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Sample records for concurrent systemic chemotherapy

  1. WE-D-BRE-04: Modeling Optimal Concurrent Chemotherapy Schedules

    SciTech Connect

    Jeong, J; Deasy, J O

    2014-06-15

    Purpose: Concurrent chemo-radiation therapy (CCRT) has become a more common cancer treatment option with a better tumor control rate for several tumor sites, including head and neck and lung cancer. In this work, possible optimal chemotherapy schedules were investigated by implementing chemotherapy cell-kill into a tumor response model of RT. Methods: The chemotherapy effect has been added into a published model (Jeong et al., PMB (2013) 58:4897), in which the tumor response to RT can be simulated with the effects of hypoxia and proliferation. Based on the two-compartment pharmacokinetic model, the temporal concentration of chemotherapy agent was estimated. Log cell-kill was assumed and the cell-kill constant was estimated from the observed increase in local control due to concurrent chemotherapy. For a simplified two cycle CCRT regime, several different starting times and intervals were simulated with conventional RT regime (2Gy/fx, 5fx/wk). The effectiveness of CCRT was evaluated in terms of reduction in radiation dose required for 50% of control to find the optimal chemotherapy schedule. Results: Assuming the typical slope of dose response curve (?50=2), the observed 10% increase in local control rate was evaluated to be equivalent to an extra RT dose of about 4 Gy, from which the cell-kill rate of chemotherapy was derived to be about 0.35. Best response was obtained when chemotherapy was started at about 3 weeks after RT began. As the interval between two cycles decreases, the efficacy of chemotherapy increases with broader range of optimal starting times. Conclusion: The effect of chemotherapy has been implemented into the resource-conservation tumor response model to investigate CCRT. The results suggest that the concurrent chemotherapy might be more effective when delayed for about 3 weeks, due to lower tumor burden and a larger fraction of proliferating cells after reoxygenation.

  2. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2003-01-01

    The Document Concurrence System is a combination of software modules for routing users' expressions of concurrence with documents. This system enables determination of the current status of concurrences and eliminates the need for the prior practice of manually delivering paper documents to all persons whose approvals were required. This system runs on a server, and participants gain access via personal computers equipped with Web-browser and electronic-mail software. A user can begin a concurrence routing process by logging onto an administration module, naming the approvers and stating the sequence for routing among them, and attaching documents. The server then sends a message to the first person on the list. Upon concurrence by the first person, the system sends a message to the second person, and so forth. A person on the list indicates approval, places the documents on hold, or indicates disapproval, via a Web-based module. When the last person on the list had concurred, a message is sent to the initiator, who can then finalize the process through the administration module. A background process running on the server identifies concurrence processes that are overdue and sends reminders to the appropriate persons.

  3. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2003-01-01

    The Document Concurrence System is a combination of software modules for routing users' expressions of concurrence with documents. This system enables determination of the current status of concurrences and eliminates the need for the prior practice of manually delivering paper documents to all persons whose approvals were required. This system runs on a server, and participants gain access via personal computers equipped with Web-browser and electronic-mail software. A user can begin a concurrence routing process by logging onto an administration module, naming the approvers and stating the sequence for routing among them, and attaching documents. The server then sends a message to the first person on the list. Upon concurrence by the first person, the system sends a message to the second person, and so forth. A person on the list indicates approval, places the documents on hold, or indicates disapproval, via a Web-based module. When the last person on the list has concurred, a message is sent to the initiator, who can then finalize the process through the administration module. A background process running on the server identifies concurrence processes that are overdue and sends reminders to the appropriate persons.

  4. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2004-01-01

    The Document Concurrence System is a combination of software modules for routing users expressions of concurrence with documents. This system enables determination of the current status of concurrences and eliminates the need for the prior practice of manually delivering paper documents to all persons whose approvals were required. This system runs on a server, and participants gain access via personal computers equipped with Web-browser and electronic-mail software. A user can begin a concurrence routing process by logging onto an administration module, naming the approvers and stating the sequence for routing among them, and attaching documents. The server then sends a message to the first person on the list. Upon concurrence by the first person, the system sends a message to the second person, and so forth. A person on the list indicates approval, places the documents on hold, or indicates disapproval, via a Web-based module. When the last person on the list has concurred, a message is sent to the initiator, who can then finalize the process through the administration module. A background process running on the server identifies concurrence processes that are overdue and sends reminders to the appropriate persons.

  5. Proton Beam Therapy and Concurrent Chemotherapy for Esophageal Cancer

    SciTech Connect

    Lin, Steven H.; Komaki, Ritsuko; Liao Zhongxing; Wei, Caimiao; Myles, Bevan; Guo Xiaomao; Palmer, Matthew; Mohan, Radhe; Swisher, Stephen G.; Hofstetter, Wayne L.; Ajani, Jaffer A.; Cox, James D.

    2012-07-01

    Purpose: Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT (CChT/PBT) at MD Anderson Cancer Center. Methods and Materials: This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with passive scattering PBT with two- or three-field beam arrangement using 180 to 250 MV protons. We used the Kaplan-Meier method to assess time-to-event outcomes and compared the distributions between groups using the log-rank test. Results: The median follow-up time was 20.1 months for survivors. The median age was 68 years (range, 38-86). Most patients were males (82%) who had adenocarcinomas (76%) and Stage II-III disease (84%). The median radiation dose was 50.4 Gy (RBE [relative biologic equivalence]) (range, 36-57.6). The most common grade 2 to 3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two cases of grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT, with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rates (0%-1% residual cells) were 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) than in the definitive CChT/PBT group (16/33) (log-rank test, p = 0.005), there were no differences in distant metastatic (DM)-free interval or overall survival (OS) between the two groups. Conclusions: This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities, but the pathologic response and clinical outcomes are encouraging. Prospective comparison with more traditional approach is warranted.

  6. Efficacy of concurrent single-agent chemotherapy using radiotherapy in patients with cervical cancer: a meta-analysis.

    PubMed

    Zhang, Ying; Yang, Zhicheng; Zhou, Yijin; Pan, Jingjing; Liu, Yongyuan

    2015-01-01

    Concurrent chemoradiotherapy has proven to be more effective on patients with advanced cervical cancer than radiotherapy alone. Although cisplatin has been recommended to be the standard agent in chemotherapy, it has some limitations in clinical use because of its strong side effects. Moreover, the optimal chemotherapy regimen remains unclear. A comprehensive electronic search was conducted via the Internet retrieval system to identify eligible trials. The ending points included response, overall survival (OS), local recurrent, and distant metastasis rates. Odds ratios and 95% confidence interval were calculated to compare the effects. Fifteen trials with 1142 patients were eligible. With regard to the response rate, only nedaplatin showed a significant improvement compared with cisplatin. Docetaxel, pacitaxel, fluoropyrimidine, paclitaxel liposome, and irinotecan did not show any advantages. When targeted on OS or local recurrent rate, no significant advantage was found when these single-drug regimens were compared with cisplatin. However, when aimed at distant metastasis rate, fluoropyrimidine showed a disadvantage to cisplatin, whereas others showed equal efficacy. Nedaplatin, docetaxel, pacitaxel, and fluoropyrimidine showed a better effect on reducing chemotherapy toxicity than cisplatin. Single-drug chemotherapy concurrent with radiotherapy, except for nedaplatin, may have no advantage on clinical outcomes when compared with cisplatin but showed a better effect on reducing chemotherapy toxicity, which could be used as an alternative to patients who can not tolerate the side effects of cisplatin. Nedaplatin is also effective and safe, and may be highly valuable in clinical applications. PMID:26309518

  7. Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer

    SciTech Connect

    Nagar, Himanshu; Boothe, Dustin; Parikh, Amar; Yondorf, Menachem; Parashar, Bhupesh; Gupta, Divya; Holcomb, Kevin; Caputo, Thomas; Chao, K. S. Clifford; Nori, Dattatreyudu; Wernicke, A. Gabriella

    2013-11-15

    Purpose: To evaluate the tolerability and toxicity of administering vaginal brachytherapy (VB) concurrently during chemotherapy compared with the sequential approach for patients with endometrial cancer. Methods and Materials: A retrospective analysis of 372 surgically staged patients with endometrial cancer American Joint Committee on Cancer 2009 stages I to IV treated with adjuvant postoperative radiation therapy (RT) at our institution from 2001 to 2012 was conducted. All patients received VB + external beam RT (EBRT) + 6 cycles of adjuvant carboplatin- and paclitaxel-based chemotherapy. The VB mean dose was 15.08 Gy (range, 15-20 Gy), with 3 to 4 weekly applications, and the EBRT mean dose was 45 Gy delivered with 3-dimensional or intensity modulated RT techniques. Hematologic, gastrointestinal (GI), and genitourinary (GU) toxicities were assessed by Common Toxicity Criteria (CTC) and compared between sequential and concurrent chemotherapy and VB schedules. Results: Among patients who received RT and adjuvant chemotherapy, 180 of 372 patients (48%) received RT sandwiched between cycles 3 and 4 of chemotherapy. A separate group of 192 patients (52%) were treated with VB during the first 3 cycles of chemotherapy, with a weekly application on nonchemotherapy days, and received the EBRT portion in a sandwiched fashion. Patients treated with VB during chemotherapy had a decreased overall treatment time by 4 weeks (P<.001; 95% confidence interval: 3.99-4.02) and sustained no difference in CTC-graded acute hematologic, GI, or GU toxicities in comparison with the patients treated with VB and chemotherapy in a sequential manner (P>.05). CTC grade 3 or 4 hematologic, GI, and GU toxicities were zero. Conclusions: VB during chemotherapy is well tolerated, decreases overall treatment time, and does not render more toxicity than the sequential regimen.

  8. Intensity-Modulated Radiation Therapy With Concurrent Chemotherapy as Preoperative Treatment for Localized Gastric Adenocarcinoma

    SciTech Connect

    Chakravarty, Twisha; Crane, Christopher H.; Ajani, Jaffer A.; Mansfield, Paul F.; Briere, Tina M.; Beddar, A. Sam; Mok, Henry; Reed, Valerie K.; Krishnan, Sunil; Delclos, Marc E.; Das, Prajnan

    2012-06-01

    Purpose: The goal of this study was to evaluate dosimetric parameters, acute toxicity, pathologic response, and local control in patients treated with preoperative intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for localized gastric adenocarcinoma. Methods: Between November 2007 and April 2010, 25 patients with localized gastric adenocarcinoma were treated with induction chemotherapy, followed by preoperative IMRT and concurrent chemotherapy and, finally, surgical resection. The median radiation therapy dose was 45 Gy. Concurrent chemotherapy was 5-fluorouracil and oxaliplatin in 18 patients, capecitabine in 3, and other regimens in 4. Subsequently, resection was performed with total gastrectomy in 13 patients, subtotal gastrectomy in 7, and other surgeries in 5. Results: Target coverage, expressed as the ratio of the minimum dose received by 99% of the planning target volume to the prescribed dose, was a median of 0.97 (range, 0.92-1.01). The median V{sub 30} (percentage of volume receiving at least 30 Gy) for the liver was 26%; the median V{sub 20} (percentage of volume receiving at least 20 Gy) for the right and left kidneys was 14% and 24%, respectively; and the median V{sub 40} (percentage of volume receiving at least 40 Gy) for the heart was 18%. Grade 3 acute toxicity developed in 14 patients (56%), including dehydration in 10, nausea in 8, and anorexia in 5. Grade 4 acute toxicity did not develop in any patient. There were no significant differences in the rates of acute toxicity, hospitalization, or feeding tube use in comparison to those in a group of 50 patients treated with preoperative three-dimensional conformal radiation therapy with concurrent chemotherapy. R0 resection was obtained in 20 patients (80%), and pathologic complete response occurred in 5 (20%). Conclusions: Preoperative IMRT for gastric adenocarcinoma was well tolerated, accomplished excellent target coverage and normal structure sparing, and led to appropriate pathologic outcomes.

  9. Acute Esophagus Toxicity in Lung Cancer Patients After Intensity Modulated Radiation Therapy and Concurrent Chemotherapy

    SciTech Connect

    Kwint, Margriet; Uyterlinde, Wilma; Nijkamp, Jasper; Chen, Chun; Bois, Josien de; Sonke, Jan-Jakob; Heuvel, Michel van den; Knegjens, Joost; Herk, Marcel van; Belderbos, Jose

    2012-10-01

    Purpose: The purpose of this study was to investigate the dose-effect relation between acute esophageal toxicity (AET) and the dose-volume parameters of the esophagus after intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with non-small cell lung cancer (NSCLC). Patients and Methods: One hundred thirty-nine patients with inoperable NSCLC treated with IMRT and concurrent chemotherapy were prospectively analyzed. The fractionation scheme was 66 Gy in 24 fractions. All patients received concurrently a daily dose of cisplatin (6 mg/m Superscript-Two ). Maximum AET was scored according to Common Toxicity Criteria 3.0. Dose-volume parameters V5 to V70, D{sub mean} and D{sub max} of the esophagus were calculated. A logistic regression analysis was performed to analyze the dose-effect relation between these parameters and grade {>=}2 and grade {>=}3 AET. The outcome was compared with the clinically used esophagus V35 prediction model for grade {>=}2 after radical 3-dimensional conformal radiation therapy (3DCRT) treatment. Results: In our patient group, 9% did not experience AET, and 31% experienced grade 1 AET, 38% grade 2 AET, and 22% grade 3 AET. The incidence of grade 2 and grade 3 AET was not different from that in patients treated with CCRT using 3DCRT. The V50 turned out to be the most significant dosimetric predictor for grade {>=}3 AET (P=.012). The derived V50 model was shown to predict grade {>=}2 AET significantly better than the clinical V35 model (P<.001). Conclusions: For NSCLC patients treated with IMRT and concurrent chemotherapy, the V50 was identified as most accurate predictor of grade {>=}3 AET. There was no difference in the incidence of grade {>=}2 AET between 3DCRT and IMRT in patients treated with concurrent chemoradiation therapy.

  10. Comparison of Outcomes for Patients With Unresectable, Locally Advanced Non-Small-Cell Lung Cancer Treated With Induction Chemotherapy Followed By Concurrent Chemoradiation vs. Concurrent Chemoradiation Alone

    SciTech Connect

    Huang, Eugene H.; Liao Zhongxing; Cox, James D.; Guerrero, Thomas M.; Chang, Joe Y.; Jeter, Melinda; Borghero, Yerko; Wei Xiong; Fossella, Frank; Allen, Pamela K.; Komaki, Ritsuko . E-mail: rkomaki@mdanderson.org

    2007-07-01

    Purpose: To retrospectively compare outcomes for patients with unresectable locally advanced non-small-cell lung cancer (NSCLC) treated at our institution with concurrent chemoradiation with or without induction chemotherapy. Methods and Materials: We retrospectively analyzed 265 consecutive patients who received definitive treatment with three-dimensional conformal radiation and concurrent chemotherapy. Of these, 127 patients received induction chemotherapy before concurrent chemoradiation. Results: The two groups of patients (with induction vs. without induction chemotherapy) were similar in age, performance status, weight loss, histology, grade, and stage. Patients who received induction chemotherapy had better overall survival (median, 1.9 vs. 1.4 years; 5-year rate, 25% vs. 12%; p < 0.001) and distant metastasis-free survival (5-year rate, 42% vs. 23%; p = 0.021). Locoregional control was not significantly different between the two groups. Multivariate analysis showed that induction chemotherapy was the most significant factor affecting overall survival, with a hazard ratio of 0.55 (95% confidence interval 0.40-0.75; p < 0.001). A planned subgroup analysis showed that induction chemotherapy was associated with a significant overall survival benefit for patients with adenocarcinoma or large-cell carcinoma (5-year rate, 24% vs. 8%; p = 0.003) but not for those with squamous cell carcinoma. A multivariate analysis of patients with adenocarcinoma or large-cell carcinoma confirmed that induction chemotherapy was the most significant factor associated with better overall survival, with a hazard ratio of 0.47 (95% confidence interval, 0.28-0.78; p = 0.003). Conclusion: Our retrospective analysis suggests that in combination with concurrent chemoradiation, induction chemotherapy may provide a small but significant survival benefit for patients with unresectable locally advanced adenocarcinoma or large-cell carcinoma of the lung.

  11. High-dose Helical Tomotherapy With Concurrent Full-dose Chemotherapy for Locally Advanced Pancreatic Cancer

    SciTech Connect

    Chang, Jee Suk; Wang, Michael L.C.; Koom, Woong Sub; Yoon, Hong In; Chung, Yoonsun; Song, Si Young; Seong, Jinsil

    2012-08-01

    Purpose: To improve poor therapeutic outcome of current practice of chemoradiotherapy (CRT), high-dose helical tomotherapy (HT) with concurrent full-dose chemotherapy has been performed on patients with locally advanced pancreatic cancer (LAPC), and the results were analyzed. Methods and Materials: We retrospectively reviewed 39 patients with LAPC treated with radiotherapy using HT (median, 58.4 Gy; range, 50.8-59.9 Gy) and concomitant chemotherapy between 2006 and 2009. Radiotherapy was directed to the primary tumor with a 0.5-cm margin without prophylactic nodal coverage. Twenty-nine patients (79%) received full-dose (1000 mg/m{sup 2}) gemcitabine-based chemotherapy during HT. After completion of CRT, maintenance chemotherapy was administered to 37 patients (95%). Results: The median follow-up was 15.5 months (range, 3.4-43.9) for the entire cohort, and 22.5 months (range, 12.0-43.9) for the surviving patients. The 1- and 2-year local progression-free survival rates were 82.1% and 77.3%, respectively. Eight patients (21%) were converted to resectable status, including 1 with a pathological complete response. The median overall survival and progression-free survival were 21.2 and 14.0 months, respectively. Acute toxicities were acceptable with no gastrointestinal (GI) toxicity higher than Grade 3. Severe late GI toxicity ({>=}Grade 3) occurred in 10 patients (26%); 1 treatment-related death from GI bleeding was observed. Conclusion: High-dose helical tomotherapy with concurrent full-dose chemotherapy resulted in improved local control and long-term survival in patients with LAPC. Future studies are needed to widen the therapeutic window by minimizing late GI toxicity.

  12. Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer

    PubMed Central

    FAN, TING-YONG; XING, JUN; LU, JIE; LIU, TONG-HAI; XU, MIN; ZHANG, YING-JIE; SHAO, QIAN; LI, JIAN-BIN; YU, JIN-MING

    2013-01-01

    This study aimed to evaluate the efficacy, toxicity and tolerability of simultaneous modulated accelerated radiation therapy (SMART)-intensity modulated radiotherapy (IMRT) plus cisplatin and 5-fluorouracil (5-FU) chemotherapy for patients with advanced nasopharyngeal cancer (NPC). Forty-five patients with stage II–IV NPC, determined by the American Joint Committee on Cancer system, were treated with prescribed doses of 72 Gy total to the gross tumor volume, 60 Gy to the clinical target volume and metastatic nodal station, and 54 Gy to the clinically-negative neck region. Before radiotherapy, two cycles of cisplatin (30 mg/m2/day on days 1–3) plus 5-FU (400 mg/m2/day on days 1–5) were delivered every three weeks for two cycles. Patients received two cycles of cisplatin (30 mg/m2 day on days 1–3) every three weeks during radiotherapy. In addition, two cycles of cisplatin and 5-FU were given after radiation. All patients completed the prescribed radiotherapy and all scheduled cycles of chemotherapy. Thirty of the 45 patients (66.6%) had a complete response at the end of treatment. Grade 3 mucositis occurred in 4/45 patients (8.8%) and grade 3 dermatitis occurred in 5/45 (11.1%) during radiotherapy. Grade 3 neutropenia occurred in 6/45 (13.3%) during concurrent chemotherapy. There was no treatment-related mortality. After a median follow-up time of 51 months, only three patients’ treatments had failed. Local and distant failure rates were 1.5 and 3.0%, respectively. SMART-IMRT plus cisplatin and 5-FU chemotherapy showed promising activity with manageable toxicity. It is a feasible regimen and improves locoregional disease control. PMID:23426016

  13. Concurrent ultrasonic weld evaluation system

    DOEpatents

    Hood, Donald W. (Idaho Falls, ID); Johnson, John A. (Idaho Falls, ID); Smartt, Herschel B. (Idaho Falls, ID)

    1987-01-01

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws.

  14. Concurrent ultrasonic weld evaluation system

    DOEpatents

    Hood, D.W.; Johnson, J.A.; Smartt, H.B.

    1987-12-15

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder is disclosed. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws. 5 figs.

  15. Concurrent ultrasonic weld evaluation system

    DOEpatents

    Hood, D.W.; Johnson, J.A.; Smartt, H.B.

    1985-09-04

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws.

  16. Automated Concurrent Blackboard System Generation in C++

    NASA Technical Reports Server (NTRS)

    Kaplan, J. A.; McManus, J. W.; Bynum, W. L.

    1999-01-01

    In his 1992 Ph.D. thesis, "Design and Analysis Techniques for Concurrent Blackboard Systems", John McManus defined several performance metrics for concurrent blackboard systems and developed a suite of tools for creating and analyzing such systems. These tools allow a user to analyze a concurrent blackboard system design and predict the performance of the system before any code is written. The design can be modified until simulated performance is satisfactory. Then, the code generator can be invoked to generate automatically all of the code required for the concurrent blackboard system except for the code implementing the functionality of each knowledge source. We have completed the port of the source code generator and a simulator for a concurrent blackboard system. The source code generator generates the necessary C++ source code to implement the concurrent blackboard system using Parallel Virtual Machine (PVM) running on a heterogeneous network of UNIX(trademark) workstations. The concurrent blackboard simulator uses the blackboard specification file to predict the performance of the concurrent blackboard design. The only part of the source code for the concurrent blackboard system that the user must supply is the code implementing the functionality of the knowledge sources.

  17. Successful low-dose concurrent chemotherapy and radiation for locally advanced or inoperable non-small cell lung carcinoma: a report of six cases.

    PubMed Central

    Anku, V.

    2000-01-01

    Many studies now demonstrate high overall response rates with concurrent chemotherapy and radiation (CCR) for locoregionally advanced or inoperable non-small cell lung carcinoma (NSCLC) but often with severe toxicity and only modest improvement in survival beyond 3 years. We report a simple CCR protocol for NSCLC that has resulted in long-term disease-free survival with low toxicity. In this retrospective review, 84 patients with NSCLC were seen between 1985 and 1991. Of these, 10 patients had stage IIIa or IIIb NSCLC without effusion or inoperable NSCLC, with no failed prior treatment at the time of referral for oncology evaluation. Six of these were treated with CCR consisting of three cycles of cisplatin and 5-fluorouracil administered concurrently with radiation treatment followed by maintenance chemotherapy for at least five additional cycles. All six patients treated with this protocol had complete response with minimal side effects. Survival times ranged from 4.5 to more than 10 years. Three patients survived in complete remission; three others were in complete remission at the time of death due to unrelated causes. Stage III NSCLC without effusion and inoperable NSCLC can be treated effectively with concurrent local and systemic treatment without significant toxicity. In patients with complete response, maintenance chemotherapy may overcome residual microscopic systemic disease, leading to long-term survival and possible cure. The CCR strategy that resulted in this favorable outcome is noteworthy and should be pursued in larger numbers of patients. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:10745640

  18. Concurrent Chemotherapy and Intensity-Modulated Radiotherapy for Locoregionally Advanced Laryngeal and Hypopharyngeal Cancers

    SciTech Connect

    Lee, Nancy Y. O'Meara, William; Chan, Kelvin; Della-Bianca, Cesar; Mechalakos, James G.; Zhung, Joanne; Wolden, Suzanne L.; Narayana, Ashwatha; Kraus, Dennis; Shah, Jatin P.; Pfister, David G.

    2007-10-01

    Purpose: To perform a retrospective review of laryngeal/hypopharyngeal carcinomas treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT). Methods and Materials: Between January 2002 and June 2005, 20 laryngeal and 11 hypopharyngeal carcinoma patients underwent IMRT with concurrent platinum-based chemotherapy; most patients had Stage IV disease. The prescription of the planning target volume for gross, high-risk, and low-risk subclinical disease was 70, 59.4, and 54 Gy, respectively. Acute/late toxicities were retrospectively scored using the Common Toxicity Criteria scale. The 2-year local progression-free, regional progression-free, laryngectomy-free, distant metastasis-free, and overall survival rates were calculated using the Kaplan-Meier method. Results: The median follow-up of the living patients was 26 months (range, 17-58 months). The 2-year local progression-free, regional progression-free, laryngectomy-free, distant metastasis-free, and overall survival rate was 86%, 94%, 89%, 92%, and 63%, respectively. Grade 2 mucositis or higher occurred in 48% of patients, and all experienced Grade 2 or higher pharyngitis during treatment. Xerostomia continued to decrease over time from the end of RT, with none complaining of Grade 2 toxicity at this analysis. The 2-year post-treatment percutaneous endoscopic gastrostomy-dependency rate for those with hypopharyngeal and laryngeal tumors was 31% and 15%, respectively. The most severe late complications were laryngeal necrosis, necrotizing fascitis, and a carotid rupture resulting in death 3 weeks after salvage laryngectomy. Conclusion: These preliminary results have shown that IMRT achieved encouraging locoregional control of locoregionally advanced laryngeal and hypopharyngeal carcinomas. Xerostomia improved over time. Pharyngoesophageal stricture with percutaneous endoscopic gastrostomy dependency remains a problem, particularly for patients with hypopharyngeal carcinoma and, to a lesser extent, those with laryngeal cancer. Strategies using IMRT to limit the dose delivered to the esophagus/inferior constrictor musculature without compromising target coverage might be useful to further minimize this late complication.

  19. Efficacy of Concurrent Chemotherapy for Intermediate Risk NPC in the Intensity-Modulated Radiotherapy Era: a Propensity-Matched Analysis

    PubMed Central

    Zhang, Fan; Zhang, Yuan; Li, Wen-Fei; Liu, Xu; Guo, Rui; Sun, Ying; Lin, Ai-Hua; Chen, Lei; Ma, Jun

    2015-01-01

    This study is to evaluate the efficacy of additional concurrent chemotherapy for intermediate risk (stage II and T3N0M0) NPC patients treated with intensity-modulated radiotherapy (IMRT).440 patients with intermediate risk NPC were studied retrospectively, including 128 patients treated with IMRT alone [radiotherapy group (RT group)] and 312 paitents treated with IMRT plus concurrent chemotherapy [chemoradiotherapy group (CRT group)]. Propensity score matching was carried out to create RT and CRT cohorts equally matched for host and tumor factor. Significantly more severe acute toxicities were observed in the CRT group than in the RT group. Multivariate analyses of 440 patients failed to demonstrate concurrent chemotherapy as an independent prognostic factor for FFS, LR-FFS, and D-FFS. Between the well-matched RT cohort and the CRT cohort, no significant difference was demonstrated in all survival endpoints (FFS: 92.8% versus 91.2%, P?=?0.801; LR-FFS: 95.2% versus 94.4%, P?=?0.755; D-FFS: 96.4% versus 96.3%, P?=?0.803; OS: 98.2% versus 98.9%, P?=?0.276). Our results demonstrated that for patients with intermediate risk NPC treated with IMRT, additional concurrent chemotherapy did not provide any significant survival benefit but significantly more severe acute toxicities. However, prospective randomized trials are warranted for the ultimate confirm of our findings. PMID:26611462

  20. Specifying the behavior of concurrent systems

    NASA Technical Reports Server (NTRS)

    Furtek, F. C.

    1984-01-01

    A framework for rigorously specifying the behavior of concurrent systems is proposed. It is based on the view of a concurrent system as a collection of interacting processes but no assumptions are made about the mechanisms for process synchronization and communication. A formal language is described that permits the expression of a broad range of logical and timing dependencies.

  1. Concurrent Cyclophosphamide, Methotrexate, and 5-Fluorouracil Chemotherapy and Radiotherapy for Early Breast Carcinoma

    SciTech Connect

    Livi, Lorenzo Saieva, Calogero; Borghesi, Simona; Paoletti, Lisa; Meattini, Icro; Rampini, Andrea; Petrucci, Alessia; Scoccianti, Silvia; Paiar, Fabiola; Cataliotti, Luigi; Leonulli, Barbara Grilli; Bianchi, Simonetta; Biti, Gian Paolo

    2008-07-01

    Purpose: The optimal sequencing of adjuvant chemotherapy (CT) and radiation therapy (RT) in patients with early-stage breast cancer remains unclear. Patients and Methods: We retrospectively compared 485 patients treated with conservative breast surgery and postoperative whole-breast RT and six courses of CMF (cyclophosphamide 600 mg/m{sup 2}, methotrexate 40 mg/m{sup 2}, and 5-fluorouracil 600 mg/m{sup 2}) with 300 patients who received postoperative CMF only and with 509 patients treated with postoperative whole-breast RT only. The mean radiation dose delivered was 50 Gy (range, 46-52 Gy) with standard fractionation. The boost dose was 6-16 Gy according to resection margins and at the discretion of the radiation oncologist. Acute and late RT toxicity were scored using respectively the Radiation Therapy Oncology Group and the Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scale. Results: A slightly higher Grade 2 acute skin toxicity was recorded in the concurrent group (21.2% vs. 11.2% of the RT only group, p < 0.0001). RT was interrupted more frequently in the CMF/RT group respective to the RT group (8.5% vs. 4.1%; p = 0.006). There was no difference in late toxicity between the two groups. All patients in the concurrent group successfully received the planned dose of RT and CT. Local recurrence rate was 7.6% in CT/RT group and 9.8% in RT group; this difference was not statistically significant at univariate analysis (log-rank test p = 0.98). However, at multivariate analysis adjusted also for pathological tumor, pathological nodes, and age, the CT/RT group showed a statistically lower rate of local recurrence (p = 0.04). Conclusions: Whole-breast RT and concurrent CMF are a safe adjuvant treatment in terms of toxicity.

  2. Concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone for the treatment of locally advanced nasopharyngeal carcinoma: a retrospective controlled study

    PubMed Central

    Liang, Z.; Zhu, X.; Li, L.; Qu, S.; Liang, X.; Liang, Z.; Su, F.; Li, Y.; Zhao, W.

    2014-01-01

    Objective We evaluated the survival benefit of providing concurrent chemoradiotherapy (ccrt) plus adjuvant chemotherapy compared with ccrt alone to patients with locally advanced nasopharyngeal carcinoma. Methods This retrospective study included 130 patients with nasopharyngeal carcinoma treated with ccrt plus adjuvant chemotherapy from June 2005 to December 2010. Another 130 patients treated with ccrt alone during the same period were matched on age, sex, World Health Organization histology, T stage, N stage, and technology used for radiotherapy. The endpoints included overall survival, locoregional failure-free survival, distant metastasis failure-free survival, and failure-free survival. Results At a mean follow-up of 42.1 months (range: 8–85 months), the observed hazard ratios for the group receiving ccrt plus adjuvant chemotherapy compared with the group receiving ccrt alone were: for overall survival, 0.77 [95% confidence interval (ci): 0.37 to 1.57]; for locoregional failure-free survival, 1.00 (95% ci: 0.37 to 2.71); for distant metastasis failure-free survival, 1.15 (95% ci: 0.56 to 2.37); and for failure-free survival, 1.26 (95% ci: 0.69 to 2.28). There were no significant differences in survival between the groups. After stratification by disease stage, ccrt plus adjuvant chemotherapy provided a borderline significant benefit for patients with N2–3 disease (hazard ratio: 0.35; 95% ci: 0.11 to 1.06; p = 0.052). Multivariate analyses indicated that only tumour stage was a prognostic factor for overall survival. Conclusions Patients with locally advanced nasopharyngeal carcinoma received no significant survival benefit from the addition of adjuvant chemotherapy to ccrt. However, patients with N2–3 disease might benefit from the addition of adjuvant chemotherapy to ccrt. PMID:24940100

  3. Chemotherapy

    MedlinePLUS

    ( Quimioterapia ) Chemotherapy (say: kee-moe-THER-ah-pee) is the use of medicines to treat cancer. Cancer is a ... throughout the body making the person very sick. Chemotherapy medicines stop the growth of cancer cells. As ...

  4. Salivary Gland Tumors Treated With Adjuvant Intensity-Modulated Radiotherapy With or Without Concurrent Chemotherapy

    SciTech Connect

    Schoenfeld, Jonathan D.; Sher, David J.; Norris, Charles M.; Haddad, Robert I.; Posner, Marshall R.; Balboni, Tracy A.; Tishler, Roy B.

    2012-01-01

    Purpose: To analyze the recent single-institution experience of patients with salivary gland tumors who had undergone adjuvant intensity-modulated radiotherapy (IMRT), with or without concurrent chemotherapy. Patients and Methods: We performed a retrospective analysis of 35 salivary gland carcinoma patients treated primarily at the Dana-Farber Cancer Institute between 2005 and 2010 with surgery and adjuvant IMRT. The primary endpoints were local control, progression-free survival, and overall survival. The secondary endpoints were acute and chronic toxicity. The median follow-up was 2.3 years (interquartile range, 1.2-2.8) among the surviving patients. Results: The histologic types included adenoid cystic carcinoma in 15 (43%), mucoepidermoid carcinoma in 6 (17%), adenocarcinoma in 3 (9%), acinic cell carcinoma in 3 (9%), and other in 8 (23%). The primary sites were the parotid gland in 17 (49%), submandibular glands in 6 (17%), tongue in 4 (11%), palate in 4 (11%), and other in 4 (11%). The median radiation dose was 66 Gy, and 22 patients (63%) received CRT. The most common chemotherapy regimen was carboplatin and paclitaxel (n = 14, 64%). A trend was seen for patients undergoing CRT to have more adverse prognostic factors, including Stage T3-T4 disease (CRT, n = 12, 55% vs. n = 4, 31%, p = .29), nodal positivity (CRT, n = 8, 36% vs. n = 1, 8%, p = .10), and positive margins (n = 13, 59% vs. n = 5, 38%, p = .30). One patient who had undergone CRT developed an in-field recurrence, resulting in an overall actuarial 3-year local control rate of 92%. Five patients (14%) developed distant metastases (1 who had undergone IMRT only and 4 who had undergone CRT). Acute Grade 3 mucositis, esophagitis, and dermatitis occurred in 8%, 8%, and 8% (1 each) of IMRT patients and in 18%, 5%, and 14% (4, 1, and 3 patients) of the CRT group, respectively. No acute Grade 4 toxicity occurred. The most common late toxicity was Grade 1 xerostomia (n = 8, 23%). Conclusions: Treatment of salivary gland malignancies with postoperative IMRT was well tolerated with a high rate of local control. Chemoradiotherapy resulted in excellent local control in a subgroup of patients with adverse prognostic factors and might be warranted in select patients.

  5. Concurrent Radiotherapy and Gemcitabine for Unresectable Pancreatic Adenocarcinoma: Impact of Adjuvant Chemotherapy on Survival

    SciTech Connect

    Ogawa, Kazuhiko; Ito, Yoshinori; Hirokawa, Naoki; Shibuya, Keiko; Kokubo, Masaki; Ogo, Etsuyo; Shibuya, Hitoshi; Saito, Tsutomu; Onishi, Hiroshi; Karasawa, Katsuyuki; Nemoto, Kenji; Nishimura, Yasumasa

    2012-06-01

    Purpose: To retrospectively analyze results of concurrent chemoradiotherapy (CCRT) using gemcitabine (GEM) for unresectable pancreatic adenocarcinoma. Methods and Materials: Records of 108 patients treated with concurrent external beam radiotherapy (EBRT) and GEM were reviewed. The median dose of EBRT in all 108 patients was 50.4 Gy (range, 3.6-60.8 Gy), usually administered in conventional fractionations (1.8-2 Gy/day). During radiotherapy, most patients received GEM at a dosage of 250 to 350 mg/m{sup 2} intravenously weekly for approximately 6 weeks. After CCRT, 59 patients (54.6%) were treated with adjuvant chemotherapy (AC), mainly with GEM. The median follow-up for all 108 patients was 11.0 months (range, 0.4-37.9 months). Results: Initial responses after CCRT for 85 patients were partial response: 26 patients, no change: 51 patients and progressive disease: 8 patients. Local progression was observed in 35 patients (32.4%), and the 2-year local control (LC) rate in all patients was 41.9%. Patients treated with total doses of 50 Gy or more had significantly more favorable LC rates (2-year LC rate, 42.9%) than patients treated with total doses of less than 50 Gy (2-year LC rate, 29.6%). Regional lymph node recurrence was found in only 1 patient, and none of the 57 patients with clinical N0 disease had regional lymph node recurrence. The 2-year overall survival (OS) rate and the median survival time in all patients were 23.5% and 11.6 months, respectively. Patients treated with AC had significantly more favorable OS rates (2-year OS, 31.8%) than those treated without AC (2-year OS, 12.4%; p < 0.0001). On multivariate analysis, AC use and clinical T stage were significant prognostic factors for OS. Conclusions: CCRT using GEM yields a relatively favorable LC rate for unresectable pancreatic adenocarcinoma, and CCRT with AC conferred a survival benefit compared to CCRT without AC.

  6. Methodologies and systems for heterogeneous concurrent computing

    NASA Technical Reports Server (NTRS)

    Sunderam, V. S.

    1994-01-01

    Heterogeneous concurrent computing is gaining increasing acceptance as an alternative or complementary paradigm to multiprocessor-based parallel processing as well as to conventional supercomputing. While algorithmic and programming aspects of heterogeneous concurrent computing are similar to their parallel processing counterparts, system issues, partitioning and scheduling, and performance aspects are significantly different. In this paper, we discuss critical design and implementation issues in heterogeneous concurrent computing, and describe techniques for enhancing its effectiveness. In particular, we highlight the system level infrastructures that are required, aspects of parallel algorithm development that most affect performance, system capabilities and limitations, and tools and methodologies for effective computing in heterogeneous networked environments. We also present recent developments and experiences in the context of the PVM system and comment on ongoing and future work.

  7. Locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy plus concurrent weekly cisplatin with or without neoadjuvant chemotherapy

    PubMed Central

    Wee, Chan Woo; Keam, Bhumsuk; Heo, Dae Seog; Sung, Myung-Whun; Won, Tae-Bin

    2015-01-01

    Purpose The outcomes of locoregionally advanced nasopharyngeal carcinoma patients treated with concurrent chemoradiation (CCRT) using intensity-modulated radiotherapy (IMRT) with/without neoadjuvant chemotherapy (NCT) were evaluated. Materials and Methods Eighty-three patients who underwent NCT followed by CCRT (49%) or CCRT with/without adjuvant chemotherapy (51%) were reviewed. To the gross tumor, 67.5 Gy was prescribed. Weekly cisplatin was used as concurrent chemotherapy. Results With a median follow-up of 49.4 months, the 5-year local control, regional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival rates were 94.7%, 89.3%, 77.8%, 68.0%, and 81.8%, respectively. In multivariate analysis, the American Joint Committee on Cancer stage (p = 0.016) and N stage (p = 0.001) were negative factors for DMFS and DFS, respectively. Overall, NCT demonstrated no benefit and an increased risk of severe hematologic toxicity. However, compared to patients treated with CCRT alone, NCT showed potential of improving DMFS in stage IV patients. Conclusion CCRT using IMRT resulted in excellent local control and survival outcome. Without evidence of survival benefit from phase III randomized trials, NCT should be carefully administered in locoregionally advanced nasopharyngeal carcinoma patients who are at high-risk of developing distant metastasis and radiotherapy-related mucositis. The results of ongoing trials are awaited. PMID:26157679

  8. Neoadjuvant Chemotherapy with or without Concurrent Hormone Therapy in Estrogen Receptor-Positive Breast Cancer:NACED-Randomized Multicenter Phase II Trial.

