Publications by authors named "Alexander Fabian"

Purpose: PSMA-PET/CT is frequently used for staging patients with de-novo or recurrent prostate cancer (PCa). In patients with oligometastatic PCa PSMA-PET/CT guided stereotactic ablative body radiotherapy (SABR) is a common treatment option. Follow-up is regularly performed via measurement of prostate-specific-antigen (PSA) level.

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Purpose: A subset of prostate cancer patients develops local relapse at the primary site after radiotherapy. The optimal local salvage strategy is unknown. Therefore, we aimed to explore prevalence and determinants of decision regret among patients after reirradiation of the primary site.

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Head and neck cancer (HNC) patients may experience toxicities as a result of their treatment modality. While acute toxicities have been well documented, the prevalence of toxicities at long-term follow-up of HNC survivors is less clear. As part of a multi-national, cross-sectional study, HNC survivors at least 5 years post-diagnosis were invited to undergo a toxicity examination.

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Artificial intelligence (AI) is a disruptive technology that is currently finding widespread application after having long been confined to the domain of specialists. In urology, in particular, new fields of application are continuously emerging, which are being studied both in preclinical basic research and in clinical applications. Potential applications include image recognition in the operating room or interpreting images from radiology and pathology, the automatic measurement of urinary stones and radiotherapy.

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Purpose: There is an urgent need to recruit and retain young professionals in radiation oncology and radiation research as the healthcare system faces major challenges. Our study investigated the experiences and needs of young professionals in this field, focusing on the impact of unpaid care work and gender-related issues.

Methods: A web-based survey was created and distributed over a six-week period, featuring one general questionnaire along with three occupation-specific versions tailored for physicians, biologists, and medical physicists involved in radiation oncology and research.

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Purpose: Patients with localized prostate cancer have various treatment options. Decision regret from a patient's view is an unpleasant feeling concerning a decision in health care. We aimed to explore regret and its determinants after external beam radiotherapy (EBRT) with a high dose-rate brachytherapy (HDR-BT) boost as traditional method of treatment intensification.

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Purpose: Implications of radiation dose exposure to the urethra on urinary morbidity after prostate radiotherapy are poorly understood, especially by long-term patient-reported outcomes (PRO). Therefore, our primary objective was to investigate associations of urethral dose and long-term patient-reported urinary morbidity after external beam radiotherapy and high-dose rate brachytherapy boost for prostate cancer.

Materials And Methods: We conducted a pre-registered (https://doi.

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Article Synopsis
  • The study evaluates the effectiveness of stereotactic body radiotherapy (SBRT) in improving survival outcomes for patients with oligometastatic head-and-neck squamous cell carcinoma (HNSCC) and pulmonary metastases across 16 international centers.
  • Out of 178 patients treated, the median overall survival was 33 months, while progression-free survival was 9 months, with low rates of local failure and minimal severe toxicity reported.
  • Factors influencing survival included age and sex, with older patients and females having worse outcomes, while a longer time between HNSCC diagnosis and SBRT treatment was linked to better survival rates.
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Purpose: Cumulative cisplatin doses of ≥ 200 mg/m improve survival in adults with head-and-neck squamous cell carcinoma (HNSCC) undergoing chemoradiation, but many older adults with HNSCC cannot receive this prognostically relevant dose due to toxicities. This study aims to develop predictive models to assess the likelihood of older adults with HNSCC receiving ≥ 200 mg/m cisplatin during chemoradiation.

Methods: 366 patients from the SENIOR database, an international cohort of adults ≥ 65 years with HNSCC, received definitive chemoradiation with single-agent cisplatin and were analyzed.

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Metastasis-directed therapy (MDT) for oligometastatic breast cancer (≤ 5 metastases) has shown little effect in specific scenarios of randomized trials. Therefore, we aimed to assess outcomes after metastasis-directed stereotactic radiotherapy (SRT) in various clinical scenarios. We conducted an international retrospective cohort study in thirteen centers including breast cancer patients receiving SRT to any metastatic site.

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Background: Radiation science is of utmost significance not only due to its growing importance for clinical use, but also in everyday life such as in radiation protection questions. The expected increase in cancer incidence due to an aging population combined with technical advancements further implicates this importance and results in a higher need for sufficient highly educated and motivated personnel. Thus, factors preventing young scientists and medical personnel from entering or remaining in the field need to be identified.

