Nikola Cihoric | Inselspital Bern (original) (raw)

Papers by Nikola Cihoric

Research paper thumbnail of Current status and perspectives of interventional clinical trials for glioblastoma – analysis of ClinicalTrials.gov

The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on... more The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on the 19th of February 2016. Phase II and III trials including patients with glioblastoma were selected for further classification and analysis. Based on the disease settings, trials were classified into three groups: newly diagnosed glioblastoma, recurrent disease and trials with no differentiation according to disease setting. Furthermore, we categorized trials according to the experimental interventions, the primary sponsor, the source of financial support and trial design elements. Trends were evaluated using the autoregressive integrated moving average model. Two hundred sixteen (0.1%) trials were selected for further analysis. Academic centers (investigator initiated trials) were recorded as primary sponsors in 56.9% of trials, followed by industry 25.9%. Industry was the leading source of monetary support for the selected trials in 44.4%, followed by 25% of trials with primarily academic financial support. The number of newly initiated trials between 2005 and 2015 shows a positive trend, mainly through an increase in phase II trials, whereas phase III trials show a negative trend. The vast majority of trials evaluate forms of different systemic treatments (91.2%). In total, one hundred different molecular entities or biologicals were identified. Of those, 60% were involving drugs specifically designed for central nervous system malignancies. Trials that specifically address radiotherapy, surgery, imaging and other therapeutic or diagnostic methods appear to be rare. Current research in glioblastoma is mainly driven or sponsored by industry, academic medical oncologists and neuro-oncologists, with the majority of trials evaluating forms of systemic therapies. Few trials reach phase III. Imaging, radiation therapy and surgical procedures are underrepresented in current trials portfolios. Optimization in research portfolio for glioblastoma is needed.

Research paper thumbnail of Analysis of Clinical Trials in Radiation Oncology: A Systematic Characterization of the Clinicaltrials.gov Database

International Journal of Radiation Oncology*Biology*Physics, 2014

Research paper thumbnail of What is the Role of BED and Margin Concept in SBRT of Lung Lesions?

PURPOSE To evaluate the role of BED and F-18 FDG PET/CT for target volume delineation and clinica... more PURPOSE To evaluate the role of BED and F-18 FDG PET/CT for target volume delineation and clinical outcome after SBRT 47 lung lesions were analyzed prospectively. METHOD AND MATERIALS Inclusion criteria: histologically proven NSCLC stage I or hypermetabolic oligometastatic lung lesions. Peripheral or central localization, maximal tumor diameter of 50mm. Karnofsky index > 60%. Medically inoperable. Moving of the lung lesion during breathing less than 5mm as detected by 4D-CT. Initial staging: whole body and deep inspiration breath hold F-18 FDG PET/CT in radiation treatment position, MRI of the brain. Radiation treatment planning: 4D-CT and angio-CT in radiation treatment position for target volume delineation. Using 4D-CT for target volume delineation, a Boolean operation was used to sum the multiple gross target volumes (GTV) delineated in diagnostic lung window to form an internal target volume (ITV). The planning target volume (PTV) was derived by a three-dimensional isotropic...

Research paper thumbnail of Hyperthermia-related clinical trials on cancer treatment within the ClinicalTrials.gov registry

International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group, Jan 15, 2015

Hyperthermia has been shown to improve the effectiveness of chemotherapy and radiotherapy in the ... more Hyperthermia has been shown to improve the effectiveness of chemotherapy and radiotherapy in the treatment of cancer. This paper summarises all recent clinical trials registered in the ClinicalTrials.gov registry. The records of 175,538 clinical trials registered at ClinicalTrials.gov were downloaded on 29 September 2014 and a database was established. We searched this database for hyperthermia or equivalent words. A total of 109 trials were identified in which hyperthermia was part of the treatment regimen. Of these, 49 trials (45%) had hyperthermic intraperitoneal chemotherapy after cytoreductive surgery (HIPEC) as the primary intervention, and 14 other trials (13%) were also testing some form of intraperitoneal hyperthermic chemoperfusion. Seven trials (6%) were testing perfusion attempts to other locations (thoracic/pleural n = 4, limb n = 2, hepatic n = 1). Sixteen trials (15%) were testing regional hyperthermia, 13 trials (12%) whole body hyperthermia, seven trials (6%) superf...