    PubMed

    Sugiu, Kumi; Iwamoto, Takayuki; Kelly, Catherine M; Watanabe, Naoki; Motoki, Takayuki; Ito, Mitsuya; Ohtani, Shoichiro; Higaki, Kenji; Imada, Takako; Yuasa, Takeshi; Omori, Masako; Sonobe, Hiroshi; Fujiwara, Toshiyoshi; Matsuoka, Junji

    2015-10-01

    Although in the neoadjuvant setting for estrogen receptor (ER)-positive breast cancers, chemotherapy or hormone therapy alone does not result in satisfactory tumor response, it is unknown whether concurrent chemo-endocrine therapy is superior to chemotherapy alone in clinical outcomes. We conducted a randomized phase II trial to test the responses of ER-positive patients to concurrent administration of chemo-endocrine therapy in the neoadjuvant setting. Women with stage II-III, ER-positive, invasive breast cancer (n=28) received paclitaxel followed by fluorouracil, epirubicin, cyclophosphamide (T-FEC) and were randomized to receive concurrent chemo-endocrine therapy consisting of goserelin administered subcutaneously for premenopausal women or an aromatase inhibitor for postmenopausal women. The primary endpoint was the pathological complete response (pCR) rate after neoadjuvant therapy. Twenty-eight patients were randomized. There were no significant differences in pCR rate between the concurrent group (12.5%;2/16) and the chemotherapy alone group (8.3%;1/12). Tumor size after therapy was significantly reduced in the concurrent therapy group (p=0.035), but not in the chemotherapy-alone group (p=0.622). Neoadjuvant chemotherapy with concurrent hormone therapy provided no significant improvement in pCR rate in ER-positive breast cancers. These preliminary results should be followed up by further studies. PMID:26490026

  9. Sleep characteristics and psychological symptoms in patients with locally advanced nasopharyngeal carcinoma before and after intensity-modulated radiotherapy and concurrent chemotherapy.

    PubMed

    Qin, Ling; Mo, Yan-Lin; Li, Ling; Wei, Zhou-Ji; Zhu, Xiao-Dong; Yin, Xue; Wei, Qing

    2015-01-01

    Sleep disturbances and psychological distress are the most common adverse effects associated with cancer diagnosis and treatment. The aim of this study was to examine sleep and psychological characteristics in patients with local-advanced nasopharyngeal carcinoma (NPC) following completion of intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy, and to describe the predictors of post-test psychological symptoms after treatment. Sleep quality and psychological symptoms were measured using Pittsburgh sleep-quality index (PSQI) and symptom checklist-90 in 60 local-advanced NPC patients treated with IMRT and concurrent chemotherapy, respectively. After treatment, the subscores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction increased significantly compared with their pre-test scores. Similar results were observed for the mean PSQI global score. However, for psychological symptoms, only subscores of somatization and depression were higher than their baseline level. Multivariate analysis revealed that concurrent chemotherapy cycle was the only predictor of depression after treatment among all of the psychological symptoms assessed. These findings indicate that sleep disturbance and psychological distress are significant problems in NPC patients treated with IMRT and concurrent chemotherapy. Patients who receive many cycles of concurrent chemotherapy may be at an increased risk of depression after completion of IMRT. PMID:25299689

  10. Induction Cisplatin and Fluorouracil-Based Chemotherapy Followed by Concurrent Chemoradiation for Muscle-Invasive Bladder Cancer

    SciTech Connect

    Lin, C.-C.; Hsu, C.-H.; Cheng, Jason C.; Huang, C.-Y.; Tsai, Y.-C.; Hsu, F.-M.; Huang, K.-H.; Cheng, A.-L.; Pu, Y.-S.

    2009-10-01

    Purpose: To evaluate a multimodality bladder-preserving therapy in patients with muscle-invasive bladder cancer. Methods and Materials: Patients with stages T2-4aN0M0 bladder cancer suitable for cystectomy underwent radical transurethral resection and induction chemotherapy, followed by concurrent chemoradiotherapy (CCRT). Patients with a Karnofsky performance status (KPS) <80 or age {>=}70 years underwent Protocol A: induction chemotherapy with three cycles of the cisplatin and 5-fluorouracil (CF) regimen, and CCRT with six doses of weekly cisplatin and 64.8 Gy radiotherapy given with the shrinking-field technique. Patients with KPS {>=}80 and age <70 years underwent Protocol B: induction chemotherapy with three cycles of weekly paclitaxel plus the CF regimen, and CCRT with six doses of weekly paclitaxel and cisplatin plus 64.8 Gy radiotherapy. Interval cystoscopy was employed after induction chemotherapy and when radiotherapy reached 43.2 Gy. Patients without a complete response (CR) were referred for salvage cystectomy. Results: Among 30 patients (median, 66 years) enrolled, 17 and 13 patients underwent Protocol A and B, respectively. After induction chemotherapy, 23 patients achieved CR. Five (17%) of 7 patients without CR underwent salvage cystectomy. Overall, 28 patients (93%) completed the protocol treatment. Of 22 patients who completed CCRT, 1 had recurrence with carcinoma in situ and 3 had distant metastases. After a median follow-up of 47 months, overall and progression-free survival rate for all patients were 77% and 54% at 3 years, respectively. Of 19 surviving patients, 15 (79%) retained functioning bladders. Conclusions: Our protocols may be alternatives to cystectomy for selected patients who wish to preserve the bladder.

  11. A Matched-Case Comparison to Explore the Role of Consolidation Chemotherapy After Concurrent Chemoradiation in Cervical Cancer

    SciTech Connect

    Choi, Chel Hun; Lee, Yoo-Young; Kim, Min Kyu; Kim, Tae-Joong; Lee, Jeong-Won; Nam, Hee Rim; Huh, Seung Jae; Lee, Je-Ho; Bae, Duk-Soo; Kim, Byoung-Gie

    2011-12-01

    Purpose: The aim of this study was to compare the efficacy and toxicity of consolidation chemotherapy after concurrent chemoradiation (CCRT) and CCRT alone in patients with locally advanced cervical carcinoma. Methods and Materials: Using medical records from January 2001 to December 2007, 39 patients treated with consolidation chemotherapy after CCRT (Group 1) were matched to 39 patients treated with CCRT alone (Group 2). Consolidation chemotherapy consisted of three additional cycles of chemotherapy with cisplatin 60 mg/m{sup 2} (Day 1) and 5-fluorouracil 1,000 mg/m{sup 2} per day (Days 1-5) given every 3 weeks. The primary endpoint was overall survival. Results: During a median follow-up period of 35 months (range, 8-96 months), 10 (25.6%) and 16 (41.0%) patients showed disease progression in Groups 1 and 2, respectively. Distant recurrence with or without locoregional/lymphogenous recurrence occurred more frequently in Group 2 than in Group 1 (23.1% vs. 7.7%, p = 0.06). By contreast, there was no difference in locoregional or lymphogenous recurrence between the two groups. The rate of overall survival was higher in Group 1 than in Group 2 (92.7% vs. 69.9%, p = 0.042), whereas the difference in progression-free survival between the groups was not statistically significant (70.1% vs. 55.1%, p = 0.079). Although the difference was not statistically significant, neutropenia was more common in Group 1 than in Group 2 (10.9% vs. 4.7%, p = 0.07). Conclusions: Consolidation chemotherapy after CCRT may improve survival and reduce distant recurrence without additional toxicity compared to CCRT alone in patients with locally advanced cervical carcinoma.

  12. Chemotherapy

    Cancer.gov

    Describes how chemotherapy is used to treat cancer. Includes information about you can expect during treatment, tips for managing diet needs, and things to think about if you plan to work during treatment.

  13. Factors Associated With Pharyngoesophageal Stricture In Patients Treated With Concurrent Chemotherapy And Radiation Therapy For Oropharyngeal Squamous Cell Carcinoma

    PubMed Central

    Best, Simon R.; Ha, Patrick K.; Blanco, Ray G.; Saunders, John R.; Zinreich, Eva S.; Levine, Marshall A.; Pai, Sara I.; Walker, Melissa; Trachta, Jaclyn; Ulmer, Karen; Murakami, Peter; Thompson, Richard; Califano, Joseph A.

    2015-01-01

    Background The purpose of this study was to elucidate factors associated with pharyngoesophageal strictures after treatment for head and neck squamous cell carcinoma (SCC). Methods We conducted a retrospective review of patients receiving cisplatin and 5-fluorouracil chemotherapy combined with concurrent hyperfractionated radiation therapy for oropharyngeal squamous cell carcinoma. Results Strictures developed in 13 of 67 patients (19%). Strictures were associated with tumor location (tonsil vs base of tongue; p = .03), neck dissection after completion of therapy (p = .03), and the duration of treatment-induced mucositis (weeks with mucositis grade ?2; National Cancer Institute (NCI) Common Toxicity Criteria; p < .001). Age, sex, race, tumor stage, nodal stage, American Joint Committee on Cancer (AJCC) stage, human papillomavirus (HPV) status, smoking, radiation dose, maximum severity of mucositis, amifostine use, and pretreatment swallow dysfunction were not significantly associated with stricture. In multivariate analysis, only duration of mucositis, after controlling for age, sex, and tumor location, remained highly significant (p < .01). Conclusion The duration of treatment-related mucositis is an independent risk factor for stricture formation in patients with oropharyngeal SCC treated with concurrent chemotherapy and radiation therapy. PMID:21246640

  14. Neoadjuvant chemotherapy in locally advanced nasopharyngeal carcinoma: Defining high-risk patients who may benefit before concurrent chemotherapy combined with intensity-modulated radiotherapy

    PubMed Central

    Du, Xiao-Jing; Tang, Ling-Long; Chen, Lei; Mao, Yan-Ping; Guo, Rui; Liu, Xu; Sun, Ying; Zeng, Mu-Sheng; Kang, Tie-Bang; Shao, Jian-Yong; Lin, Ai-Hua; Ma, Jun

    2015-01-01

    The purpose of this study was to create a prognostic model for distant metastasis in patients with locally advanced NPC who accept concurrent chemotherapy combined with intensity-modulated radiotherapy (CCRT) to identify high-risk patients who may benefit from neoadjuvant chemotherapy (NACT). A total of 881 patients with newly-diagnosed, non-disseminated, biopsy-proven locoregionally advanced NPC were retrospectively reviewed; 411 (46.7%) accepted CCRT and 470 (53.3%) accepted NACT followed by CCRT. Multivariate analysis demonstrated N2–3 disease, plasma Epstein–Barr virus (EBV) DNA?>?4000 copies/mL, serum albumin ?46?g/L and platelet count >300?k/cc were independent prognostic factors for distant metastasis in the CCRT group. Using these four factors, a prognostic model was developed, as follows: 1) low-risk group: 0–1 risk factors; and 2) high-risk group: 2–4 risk factors. In the high-risk group, patients who accepted NACT?+?CCRT had significantly higher distant metastasis-free survival and progression-free survival rates than the CCRT group (P?=?0.001; P?=?0.011). This simple prognostic model for distant metastasis in locoregionally advanced NPC may facilitate with the selection of high-risk patients who may benefit from NACT prior to CCRT. PMID:26564805

  15. Neoadjuvant chemotherapy in locally advanced nasopharyngeal carcinoma: Defining high-risk patients who may benefit before concurrent chemotherapy combined with intensity-modulated radiotherapy.

    PubMed

    Du, Xiao-Jing; Tang, Ling-Long; Chen, Lei; Mao, Yan-Ping; Guo, Rui; Liu, Xu; Sun, Ying; Zeng, Mu-Sheng; Kang, Tie-Bang; Shao, Jian-Yong; Lin, Ai-Hua; Ma, Jun

    2015-01-01

    The purpose of this study was to create a prognostic model for distant metastasis in patients with locally advanced NPC who accept concurrent chemotherapy combined with intensity-modulated radiotherapy (CCRT) to identify high-risk patients who may benefit from neoadjuvant chemotherapy (NACT). A total of 881 patients with newly-diagnosed, non-disseminated, biopsy-proven locoregionally advanced NPC were retrospectively reviewed; 411 (46.7%) accepted CCRT and 470 (53.3%) accepted NACT followed by CCRT. Multivariate analysis demonstrated N2-3 disease, plasma Epstein-Barr virus (EBV) DNA?>?4000 copies/mL, serum albumin ?46?g/L and platelet count >300?k/cc were independent prognostic factors for distant metastasis in the CCRT group. Using these four factors, a prognostic model was developed, as follows: 1) low-risk group: 0-1 risk factors; and 2) high-risk group: 2-4 risk factors. In the high-risk group, patients who accepted NACT?+?CCRT had significantly higher distant metastasis-free survival and progression-free survival rates than the CCRT group (P?=?0.001; P?=?0.011). This simple prognostic model for distant metastasis in locoregionally advanced NPC may facilitate with the selection of high-risk patients who may benefit from NACT prior to CCRT. PMID:26564805

  16. Preliminary Results of a Prospective Randomized Trial Comparing Concurrent Chemoradiotherapy Plus Adjuvant Chemotherapy With Radiotherapy Alone in Patients With Locoregionally Advanced Nasopharyngeal Carcinoma in Endemic Regions of China

    SciTech Connect

    Chen Yong; Liu Mengzhong; Liang Shaobo; Zong Jingfeng; Mao Yanping; Tang Linglong; Guo Ying; Lin Aihua; Zeng Xiangfa; Ma Jun

    2008-08-01

    Purpose: A prospective randomized trial was performed to evaluate the efficacy of concurrent chemotherapy and adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) in endemic regions of China. Methods and Materials: Between July 2002 and September 2005, 316 eligible patients were randomly assigned to receive either radiotherapy alone (RT) or chemoradiotherapy concurrent with adjuvant chemotherapy (CRT). All patients received 70 Gy in 7 weeks using standard RT portals and techniques. The CRT patients were given concurrent cisplatin (40 mg/m{sup 2} on Day 1) weekly during RT, followed by cisplatin (80 mg/m{sup 2} on Day 1) and fluorouracil (800 mg/m{sup 2} on Days 1-5) every 4 weeks (Weeks 5, 9, and 13) for three cycles after completion of RT. All patients were analyzed by intent-to-treat analysis. Results: The two groups were well-balanced in all prognostic factors and RT parameters. The CRT group experienced significantly more acute toxicity (62.6% vs. 32%, p = 0.000). A total of 107 patients (68%) and 97 patients (61%) completed all cycles of concurrent chemotherapy and adjuvant chemotherapy, with a median follow-up time of 29 months. The 2-year overall survival rate, failure-free survival rate, distant failure-free survival rate, and locoregional failure-free survival rate for the CRT and RT groups were 89.8% vs. 79.7% (p = 0.003), 84.6% vs. 72.5% (p = 0.001), 86.5% vs. 78.7% (p = 0.024), and 98.0% vs. 91.9% (p = 0.007), respectively. Conclusions: This trial demonstrated the significant survival benefits of concurrent chemotherapy plus adjuvant chemotherapy in patients with locoregionally advanced NPC in endemic regions of China.

  17. Radiotherapy With or Without Concurrent Chemotherapy for Lymph Node Recurrence After Radical Surgery of Thoracic Esophageal Squamous Cell Carcinoma

    SciTech Connect

    Lu Jincheng; Kong Cheng; Tao Hua

    2010-11-01

    Purpose: To retrospectively compare the outcomes of patients with lymph node recurrence after radical surgery of esophageal cancer, when given radiotherapy with or without concurrent chemotherapy. Methods and Materials: Between January 1996 and December 2005, the data from 73 patients with lymph node recurrence after radical surgery of thoracic esophageal squamous cell carcinoma were retrospectively reviewed. The patients were separated into two groups: radiochemotherapy (RC, 31 patients) and radiotherapy alone (RA, 42 patients). Patients in the RC group received at least two cycles of 5-fluorouracil/cisplatin chemotherapy concurrently with radiotherapy. Results: The median duration of follow-up was 11 months (range, 2-48). The overall survival rate for all patients was 46.7% and 4.7% at 1 and 3 years, respectively. The median overall survival time was 9 months (95% confidence interval, 6.96-11.04) and 17 months (95% confidence interval, 13.61-20.39) for RA and RC groups, respectively. The survival rate at 1 and 3 years was 62.5% and 10.5% in the RC group and 33.8% and 0% in the RA group (p = .0049, log-rank test; hazard ratio for death, 0.52; 95% confidence interval, 0.30-0.92). Acute toxicities were more frequent in the RC group than in the RA group. No significant differences were found in the late toxicity profiles between the two groups. Conclusion: The results of the present retrospective analysis suggest that RC should be considered an effective and well-tolerated treatment of patients with thoracic esophageal squamous cell carcinoma and postoperative lymph node recurrence.

  18. The Utility of Proton Beam Therapy with Concurrent Chemotherapy for the Treatment of Esophageal Cancers

    PubMed Central

    Lin, Steven H.

    2011-01-01

    The standard of care for the management of locally advanced esophageal cancers in the United States is chemotherapy combined with radiation, either definitively, or for those who could tolerate surgery, preoperatively before esophagectomy. Although the appropriate radiation dose remains somewhat controversial, the quality of the radiation delivery is critical for the treatment of esophageal cancer since the esophagus is positioned close to vital structures, such as the heart and lung. The volume and relative doses to these normal tissues affect acute and late term complications. Advances in radiation delivery from 2D to 3D conformal radiation therapy, to Intensity Modulated Radiation Therapy (IMRT) or charged particle therapy (carbon ion or proton beam therapy (PBT)), allow incremental improvements in the therapeutic ratio. This could have implications in non-cancer related morbidity for long term survivors. This article reviews the evolution in radiation technologies and the use of PBT with chemotherapy in the management of esophageal cancer. PMID:24213126

  19. A Phase II Study of Radiotherapy and Concurrent Paclitaxel Chemotherapy in Breast-Conserving Treatment for Node-Positive Breast Cancer

    SciTech Connect

    Chen, William C.; Kim, Janice; Kim, Edward; Silverman, Paula; Overmoyer, Beth; Cooper, Brenda W.; Anthony, Sue; Shenk, Robert; Leeming, Rosemary; Hanks, Shelli H.; Lyons, Janice A.

    2012-01-01

    Purpose: Administering adjuvant chemotherapy before breast radiotherapy decreases the risk of systemic recurrence, but delays in radiotherapy could yield higher local failure. We assessed the feasibility and efficacy of placing radiotherapy earlier in the breast-conserving treatment course for lymph node-positive breast cancer. Methods and Materials: Between June 2000 and December 2004, 44 women with node-positive Stage II and III breast cancer were entered into this trial. Breast-conserving surgery and 4 cycles of doxorubicin (60 mg/m{sup 2})/cyclophosphamide (600 mg/m{sup 2}) were followed by 4 cycles of paclitaxel (175 mg/m{sup 2}) delivered every 3 weeks. Radiotherapy was concurrent with the first 2 cycles of paclitaxel. The breast received 39.6 Gy in 22 fractions with a tumor bed boost of 14 Gy in 7 fractions. Regional lymphatics were included when indicated. Functional lung volume was assessed by use of the diffusing capacity for carbon monoxide as a proxy. Breast cosmesis was evaluated with the Harvard criteria. Results: The 5-year actuarial rate of disease-free survival is 88%, and overall survival is 93%. There have been no local failures. Median follow-up is 75 months. No cases of radiation pneumonitis developed. There was no significant change in the diffusing capacity for carbon monoxide either immediately after radiotherapy (p = 0.51) or with extended follow-up (p = 0.63). Volume of irradiated breast tissue correlated with acute cosmesis, and acute Grade 3 skin toxicity developed in 2 patients. Late cosmesis was not adversely affected. Conclusions: Concurrent paclitaxel chemotherapy and radiotherapy after breast-conserving surgery shortened total treatment time, provided excellent local control, and was well tolerated.

  20. IMRT With Simultaneous Integrated Boost and Concurrent Chemotherapy for Locoregionally Advanced Squamous Cell Carcinoma of the Head and Neck

    SciTech Connect

    Montejo, Michael E.; Shrieve, Dennis C.; Bentz, Brandon G.; Hunt, Jason P.; Buchman, Luke O.; Agarwal, Neeraj; Hitchcock, Ying J.

    2011-12-01

    Purpose: To evaluate the efficacy and toxicity of accelerated radiotherapy with concurrent chemotherapy in advanced head-and-neck squamous cell carcinoma. Methods and Materials: Between April 2003 and May 2008, 43 consecutive patients with advanced head-and-neck squamous cell carcinoma received accelerated chemoradiation with concurrent cisplatin or cetuximab. The doses for intensity-modulated radiotherapy with simultaneous integrated boost were 67.5, 60.0, and 54 Gy in 30 daily fractions of 2.25, 2.0, and 1.8 Gy to the planning target volumes for gross disease, high-risk nodes, and low-risk nodes, respectively. Results: Of the patients, 90.7% completed chemoradiotherapy as prescribed. The median treatment duration was 43 days (range, 38-55 days). The complete response rate was 74.4%. With median follow-up of 36.7 months (range, 16.8-78.1 months) in living patients, the estimated 1-, 2-, and 5-year locoregional control, overall survival, and disease-free survival rates were 82%, 82%, and 82%; 73%, 65%, and 61%; and 73%, 73%, and 70%, respectively. One treatment-related death occurred from renal failure. Grade 3 mucositis and dermatitis occurred in 13 patients (30.2%) and 3 patients (6.9%), respectively. Grade 2 xerostomia occurred in 12 patients (27.9%). In patients with adequate follow-up, 82% were feeding tube free by 6 months after therapy; 13% remained feeding tube dependent at 1 year. Grade 3 soft-tissue fibrosis, esophageal stricture, osteoradionecrosis, and trismus occurred in 3 patients (6.9%), 5 patients (11.6%), 1 patient (2.3%), and 3 patients (6.9%), respectively. Conclusions: Our results show that intensity-modulated radiotherapy with simultaneous integrated boost with concurrent chemotherapy improved local and regional control. Acute and late toxicities were tolerable and acceptable. A prospective trial of this fractionation regimen is necessary for further assessment of its efficacy and toxicity compared with other approaches.

  1. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    SciTech Connect

    Herrera, Higmar; Yanez, Elvia; Lopez, Jesus

    2012-10-23

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerologia de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  2. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    NASA Astrophysics Data System (ADS)

    Herrera, Higmar; Yañez, Elvia; López, Jesús

    2012-10-01

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerología de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  3. Creating and standardizing annual chemotherapy competencies throughout a healthcare system.

    PubMed

    Carreon, Nancy; Sugarman, Cathleen; Beener, Elizabeth; Agan, Donna

    2015-01-01

    Changes in chemotherapy delivery from inpatient to outpatient settings and transition from intravenous to oral administration threaten the competency level of chemotherapy nurses. To standardize care and demonstrate competency across five hospital campuses and four outpatient infusion centers, one health system developed a hands-on competency evaluation for chemotherapy nurses based on a scenario approach. Results included improved confidence, competence, identification of variation, and standardization of equipment, process, and policy. PMID:25608095

  4. Prospective evaluation of concurrent paclitaxel and radiation therapy after adjuvant doxorubicin and cyclophosphamide chemotherapy for Stage II or III breast cancer

    SciTech Connect

    Burstein, Harold J. . E-mail: hburstein@partners.org; Bellon, Jennifer R.; Galper, Sharon; Lu, H.-M.; Kuter, Irene; Wong, Julia; Gelman, Rebecca; Bunnell, Craig A.; Parker, Leroy M.; Garber, Judy E.; Winer, Eric P.; Harris, Jay R.; Powell, Simon N.

    2006-02-01

    Purpose: To evaluate the safety and feasibility of concurrent radiation therapy and paclitaxel-based adjuvant chemotherapy, given either weekly or every 3 weeks, after adjuvant doxorubicin and cyclophosphamide (AC). Methods and Materials: After definitive breast surgery and AC chemotherapy, 40 patients with operable Stage II or III breast cancer received protocol-based treatment with concurrent paclitaxel and radiation therapy. Paclitaxel was evaluated on 2 schedules, with treatment given either weekly x 12 weeks (60 mg/m{sup 2}), or every 3 weeks x 4 cycles (135-175 mg/m{sup 2}). Radiation fields and schedules were determined by the patient's surgery and pathology. The tolerability of concurrent therapy was evaluated in cohorts of 8 patients as a phase I study. Results: Weekly paclitaxel treatment at 60 mg/m{sup 2} per week with concurrent radiation led to dose-limiting toxicity in 4 of 16 patients (25%), including 3 who developed pneumonitis (either Grade 2 [1 patient] or Grade 3 [2 patients]) requiring steroids. Efforts to eliminate this toxicity in combination with weekly paclitaxel through treatment scheduling and CT-based radiotherapy simulation were not successful. By contrast, dose-limiting toxicity was not encountered among patients receiving concurrent radiation with paclitaxel given every 3 weeks at 135-175 mg/m{sup 2}. However, Grade 2 radiation pneumonitis not requiring steroid therapy was seen in 2 of 24 patients (8%) treated in such a fashion. Excessive radiation dermatitis was not observed with either paclitaxel schedule. Conclusions: Concurrent treatment with weekly paclitaxel and radiation therapy is not feasible after adjuvant AC chemotherapy for early-stage breast cancer. Concurrent treatment using a less frequent paclitaxel dosing schedule may be possible, but caution is warranted in light of the apparent possibility of pulmonary injury.

  5. Concurrent administration of adjuvant chemotherapy and radiotherapy after breast-conserving surgery enhances late toxicities: Long-term results of the ARCOSEIN multicenter randomized study

    SciTech Connect

    Toledano, Alain . E-mail: alain.toledano@gmail.com; Garaud, Pascal; Serin, Daniel; Fourquet, Alain; Bosset, Jean-Francois; Breteau, Noel; Body, Gilles; Azria, David; Le Floch, Olivier; Calais, Gilles

    2006-06-01

    Purpose: In 1996, a multicenter randomized study was initiated that compared sequential vs. concurrent adjuvant chemotherapy (CT) with radiation therapy (RT) after breast-conserving surgery (ARCOSEIN study). After a median follow-up of 6.7 years (range, 4.3-9 years), we decided to prospectively evaluate the late effects of these 2 strategies. Methods and Materials: A total of 297 patients from the 5 larger participating institutions were asked to report for a follow-up examination. Seventy-two percent (214 patients) were eligible for evaluation of late toxicity. After breast-conserving surgery, patients were treated either with sequential treatment with CT first followed by RT (Arm A) or CT administered concurrently with RT (Arm B). In all patients, CT regimen consisted of mitoxantrone (12 mg/m{sup 2}), 5-FU (500 mg/m{sup 2}), and cyclophosphamide (500 mg/m{sup 2}), 6 cycles (Day 1 to Day 21). Conventional RT was delivered to the whole breast by administration of a 2 Gy per fraction protocol to a total dose of 50 Gy ({+-} boost to the primary tumor bed). The assessment of toxicity was blinded to treatment and was graded by the radiation oncologist, according to the LENT/SOMA scale. Skin pigmentation was also evaluated according to a personal 5-points scoring system (excellent, good, moderate, poor, very poor). Results: Among the 214 evaluable patients, 107 were treated in each arm. The 2 populations were homogeneous for patient, tumor, and treatment characteristics. Subcutaneous fibrosis (SF), telangectasia (T), skin pigmentation (SP), and breast atrophy (BA) were significantly increased in Arm B. No statistical difference was observed between the 2 arms of the study concerning Grade 2 or higher pain, breast edema, or lymphedema. No deaths were caused by late toxicity. Conclusion: After breast-conserving surgery, the concurrent use of CT with RT is significantly associated with an increase incidence of Grade 2 or greater late side effects.

  6. Intensity modulated radiotherapy (IMRT) combined with concurrent but not adjuvant chemotherapy in primary nasopharyngeal cancer – a retrospective single center analysis

    PubMed Central

    2013-01-01

    Background We report our experience in 49 consecutive patients with nasopharyngeal carcinoma who were treated by Intensity-modulated radiation therapy (IMRT) combined with simultaneous but not adjuvant chemotherapy (CHT). Methods The medical records of 49 patients with histologically proven primary nasopharygeal carcinoma treated with IMRT and concurrent platin-based CHT (predominantly cisplatin weekly) were retrospectively reviewed. The majority of patients showed advanced clinical stages (stage III/IV:72%) with undifferentiated histology (82%). IMRT was performed in step-and-shoot technique using an integrated boost concept in 84%. In this concept, the boost volume covered the primary tumor and involved nodes with doses of 66–70.4 Gy (single dose 2.2 Gy). Uninvolved regional nodal areas were covered with doses of 54–59.4 Gy (median single dose 1.8 Gy). At least one parotid gland was spared. None of the patients received adjuvant CHT. Results The median follow-up for the entire cohort was 48 months. Radiation therapy was completed without interruption in all patients and 76% of the patients received at least 80% of the scheduled CHT. Four local recurrences have been observed, transferring into 1-, 3-, and 5-year Local Control (LC) rates of 98%, 90% and 90%. One patient developed an isolated regional nodal recurrence, resulting in 1-, 3-, and 5-year Regional Control (RC) rates of 98%. All locoregional failures were located inside the radiation fields. Distant metastases were found in six patients, transferring into 1-, 3, and 5-year Distant Control (DC) rates of 92%, 86% and 86%. Progression free survival (PFS) rates after 1, 3 and 5 years were 86%, 70% and 69% and 1-, 3- and 5-year Overall Survival (OS) rates were 96%, 82% and 79%. Acute toxicity???grade III mainly consisted of dysphagia (32%), leukopenia (24%), stomatitis (16%), infection (8%) and nausea (8%). Severe late toxicity (grade III) was documented in 18% of the patients, mainly as xerostomia (10%). Conclusion Concurrent chemoradiation without the addition of adjuvant chemotherapy cycles using IMRT with an integrated boost concept yielded good disease control and overall survival in patients suffering from primary nasopharyngeal cancer with acceptable acute side effects and limited rates of late toxicity. PMID:23347410

  7. Treatment of Stage IV(A-B) nasopharyngeal carcinoma by induction-concurrent chemoradiotherapy and accelerated fractionation: Impact of chemotherapy schemes

    SciTech Connect

    Yau, T.K. . E-mail: tkokyau@gmail.com; Lee, Anne; Wong, Dominique; Pang, Ellie S.Y.; Ng, W.T.; Yeung, Rebecca; Soong, Inda S.

    2006-11-15

    Purpose: The aim of this study was to evaluate the impact of different chemotherapy regimens in patients with advanced nasopharyngeal carcinoma (NPC) treated by induction-concurrent chemoradiotherapy. Methods and Materials: Between 1998 and 2003, 75 Stage IV(A-B) NPC patients were treated with 3 cycles of induction chemotherapy with cisplatin plus 5-fluorouracil (PF) (n = 41) or cisplatin plus gemcitabine (PG) (n = 34), followed by accelerated radiotherapy in concurrence with 2 cycles of cisplatin. In 18 (24%) patients, cisplatin was completely replaced by carboplatin in both concurrent cycles, mainly because of borderline renal functions. Results: The median follow-up was 3.6 years. The 3-year locoregional failure-free survival, progression-free survival, and overall survival of the whole group were 80%, 68%, and 80% respectively. No significant difference was found between patients treated with either induction regimens. However, patients with only carboplatin in the 2 concurrent cycles had significantly inferior 3-year locoregional failure-free survival (56% vs. 86%, p = 0.014), progression-free survival (39% vs. 72%, p = 0.001), and overall survival (61% vs. 87%, p = 0.046) when compared with the rest of the group. In multivariate analysis, the complete replacement of cisplatin by carboplatin during concurrent chemoradiotherapy was still an independent adverse factor in locoregional failure-free survival (hazard ratio, 3.662; 95% CI, 1.145-11.765; p = 0.029) and progression-free survival (hazard ratio, 3.390; 95% CI, 1.443-7.937; p = 0.005). Conclusions: The more convenient PG regimen is as effective as the PF regimen as induction chemotherapy for patients with advanced NPC. Replacing cisplatin with carboplatin in the concurrent phase carries a poor prognosis.

  8. Overall survival and toxicities regarding thoracic three-dimensional radiotherapy with concurrent chemotherapy for stage IV non-small cell lung cancer: results of a prospective single-center study

    PubMed Central

    2013-01-01

    Background The role of chemotherapy given concurrently with thoracic three-dimensional radiotherapy for stage IV non-small cell lung cancer (NSCLC) is not well defined. We performed this study to investigate overall survival and toxicity in patients with stage IV NSCLC treated with this modality. Methods From 2003 to 2010, 201 patients were enrolled in this study. All patients received chemotherapy with concurrent thoracic three-dimensional radiotherapy. The study endpoints were the assessment of overall survival (OS) and acute toxicity. Results For all patients, the median survival time (MST) was 10.0 months, and the 1-, 2- and 3-year OS rates were 40.2%, 16.4%, and 9.6%, respectively. The MST was 14.0 months for patients who received a total radiation dose ?63 Gy to the primary tumor, whereas it was 8.0 months for patients who received a total dose <63 Gy (P?=?0.000). On multivariate analysis, a total dose ?63 Gy, a single site of metastatic disease, and undergoing ?4 cycles of chemotherapy were independent prognostic factors for better OS (P?=?0.007, P?=?0.014, and P?=?0.038, respectively); radiotherapy involving metastatic sites was a marginally significant prognostic factor (P?=?0.063). When the whole group was subdivided into patients with metastasis at a single site and multiple sites, a higher radiation dose to the primary tumor remained a significant prognostic factor for improved OS. For patients who received ?4 cycles of chemotherapy, high radiation dose remained of benefit for OS (P?=?0.001). Moreover, for the subgroup that received <4 chemotherapy cycles, the radiation dose was of marginal statistical significance regarding OS (P?=?0.063). Treatment-related toxicity was found to be acceptable. Conclusions Radiation dose to primary tumor, the number of metastatic sites, and the number of chemotherapy cycles were independent prognostic factors for OS in stage IV NSCLC patients treated with concurrent chemoradiotherapy. In addition to systemic chemotherapy, aggressive thoracic radiotherapy was shown to play an important role in improving OS. Trial registration Registered on (ChiCTR-TNC-10001026) PMID:24118842

  9. [Management of locally advanced anal canal carcinoma with modulated arctherapy and concurrent chemotherapy].

    PubMed

    Troussier, I; Huguet, F; Servagi-Vernat, S; Benahim, C; Khalifa, J; Darmon, I; Ortholan, C; Krebs, L; Dejean, C; Fenoglietto, P; Vieillot, S; Bensadoun, R-J; Thariat, J

    2015-04-01

    The standard treatment of locally advanced (stage II and III) squamous cell carcinoma of the anal canal consists of concurrent chemoradiotherapy (two cycles of 5-fluoro-uracil, mitomycin C, on a 28-day cycle), with a dose of 45 Gy in 1.8 Gy per fraction in the prophylactic planning target volume and additional 14 to 20 Gy in the boost planning target volume (5 days per week) with a possibility of 15 days gap period between the two sequences. While conformal irradiation may only yield suboptimal tumor coverage using complex photon/electron field junctions (especially on nodal areas), intensity modulated radiation therapy techniques (segmented static, dynamic, volumetric modulated arc therapy and helical tomotherapy) allow better tumour coverage while sparing organs at risk from intermediate/high doses (small intestine, perineum/genitalia, bladder, pelvic bone, etc.). Such dosimetric advantages result in fewer severe acute toxicities and better potential to avoid a prolonged treatment break that increases risk of local failure. These techniques also allow a reduction in late gastrointestinal and skin toxicities of grade 3 or above, as well as better functional conservation of anorectal sphincter. The technical achievements (simulation, contouring, prescription dose, treatment planning, control quality) of volumetric modulated arctherapy are discussed. PMID:25770884

  10. Radiation Therapy in the Management of Head-and-Neck Cancer of Unknown Primary Origin: How Does the Addition of Concurrent Chemotherapy Affect the Therapeutic Ratio?

    SciTech Connect

    Chen, Allen M.; Farwell, D. Gregory; Lau, Derick H.; Li Baoqing; Luu, Quang; Donald, Paul J.

    2011-10-01

    Purpose: To determine how the addition of cisplatin-based concurrent chemotherapy to radiation therapy influences outcomes among a cohort of patients treated for head-and-neck cancer of unknown primary origin. Methods and Materials: The medical records of 60 consecutive patients treated by radiation therapy for squamous cell carcinoma of the head and neck presenting as cervical lymph node metastasis of occult primary origin were reviewed. Thirty-two patients (53%) were treated by concurrent chemoradiation, and 28 patients (47%) were treated by radiation therapy alone. Forty-five patients (75%) received radiation therapy after surgical resection, and 15 patients (25%) received primary radiation therapy. Thirty-five patients (58%) were treated by intensity-modulated radiotherapy. Results: The 2-year estimates of overall survival, local-regional control, and progression-free survival were 89%, 89%, and 79%, respectively, among patients treated by chemoradiation, compared to 90%, 92%, and 83%, respectively, among patients treated by radiation therapy alone (p > 0.05, for all). Exploratory analysis failed to identify any subset of patients who benefited from the addition of concurrent chemotherapy to radiation therapy. The use of concurrent chemotherapy was associated with a significantly increased incidence of Grade 3+ acute and late toxicity (p < 0.001, for both). Conclusions: Concurrent chemoradiation is associated with significant toxicity without a clear advantage to overall survival, local-regional control, and progression-free survival in the treatment of head-and-neck cancer of unknown primary origin. Although selection bias cannot be ignored, prospective data are needed to further address this question.

  11. Radiation and concurrent chemotherapy for the treatment of Lewis lung tumor and B16 melanoma tumor in C57/BL mice

    SciTech Connect

    Pedersen, J.E.; Barron, G.

    1984-08-01

    C57/BL mice bearing either Lewis lung tumor or B16 melanoma tumor were treated with radiation and concurrent chemotherapy. The treatment results were determined in vivo by tumor regrowth delay assay. When continuous infusion of either Cyclophosphamide (CYCLO) or 5-Fluorouracil (5-FU) or Adriamycin (ADRIA) or Mitomycin-C (MITO-C) was used in combination with continuous radiation at 1 cGy/min, no increase in tumor regrowth delay was observed over that of radiation alone. When multiple drug chemotherapy, FAM (5-FU, ADRIA, MITO-C) was administered in combination with radiation at 80 cGy/min, no increase in tumor regrowth delay was observed over that of radiation alone. In these two murine tumor models, when clinically relevant concentrations of commonly used chemotherapy agents were combined with radiation, no therapeutic advantage was observed.

  12. Chemotherapy

    MedlinePLUS

    ... tumor cells in one of two ways: Systemic Delivery: Systemic drugs travel through the body in the bloodstream, cross ... the skin, or are taken by mouth. Local Delivery: Some drugs can be placed closer to the tumor, or ...