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Article Synopsis
  • The study focused on establishing minimal important change (MIC) estimates for quality of life (QoL) in head and neck cancer patients using the EORTC QLQ-HN43 questionnaire.
  • A total of 503 patients from 15 countries completed the questionnaire at three different time points during treatment, and results indicated varying MICs for different QoL domains such as swallowing, speech, and dry mouth.
  • Findings revealed that MIC values for deterioration were generally higher than those for improvement, implying that a universal MIC or minimal detectable change (MDC) cannot be uniformly applied across all scales of the EORTC QLQ-HN43.
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Objectives: Sexuality is an important dimension of health-related quality of life (HRQOL) in cancer patients. Studies evidence that most patients report impairments of their sexual health related to their disease or its treatment. The Quality of Life Group of the European Organization for the Research and Treatment of Cancer (EORTC) developed a patient reported outcome measure assessing multidimensional aspects of sexual health.

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Importance: Clinicians should understand how patients who were treated with laryngeal cancer surgery think about this later on and what factors may be related with regretting surgery.

Objective: To assess variables associated with a positive attitude toward laryngeal cancer surgery.

Design, Setting, And Participants: This combination of 2 cohorts, based on patient interviews and questionnaires, was studied in 16 hospitals in Germany.

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Total neoadjuvant therapy (TNT) is an evolving treatment schedule for locally advanced rectal cancer (LARC), allowing for organ preservation in a relevant number of patients in the case of complete response. Patients who undergo this so-called "watch and wait" approach are likely to benefit regarding their quality of life (QoL), especially if definitive ostomy could be avoided. In this work, we performed the first cost-effectiveness analysis from the patient perspective to compare costs for TNT with radical resection after neoadjuvant chemoradiation (CRT) in the German health care system.

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Background And Objective: Data on enteral tube feeding in head and neck cancer (HNC) patients undergoing chemoradiotherapy vary considerably between German institutions. This survey aims to investigate the management of feeding tubes in an interdisciplinary context across Germany.

Materials And Methods: Between December 2022 and May 2023, 70 participants (42 radiation oncologists, 12 medical oncologists, 14 head and neck surgeons, and 2 physicians covering several specialties) responded to our web-based survey.

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Head and neck cancer (HNC) patients suffer from a range of health-related quality of life (HRQoL) issues, but little is known about their long-term HRQoL. This study explored associations between treatment group and HRQoL at least 5 years' post-diagnosis in HNC survivors. In an international cross-sectional study, HNC survivors completed the European Organization for Research and Treatment of Cancer (EORTC) quality of life core questionnaire (EORTC-QLQ-C30) and its HNC module (EORTC-QLQ-H&N35).

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Purpose: Patient satisfaction with healthcare has been linked to clinical outcomes and regulatory agencies demand its regular assessment. Therefore, we aimed to investigate patient satisfaction with radiotherapy care and its determinants.

Methods: This is a secondary analysis of a multicenter prospective cross-sectional study.

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Purpose: The number of older adults with head and neck squamous cell carcinoma (HNSCC) is increasing, and treatment of these patients is challenging. Although cisplatin-based chemotherapy concomitantly with radiation therapy is considered the standard regimen for patients with locoregionally advanced HNSCC, there is substantial real-world heterogeneity regarding concomitant chemotherapy in older patients with HNSCC.

Methods And Materials: The SENIOR study is an international multicenter cohort study including older patients (≥65 years) with HNSCC treated with definitive radiation therapy at 13 academic centers in the United States and Europe.

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Background: Head and neck cancers (HNCs) are very common malignancies, and treatment often requires multimodal approaches, including radiotherapy and chemotherapy. Patients with HNC often display a high symptom burden, both due to the disease itself and the adverse effects of the multimodal therapy. Close telemonitoring of symptoms and quality of life during the course of treatment may help to identify those patients requiring early medical support.

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Purpose: Palliative radiotherapy for patients with head and neck cancer can be used to alleviate symptoms. Only a few studies have investigated its impact on patient-reported outcomes (PRO). Therefore, we conducted a prospective multicenter observational study.

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Purpose: Psychosocial distress is common among cancer patients in general, but those undergoing radiotherapy may face specific challenges. Therefore, we investigated the prevalence and risk factors for distress in a large national cohort.

Methods: We performed a secondary analysis of a multicenter prospective cross-sectional study which surveyed cancer patients at the end of a course of radiotherapy using a patient-reported questionnaire.

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The long-term problems of head and neck cancer survivors (HNCS) are not well known. In a cross-sectional international study aimed at exploring the long-term quality of life in this population, 1114 HNCS were asked to state their two most serious long-term effects. A clinician recorded the responses during face-to-face appointments.

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Purpose: To establish and confirm prevalence as well as risk factors of financial toxicity in a large national cohort of cancer patients undergoing radiotherapy in a universal health care system.

Methods: We conducted a prospective cross-sectional study offering a patient-reported questionnaire to all eligible cancer patients treated with radiotherapy in 11 centers in Germany during 60 consecutive days. The four-point subjective financial distress question of the EORTC QLQ-C30 was used as a surrogate for financial toxicity.

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