TY  - JOUR
A1  - Gaab, Christine
A1  - Adolph, Jonas E.
A1  - Tippelt, Stephan
A1  - Mikasch, Ruth
A1  - Obrecht, Denise
A1  - Mynarek, Martin
A1  - Rutkowski, Stefan
A1  - Pfister, Stefan M.
A1  - Milde, Till
A1  - Witt, Olaf
A1  - Bison, Brigitte
A1  - Warmuth-Metz, Monika
A1  - Kortmann, Rolf-Dieter
A1  - Dietzsch, Stefan
A1  - Pietsch, Torsten
A1  - Timmermann, Beate
A1  - Sträter, Ronald
A1  - Bode, Udo
A1  - Faldum, Andreas
A1  - Kwiecien, Robert
A1  - Fleischhack, Gudrun
T1  - Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 Study
JF  - Cancers
N2  - 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.
KW  - medulloblastoma
KW  - refractory
KW  - recurrent
KW  - children
KW  - chemotherapy
KW  - surgery
KW  - radiotherapy
KW  - re-irradiation
KW  - intraventricular therapy
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-254809
SN  - 2072-6694
VL  - 14
IS  - 3
ER  - 
TY  - JOUR
A1  - Dufner, Vera
A1  - Kessler, Almuth Friederike
A1  - Just, Larissa
A1  - Hau, Peter
A1  - Bumes, Elisabeth
A1  - Pels, Hendrik Johannes
A1  - Grauer, Oliver Martin
A1  - Wiese, Bettina
A1  - Löhr, Mario
A1  - Jordan, Karin
A1  - Strik, Herwig
T1  - The emesis trial: depressive glioma patients are more affected by chemotherapy-induced nausea and vomiting
JF  - Frontiers in Neurology
N2  - Purpose
Glioma patients face a limited life expectancy and at the same time, they suffer from afflicting symptoms and undesired effects of tumor treatment. Apart from bone marrow suppression, standard chemotherapy with temozolomide causes nausea, emesis and loss of appetite. In this pilot study, we investigated how chemotherapy-induced nausea and vomiting (CINV) affects the patients' levels of depression and their quality of life.

Methods
In this prospective observational multicentre study (n = 87), nausea, emesis and loss of appetite were evaluated with an expanded MASCC questionnaire, covering 10 days during the first and the second cycle of chemotherapy. Quality of life was assessed with the EORTC QLQ-C30 and BN 20 questionnaire and levels of depression with the PHQ-9 inventory before and after the first and second cycle of chemotherapy.

Results
CINV affected a minor part of patients. If present, it reached its maximum at day 3 and decreased to baseline level not before day 8. Levels of depression increased significantly after the first cycle of chemotherapy, but decreased during the further course of treatment. Patients with higher levels of depression were more severely affected by CINV and showed a lower quality of life through all time-points.

Conclusion
We conclude that symptoms of depression should be perceived in advance and treated in order to avoid more severe side effects of tumor treatment. Additionally, in affected patients, delayed nausea was most prominent, pointing toward an activation of the NK1 receptor. We conclude that long acting antiemetics are necessary totreat temozolomide-induced nausea.
KW  - glioblastoma
KW  - chemotherapy
KW  - depression
KW  - nausea and emesis
KW  - quality of life
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-262859
SN  - 1664-2295
VL  - 13
ER  -