  13. Prospective Evaluation of Acute Toxicity and Quality of Life After IMRT and Concurrent Chemotherapy for Anal Canal and Perianal Cancer

    SciTech Connect

    Han, Kathy; Cummings, Bernard J.; Lindsay, Patricia; Skliarenko, Julia; Craig, Tim; Le, Lisa W.; Brierley, James; Wong, Rebecca; Dinniwell, Robert; Bayley, Andrew J.; Dawson, Laura A.; Ringash, Jolie; Krzyzanowska, Monika K.; Moore, Malcolm J.; Chen, Eric X.; Easson, Alexandra M.; Kassam, Zahra; Cho, Charles; Kim, John

    2014-11-01

    Purpose: A prospective cohort study was conducted to evaluate toxicity, quality of life (QOL), and clinical outcomes in patients treated with intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for anal and perianal cancer. Methods and Materials: From June 2008 to November 2010, patients with anal or perianal cancer treated with IMRT were eligible. Radiation dose was 27 Gy in 15 fractions to 36 Gy in 20 fractions for elective targets and 45 Gy in 25 fractions to 63 Gy in 35 fractions for gross targets using standardized, institutional guidelines, with no planned treatment breaks. The chemotherapy regimen was 5-fluorouracil and mitomycin C. Toxicity was graded with the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. QOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and CR29 questionnaires. Correlations between dosimetric parameters and both physician-graded toxicities and patient-reported outcomes were evaluated by polyserial correlation. Results: Fifty-eight patients were enrolled. The median follow-up time was 34 months; the median age was 56 years; 52% of patients were female; and 19% were human immunodeficiency virus—positive. Stage I, II, III, and IV disease was found in 9%, 57%, 26%, and 9% of patients, respectively. Twenty-six patients (45%) required a treatment break because of acute toxicity, mainly dermatitis (23/26). Acute grade 3 + toxicities included skin 46%, hematologic 38%, gastrointestinal 9%, and genitourinary 0. The 2-year overall survival (OS), disease-free survival (DFS), colostomy-free survival (CFS), and cumulative locoregional failure (LRF) rates were 90%, 77%, 84%, and 16%, respectively. The global QOL/health status, skin, defecation, and pain scores were significantly worse at the end of treatment than at baseline, but they returned to baseline 3 months after treatment. Social functioning and appetite scores were significantly better at 12 months than at baseline. Multiple dose-volume parameters correlated moderately with diarrhea, skin, and hematologic toxicity scores. Conclusion: IMRT reduces acute grade 3 + hematologic and gastrointestinal toxicities compared with reports from non-IMRT series, without compromising locoregional control. The reported QOL scores most relevant to acute toxicities returned to baseline by 3 months after treatment.

  14. Concurrent Chemoradiotherapy With Paclitaxel and Nedaplatin Followed by Consolidation Chemotherapy in Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix: Preliminary Results of a Phase II Study

    SciTech Connect

    Zhang Meiqin; Liu Suping; Wang, Xiang-E.

    2010-11-01

    Purpose: To evaluate the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) and consolidation chemotherapy in patients with locally advanced squamous cell cervical carcinoma. Methods and Materials: Patients with LASCC (FIGO Stage IIB-IIIB) were treated with pelvic external beam radiotherapy (45 Gy for Stage IIB and 50 Gy for Stage III) and high-dose-rate intracavitary brachytherapy (50 Gy for Stage IIB and 35 Gy for Stage III). The cumulative dose at point A was 50 Gy for Stage IIB and 65 Gy for Stage III. Concurrent chemotherapy with paclitaxel (35 mg/m{sup 2}) and nedaplatin (20 mg/m{sup 2}) was given every week for 6 weeks. Consolidation chemotherapy with paclitaxel (135 mg/m{sup 2}) and nedaplatin (60 mg/m{sup 2}) was administered every 3 weeks for 4 cycles. Results: All patients completed CCRT, and 28 of 34 patients completed consolidation chemotherapy. The complete response rate was 88% (95% CI, 73-96%). The most common Grade 3 or higher toxicities were leukopenia/neutropenia (10.9% of the cycles). During a median follow up of 23 months (range, 14-30 months), 5 patients had locoregional failure and 1 patient had distant metastasis. The estimated 2-year progression-free survival and overall survival were 82% (95% CI, 68-95%) and 93% (95% CI, 83-100%), respectively. Grade 3 late complications occurred in 3 patients (9%). Conclusions: CCRT with paclitaxel and nedaplatin followed by consolidation chemotherapy is well tolerated and effective in patients with locally advanced squamous cell cervical carcinoma. Further randomized trials of comparing this regimen with the standard treatment are worth while.

  15. A Concurrent Distributed System for Aircraft Tactical Decision Generation

    NASA Technical Reports Server (NTRS)

    McManus, John W.

    1990-01-01

    A research program investigating the use of artificial intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range (WVR) air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of a concurrent version of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS) program, a second generation TDG, is presented. Concurrent computing environments and programming approaches are discussed and the design and performance of a prototype concurrent TDG system are presented.

  16. Randomized Clinical Trial of Weekly vs. Triweekly Cisplatin-Based Chemotherapy Concurrent With Radiotherapy in the Treatment of Locally Advanced Cervical Cancer

    SciTech Connect

    Ryu, Sang-Young; Lee, Won-Moo; Kim, Kidong; Park, Sang-Il; Kim, Beob-Jong; Kim, Moon-Hong; Choi, Seok-Cheol; Cho, Chul-Koo; Nam, Byung-Ho; Lee, Eui-Don

    2011-11-15

    Purpose: To compare compliance, toxicity, and outcome of weekly and triweekly cisplatin administration concurrent with radiotherapy in locally advanced cervical cancer. Methods and Materials: In this open-label, randomized trial, 104 patients with histologically proven Stage IIB-IVA cervical cancer were randomly assigned by a computer-generated procedure to weekly (weekly cisplatin 40 mg/m{sup 2}, six cycles) and triweekly (cisplatin 75 mg/m{sup 2} every 3 weeks, three cycles) chemotherapy arms during concurrent radiotherapy. The difference of compliance and the toxicity profiles between the two arms were investigated, and the overall survival rate was analyzed after 5 years. Results: All patients tolerated both treatments very well, with a high completion rate of scheduled chemotherapy cycles. There was no statistically significant difference in compliance between the two arms (86.3% in the weekly arm, 92.5% in the triweekly arm, p > 0.05). Grade 3-4 neutropenia was more frequent in the weekly arm (39.2%) than in the triweekly arm (22.6%) (p = 0.03). The overall 5-year survival rate was significantly higher in the triweekly arm (88.7%) than in the weekly arm (66.5%) (hazard ratio 0.375; 95% confidence interval 0.154-0.914; p = 0.03). Conclusions: Triweekly cisplatin 75-mg/m{sup 2} chemotherapy concurrent with radiotherapy is more effective and feasible than the conventional weekly cisplatin 40-mg/m{sup 2} regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer.

  17. Pretreatment anemia is correlated with the reduced effectiveness of radiation and concurrent chemotherapy in advanced head and neck cancer

    SciTech Connect

    Prosnitz, Robert G. . E-mail: robert.prosnitz@duke.edu; Yao, Bin M.S.; Farrell, Catherine L.; Clough, Robert; Brizel, David M.

    2005-03-15

    Purpose: Pretreatment anemia is an adverse prognostic variable in squamous cell head-and-neck cancer (HNC) patients treated with radiotherapy (RT) alone. Tumor hypoxia is an adverse parameter for treatment with RT alone or with RT and concurrent chemotherapy (CCT). Tumor hypoxia is more prevalent in patients who present with pretreatment hemoglobin (Hgb) concentrations less than 13 g/dL. RT/CCT improves survival over RT alone in advanced HNC, and its use is becoming more widespread. This study was performed to evaluate whether pretreatment Hgb less than 13 g/dL was correlated with treatment outcome in patients with advanced HNC treated with a uniform regimen of RT/CCT. Methods and materials: The study population consisted of patients with AJCC Stage III or IV, M0 HNC who were treated with 70 to 72.5 Gy accelerated hyperfractionated RT (1.25 Gy b.i.d.) and CCT consisting of 2 cycles of CDDP (12-20 mg/m{sup 2}/d x 5 days) and continuous infusion 5-FU (600 mg/m{sup 2}/d x 5 days) during Week 1 and Week 6. A planned break in RT occurred during Week 4. These patients were enrolled on the experimental arm of a prospective randomized trial that compared this regimen to hyperfractionated irradiation alone from 1990 to 1996. RT/CCT was delivered as standard therapy from 1996 to 2000. The primary endpoint was failure-free survival (FFS). Secondary endpoints included local-regional control and overall survival. Results: One hundred and fifty-nine patients were treated from 1990 to 2000. The median (25-75%) pretreatment Hgb was 13.6 (12.2-13.5) g/dL. Hgb was 13 g/dL or higher in 105 patients and less than 13 g/dL in 54 patients. Primary tumor sites included oropharynx (43%), hypopharynx/larynx (36%), oral cavity (9%), and nasopharynx (6%). Seventy-eight percent of the patients with Hgb 13 g/dL or higher and 92% of the patients with Hgb less than 13 g/dL had a primary tumor stage of T3 or T4 (p = 0.01). Node-positive disease was present in 74 of 105 (70%) of patients with Hgb 13 g/dL or higher patients and in 36/54 (67%) of patients with Hgb less than 13 g/dL patients. Median follow-up of surviving patients was 42 months (range, 4-128 months). Five-year FFS was 75% for patients with Hgb 13 g/dL or higher vs. 50% for patients with Hgb less than 13 g/dL had a (p < 0.01). A total of 49 failures occurred in both patient cohorts. The median (25-75%) decrease in Hgb during RT/CCT was 2.2 (1.3-3.1) g/dL, both in patients who failed and in those who remained disease-free. Conclusion: Pretreatment Hgb less than 13 g/dL is correlated with adverse outcomes in advanced HNC patients treated with RT/CCT. Whether anemia actually causes poor outcomes remains unknown. The therapeutic effect of anemia correction is being evaluated in prospective trials.

  18. Factors Associated With Severe Acute Esophagitis From Hyperfractionated Radiotherapy With Concurrent Chemotherapy for Limited-Stage Small-Cell Lung Cancer

    SciTech Connect

    Watkins, John M.; Wahlquist, Amy E. M.S.; Shirai, Keisuke; Garrett-Mayer, Elizabeth; Aguero, Eric G.; Fortney, John A.; Sherman, Carol A.; Sharma, Anand K.

    2009-07-15

    Purpose: To describe incidence and identify factors associated with development of severe acute esophagitis during hyperfractionated radiotherapy with concurrent chemotherapy (BID-CRT) in patients with limited-stage small-cell lung cancer (SCLC). Methods and Materials: Retrospective cohort analysis of patient-, tumor-, and treatment-related variables was performed to identify factors associated with Radiation Therapy Oncology Group (RTOG) Grade 3 acute esophagitis. Twice-daily chemoradiotherapy (BID-CRT) involved 45 Gy at 1.5 Gy per fraction, treated twice daily with concurrent platinum-based chemotherapy. Logistic regression analyses were used to identify factors associated with esophagitis. Results: Between June 1999 and June 2007, 48 patients underwent curative intent BID-CRT for SCLC and were included in the analysis. Median radiotherapy dose was 45 Gy (range, 42-51 Gy) delivered with a median 4 cycles of chemotherapy (range, 2-6). RTOG Grade 3 acute esophagitis developed in 11 patients. No patient developed Grade 4 or 5 esophagitis. Simple logistic regression analyses demonstrated a highly significant association between Grade 3 acute esophagitis and mean esophageal dose (p = 0.002) as well as relative volume dosimetric area under curve (RV-AUC; p = 0.004). Using multiple regression analysis, RV-AUC was identified as the only factor associated with Grade 3 esophagitis (p = 0.004). The most strongly associated dosimetric volume was the V15 (Grade 3 esophagitis rates of 15% vs. 64% for V15 <60% versus {>=}60%, respectively). Conclusions: RV-AUC is the factor most associated with development of Grade 3 acute esophagitis in limited stage SCLC patients receiving BID-CRT.

  19. Feasibility Study of Moderately Accelerated Intensity-Modulated Radiotherapy Plus Concurrent Weekly Cisplatin After Induction Chemotherapy in Locally Advanced Head-and Neck Cancer

    SciTech Connect

    Morganti, Alessio G.; Mignogna, Samantha; Deodato, Francesco; Massaccesi, Mariangela; Cilla, Savino; Calista, Franco; Serafini, Giovanni; Digesu, Cinzia; Macchia, Gabriella; Picardi, Vincenzo; Caravatta, Luciana; Di Lullo, Liberato; Giglio, Gianfranco; Sallustio, Giuseppina; Piermattei, Angelo

    2011-03-15

    Purpose: To evaluate the feasibility and efficacy of moderately accelerated intensity-modulated radiation therapy (IMRT) along with weekly cisplatin, after induction chemotherapy, in patients with locally advanced unresectable head and neck cancer (HNC). Methods and Materials: Patients with Stage III or IV locally advanced HNC, without progressive disease after three courses of induction chemotherapy, received concurrent chemo-IMRT (weekly cisplatin 30 mg/m{sup 2} plus simultaneous integrated boost IMRT). A total of 67.5 Gy in 30 fractions were delivered to primary tumor and involved nodes, 60 Gy in 30 fractions to high-risk nodal areas, and 55.5 Gy in 30 fractions to low-risk nodal areas. Results: In all, 36 patients (median age, 56 years) with International Union Against Cancer (UICC) Stage III (n = 5) and IV (n = 31) were included. Of the 36 patients, 17 had received CF (cisplatin and 5-fluorouracil (CF) and 19 had received docetaxel cisplatin and 5-fluorouracil (DCF). During concurrent chemoradiation, 11 of 36 patients (30.5%) experienced Grade III mucositis (CF, 47%; DCF, 15%; p < 0.04). Grade III pharyngeal-esophageal toxicity was observed in 5 of 19 patients (26.3%; CF, 0.0%; DCF, 26.3%; p = 0.02). Two patients died of complications (5.5%). After chemoradiation, the complete response rate was 63.8%. Two-year local control was 88.7%. Two-year progression free survival and overall survival were 74.5% and 60.9%, respectively. Conclusions: In our experience, a moderately accelerated chemo-IMRT was feasible after induction chemotherapy. However, a noteworthy early death rate of 5.5% was observed. Intensive supportive care strategies should be defined to better manage radiation-induced toxic effects. Longer follow-up is required to determine the incidence of late radiation toxicities and tumor control rates.

  20. Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

    PubMed Central

    Baas, P; Belderbos, J S A; Senan, S; Kwa, H B; van Bochove, A; van Tinteren, H; Burgers, J A; van Meerbeeck, J P

    2006-01-01

    To improve the prognosis of limited stage small cell lung cancer (LS-SCLC) the addition of concurrent thoracic radiotherapy to a platinum-containing regimen is important. In the Netherlands, we initiated a multicenter, phase II study, of the combination of four cycles of carboplatin (AUC 5), paclitaxel (200?mg?m?2) and etoposide (2 × 50?mg orally for 5 days) combined with 45?Gy (daily fractions of 1.8?Gy). The radiation was given to the involved field and concurrently with the second and third chemotherapy cycle. Patients with a partial or complete response received prophylactic cranial irradiation to a dose of 30?Gy. From January 1999 to December 2001, 37 of the 38 patients with LS-SCLC entered were eligible for toxicity analysis and response. Grade 3 and 4 haematological toxicity occurred in 57% (21/37) with febrile neutropenia in 24% (9/37). There were no treatment-related deaths or other grade 4 toxicity. Grade 3 toxicities were oesophagitis (27%), radiation pneumonitis (6%), anorexia (14%), nausea (16%), dyspnea (19%) and lethargy (22%). The objective response rate was 92% (95% confidence interval (CI) 80–98%) with a median survival time of 19.5 months (95% CI 12.8–29.2). The 1-, 2- and 5-year survival rate was 70, 47 and 27%, respectively. In field local recurrences occurred in six patients. Distant metastases were observed in 19 patients of which 13 in the brain. This study indicates that combination chemotherapy with concurrent involved-field radiation therapy is an effective treatment for LS-SCLC. Despite PCI, the brain remained the most important site of recurrence. PMID:16465191

  1. The use of nanoparticulate delivery systems in metronomic chemotherapy.

    PubMed

    Yu, De-Hong; Ban, Fu-Qiang; Zhao, Mei; Lu, Qin; Lovell, Jonathan F; Bai, Fan; Wang, Chao; Guan, Ying-Yun; Luan, Xin; Liu, Ya-Rong; Fang, Chao; Chen, Hong-Zhuan

    2013-05-01

    Metronomic chemotherapy aiming at inhibiting tumor angiogenesis with conventional chemotherapeutics is a promising strategy for antiangiogenic cancer therapy. However, current metronomic chemotherapy mainly focuses on free small-molecule drugs, without any effort to achieve tumor-specific biodistribution, which may lead to long-term toxicity concerns. Metronomic chemotherapy using nanoparticulate drug delivery system (DDS) offers significant upside to reduce off-target side effects, decrease accumulated dose, and enhance the efficacy of tumor vessel targeting without compromising antitumor efficacy; but there has been a lack of thorough experimental data describing the targeted metronomic chemotherapy. Here, we develop a new nanoparticulate DDS, SP5.2 peptide conjugated, Flt-1 (VEGFR-1) targeted nanoparticles for docetaxel (SP5.2-DTX-NP), as a model for the investigation of targeted metronomic chemotherapy with respect to both antitumor efficacy and toxicity. The results demonstrate that metronomic SP5.2-DTX-NP exerts antitumor activity mainly through the antiangiogenic effect of docetaxel, which is specifically delivered into the tumor vascular endothelial cells through the nanoparticle internalization mediated by the interaction of SP5.2 and over-expressed Flt-1 receptors on tumor vessels. Moreover, the antitumor efficacy of targeted metronomic chemotherapy is better than that of the treatment with the DDS given in the maximum tolerated dose (MTD) regimen, which is shown in significantly prolonged mice survival and minimal drug-associated toxicity (bone marrow suppression, hematological toxicity, and mucosal injury of small intestine). The present research reveals and highlights the significance of targeted metronomic therapy with nanoparticulate DDS in antiangiogenic cancer therapy. PMID:23465835

  2. Neutrophil dynamics during concurrent chemotherapy and G-CSF administration: Mathematical modelling guides dose optimisation to minimise neutropenia.

    PubMed

    Craig, Morgan; Humphries, Antony R; Nekka, Fahima; Bélair, Jacques; Li, Jun; Mackey, Michael C

    2015-11-21

    The choice of chemotherapy regimens is often constrained by the patient's tolerance to the side effects of chemotherapeutic agents. This dose-limiting issue is a major concern in dose regimen design, which is typically focused on maximising drug benefits. Chemotherapy-induced neutropenia is one of the most prevalent toxic effects patients experience and frequently threatens the efficient use of chemotherapy. In response, granulocyte colony-stimulating factor (G-CSF) is co-administered during chemotherapy to stimulate neutrophil production, increase neutrophil counts, and hopefully avoid neutropenia. Its clinical use is, however, largely dictated by trial and error processes. Based on up-to-date knowledge and rational considerations, we develop a physiologically realistic model to mathematically characterise the neutrophil production in the bone marrow which we then integrate with pharmacokinetic and pharmacodynamic (PKPD) models of a chemotherapeutic agent and an exogenous form of G-CSF (recombinant human G-CSF, or rhG-CSF). In this work, model parameters represent the average values for a general patient and are extracted from the literature or estimated from available data. The dose effect predicted by the model is confirmed through previously published data. Using our model, we were able to determine clinically relevant dosing regimens that advantageously reduce the number of rhG-CSF administrations compared to original studies while significantly improving the neutropenia status. More particularly, we determine that it could be beneficial to delay the first administration of rhG-CSF to day seven post-chemotherapy and reduce the number of administrations from ten to three or four for a patient undergoing 14-day periodic chemotherapy. PMID:26343861

  3. Towards PCC for Concurrent and Distributed Systems (Work in Progress)

    NASA Technical Reports Server (NTRS)

    Henriksen, Anders S.; Filinski, Andrzej

    2009-01-01

    We outline some conceptual challenges in extending the PCC paradigm to a concurrent and distributed setting, and sketch a generalized notion of module correctness based on viewing communication contracts as economic games. The model supports compositional reasoning about modular systems and is meant to apply not only to certification of executable code, but also of organizational workflows.

  4. Concurrent Online Testing for Many Core Systems-on-Chips 

    E-print Network

    Lee, Jason Daniel

    2012-02-14

    Vector Storage ILP Instruction Level Parallelism IMA Integrated Modular Avionics IP Intellectual Property MTBF Mean Time Between Failure MTTR Mean Time to Repair NoC Network-on-Chip SoC System-on-Chip TLP Thread Level Parallelism viii... ............................................................. 17 C. Recent Proposals in Concurrent Online Testing ...................... 17 1. Test Infrastructure IP Cores ............................................ 17 2. Software-Based Testing...

  5. Structured Modeling of Concurrent Stochastic Hybrid Systems #

    E-print Network

    Alur, Rajeev

    Charon for hybrid systems, a simulation tool, and case studies using the tool. 1 Introduction Hybrid systems (for example, Charon [2], hybrid I/O automata [14]), and for timed probabilistic systems (c.f. [13 our model by extending the modeling language Charon, a de­ sign environment for specification

  6. Hypofractionated Accelerated Radiotherapy With Concurrent Chemotherapy For Locally Advanced Squamous Cell Carcinoma of the Head and Neck

    SciTech Connect

    Sanghera, Paul; McConkey, Chris; Ho, Kean-Fatt; Glaholm, John; Hartley, Andrew . E-mail: andrew.hartley@uhb.nhs.uk

    2007-04-01

    Purpose: To investigate the tumor control rates in locally advanced head-and-neck cancer using accelerated hypofractionated radiotherapy with chemotherapy. Methods and Materials: The data from patients with squamous cell cancer of the larynx, oropharynx, oral cavity, and hypopharynx (International Union Against Cancer Stage II-IV), who received accelerated hypofractionated radiotherapy with chemotherapy between January 1, 1998, and April 1, 2005, were retrospectively analyzed. Two different chemotherapy schedules were used, carboplatin and methotrexate, both single agents administered on an outpatient basis. The endpoints were overall survival, local control, and disease-free survival. Results: A total of 81 patients were analyzed. The 2-year overall survival rate was 71.6% (95% confidence interval [CI], 61.5-81.8%). The 2-year disease-free survival rate was 68.6% (95% CI, 58.4-78.8%). The 2-year local control rate was 75.4% (95% CI, 65.6-85.1%). When excluding patients with Stage II oral cavity, larynx, and hypopharynx tumors, 68 patients remained. For these patients, the 2-year overall survival, local control, and disease-free survival rate was 67.6% (95% CI, 56.0-79.2%), 72.0% (95% CI, 61.0-83.0%), and 64.1% (95% CI, 52.6-75.7%), respectively. Conclusion: Accelerated hypofractionated radiotherapy and synchronous chemotherapy can achieve high tumor control rates while being resource sparing and should be the subject of prospective evaluation.

  7. The evolution of the PVM concurrent computing system

    SciTech Connect

    Giest, G.A.; Sunderam, V.S.

    1993-07-01

    Concurrent and distributed computing, using portable software systems or environments on general purpose networked computing platforms, has recently gained widespread attention. Many such systems have been developed, and several are in production use. This paper describes the evolution of the PVM system, a software infrastructure for concurrent computing in networked environments. PVM has evolved over the past years; it is currently in use at several hundred institutions worldwide for applications ranging from scientific supercomputing to high performance computations in medicine, discrete mathematics, and databases, and for learning parallel programming. We describe the historical evolution of the PVM system, outline the programming model and supported features, present results gained from its use, list representative applications from a variety of disciplines that PVM has been used for, and comment on future trends and ongoing research projects.

  8. Initial Evaluation of Treatment-Related Pneumonitis in Advanced-Stage Non-Small-Cell Lung Cancer Patients Treated With Concurrent Chemotherapy and Intensity-Modulated Radiotherapy

    SciTech Connect

    Yom, Sue S.; Liao Zhongxing . E-mail: zliao@mdanderson.org; Liu, H. Helen; Tucker, Susan L.; Hu, C.-S.; Wei Xiong; Wang Xuanming; Wang Shulian; Mohan, Radhe; Cox, James D.; Komaki, Ritsuko

    2007-05-01

    Purpose: To investigate the rate of high-grade treatment-related pneumonitis (TRP) in patients with advanced non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT). Methods and Materials: From August 2002 to August 2005, 151 NSCLC patients were treated with IMRT. We excluded patients who did not receive concurrent chemotherapy or who had early-stage cancers, a history of major lung surgery, prior chest RT, a dose <50 Gy, or IMRT combined with three-dimensional conformal RT (3D-CRT). Toxicities were graded by Common Terminology Criteria for Adverse Events version 3.0. Grade {>=}3 TRP for 68 eligible IMRT patients was compared with TRP among 222 similar patients treated with 3D-CRT. Results: The median follow-up durations for the IMRT and 3D-CRT patients were 8 months (range, 0-27 months) and 9 months (range, 0-56 months), respectively. The median IMRT and 3D-CRT doses were 63 Gy. The median gross tumor volume was 194 mL (range, 21-911 mL) for IMRT, compared with 142 mL (range, 1.5-1,186 mL) for 3D-CRT (p = 0.002). Despite the IMRT group's larger gross tumor volume, the rate of Grade {>=}3 TRP at 12 months was 8% (95% confidence interval 4%-19%), compared with 32% (95% confidence interval 26%-40%) for 3D-CRT (p = 0.002). Conclusions: In advanced NSCLC patients treated with chemoradiation, IMRT resulted in significantly lower levels of Grade {>=}3 TRP compared with 3D-CRT. Clinical, dosimetric, and patient selection factors that may have influenced rates of TRP require continuing investigation. A randomized trial comparing IMRT with 3D-CRT has been initiated.

  9. A Simple Approach to Specifying Concurrent Systems

    E-print Network

    Lamport ,Leslie

    in whole or in part without payment of fee is granted for nonprofit educational and research purposes; an acknowledgement of the authors and individual contributors to the work; and all applicable por- tions with payment of fee to the Systems Research Center. All rights reserved. #12;Author's Abstract

  10. A Simple Approach to Specifying Concurrent Systems

    E-print Network

    Borgs, Christian

    in whole or in part without payment of fee is granted for nonprofit educational and research purposes; an acknowledgement of the authors and individual contributors to the work; and all applicable por­ tions with payment of fee to the Systems Research Center. All rights reserved. #12; Author's Abstract

  11. High-dose Extended-Field Irradiation and High-Dose-Rate Brachytherapy With Concurrent Chemotherapy for Cervical Cancer With Positive Para-Aortic Lymph Nodes

    SciTech Connect

    Kim, Young Seok; Kim, Jong Hoon; Ahn, Seung Do; Lee, Sang-wook; Shin, Seong Soo; Nam, Joo-Hyun; Kim, Young-Tak; Kim, Yong-Man; Kim, Jong-Hyeok; Choi, Eun Kyung

    2009-08-01

    Purpose: To determine the efficacy and toxicity of extended-field radiotherapy (RT) with concurrent platinum-based chemotherapy in patients with uterine cervical carcinoma and positive para-aortic nodes. Methods and Materials: We retrospectively reviewed the results for 33 women with Stage IB-IVB cervical cancer. Each patient had received 59.4 Gy, including a three-dimensional conformal boost to the para-aortic lymph nodes and 41.4-50.4 Gy of external beam radiotherapy to the pelvis. Each patient also underwent six or seven applications of high-dose-rate brachytherapy (median, 5 Gy to point A at each session). Results: The median follow-up period of surviving patients was 39 months. The most common acute toxicity was hematologic, observed in 23 women. Severe acute and late gastrointestinal toxicity was observed in 3 and 4 patients, respectively. More than three-quarters of patients showed a complete response, encompassing the primary mass, metastatic pelvic, and para-aortic lymph nodes. Of the 33 women, 15 had no evidence of disease, 6 had persistent disease, 4 developed in-field failures, and 6 developed distant failures. The 5-year overall and disease-free survival rate was 47% and 42%, respectively. Conclusion: Concurrent chemoradiotherapy with extended-field radiotherapy is feasible in women with uterine cervical carcinoma and positive para-aortic lymph nodes, with acceptable late morbidity and a high survival rate, although it was accompanied by substantial acute toxicity.

  12. A concurrent distributed system for aircraft tactical decision generation

    NASA Technical Reports Server (NTRS)

    Mcmanus, John W.

    1990-01-01

    A research program investigating the use of AI techniques to aid in the development of a tactical decision generator (TDG) for within visual range (WVR) air combat engagements is discussed. The application of AI programming and problem-solving methods in the development and implementation of a concurrent version of the computerized logic for air-to-air warfare simulations (CLAWS) program, a second-generation TDG, is presented. Concurrent computing environments and programming approaches are discussed, and the design and performance of prototype concurrent TDG system (Cube CLAWS) are presented. It is concluded that the Cube CLAWS has provided a useful testbed to evaluate the development of a distributed blackboard system. The project has shown that the complexity of developing specialized software on a distributed, message-passing architecture such as the Hypercube is not overwhelming, and that reasonable speedups and processor efficiency can be achieved by a distributed blackboard system. The project has also highlighted some of the costs of using a distributed approach to designing a blackboard system.

  13. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma

    SciTech Connect

    Lee, Anne W.M. . E-mail: awmlee@ha.org.hk; Tung, Stewart Y.; Chan, Anthony T.C.; Chappell, Rick; Fu, Y.-T.; Lu, Tai-Xiang; Tan, Terence; Chua, Daniel T.T.; O'Sullivan, Brian; Xu, Shirley L.; Pang, Ellie S.Y.; Sze, W.-M.; Leung, T.-W.; Kwan, W.-H.; Chan, Paddy; Liu, X.-F.; Tan, E.-H.; Sham, Jonathan; Siu, Lillian; Lau, W.-H.

    2006-09-01

    Purpose: To compare the benefit achieved by concurrent chemoradiotherapy (CRT) and/or accelerated fractionation (AF) vs. radiotherapy (RT) alone with conventional fractionation (CF) for patients with T3-4N0-1M0 nasopharyngeal carcinoma (NPC). Methods and Materials: All patients were irradiated with the same RT technique to {>=}66 Gy at 2 Gy per fraction, conventional five fractions/week in the CF and CF+C (chemotherapy) arms, and accelerated six fractions/week in the AF and AF+C arms. The CF+C and AF+C patients were given the Intergroup 0099 regimen (concurrent cisplatin plus adjuvant cisplatin and 5-fluorouracil). Results: Between 1999 and April 2004, 189 patients were randomly assigned; the trial was terminated early because of slow accrual. The median follow-up was 2.9 years. When compared with the CF arm, significant improvement in failure-free survival (FFS) was achieved by the AF+C arm (94% vs. 70% at 3 years, p = 0.008), but both the AF arm and the CF+C arm were insignificant (p {>=} 0.38). Multivariate analyses showed that CRT was a significant factor: hazard ratio (HR) = 0.52 (0.28-0.97), AF per se was insignificant: HR = 0.68 (0.37-1.25); the interaction of CRT by AF was strongly significant (p = 0.006). Both CRT arms had significant increase in acute toxicities (p < 0.005), and the AF+C arm also incurred borderline increase in late toxicities (34% vs. 14% at 3 years, p = 0.05). Conclusions: Preliminary results suggest that concurrent chemoradiotherapy with accelerated fractionation could significantly improve tumor control when compared with conventional RT alone; further confirmation of therapeutic ratio is warranted.

  14. Concurrent hypercube system with improved message passing

    NASA Technical Reports Server (NTRS)

    Peterson, John C. (Inventor); Tuazon, Jesus O. (Inventor); Lieberman, Don (Inventor); Pniel, Moshe (Inventor)

    1989-01-01

    A network of microprocessors, or nodes, are interconnected in an n-dimensional cube having bidirectional communication links along the edges of the n-dimensional cube. Each node's processor network includes an I/O subprocessor dedicated to controlling communication of message packets along a bidirectional communication link with each end thereof terminating at an I/O controlled transceiver. Transmit data lines are directly connected from a local FIFO through each node's communication link transceiver. Status and control signals from the neighboring nodes are delivered over supervisory lines to inform the local node that the neighbor node's FIFO is empty and the bidirectional link between the two nodes is idle for data communication. A clocking line between neighbors, clocks a message into an empty FIFO at a neighbor's node and vica versa. Either neighbor may acquire control over the bidirectional communication link at any time, and thus each node has circuitry for checking whether or not the communication link is busy or idle, and whether or not the receive FIFO is empty. Likewise, each node can empty its own FIFO and in turn deliver a status signal to a neighboring node indicating that the local FIFO is empty. The system includes features of automatic message rerouting, block message transfer and automatic parity checking and generation.

  15. Concurrency in a System for Symbolic and Algebraic Computations 

    E-print Network

    Mai, Stefan

    2009-06-09

    AND ALGEBRAIC COMPUTATIONS A Senior Scholars Thesis by STEFAN MAI Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the designation of UNDERGRADUATE RESEARCH SCHOLAR April 2009 Major: Computer... Engineering CONCURRENCY IN A SYSTEM FOR SYMBOLIC AND ALGEBRAIC COMPUTATIONS A Senior Scholars Thesis by STEFAN MAI Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the designation...

  16. Performance study of optimistic concurrency control schemes for distributed database systems 

    E-print Network

    Kim Lee, Hyunsoon

    1993-01-01

    In distributed database systems, a concurrency control mechanism is needed to coordinate accesses to the same data items by more than one transactions for data consistency. There are two basic approaches to the concurrency control problem...

  17. Cisplatin-Based Chemotherapy versus Cetuximab in Concurrent Chemoradiotherapy for Locally Advanced Head and Neck Cancer Treatment

    PubMed Central

    Hu, Ming-Hung; Wang, Ling-Wei; Lu, Hsueh-Ju; Chu, Pen-Yuan; Tai, Shyh-Kuan; Lee, Tsung-Lun; Chen, Ming-Huang; Yang, Muh-Hwa; Chang, Peter Mu-Hsin

    2014-01-01

    Background and Purpose. This study aimed to analyze survival, clinical responses, compliance, and adverse effects in locally advanced head and neck cancer (LAHNC) patients treated with split-dose cisplatin-based concurrent chemoradiation therapy (SD-CCRT) or cetuximab with concurrent radiation therapy (BioRT). Materials and Methods. We retrospectively evaluated 170 LAHNC patients diagnosed between January 1, 2009, and July 31, 2012: 116 received CCRT and 54 received BioRT. Results. Complete response rates were similar in the SD-CCRT and BioRT groups (63.8% versus 59.3%; P = 0.807), and locoregional relapse rates were 18.1% and 13.0%, respectively (P = 0.400). The 3-year relapse-free survival rate was 65.8% in the SD-CCRT group and 65.5% in the BioRT group, respectively (P = 0.647). The 3-year overall survival rate was 78.5% in the SD-CCRT group and 70.9% in the BioRT group, respectively (P = 0.879). Hematologic side effects were significantly more frequent in the SD-CCRT than in the BioRT group. Mucositis frequency was similar. Conclusions. Primary SD-CCRT and BioRT both showed good clinical response and survival. Hematologic toxicities were more frequent, but tolerable, in the SD-CCRT group. Both groups showed good compliance. PMID:25110705

  18. Postoperative Radiation Therapy With or Without Concurrent Chemotherapy for Node-Positive Thoracic Esophageal Squamous Cell Carcinoma

    SciTech Connect

    Chen, Junqiang; Pan, Jianji; Liu, Jian; Li, Jiancheng; Zhu, Kunshou; Zheng, Xiongwei; Chen, Mingqiang; Chen, Ming; Liao, Zhongxing

    2013-07-15

    Purpose: To retrospectively compare the efficacy of radiation therapy (RT) and chemotherapy plus RT (CRT) for the postoperative treatment of node-positive thoracic esophageal squamous cell carcinoma (TESCC) and to determine the incidence and severity of toxic reactions. Methods and Materials: We retrospectively reviewed data from 304 patients who had undergone esophagectomy with 3-field lymph node dissection for TESCC and were determined by postoperative pathology to have lymph node metastasis without distant hematogenous metastasis. Of these patients, 164 underwent postoperative chemotherapy (cisplatin 80 mg/m{sup 2}, average days 1-3, plus paclitaxel 135 mg/m{sup 2}, day 1; 21-day cycle) plus RT (50 Gy), and 140 underwent postoperative RT alone. Results: The 5-year overall survival rates for the CRT and RT groups were 47.4% and 38.6%, respectively (P=.030). The distant metastasis rate, the mixed (regional lymph node and distant) metastasis rate, and the overall recurrence rate were significantly lower in the CRT group than in the RT group (P<.05). However, mild and severe early toxic reactions, including neutropenia, radiation esophagitis, and gastrointestinal reaction, were significantly more common in the CRT group than in the RT group (P<.05). No significant differences in incidence of late toxic reactions were found between the 2 groups. Conclusions: Our results show that in node-positive TESCC patients, postoperative CRT is significantly more effective than RT alone at increasing the overall survival and decreasing the rates of distant metastasis, mixed metastasis, and overall recurrence. Severe early toxic reactions were more common with CRT than with RT alone, but patients could tolerate CRT.

  19. Model-Based Systems Engineering in Concurrent Engineering Centers

    NASA Technical Reports Server (NTRS)

    Iwata, Curtis; Infeld, Samantha; Bracken, Jennifer Medlin; McGuire; McQuirk, Christina; Kisdi, Aron; Murphy, Jonathan; Cole, Bjorn; Zarifian, Pezhman

    2015-01-01

    Concurrent Engineering Centers (CECs) are specialized facilities with a goal of generating and maturing engineering designs by enabling rapid design iterations. This is accomplished by co-locating a team of experts (either physically or virtually) in a room with a focused design goal and a limited timeline of a week or less. The systems engineer uses a model of the system to capture the relevant interfaces and manage the overall architecture. A single model that integrates other design information and modeling allows the entire team to visualize the concurrent activity and identify conflicts more efficiently, potentially resulting in a systems model that will continue to be used throughout the project lifecycle. Performing systems engineering using such a system model is the definition of model-based systems engineering (MBSE); therefore, CECs evolving their approach to incorporate advances in MBSE are more successful in reducing time and cost needed to meet study goals. This paper surveys space mission CECs that are in the middle of this evolution, and the authors share their experiences in order to promote discussion within the community.

  20. Association Between Bone Marrow Dosimetric Parameters and Acute Hematologic Toxicity in Anal Cancer Patients Treated With Concurrent Chemotherapy and Intensity-Modulated Radiotherapy

    SciTech Connect

    Mell, Loren K. Schomas, David A.; Salama, Joseph K.; Devisetty, Kiran; Aydogan, Bulent; Miller, Robert C.; Jani, Ashesh B.; Kindler, Hedy L.; Roeske, John C.; Chmura, Steven J.