Research paper thumbnail of Is Molecular Remission as Detected by 18F-FDG PET/CT and Regression Grade After Neoadjuvant Treatment in the Primary Tumor and the Involved Mediastinal Lymph Nodes a Prognostic Factor in Patients With NSCLC Stage III?

International Journal of Radiation Oncology*Biology*Physics, 2014

Introduction: CT alone cannot provide sufficient information referring to response after neoadjuv... more Introduction: CT alone cannot provide sufficient information referring to response after neoadjuvant therapy in a timely manner. To evaluate the role of 18 F-FDG-PET after neoadjuvant chemoradiation as a valid, non-invasive predictor for early therapy response and its effect on survival as compared to histopathologic tumor response, data of 32 of 210 randomized patients with NSCLC stage IIIA/IIIB, who were treated in a prospective randomized controlled multicenter trial (LUCAS-MD), were re-evaluated. Material and Methods: For 32 patients with NSCLC stage IIIA (44%) IIIB (56%) neoadjuvant treatment consisted of two to three cycles of chemotherapy (225 mg/m 2 paclitaxel and carboplatin AUC 6 d1q22) and concomitant chemoradiation (50 mg/m 2 paclitaxel and carboplatin AUC 2 d1, d8, d15; 1.5 Gy b.i.d. up to 45 Gy). Documentation of involved lymph node stations as detected by 18 F-FDG-PET/CT and lymph node sampling during surgery according to the IASLC lymph node mapping (2009). Evaluation of histological regression grade (RG) according to Junker et al. (2001) and correlation with 18 F-FDG-PET/CT for primary tumor and each lymph node station. Calculation of disease free survival using Kaplan-Meier estimates and log rank tests. Results: Actuarial tumor specific survival for the 32 patients with concomitant chemoradiation plus chemotherapy: complete vs. incomplete metabolic remission prior to surgery after 60 months: N. D. Klass et al.

Research paper thumbnail of In Regard to Lao et al

International journal of radiation oncology, biology, physics, 2015

Research paper thumbnail of A Call for Careful Interpretation of Outcome of Nonsurgical Approach in Clinical Stage IIIa Non-Small Cell Lung Cancer in the National Cancer Database

The Annals of Thoracic Surgery, 2015

Research paper thumbnail of Impact of PET-CT-guided interventions with regard to the therapeutic management of cancer patients planned for radiotherapy: Initial experiences

Research paper thumbnail of Treatment Response in FDG-Pet-Based Treatment Planning for Dose Escalation in Locoregional Advanced Cervical Cancer

Research paper thumbnail of No Role For Trimodality Therapy and Consolidation Chemotherapy Compared With Concurrent Radiochemotherapy Alone in Stage III Non-Small-Cell Lung Cancer

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 16, 2015

Research paper thumbnail of Intensity Modulated Radiotherapy (Imrt) in the Treatment of Cervical Cancer Patients-Our Experience

Research paper thumbnail of Local Failure in Breast-Conserving Therapy with Regard to Localisation and Dose of Radiotherapy

Research paper thumbnail of What is the role of 99mTc-MAA SPECT/CT for radiation treatment planning in thoracic tumors using VMAT?

Research paper thumbnail of Comparison of 3DCRT, IMRT and VMAT treatment plans for bilateral breast cancer

Research paper thumbnail of Outcome of patients with vulvar cancer treated with postoperative IMRT

Research paper thumbnail of Accelerated partial breast irradiation (apbi) with multicatheter brachytherapy (mcb): experience of a single institution

Research paper thumbnail of Locoregional control of proximal esophageal cancer after definitive radio-/chemotherapy

Research paper thumbnail of VMAT radiotherapy with cisplatin and gemcitabine for treatment of loco-regionally advanced cervical cancer

Research paper thumbnail of Is there a role of 99MTC-MAA spect/CT for radiation treatment planning in thoracic tumors using VMAT?

