• Assessment of extracranial metastatic disease in patients with brain metastases: How much effort is needed in the context of evolving survival prediction models? 

      Nieder, Carsten; Mehta, Minesh P.; Guckenberger, Matthias; Gaspar, Laurie E.; Rusthoven, Chad G.; Sahgal, Arjun; Grosu, Anca L.; De Ruysscher, Dirk (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-03-04)
      Survival prediction models may serve as decision-support tools for clinicians who have to assign the right treatment to each patient, in a manner whereby harmful over- or undertreatment is avoided as much as possible. Current models differ regarding their components, the overall number of components and the weighting of individual components. Some of the components are easy to assess, such as age ...
    • Brain Metastases Research 1990-2010: Pattern of Citation and Systematic Review of Highly Cited Articles 

      Nieder, Carsten; Grosu, Anca L.; Mehta, Minesh P. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      High and continuously increasing research activity related to different aspects of prevention, prediction, diagnosis and treatment of brain metastases has been performed between 1990 and 2010. One of the major databases contains 2695 scientific articles that were published during this time period. Different measures of impact, visibility, and quality of published research are available, each with ...
    • Brain Metastases: Is There Still a Role for Whole-Brain Radiation Therapy? 

      Nieder, Carsten; Andratschke, Nicolaus H.; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-03-27)
      Whole-brain radiation therapy (WBRT) has commonly been prescribed to palliate symptoms from brain metastases, to reduce the risk of local relapse after surgical resection, and to improve distant brain control after resection or radiosurgery. While targeting micrometastases throughout the brain can be considered advantageous, the simultaneous exposure of healthy brain tissue might cause adverse events. ...
    • Can current prognostic scores reliably guide treatment decisions in patients with brain metastases from malignant melanoma? 

      Nieder, Carsten; Marienhagen, Kirsten; Geinitz, Hans; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)
      We evaluated the performance of the new 4-tiered melanoma-specific graded prognostic assessment (GPA) score and the previously published general GPA score in patients with brain metastases from malignant melanoma managed with different approaches including best supportive care. Materials and Methods: Retrospective analysis of 51 patients. Compared with the original analysis of the melanoma-specific ...
    • The challenge of durable brain control in patients with brain-only metastases from breast cancer 

      Nieder, Carsten; Oehlke, Oliver; Hintz, Mandy; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2015-10-07)
      The vast majority of patients with brain metastases from breast cancer have extracranial metastases, e.g., in the liver, lungs or bones, with serious impact on prognosis. Limited research has been performed on patients with brain-only disease. We analyzed patterns of treatment, brain control and survival in uni- and multivariate analyses. All 25 patients with brain-only disease were treated with ...
    • Development of a Score Predicting Survival after Palliative Reirradiation 

      Nieder, Carsten; Andratschke, Nicolaus; Angelo, Kent; Haukland, Ellinor; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2014)
    • Hippocampus-Avoidance Whole-Brain Radiation Therapy Is Efficient in the Long-Term Preservation of Hippocampal Volume 

      Popp, Ilinca; Rau, Alexander; Kellner, Elias; Reisert, Marco; Fennell, Jamina; Rothe, Thomas; Nieder, Carsten; Urbach, Horst; Egger, Karl; Grosu, Anca L.; Kaller, Christoph P. (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-08-19)
      Background and Purpose: With improved life expectancy, preventing neurocognitive decline after cerebral radiotherapy is gaining more importance. Hippocampal damage has been considered the main culprit for cognitive deficits following conventional whole-brain radiation therapy (WBRT). Here, we aimed to determine to which extent hippocampus-avoidance WBRT (HA-WBRT) can prevent hippocampal atrophy ...
    • How we treat octogenarians with brain metastases 

      Nieder, Carsten; Andratschke, Nicolaus H.; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-08-08)
      Biologically younger, fully independent octogenarians are able to tolerate most oncological treatments. Increasing frailty results in decreasing eligibility for certain treatments, e.g., chemotherapy and surgery. Most brain metastases are not an isolated problem, but part of widespread cancer dissemination, often in combination with compromised performance status. Multidisciplinary assessment ...
    • Long-term survival results after treatment for oligometastatic brain disease 

      Nieder, Carsten; Hintz, Mandy; Popp, Ilinca; Bilger, Angelika; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2020-03-04)
      Aim - The aim of this study was to characterize the survival results of patients with up to four brain metastases after intense local therapy (primary surgery or stereotactic radiotherapy) if extracranial metastases were absent or limited to one site, e.g. the lungs.<p> <p>Background - Oligometastatic disease has repeatedly been reported to convey a favorable prognosis.<p> <p>Material and ...
    • Management of patients with brain metastases from non-small cell lung cancer and adverse prognostic features: multi-national radiation treatment recommendations are heterogeneous 