    2008-04-01

    Purpose: To test the hypothesis that the volume of pelvic bone marrow (PBM) receiving 10 and 20 Gy or more (PBM-V{sub 10} and PBM-V{sub 20}) is associated with acute hematologic toxicity (HT) in anal cancer patients treated with concurrent chemoradiotherapy. Methods and Materials: We analyzed 48 consecutive anal cancer patients treated with concurrent chemotherapy and intensity-modulated radiation therapy. The median radiation dose to gross tumor and regional lymph nodes was 50.4 and 45 Gy, respectively. Pelvic bone marrow was defined as the region extending from the iliac crests to the ischial tuberosities, including the os coxae, lumbosacral spine, and proximal femora. Endpoints included the white blood cell count (WBC), absolute neutrophil count (ANC), hemoglobin, and platelet count nadirs. Regression models with multiple independent predictors were used to test associations between dosimetric parameters and HT. Results: Twenty patients (42%) had Stage T3-4 disease; 15 patients (31%) were node positive. Overall, 27 (56%), 24 (50%), 4 (8%), and 13 (27%) experienced acute Grade 3-4 leukopenia, neutropenia, anemia, and thrombocytopenia, respectively. On multiple regression analysis, increased PBM-V{sub 5}, V{sub 10}, V{sub 15}, and V{sub 20} were significantly associated with decreased WBC and ANC nadirs, as were female gender, decreased body mass index, and increased lumbosacral bone marrow V{sub 10}, V{sub 15}, and V{sub 20} (p < 0.05 for each association). Lymph node positivity was significantly associated with a decreased WBC nadir on multiple regression analysis (p < 0.05). Conclusion: This analysis supports the hypothesis that increased low-dose radiation to PBM is associated with acute HT during chemoradiotherapy for anal cancer. Techniques to limit bone marrow irradiation may reduce HT in anal cancer patients.

  1. Dose Escalation of Total Marrow Irradiation with Concurrent Chemotherapy in Patients with Advanced Acute Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation

    PubMed Central

    Wong, Jeffrey Y.C.; Forman, Stephen; Somlo, George; Rosenthal, Joseph; Liu, An; Schultheiss, Timothy; Radany, Eric; Palmer, Joycelynne; Stein, Anthony

    2014-01-01

    Purpose We have demonstrated that toxicities are acceptable with total marrow irradiation (TMI) 16 Gy without chemotherapy or TMI 12 Gy and the reduced intensity regimen of fludarabine/melphalan in patients undergoing hematopoietic cell transplantation (HCT). This study reports on TMI combined with higher intensity chemotherapy regimens on two phase I trials in patients with advanced AML/ALL who would do poorly on standard intent-to-cure HCT regimens. Methods Trial 1: TMI on days -10 to -6, VP16 day -5 (60 mg/kg), and cyclophoshamide (CY) day -3 (100 mg/kg). TMI dose (Gy) was 12 (n=3), 13.5 (n=3) and 15 (n=6) at 1.5 Gy BID. Trial 2: Busulfan (BU) days -12 to -8 (800 uM min), TMI days -8 to -4, and VP16 day -3 (30 mg/kg). TMI dose (Gy) was 12 (n=18) and 13.5 (n=2) at 1.5 Gy BID. Results Trial 1: 12 patients; median age 33; 6 induction failure (IF), 6 first relapse (1RL); 9 with marrow blasts (10–98%), 5 with circulating blasts (24–85%) and 2 with chloromas. No dose limiting toxicities were observed. Eleven achieved CR at day 30. With a median follow-up 14.75 months, 5 remain in complete remission from 13.5–37.7 months. Trial 2: 20 patients; median age 41; 13 IF, 5 1RL, 2 in 2nd relapse; 19 with marrow blasts (3–100%) and 13 with peripheral blasts (6–63%). Grade 4 dose limiting toxicities were seen at 13.5 Gy (stomatitis and hepatotoxicity). Stomatitis was the most frequent toxicity in both trials. Conclusions TMI dose escalation to 15 Gy is possible when combined with CY/VP16 and is associated with acceptable toxicities and encouraging outcomes. TMI dose escalation is not possible with BU/VP16 due to dose-limiting toxicities. Future efforts will focus on whether further dose escalation with CY/VP16 is safe with the goal of improving disease control in this high risk population. PMID:22592050

  2. Dose Escalation of Total Marrow Irradiation With Concurrent Chemotherapy in Patients With Advanced Acute Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation

    SciTech Connect

    Wong, Jeffrey Y.C.; Forman, Stephen; Somlo, George; Liu An; Schultheiss, Timothy; Radany, Eric; Palmer, Joycelynne; Stein, Anthony

    2013-01-01

    Purpose: We have demonstrated that toxicities are acceptable with total marrow irradiation (TMI) at 16 Gy without chemotherapy or TMI at 12 Gy and the reduced intensity regimen of fludarabine/melphalan in patients undergoing hematopoietic cell transplantation (HCT). This article reports results of a study of TMI combined with higher intensity chemotherapy regimens in 2 phase I trials in patients with advanced acute myelogenous leukemia or acute lymphoblastic leukemia (AML/ALL) who would do poorly on standard intent-to-cure HCT regimens. Methods and Materials: Trial 1 consisted of TMI on Days -10 to -6, etoposide (VP16) on Day -5 (60 mg/kg), and cyclophosphamide (CY) on Day -3 (100 mg/kg). TMI dose was 12 (n=3 patients), 13.5 (n=3 patients), and 15 (n=6 patients) Gy at 1.5 Gy twice daily. Trial 2 consisted of busulfan (BU) on Days -12 to -8 (800 {mu}M min), TMI on Days -8 to -4, and VP16 on Day -3 (30 mg/kg). TMI dose was 12 (n=18) and 13.5 (n=2) Gy at 1.5 Gy twice daily. Results: Trial 1 had 12 patients with a median age of 33 years. Six patients had induction failures (IF), and 6 had first relapses (1RL), 9 with leukemia blast involvement of bone marrow ranging from 10%-98%, 5 with circulating blasts (24%-85%), and 2 with chloromas. No dose-limiting toxicities were observed. Eleven patients achieved complete remission at Day 30. With a median follow-up of 14.75 months, 5 patients remained in complete remission from 13.5-37.7 months. Trial 2 had 20 patients with a median age of 41 years. Thirteen patients had IF, and 5 had 1RL, 2 in second relapse, 19 with marrow blasts (3%-100%) and 13 with peripheral blasts (6%-63%). Grade 4 dose-limiting toxicities were seen at 13.5 Gy (stomatitis and hepatotoxicity). Stomatitis was the most frequent toxicity in both trials. Conclusions: TMI dose escalation to 15 Gy is possible when combined with CY/VP16 and is associated with acceptable toxicities and encouraging outcomes. TMI dose escalation is not possible with BU/VP16 due to dose-limiting toxicities. Future efforts will focus on whether further dose escalation with CY/VP16 is safe, with the goal of improving disease control in this high-risk population.

  3. Multiprocessor system with multiple concurrent modes of execution

    DOEpatents

    Ahn, Daniel; Ceze, Luis H; Chen, Dong; Gara, Alan; Heidelberger, Philip; Ohmacht, Martin

    2013-12-31

    A multiprocessor system supports multiple concurrent modes of speculative execution. Speculation identification numbers (IDs) are allocated to speculative threads from a pool of available numbers. The pool is divided into domains, with each domain being assigned to a mode of speculation. Modes of speculation include TM, TLS, and rollback. Allocation of the IDs is carried out with respect to a central state table and using hardware pointers. The IDs are used for writing different versions of speculative results in different ways of a set in a cache memory.

  4. HPV Genotypes Predict Survival Benefits From Concurrent Chemotherapy and Radiation Therapy in Advanced Squamous Cell Carcinoma of the Cervix

    SciTech Connect

    Wang, Chun-Chieh; Department of Medical Imaging and Radiological Science, Chang Gung University, School of Medicine, Taoyuan, Taiwan ; Lai, Chyong-Huey; Huang, Yi-Ting; Chao, Angel; Chou, Hung-Hsueh; Hong, Ji-Hong; Department of Medical Imaging and Radiological Science, Chang Gung University, School of Medicine, Taoyuan, Taiwan

    2012-11-15

    Purpose: To study the prognostic value of human papillomavirus (HPV) genotypes in patients with advanced cervical cancer treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Methods and Materials: Between August 1993 and May 2000, 327 patients with advanced squamous cell carcinoma of the cervix (International Federation of Gynecology and Obstetrics stage III/IVA or stage IIB with positive lymph nodes) were eligible for this study. HPV genotypes were determined using the Easychip Registered-Sign HPV genechip. Outcomes were analyzed using Kaplan-Meier survival analysis and the Cox proportional hazards model. Results: We detected 22 HPV genotypes in 323 (98.8%) patients. The leading 4 types were HPV16, 58, 18, and 33. The 5-year overall and disease-specific survival estimates for the entire cohort were 41.9% and 51.4%, respectively. CCRT improved the 5-year disease-specific survival by an absolute 9.8%, but this was not statistically significant (P=.089). There was a significant improvement in disease-specific survival in the CCRT group for HPV18-positive (60.9% vs 30.4%, P=.019) and HPV58-positive (69.3% vs 48.9%, P=.026) patients compared with the RT alone group. In contrast, the differences in survival with CCRT compared with RT alone in the HPV16-positive and HPV-33 positive subgroups were not statistically significant (P=.86 and P=.53, respectively). An improved disease-specific survival was observed for CCRT treated patients infected with both HPV16 and HPV18, but these differenced also were not statistically significant. Conclusions: The HPV genotype may be a useful predictive factor for the effect of CCRT in patients with advanced squamous cell carcinoma of the cervix. Verifying these results in prospective trials could have an impact on tailoring future treatment based on HPV genotype.

  5. Phase II study of induction chemotherapy with gemcitabine and vinorelbine followed by concurrent chemoradiotherapy with oral etoposide and cisplatin in patients with inoperable stage III non-small-cell lung cancer

    SciTech Connect

    Lee, Dae Ho; Han, Ji-Youn; Cho, Kwan Ho; Pyo, Hong Ryull; Kim, Hyae Young; Yoon, Sung Jin B.S.; Lee, Jin Soo . E-mail: jslee@ncc.re.kr

    2005-11-15

    Purpose: For locoregionally advanced inoperable non-small-cell lung cancer (NSCLC), concurrent chemoradiotherapy has become a standard therapy. We conducted a Phase II trial to examine the efficacy and toxicity of adding gemcitabine and vinorelbine induction chemotherapy to concurrent chemoradiotherapy with oral etoposide and cisplatin. Methods and Materials: Eligibility included inoperable clinical Stage III NSCLC without pleural effusion, ECOG performance status 0-1, and weight loss {<=}5%. Induction chemotherapy consisted of three cycles of gemcitabine 1,000 mg/m{sup 2} and vinorelbine 30 mg/m{sup 2}, each given i.v. on Days 1 and 8, every 3 weeks. During once-daily thoracic radiotherapy (1.8 Gy/day, total 63 Gy), two cycles of oral etoposide (100 mg on Days 1-5 and 8-12) plus cisplatin (50 mg/m{sup 2} on Days 1 and 8) were given concurrently 4 weeks apart. Results: Between April 2002 and November 2003, 42 patients were enrolled and 40 were included in response and toxicity evaluation. The median age was 59 years and 13 patients had IIIA and 27 had IIIB; 24 had squamous ca, 12 had adenocarcinoma, and 4 had others. Objective tumor responses were obtained in 29 patients (72.5%), including 18 (45.0%) after induction chemotherapy. After a median follow-up of 23.8 months, the median survival time and progression-free survival was 23.2 months and 10.9 months, respectively, with 2-year survival rate of 43.9%. For the patients with supraclavicular nodal involvement, the median survival time was 11.8 months with 2-year survival rate of 16.7%, whereas the corresponding figures were 27.8 months and 52.0%, respectively, for those without supraclavicular nodal involvement. Toxicity of induction chemotherapy was mild and well tolerated. However, concurrent chemoradiotherapy was associated with G3/4 hematologic toxicity in 75.7%, G3 esophagitis in 24.2%, and two treatment-related deaths. There were nonlife-threatening late toxicities in additional 6 patients. Conclusions: Induction chemotherapy with gemcitabine and vinorelbine followed by concurrent chemoradiotherapy with etoposide and cisplatin showed very promising survival in patients with Stage III NSCLC, especially in those without supraclavicular nodal involvement, which warrants further evaluation.

  6. Hypothyroidism as a Consequence of Intensity-Modulated Radiotherapy With Concurrent Taxane-Based Chemotherapy for Locally Advanced Head-and-Neck Cancer

    SciTech Connect

    Diaz, Roberto; Jaboin, Jerry J.; Morales-Paliza, Manuel; Koehler, Elizabeth; Phillips, John G.; Stinson, Scott; Gilbert, Jill; Chung, Christine H.; Murphy, Barbara A.; Murphy, Patrick B.; Shyr, Yu; Cmelak, Anthony J.

    2010-06-01

    Purpose: To conduct a retrospective review of 168 consecutively treated locally advanced head-and-neck cancer (LAHNC) patients treated with intensity-modulated radiotherapy (IMRT)/chemotherapy, to determine the rate and risk factors for developing hypothyroidism. Methods and Materials: Intensity-modulated radiotherapy was delivered in 33 daily fractions to 69.3 Gy to gross disease and 56.1 Gy to clinically normal cervical nodes. Dose-volume histograms (DVHs) of IMRT plans were used to determine radiation dose to thyroid and were compared with DVHs using conventional three-dimensional radiotherapy (3D-RT) in 10 of these same patients randomly selected for replanning and with DVHs of 16 patients in whom the thyroid was intentionally avoided during IMRT. Weekly paclitaxel (30 mg/m{sup 2}) and carboplatin area under the curve-1 were given concurrently with IMRT. Results: Sixty-one of 128 evaluable patients (47.7%) developed hypothyroidism after a median of 1.08 years after IMRT (range, 2.4 months to 3.9 years). Age and volume of irradiated thyroid were associated with hypothyroidism development after IMRT. Compared with 3D-RT, IMRT with no thyroid dose constraints resulted in significantly higher minimum, maximum, and median dose (p < 0.0001) and percentage thyroid volume receiving 10, 20, and 60 Gy (p < 0.05). Compared with 3D-RT, IMRT with thyroid dose constraints resulted in lower median dose and percentage thyroid volume receiving 30, 40, and 50 Gy (p < 0.005) but higher minimum and maximum dose (p < 0.005). Conclusions: If not protected, IMRT for LAHNC can result in higher radiation to the thyroid than with conventional 3D-RT. Techniques to reduce dose and volume of radiation to thyroid tissue with IMRT are achievable and recommended.

  7. Systemic Chemotherapy Is Modulated by Platelet-Activating Factor-Receptor Agonists

    PubMed Central

    Sahu, Ravi P.; Ferracini, Matheus; Travers, Jeffrey B.

    2015-01-01

    Chemotherapy is used to treat numerous cancers including melanoma. However, its effectiveness in clinical settings is often hampered by various mechanisms. Previous studies have demonstrated that prooxidative stressor-mediated generation of oxidized lipids with platelet-activating factor-receptor (PAF-R) agonistic activity induces systemic immunosuppression that augments the growth of experimental melanoma tumors. We have recently shown that treatment of murine B16F10 melanoma cells in vitro or tumors implanted into syngeneic mice and treated intratumorally with various chemotherapeutic agents generated PAF-R agonists in a process blocked by antioxidants. Notably, these intratumoral chemotherapy-generated PAF-R agonists augmented the growth of secondary (untreated) tumors in a PAF-R dependent manner. As both localized and systemic chemotherapies are used based on tumor localization/stage and metastases, the current studies were sought to determine effects of PAF-R agonists on systemic chemotherapy against experimental melanoma. Here, we show that systemic chemotherapy with etoposide (ETOP) attenuates the growth of melanoma tumors when given subsequent to the tumor cell implantation. Importantly, this ETOP-mediated suppression of melanoma tumor growth was blocked by exogenous administration of a PAF-R agonist, CPAF. These findings indicate that PAF-R agonists not only negatively affect the ability of localized chemotherapy but also compromise the efficacy of systemic chemotherapy against murine melanoma. PMID:25922565

  8. Usefulness of Interim FDG-PET After Induction Chemotherapy in Patients With Locally Advanced Squamous Cell Carcinoma of the Head and Neck Receiving Sequential Induction Chemotherapy Followed by Concurrent Chemoradiotherapy

    SciTech Connect

    Yoon, Dok Hyun; Cho, Yoojin; Kim, Sang Yoon; Nam, Soon Yuhl; Choi, Seung-Ho; Roh, Jong-Lyel; Lee, Sang-wook; Song, Si Yeol; Lee, Jeong Hyun; Kim, Jae Seung; Cho, Kyung-Ja; Kim, Sung-Bae

    2011-09-01

    Purpose: Induction chemotherapy (ICT) has been used to select patients for organ preservation and determine subsequent treatments in patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN). Still, the clinical outcomes of LASCCHN patients who showed response to ICT are heterogeneous. We evaluated the efficacy of interim 18-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) after ICT in this specific subgroup of LASCCHN patients who achieved partial response (PR) after ICT to predict clinical outcomes after concurrent chemoradiotherapy (CCRT). Methods and Materials: Twenty-one patients with LASCCHN who showed PR to ICT by Response Evaluation Criteria In Solid Tumors before definitive CCRT were chosen in this retrospective analysis. FDG-PET was performed before and 2-4 weeks after ICT to assess the extent of disease at baseline and the metabolic response to ICT, respectively. We examined the correlation of the metabolic response by the percentage decrease of maximum standardized uptake value (SUVmax) on the primary tumor or lymph node after ICT or a specific threshold of SUVmax on interim FDG-PET with clinical outcomes including complete response (CR) rate to CCRT, progression-free survival (PFS), and overall survival (OS). Results: A SUVmax of 4.8 on interim FDG-PET could predict clinical CR after CCRT (100% vs. 20%, p = 0.001), PFS (median, not reached vs. 8.5 mo, p < 0.001), and OS (median, not reached vs. 12.0 months, p = 0.001) with a median follow-up of 20.3 months in surviving patients. A 65% decrease in SUVmax after ICT from baseline also could predict clinical CR after CCRT (100% vs. 33.3%, p = 0.003), PFS (median, not reached vs. 8.9 months, p < 0.001) and OS (median, not reached vs. 24.4 months, p = 0.001) of the patients. Conclusion: These data suggest that interim FDG-PET after ICT might be a useful determinant to predict clinical outcomes in patients with LASCCHN receiving sequential ICT followed by CCRT.

  9. Synthesis of Concurrent Systems for an Atomic Read / Atomic Write Model of Computation

    E-print Network

    Emerson, E. Allen

    Synthesis of Concurrent Systems for an Atomic Read / Atomic Write Model of Computation (Extended drawback of these methods in practice, however, is that they produce concurrent programs for models based on atomic read / atomic write primitives such as Peterson's solution to the mutual exclusion

  10. Design and Analysis Tools for Concurrent Blackboard Systems

    NASA Technical Reports Server (NTRS)

    McManus, John W.

    1991-01-01

    A blackboard system consists of a set of knowledge sources, a blackboard data structure, and a control strategy used to activate the knowledge sources. The blackboard model of problem solving is best described by Dr. H. Penny Nii of the Stanford University AI Laboratory: "A Blackboard System can be viewed as a collection of intelligent agents who are gathered around a blackboard, looking at pieces of information written on it, thinking about the current state of the solution, and writing their conclusions on the blackboard as they generate them. " The blackboard is a centralized global data structure, often partitioned in a hierarchical manner, used to represent the problem domain. The blackboard is also used to allow inter-knowledge source communication and acts as a shared memory visible to all of the knowledge sources. A knowledge source is a highly specialized, highly independent process that takes inputs from the blackboard data structure, performs a computation, and places the results of the computation in the blackboard data structure. This design allows for an opportunistic control strategy. The opportunistic problem-solving technique allows a knowledge source to contribute towards the solution of the current problem without knowing which of the other knowledge sources will use the information. The use of opportunistic problem-solving allows the data transfers on the blackboard to determine which processes are active at a given time. Designing and developing blackboard systems is a difficult process. The designer is trying to balance several conflicting goals and achieve a high degree of concurrent knowledge source execution while maintaining both knowledge and semantic consistency on the blackboard. Blackboard systems have not attained their apparent potential because there are no established tools or methods to guide in their construction or analyze their performance.

  11. Use of taxane-containing induction chemotherapy in combination with concurrent chemoradiotherapy in Chinese patients with locally advanced nasopharyngeal carcinoma: a meta-analysis

    PubMed Central

    Tian, Rui; Ye, Hong Xun; Zhang, Bao Guo; Gu, Dong Ying; Zhang, Bing Wen; Teng, Zhi Pan; Jin, Mao Yong; Chen, Jin Fei; Qi, Jian Wei

    2015-01-01

    Purpose Taxane-containing induction chemotherapy (IC) regimens in combination with concurrent chemoradiotherapy (CCRT) have been compared with non-taxane-containing IC combined with CCRT in randomized controlled trials (RCTs) in Chinese patients with advanced nasopharyngeal carcinoma (NPC). This meta-analysis aimed to systematically evaluate their clinical efficacy and safety profiling in this ethnic population. Methods The electronic databases, PubMed, Embase, MEDLINE, and Chinese Biomedical Database, were searched for eligible studies. The outcomes included overall response rate (ORR), 1-year survival rate, and different types of adverse events. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the associations. Results A total of 12 RCTs (representing 835 patients) were identified. The pooled analysis showed that taxane-containing regimens had a significant improvement in ORR for nasopharyngeal lesion (OR =4.57, 95% CI =1.14–18.30, P=0.032, z=2.15) but not in cervical lymph nodes (OR =1.23, 95% CI =0.65–2.36, P=0.532, z=0.64) and in 1-year survival rates (OR =1.19, 95% CI =0.10–14.82, P=0.893, z=0.13) compared with non-taxane-containing regimens. Regarding the adverse events and toxicities, grade 3–4 leukopenia and neutropenia were significantly different between the two groups (P<0.001) in favor of the non-taxane-containing regimens, but grade 3–4 vomiting was significantly different between the two groups (P<0.005) in favor of the taxane-containing regimens. Conclusion When combined with CCRT, taxane-containing IC regimens may be more efficient for short-term local control in Chinese patients with locally advanced NPC than the non-taxane-containing IC regimens. Moreover, the major toxic effects, which were bone marrow suppression, could be tolerated by majority of patients. More long-term follow-up and high-quality trials of NPC are needed to validate our findings. PMID:26604792

  12. Monitoring Dosimetric Impact of Weight Loss With Kilovoltage (KV) Cone Beam CT (CBCT) During Parotid-Sparing IMRT and Concurrent Chemotherapy

    SciTech Connect

    Ho, Kean Fatt; Marchant, Tom; Moore, Chris; Webster, Gareth; Rowbottom, Carl; Penington, Hazel; Lee, Lip; Yap, Beng; Sykes, Andrew; Slevin, Nick

    2012-03-01

    Purpose: Parotid-sparing head-and-neck intensity-modulated radiotherapy (IMRT) can reduce long-term xerostomia. However, patients frequently experience weight loss and tumor shrinkage during treatment. We evaluate the use of kilovoltage (kV) cone beam computed tomography (CBCT) for dose monitoring and examine if the dosimetric impact of such changes on the parotid and critical neural structures warrants replanning during treatment. Methods and materials: Ten patients with locally advanced oropharyngeal cancer were treated with contralateral parotid-sparing IMRT concurrently with platinum-based chemotherapy. Mean doses of 65 Gy and 54 Gy were delivered to clinical target volume (CTV)1 and CTV2, respectively, in 30 daily fractions. CBCT was prospectively acquired weekly. Each CBCT was coregistered with the planned isocenter. The spinal cord, brainstem, parotids, larynx, and oral cavity were outlined on each CBCT. Dose distributions were recalculated on the CBCT after correcting the gray scale to provide accurate Hounsfield calibration, using the original IMRT plan configuration. Results: Planned contralateral parotid mean doses were not significantly different to those delivered during treatment (p > 0.1). Ipsilateral and contralateral parotids showed a mean reduction in volume of 29.7% and 28.4%, respectively. There was no significant difference between planned and delivered maximum dose to the brainstem (p = 0.6) or spinal cord (p = 0.2), mean dose to larynx (p = 0.5) and oral cavity (p = 0.8). End-of-treatment mean weight loss was 7.5 kg (8.8% of baseline weight). Despite a {>=}10% weight loss in 5 patients, there was no significant dosimetric change affecting the contralateral parotid and neural structures. Conclusions: Although patient weight loss and parotid volume shrinkage was observed, overall, there was no significant excess dose to the organs at risk. No replanning was felt necessary for this patient cohort, but a larger patient sample will be investigated to further confirm these results. Nevertheless, kilovoltage CBCT is a valuable tool for patient setup verification and monitoring of dosimetric variation during radiotherapy.

  13. A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma

    SciTech Connect

    Lee, Nancy Y. . E-mail: leen2@mskcc.org; Arruda, Fernando F. de; Puri, Dev R.; Wolden, Suzanne L.; Narayana, Ashwatha; Mechalakos, James; Venkatraman, Ennapadam S.; Kraus, Dennis; Shaha, Ashok; Shah, Jatin P.; Pfister, David G.; Zelefsky, Michael J.

    2006-11-15

    Purpose: The aim of this study was to compare toxicity/efficacy of conventional radiotherapy using delayed accelerated concomitant boost radiotherapy (CBRT) vs. intensity-modulated radiotherapy (IMRT) in the setting of concurrent chemotherapy (CT) for locally advanced oropharyngeal carcinoma. Methods and Materials: Between September 1998 and June 2004, a total of 293 consecutive patients were treated at our institution for cancer of the oropharynx. Of these, 112 had Stage III/IV disease and squamous cell histology. In all, 41 were treated with IMRT/CT and 71 were treated with CBRT/CT, both to a median dose of 70 Gy. Most common CT was a planned two cycles given every 3 to 4 weeks of cisplatin, 100 mg/m{sup 2} i.v., but an additional cycle was given to IMRT patients when possible. Both groups were well-matched for all prognostic factors. Results: Median follow-up was 46 months (range, 3-93 months) for the CBRT patients and 31 months (range, 20-64 months) for the IMRT group. Three-year actuarial local-progression-free, regional-progression-free, locoregional progression-free, distant-metastases-free, disease-free, and overall survival rates were 85% vs. 95% (p = 0.17), 95% vs. 94% (p = 0.90), 82% vs. 92% (p = 0.18), 85% vs. 86% (p = 0.78), 76% vs. 82% (p = 0.57), and 81% vs. 91% (p = 0.10) for CBRT and IMRT patients, respectively. Three patients died of treatment-related toxicity in the CBRT group vs. none undergoing IMRT. At 2 years, 4% IMRT patients vs. 21% CBRT patients were dependent on percutaneous endoscopic gastrostomy (p = 0.02). Among those who had {>=}20 months follow-up, there was a significant difference in Grade {>=}2 xerostomia as defined by the criteria of Radiation Therapy and Oncology Group, 67% vs. 12% (p = 0.02), in the CBRT vs. IMRT arm. Conclusion: In the setting of CT for locally advanced oropharyngeal carcinoma, IMRT results in lower toxicity and similar treatment outcomes when compared with CBRT.

  14. Efficacy of Procarbazine, Lomustine, and Vincristine Chemotherapy for Recurrent Primary Central Nervous System Lymphomas

    PubMed Central

    Kim, Young-Joo; Choe, Jai-ho; Park, Jae-Hyun

    2015-01-01

    Background Optimal treatment for recurrent primary central nervous system lymphomas (PCNSLs) has not been defined yet and there is no general consensus about the salvage chemotherapy after high-dose methotrexate (HD-MTX)-based chemotherapy. The purpose of the present study was to evaluate the efficacy and safety of procarbazine, lomustine, and vincristine (PCV) chemotherapy for recurrent PCNSLs. Methods We reviewed eight immunocompetent patients (five males/three females, mean age: 56 years) who received salvage PCV chemotherapy (procarbazine 60 mg/m2, days 8 through 21: CCNU 110 mg/m2, day 1: vincristine 2 mg, days 8 and 28) for recurrent PCNSL and two patients switched to PCV chemotherapy due to severe adverse effects of HD-MTX chemotherapy. Radiologic responses, survival, and adverse effects were analyzed. Results Of the eight recurrent PCNSLs, three patients (37.5%) showed radiologic complete response, one patient (12.5%) showed partial response, and four patients (50%) showed progressive disease after PCV chemotherapy. Median progression free survival (PFS) from the first administration of PCV to relapse or last follow-up was 7 months (range 5-32 months) and median overall survival was 8 months (range 2-41 months). The two patients who switched to PCV chemotherapy showed PFS of 9 and 5 months from the beginning of PCV to relapse. The common side effects were thrombocytopenia, neutropenia, and peripheral neuropathy. There were 4 grade III or IV myelo-suppression, but no fatal complications, including severe hemorrhage or infection, were observed. Conclusion Salvage PCV chemotherapy has a moderate anti-lymphoma activity for recurrent PCNSLs after the HD-MTX-based chemotherapy with tolerable toxicity. PMID:26605261

  15. [The system design of an intraperitoneal perfusion machine for hyperthermic chemotherapy based on single chip microcomputer].

    PubMed

    Zhang, Zhiyong; Yang, Xuandong; Li, Kaiyang

    2005-06-01

    A new kind of method for intraperitoneal hyperthermic chemotherapy has been proved to be very effective for the therapy of gastrointestinal cancer. In this article is reported an intraperitoneal perfusion machine which is designed for instituting the treatment. The liquor of the chemotherapy drug is infused into the abdomen after being heated by heating system; the liquor flows out of the abdomen is abandoned. The temperature of heating and the velocity of flow are controlled by MCU, thus the temperature of the liquor of the chemotherapy drug in the abdomen can be adjusted to the most favarable temperature. PMID:16013264

  16. Pulmonary Toxicity in Stage III Non-Small Cell Lung Cancer Patients Treated With High-Dose (74 Gy) 3-Dimensional Conformal Thoracic Radiotherapy and Concurrent Chemotherapy Following Induction Chemotherapy: A Secondary Analysis of Cancer and Leukemia Group B (CALGB) Trial 30105

    SciTech Connect

    Salama, Joseph K.; Stinchcombe, Thomas E.; Gu Lin; Wang Xiaofei; Morano, Karen; Bogart, Jeffrey A.; Crawford, Jeffrey C.; Socinski, Mark A.; Blackstock, A. William; Vokes, Everett E.

    2011-11-15

    Purpose: Cancer and Leukemia Group B (CALGB) 30105 tested two different concurrent chemoradiotherapy platforms with high-dose (74 Gy) three-dimensional conformal radiotherapy (3D-CRT) after two cycles of induction chemotherapy for Stage IIIA/IIIB non-small cell lung cancer (NSCLC) patients to determine if either could achieve a primary endpoint of >18-month median survival. Final results of 30105 demonstrated that induction carboplatin and gemcitabine and concurrent gemcitabine 3D-CRT was not feasible because of treatment-related toxicity. However, induction and concurrent carboplatin/paclitaxel with 74 Gy 3D-CRT had a median survival of 24 months, and is the basis for the experimental arm in CALGB 30610/RTOG 0617/N0628. We conducted a secondary analysis of all patients to determine predictors of treatment-related pulmonary toxicity. Methods and Materials: Patient, tumor, and treatment-related variables were analyzed to determine their relation with treatment-related pulmonary toxicity. Results: Older age, higher N stage, larger planning target volume (PTV)1, smaller total lung volume/PTV1 ratio, larger V20, and larger mean lung dose were associated with increasing pulmonary toxicity on univariate analysis. Multivariate analysis confirmed that V20 and nodal stage as well as treatment with concurrent gemcitabine were associated with treatment-related toxicity. A high-risk group comprising patients with N3 disease and V20 >38% was associated with 80% of Grades 3-5 pulmonary toxicity cases. Conclusions: Elevated V20 and N3 disease status are important predictors of treatment related pulmonary toxicity in patients treated with high-dose 3D-CRT and concurrent chemotherapy. Further studies may use these metrics in considering patients for these treatments.

  17. Proposal for direct measurement of concurrence via visibility in a cavity QED system

    E-print Network

    Sang Min Lee; Se-Wan Ji; Hai-Woong Lee; M. Suhail Zubairy

    2008-04-21

    An experimental scheme is proposed that allows direct measurement of the concurrence of a two-qubit cavity system. It is based on the cavity-QED technology using atoms as flying qubits and relies on the identity of the two-particle visibility of the atomic probability with the concurrence of the cavity system. The scheme works for any arbitrary pure initial state of the two-qubit cavity system.

  18. On bisimulation and model-checking for concurrent systems with partial order semantics 

    E-print Network

    Gutierrez, Julian

    2011-06-30

    In concurrency theory—the branch of (theoretical) computer science that studies the logical and mathematical foundations of parallel computation—there are two main formal ways of modelling the behaviour of systems where ...

  19. A Portable Concurrent Object Oriented System Based On C++* Laxmikant V. Kale

    E-print Network

    Browne, James C.

    CHARM++ : A Portable Concurrent Object Oriented System Based On C++* Laxmikant V. Kale Department of Computer Science University of Illinois, Urbana­Champaign email : kale@cs.uiuc.edu Sanjeev Krishnan

  20. SFWR ENG 3BB4 --Software Design 3 --Concurrent System Design 1.2 4 Software Design III

    E-print Network

    Sekerinski, Emil

    Design 1.19 21 Non-Sequential Systems · Client-Server Systems: ­ ATM-Banking systems ­ WWW · Peer Description (Calendar) · Processes, threads, concurrency; · Synchronization mechanisms, resource management

  1. A Phase I/II Radiation Dose Escalation Study With Concurrent Chemotherapy for Patients With Inoperable Stages I to III Non-Small-Cell Lung Cancer: Phase I Results of RTOG 0117

    SciTech Connect

    Bradley, Jeffrey D.; Moughan, Jennifer; Graham, Mary V.; Byhardt, Roger; Govindan, Ramaswamy; Fowler, Jack; Purdy, James A.; Michalski, Jeff M.; Gore, Elizabeth; Choy, Hak

    2010-06-01

    Purpose: In preparation for a Phase III comparison of high-dose versus standard-dose radiation therapy, this Phase I/II study was initiated to establish the maximum tolerated dose of radiation therapy in the setting of concurrent chemotherapy, using three-dimensional conformal radiation therapy for non-small-cell lung cancer. Methods and Materials: Eligibility included patients with histologically proven, unresectable Stages I to III non-small-cell lung cancer. Concurrent chemotherapy consisted of paclitaxel, 50 mg/m{sup 2}, and carboplatin, AUC of 2, given weekly. The radiation dose was to be sequentially intensified by increasing the daily fraction size, starting from 75.25 Gy/35 fractions. Results: The Phase I portion of this study accrued 17 patients from 10 institutions and was closed in January 2004. After the initial 8 patients were accrued to cohort 1, the trial closed temporarily on September 26, 2002, due to reported toxicity. Two acute treatment-related dose-limiting toxicities (DLTs) were reported at the time: a case of grade 5 and grade 3 radiation pneumonitis. The protocol, therefore, was revised to de-escalate the radiation therapy dose (74 Gy/37 fractions). Patients in cohort 1 continued to develop toxicity, with 6/8 (75%) patients eventually developing grade >=3 events. Cohort 2 accrued 9 patients. There was one DLT, a grade 3 esophagitis, in cohort 2 in the first 5 patients (1/5 patients) and no DLTs for the next 2 patients (0/2 patients). Conclusions: The maximum tolerated dose was determined to be 74 Gy/37 fractions (2.0 Gy per fraction) using three-dimensional conformal radiation therapy with concurrent paclitaxel and carboplatin therapy. This dose level in the Phase II portion has been well tolerated, with low rates of acute and late lung toxicities.

  2. The Concert system - Compiler and runtime technology for efficient concurrent object-oriented programming

    NASA Technical Reports Server (NTRS)

    Chien, Andrew A.; Karamcheti, Vijay; Plevyak, John; Sahrawat, Deepak

    1993-01-01

    Concurrent object-oriented languages, particularly fine-grained approaches, reduce the difficulty of large scale concurrent programming by providing modularity through encapsulation while exposing large degrees of concurrency. Despite these programmability advantages, such languages have historically suffered from poor efficiency. This paper describes the Concert project whose goal is to develop portable, efficient implementations of fine-grained concurrent object-oriented languages. Our approach incorporates aggressive program analysis and program transformation with careful information management at every stage from the compiler to the runtime system. The paper discusses the basic elements of the Concert approach along with a description of the potential payoffs. Initial performance results and specific plans for system development are also detailed.

  3. A Design Space For Multimodal Systems: Concurrent Processing and Data Fusion

    E-print Network

    Nigay, Laurence

    A Design Space For Multimodal Systems: Concurrent Processing and Data Fusion Laurence Nigay, Joëlle 40 E-mail: nigay@imag.imag.fr, joelle@imag.imag.fr ABSTRACT Multimodal interaction enables the user system. To do so, a software engineering perspective is adopted. First, the notion of "multimodal system

  4. A Design Space For Multimodal Systems: Concurrent Processing and Data Fusion

    E-print Network

    Nigay, Laurence

    A Design Space For Multimodal Systems: Concurrent Processing and Data Fusion Laurence Nigay, Joëlle 40 E­mail: nigay@imag.imag.fr, joelle@imag.imag.fr ABSTRACT Multimodal interaction enables the user system. To do so, a software engineering perspective is adopted. First, the notion of ``multimodal system

  5. Integrated System-Level Optimization for Concurrent Engineering With Parametric Subsystem Modeling

    NASA Technical Reports Server (NTRS)

    Schuman, Todd; DeWeck, Oliver L.; Sobieski, Jaroslaw

    2005-01-01

    The introduction of concurrent design practices to the aerospace industry has greatly increased the productivity of engineers and teams during design sessions as demonstrated by JPL's Team X. Simultaneously, advances in computing power have given rise to a host of potent numerical optimization methods capable of solving complex multidisciplinary optimization problems containing hundreds of variables, constraints, and governing equations. Unfortunately, such methods are tedious to set up and require significant amounts of time and processor power to execute, thus making them unsuitable for rapid concurrent engineering use. This paper proposes a framework for Integration of System-Level Optimization with Concurrent Engineering (ISLOCE). It uses parametric neural-network approximations of the subsystem models. These approximations are then linked to a system-level optimizer that is capable of reaching a solution quickly due to the reduced complexity of the approximations. The integration structure is described in detail and applied to the multiobjective design of a simplified Space Shuttle external fuel tank model. Further, a comparison is made between the new framework and traditional concurrent engineering (without system optimization) through an experimental trial with two groups of engineers. Each method is evaluated in terms of optimizer accuracy, time to solution, and ease of use. The results suggest that system-level optimization, running as a background process during integrated concurrent engineering sessions, is potentially advantageous as long as it is judiciously implemented.