Research paper thumbnail of Detection of systemic metastases and secondary malignant tumors by 18F-FDG PET/CT in head and neck squamous cell carcinoma (HNSCC)

Research paper thumbnail of Current status and perspectives of interventional clinical trials for glioblastoma – analysis of ClinicalTrials.gov

The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on... more The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on the 19th of February 2016. Phase II and III trials including patients with glioblastoma were selected for further classification and analysis. Based on the disease settings, trials were classified into three groups: newly diagnosed glioblastoma, recurrent disease and trials with no differentiation according to disease setting. Furthermore, we categorized trials according to the experimental interventions, the primary sponsor, the source of financial support and trial design elements. Trends were evaluated using the autoregressive integrated moving average model. Two hundred sixteen (0.1%) trials were selected for further analysis. Academic centers (investigator initiated trials) were recorded as primary sponsors in 56.9% of trials, followed by industry 25.9%. Industry was the leading source of monetary support for the selected trials in 44.4%, followed by 25% of trials with primarily academic financial support. The number of newly initiated trials between 2005 and 2015 shows a positive trend, mainly through an increase in phase II trials, whereas phase III trials show a negative trend. The vast majority of trials evaluate forms of different systemic treatments (91.2%). In total, one hundred different molecular entities or biologicals were identified. Of those, 60% were involving drugs specifically designed for central nervous system malignancies. Trials that specifically address radiotherapy, surgery, imaging and other therapeutic or diagnostic methods appear to be rare. Current research in glioblastoma is mainly driven or sponsored by industry, academic medical oncologists and neuro-oncologists, with the majority of trials evaluating forms of systemic therapies. Few trials reach phase III. Imaging, radiation therapy and surgical procedures are underrepresented in current trials portfolios. Optimization in research portfolio for glioblastoma is needed.

Research paper thumbnail of Analysis of Clinical Trials in Radiation Oncology: A Systematic Characterization of the Clinicaltrials.gov Database

International Journal of Radiation Oncology*Biology*Physics, 2014

Research paper thumbnail of What is the Role of BED and Margin Concept in SBRT of Lung Lesions?

PURPOSE To evaluate the role of BED and F-18 FDG PET/CT for target volume delineation and clinica... more PURPOSE To evaluate the role of BED and F-18 FDG PET/CT for target volume delineation and clinical outcome after SBRT 47 lung lesions were analyzed prospectively. METHOD AND MATERIALS Inclusion criteria: histologically proven NSCLC stage I or hypermetabolic oligometastatic lung lesions. Peripheral or central localization, maximal tumor diameter of 50mm. Karnofsky index > 60%. Medically inoperable. Moving of the lung lesion during breathing less than 5mm as detected by 4D-CT. Initial staging: whole body and deep inspiration breath hold F-18 FDG PET/CT in radiation treatment position, MRI of the brain. Radiation treatment planning: 4D-CT and angio-CT in radiation treatment position for target volume delineation. Using 4D-CT for target volume delineation, a Boolean operation was used to sum the multiple gross target volumes (GTV) delineated in diagnostic lung window to form an internal target volume (ITV). The planning target volume (PTV) was derived by a three-dimensional isotropic...

Research paper thumbnail of Hyperthermia-related clinical trials on cancer treatment within the ClinicalTrials.gov registry

International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group, Jan 15, 2015

Hyperthermia has been shown to improve the effectiveness of chemotherapy and radiotherapy in the ... more Hyperthermia has been shown to improve the effectiveness of chemotherapy and radiotherapy in the treatment of cancer. This paper summarises all recent clinical trials registered in the ClinicalTrials.gov registry. The records of 175,538 clinical trials registered at ClinicalTrials.gov were downloaded on 29 September 2014 and a database was established. We searched this database for hyperthermia or equivalent words. A total of 109 trials were identified in which hyperthermia was part of the treatment regimen. Of these, 49 trials (45%) had hyperthermic intraperitoneal chemotherapy after cytoreductive surgery (HIPEC) as the primary intervention, and 14 other trials (13%) were also testing some form of intraperitoneal hyperthermic chemoperfusion. Seven trials (6%) were testing perfusion attempts to other locations (thoracic/pleural n = 4, limb n = 2, hepatic n = 1). Sixteen trials (15%) were testing regional hyperthermia, 13 trials (12%) whole body hyperthermia, seven trials (6%) superf...

