Publications by authors named "Maximilian Schmid"

Triple negative breast cancer (TNBC) is a heterogeneous and a highly aggressive type of breast cancer. Standard of care for TNBC patients includes surgery, radio-, chemo- and immunotherapy, depending on the stage of the disease. Immunotherapy is ineffective as monotherapy but can be enhanced with taxane chemotherapy or radiotherapy.

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Crack propagation in solder joints remains a major challenge impacting the thermo-mechanical reliability of electronic devices, underscoring the importance of optimizing package and solder pad designs. Traditional Finite Element Analysis (FEA) techniques for predicting solder joint lifespan often rely on manual post-processing to identify high-risk regions for plastic strain accumulation. However, this manual process can fail to detect complex and subtle failure mechanisms and purely based on averaging the creep strain and correlating it to lifetime values collected from experiments using Coffin Manson equation.

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Purpose: External beam radiation therapy (EBRT), concomitant cisplatin, and magnetic resonance image guided adaptive brachytherapy performed according to the EMBRACE-II study protocol (IntErnational study on MRI-guided BRAchytherapy in locally advanced CErvical cancer) is considered state-of-the-art for the treatment of locally advanced cervical cancer. The aim of the present study was to evaluate the possibilities for realizing the planning aims and to assess the clinical outcome of using the EMBRACE-II treatment principles in real-world patients.

Methods And Materials: The EMBRACE-II treatment protocol was implemented in 2015 at Aarhus University Hospital as standard for all patients.

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Purpose: This study aimed to assess patterns and risks of distant metastasis (DM) in patients with cervical cancer treated with chemoradiation therapy and MR-image guided adaptive brachytherapy (IGABT) and to explore a potential dose-effect relationship of concomitant cisplatin.

Methods And Materials: Data were derived from EMBRACE I, an international, prospective, and multicenter cohort study conducted at 24 centers across Europe, Asia, and North America from July 30, 2008, to December 29, 2015. The study included 1416 patients with biopsy-confirmed cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage IB-IVA or stage IVB limited to paraaortic lymph nodes below the L1/L2 interspace).

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Objective: Systemic chemotherapy in recurrent cervical cancer is a palliative treatment approach with limited oncologic outcome. As emerging evidence supports favorable prognosis following radical local treatment strategies for oligometastatic recurrence in gynecologic malignancies, there is an unmet clinical need to define prognostic implications of surgical metastasectomy in recurrent cervical cancer.

Methods: Data of 139 consecutive cervical cancer patients, who underwent primary external-beam radiotherapy with concomitant chemotherapy, followed by magnetic resonance image-guided adaptive brachytherapy between 2015 and 2019, was analyzed.

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Quantifying changes in the properties of smoke aerosols under varying conditions is important for understanding the health and environmental impacts of exposure to smoke. Smoke composition, aerosol liquid water content, effective density (ρ), and other properties can change significantly as smoke travels through areas under different ambient conditions and over time. During this study, we measured changes in smoke composition and physical properties due to oxidative aging and exposure to humidity.

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Article Synopsis
  • The ESSR updated its 2015 consensus on soft tissue tumor imaging due to advancements in technology and updated classifications.
  • A panel of 46 radiologists from 12 European countries used a validated Delphi method to reach consensus on imaging strategies, resulting in high agreement on 47 statements.
  • Key findings highlight that MRI is preferred for monitoring soft tissue sarcomas, with chest CT recommended for assessing metastasis and interventional radiology playing a role in treating specific cases.
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Introduction: Digital tools could assist obstetric providers by delivering information given increasing options for fetal aneuploidy screening.

Purpose: To determine the impact of a chatbot for pre-test education and counseling in low-risk pregnancies.

Methods: Two sites participated in this randomized controlled trial.

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Purpose: The purpose of this study was to provide risk estimations for vaginal morbidity with regard to vaginal dilation (summarizing the use of dilators and/or sexual activity) in patients with locally advanced cervical cancer treated with definitive radiochemotherapy and image guided adaptive brachytherapy within the prospective, multi-institutional EMBRACE-I study.

Methods And Materials: Physician-assessed vaginal morbidity (National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0), use of vaginal dilators, and patient-reported sexual activity (EORTC-CX24) were prospectively assessed at baseline and during regular follow-ups.

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Purpose: BIOEMBRACE was designed to study the impact of biomarkers in addition to clinicopathological factors on disease outcomes in patients treated with chemoradiation and magnetic resonance imaging (MRI)-guided brachytherapy (BT) for locally advanced cervical cancer in the EMBRACE study.

Methods And Materials: Between 2018 and 2021, 8 EMBRACE-I sites contributed tumor tissue for the immunohistochemistry of p16, PD-L1, and L1CAM. These biomarkers and clinicopathological factors (International Federation of Gynecology and Obstetrics 2009 stage, nodal status, histology, and necrosis on MRI) were analyzed to predict poor response at BT (high-risk clinical target volume [HR-CTV] ≥ 40 cc) at BT) and 5-year local control, pelvic control, and disease-free survival.