  6. Clinical-dosimetric analysis of measures of dysphagia including gastrostomy-tube dependence among head and neck cancer patients treated definitively by intensity-modulated radiotherapy with concurrent chemotherapy

    PubMed Central

    2009-01-01

    Purpose To investigate the association between dose to various anatomical structures and dysphagia among patients with head and neck cancer treated by definitive intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy. Methods and materials Thirty-nine patients with squamous cancer of the head and neck were treated by definitive concurrent chemotherapy and IMRT to a median dose of 70 Gy (range, 68 to 72). In each patient, a gastrostomy tube (GT) was prophylacticly placed prior to starting treatment. Prolonged GT dependence was defined as exceeding the median GT duration of 192 days. Dysphagia was scored using standardized quality-of-life instruments. Dose-volume histogram (DVH) data incorporating the superior/middle pharyngeal constrictors (SMPC), inferior pharyngeal constrictor (IPC), cricoid pharyngeal inlet (CPI), and cervical esophagus (CE) were analyzed in relation to prolonged GT dependence, dysphagia, and weight loss. Results At 3 months and 6 months after treatment, 87% and 44% of patients, respectively, were GT dependent. Spearman's ? analysis identified statistical correlations (p < 0.05) between prolonged GT dependence or high grade dysphagia with IPC V65, IPC V60, IPC Dmean, and CPI Dmax. Logistic regression model showed that IPC V65 > 30%, IPC V60 > 60%, IPC Dmean > 60 Gy, and CPI Dmax > 62 Gy predicted for greater than 50% probability of prolonged GT dependence. Conclusion Our analysis suggests that adhering to the following parameters may decrease the risk of prolonged GT dependence and dysphagia: IPC V65 < 15%, IPC V60 < 40%, IPC Dmean < 55 Gy, and CPI Dmax < 60 Gy. PMID:19909531

  7. Systems assessment of intercalated combination of chemotherapy and EGFR TKIs versus chemotherapy or EGFR TKIs alone in advanced NSCLC patients

    PubMed Central

    Yan, Han; Li, Qin; Wang, Wei; Zhen, Hongchao; Cao, Bangwei

    2015-01-01

    Both chemotherapy and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) are widely applied for the treatment of non-small cell lung cancer (NSCLC), but the efficacy of these two treatments in combination is not yet clear. Thus, we sought to evaluate the efficacy of the intercalated combination of these two treatments in NSCLC. The PubMed database, EMBASE, Cochrane Controlled Trials Register, and Chinese Biomedical Database were systematically searched by two researchers for randomized clinical trials (RCTs) that examined the intercalated combination of chemotherapy and EGFR TKIs in NSCLC. Ten studies involving 1,660 patients were included in this systematic review. The statistical results showed that the intercalated combination of chemotherapy and EGFR TKIs significantly improved overall survival (OS) (hazard ratio (HR)?=?0.83, 95% confidence interval (CI): 0.70–0.98), progression-free survival (PFS) (HR?=?0.65, 95% CI: 0.51–0.84), and the objective response rate (ORR) (risk ratio (RR)?=?1.90, 95% CI: 1.22–2.98) compared to chemotherapy alone. Similarly, compared to EGFR TKIs monotherapy, the intercalated combination of chemotherapy and EGFR TKIs seemed superior to EGFR TKIs alone in terms of PFS, ORR and DCR (PFS: HR?=?0.75, 95% CI: 0.62–0.91, ORR: RR?=?1.49, 95% CI: 1.12–2.00 and DCR: RR?=?1.33, 95% CI: 1.15–1.54) in advanced NSCLC therapy. PMID:26481697

  8. Exposure, infection, systemic cytokine levels and antibody responses in young children concurrently exposed to

    E-print Network

    Mutapi, Francisca

    Exposure, infection, systemic cytokine levels and antibody responses in young children concurrently measures infection levels of both parasites and relates them to exposure and immune responses in young-specific and Plasmodium-specific responses. Systemic cytokine levels rose with age as well as with schistosome infection

  9. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    SciTech Connect

    Saitoh, Jun-Ichi; Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro; Sakai, Hiroshi; Kurimoto, Futoshi; Kato, Shingo; Shibuya, Kei

    2012-04-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m{sup 2}, and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade {>=}3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade {>=}3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  10. Chemoradiotherapy with concurrent gemcitabine and cisplatin with or without sequential chemotherapy with gemcitabine/cisplatin vs chemoradiotherapy with concurrent 5-fluorouracil in patients with locally advanced pancreatic cancer – a multi-centre randomised phase II study

    PubMed Central

    Wilkowski, R; Boeck, S; Ostermaier, S; Sauer, R; Herbst, M; Fietkau, R; Flentje, M; Miethe, S; Boettcher, H D; Scholten, T; Bruns, C J; Rau, H G; Hinke, A; Heinemann, V

    2009-01-01

    Background: No standard treatment for locally advanced pancreatic cancer (LAPC) is defined. Patients and methods Within a multi-centre, randomised phase II trial, 95 patients with LAPC were assigned to three different chemoradiotherapy (CRT) regimens: patients received conventionally fractionated radiotherapy of 50?Gy and were randomised to concurrent 5-fluorouracil (350?mg?m?2 per day on each day of radiotherapy, RT-5-FU arm), concurrent gemcitabine (300?mg?m?2), and cisplatin (30?mg?m?2) on days 1, 8, 22, and 29 (RT-GC arm), or the same concurrent treatment followed by sequential full-dose gemcitabine (1000?mg?m?2) and cisplatin (50?mg?m?2) every 2 weeks (RT-GC+GC arm). Primary end point was the overall survival (OS) rate after 9 months. Results: The 9-month OS rate was 58% in the RT-5-FU arm, 52% in the RT-GC arm, and 45% in the RT-GC+GC arm. Corresponding median survival times were 9.6, 9.3, and 7.3 months (P=0.61) respectively. The intent-to-treat response rate was 19, 22, and 13% respectively. Median progression-free survival was estimated with 4.0, 5.6, and 6.0 months (P=0.21). Grade 3/4 haematological toxicities were more frequent in the two GC-containing arms, no grade 3/4 febrile neutropaenia was observed. Conclusion: None of the three CRT regimens tested met the investigators' definition for efficacy; the median OS was similar to those previously reported with gemcitabine alone in LAPC. PMID:19904268

  11. Proposal for direct measurement of concurrence via visibility in a cavity QED system 

    E-print Network

    Lee, Sang Min; Ji, Se-Wan; Lee, Hai-Woong; Zubairy, M. Suhail

    2008-01-01

    An experimental scheme is proposed that allows direct measurement of the concurrence of a two-qubit cavity system. It is based on the cavity-QED technology using atoms as flying qubits and relies on the identity of the two-particle visibility...

  12. Concurrent and Discriminant Validity of the Gordon Diagnostic System: A Preliminary Study.

    ERIC Educational Resources Information Center

    Wherry, Jeffrey N.; And Others

    1993-01-01

    Investigated discriminant and concurrent validity of Gordon Diagnostic System (GDS) in 29 boys categorized into "normals" or "attention deficit hyperactivity disordered" (ADHD) based on teacher ratings. Results failed to demonstrate discriminant validity of any GDS score regardless of behavior rating used. Vigilance Correct and Vigilance Omission…

  13. Target hepatic artery regional chemotherapy and bevacizumab perfusion in liver metastatic colorectal cancer after failure of first-line or second-line systemic chemotherapy.

    PubMed

    Chen, Hui; Zhang, Ji; Cao, Guang; Liu, Peng; Xu, Haifeng; Wang, Xiaodong; Zhu, Xu; Gao, Song; Guo, Jianhai; Zhu, Linzhong; Zhang, Pengjun

    2016-02-01

    Colorectal cancer liver metastasis (CRLM) is a refractory disease after failure of first-line or second-line chemotherapy. Bevacizumab is recommended as first-line therapy for advanced colorectal cancer, but is unproven in CRLM through the hepatic artery. We report favorable outcomes with targeted vessel regional chemotherapy (TVRC) for liver metastatic gastric cancer. TVRC with FOLFOX and bevacizumab perfusion through the hepatic artery was attempted for CRLM for efficacy and safety evaluation. In a single-institution retrospective observational study, 246 patients with CRLM after at least first-line or second-line failure of systemic chemotherapy received TVRC with FOLFOX (i.e. oxaliplatin, leucovorin, and 5-fluorouracil). Of 246 patients, 63 were enrolled into two groups: group 1 (n=30) received bevacizumab and TVRC following tumor progression during previous TVRC treatments; group 2 (n=33) received TVRC plus bevacizumab for CRLM on initiating TVRC. There were no significant differences in the median survival time (14.7 vs. 13.2 months, P=0.367), although the median time to progression was significant (3.3 vs. 5.5 months, P=0.026) between groups. No severe adverse events related to TVRC plus bevacizumab perfusion occurred. Target vessel regional chemotherapy with FOLFOX plus bevacizumab perfusion through the hepatic artery was effective and safe in CRLM. The optimal combination of TVRC and bevacizumab needs further confirmation in future phase II-III clinical trials. PMID:26566233

  14. A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

    SciTech Connect

    Cho, Hanbyoul; Nam, Byung-Ho; Kim, Seok Mo; Cho, Chi-Heum; Kim, Byoung Gie; Ryu, Hee-Sug; Kang, Soon Beom; Kim, Jae-Hoon

    2014-09-01

    Purpose: A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer. Methods and Materials: Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m{sup 2} was administered once weekly for 5 weeks during radiation therapy. Results: Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively. Conclusions: Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study.

  15. Dynamic data structures and concurrency in a real-time data acquisition system

    SciTech Connect

    Cort, G.; Goldstone, J.A.; Nelson, R.O.; Poore, R.V.; Miller, L.; Barrus, D.M.

    1985-01-01

    We report on our efforts in developing an innovative real-time data acquisition system that makes extensive use of dynamic data structures, concurrency and state machine features. The Data Acquisition Command Language developed at the Los Alamos Weapons Neutron Research (WNR) Facility is a Pascal-based system that incorporates these features to maximize system performance, reliability and adapability while supporting a consistent, familiar and comfortable user interface. The details and benefits of the implementation philosophy and underlying structures are discussed.

  16. Cytoreductive Surgery of Colorectal Peritoneal Metastases: Outcomes after Complete Cytoreductive Surgery and Systemic Chemotherapy Only

    PubMed Central

    Désolneux, Grégoire; Mazière, Camille; Vara, Jérémy; Brouste, Véronique; Fonck, Marianne; Béchade, Dominique; Bécouarn, Yves; Evrard, Serge

    2015-01-01

    Background Cytoreductive peritoneal surgery (CRS) associated with hyperthermic peritoneal chemotherapy (HIPEC) has long been considered the standard treatment for colorectal peritoneal metastases (CPM). However, although efficacy of surgery has been demonstrated, evidence supporting HIPEC’s role is less certain. Method Overall survival (OS), progression-free survival (PFS) and morbidity were analysed retrospectively for fifty consecutively included patients treated for colorectal CPM with complete CRS and systemic chemotherapy only. Results Median peritoneal cancer index (PCI) was 8 (range 1-24). 23 patients had liver or lung metastases (LLM). 22 patients had synchronous CPM. 27 complications occurred (12 Grade 1/2, 14 Grade 3, 1 Grade 4a, 0 Grade 5). Median follow-up was 62.5 months (95 %CI 45.4-81.3), median survival 32.4 months (21.5-41.7). Three- and 5-year OS were 45.5% (0.31-0.59) and 29.64% (0.17-0.44) respectively. Presence of LLMs associated with peritoneal carcinomatosis was significantly associated with poorer prognosis, with survival at 5 years of 13.95% (95 %CI 2.9-33.6) vs. 43.87% (22.2-63.7) when no metastases were present (P= 0.018). Median PFS was 9.5 months (95 %CI 6.2-11.1). Conclusion With an equivalent PCI range and despite one of the highest rates of LLM in the literature, our survival data of CRS + systemic chemotherapy only compare well with results reported after additional HIPEC. Tolerance was better with acceptable morbidity without any mortality. Extra-hepatic metastasis (LLM) is a strong factor of poor prognosis. Awaiting the results of the randomized PRODIGE trial, these results indicate that CRS + systemic chemotherapy only is a robust hypothesis to treat colorectal CPM. PMID:25825874

  17. Preoperative radiation with concurrent chemotherapy for resectable rectal cancer: Effect of dose escalation on pathologic complete response, local recurrence-free survival, disease-free survival, and overall survival

    SciTech Connect

    Wiltshire, Kirsty L. . E-mail: kirsty.wiltshire@lycos.com; Ward, Iain G.; Swallow, Carol; Oza, Amit M.; Cummings, Bernard; Pond, Gregory R.; Catton, Pamela; Kim, John; Ringash, Jolie; Wong, Chong S.; Wong, Rebecca; Siu, Lillian L.; Moore, Malcolm; Brierley, James

    2006-03-01

    Purpose: Three Phase II studies of preoperative radiotherapy and concurrent 5FU chemotherapy were undertaken. The primary endpoints were acute toxicity and pathologic complete response rate (pCR). Secondary endpoints were local recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS). Methods and Materials: A total of 134 patients with adenocarcinoma of the rectum (clinical T3/T4 or N1/N2) were treated. The initial cohort received 40 Gy in 20 fractions, the second 46 Gy in 23 fractions, and the third 50 Gy in 25 fractions. 5FU (225 mg/m{sup 2}/day) was given continuously throughout radiotherapy. A total of 121 patients underwent surgical resection. Results: Treatment was well tolerated. Grade 3/4 acute toxicity was observed in 13%, 4%, and 14% of patients in the 40 Gy, 46 Gy, and 50 Gy cohorts, respectively (p = 0.20). pCR was documented in 15%, 23%, and 33% of patients, respectively (p = 0.07). The 2-year actuarial LRFS was 72%, 90%, and 89% (p = 0.02); DFS was 62%, 84%, and 78% (p = 0.02); and OS was 72%, 94%, and 92%, respectively (p = 0.03). Conclusions: All treatment schedules were well tolerated. There was a trend toward increased pCR with higher doses. A statistically significant increase in LRFS, DFS, and OS was seen with radiation doses of 46 Gy and greater, but there was no difference between 46 Gy and 50 Gy.

  18. Design and Analysis Techniques for Concurrent Blackboard Systems. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Mcmanus, John William

    1992-01-01

    Blackboard systems are a natural progression of knowledge-based systems into a more powerful problem solving technique. They provide a way for several highly specialized knowledge sources to cooperate to solve large, complex problems. Blackboard systems incorporate the concepts developed by rule-based and expert systems programmers and include the ability to add conventionally coded knowledge sources. The small and specialized knowledge sources are easier to develop and test, and can be hosted on hardware specifically suited to the task that they are solving. The Formal Model for Blackboard Systems was developed to provide a consistent method for describing a blackboard system. A set of blackboard system design tools has been developed and validated for implementing systems that are expressed using the Formal Model. The tools are used to test and refine a proposed blackboard system design before the design is implemented. My research has shown that the level of independence and specialization of the knowledge sources directly affects the performance of blackboard systems. Using the design, simulation, and analysis tools, I developed a concurrent object-oriented blackboard system that is faster, more efficient, and more powerful than existing systems. The use of the design and analysis tools provided the highly specialized and independent knowledge sources required for my concurrent blackboard system to achieve its design goals.

  19. Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239

    SciTech Connect

    Komaki, Ritsuko; Paulus, Rebecca; Ettinger, David S.; Videtic, Gregory M.M.; Bradley, Jeffrey D.; Glisson, Bonnie S.; Sause, William T.; Curran, Walter J.; Choy, Hak

    2012-07-15

    Purpose: To investigate whether high-dose thoracic radiation given twice daily during cisplatin-etoposide chemotherapy for limited small-cell lung cancer (LSCLC) improves survival, acute esophagitis, and local control rates relative to findings from Intergroup trial 0096 (47%, 27%, and 64%). Patients and Methods: Patients were accrued over a 3-year period from 22 US and Canadian institutions. Patients with LSCLC and good performance status were given thoracic radiation to 61.2 Gy over 5 weeks (daily 1.8-Gy fractions on days 1-22, then twice-daily 1.8-Gy fractions on days 23-33). Cisplatin (60 mg/m{sup 2} IV) was given on day 1 and etoposide (120 mg/m{sup 2} IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin plus etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (Common Toxicity Criteria v 2.0) and treatment-related fatalities; response (Response Evaluation Criteria in Solid Tumors); and local control. Results: Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63 years; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, the overall survival rate was 36.6% (95% confidence interval [CI] 25.6%-47.7%), and progression-free survival 19.7% (95% CI 11.4%-29.6%). Thirteen patients (18%) experienced severe acute esophagitis, and 2 (3%) died of treatment-related causes; 41% achieved complete response, 39% partial response, 10% stable disease, and 6% progressive disease. The local control rate was 73%. Forty-three patients (61%) received prophylactic cranial irradiation. Conclusions: The overall survival rate did not reach the projected goal; however, rates of esophagitis were lower, and local control higher, than projected. This treatment strategy is now one of three arms of a prospective trial of chemoradiation for LSCLC (Radiation Therapy Oncology Group 0538/Cancer and Leukemia Group B 30610).

  20. Prognostic Value of Pretreatment Carcinoembryonic Antigen After Definitive Radiotherapy With or Without Concurrent Chemotherapy for Squamous Cell Carcinoma of the Uterine Cervix

    SciTech Connect

    Huang, Eng-Yen; Hsu, Hsuan-Chih; Sun, Li-Min; Chanchien, Chan-Chao; Lin, Hao; Chen, Hui-Chun; Tseng, Chih-Wen; Ou, Yu-Che; Chang, Hung-Yao; Fang, Fu-Min; Huang, Yu-Jie; Wang, Chang-Yu; Lu, Hsien-Ming; Tsai, Ching-Chou; and others

    2011-11-15

    Purpose: To evaluate whether pretreatment carcinoembryonic antigen (CEA) levels have a prognostic role in patients after definitive radiotherapy for squamous cell carcinoma (SCC) of the uterine cervix. Methods and Materials: A retrospective study of 550 patients was performed. The SCC antigen (SCC-Ag) and CEA levels were regarded as elevated when they were {>=}2 and {>=}5 ng/mL, respectively. A total of 208 patients underwent concurrent chemoradiotherapy (CCRT). The Kaplan-Meier method was used to calculate the distant metastasis (DM), local failure (LF), disease-free survival (DFS), and overall survival (OS) rates. Multivariate analysis was performed using the Cox proportional hazards model. The hazard ratio (HR) with 95% confidence interval (CI) was evaluated for the risk of a poor prognosis. Results: Compared with the patients with normal CEA/SCC-Ag levels, CEA levels {>=}10 ng/mL but without elevated SCC-Ag levels was an independent factor for LF (HR, 51.81; 95% CI, 11.51-233.23; p < .001), DM (HR, 6.04; 95% CI, 1.58-23.01; p = .008), DFS (HR, 10.17; 95% CI, 3.18-32.56; p < .001), and OS (HR, 5.75; 95% CI, 1.82-18.18; p = .003) after RT alone. However, no significant role for CEA was noted in patients with SCC-Ag levels {>=}2 ng/mL. In patients undergoing CCRT, a CEA level {>=}10 ng/mL was an independent factor for LF (HR, 2.50; 95% CI, 1.01-6.21; p = .047), DM (HR, 3.41; 95% CI, 1.56-7.46; p = .002), DFS (HR, 2.73; 95% CI, 1.39-5.36; p = .003), and OS (HR, 3.93; 95% CI 1.99-7.75; p < .001). A SCC-Ag level of {>=}40 ng/mL was another prognostic factor for DM, DFS, and OS in patients undergoing not only CCRT, but also RT alone. The 5-year OS rate for CCRT patients with CEA <10 ng/mL and {>=}10 ng/mL was 75.3% and 35.8%, respectively (p < .001). CCRT was an independent factor for better OS (HR, 0.69; 95% CI, 0.50-0.97; p = .034). Conclusion: Pretreatment CEA levels in patients with SCC of the uterine cervix provide complementary information for predicting LF, DM, DFS, and OS, except for in patients with abnormal SCC-Ag levels before RT alone. More aggressive therapy might be advisable for patients with CEA levels of {>=}10 ng/mL.

  1. Cancer Chemotherapy

    MedlinePLUS

    ... cells grow and die in a controlled way. Cancer cells keep forming without control. Chemotherapy is drug ... Your course of therapy will depend on the cancer type, the chemotherapy drugs used, the treatment goal ...

  2. Phase I Study of Concurrent High-Dose Three-Dimensional Conformal Radiotherapy With Chemotherapy Using Cisplatin and Vinorelbine for Unresectable Stage III Non-Small-Cell Lung Cancer

    SciTech Connect

    Sekine, Ikuo; Sumi, Minako; Ito, Yoshinori; Horinouchi, Hidehito; Nokihara, Hiroshi; Yamamoto, Noboru; Kunitoh, Hideo; Ohe, Yuichiro; Kubota, Kaoru; Tamura, Tomohide

    2012-02-01

    Purpose: To determine the maximum tolerated dose in concurrent three-dimensional conformal radiotherapy (3D-CRT) with chemotherapy for unresectable Stage III non-small-cell lung cancer (NSCLC). Patients and Methods: Eligible patients with unresectable Stage III NSCLC, age {>=}20 years, performance status 0-1, percent of volume of normal lung receiving 20 GY or more (V{sub 20}) {<=}30% received three to four cycles of cisplatin (80 mg/m{sup 2} Day 1) and vinorelbine (20 mg/m{sup 2} Days 1 and 8) repeated every 4 weeks. The doses of 3D-CRT were 66 Gy, 72 Gy, and 78 Gy at dose levels 1 to 3, respectively. Results: Of the 17, 16, and 24 patients assessed for eligibility, 13 (76%), 12 (75%), and 6 (25%) were enrolled at dose levels 1 to 3, respectively. The main reasons for exclusion were V{sub 20} >30% (n = 10) and overdose to the esophagus (n = 8) and brachial plexus (n = 2). There were 26 men and 5 women, with a median age of 60 years (range, 41-75). The full planned dose of radiotherapy could be administered to all the patients. Grade 3-4 neutropenia and febrile neutropenia were noted in 24 (77%) and 5 (16%) of the 31 patients, respectively. Grade 4 infection, Grade 3 esophagitis, and Grade 3 pulmonary toxicity were noted in 1 patient, 2 patients, and 1 patient, respectively. The dose-limiting toxicity was noted in 17% of the patients at each dose level. The median survival and 3-year and 4-year survival rates were 41.9 months, 72.3%, and 49.2%, respectively. Conclusions: 72 Gy was the maximum dose that could be achieved in most patients, given the predetermined normal tissue constraints.

  3. Concurrent Mission and Systems Design at NASA Glenn Research Center: The Origins of the COMPASS Team

    NASA Technical Reports Server (NTRS)

    McGuire, Melissa L.; Oleson, Steven R.; Sarver-Verhey, Timothy R.

    2012-01-01

    Established at the NASA Glenn Research Center (GRC) in 2006 to meet the need for rapid mission analysis and multi-disciplinary systems design for in-space and human missions, the Collaborative Modeling for Parametric Assessment of Space Systems (COMPASS) team is a multidisciplinary, concurrent engineering group whose primary purpose is to perform integrated systems analysis, but it is also capable of designing any system that involves one or more of the disciplines present in the team. The authors were involved in the development of the COMPASS team and its design process, and are continuously making refinements and enhancements. The team was unofficially started in the early 2000s as part of the distributed team known as Team JIMO (Jupiter Icy Moons Orbiter) in support of the multi-center collaborative JIMO spacecraft design during Project Prometheus. This paper documents the origins of a concurrent mission and systems design team at GRC and how it evolved into the COMPASS team, including defining the process, gathering the team and tools, building the facility, and performing studies.

  4. Modeling of concurrent task execution in a distributed system for real-time control

    SciTech Connect

    Peng, D.; Shin, K.G.

    1987-04-01

    In a distributed system that implements real-time control, computational tasks are distributed over different nodes for execution to improve response time and system reliability. To model system behavior, tasks in each node are first decomposed into activities. The activities and precedence constraints among them are then modeled by a generalized stochastic Petri net (GSPN). Finally, a sequence of homogeneous continuous-time Markov chains (CTMC's) is built from the GSPN to model the concurrent task execution in the system. The CTMC model is useful for the study of various design and analysis issues in distributed real-time systems. To demonstrate its utility and power, the CTMC model is applied to an important analysis problem: computation of the probability of missing a hard deadline given an activity selection policy and the local state of each node.

  5. A comparative study of concurrence and negativity of general three-level quantum systems of two particles

    SciTech Connect

    Erol, V.

    2015-03-30

    Quantum entanglement is at the heart of quantum information processing. Ordering the quantum systems due to their entanglement is a popular problem of the field. For two level (qubit) systems of two particles, state ordering has been studied with respect to well-known entanglement measures such as Concurrence, Negativity and Relative Entropy of Entanglement (REE) [1-5]. In this work, we study the state ordering of the three-level quantum systems of two particles with respect to Concurrence and Negativity. In particular, constructing 10K random states and calculating their Concurrences and Negativities, we obtain the orderings of the states and present our results which are interesting when compared to that of two-level systems.

  6. Automated dual capillary electrophoresis system with hydrodynamic injection for the concurrent determination of cations and anions.

    PubMed

    Pham, Thi Thanh Thuy; Mai, Thanh Duc; Nguyen, Thanh Dam; Sáiz, Jorge; Pham, Hung Viet; Hauser, Peter C

    2014-09-01

    The capillary electrophoresis instrument developed for the concurrent determination of cations and anions features two separate capillaries and individual detectors to allow independent optimization for each group of ions. The capillaries are joined in a common injector block. The sample is drawn into the injector with a small membrane pump and automated simultaneous injection into both capillaries is achieved by pressurization of the fluid with compressed air. Flushing of the injector and of the capillaries with the background electrolyte is also carried out automatically by the same means. The buffer consisted of 12mM histidine and 2mM 18-crown-6 adjusted to pH 4 with acetic acid and was suitable for the contactless conductivity detection employed. The system was optimized for the determination of cationic NH4(+) and anionic NO3(-) and NO2(-), and linear calibration curves from about 20?M up to about 1.5mM were obtained for these ions. In a test run over 8h, the reproducibility for the peak areas was within ±7%. For demonstration, the instrument was successfully applied to the concurrent monitoring of the concentrations of the three ions during the biological removal of ammonium from contaminated groundwater in a sequencing batch reactor, where NO3(-) and NO2(-) are formed as intermediate products. PMID:25109864

  7. Post-game analysis: An initial experiment for heuristic-based resource management in concurrent systems

    NASA Technical Reports Server (NTRS)

    Yan, Jerry C.

    1987-01-01

    In concurrent systems, a major responsibility of the resource management system is to decide how the application program is to be mapped onto the multi-processor. Instead of using abstract program and machine models, a generate-and-test framework known as 'post-game analysis' that is based on data gathered during program execution is proposed. Each iteration consists of (1) (a simulation of) an execution of the program; (2) analysis of the data gathered; and (3) the proposal of a new mapping that would have a smaller execution time. These heuristics are applied to predict execution time changes in response to small perturbations applied to the current mapping. An initial experiment was carried out using simple strategies on 'pipeline-like' applications. The results obtained from four simple strategies demonstrated that for this kind of application, even simple strategies can produce acceptable speed-up with a small number of iterations.

  8. Concurrent programming

    SciTech Connect

    Axford, T.

    1989-01-01

    This book presents an overview of concurrent programming, including some of the basic concurrency problems. Low level mutual exclusion algorithms are discussed. Other topics covered include: Synchronization in the Unix kernel; Semaphore; Buffering techniques; Mascot real-time design; and Parallel processing of sets of data.

  9. Proceeding of International Conference on Application of Concurrency to System Design, p. 34-40, Fukushima, Japan, March 1998 Hierarchical Concurrent Finite State Machines in Ptolemy

    E-print Network

    California at Berkeley, University of

    -40, Fukushima, Japan, March 1998 Hierarchical Concurrent Finite State Machines in Ptolemy Bilung Lee and Edward the Ptolemy software environment. The FSM domain is successfully integrated with synchronous data- flow (SDF) and discrete-event (DE) concurrency domains in Ptolemy. In this heterogeneous combination, the seman- tics

  10. Algorithms incorporating concurrency and caching

    E-print Network

    Fineman, Jeremy T

    2009-01-01

    This thesis describes provably good algorithms for modern large-scale computer systems, including today's multicores. Designing efficient algorithms for these systems involves overcoming many challenges, including concurrency ...

  11. Concurrency: Mutual Exclusion and

    E-print Network

    Mikulas, Szabolcs

    Chapter 5 Concurrency: Mutual Exclusion and Synchronization Operating Systems: Internals and Design · Data incoherency · Deadlock: processes are "frozen" because of mutual dependency on each other Regions Mutual exclusion using critical regions #12;Mutual exclusion Critical region: part of the program

  12. Millimeter-Wave Concurrent Dual-Band BiCMOS RFIC Transmitter for Radar and Communication Systems 

    E-print Network

    Huynh, Cuong Phu Minh 1976-

    2012-11-21

    capabilities of producing very narrow and tunable RF pulses with extremely RF leakage and working concurrently in dual bands at 24.5 and 35 GHz was designed. Capability of generating narrow and tunable RF pulses allows the radar system to flexibly work at high...

  13. Bi-Level Integrated System Synthesis (BLISS) for Concurrent and Distributed Processing

    NASA Technical Reports Server (NTRS)

    Sobieszczanski-Sobieski, Jaroslaw; Altus, Troy D.; Phillips, Matthew; Sandusky, Robert

    2002-01-01

    The paper introduces a new version of the Bi-Level Integrated System Synthesis (BLISS) methods intended for optimization of engineering systems conducted by distributed specialty groups working concurrently and using a multiprocessor computing environment. The method decomposes the overall optimization task into subtasks associated with disciplines or subsystems where the local design variables are numerous and a single, system-level optimization whose design variables are relatively few. The subtasks are fully autonomous as to their inner operations and decision making. Their purpose is to eliminate the local design variables and generate a wide spectrum of feasible designs whose behavior is represented by Response Surfaces to be accessed by a system-level optimization. It is shown that, if the problem is convex, the solution of the decomposed problem is the same as that obtained without decomposition. A simplified example of an aircraft design shows the method working as intended. The paper includes a discussion of the method merits and demerits and recommendations for further research.

  14. A novel nanoscale delivery system for spatio-temporal delivery of combination chemotherapy

    E-print Network

    Eavarone, David A. (David Alan)

    2009-01-01

    In the continuing search for effective treatments for cancer, the emerging model is the combination of traditional chemotherapy with anti-angiogenesis agents that inhibit blood vessel growth. However, the implementation ...

  15. Engineering Melanin Nanoparticles as an Efficient Drug-Delivery System for Imaging-Guided Chemotherapy.

    PubMed

    Zhang, Ruiping; Fan, Quli; Yang, Min; Cheng, Kai; Lu, Xiaomei; Zhang, Lei; Huang, Wei; Cheng, Zhen

    2015-09-01

    In order to promote imaging-guided chemotherapy for preclinical and clinical applications, endogenous nanosystems with both contrast and drug-delivery properties are highly desired. Here, the simple use of melanin is first reported, and this biopolymer with good biocompatibility and biodegradability, binding ability to drugs and ions, and intrinsic photoacoustic properties, can serve as an efficient endogenous nanosystem for imaging-guided tumor chemotherapy in living mice. PMID:26222210

  16. Interactive realization system of visual reality using hierarchical model-driven concurrent processing

    NASA Astrophysics Data System (ADS)

    Enomoto, Hajime; Murao, Yo

    1998-04-01

    To realize and integrate various kinds of media information with the least data, a new hierarchical software architecture has been developed. Aiming at easier manipulation, this system is based on a model driven method. Four kinds of generic models; data, object, role, and process models are employed in this system. These models have hierarchical interfaces from data to process layers. In case of the data model, attribute values of data are defined in template forms. If necessary, several constraints are attached to them. In the object model case, every object is defined by `formal' and `feature' structures. Formal structures are defined by our object network which is composed of noun and verb objects. Feature structures are mainly composed of a set of properties, which are described by constraints. For the role model, schemes of various levels of coordination relating multiple roles are represented to satisfy their intentions. These structures are defined by generic goals and constraints. The process model is designed so that all roles are executed concurrently in order to satisfy their interactive intentions under cooperative or competitive conditions. Integrated results of various media can be provided by using or Extensible WELL (Window-based Elaboration Language) system.

  17. Phase I Trial Using Patupilone (Epothilone B) and Concurrent Radiotherapy for Central Nervous System Malignancies

    SciTech Connect

    Fogh, Shannon; Machtay, Mitchell; Werner-Wasik, Maria; Curran, Walter J.; Bonanni, Roseann; Axelrod, Rita; Andrews, David; Dicker, Adam P.

    2010-07-15

    Purpose: Based on preclinical data indicating the radiosensitizing potential of epothilone B, the present study was designed to evaluate the toxicity and response rate of patupilone, an epothilone B, with concurrent radiotherapy (RT) for the treatment of central nervous system malignancies. Methods and Materials: The present Phase I study evaluated the toxicities associated with patupilone combined with RT to establish the maximal tolerated dose. Eligible patients had recurrent gliomas (n = 10) primary (n = 5) or metastatic (n = 17) brain tumors. Dose escalation occurred if no dose-limiting toxicities, defined as any Grade 4-5 toxicity or Grade 3 toxicity requiring hospitalization, occurred during treatment. Results: Of 14 patients, 5 were treated with weekly patupilone at 1.5 mg/m{sup 2}, 4 at 2.0 mg/m{sup 2}, 4 at 2.5 mg/m{sup 2}, and 1 at 4 mg/m{sup 2}. Of 18 patients, 7 were treated in the 6-mg/m{sup 2} group, 6 in the 8-mg/m{sup 2} group, and 5 in the 10-mg/m{sup 2} group. Primary central nervous system malignancies received RT to a median dose of 60 Gy. Central nervous system metastases received whole brain RT to a median dose of 37.4 Gy, and patients with recurrent gliomas underwent stereotactic RT to a median dose of 37.5 Gy. One dose-limiting toxicity (pneumonia) was observed in group receiving 8-mg/m{sup 2} every 3 weeks. At the subsequent dose level (10 mg/m{sup 2}), two Grade 4 dose-limiting toxicities occurred (renal failure and pulmonary hemorrhage); thus, 8 mg/m{sup 2} every 3 weeks was the maximal tolerated dose and the recommended Phase II dose. Conclusion: Combined with a variety of radiation doses and fractionation schedules, concurrent patupilone was well tolerated and safe, with a maximal tolerated dose of 8 mg/m{sup 2} every 3 weeks.

  18. Radiation Therapy Oncology Group Protocol 02-29: A Phase II Trial of Neoadjuvant Therapy With Concurrent Chemotherapy and Full-Dose Radiation Therapy Followed by Surgical Resection and Consolidative Therapy for Locally Advanced Non-small Cell Carcinoma of the Lung

    SciTech Connect

    Suntharalingam, Mohan; Paulus, Rebecca; Edelman, Martin J.; Krasna, Mark; Burrows, Whitney; Gore, Elizabeth; Wilson, Lynn D.; Choy, Hak

    2012-10-01

    Purpose: To evaluate mediastinal nodal clearance (MNC) rates after induction chemotherapy and concurrent, full-dose radiation therapy (RT) in a phase II trimodality trial (Radiation Therapy Oncology Group protocol 0229). Patients and Methods: Patients (n=57) with stage III non-small cell lung cancer (pathologically proven N2 or N3) were eligible. Induction chemotherapy consisted of weekly carboplatin (AUC = 2.0) and paclitaxel 50 mg/m{sup 2}. Concurrent RT was prescribed, with 50.4 Gy to the mediastinum and primary tumor and a boost of 10.8 Gy to all gross disease. The mediastinum was pathologically reassessed after completion of chemoradiation. The primary endpoint of the study was MNC, with secondary endpoints of 2-year overall survival and postoperative morbidity/mortality. Results: The grade 3/4 toxicities included hematologic 35%, gastrointestinal 14%, and pulmonary 23%. Forty-three patients (75%) were evaluable for the primary endpoint. Twenty-seven patients achieved the primary endpoint of MNC (63%). Thirty-seven patients underwent resection. There was a 14% incidence of grade 3 postoperative pulmonary complications and 1 30-day, postoperative grade 5 toxicity (3%). With a median follow-up of 24 months for all patients, the 2-year overall survival rate was 54%, and the 2-year progression-free survival rate was 33%. The 2-year overall survival rate was 75% for those who achieved nodal clearance, 52% for those with residual nodal disease, and 23% for those who were not evaluable for the primary endpoint (P=.0002). Conclusions: This multi-institutional trial confirms the ability of neoadjuvant concurrent chemoradiation with full-dose RT to sterilize known mediastinal nodal disease.

  19. [Evidence based chemotherapy for lung cancer].

    PubMed

    Watanabe, H; Saijo, N

    2000-01-01

    There is often little foundation for decisions in experience-based or impression-based medicine. Therapy, however, should be based on the highest level of available evidence. In many clinical cancer practices, "uncertainty" exists. When no evidence is available, it is important that we perform clinical trials to generate new evidence. Organizing multi-institutional clinical trials in Japan is an urgent necessity. Limited disease SCLC Concurrent radiotherapy in combination with cisplatin and etoposide is considered to be a standard treatment in limited disease SCLC. Extensive disease SCLC Chemotherapy regiments such as PE or CAV/PE are standard therapy for ED SCLC. There is no current evidence for alternating chemotherapy, dose intensive chemotherapy, high dose chemotherapy, late intensification chemotherapy or maintenance chemotherapy in extensive disease SCLC. New drugs in combination with cisplatin have been reported to show promising antitumor activity in extensive disease SCLC. The impact of CPT-11 + CDDP on survival may be discussed at the 2000 ASCO meeting. Surgically unresectable stage III NSCLC In a recent meta-analysis, cisplatin-based chemotherapy plus radiotherapy was compared with radiotherapy alone in prolonging survival. Cisplatin-based chemotherapy with or followed by radiation was proven to enhance survival. However, the optimal sequencing of chemotherapy and radiation has not been definitively established. Chemoradiotherapy with new drugs (paclitaxel, docetaxel, vinorelbine, gemicitabine, CPT-11) has been evaluated for activity and efficacy. Metastatic stage IV NSCLC Compared with the best supportive care alone, cisplatin-based chemotherapy yields an absolute improvement in survival. New drugs in combination with cisplatin or carboplatin have been reported to show promising antitumor activity. There is no combination therapy including a new anti-cancer agent which can be recommended as a "gold standard". There is no current evidence that either confirms or refutes non-platinum-based combination chemotherapy. Second line chemotherapy Second line chemotherapy (docetaxel 75 mg/m2) improves survival in patients previously treated with platinum-based chemotherapy. PMID:10660731

  20. Chemotherapy Resistance in Lung Cancer.

    PubMed

    Kim, Eric S

    2016-01-01

    Despite a growing interest in development of non-cytotoxic targeted agents, systemic chemotherapy is still the mainstay of treatment for both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). However, chemotherapy resistance limits our ability to effectively treat advanced lung cancer. Some lung tumors are intrinsically resistant to chemotherapy, and in virtually all cases, even the initial responders rapidly develop acquired resistance. While targeting histology could result in enhanced tumor sensitivity to a particular chemotherapeutic agent, better understanding of molecular determinants of chemotherapy sensitivity/resistance would be critically important. Development of predictive biomarkers to personalize chemotherapeutic agents and combining novel agents targeting specific resistance pathways with standard chemotherapy could be some promising strategies to overcome chemotherapy resistance in lung cancer. In this chapter, we will discuss some key mechanisms of resistance for commonly used chemotherapeutic agents in lung cancer. PMID:26667345

  1. Chemotherapy advances in locally advanced head and neck cancer

    PubMed Central

    Georges, Peter; Rajagopalan, Kumar; Leon, Chady; Singh, Priya; Ahmad, Nadir; Nader, Kamyar; Kubicek, Gregory J

    2014-01-01

    The management of locally advanced unresectable head and neck squamous cell cancer (HNSCC) continues to improve. One of the major advances in the treatment of HNSCC was the addition of chemotherapy to radiation in the treatment of non-surgical patients. The majority of the data regarding chemotherapy in HNSCC involve cisplatin chemotherapy with concurrent radiation. However, several new approaches have included targeted therapy against epidermal growth factor receptor and several recent studies have explored the role of induction chemotherapy in the treatment of HNSCC. The purpose of this article is to provide an overview of the role of chemotherapy in the treatment of locally advanced HNSCC. PMID:25493232

  2. Chemotherapy advances in locally advanced head and neck cancer.

    PubMed

    Georges, Peter; Rajagopalan, Kumar; Leon, Chady; Singh, Priya; Ahmad, Nadir; Nader, Kamyar; Kubicek, Gregory J

    2014-12-10

    The management of locally advanced unresectable head and neck squamous cell cancer (HNSCC) continues to improve. One of the major advances in the treatment of HNSCC was the addition of chemotherapy to radiation in the treatment of non-surgical patients. The majority of the data regarding chemotherapy in HNSCC involve cisplatin chemotherapy with concurrent radiation. However, several new approaches have included targeted therapy against epidermal growth factor receptor and several recent studies have explored the role of induction chemotherapy in the treatment of HNSCC. The purpose of this article is to provide an overview of the role of chemotherapy in the treatment of locally advanced HNSCC. PMID:25493232

  3. Understanding Chemotherapy

    MedlinePLUS

    ... you may get chemotherapy before a peripheral blood stem cell transplant. Fill this section in with your doctor or nurse. I am getting chemo ... can be given in these forms: An IV (intravenously) A shot (injection) into a muscle or other part of your body A pill ...

