {Journal of Clinical Medicine}, number = {7}, issn = {2077-0383}, doi = {10.3390/jcm11072011}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270638}, year = {2022}, abstract = {Background: During the last decade, cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) was a current research focus without a standardized classification in digital subtraction angiography (DSA). This study was performed to investigate a device-independent visual cerebral vasospasm classification for endovascular treatment. Methods: The analyses are DSA based rather than multimodal. Ten defined points of intracranial arteries were measured in 45 patients suffering from cerebral vasospasm after SAH at three time points (hospitalization, before spasmolysis, control after six months). Mathematical clustering of vessel diameters was performed to generate four objective grades for comparison. Six interventional neuroradiologists in two groups scored 237 DSAs after a new visual classification (grade 0-3) developed on a segmental pattern of vessel contraction. For the second group, a threshold-based criterion was amended. Results: The raters had a reproducibility of 68.4\% in the first group and 75.2\% in the second group. The complementary threshold-based criterion increased the reproducibility by about 6.8\%, while the rating deviated more from the mathematical clustering in all grades. Conclusions: The proposed visual classification scheme of cerebral vasospasm is suitable as a standard grading procedure for endovascular treatment. There is no advantage of a threshold-based criterion that compensates for the effort involved. Automated vessel analysis is superior to compare inter-group results in research settings.}, language = {en} }