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Major improvements in radiotherapy over the past two decades in the definitive treatment of locally advanced cervical cancer have significantly improved loco-regional control and survival, whereas little progress has been made with chemotherapy since the implementation of concomitant cisplatin 25 years ago. However, the randomized study INTERLACE (A phase III multicenter trial of weekly induction chemotherapy followed by standard chemoradiation versus standard chemoradiation alone in patients with locally advanced cervical cancer) of neoadjuvant chemotherapy presented recently, has shown significant improvement in survival with the use of six cycles of weekly carboplatin and paclitaxel. Although INTERLACE is yet to be published, neoadjuvant chemotherapy is already being advocated as the new standard, and studies are being designed with neoadjuvant chemotherapy followed by chemoradiation and brachytherapy as the standard arm.

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Autophagy is an intracellular process that targets various cargos for degradation, including members of the cGAS-STING signaling cascade. cGAS-STING senses cytosolic double-stranded DNA and triggers an innate immune response through type I interferons. Emerging evidence suggests that autophagy plays a crucial role in regulating and fine-tuning cGAS-STING signaling.

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Article Synopsis
  • This study aimed to fill the gap in published information regarding brachytherapy for pediatric rhabdomyosarcoma and to establish guidelines for its use.*
  • An expert panel, consisting of 24 professionals in pediatric oncology and related fields, gathered to discuss their experiences and review relevant data to inform their findings.*
  • The panel concluded that brachytherapy is often used alongside tumor removal and developed consensus guidelines that will inform future research and treatment practices for this type of cancer.*
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This study describes the synthesis, radiofluorination and purification of an anionic amphiphilic teroligomer developed as a stabilizer for siRNA-loaded calcium phosphate nanoparticles (CaP-NPs). As the stabilizing amphiphile accumulates on nanoparticle surfaces, the fluorine-18-labeled polymer should enable to track the distribution of the CaP-NPs in brain tumors by positron emission tomography after application by convection-enhanced delivery. At first, an unmodified teroligomer was synthesized with a number average molecular weight of 4550 ± 20 Da by free radical polymerization of a defined composition of methoxy-PEG-monomethacrylate, tetradecyl acrylate and maleic anhydride.

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Primary vaginal malignancies are rare, comprising only 2% of all female genital tract malignancies in adults and 4.5% in children. As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) jointly with the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Pediatric Oncology (SIOPe) developed evidence-based guidelines in order to improve the management of patients with vaginal cancer within a multidisciplinary setting.

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In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer.

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Purpose: To develop a novel decision-support system for radiation oncology that incorporates clinical, treatment and outcome data, as well as outcome models from a large clinical trial on magnetic resonance image-guided adaptive brachytherapy (MR-IGABT) for locally advanced cervical cancer (LACC).

Methods: A system, called EviGUIDE, was developed that combines dosimetric information from the treatment planning system, patient and treatment characteristics, and established tumor control probability (TCP), and normal tissue complication probability (NTCP) models, to predict clinical outcome of radiotherapy treatment of LACC. Six Cox Proportional Hazards models based on data from 1341 patients of the EMBRACE-I study have been integrated.

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Primary vaginal malignancies are rare, comprising only 2% of all female genital tract malignancies in adults and 4.5% in children. As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) jointly with the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Pediatric Oncology (SIOPe) developed evidence-based guidelines in order to improve the management of patients with vaginal cancer within a multidisciplinary setting.

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In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer.

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Article Synopsis
  • In 2018, ESGO, ESTRO, and ESP published guidelines for cervical cancer management, which were later updated due to new evidence.
  • An expert panel of 27 clinicians across Europe was formed to review the guidelines, ensuring they are evidence-based and reflective of current research and clinical practices.
  • The updated guidelines cover various topics including diagnosis, treatment strategies, survivorship, quality of life, and include specific management approaches for different stages and scenarios of cervical cancer.
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Purpose: A meta-analysis is presented comparing clinical outcomes and toxicities between high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy (BT) for anal cancer.

Methods And Material: Retrospective or prospective clinical trials were identified on electronical databases. Data were collected per Preferred Reporting Items for Systematic Reviews and meta-Analyses guidelines.

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Purpose: To develop and implement a software that enables centers, treating patients with state-of-the-art radiation oncology, to compare their patient, treatment, and outcome data to a reference cohort, and to assess the quality of their treatment approach.

Materials And Methods: A comprehensive data dashboard was designed, which al- lowed holistic assessment of institutional treatment approaches. The software was tested in the ongoing EMBRACE-II study for locally advanced cervical cancer.

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Article Synopsis
  • The study aimed to assess how ongoing health issues affect quality of life (QOL) in survivors of locally advanced cervical cancer (LACC).
  • It involved analyzing data from the EMBRACE-I study, measuring patient-reported symptoms and QOL over time using specific scoring systems, and identifying persistent symptoms throughout follow-ups.
  • Results revealed that persistent symptoms significantly impact QOL, especially in areas like role functioning and general well-being, highlighting the need for better management of both general and organ-related symptoms post-treatment.
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Purpose: To evaluate overall severe late morbidity (grade ≥3) in patients with locally advanced cervical cancer treated with chemo-radiation therapy and magnetic resonance image guided adaptive brachytherapy within the prospective EMBRACE-I study, and to compare the results with published literature after standard radiograph based brachytherapy (BT).

Methods And Materials: From 2008 to 2015 the EMBRACE-I study enrolled 1416 patients. Morbidity was assessed (Common Terminology Criteria for Adverse Events version 3.

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