  4. A portable and compact near-infrared spectral tomography system for predicting breast tumor response to neoadjuvant chemotherapy

    NASA Astrophysics Data System (ADS)

    Zhao, Yan; El-Ghussein, Fadi; Zhang, Ziqi; Pogue, Brian W.; Paulsen, Keith D.; Jiang, Shudong

    2015-03-01

    A portable hybrid frequency domain (FD)-continuous wave (CW) Near-Infrared spectroscopy NIRS system has been developed for quantifying changes in total hemoglobin, oxygen saturation and water content in the breast during neoadjuvant chemotherapy. Simultaneous acquisition of two sets of 3 FD channels and 3 CW channels could be completed within 1 min. System calibration and homogeneous phantom measurement show phase variation less than 3% when PMT gain from 0.7 to 1.1 was used. The study of integrating this system into the workflow of clinical oncology practice is ongoing.

  5. Concurrent-scene/alternate-pattern analysis for robust video-based docking systems

    NASA Technical Reports Server (NTRS)

    Udomkesmalee, Suraphol

    1991-01-01

    A typical docking target employs a three-point design of retroreflective tape, one at each endpoint of the center-line, and one on the tip of the central post. Scenes, sensed via laser diode illumination, produce pictures with spots corresponding to desired reflection from the retroreflectors and other reflections. Control corrections for each axis of the vehicle can then be properly applied if the desired spots are accurately tracked. However, initial acquisition of these three spots (detection and identification problem) are non-trivial under a severe noise environment. Signal-to-noise enhancement, accomplished by subtracting the non-illuminated scene from the target scene illuminated by laser diodes, can not eliminate every false spot. Hence, minimization of docking failures due to target mistracking would suggest needed inclusion of added processing features pertaining to target locations. In this paper, we present a concurrent processing scheme for a modified docking target scene which could lead to a perfect docking system. Since the non-illuminated target scene is already available, adding another feature to the three-point design by marking two non-reflective lines, one between the two end-points and one from the tip of the central post to the center-line, would allow this line feature to be picked-up only when capturing the background scene (sensor data without laser illumination). Therefore, instead of performing the image subtraction to generate a picture with a high signal-to-noise ratio, a processed line-image based on the robust line detection technique (Hough transform) can be used to fuse with the actively sensed three-point target image to deduce the true locations of the docking target. This dual-channel confirmation scheme is necessary if a fail-safe system is to be realized from both the sensing and processing point-of-views. Detailed algorithms and preliminary results are presented.

  6. The TRIDEC System-of-Systems; Choreography of large-scale concurrent tasks in Natural Crisis Management

    NASA Astrophysics Data System (ADS)

    Häner, R.; Wächter, J.

    2012-04-01

    The project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC), co-funded by the European Commission in its Seventh Framework Programme aims at establishing a network of dedicated, autonomous legacy systems for large-scale concurrent management of natural crises utilising heterogeneous information resources. TRIDEC's architecture reflects the System-of- Systems (SoS) approach which is based on task-oriented systems, cooperatively interacting as a collective in a common environment. The design of the TRIDEC-SoS follows the principles of service-oriented and event-driven architectures (SOA & EDA) exceedingly focusing on a loose coupling of the systems. The SoS approach in combination with SOA and EDA has the distinction of being able to provide novel and coherent behaviours and features resulting from a process of dynamic self-organisation. Self-organisation is a process without the need for a central or external coordinator controlling it through orchestration. It is the result of enacted concurrent tasks in a collaborative environment of geographically distributed systems. Although the individual systems act completely autonomously, their interactions expose emergent structures of evolving nature. Particularly, the fact is important that SoS are inherently able to evolve on all facets of intelligent information management. This includes adaptive properties, e.g. seamless integration of new resource types or the adoption of new fields in natural crisis management. In the case of TRIDEC with various heterogeneous participants involved, concurrent information processing is of fundamental importance because of the achievable improvements regarding cooperative decision making. Collaboration within TRIDEC will be implemented with choreographies and conversations. Choreographies specify the expected behaviour between two or more participants; conversations describe the message exchange between all participants emphasising their logical relation. The TRIDEC choreography will be based on the definition of Behavioural Interfaces and Service Level Agreements, which describe the interactions of all participants involved in the collaborative process by binding the tasks of dedicated systems to high-level business processes. All methods of a Behavioural Interfaces can be assigned dynamically to the activities of a business process. This allows it to utilise a system during the run-time of a business process and thus, for example enabling task balancing or the delegation of responsibilities. Since the individual parts of a SoS are normally managed independently and operate autonomously because of their geographical distribution it is of vital importance to ensure the reliability (robustness and correctness) of their interactions which will be achieved by applying the Design by Contract (DbC) approach to the TRIDEC architecture. Key challenge for TRIDEC is establishing a reliable adaptive system which exposes an emergent behaviour, for example intelligent monitoring strategies or dynamic system adaptions even in case of partly system failures. It is essential for TRIDEC that for example redundant parts of the system can take over tasks from defect components in a process of re-organising its network.

  7. Influence of complementary Viscum album (Iscador) administration on microcirculation and immune system of ear, nose and throat carcinoma patients treated with radiation and chemotherapy.

    PubMed

    Klopp, R; Schmidt, W; Werner, E; Werner, M; Niemer, W; Beuth, J

    2005-01-01

    With the techniques of vital microscopic and reflection spectrometric imaging, representative characteristics of microcirculation and immunology of white blood cells were evaluated before, during and after radiotherapy and chemotherapy of patients suffering from ear, nose and throat carcinomas. Adverse effects of radiotherapy and chemotherapy on the microcirculation and the immune system were decreased and reconstitution processes were accelerated by complementary administration of a standardized mistletoe extract (Iscador). PMID:15816634

  8. Dynamic programming methods for concurrent design and dynamic allocation of vehicles embedded in a system-of-systems

    NASA Astrophysics Data System (ADS)

    Nusawardhana

    2007-12-01

    Recent developments indicate a changing perspective on how systems or vehicles should be designed. Such transition comes from the way decision makers in defense related agencies address complex problems. Complex problems are now often posed in terms of the capabilities desired, rather than in terms of requirements for a single systems. As a result, the way to provide a set of capabilities is through a collection of several individual, independent systems. This collection of individual independent systems is often referred to as a "System of Systems'' (SoS). Because of the independent nature of the constituent systems in an SoS, approaches to design an SoS, and more specifically, approaches to design a new system as a member of an SoS, will likely be different than the traditional design approaches for complex, monolithic (meaning the constituent parts have no ability for independent operation) systems. Because a system of system evolves over time, this simultaneous system design and resource allocation problem should be investigated in a dynamic context. Such dynamic optimization problems are similar to conventional control problems. However, this research considers problems which not only seek optimizing policies but also seek the proper system or vehicle to operate under these policies. This thesis presents a framework and a set of analytical tools to solve a class of SoS problems that involves the simultaneous design of a new system and allocation of the new system along with existing systems. Such a class of problems belongs to the problems of concurrent design and control of a new systems with solutions consisting of both optimal system design and optimal control strategy. Rigorous mathematical arguments show that the proposed framework solves the concurrent design and control problems. Many results exist for dynamic optimization problems of linear systems. In contrary, results on optimal nonlinear dynamic optimization problems are rare. The proposed framework is equipped with the set of analytical tools to solve several cases of nonlinear optimal control problems: continuous- and discrete-time nonlinear problems with applications on both optimal regulation and tracking. These tools are useful when mathematical descriptions of dynamic systems are available. In the absence of such a mathematical model, it is often necessary to derive a solution based on computer simulation. For this case, a set of parameterized decision may constitute a solution. This thesis presents a method to adjust these parameters based on the principle of stochastic approximation simultaneous perturbation using continuous measurements. The set of tools developed here mostly employs the methods of exact dynamic programming. However, due to the complexity of SoS problems, this research also develops suboptimal solution approaches, collectively recognized as approximate dynamic programming solutions, for large scale problems. The thesis presents, explores, and solves problems from an airline industry, in which a new aircraft is to be designed and allocated along with an existing fleet of aircraft. Because the life cycle of an aircraft is on the order of 10 to 20 years, this problem is to be addressed dynamically so that the new aircraft design is the best design for the fleet over a given time horizon.

  9. Hepatic Arterial Infusion Chemotherapy Using Fluorouracil Followed by Systemic Therapy Using Oxaliplatin Plus Fluorouracil and Leucovorin for Patients with Unresectable Liver Metastases from Colorectal Cancer

    SciTech Connect

    Seki, Hiroshi Ozaki, Toshirou; Shiina, Makoto

    2009-07-15

    The purpose of this study was to assess retrospectively the sequential treatment of hepatic arterial infusion (HAI) chemotherapy followed by systemic therapy using oxaliplatin plus 5-flourouracil (5-FU) and leucovorin, namely, FOLFOX, for patients with liver metastases from colorectal cancer. We reviewed 20 patients with unresectable liver metastases from colorectal cancer. Patients were initially treated with HAI chemotherapy until disease progression (5-fluorouracil, 1000 mg/m{sup 2} intra-arterial infusion, weekly) and then with FOLFOX thereafter (FOLFOX4, n = 13; modified FOLFOX6, n = 7). Adverse events, tumor response, and time to progression for each therapy were evaluated retrospectively, and overall survival was estimated. Toxicity of HAI chemotherapy was generally mild. Of 20 patients, adverse events leading to treatment discontinuation occurred in only 1 patient (5%) during initial therapy using HAI chemotherapy, while 9 patients (45%) exhibited adverse events during subsequent FOLFOX therapy. For HAI chemotherapy and FOLFOX, objective response rates were 85.0% and 35.0%, respectively, and median time to progression was 11.6 and 5.1 months, respectively. Median overall survival was 30.1 months. In conclusion, the sequence of HAI chemotherapy followed by FOLFOX is a promising treatment strategy for the long-term use of active chemotherapeutic agents, leading to a superior tumor response and fewer toxic effects in patients with unresectable liver metastases from colorectal cancer.

  10. Sensors 2000! Program: Advanced Biosensor and Measurement Systems Technologies for Spaceflight Research and Concurrent, Earth-Based Applications

    NASA Technical Reports Server (NTRS)

    Hines, J.

    1999-01-01

    Sensors 2000! (S2K!) is a specialized, integrated projects team organized to provide focused, directed, advanced biosensor and bioinstrumentation systems technology support to NASA's spaceflight and ground-based research and development programs. Specific technology thrusts include telemetry-based sensor systems, chemical/ biological sensors, medical and physiological sensors, miniaturized instrumentation architectures, and data and signal processing systems. A concurrent objective is to promote the mutual use, application, and transition of developed technology by collaborating in academic-commercial-govemment leveraging, joint research, technology utilization and commercialization, and strategic partnering alliances. Sensors 2000! is organized around three primary program elements: Technology and Product Development, Technology infusion and Applications, and Collaborative Activities. Technology and Product Development involves development and demonstration of biosensor and biotelemetry systems for application to NASA Space Life Sciences Programs; production of fully certified spaceflight hardware and payload elements; and sensor/measurement systems development for NASA research and development activities. Technology Infusion and Applications provides technology and program agent support to identify available and applicable technologies from multiple sources for insertion into NASA's strategic enterprises and initiatives. Collaborative Activities involve leveraging of NASA technologies with those of other government agencies, academia, and industry to concurrently provide technology solutions and products of mutual benefit to participating members.

  11. The PVM (Parallel Virtual Machine) system: Supercomputer level concurrent computation on a network of IBM RS/6000 power stations

    SciTech Connect

    Sunderam, V.S. . Dept. of Mathematics and Computer Science); Geist, G.A. )

    1991-01-01

    The PVM (Parallel Virtual Machine) system enables supercomputer level concurrent computations to be performed on interconnected networks of heterogeneous computer systems. Specifically, a network of 13 IBM RS/6000 powerstations has been successfully used to execute production quality runs of superconductor modeling codes at more than 250 Mflops. This work demonstrates the effectiveness of cooperative concurrent processing for high performance applications, and shows that supercomputer level computations may be attained at a fraction of the cost on distributed computing platforms. This paper describes the PVM programming environment and user facilities, as they apply to hardware platforms comprising a network of IBM RS/6000 powerstations. The salient design features of PVM will be discussed; including heterogeneity, scalability, multilanguage support, provisions for fault tolerance, the use of multiprocessors and scalar machines, an interactive graphical front end, and support for profiling, tracing, and visual analysis. The PVM system has been used extensively, and a range of production quality concurrent applications have been successfully executed using PVM on a variety of networked platforms. The paper will mention representative examples, and discuss two in detail. The first is a material sciences problem that was originally developed on a Cray 2. This application code calculates the electronic structure of metallic alloys from first principles and is based on the KKR-CPA algorithm. The second is a molecular dynamics simulation for calculating materials properties. Performance results for both applicants on networks of RS/6000 powerstations will be presented, and accompanied by discussions of the other advantages of PVM and its potential as a complement or alternative to conventional supercomputers.

  12. Hyperthermia-mediated local drug delivery by a bubble-generating liposomal system for tumor-specific chemotherapy.

    PubMed

    Chen, Ko-Jie; Chaung, Er-Yuan; Wey, Shiaw-Pyng; Lin, Kun-Ju; Cheng, Felice; Lin, Chia-Chen; Liu, Hao-Li; Tseng, Hsiang-Wen; Liu, Chih-Peng; Wei, Ming-Cheng; Liu, Chun-Min; Sung, Hsing-Wen

    2014-05-27

    As is widely suspected, lysolipid dissociation from liposomes contributes to the intravenous instability of ThermoDox (lysolipid liposomes), thereby impeding its antitumor efficacy. This work evaluates the feasibility of a thermoresponsive bubble-generating liposomal system without lysolipids for tumor-specific chemotherapy. The key component in this liposomal formulation is its encapsulated ammonium bicarbonate (ABC), which is used to actively load doxorubicin (DOX) into liposomes and trigger a drug release when heated locally. Incubating ABC liposomes with whole blood results in a significantly smaller decrease in the retention of encapsulated DOX than that by lysolipid liposomes, indicating superior plasma stability. Biodistribution analysis results indicate that the ABC formulation circulates longer than its lysolipid counterpart. Following the injection of ABC liposome suspension into mice with tumors heated locally, decomposition of the ABC encapsulated in liposomes facilitates the immediate thermal activation of CO2 bubble generation, subsequently increasing the intratumoral DOX accumulation. Consequently, the antitumor efficacy of the ABC liposomes is superior to that of their lysolipid counterparts. Results of this study demonstrate that this thermoresponsive bubble-generating liposomal system is a highly promising carrier for tumor-specific chemotherapy, especially for local drug delivery mediated at hyperthermic temperatures. PMID:24742221

  13. Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT)

    SciTech Connect

    Wang Shulian; Liao Zhongxing . E-mail: zliao@mail.mdanderson.org; Wei Xiong; Liu, Helen H.; Tucker, Susan L.; Hu Chaosu; Mohan, Rodhe; Cox, James D.; Komaki, Ritsuko

    2006-12-01

    Purpose: To investigate factors associated with treatment-related pneumonitis in non-small-cell lung cancer patients treated with concurrent chemoradiotherapy. Patients and Methods: We retrospectively analyzed data from 223 patients treated with definitive concurrent chemoradiotherapy. Treatment-related pneumonitis was graded according to Common Terminology Criteria for Adverse Events version 3.0. Univariate and multivariate analyses were performed to identify predictive factors. Results: Median follow-up was 10.5 months (range, 1.4-58 months). The actuarial incidence of Grade {>=}3 pneumonitis was 22% at 6 months and 32% at 1 year. By univariate analyses, lung volume, gross tumor volume, mean lung dose, and relative V5 through V65, in increments of 5 Gy, were all found to be significantly associated with treatment-related pneumonitis. The mean lung dose and rV5-rV65 were highly correlated (p < 0.0001). By multivariate analysis, relative V5 was the most significant factor associated with treatment-related pneumonitis; the 1-year actuarial incidences of Grade {>=}3 pneumonitis in the group with V5 {<=}42% and V5 >42% were 3% and 38%, respectively (p = 0.001). Conclusions: In this study, a number of clinical and dosimetric factors were found to be significantly associated with treatment-related pneumonitis. However, rV5 was the only significant factor associated with this toxicity. Until it is better understood which dose range is most relevant, multiple clinical and dosimetric factors should be considered in treatment planning for non-small-cell lung cancer patients receiving concurrent chemoradiotherapy.

  14. Optical properties of the chemotherapy drugs used in the central nervous system lymphoma therapy: monitoring drug delivery

    NASA Astrophysics Data System (ADS)

    Myllylä, T.; Popov, A.; Surazy?ski, L.; Oinas, J.; Bibikova, O.; Bykov, A.; Wróbel, M. S.; Gnyba, M.; Jedrzejewska-Szczerska, M.; Meglinski, I.; Kuittinen, O.

    2015-07-01

    Our aim is to optically monitor the delivery of the chemotherapy drugs for brain tumours, particularly used in the central nervous system (CNS) lymphoma therapy. In vivo monitoring would help to optimize the treatment and avoiding unnecessary medications. Moreover, it would be beneficial to be able to measure which of the multi-regimen drugs actually do penetrate and how well into the brain tissue. There exist several potential optical measurement techniques to be utilised for the purpose. The most desired method would allow the detection of the drugs without using optical biomarkers as a contrast agent. In this case, for non-invasive sensing of the drug in the brain cortex, the drug should have a reasonably strong optical absorption band somewhere in the range between 600 nm and 1700 nm, and not directly coincident with the strong bands of haemoglobin or water. Alternatively, mid-infrared (MIR) range has the potential for invasive drug monitoring techniques. In this paper, we report the optical properties of several chemotherapy drugs used in CNS lymphoma therapy, such as rituximabi, cyclophosphamide and etoposide. We measured their transmittance and reflectance spectra in near-infrared (NIR) range, particularly 900 nm - 2500 nm, to be considered when choosing the in vivo monitoring method to be developed. The absorption and scattering coefficients were retrieved from the measurements and applying Beer's law. For the measurement of the sum of total transmission and reflection in NIR range we used integrating sphere with spektralo to enable calculation of the scattering coefficient.

  15. Chemotherapy in conjoint aging-tumor systems: some simple models for addressing coupled aging-cancer dynamics

    PubMed Central

    2010-01-01

    Background In this paper we consider two approaches to examining the complex dynamics of conjoint aging-cancer cellular systems undergoing chemotherapeutic intervention. In particular, we focus on the effect of cells growing conjointly in a culture plate as a precursor to considering the larger multi-dimensional models of such systems. Tumor cell growth is considered from both the logistic and the Gompertzian case, while normal cell growth of fibroblasts (WI-38 human diploid fibroblasts) is considered as logistic only. Results We demonstrate, in a simple approach, how the interdependency of different cell types in a tumor, together with specifications of for treatment, can lead to different evolutionary patterns for normal and tumor cells during a course of therapy. Conclusions These results have significance for understanding appropriate pharmacotherapy for elderly patients who are also undergoing chemotherapy. PMID:20550676

  16. The current role of systemic chemotherapy in the primary treatment of head and neck cancer.

    PubMed

    Busch, C-J; Tribius, S; Schafhausen, P; Knecht, R

    2015-03-01

    The treatment of patients with locoregionally advanced squamous cell carcinoma of the head and neck (HNSCC) is still evolving into the perfect combination of the different multidisciplinary approaches. Induction chemotherapy (ICT) prior to planned definitive local therapy is widely used in this patient population for over 30 years but it is still unclear how to incorporate ICT into multimodality treatment the best. It appears to have a role in selected clinical situations especially for those patients with high risk for distant metastasis. However, since ICT protocols in different studies varies a lot, a comparative and consistent statement of benefits is difficult. We show the recent developments including randomized trials comparing radiochemotherapy (RCT) and ICT followed by definitive RCT here. This review summarizes how ICT has developed over the years, provides critical remarks of recent developments, and discusses how clinical trials including ICT should be conducted in the future. PMID:25687982

  17. Correctness Criteria and Concurrency Control

    E-print Network

    Massachusetts at Amherst, University of

    10 Correctness Criteria and Concurrency Control Panos K. Chrysanthis Department of Computer Science University of Pittsburgh, Pittsburgh, PA Krithi Ramamritham Department of Computer Science University Database systems have been widely incorporated in almost all aspects of the operations of large

  18. Malaria chemotherapy.

    PubMed

    Winstanley, Peter; Ward, Stephen

    2006-01-01

    Most malaria control strategies today depend on safe and effective drugs, as they have done for decades. But sensitivity to chloroquine, hitherto the workhorse of malaria chemotherapy, has rapidly declined throughout the tropics since the 1980s, and this drug is now useless in many high-transmission areas. New options for resource-constrained governments are few, and there is growing evidence that the burden from malaria has been increasing, as has malaria mortality in Africa. In this chapter, we have tried to outline the main pharmacological properties of current drugs, and their therapeutic uses and limitations. We have summarised the ways in which these drugs are employed, both in the formal health sector and in self-medication. We have briefly touched on the limitations of current drug development, but have tried to pick out a few promising drugs that are under development. Given that Plasmodium falciparum is the organism that kills, and that has developed multi-drug resistance, we have tended to focus upon it. Similarly, given that around 90% of global mortality from malaria occurs in Africa, there is the tendency to dwell on this continent. We give no apology for placing our emphasis upon the use of antimalarial drugs in endemic populations rather than their use for prophylaxis in travellers. PMID:16735162

  19. Concepts of concurrent programming. Final report

    SciTech Connect

    Bustard, D.W.

    1990-04-01

    A concurrent program is one defining actions that may be performed simultaneously. This module discusses the nature of such programs and provides an overview of the means by which they may be constructed and executed. Emphasis is given to the terminology used in this field and the underlying concepts involved. This module is largely concerned with explicit concurrency, where concurrent behavior is specified by the program designer. Particular attention is paid to programs that can be considered inherently concurrent, that is, programs that are constructed to control or model physical systems that involve parallel activity. The module also includes a brief introduction to performance-oriented concurrency, where concurrency is used to improve program performance by taking advantage of hardware support for parallel processing. The module is divided into three sections. The first deals with basic concepts in concurrent programming, covering characteristic attributes, formal properties, standard design problems, and execution details. The second section discusses the steps in constructing concurrent programs for specification to coding. The final section briefly examines concurrency from the point of view of some common application areas. The module gives a foundation for a deeper study of specific topics in concurrent programming. It also provides the preparatory material for a study of the concurrent aspects of application areas such as real-time (embedded) systems, database systems, operating systems, and many simulation systems.

  20. Phase I Trial Using Proteasome Inhibitor Bortezomib and Concurrent Temozolomide and Radiotherapy for Central Nervous System Malignancies

    SciTech Connect

    Kubicek, Gregory J.; Werner-Wasik, Maria; Machtay, Mitchell; Mallon, Gayle; Myers, Thomas; Ramirez, Michael; Andrews, David; Curran, Walter J.; Dicker, Adam P.

    2009-06-01

    Purpose: To evaluate the toxicity and response rate of bortezomib with concurrent radiotherapy and temozolomide in the treatment of patients with central nervous system malignancies. Patients and Methods: This open-label, dose-escalation, Phase I clinical study evaluated the safety of three dose levels of intravenously administered bortezomib (0.7, 1.0, and 1.3 mg/m{sup 2}/dose) on Days 1, 4, 8, and 11 of a 21-day cycle, in addition to concurrent radiotherapy and temozolomide at a daily dose of 75 mg/m{sup 2} starting on Day 1. The primary endpoint was dose-limiting toxicity, defined as any Grade 4-5 toxicity or Grade 3 toxicity directly attributable to protocol treatment, requiring hospitalization and/or radiotherapy interruption. The secondary endpoints included feasibility, non-dose-limiting toxicity, and treatment response. Results: A total of 27 patients were enrolled, 23 of whom had high-grade glioma (10 recurrent and 13 newly diagnosed). No dose-limiting toxicities were noted in any dose group, including the highest (1.3 mg/m{sup 2}/dose). The most frequent toxicities were Grade 1 and 2 stomatitis, erythema, and alopecia. All 27 patients were evaluable for response. At a median follow-up of 15.0 months, 9 patients were still alive, with a median survival of 17.4 months for all patients and 15.0 months for patients with high-grade glioma. Conclusion: Bortezomib administered at its typical 'systemic' dose (1.3 mg/m{sup 2}) is well tolerated and safe combined with temozolomide and radiotherapy when used in the treatment of central nervous system malignancies. A Phase II study to characterize efficacy is warranted.

  1. Dual-targeting nanocarrier system based on thermosensitive liposomes and gold nanorods for cancer thermo-chemotherapy.

    PubMed

    Yu, Meng; Guo, Fang; Tan, Fengping; Li, Nan

    2015-10-10

    The primary challenge of cancer therapy was the failure of most chemotherapeutics to accumulate in the tumors, additionally causing serious systemic side effects. We designed a tumor-targeting accumulated and locally triggered-release nanocarrier system to increase the intratumoral drug concentration and thus the efficacy of chemotherapy, based on gold nanorods (GNRs) and thermosensitive liposomes (TSLs). PEGylated GNRs could not only make nanocarriers to co-accumulate in tumors depending on enhanced permeability and retention (EPR) effect, but also generated heat locally under near-infrared (NIR) stimulation. CO2 bubbles were generated by the encapsulated ammonium bicarbonate (ABC) under hyperthermia, thus the co-encapsulated drug was released and local drug concentration was increased along with the disintegration of liposomal membrane. On the other hand, this dual-targeting system prevented the drug leakage in blood circulation or other organs while facilitated most of the active agents delivered to tumors. In vitro and in vivo experiments revealed high cytotoxicity and good affinity of HTSL to MDA-MB-435 cells when used synergistically with GNRs, but low toxicity to normal cells at the same condition. When combined with thermotherapy, the smart nanocarrier system held significant promise for future cancer treatment for their markedly improved therapeutic efficacy and decreased systemic toxicity. PMID:26256259

  2. Microfluidic System Based High Throughput Drug Screening System for Curcumin/TRAIL Combinational Chemotherapy in Human Prostate Cancer PC3 Cells.

    PubMed

    An, Dami; Kim, Kwangmi; Kim, Jeongyun

    2014-07-01

    We have developed a fully automated high throughput drug screening (HTDS) system based on the microfluidic cell culture array to perform combinational chemotherapy. This system has 64 individually addressable cell culture chambers where the sequential combinatorial concentrations of two different drugs can be generated by two microfluidic diffusive mixers. Each diffusive mixer has two integrated micropumps connected to the media and the drug reservoirs respectively for generating the desired combination without the need for any extra equipment to perfuse the solution such as syringe pumps. The cell array is periodically exposed to the drug combination with the programmed LabVIEW system during a couple of days without extra handling after seeding the cells into the microfluidic device and also, this device does not require the continuous generation of solutions compared to the previous systems. Therefore, the total amount of drug being consumed per experiment is less than a few hundred micro liters in each reservoir. The utility of this system is demonstrated through investigating the viability of the prostate cancer PC3 cell line with the combinational treatments of curcumin and tumor necrosis factor-alpha related apoptosis inducing ligand (TRAIL). Our results suggest that the system can be used for screening and optimizing drug combination with a small amount of reagent for combinatorial chemotherapy against cancer cells. PMID:25143816

  3. Efficacy of intensified hyperfractionated and accelerated radiotherapy and concurrent chemotherapy with carboplatin and 5-fluorouracil: Updated results of a randomized multicentric trial in advanced head-and-neck cancer

    SciTech Connect

    Semrau, Robert . E-mail: Robert.Semrau@uk-koeln.de; Mueller, Rolf-Peter; Stuetzer, Hartmut; Staar, Susanne; Schroeder, Ursula; Guntinas-Lichius, Orlando; Kocher, Martin; Eich, Hans Theodor; Dietz, Andreas; Flentje, Michael; Rudat, Volker; Volling, Peter; Schroeder, Michael; Eckel, Hans Edmund

    2006-04-01

    Purpose: To prove an expected benefit of concurrent radiochemotherapy (RCT), a two-arm randomized multicentric study was performed. In a subgroup analysis the influence of pretherapeutical hemoglobin level (p-Hb) on survival under locoregional control (SLC) was tested. Patients and Methods: The study included primarily untreated Stage III/IV (International Union Against Cancer [UICC]) oropharyngeal and hypopharyngeal carcinomas. Patients were randomized to receive either hyperfractionated (hf) and accelerated (acc) RCT with two cycles 5-fluorouracil (600 mg/m{sup 2}/day) and carboplatin (70 mg/m{sup 2}/day) on Days 1-5 and 29-33 or hf-acc radiotherapy (RT) alone. Total RT dose in both arms was 69.9 Gy in 38 days in concomitant boost technique. Results: After a median follow-up time of 57 months, SLC is significantly better in RCT than in RT (p = 0.01), with median SLC of 17 months and 11 months, respectively. Also overall survival (OS) shows a benefit for RCT (p 0.016), with a median survival of 23 months for RCT and 16 months for RT. However, the benefit in SLC and OS is not seen in hypopharyngeal carcinomas. In a multivariate analysis of oropharyngeal cancer patients, p-Hb levels lower than 12.7 g/dL resulted in lower SLC compared with higher p-Hb levels up to 13.8 g/dL. P-Hb levels >13.8 g/dL did not further improve SLC. Conclusions: Hyperfractionated-accelerated RCT is superior to hf-acc RT in oropharyngeal carcinomas. P-Hb levels >13.8 g/dL do not further improve SLC.

  4. Concurrent determination of anions and cations in consumer fireworks with a portable dual-capillary electrophoresis system.

    PubMed

    Sáiz, Jorge; Duc, Mai Thanh; Koenka, Israel Joel; Martín-Alberca, Carlos; Hauser, Peter C; García-Ruiz, Carmen

    2014-11-01

    A new automated portable dual-channel capillary electrophoresis instrument was built and applied to the concurrent determination of cations and anions. The system uses a single buffer and hydrodynamic injection of the sample is performed autonomously. A novel engraved flow-cell interface is used at the injection ends of the capillaries allowing the autonomous operation of the system. The engraved flow-cell replaces traditionally used split injectors in purpose made capillary electrophoresis systems and makes the system design easier. A new software package with graphical user interface was employed to control the system, making its operation simple and increasing its versatility. The electrophoretic method was optimized to allow the baseline separation of 12 cations and anions commonly found in fireworks. The system was proven to be useful for the analysis of consumer fireworks, saving time and expenses compared to separate analyses for anions and cations. This is the first time that cationic and anionic compositions of fireworks are investigated together. The analysis of samples revealed several inaccuracies between the declared compositions for the fireworks and the obtained results, which could be attributed to cross-contamination during their manufacture or to a transfer between other components of the pyrotechnic item. The presence of certain unexpected peaks, however, had no apparent reason and might represent an irregularity in the manufacture of some devices. PMID:25465022

  5. Should supplemental antioxidant administration be avoided during chemotherapy and radiation therapy?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite nearly two decades of research investigating the use of dietary antioxidant supplementation during conventional chemotherapy and radiation therapy, controversy remains about the efficacy and safety of this complementary treatment. Several studies of concurrent antioxidant administration with...

  6. Concurrent Validity and Test-retest Reliability of the OPTOGait Photoelectric Cell System for the Assessment of Spatio-temporal Parameters of the Gait of Young Adults.

    PubMed

    Lee, Myung Mo; Song, Chang Ho; Lee, Kyoung Jin; Jung, Sang Woo; Shin, Doo Chul; Shin, Seung Ho

    2014-01-01

    [Purpose] The purpose of this study was to investigate the concurrent validity and test-retest reliability of the recently introduced OPTOGait Photoelectric Cell System for the assessment of spatio-temporal parameters of gait. [Subjects] Twenty healthy young adults (mean age = 27.35, SD = 7.4) were asked to walk 3 times on walkway at a comfortable speed. [Methods] Concurrent validity was assessed by comparing data obtained using the OPTOGait and GAITRite systems, and reliability was assessed by comparing data from the first and third OPTOGait sessions. [Results] Concurrent validity, as identified by intra-class correlation coefficients (ICC (2, 1) = 0.929-0.998), coefficients of variation (CVME = 0.32-11.30%), and 95% limits of agreement, showed high levels of correlation. In addition, the test-retest reliability of the OPTOGait Photoelectric Cell System was demonstrated as showing a high level of correlation with all spatio-temporal parameters by intra-class correlation coefficients (ICC (3, 1) = 0.785-0.952), coefficients of variation (CVME = 1.66-4.06%), 95% limits of agreement, standard error of measurement (SEM = 2.17-5.96%), and minimum detectable change (MDC95% = 6.01-16.52%). [Conclusion] The OPTOGait Photoelectric Cell System has strong concurrent validity along with relative and absolute test-retest reliabilities. This portable system with easy-to-use features can be used for clinical assessments or research purposes as an objective means of assessing gait. PMID:24567681

  7. Concurrent Chemoradiotherapy in Resected Extrahepatic Cholangiocarcinoma

    SciTech Connect

    Nelson, John W.; Ghafoori, A. Paiman; Willett, Christopher G.; Tyler, Douglas S.; Pappas, Theodore N.; Clary, Bryan M.; Hurwitz, Herbert I.; Bendell, Johanna C.; Morse, Michael A.; Clough, Robert W.; Czito, Brian G.

    2009-01-01

    Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age {<=}60 years and perineural involvement adversely affected survival on univariate analysis. Patients undergoing R0 resection had a significantly improved rate of local control but no survival advantage. Despite having more advanced disease at presentation, patients treated neoadjuvantly had a longer survival (5-year survival 53% vs. 23%, p = 0.16) and similar rates of Grade 2-3 surgical morbidity (16% vs. 33%, p = 0.24) compared with those treated in the postoperative setting. Conclusion: These study results suggest a possible local control benefit from chemoradiotherapy combined with surgery in patients with advanced, resected biliary cancer. Furthermore, our results suggest that a treatment strategy that includes preoperative chemoradiotherapy might result in improved tumor resectability with similar surgical morbidity compared with patients treated postoperatively, as well as potentially improved survival outcomes. Distant failure remains a significant failure pattern, suggesting the need for more effective systemic therapy.

  8. Symbolically Modeling Concurrent MCAPI Executions

    NASA Technical Reports Server (NTRS)

    Fischer, Topher; Mercer, Eric; Rungta, Neha

    2011-01-01

    Improper use of Inter-Process Communication (IPC) within concurrent systems often creates data races which can lead to bugs that are challenging to discover. Techniques that use Satisfiability Modulo Theories (SMT) problems to symbolically model possible executions of concurrent software have recently been proposed for use in the formal verification of software. In this work we describe a new technique for modeling executions of concurrent software that use a message passing API called MCAPI. Our technique uses an execution trace to create an SMT problem that symbolically models all possible concurrent executions and follows the same sequence of conditional branch outcomes as the provided execution trace. We check if there exists a satisfying assignment to the SMT problem with respect to specific safety properties. If such an assignment exists, it provides the conditions that lead to the violation of the property. We show how our method models behaviors of MCAPI applications that are ignored in previously published techniques.

  9. Chemotherapy for Nasopharyngeal Carcinoma - Current Recommendation and Controversies.

    PubMed

    Sze, Henry; Blanchard, Pierre; Ng, Wai Tong; Pignon, Jean-Pierre; Lee, Anne W M

    2015-12-01

    Radiotherapy is the primary treatment of nasopharyngeal carcinoma and combination chemotherapy can enhance treatment outcomes for locoregionally advanced disease. The Intergroup 0099 study using concurrent-adjuvant cisplatin-based chemoradiotherapy was the first trial to demonstrate a survival benefit. Since then, there have been attempts to further improve the treatment results by altering the chemotherapy sequence, using different chemotherapeutic agents or schedules, and extending the use of chemotherapy to early-stage disease. This review provides an overview of the data and highlights the current controversies behind international guidelines. PMID:26568551

  10. Experimental Validation of a Systems Architecting Framework for Objectives Definition in a Concurrent Engineering Environment

    E-print Network

    de Weck, Olivier L.

    1 Experimental Validation of a Systems Architecting Framework for Objectives Definition-phase A of space missions and programs. Effective systems architecting requires comprehensive analysis of the value architecting framework that has been developed at MIT to support system architects in the analysis

  11. Object-oriented concurrent programming

    SciTech Connect

    Yonezawa, A.; Tokoro, M.

    1986-01-01

    This book deals with a major theme of the Japanese Fifth Generation Project, which emphasizes logic programming, parallelism, and distributed systems. It presents a collection of tutorials and research papers on a new programming and design methodology in which the system to be constructed is modeled as a collection of abstract entities called ''objects'' and concurrent messages passing among objects. The book includes proposals for programming languages that support this methodology, as well as the applications of object-oriented concurrent programming to such areas as artificial intelligence, software engineering, music synthesis, office information systems, and system programming.

  12. Concurrent engineering

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Leger, L.; Hunter, D.; Jones, C.; Sprague, R.; Berke, L.; Newell, J.; Singhal, S.

    1991-01-01

    The following subject areas are covered: issues (liquid rocket propulsion - current development approach, current certification process, and costs of engineering changes); state of the art (DICE information management system, key government participants, project development strategy, quality management, and numerical propulsion system simulation); needs identified; and proposed program.

  13. (Re)engineering Earth System Models to Expose Greater Concurrency for Ultrascale Computing: Practice, Experience, and Musings

    NASA Astrophysics Data System (ADS)

    Mills, R. T.

