Wissen schafft Heilung.

 Unser Team der Klinik und Poliklinik für RadioOnkologie und Strahlentherapie am Klinikum rechts der Isar in München

  Klinik und Poliklinik
  für RadioOnkologie
  und Strahlentherapie

Logo der DKG Krebsgesellschaft

  Klinikleitung
  Univ.-Prof. Dr. med.
  Stephanie E. Combs

  Klinikum rechts der Isar
  Technische Universität München
  Ismaninger Str. 22
  D - 81675 München
  direktion.radonk@mri.tum.de

  Direktionssekretariat
  Tel.: + 49 89 4140 - 4501 / - 4502


  Für Patientenanfragen und
  Terminvereinbarung:

  Privatambulanz
  Tel.: + 49 89 4140 - 4511
  privatambulanz.radonk@mri.tum.de

  Allgemeine Ambulanz im
  Tumortherapiezentrum (TTZ)

  Tel.: + 49 89 4140 - 4510
  ambulanz.radonk@mri.tum.de

  Spezialambulanz Stereotaxie,
  Brachytherapie

  Tel.: + 49 89 4140 - 4509
  spezialambulanz.radonk@mri.tum.de

  Station R2a
 
Tel.: + 49 89 4140 - 4304

MEMORI

Metabolic and Molecular Response Evaluation for the Individualization of Therapy in Adenocarcinomas of the Gastroesophageal Junction

Adenocarcinomas of the esophagus and the esophagogastric junction (AEG) are clinically-topographically divided into subtypes I-III according to the Siewert classification and show an increased incidence. Neoadjuvant and/or perioperative chemotherapy or preoperative radiochemotherapy is well established in the management of AEG. However, a significant number of patients do not respond to preoperative chemotherapy, suffering from toxicity and facing a worse outcome due to lower R0 resection rates. Previous results from the MUNICON-1 and MUNICON-2 trials have shown that PET-based therapy individualization can be successfully integrated in neoadjuvant treatment algorithms.
Tumor-free resection edges (R0) constitute the greatest prognostic advantage in terms of overall survival. However, the R0 resection rates for patients who, according to early metabolic response evaluation, have not responded to the chemotherapy, have not been satisfactory, even after conversion to an - albeit moderate - radiochemotherapy in the MUNICON-2 trial. Thus, this patient population (so-called non responders) so far lack a beneficial neoadjuvant therapy modality.
Based on these results, the primary goal of MEMORI study is to evaluate the R0 resection rate for patients with metabolically (ie, according to PET criteria) chemotherapy-resistant locally advanced AEG, who receive an intensified neoadjuvant chemoradiotherapy (INRCT). Secondary it is planned to investigate molecular and metabolic biomarkers in relation to their predictive and prognostic value by correlating them with histopathologic responses and clinical outcome in an exploratory approach. (see also https://clinicaltrials.gov/ct2/show/NCT02287129)

Inclusion Criteria

  • Histologically confirmed AEG I-III
  • Potentially R0 - resectable AEG and primary tumor category UT2 -4
  • Functional operability : Exclusion of OP - limiting comorbidities
  • Intense FDG tracer uptake of the tumor during Baseline PET/CT examination and thus suitability for monitoring and early response prediction by FDG - PET ( [ 18F ] - FDG uptake in the tumor at baseline > 1.35 x liver SUV + 2 x standard deviation of the liver SUV)
  • Performance status (ECOG ) 0 or 1
  • Age : ≥ 18
  • creatinine clearance > 60ml/min measured in a 24 h urine or calculated with the Cockgroft -Gault formula
  • bilirubin ≤ 1.5 times upper limit of normal , serum transaminases (GOT / GPT ) ≤ 3 times ULN
  • leukocytes ≥ 3.5 g / l, platelet ≥ 100 g / l
  • Negative pregnancy test (determination of beta- HCG in urine or serum) in women of childbearing potential
  • A signed consent form after implementation of medical education

Exclusion Criteria

  • Existing distant metastases (M1b)
  • Tumor infiltration into the tracheobronchial system
  • Previous radiotherapy targeted at the thorax
  • Lack of ability of the patient to adhere to the protocol rules
  • Manifest heart failure despite optimal medication> NYHA I
  • existing angina pectoris at rest or undergoing stress without clarification via interventional cardiology and / or myocardial infarction within the last 6 months
  • Existing pregnancy or lactation
  • childbearing or fertility without using recognized safe methods of contraception
  • Coexisting other malignant diseases with the exception of a non-melanomatuous, localized skin tumor or carcinoma in situ of the cervix
  • absence of a signed consent form

Aktuelles

26.04.2018: Neue Stellenanzeige: Leitende(n) Oberarzt / Oberärztin für die Klinik für RadioOnkologie. Mehr dazu: Stellenausschreibungen


26.04.2018: Stellenanzeigen: Sie sind MTRA? - Wir suchen Sie! Werden Sie Teil unseres Teams: MTRA in Voll- oder Teilzeit, MTRA für unsere neue Tomotherapie. Mehr dazu: Stellenausschreibungen


26.04.2018: Werden Sie Teil unseres Teams! Wir suchen: Eine/n Oberarzt/-ärztin & Facharzt/-ärztin, MTRA auf Minijob-Basis, studentische Hilfskraft. Mehr dazu: Stellenausschreibungen


08.02.2018: Neuer Artikel in "Der Onkologe" erschienen! "Update − Palliative Strahlentherapie von Knochenmetastasen. Empfehlungen der S3-Leitlinie Supportive Therapie bei onkologischen Patienten". Mehr dazu: Nachlesen