Research paper thumbnail of Is Molecular Remission as Detected by 18F-FDG PET/CT and Regression Grade After Neoadjuvant Treatment in the Primary Tumor and the Involved Mediastinal Lymph Nodes a Prognostic Factor in Patients With NSCLC Stage III?

International Journal of Radiation Oncology*Biology*Physics, 2014

Introduction: CT alone cannot provide sufficient information referring to response after neoadjuv... more Introduction: CT alone cannot provide sufficient information referring to response after neoadjuvant therapy in a timely manner. To evaluate the role of 18 F-FDG-PET after neoadjuvant chemoradiation as a valid, non-invasive predictor for early therapy response and its effect on survival as compared to histopathologic tumor response, data of 32 of 210 randomized patients with NSCLC stage IIIA/IIIB, who were treated in a prospective randomized controlled multicenter trial (LUCAS-MD), were re-evaluated. Material and Methods: For 32 patients with NSCLC stage IIIA (44%) IIIB (56%) neoadjuvant treatment consisted of two to three cycles of chemotherapy (225 mg/m 2 paclitaxel and carboplatin AUC 6 d1q22) and concomitant chemoradiation (50 mg/m 2 paclitaxel and carboplatin AUC 2 d1, d8, d15; 1.5 Gy b.i.d. up to 45 Gy). Documentation of involved lymph node stations as detected by 18 F-FDG-PET/CT and lymph node sampling during surgery according to the IASLC lymph node mapping (2009). Evaluation of histological regression grade (RG) according to Junker et al. (2001) and correlation with 18 F-FDG-PET/CT for primary tumor and each lymph node station. Calculation of disease free survival using Kaplan-Meier estimates and log rank tests. Results: Actuarial tumor specific survival for the 32 patients with concomitant chemoradiation plus chemotherapy: complete vs. incomplete metabolic remission prior to surgery after 60 months: N. D. Klass et al.

Research paper thumbnail of In Regard to Lao et al

International journal of radiation oncology, biology, physics, 2015

Research paper thumbnail of A Call for Careful Interpretation of Outcome of Nonsurgical Approach in Clinical Stage IIIa Non-Small Cell Lung Cancer in the National Cancer Database

The Annals of Thoracic Surgery, 2015

Research paper thumbnail of Impact of PET-CT-guided interventions with regard to the therapeutic management of cancer patients planned for radiotherapy: Initial experiences

Research paper thumbnail of Treatment Response in FDG-Pet-Based Treatment Planning for Dose Escalation in Locoregional Advanced Cervical Cancer

Research paper thumbnail of No Role For Trimodality Therapy and Consolidation Chemotherapy Compared With Concurrent Radiochemotherapy Alone in Stage III Non-Small-Cell Lung Cancer

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 16, 2015

Research paper thumbnail of Intensity Modulated Radiotherapy (Imrt) in the Treatment of Cervical Cancer Patients-Our Experience

Research paper thumbnail of Local Failure in Breast-Conserving Therapy with Regard to Localisation and Dose of Radiotherapy

Research paper thumbnail of What is the role of 99mTc-MAA SPECT/CT for radiation treatment planning in thoracic tumors using VMAT?

Research paper thumbnail of Comparison of 3DCRT, IMRT and VMAT treatment plans for bilateral breast cancer

Research paper thumbnail of Outcome of patients with vulvar cancer treated with postoperative IMRT

Research paper thumbnail of Accelerated partial breast irradiation (apbi) with multicatheter brachytherapy (mcb): experience of a single institution

Research paper thumbnail of Locoregional control of proximal esophageal cancer after definitive radio-/chemotherapy

Research paper thumbnail of VMAT radiotherapy with cisplatin and gemcitabine for treatment of loco-regionally advanced cervical cancer

Research paper thumbnail of Is there a role of 99MTC-MAA spect/CT for radiation treatment planning in thoracic tumors using VMAT?

Research paper thumbnail of Detection of systemic metastases and secondary malignant tumors by 18F-FDG PET/CT in head and neck squamous cell carcinoma (HNSCC)