    2014-12-01

    As the high performance computing (HPC) community pushes towards the exascale horizon, the importance and prevalence of fine-grained parallelism in new computer architectures is increasing. This is perhaps most apparent in the proliferation of so-called "accelerators" such as the Intel Xeon Phi or NVIDIA GPGPUs, but the trend also holds for CPUs, where serial performance has grown slowly and effective use of hardware threads and vector units are becoming increasingly important to realizing high performance. This has significant implications for weather, climate, and Earth system modeling codes, many of which display impressive scalability across MPI ranks but take relatively little advantage of threading and vector processing. In addition to increasing parallelism, next generation codes will also need to address increasingly deep hierarchies for data movement: NUMA/cache levels, on node vs. off node, local vs. wide neighborhoods on the interconnect, and even in the I/O system. We will discuss some approaches (grounded in experiences with the Intel Xeon Phi architecture) for restructuring Earth science codes to maximize concurrency across multiple levels (vectors, threads, MPI ranks), and also discuss some novel approaches for minimizing expensive data movement/communication.

  14. AN ALGORITHM TO SUPPORT CODE-SKELETON GENERATION FOR CONCURRENT SYSTEMS*

    E-print Network

    Berry, Daniel M.

    with the SARA design methodology; we define the relationship between SARA's models and a MID-model; we define design of hardware and/or software systems. The SARA Design Methodology attempts to provide a designer from programming-in-the-large (the act of decomposing a software system into subsystems of modules) [2

  15. A Concurrent Implementation of the Cascade-Correlation Algorithm, Using the Time Warp Operating System

    NASA Technical Reports Server (NTRS)

    Springer, P.

    1993-01-01

    This paper discusses the method in which the Cascade-Correlation algorithm was parallelized in such a way that it could be run using the Time Warp Operating System (TWOS). TWOS is a special purpose operating system designed to run parellel discrete event simulations with maximum efficiency on parallel or distributed computers.

  16. An execution flow for dynamic concurrent systems: simulation of WSN on a Smalltalk/CUDA environment.

    E-print Network

    Brest, Université de

    safety, urban transports, farming, cyber-physical systems, and environemental monitoring. Investigating and analyzing such systems in terms of scalability, reliability, and other design objectives. In this paper, we solutions to build large networks requires method and tools organized around a design flow. We see this flow

  17. A Concurrency and Time Centered Framework for Certification of Autonomous Space Systems 

    E-print Network

    Dechev, Damian

    2010-07-14

    Future space missions, such as Mars Science Laboratory, suggest the engineering of some of the most complex man-rated autonomous software systems. The present process-oriented certification methodologies are becoming prohibitively expensive and do...

  18. 3D Radiotherapy Can Be Safely Combined With Sandwich Systemic Gemcitabine Chemotherapy in the Management of Pancreatic Cancer: Factors Influencing Outcome

    SciTech Connect

    Spry, Nigel Harvey, Jennifer; MacLeod, Craig; Borg, Martin; Ngan, Samuel Y.; Millar, Jeremy L.; Graham, Peter; Zissiadis, Yvonne; Kneebone, Andrew; Carroll, Susan; Davies, Terri; Reece, William H.H.; Iacopetta, Barry; Goldstein, David

    2008-04-01

    Purpose: The aim of this Phase II study was to examine whether concurrent continuous infusion 5-fluorouracil (CI 5FU) plus three-dimensional conformal planning radiotherapy sandwiched between gemcitabine chemotherapy is effective, tolerable, and safe in the management of pancreatic cancer. Methods and Materials: Patients were enrolled in two strata: (1) resected pancreatic cancer at high risk of local relapse (postsurgery arm, n = 22) or (2) inoperable pancreatic cancer in head or body without metastases (locally advanced arm, n = 41). Gemcitabine was given at 1,000 mg/m{sup 2} weekly for 3 weeks followed by 1 week rest then 5-6 weeks of radiotherapy and concurrent CI 5FU (200 mg/m{sup 2}/day). After 4 weeks' rest, gemcitabine treatment was reinitiated for 12 weeks. Results: For the two arms combined, treatment-related Grade 3 and 4 toxicities were reported by 25 (39.7%) and 7 (11.1%) patients, respectively. No significant late renal or hepatic toxicity was observed. In the postsurgery arm (R1 54.5%), median time to progressive disease from surgery was 11.0 months, median time to failure of local control was 32.9 months, and median survival time was 15.6 months. The 1- and 2-year survival rates were 63.6% and 31.8%. No significant associations between outcome and mutations in K-ras or TP53 or microsatellite instability were identified. Post hoc investigation of cancer antigen 19-9 levels found baseline levels and increases postbaseline were associated with shorter survival (p = 0.0061 and p < 0.0001, respectively). Conclusions: This three-dimensional chemoradiotherapy regimen is safe and promising, with encouraging local control for a substantial proportion of patients, and merits testing in a randomized trial.

  19. Concurrent data representation synthesis

    E-print Network

    Hawkins, Peter

    We describe an approach for synthesizing data representations for concurrent programs. Our compiler takes as input a program written using concurrent relations and synthesizes a representation of the relations as sets of ...

  20. Concurrent chemoradiation for high-risk prostate cancer

    PubMed Central

    Cooper, Benjamin T; Sanfilippo, Nicholas J

    2015-01-01

    There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients that are likely to recur after locoregional treatment that is thought of as a “high-risk” population. This more aggressive subset includes patients with clinical stage greater than T2b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/dL. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer. PMID:26266099

  1. Benchmarking An Interdisciplinary Concurrent Design Methodology for Electronic/Mechanical Systems

    E-print Network

    Martin, Tom

    substantially changing the way users interact with their computing environment. Conventional input/ output by the conventional typewriter- like keyboard whose dimensions have not changed substantially for over one hundred to information. The information can be automatically accumu- lated by the system as the user interacts

  2. Female-Driven Multiple Concurrent Sexual Partnership Systems in a Rural Part of a Southern Tanzanian Province

    PubMed Central

    Agnarson, Abela Mpobela; Strömdahl, Susanne; Levira, Francis; Masanja, Honorati; Thorson, Anna Ekéus

    2015-01-01

    Background Multiple concurrent sexual relationships are one of the major challenges to HIV prevention in Tanzania. This study aims to explore sexual behaviour patterns including the practice of multiple concurrent sexual partnerships in a rural Tanzanian setting. Methods This qualitative study used focus group discussions and in-depth interviews with men and women from the community as well as ethnographic participant observations. The data was collected during 16 months of fieldwork in 2007, 2008, and 2009. The focus group discussions and in-depth interviews were transcribed verbatim and translated into English. The data was analysed through the process of latent content analysis. An open coding coding process was applied to create categories and assign themes. Findings Mafiga matatu was an expression used in this society to describe women’s multiple concurrent sexual partners, usually three partners, which was described as a way to ensure social and financial security for their families as well as to achieve sexual pleasure. Adolescent initiation ceremonies initiated and conducted by grand mothers taught young women why and how to engage successfully in multiple concurrent sexual relationships. Some men expressed support for their female partners to behave according to mafiga matatu, while other men were hesitant around this behaviour. Our findings indicate that having multiple concurrent sexual partners is common and a normative behaviour in this setting. Economical factors and sexual pleasure were identified as drivers and viewed as legitimate reason for women to have multiple concurrent sexual partnerships. Conclusions Structural changes improving women’s financial opportunities and increasing gender equality will be important to enable women to not depend on multiple concurrent sexual partnerships for financial security. Future research should explore how normative sexual behaviour changes as these structural changes take place. PMID:26683189

  3. Computational model, method, and system for kinetically-tailoring multi-drug chemotherapy for individuals

    DOEpatents

    Gardner, Shea Nicole (San Leandro, CA)

    2007-10-23

    A method and system for tailoring treatment regimens to individual patients with diseased cells exhibiting evolution of resistance to such treatments. A mathematical model is provided which models rates of population change of proliferating and quiescent diseased cells using cell kinetics and evolution of resistance of the diseased cells, and pharmacokinetic and pharmacodynamic models. Cell kinetic parameters are obtained from an individual patient and applied to the mathematical model to solve for a plurality of treatment regimens, each having a quantitative efficacy value associated therewith. A treatment regimen may then be selected from the plurlaity of treatment options based on the efficacy value.

  4. Optimal Control in Chemotherapy of a Viral Razvan Stefanescu

    E-print Network

    Cao, Yong

    Optimal Control in Chemotherapy of a Viral Infection Razvan S¸tefanescu Department of Mathematics activities of the immune system) and minimizing the sys- temic cost of chemotherapy. We demonstrate to derive an algorithm to approximate the optimal chemotherapy strategy. Conclusive numerical simulations

  5. Preparation of chemotherapy drugs: planning policy for reduced waiting times

    E-print Network

    Boucherie, Richard J.

    Preparation of chemotherapy drugs: planning policy for reduced waiting times I.H.J. Masselink1 , T policies on patient waiting time in the Chemotherapy Day Unit of the Netherland Cancer Institute - Antoni Modelling, Queueing Systems, Pharmacy, Chemotherapy 1 Introduction Netherlands Cancer Institute - Antoni van

  6. Concurrent System Engineering and Risk Reduction for Dual-Band (RF/optical) Spacecraft Communications

    NASA Technical Reports Server (NTRS)

    Fielhauer, Karl, B.; Boone, Bradley, G.; Raible, Daniel, E.

    2012-01-01

    This paper describes a system engineering approach to examining the potential for combining elements of a deep-space RF and optical communications payload, for the purpose of reducing the size, weight and power burden on the spacecraft and the mission. Figures of merit and analytical methodologies are discussed to conduct trade studies, and several potential technology integration strategies are presented. Finally, the NASA Integrated Radio and Optical Communications (iROC) project is described, which directly addresses the combined RF and optical approach.

  7. Adjuvant chemotherapy for early female breast cancer: a systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline

    PubMed Central

    Gandhi, S.; Fletcher, G.G.; Eisen, A.; Mates, M.; Freedman, O.C.; Dent, S.F.; Trudeau, M.E.

    2015-01-01

    Background The Program in Evidence-Based Care (pebc) of Cancer Care Ontario recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer. The evidence for the guideline was compiled using a systematic review to answer the question “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?” The question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and human epidermal growth factor receptor 2 (her2)–directed therapy. Methods For the systematic review, the medline and embase databases were searched for the period January 2008 to May 2014. The Standards and Guidelines Evidence directory of cancer guidelines and the Web sites of major oncology guideline organizations were also searched. The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and results were limited to randomized controlled trials (rcts), guidelines, systematic reviews, and meta-analyses. Results Several hundred documents that met the inclusion criteria were retrieved. The Early Breast Cancer Trialists’ Collaborative Group meta-analyses encompassed many of the rcts found. Several additional studies that met the inclusion criteria were retained, as were other guidelines and systematic reviews. Chemotherapy was reviewed mainly in three classes: anti-metabolite–based regimens (for example, cyclophosphamide–methotrexate–5-fluorouracil), anthracyclines, and taxane-based regimens. In general, single-agent chemotherapy is not recommended for the adjuvant treatment of breast cancer in any patient population. Anthracycline–taxane-based polychemotherapy regimens are, overall, considered superior to earlier-generation regimens and have the most significant impact on patient survival outcomes. Regimens with varying anthracycline and taxane doses and schedules are options; in general, paclitaxel given every 3 weeks is inferior. Evidence does not support the use of bevacizumab in the adjuvant setting; other systemic therapy agents such as metformin and vaccines remain investigatory. Adjuvant bisphosphonates for menopausal women will be discussed in later work. Conclusions The results of this systematic review constitute a comprehensive compilation of the high-level evidence that is the basis for the 2014 pebc guideline on systemic therapy for early breast cancer. Use of cytotoxic chemotherapy is presented here; the results addressing endocrine therapy and her2-targeted treatment, and the final clinical practice recommendations, are published separately in this supplement. PMID:25848343

  8. Long-Term Follow-Up of Dose-Adapted and Reduced-Field Radiotherapy With or Without Chemotherapy for Central Nervous System Germinoma

    SciTech Connect

    Jensen, Ashley W.; Issa Laack, Nadia N.; Buckner, Jan C.; Schomberg, Paula J.; Wetmore, Cynthia J.; Brown, Paul D.

    2010-08-01

    Purpose: To update our institutional experience with neoadjuvant chemotherapy and minimized radiotherapy vs. radiation monotherapy for intracranial germinoma. Methods and Materials: We retrospectively reviewed records of 59 patients with diagnosis of primary intracranial germinoma between 1977 and 2007. Treatment was irradiation alone or neoadjuvant platinum-based chemotherapy and local irradiation (initial tumor plus margin) for patients with localized complete response and reduced-dose craniospinal irradiation for others. Results: For the chemoradiotherapy group (n = 28), median follow-up was 7 years. No patient died. The freedom from progression (FFP) rate was 88% at 5 years and 80% at 10 years. In 4 patients, disease recurred 1.1 to 6.8 years after diagnosis. All were young male patients who received 30.6 Gy to local fields after complete response to chemotherapy. The FFP rate was 88% for local irradiation vs. 100% for more extensive fields (p = .06). For the radiotherapy-alone group (n = 31), median follow-up was 15 years. Overall and disease-free survival rates were 93% and 93% at 5 years and 90% and 87% at 15 years. In 5 patients, disease recurred 1.1 to 4.9 years after diagnosis. Most patients in this group were young men 18 to 23 years of age with suprasellar primary disease treated with about 50 Gy to local fields. The FFP rate was 44% for local irradiation vs. 100% for more extensive fields (p < .01). Conclusions: The addition of neoadjuvant chemotherapy to local-field radiotherapy reduced central nervous system cancer recurrence when high-risk patients were excluded by thorough pretreatment staging. There was trend toward improved central nervous system tumor control when larger fields (whole brain, whole ventricle, or craniospinal axis) were used.

  9. Explicit modeling and concurrent processing in the simulation of multibody dynamic systems

    NASA Technical Reports Server (NTRS)

    Gluck, R.

    1988-01-01

    The objective is to present the activities at TRW in developing the capability to simulate the behavior of large flexible multibody space structures. The features of the simulation tools are: (1) to accommodate all rigid/flexible body degrees-of-freedom which incorporate the control system models and external forces, (2) to provide the flexibility to incorporate engineering-defined models and to retain parameters of significance to the engineer, (3) to reduce the computation cost by one order of magnitude (two orders of magnitude compared to a CRAY 1S), and (4) to keep it versatile so that radical variations in anticipated space structures can be accommodated. The current computer tools to simulate multibody systems appear not only to be very costly and time consuming, but also do not produce the desired fidelity of the mathematical models. In summary, a multibody simulation tool will be developed in the near future which will allow solution of the dynamics and controls of the deployment of the LDR backup structure, or the problem associated with the robotic assembly of the structure. The tools will allow the engineer to define the modeling technique and solve problems in less time and at reduced cost.

  10. CHOD/BVAM Chemotherapy and Whole-Brain Radiotherapy for Newly Diagnosed Primary Central Nervous System Lymphoma

    SciTech Connect

    Laack, Nadia N.; O'Neill, Brian Patrick; Ballman, Karla V.; O'Fallon, Judith Rich; Carrero, Xiomara W.; Kurtin, Paul J.; Scheithauer, Bernd W.; Brown, Paul D.; Habermann, Thomas M.; Colgan, Joseph P.; Gilbert, Mark R.; Hawkins, Roland B.; Morton, Roscoe F.; Windschitl, Harry E.; Fitch, Tom R.; Pajon, Eduardo R.

    2011-10-01

    Purpose: To assess the efficacy and toxicity of chemotherapy consisting of cyclophosphamide, doxorubicin (Adriamycin), vincristine, and dexamethasone (CHOD) plus bis-chloronitrosourea (BCNU), cytosine arabinoside, and methotrexate (BVAM) followed by whole-brain irradiation (WBRT) for patients with primary central nervous system lymphoma (PCNSL). Methods and Materials: Patients 70 years old and younger with newly diagnosed, biopsy-proven PCNSL received one cycle of CHOD followed by two cycles of BVAM. Patients then received WBRT, 30.6 Gy, if a complete response was evoked, or 50.4 Gy if the response was less than complete; both doses were given in 1.8-Gy daily fractions. The primary efficacy endpoint was 1-year survival. Results: Thirty-six patients (19 men, 17 women) enrolled between 1995 and 2000. Median age was 60.5 years (range, 34 to 69 years). Thirty (83%) patients had baseline Eastern Cooperative Oncology Group performance scores of 0 to 1. All 36 patients were eligible for survival and response evaluations. Median time to progression was 12.3 months, and median survival was 18.5 months. The percentages of patients alive at 1, 2, and 3 years were 64%, 36%, and 33%, respectively. The best response was complete response in 10 patients and immediate progression in 7 patients. Ten (28%) patients had at least one grade 3 or higher neurologic toxicity. Conclusions: This regimen did improve the survival of PCNSL patients but also caused substantial toxicity. The improvement in survival is less than that reported with high-dose methotrexate-based therapies.

  11. Bilateral isolated concurrent superior ophthalmic vein thrombosis in systemic lupus erythematosus

    PubMed Central

    Sambhav, Kumar; Shakir, Omar; Chalam, Kakarla V

    2015-01-01

    We describe a case of bilateral consecutive superior ophthalmic vein thrombosis as a presenting feature in a patient previously not known to have systemic lupus erythematosus (SLE). A 68-year-old African–American female presented with decreased vision in right eye, mild right orbital tenderness, and frontotemporal headache of 3 days duration. MRI of the orbits confirmed thrombosis of the right superior ophthalmic vein without extension into the cavernous sinus. Sequential MRI at 1 month showed interval improvement of the right superior ophthalmic vein thrombosis and a new thrombosis in the left superior ophthalmic vein. Renal biopsy revealed granular membranous and mesangial deposits of IgG, IgA, IgM, C3, and C1q and confirmed the diagnosis of SLE. PMID:26392788

  12. Bufalin loaded biotinylated chitosan nanoparticles: an efficient drug delivery system for targeted chemotherapy against breast carcinoma.

    PubMed

    Tian, Xin; Yin, Hongzhuan; Zhang, Shichen; Luo, Ying; Xu, Kai; Ma, Ping; Sui, Chengguang; Meng, Fandong; Liu, Yunpeng; Jiang, Youhong; Fang, Jun

    2014-08-01

    Bufalin is a traditional oriental medicine which is known to induce apoptosis in many tumor cells, and it is thus considered as a new anticancer therapeutic. By now, most of the studies of bufalin are in vitro, however in vivo evaluations of its therapeutic efficacy are less and are in great demand for its development toward anticancer drug. One of the problems probably hampering the development of bufalin is the lack of tumor selectivity, which may reduce the therapeutic effect as well as showing side effects. To overcome this drawback, in this study, we designed a tumor-targeted drug delivery system of bufalin based on enhanced permeability and retention (EPR) effect, by using biotinylated chitosan, resulting in bufalin encapsulating nanoparticles (Bu-BCS-NPs) with mean hydrodynamic size of 171.6 nm, as evidenced by dynamic light scattering and transmission electron microscope. Bu-BCS-NPs showed a relative slow and almost linear release of bufalin, and about 36.8% of bufalin was released in 24 h when dissolved in sodium phosphate buffer. Compared to native bufalin, Bu-BCS-NPs exhibited a stronger cytotoxicity against breast cancer MCF-7 cells (IC50 of 0.582 ?g/ml vs 1.896 ?g/ml of native bufalin). Similar results were also obtained in intracellular reactive oxygen species production, apoptosis induction, and decrease in mitochondria membrane potential. These results may contribute to the rapid intracellular uptake of nanoparticles, partly benefiting from the highly expressed biotin receptors in tumor cells. In vivo studies using MCF-7 tumor models in nude mice confirmed the remarkable therapeutic effect of Bu-BCS-NPs. These findings suggest the potential of Bu-BCS-NPs as an anticancer drug with tumor targeting property. PMID:24846793

  13. Measuring and modelling concurrency

    PubMed Central

    Sawers, Larry

    2013-01-01

    This article explores three critical topics discussed in the recent debate over concurrency (overlapping sexual partnerships): measurement of the prevalence of concurrency, mathematical modelling of concurrency and HIV epidemic dynamics, and measuring the correlation between HIV and concurrency. The focus of the article is the concurrency hypothesis – the proposition that presumed high prevalence of concurrency explains sub-Saharan Africa's exceptionally high HIV prevalence. Recent surveys using improved questionnaire design show reported concurrency ranging from 0.8% to 7.6% in the region. Even after adjusting for plausible levels of reporting errors, appropriately parameterized sexual network models of HIV epidemics do not generate sustainable epidemic trajectories (avoid epidemic extinction) at levels of concurrency found in recent surveys in sub-Saharan Africa. Efforts to support the concurrency hypothesis with a statistical correlation between HIV incidence and concurrency prevalence are not yet successful. Two decades of efforts to find evidence in support of the concurrency hypothesis have failed to build a convincing case. PMID:23406964

  14. High Incidences of Invasive Fungal Infections in Acute Myeloid Leukemia Patients Receiving Induction Chemotherapy without Systemic Antifungal Prophylaxis: A Prospective Observational Study in Taiwan

    PubMed Central

    Kung, Hsiang-Chi; Yao, Ming; Wu, Un-In; Hsu, Szu-Chun; Lin, Chien-Ting; Li, Chi-Cheng; Wu, Shang-Ju; Hou, Hsin-An; Chou, Wen-Chien; Huang, Shang-Yi; Tsay, Woei; Chen, Yao-Chang; Chen, Yee-Chun; Chang, Shan-Chwen; Ko, Bor-Sheng; Tien, Hwei-Fang

    2015-01-01

    Invasive fungal infections (IFIs) is an important complication for acute myeloid leukemia (AML) patients receiving induction chemotherapy. However, the epidemiological information is not clear in Southeastern Asia, an area of potential high incidences of IFIs. To clarify it, we enrolled 298 non-M3 adult AML patients receiving induction chemotherapy without systemic anti-fungal prophylaxis from Jan 2004 to Dec 2009, when we applied a prospective diagnostic and treatment algorithm for IFIs. Their demographic parameters, IFI characters, and treatment outcome were collected for analysis. The median age of these patients was 51 years. Standard induction chemotherapy was used for 246 (82.6%) patients, and 66.8% of patients achieved complete remission (CR) or partial remission. The incidence of all-category IFIs was 34.6% (5.7% proven IFIs, 5.0% probable IFIs and 23.8% possible IFIs). Candida tropicalis was the leading pathogen among yeast, and lower respiratory tract was the most common site for IFIs (75.4%, 80/106). Standard induction chemotherapy and failure to CR were identified as risk factors for IFIs. The presence of IFI in induction independently predicted worse survival (hazard ratio 1.536 (1.100–2.141), p value = 0.012). Even in those who survived from the initial IFI insults after 3 months, the presence of IFIs in induction still predicted a poor long-term survival. This study confirms high incidences of IFIs in Southeastern Asia, and illustrates potential risk factors; poor short-term and long-term outcomes are also demonstrated. This epidemiological information will provide useful perspectives for anti-fungal prophylaxis and treatment for AML patients during induction, so that best chances of cure and survival can be provided. PMID:26061179

  15. Optimization of Concurrent Deployments of the Juvenile Salmon Acoustic Telemetry System and Other Hydroacoustic Equipment at John Day Dam

    SciTech Connect

    Ploskey, Gene R.; Hughes, James S.; Khan, Fenton; Kim, Jina; Lamarche, Brian L.; Johnson, Gary E.; Choi, Eric Y.; Faber, Derrek M.; Wilberding, Matthew C.; Deng, Zhiqun; Weiland, Mark A.; Zimmerman, Shon A.; Fischer, Eric S.; Cushing, Aaron W.

    2008-09-01

    The purpose of this report is to document the results of the acoustic optimization study conducted at John Day Dam during January and February 2008. The goal of the study was to optimize performance of the Juvenile Salmon Acoustic Telemetry System (JSATS) by determining deployment and data acquisition methods to minimize electrical and acoustic interference from various other acoustic sampling devices. Thereby, this would allow concurrent sampling by active and passive acoustic methods during the formal evaluations of the prototype surface flow outlets at the dam during spring and summer outmigration seasons for juvenile salmonids. The objectives for the optimization study at John Day Dam were to: 1. Design and test prototypes and provide a total needs list of pipes and trolleys to deploy JSATS hydrophones on the forebay face of the powerhouse and spillway. 2. Assess the effect on mean percentage decoded of JSATS transmissions from tags arrayed in the forebay and detected on the hydrophones by comparing: turbine unit OFF vs. ON; spill bay OPEN vs. CLOSED; dual frequency identification sonar (DIDSON) and acoustic Doppler current profiler (ADCP) both OFF vs. ON at a spill bay; and, fixed-aspect hydroacoustic system OFF vs. ON at a turbine unit and a spill bay. 3. Determine the relationship between fixed-aspect hydroacoustic transmit level and mean percentage of JSATS transmissions decoded. The general approach was to use hydrophones to listen for transmissions from JSATS tags deployed in vertical arrays in a series perpendicular to the face of the dam. We used acoustic telemetry equipment manufactured by Technologic and Sonic Concepts. In addition, we assessed old and new JSATS signal detectors and decoders and two different types of hydrophone baffling. The optimization study consisted of a suite of off/on tests. The primary response variable was mean percentage of tag transmissions decoded. We found that there was no appreciable adverse effect on mean percentage decoded for JSATS transmitters from: turbine operations; spillway operations; DIDSON/ADCP acoustic energy; and PAS hydroacoustic systems at transmit level of -12 dB, although there was a significant impact at all higher transmit levels (-11 to -6 dB). The main conclusion from this optimization study is that valid JSATS telemetry data can be collected simultaneously with a DIDSON/ADCP and a PAS hydroacoustic system at transmit level -12 dB. Multiple evaluation tools should be considered to increase the robustness and thoroughness of future fish passage evaluations at John Day and other dams.

  16. Photoswitchable nanoparticles for in vivo cancer chemotherapy

    E-print Network

    Tong, Rong

    There are many obstacles to effective cancer chemotherapy, including drug penetration and accumulation in tumors and drug systemic toxicity. The penetration of therapies into tumors is limited by the dense tumor matrix and ...

  17. Chemotherapy for Soft Tissue Sarcomas

    MedlinePLUS

    ... Chemotherapy for soft tissue sarcomas Targeted therapy for soft tissue sarcoma Clinical trials for soft tissue sarcomas Complementary and ... soft tissue sarcomas Next Topic Targeted therapy for soft tissue sarcoma Chemotherapy for soft tissue sarcomas Chemotherapy (chemo) is ...

  18. An Automated System for Detecting Nonadherence in Laboratory Testing and Monitoring for Myelosuppression in Patients Receiving Self-Administered Oral Chemotherapy

    PubMed Central

    Morrell, Robert M.; Tooze, Janet A.; Harmon, Michele S.; Carter, Annette F.; DeTroye, Alisha T.; Lesser, Glenn J.

    2013-01-01

    Introduction: Patient compliance with routine monitoring for self-administered chemotherapy is problematic. We sought to assess monitoring lapses and incidents of myelosuppression in patients undergoing self-administered chemotherapy for glioblastoma, as well as test software designed to detect and alert clinicians to lapses in monitoring. Patients and Methods: A retrospective analysis was conducted to identify patients (N = 117) who received standard oral temozolomide for glioblastoma at our institution from 2003 to 2010. Gaps in monitoring were classified as minor (10 to 12 days) or major (13 to 28 days), and adverse events were graded using standard criteria. During the prospective portion of the study, we tested a software-based system that alerted clinicians of monitoring lapses and adverse events among patients receiving self-administered temozolomide for glioblastoma (n = 37). Results: Our retrospective review found that 34 of 117 patients experienced monitoring gaps during treatment. No association between gaps and risk of myelosuppression were found. Patients with gaps were more likely to be male (P = .04). Patients monitored prospectively with the software experienced no major gaps in monitoring (P = .007 compared with retrospective patients). Conclusion: Our retrospective review demonstrated that monitoring nonadherence was occurring at a substantial rate. Our computerized system eliminated major gaps in monitoring in the prospective portion of our study. Although there is no association between monitoring gaps and the occurrence of adverse events, when they do coincide, continuing oral chemotherapy during an unrecognized adverse event may worsen the patient's condition. Automated systems are justified and serve a function not currently being addressed. PMID:23943891

  19. Concurrent engineering research center

    NASA Technical Reports Server (NTRS)

    Callahan, John R.

    1995-01-01

    The projects undertaken by The Concurrent Engineering Research Center (CERC) at West Virginia University are reported and summarized. CERC's participation in the Department of Defense's Defense Advanced Research Project relating to technology needed to improve the product development process is described, particularly in the area of advanced weapon systems. The efforts committed to improving collaboration among the diverse and distributed health care providers are reported, along with the research activities for NASA in Independent Software Verification and Validation. CERC also takes part in the electronic respirator certification initiated by The National Institute for Occupational Safety and Health, as well as in the efforts to find a solution to the problem of producing environment-friendly end-products for product developers worldwide. The 3M Fiber Metal Matrix Composite Model Factory Program is discussed. CERC technologies, facilities,and personnel-related issues are described, along with its library and technical services and recent publications.

  20. Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT1A receptors without diminishing nervous system function or chemotherapy efficacy

    PubMed Central

    Ward, Sara Jane; McAllister, Sean D; Kawamura, Rumi; Murase, Ryuchi; Neelakantan, Harshini; Walker, Ellen A

    2014-01-01

    Background and Purpose Paclitaxel (PAC) is associated with chemotherapy-induced neuropathic pain (CIPN) that can lead to the cessation of treatment in cancer patients even in the absence of alternate therapies. We previously reported that chronic administration of the non-psychoactive cannabinoid cannabidiol (CBD) prevents PAC-induced mechanical and thermal sensitivity in mice. Hence, we sought to determine receptor mechanisms by which CBD inhibits CIPN and whether CBD negatively effects nervous system function or chemotherapy efficacy. Experimental Approach The ability of acute CBD pretreatment to prevent PAC-induced mechanical sensitivity was assessed, as was the effect of CBD on place conditioning and on an operant-conditioned learning and memory task. The potential interaction of CBD and PAC on breast cancer cell viability was determined using the MTT assay. Key Results PAC-induced mechanical sensitivity was prevented by administration of CBD (2.5 – 10?mg·kg?1) in female C57Bl/6 mice. This effect was reversed by co-administration of the 5-HT1A antagonist WAY 100635, but not the CB1 antagonist SR141716 or the CB2 antagonist SR144528. CBD produced no conditioned rewarding effects and did not affect conditioned learning and memory. Also, CBD + PAC combinations produce additive to synergistic inhibition of breast cancer cell viability. Conclusions and Implications Our data suggest that CBD is protective against PAC-induced neurotoxicity mediated in part by the 5-HT1A receptor system. Furthermore, CBD treatment was devoid of conditioned rewarding effects or cognitive impairment and did not attenuate PAC-induced inhibition of breast cancer cell viability. Hence, adjunct treatment with CBD during PAC chemotherapy may be safe and effective in the prevention or attenuation of CIPN. PMID:24117398

  1. Concurrent Software Engineering Project

    ERIC Educational Resources Information Center

    Stankovic, Nenad; Tillo, Tammam

    2009-01-01

    Concurrent engineering or overlapping activities is a business strategy for schedule compression on large development projects. Design parameters and tasks from every aspect of a product's development process and their interdependencies are overlapped and worked on in parallel. Concurrent engineering suffers from negative effects such as excessive…

  2. Consolidation Radiotherapy in Primary Central Nervous System Lymphomas: Impact on Outcome of Different Fields and Doses in Patients in Complete Remission After Upfront Chemotherapy

    SciTech Connect

    Ferreri, Andres Jose Maria; Verona, Chiara; Politi, Letterio Salvatore; Chiara, Anna; Perna, Lucia; Villa, Eugenio; Reni, Michele

    2011-05-01

    Purpose: Avoidance radiotherapy or reduction of irradiation doses in patients with primary central nervous system lymphoma (PCNSL) in complete remission (CR) after high-dose methotrexate (HD-MTX)-based chemotherapy has been proposed to minimize the neurotoxicity risk. Nevertheless, no study has focused on the survival impact of radiation parameters, as far as we know, and the optimal radiation schedule remains to be defined. Methods and Materials: The impact on outcome and neurologic performance of different radiation fields and doses was assessed in 33 patients with PCNSL who achieved CR after MTX-containing chemotherapy and were referred to consolidation whole-brain irradiation (WBRT). Patterns of relapse were analyzed on computed tomography-guided treatment planning, and neurologic impairment was assessed by the Mini Mental Status Examination. Results: At a median follow-up of 50 months, 21 patients are relapse-free (5-year failure-free survival [FFS], 51%). WBRT doses {>=}40 Gy were not associated with improved disease control in comparison with a WBRT dose of 30 to 36 Gy (relapse rate, 46% vs. 30%; 5-year FFS, 51% vs. 50%; p = 0.26). Disease control was not significantly different between patients irradiated to the tumor bed with 45 to 54 Gy or with 36 to 44 Gy, with a 5-year FFS of 35% and 44% (p = 0.43), respectively. Twenty patients are alive (5-year overall survival, 54%); WB and tumor bed doses did not have an impact on survival. Impairment as assessed by the Mini Mental Status Examination was significantly more common in patients treated with a WBRT dose {>=}40 Gy. Conclusion: Consolidation with WBRT 36 Gy is advisable in patients with PCNSL in CR after HD-MTX-based chemotherapy. Higher doses do not change the outcome and could increase the risk of neurotoxicity.

  3. Role of systemic chemotherapy in the management of resected or resectable colorectal liver metastases: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Ciliberto, Domenico; Prati, Ubaldo; Roveda, Laura; Barbieri, Vito; Staropoli, Nicoletta; Abbruzzese, Alberto; Caraglia, Michele; Di Maio, Massimo; Flotta, Domenico; Tassone, Pierfrancesco; Tagliaferri, Pierosandro

    2012-06-01

    Liver metastases are a common event in patients with colorectal cancer. Surgical resection, if feasible, produces a survival benefit. We performed a systematic review of randomized clinical trials (RCT) and meta-analysis to address the question if current available studies support the use of systemic chemotherapy as an adjunct to surgery in resected/resectable patients. The search was based on major databases (Pubmed, CancerLit, Embase, Medscape and Cochrane) of published literature and selecting abstracts from major cancer meetings. We performed a literature for the January 1982-May 2010 time frame. The hazard ratios (HRs), with confidence intervals, as presented in retrieved studies, referred to the disease- and/or progression-free (DFS and/or PFS) and overall survival (OS) were extracted. The meta-analysis was carried out by the fixed-effect and the random-effects model. Three studies randomizing combined treatment vs. surgery alone for a total of 666 patients (642 evaluable for survival analysis) were selected and included in the final analysis. Evidence for chemotherapy-induced benefit in terms of both DFS (pooled HR, 0.71; CI, 0.582-0.878; p=0.001) and PFS (pooled HR, 0.75; CI, 0.620-0.910; p=0.003) was demonstrated. However, our meta-analysis failed to demonstrate a significant advantage of combined treatment in terms of OS (pooled HR, 0.743; CI, 0.527-1.045; p=0.088). Chemotherapy combined with surgical resection of colorectal liver metastases improves DFS and PFS whereas the benefit in OS is not demonstrated on the basis of the available results of RCTs. New prospective trials in the era of targeted therapy are eagerly awaited on this specific topic. PMID:22446591

  4. Testing of concurrent programs and partial specifications

    SciTech Connect

    Hamlet, D.

    1982-12-01

    The testing problems of concurrent systems include those of sequential programs, but there are two additional difficulties: the scheduling of tasks may alter the behavior, making tests misleading; testing may be conducted at an early stage of development, by users who are not software experts. Concurrent process systems can be modeled by a collection of finite-state transducers, in a way that displays their unique problems. The specification languages PAISLey and Gist approach the definition of concurrent systems differently, but both permit users to execute partially defined systems. The declarative language PROLOG, although not explicitly designed for concurrent programming, exhibits similar characteristics. Prototype execution has some unexpected implications for testing, and for final implementation.

  5. Side Effects of Chemotherapy

    MedlinePLUS

    ... PCF Spotlight Glossary African American Men Living with Prostate Cancer Side Effects of Chemotherapy Side Effects Urinary Dysfunction ... side effects of docetaxel as used to treat prostate cancer are VERY different and less severe than the ...

  6. Chemotherapy (For Parents)

    MedlinePLUS

    ... growth. Chemotherapy works by disrupting cell division and killing actively dividing cancer cells. In contrast to radiation ... About a Kid With Cancer Cancer: Parents Talk (Video) Immunotherapy Nutritional Needs for Kids With Cancer Cancer ...

  7. Chemotherapy induced peripheral neuropathic pain.

    PubMed

    Park, Hue Jung

    2014-07-01

    Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most serious complications associated with anticancer drugs. CIPN leads to a lower quality of life and dysfunction of the sensory, motor, and autonomic systems, and often causes patients to discontinue chemotherapy. It is usually misdiagnosed and undertreated due to a lack of consensus and unclear pathophysiology, for which many mechanisms have been suggested, including mitochondrial dysfunction, various pain mediators, abnormal spontaneous discharge in A and C fibers, and others. To date, no agents have been shown to effectively prevent CIPN, leading to debate as to the standard protocol. Duloxetine has demonstrated a moderate therapeutic effect against CIPN. Although tricyclic antidepressants (such as nortriptyline or desipramine), gabapentin, and a topical gel containing baclofen (10 mg), amitriptyline HCL (40 mg), and ketamine (20 mg) showed inconclusive results in CIPN trials, these agents are currently considered the best options for CIPN treatment. Therefore, further studies on the pathophysiology and treatment of CIPN are needed. PMID:25097731

  8. Chemotherapy for Melanoma.

    PubMed

    Wilson, Melissa A; Schuchter, Lynn M

    2016-01-01

    Prior to the recent therapeutic advances, chemotherapy was the mainstay of treatment options for advanced-stage melanoma. A number of studies have investigated various chemotherapy combinations in order to expand on the clinical responses achieved with single-agent dacarbazine, but these have not demonstrated an improvement in overall survival. Similar objective responses were observed with the combination of carboplatin and paclitaxel as were seen with single-agent dacarbazine. The combination of chemotherapy and immunotherapy, known as biochemotherapy, has shown high clinical responses; however, biochemotherapy has not been shown to improve overall survival and resulted in increased toxicities. In contrast, palliation and long-term responses have been observed with localized treatment with isolated limb perfusion or infusion in limb-isolated disease. Although new, improved therapeutic options exist for first-line management of advanced-stage melanoma, chemotherapy may still be important in the palliative treatment of refractory, progressive, and relapsed melanoma. We review the various chemotherapy options available for use in the treatment and palliation of advanced-stage melanoma, discuss the important clinical trials supporting the treatment recommendations, and focus on the clinical circumstances in which treatment with chemotherapy is useful. PMID:26601864

  9. An Immune-Modulating Diet in Combination with Chemotherapy Prevents Cancer Cachexia by Attenuating Systemic Inflammation in Colon 26 Tumor-Bearing Mice.