      Nieder, Carsten; Guckenberger, Matthias; Gaspar, Laurie E.; Rusthoven, Chad G.; De Ruysscher, Dirk; Sahgal, Arjun; Nguyen, Timothy; Grosu, Anca L.; Mehta, Minesh P. (Journal article; Tidsskriftartikkel; Peer reviewed, 2019-02-15)
      <p><i>Background - </i>Different management options exist for patients with brain metastases from non-small cell lung cancer (NSCLC), patients whose treatment with whole brain radiotherapy (WBRT) has become more controversial over the last decade. It is not trivial to find the optimal balance of over- versus undertreatment in these patients. Several recent trials, including the randomized QUARTZ ...
    • Personalized radiotherapy of brain metastases: survival prediction by means of dichotomized or differentiated blood test results? 

      Nieder, Carsten; Andratschke, Nicolaus H.; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-04-11)
      Background and objectives: The validated LabBM score (laboratory parameters in patients with brain metastases) represents a widely applicable survival prediction model, which incorporates 5 blood test results (serum lactate dehydrogenase (LDH), C-reactive protein (CRP), albumin, platelets and hemoglobin). All tests are classified as normal or abnormal, without accounting for the wide range of ...
    • Personalized treatment of brain metastases: Evolving survival prediction models may benefit from evaluation of serum tumor markers (narrative review) 

      Nieder, Carsten; Andratschke, Nicolaus H.; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-12-01)
      Treatment of a limited number of brain metastases (oligometastases) might include complex and sometimes invasive approaches, e.g. neurosurgical resection followed by post-operative stereotactic radiotherapy, and thus, correct identification of patients who are appropriate candidates is crucial. Both, staging procedures that visualize the true number of metastastic lesions and prognostic assessments ...
    • Preserving the legacy of reirradiation: A narrative review of historical publications 

      Nieder, Carsten; Langendijk, Johannes A.; Guckenberger, Matthias; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-02-21)
      The purpose of this study is to illustrate the historical development of reirradiation during several decades of the 20th century, in particular between 1920 and 1960. <br> <br> Methods and materials: We chose the format of a narrative review because the historical articles are heterogeneous. No systematic extraction of baseline data, treatment details, or follow-up care was possible in many ...
    • Short survival time after palliative whole brain radiotherapy: Can we predict potential overtreatment by use of a nomogram? 

      Nieder, Carsten; Norum, Jan; Hintz, Mandy; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-06-01)
      Background:<br> Many patients with brain metastases undergoing whole brain radiotherapy (WBRT) have very limited survival. The purpose of this study was to validate a nomogram derived from a large American database and to examine its ability to better predict short survival (cut -off 2 months) than previous models. <br>Material and Methods: <br> This retrospective study included 254 European patients ...
    • Validation of the graded prognostic assessment for gastrointestinal cancers with brain metastases (GI-GPA) 

      Nieder, Carsten; Hintz, Mandy; Popp, Ilinca; Bilger, Angelika; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2020-02-13)
      <i>Purpose</i> - The purpose of this study was to validate a new prognostic model (GI-GPA) originally derived from a multi-center database (USA, Canada, Japan).<p><p> <i>Patients and Methods</i> - This retrospective study included 92 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy. Information about age, extracranial spread, number of brain ...
    • Validation of the graded prognostic assessment for lung cancer with brain metastases using molecular markers(lung-molGPA) 

      Nieder, Carsten; Hintz, Mandy; Oehlke, Oliver; Bilger, Angelika; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-06-26)
      Background:<br>Many patients with brain metastases from non-small cell lung cancer have limited survival, while others survive for several years, depending on patterns of spread, EGFR and ALK alterations, among others. The purpose of this study was to validate a new prognostic model (Lung-molGPA) originally derived from a North American database.<br>Patients and methods:<br>This retrospective study ...
    • Validation of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA). 

      Nieder, Carsten; Hintz, Mandy; Bilger, Angelika; Oehlke, Oliver; Grosu, Anca L. (Journal article; Tidsskriftartikkel; Peer reviewed, 2018-03)
      Background: It has been suggested to replace the diagnosis-specific graded prognostic assessment (DS-GPA, based on performance status and number of brain metastases) for patients with primary malignant melanoma with the new Melanoma-molGPA. The latter is a more complex assessment, which also includes BRAF mutation status, age and extracranial metastases. To test the performance of the Melanoma-molGPA, ...