    PubMed

    Nakamura, Kentaro; Sasayama, Akina; Takahashi, Takeshi; Yamaji, Taketo

    2015-01-01

    Cancer cachexia is characterized by muscle wasting caused partly by systemic inflammation. We previously demonstrated an immune-modulating diet (IMD), an enteral diet enriched with immunonutrition and whey-hydrolyzed peptides, to have antiinflammatory effects in some experimental models. Here, we investigated whether the IMD in combination with chemotherapy could prevent cancer cachexia in colon 26 tumor-bearing mice. Forty tumor-bearing mice were randomized into 5 groups: tumor-bearing control (TB), low dose 5-fluorouracil (5-FU) and standard diet (LF/ST), low dose 5-FU and IMD (LF/IMD), high dose 5-FU and standard diet (HF/ST) and high dose 5-FU and IMD (HF/IMD). The ST and IMD mice received a standard diet or the IMD ad libitum for 21 days. Muscle mass in the IMD mice was significantly higher than that in the ST mice. The LF/IMD in addition to the HF/ST and HF/IMD mice preserved their body and carcass weights. Plasma prostaglandin E2 levels were significantly lower in the IMD mice than in the ST mice. A combined effect was also observed in plasma interleukin-6, glucose, and vascular endothelial growth factor levels. Tumor weight was not affected by different diets. In conclusion, the IMD in combination with chemotherapy prevented cancer cachexia without suppressing chemotherapeutic efficacy. PMID:26133950

  10. Testing Concurrent Software

    NASA Astrophysics Data System (ADS)

    Ur, Shmuel

    This short two hour tutorial tries to teach practical techniques for testing, review and debugging of concurrent software, based on the Dr. Ur's research and practical industrial experience in the last ten years.

  11. Inhaled chemotherapy in lung cancer: future concept of nanomedicine

    PubMed Central

    Zarogoulidis, Paul; Chatzaki, Ekaterini; Porpodis, Konstantinos; Domvri, Kalliopi; Hohenforst-Schmidt, Wolfgang; Goldberg, Eugene P; Karamanos, Nikos; Zarogoulidis, Konstantinos

    2012-01-01

    Regional chemotherapy was first used for lung cancer 30 years ago. Since then, new methods of drug delivery and pharmaceuticals have been investigated in vitro, and in animals and humans. An extensive review of drug delivery systems, pharmaceuticals, patient monitoring, methods of enhancing inhaled drug deposition, safety and efficacy, and also additional applications of inhaled chemotherapy and its advantages and disadvantages are presented. Regional chemotherapy to the lung parenchyma for lung cancer is feasible and efficient. Safety depends on the chemotherapy agent delivered to the lungs and is dose-dependent and time-dependent. Further evaluation is needed to provide data regarding early lung cancer stages, and whether regional chemotherapy can be used as neoadjuvant or adjuvant treatment. Finally, inhaled chemotherapy could one day be administered at home with fewer systemic adverse effects. PMID:22619512

  12. C formal verification with unix communication and concurrency

    NASA Technical Reports Server (NTRS)

    Hoover, Doug N.

    1990-01-01

    The results of a NASA SBIR project are presented in which CSP-Ariel, a verification system for C programs which use Unix system calls for concurrent programming, interprocess communication, and file input and output, was developed. This project builds on ORA's Ariel C verification system by using the system of Hoare's book, Communicating Sequential Processes, to model concurrency and communication. The system runs in ORA's Clio theorem proving environment. The use of CSP to model Unix concurrency and sketch the CSP semantics of a simple concurrent program is outlined. Plans for further development of CSP-Ariel are discussed. This paper is presented in viewgraph form.

  13. BOISE STATE UNIVERSITY CONCURRENT ENROLLMENT

    E-print Network

    Barrash, Warren

    BOISE STATE UNIVERSITY CONCURRENT ENROLLMENT STUDENT HANDBOOK 2015-2016 Providing University on Facebook! Search for Boise State Concurrent Enrollment. R Welcome to Concurrent Enrollment Introduction Free Tutorial Services 2 myBoiseState Account and Email 3 R Credits for Concurrent Enrollment Credits 3

  14. A measurement-based study of concurrency in a multiprocessor

    NASA Technical Reports Server (NTRS)

    Mcguire, Patrick John

    1987-01-01

    A systematic measurement-based methodology for characterizing the amount of concurrency present in a workload, and the effect of concurrency on system performance indices such as cache miss rate and bus activity are developed. Hardware and software instrumentation of an Alliant FX/8 was used to obtain data from a real workload environment. Results show that 35% of the workload is concurrent, with the concurrent periods typically using all available processors. Measurements of periods of change in concurrency show uneven usage of processors during these times. Other system measures, including cache miss rate and processor bus activity, are analyzed with respect to the concurrency measures. Probability of a cache miss is seen to increase with concurrency. The change in cache miss rate is much more sensitive to the fraction of concurrent code in the worklaod than the number of processors active during concurrency. Regression models are developed to quantify the relationships between cache miss rate, bus activity, and the concurrency measures. The model for cache miss rate predicts an increase in the median miss rate value as much as 300% for a 100% increase in concurrency in the workload.

  15. A Unified Geometric Framework for Kinematics, Dynamics and Concurrent Control of Free-Base, Open-Chain Multi-Body Systems with Holonomic and Nonholonomic Constraints

    NASA Astrophysics Data System (ADS)

    Chhabra, Robin

    This thesis presents a geometric approach to studying kinematics, dynamics and controls of open-chain multi-body systems with non-zero momentum and multi-degree-of-freedom joints subject to holonomic and nonholonomic constraints. Some examples of such systems appear in space robotics, where mobile and free-base manipulators are developed. The proposed approach introduces a unified framework for considering holonomic and nonholonomic, multi-degree-of-freedom joints through: (i) generalization of the product of exponentials formula for kinematics, and (ii) aggregation of the dynamical reduction theories, using differential geometry. Further, this framework paves the ground for the input-output linearization and controller design for concurrent trajectory tracking of base-manipulator(s). In terms of kinematics, displacement subgroups are introduced, whose relative configuration manifolds are Lie groups and they are parametrized using the exponential map. Consequently, the product of exponentials formula for forward and differential kinematics is generalized to include multi-degree-of-freedom joints and nonholonomic constraints in open-chain multi-body systems. As for dynamics, it is observed that the action of the relative configuration manifold corresponding to the first joint of an open-chain multi-body system leaves Hamilton's equation invariant. Using the symplectic reduction theorem, the dynamical equations of such systems with constant momentum (not necessarily zero) are formulated in the reduced phase space, which present the system dynamics based on the internal parameters of the system. In the nonholonomic case, a three-step reduction process is presented for nonholonomic Hamiltonian mechanical systems. The Chaplygin reduction theorem eliminates the nonholonomic constraints in the first step, and an almost symplectic reduction procedure in the unconstrained phase space further reduces the dynamical equations. Consequently, the proposed approach is used to reduce the dynamical equations of nonholonomic open-chain multi-body systems. Regarding the controls, it is shown that a generic free-base, holonomic or nonholonomic open-chain multi-body system is input-output linearizable in the reduced phase space. As a result, a feed-forward servo control law is proposed to concurrently control the base and the extremities of such systems. It is shown that the closed-loop system is exponentially stable, using a proper Lyapunov function. In each chapter of the thesis, the developed concepts are illustrated through various case studies.

  16. Managing Chemotherapy Side Effects: Pain

    MedlinePLUS

    ... anD human services national institutes of health Managing Chemotherapy Side Effects Pain “I was worried about getting ... need help to pay for pain medicine. Managing Chemotherapy Side Effects: Pain Keep track of the pain. ...

  17. Treatment of Children With Central Nervous System Primitive Neuroectodermal Tumors/Pinealoblastomas in the Prospective Multicentric Trial HIT 2000 Using Hyperfractionated Radiation Therapy Followed by Maintenance Chemotherapy

    SciTech Connect

    Gerber, Nicolas U.; Hoff, Katja von; Resch, Anika; Ottensmeier, Holger; Kwiecien, Robert; Faldum, Andreas; Matuschek, Christiane; Hornung, Dagmar; Bremer, Michael; Benesch, Martin; Pietsch, Torsten; Warmuth-Metz, Monika; Kuehl, Joachim; Rutkowski, Stefan; Kortmann, Rolf D.

    2014-07-15

    Purpose: The prognosis for children with central nervous system primitive neuroectodermal tumor (CNS-PNET) or pinealoblastoma is still unsatisfactory. Here we report the results of patients between 4 and 21 years of age with nonmetastatic CNS-PNET or pinealoblastoma diagnosed from January 2001 to December 2005 and treated in the prospective GPOH-trial P-HIT 2000-AB4. Methods and Materials: After surgery, children received hyperfractionated radiation therapy (36 Gy to the craniospinal axis, 68 Gy to the tumor region, and 72 Gy to any residual tumor, fractionated at 2 × 1 Gy per day 5 days per week) accompanied by weekly intravenous administration of vincristine and followed by 8 cycles of maintenance chemotherapy (lomustine, cisplatin, and vincristine). Results: Twenty-six patients (15 with CNS-PNET; 11 with pinealoblastoma) were included. Median age at diagnosis was 11.5 years old (range, 4.0-20.7 years). Gross total tumor resection was achieved in 6 and partial resection in 16 patients (indistinct, 4 patients). Median follow-up of the 15 surviving patients was 7.0 years (range, 5.2-10.0 years). The combined response rate to postoperative therapy was 17 of 20 (85%). Eleven of 26 patients (42%; 7 of 15 with CNS-PNET; 4 of 11 with pinealoblastoma) showed tumor progression or relapse at a median time of 1.3 years (range, 0.5-1.9 years). Five-year progression-free and overall survival rates (±standard error [SE]) were each 58% (±10%) for the entire cohort: CNS-PNET was 53% (±13); pinealoblastoma was 64% (±15%; P=.524 and P=.627, respectively). Conclusions: Postoperative hyperfractionated radiation therapy with local dose escalation followed by maintenance chemotherapy was feasible without major acute toxicity. Survival rates are comparable to those of a few other recent studies but superior to those of most other series, including the previous trial, HIT 1991.

  18. DREAMS and IMAGE: A Model and Computer Implementation for Concurrent, Life-Cycle Design of Complex Systems

    NASA Technical Reports Server (NTRS)

    Hale, Mark A.; Craig, James I.; Mistree, Farrokh; Schrage, Daniel P.

    1995-01-01

    Computing architectures are being assembled that extend concurrent engineering practices by providing more efficient execution and collaboration on distributed, heterogeneous computing networks. Built on the successes of initial architectures, requirements for a next-generation design computing infrastructure can be developed. These requirements concentrate on those needed by a designer in decision-making processes from product conception to recycling and can be categorized in two areas: design process and design information management. A designer both designs and executes design processes throughout design time to achieve better product and process capabilities while expanding fewer resources. In order to accomplish this, information, or more appropriately design knowledge, needs to be adequately managed during product and process decomposition as well as recomposition. A foundation has been laid that captures these requirements in a design architecture called DREAMS (Developing Robust Engineering Analysis Models and Specifications). In addition, a computing infrastructure, called IMAGE (Intelligent Multidisciplinary Aircraft Generation Environment), is being developed that satisfies design requirements defined in DREAMS and incorporates enabling computational technologies.

  19. Chemotherapy in Elderly Patients with Gastric Cancer

    PubMed Central

    Kim, Hyeong Su; Kim, Jung Han; Kim, Ji Won; Kim, Byung Chun

    2016-01-01

    Gastric cancer (GC) is one of the most frequent malignant diseases in the elderly. Systemic chemotherapy showed an improvement of quality of life and survival benefit compared to supportive care alone in patients with advanced GC. Because comorbidities or age-related changes in pharmacokinetics and pharmacodynamics may lead to higher toxicity, however, many oncologists hesitate to recommend elderly patients to receive chemotherapy. Available data suggest that elderly patients with GC are able to tolerate and benefit from systemic chemotherapy to the same extent as younger patients. The age alone should not be the only criteria to preclude effective chemotherapy. However, proper patient selection is extremely important to deliver effective treatment safely. A comprehensive geriatric assessment (CGA) is a useful method to assess life expectancy and risk of morbidity in older patients and to guide providing optimal treatment. Treatment should be personalized based on the nature of the disease, the life expectancy, the risk of complication, and the patient's preference. Combination chemotherapy can be considered for older patients with metastatic GC who are classified as non-frail patients by CGA. For frail or vulnerable patients, however, monotherapy or only symptomatic treatment may be desirable. Targeted agents seem to be promising treatment options for elderly patients with GC considering their better efficacy and less toxicity. PMID:26722364

  20. Chemotherapy, cognitive impairment and hippocampal toxicity.

    PubMed

    Dietrich, J; Prust, M; Kaiser, J

    2015-11-19

    Cancer therapies can be associated with significant central nervous system (CNS) toxicity. While radiation-induced brain damage has been long recognized both in pediatric and adult cancer patients, CNS toxicity from chemotherapy has only recently been acknowledged. Clinical studies suggest that the most frequent neurotoxic adverse effects associated with chemotherapy include memory and learning deficits, alterations of attention, concentration, processing speed and executive function. Preclinical studies have started to shed light on how chemotherapy targets the CNS both on cellular and molecular levels to disrupt neural function and brain plasticity. Potential mechanisms include direct cellular toxicity, alterations in cellular metabolism, oxidative stress, and induction of pro-inflammatory processes with subsequent disruption of normal cellular and neurological function. Damage to neural progenitor cell populations within germinal zones of the adult CNS has been identified as one of the key mechanisms by which chemotherapy might exert long-lasting and progressive neurotoxic effects. Based on the important role of the hippocampus for maintenance of brain plasticity throughout life, several experimental studies have focused on the study of chemotherapy effects on hippocampal neurogenesis and associated learning and memory. An increasing body of literature from both animal studies and neuroimaging studies in cancer patients suggests a possible relationship between chemotherapy induced hippocampal damage and the spectrum of neurocognitive deficits and mood alterations observed in cancer patients. This review aims to briefly summarize current preclinical and neuroimaging studies that are providing a potential link between the neurotoxic effects of chemotherapy and hippocampal dysfunction, highlighting challenges and future directions in this field of investigation. PMID:26086545

  1. Refactoring Sequential Java Code for Concurrency via Concurrent Libraries

    E-print Network

    Ernst, Michael D.

    2008-09-30

    Parallelizing existing sequential programs to run efficiently on multicores is hard. The Java 5 packagejava.util.concurrent (j.u.c.) supports writing concurrent programs: much of the complexity of writing threads-safe and ...

  2. Comparison of Pathologic Response Evaluation Systems after Anthracycline with/without Taxane-Based Neoadjuvant Chemotherapy among Different Subtypes of Breast Cancers

    PubMed Central

    Song, In Hye; Kim, Sung-Bae; Jung, Kyung Hae; Ahn, Jin-Hee; Ahn, Sei-Hyun; Kim, Hak Hee; Gong, Gyungyub

    2015-01-01

    Purpose Several methods are used to assess the pathologic response of breast cancer after neoadjuvant chemotherapy (NAC) to predict clinical outcome. However, the clinical utility of these systems for each molecular subtype of breast cancer is unclear. Therefore, we applied six pathologic response assessment systems to specific subtypes of breast cancer and compared the results. Patients and Methods Five hundred and eighty eight breast cancer patients treated with anthracycline with/without taxane-based NAC were retrospectively analyzed, and the ypTNM stage, residual cancer burden (RCB), residual disease in breast and nodes (RDBN), tumor response ratio, Sataloff’s classification, and Miller—Payne grading system were evaluated. The results obtained for each assessment system were analyzed in terms of patient survival. Results In triple-negative tumors, all systems were significantly associated with disease-free survival and Kaplan-Meier survival curves for disease-free survival were clearly separated by all assessment methods. For HR+/HER2- tumors, systems assessing the residual tumor (ypTNM stage, RCB, and RDBN) had prognostic significance. However, for HER2+ tumors, the association between patient survival and the pathologic response assessment results varied according to the system used, and none resulted in distinct Kaplan—Meier curves. Conclusion Most of the currently available pathologic assessment systems used after anthracycline with/without taxane-based NAC effectively classified triple-negative breast cancers into groups showing different prognoses. The pathologic assessment systems evaluating residual tumors only also had prognostic significance in HR+/HER2- tumors. However, new assessment methods are required to effectively evaluate the pathologic response of HR+/HER2+ and HR-/HER2+ tumors to anthracycline with/without taxane-based NAC. PMID:26394326

  3. Transportation Concurrency 1 2002 Comp Plan Update Workshops November 4, 2001

    E-print Network

    Workshops 6. The law requires a transportation concurrency system if you plan under the Growth Management system. 2. To outline some of the requirements applicable to a transportation concurrency system. 3. Summarize Redmond's current transportation concurrency system and the lessons the author has taken from

  4. High-dose chemotherapy and multiple sclerosis

    PubMed Central

    Harrison, Daniel; Gladstone, Douglas E.

    2015-01-01

    Purpose of review Immunomodulatory medications for multiple sclerosis provide only modest control of this potentially debilitating auto-immune disease of the central nervous system. The immunosuppression provided by high-dose chemotherapy has been studied to address treatment-refractory disease. In this review, we discuss the recent significant work in this field and its associated controversies. Recent findings Conclusive evidence for the efficacy of high-dose chemotherapy with stem cell rescue is lacking given the lack of uniform patient populations and varying treatment protocols. Moreover, the significant toxicity associated with this procedure has dampened enthusiasm for its widespread use. High-dose chemotherapy without stem cell rescue has been trialed as a less toxic approach that eliminates the possibility of re-infusing autoreactive lymphocytes found in the stem cell product. Summary Before high-dose chemotherapy with or without stem cell rescue can be adopted for clinical practice, both approaches require testing in randomized clinical trials. Both procedures have the possibility of decreasing disease activity but high-dose chemotherapy without stem cell rescue having a more favorable safety profile, may prove a more significant advance in the field of high-dose therapy for multiple sclerosis. PMID:21169833

  5. -PTOLEMY II -HETEROGENEOUS CONCURRENT

    E-print Network

    California at Berkeley, University of

    -PTOLEMY II - HETEROGENEOUS CONCURRENT MODELING AND DESIGN IN JAVA John Davis, II Mudit Goel University of California at Berkeley http://ptolemy.eecs.berkeley.edu Memorandum UCB/ERL M99/40 Document Contents Part 1: Using Ptolemy II 1. Introduction 1-1 1.1.Modeling and Design 1-1 1.2.Architecture Design 1

  6. -PTOLEMY II -HETEROGENEOUS CONCURRENT

    E-print Network

    California at Berkeley, University of

    -PTOLEMY II - HETEROGENEOUS CONCURRENT MODELING AND DESIGN IN JAVA John Davis, II Christopher of Electrical Engineering and Computer Sciences University of California at Berkeley http://ptolemy with Ptolemy II 1.0 March 15, 2001 This project is supported by the Defense Advanced Research Projects Agency

  7. THE POSSIBILITIES OF TRANSPORTATION CONCURRENCY PROPOSAL AND EVALUATION OF MEASUREMENT ALTERNATIVES

    E-print Network

    , ride sharing programs, demand management, and other transportation systems management strategies." #12 endorsed by them. TRANSPORTATION CONCURRENCY Washington State's Growth Management Act (GMA) requires jurisdictions to adopt ordinances that establish a concurrency measurement system for transportation

  8. Five Years' Experience Treating Locally Advanced Cervical Cancer With Concurrent Chemoradiotherapy and High-Dose-Rate Brachytherapy: Results From a Single Institution

    SciTech Connect

    Parker, Kate; Gallop-Evans, Eve; Hanna, Louise Adams, Malcolm

    2009-05-01

    Purpose: To assess the clinical outcomes after concurrent cisplatin chemotherapy and radiotherapy (RT) followed by high-dose-rate brachytherapy for locally advanced carcinoma of the cervix and perform a multivariate analysis of the prognostic factors. Methods and Materials: The outcomes were analyzed for all women treated between 1999 and 2004 with concurrent cisplatin chemotherapy and RT followed by high-dose-rate brachytherapy. Kaplan-Meier analysis was used for overall survival (OS), local control (LC), and distant control (DC). The Cox proportional hazards model was used to perform multivariate analysis of the prognostic variables. Results: The standard regimen comprised whole pelvic external RT 45 Gy in 25 fractions with concurrent weekly cisplatin 40 mg/m{sup 2}, followed by four high-dose-rate brachytherapy insertions of 6 Gy. Patients with radiologically enlarged para-aortic lymph nodes underwent extended-field RT. Of 92 patients, the OS rate was 72% at 2 years and 55% at 5 years. The LC rate was 76% at 2 years and 67% at 5 years. The DC rate was 68% at 2 years and 48% at 5 years. The most important prognostic factor for OS, LC, and DC was the pretreatment hemoglobin. For OS, the tumor size and the presence of enlarged lymph nodes were also important. For LC, the number of brachytherapy insertions was important; and for DC, the number of chemotherapy treatments was important. Of the patients, 4% experienced late Grade 3 or 4 toxicity. Conclusion: The results of our study have shown that the regimen is effective, with acceptable long-term side effects. In this cohort, the most important prognostic factor was the pretreatment hemoglobin level, a disease-related factor. However, more effective systemic treatments are needed.

  9. Clinical concepts derived from animal chemotherapy studies

    SciTech Connect

    Goldin, A.; Schabel, F.M.

    1981-01-01

    Animal chemotherapy studies have contributed significantly to clinical concepts in tumor therapy. Preclinical investigations have led to the discovery of new drugs and have demonstrated that it is possible to cure advanced metastatic neoplasia. A fundamental clinical concept stemming from animal chemotherapy studies is that increased selectivity and improved therapeutic effectiveness of antitumor agents may result from appropriate pharmacologic, biochemical, and biologic manipulation of the host-tumor drug relationship. Clinically important factors that may increase antitumor drug selectivity are reviewed and pertinent studies in animal model systems are cited.

  10. BOISE STATE UNIVERSITY CONCURRENT ENROLLMENT

    E-print Network

    Barrash, Warren

    BOISE STATE UNIVERSITY CONCURRENT ENROLLMENT STUDENT HANDBOOK 2014-2015 Providing University in concurrent enrollment opportunities. For the past 16 years Boise State has been working to build the premier concurrent enrollment program in the state of Idaho. Our focus is in providing you with rigorous academic

  11. Rituximab with chemotherapy in children and adolescents with central nervous system and/or bone marrow-positive Burkitt lymphoma/leukaemia: A Children’s Oncology Group Report

    PubMed Central

    Goldman, Stanton; Smith, Lynette; Galardy, Paul; Perkins, Sherrie L.; Frazer, J. Kimble; Sanger, Warren; Anderson, James R.; Gross, Thomas G.; Weinstein, Howard; Harrison, Lauren; Shiramizu, Bruce; Barth, Matthew; Cairo, Mitchell S.

    2014-01-01

    Summary Children and adolescents with Burkitt Lymphoma (BL) and combined central nervous system (CNS) and bone marrow involvement still have a poor prognosis with chemotherapy alone. We therefore investigated in children and adolescents with bone marrow (?25% blasts) and/or CNS-positive Burkitt lymphoma the chemoimmunotherapy combination of rituximab (375 mg/m2) and the standard chemotherapy arm of our previously reported French-American-British (FAB) Lymphome Malins de Burkitt (LMB) 96 trial. Central pathological and cytogenetic characterization was also performed. There were 40 evaluable patients with Burkitt histology (25 with leukaemia and 15 with CNS disease ± leukaemia). The chemoimmunotherapy regimen was well tolerated. The incidence of grade III/IV mucositis during induction cycles with combined chemotherapy and rituximab was 31% and 26%, respectively. The 3-year event-free survival (EFS)/overall survival (OS) was 90% (95% confidence interval [CI], 76–96%) in the entire cohort and 93% (95% CI, 61–99%) in patients with CNS disease. Based on the results of this trial, an international randomized study of FAB/LMB 96 chemotherapy ± rituximab for high-risk patients is currently under investigation. PMID:25066629

  12. Concurrent Image Processing Executive (CIPE)

    NASA Technical Reports Server (NTRS)

    Lee, Meemong; Cooper, Gregory T.; Groom, Steven L.; Mazer, Alan S.; Williams, Winifred I.

    1988-01-01

    The design and implementation of a Concurrent Image Processing Executive (CIPE), which is intended to become the support system software for a prototype high performance science analysis workstation are discussed. The target machine for this software is a JPL/Caltech Mark IIIfp Hypercube hosted by either a MASSCOMP 5600 or a Sun-3, Sun-4 workstation; however, the design will accommodate other concurrent machines of similar architecture, i.e., local memory, multiple-instruction-multiple-data (MIMD) machines. The CIPE system provides both a multimode user interface and an applications programmer interface, and has been designed around four loosely coupled modules; (1) user interface, (2) host-resident executive, (3) hypercube-resident executive, and (4) application functions. The loose coupling between modules allows modification of a particular module without significantly affecting the other modules in the system. In order to enhance hypercube memory utilization and to allow expansion of image processing capabilities, a specialized program management method, incremental loading, was devised. To minimize data transfer between host and hypercube a data management method which distributes, redistributes, and tracks data set information was implemented.

  13. Optimal Control for a Bilinear Model with Recruiting Agent in Cancer Chemotherapy Urszula Ledzewicz

    E-print Network

    Ledzewicz, Urszula

    Optimal Control for a Bilinear Model with Recruiting Agent in Cancer Chemotherapy Urszula Ledzewicz chemotherapy as optimal control problem for a bilinear system and give necessary and sufficient conditions in mathematical models for cancer chemotherapy when treatment protocols over a fixed therapy interval

  14. A Geometric Analysis of Bang-Bang Extremals in Optimal Control Problems for Combination Cancer Chemotherapy*

    E-print Network

    Ledzewicz, Urszula

    Chemotherapy* Heinz Sch¨attler Dept. of Electrical and Systems Engineering, Washington University, St. Louis of cancer cells under combination chemotherapies are considered as multi-input optimal control problems over for chemotherapy over a fixed therapy interval. For these problems, and consistent with medical practice, optimal

  15. Optimal Protocols for a Mathematical Model of Tumor-Immune Interactions under Chemotherapy with Immune Boost

    E-print Network

    Ledzewicz, Urszula

    Optimal Protocols for a Mathematical Model of Tumor-Immune Interactions under Chemotherapy of cancer chemotherapy with immunotherapy in form of a boost to the immune system is considered as a multi-input optimal control problem for combinations of cancer chemotherapy with immunotherapy in form of a boost

  16. Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy

    PubMed Central

    MacDermed, Dhara M.; Miller, Luke L.; Peabody, Terrance D.; Simon, Michael A.; Luu, Hue H.; Haydon, Rex C.; Montag, Anthony G.; Undevia, Samir D.; Connell, Philip P.

    2010-01-01

    Purpose Various neoadjuvant approaches have been evaluated for the treatment of locally advanced soft tissue sarcomas. This retrospective study describes a uniquely modified version of the Eilber regimen developed at University of Chicago. Methods and Materials Thirty-four patients (28 stage III and 6 stage IV) patients with locally advanced soft tissue sarcomas of an extremity were treated between 1995 and 2008. All patients received preoperative therapy including ifosfamide (2.5 g/m2/day × 5 days) with concurrent radiation (28 Gy in 3.5 Gy daily fractions), sandwiched between various chemotherapy regimens. Postoperatively, 47% received further adjuvant chemotherapy. Results Most tumors (94%) were grade 3 and all were T2b, with a median size of 10.3 cm. Wide excision was performed in 29 patients (85%), and 5 required amputation. Of the resected tumor specimens, 50% exhibited high (?90%) treatment-induced necrosis and 11.8% had a complete pathologic response. Surgical margins were negative in all patients. The 5-year survival was 42.3% for all patients and 45.2% for stage III patients. For limb-preservation patients, the 5-year local control was 89.0% and reoperation was required for wound complications in 17.2%. The 5-year freedom from distant metastasis (FFDM) was 53.4% (stage IV patients excluded), and FFDM was superior if treatment-induced tumor necrosis was ?90% (84.6% vs. 19.9%, p=0.02). Conclusion This well-tolerated concurrent chemoradiotherapy approach yields excellent rates of limb preservation and local control. The resulting treatment-induced necrosis rates are predictive of subsequent metastatic risk, and this information may provide an opportunity to guide postoperative systemic therapies. PMID:19577863

  17. Prevalence and risk factors of cataract after chemotherapy with or without central nervous system irradiation for childhood acute lymphoblastic leukaemia: an LEA study.

    PubMed

    Alloin, Anne-Lise; Barlogis, Vincent; Auquier, Pascal; Contet, Audrey; Poiree, Maryline; Demeocq, François; Herrmann, Iris; Villes, Virginie; Bertrand, Yves; Plantaz, Dominique; Kanold, Justyna; Chastagner, Pascal; Chambost, Hervé; Sirvent, Nicolas; Michel, Gérard

    2014-01-01

    Corticosteroid and central nervous system (CNS) irradiation can induce cataract in childhood lymphoblastic leukaemia survivors. Few prospective studies with systematic ophthalmological evaluation have been published. Cataract was prospectively assessed by serial slip lamp tests in 517 patients. All had acute lymphoblastic leukaemia, all had been treated by chemotherapy with or without CNS irradiation, and none had received haematopoietic stem cell transplantation. Median ages at last evaluation and follow-up duration from leukaemia diagnosis were 16·8 and 10·9 years, respectively. Cataract was observed in 21/517 patients (4·1%). Cumulative incidence was 4·5 ± 1·2% at 15 years and reached 26 ± 8·1% at 25 years. CNS irradiation was the only risk factor: prevalence was 11·1% in patients who had received irradiation and 2·8% in those who did not. We did not detect any steroid dose effect: cumulative dose was 5133 and 5190 mg/m(2) in patients with and without cataract, respectively. Cataract occurrence did not significantly impact quality of life. We conclude that, in the range of steroid dose reported here, the cataract risk proves very low 15 years after treatment without CNS irradiation but an even more prolonged follow-up is required because of potential very late occurrence. PMID:24116693

  18. Concurrent calorimetric and interferometric studies of steady-state natural convection from miniaturized horizontal single plate-fin systems and plate-fin arrays

    E-print Network

    Harahap, Filino

    Concurrent calorimetric and interferometric studies have been conducted to investigate the effect that reduction of the base-plate dimensions has on the steady-state performance of the rate of natural convection heat ...

  19. Neoadjuvant Sandwich Treatment With Oxaliplatin and Capecitabine Administered Prior to, Concurrently With, and Following Radiation Therapy in Locally Advanced Rectal Cancer: A Prospective Phase 2 Trial

    SciTech Connect

    Gao, Yuan-Hong; Lin, Jun-Zhong; An, Xin; Luo, Jie-Lin; Cai, Mu-Yan; Cai, Pei-Qiang; Kong, Ling-Heng; Liu, Guo-Chen; Tang, Jing-Hua; Chen, Gong; Pan, Zhi-Zhong; Ding, Pei-Rong

    2014-12-01

    Purpose: Systemic failure remains the major challenge in management of locally advanced rectal cancer (LARC). To optimize the timing of neoadjuvant treatment and enhance systemic control, we initiated a phase 2 trial to evaluate a new strategy of neoadjuvant sandwich treatment, integrating induction chemotherapy, concurrent chemoradiation therapy, and consolidation chemotherapy. Here, we present preliminary results of this trial, reporting the tumor response, toxicities, and surgical complications. Methods and Materials: Fifty-one patients with LARC were enrolled, among which were two patients who were ineligible because of distant metastases before treatment. Patients were treated first with one cycle of induction chemotherapy consisting of oxaliplatin, 130 mg/m² on day 1, with capecitabine, 1000 mg/m² twice daily for 14 days every 3 weeks (the XELOX regimen), followed by chemoradiation therapy, 50 Gy over 5 weeks, with the modified XELOX regimen (oxaliplatin 100 mg/m²), and then with another cycle of consolidation chemotherapy with the XELOX regimen. Surgery was performed 6 to 8 weeks after completion of radiation therapy. Tumor responses, toxicities, and surgical complications were recorded. Results: All but one patent completed the planned schedule of neoadjuvant sandwich treatment. Neither life-threatening blood count decrease nor febrile neutropenia were observed. Forty-five patents underwent optimal surgery with total mesorectal excision (TME). Four patients refused surgery because of clinically complete response. There was no perioperative mortality in this cohort. Five patients (11.1%) developed postoperative complications. Among the 45 patients who underwent TME, pathologic complete response (pCR), pCR or major regression, and at least moderate regression were achieved in 19 (42.2%), 37 (82.2%), and 44 patients (97.8%), respectively. Conclusions: Preliminary results suggest that the strategy of neoadjuvant sandwich treatment using XELOX regimen as induction, concomitant, and consolidation chemotherapy to the conventional radiation is well tolerated. The strategy is highly effective in terms of pCR and major regression, which warrants further investigation.

  20. Exclusive Alternating Chemotherapy and Radiotherapy in Nonmetastatic Inflammatory Breast Cancer: 20 Years of Follow-Up

    SciTech Connect

    Bourgier, Celine; Pessoa, Eduardo Lima; Dunant, Ariane; Heymann, Steve; Spielmann, Marc; Uzan, Catherine; Mathieu, Marie-Christine; Arriagada, Rodrigo; Marsiglia, Hugo

    2012-02-01

    Background: Locoregional treatment of inflammatory breast cancer (IBC) is crucial because local relapses may be highly symptomatic and are commonly associated with distant metastasis. With a median follow-up of 20 years, we report here the long-term results of a monocentric clinical trial combining primary chemotherapy (CT) with a schedule of anthracycline-based CT and an alternating split-course of radiotherapy (RT Asterisk-Operator CT) without mastectomy. Methods and Materials: From September 1983 to December 1989, 124 women with nonmetastatic IBC (T4d M0) were treated with three cycles of primary AVCMF chemotherapy (anthracycline, vincristine, cyclophosphamide, methotrexate, and 5-fluorouracil) and then an alternating RT Asterisk-Operator CT schedule followed by three cycles of FAC. Hormonal therapy was systematically administered: ovarian irradiation (12 Gy in four fractions) or tamoxifen 20 mg daily. Results: Local control was achieved in 82% of patients. The 10- and 20-year local relapse rates were 26% and 33%, respectively, but only 10% of locally controlled cases were not associated with concurrent distant metastasis. The 10- and 20-year overall survival rates were 39% and 19%, respectively. Severe fibrosis occurred in 54% of patients, grade 3 brachial plexus neuropathy in 4%, grade 2 pneumonitis in 9%. Grade 1, 2 and 3 cardiac toxicity was observed in 3.8%, 3.8% and 1.2% of cases respectively. Conclusions: This combined regimen allowed good long-term local control without surgery. Survival rates were similar to those obtained with conventional regimens (primary chemotherapy, total mastectomy, and adjuvant radiotherapy). Since IBC continues to be an entity with a dismal prognosis, this approach, safely combining preoperative or postoperative radiation therapy and systemic treatments, should be reassessed when suitable targeted agents are available.

  1. A Rule-Oriented Concurrent Architecture to Effect Adaptiveness for Integrated Manufacturing Enterprises

    E-print Network

    Hsu, Cheng

    base for enterprise integration, (2) a concurrent architecture using the metadatabase for integrationA Rule-Oriented Concurrent Architecture to Effect Adaptiveness for Integrated Manufacturing Enterprises Cheng Hsu and Gilbert Babin Decision Sciences and Engineering Systems, Rensselaer Polytechnic

  2. Risk management in concurrent engineering in presence of intelligent agents

    E-print Network

    Fox, Mark S.

    Risk management in concurrent engineering in presence of intelligent agents Taner Bilgi describe how a specific facet of systems engineering (risks) can be managed for large, concurrent categorized as: ffl events that cause a delay in the project, ffl events that cause cost overruns, ffl events

  3. 48 CFR 9903.304 - Concurrent full and modified coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Concurrent full and... AND COST ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.304 Concurrent full and modified coverage. Contracts subject to full coverage may be performed during a period in which...

  4. 48 CFR 9903.304 - Concurrent full and modified coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Concurrent full and... AND COST ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.304 Concurrent full and modified coverage. Contracts subject to full coverage may be performed during a period in which...

  5. 48 CFR 9903.304 - Concurrent full and modified coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Concurrent full and... AND COST ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.304 Concurrent full and modified coverage. Contracts subject to full coverage may be performed during a period in which...

  6. 48 CFR 9903.304 - Concurrent full and modified coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Concurrent full and... AND COST ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.304 Concurrent full and modified coverage. Contracts subject to full coverage may be performed during a period in which...

  7. Brief Announcement: Tree Decomposition for Faster Concurrent Data Structures

    E-print Network

    such as sets and maps. We demonstrate its simplicity and its effectiveness using a concurrent sorted linked: E.1 Data struc- tures General terms: algorithms, performance Key Words: concurrent data structures since the 1970s. In database systems only whole blocks with several data records can be locked due

  8. Lower Bound of Concurrence Based on Generalized Positive Maps

    E-print Network

    Hui-hui Qin; Shao-Ming Fei

    2014-01-08

    We study the concurrence of arbitrary dimensional bipartite quantum systems. By using a positive but not completely positive map, we present an analytical lower bound of concurrence. Detailed examples are used to show that our bound can detect entanglement better and can improve the well known existing lower bounds.

  9. Multidisciplinary Concurrent Design Optimization via the Internet

    NASA Technical Reports Server (NTRS)

    Woodard, Stanley E.; Kelkar, Atul G.; Koganti, Gopichand

    2001-01-01

    A methodology is presented which uses commercial design and analysis software and the Internet to perform concurrent multidisciplinary optimization. The methodology provides a means to develop multidisciplinary designs without requiring that all software be accessible from the same local network. The procedures are amenable to design and development teams whose members, expertise and respective software are not geographically located together. This methodology facilitates multidisciplinary teams working concurrently on a design problem of common interest. Partition of design software to different machines allows each constituent software to be used on the machine that provides the most economy and efficiency. The methodology is demonstrated on the concurrent design of a spacecraft structure and attitude control system. Results are compared to those derived from performing the design with an autonomous FORTRAN program.

  10. Oral Chemotherapy: What You Need to Know

    MedlinePLUS

    Oral Chemotherapy: What You Need to Know Oral chemo is any drug you take by mouth to treat cancer. ... be ready for oral chemo. What is oral chemotherapy? There are many types of chemotherapy (chemo). Oral ...

  11. Concurrent Stereotactic Radiosurgery and Bevacizumab in Recurrent Malignant Gliomas: A Prospective Trial

    SciTech Connect

    Cabrera, Alvin R.; Cuneo, Kyle C.; Desjardins, Annick; Sampson, John H.; McSherry, Frances; Herndon, James E.; Peters, Katherine B.; Allen, Karen; Hoang, Jenny K.; Chang, Zheng; Craciunescu, Oana; Vredenburgh, James J.; Friedman, Henry S.; Kirkpatrick, John P.

    2013-08-01

    Purpose: Virtually all patients with malignant glioma (MG) eventually recur. This study evaluates the safety of concurrent stereotactic radiosurgery (SRS) and bevacizumab (BVZ), an antiangiogenic agent, in treatment of recurrent MG. Methods and Materials: Fifteen patients with recurrent MG, treated at initial diagnosis with surgery and adjuvant radiation therapy/temozolomide and then at least 1 salvage chemotherapy regimen, were enrolled in this prospective trial. Lesions <3 cm in diameter were treated in a single fraction, whereas those 3 to 5 cm in diameter received 5 5-Gy fractions. BVZ was administered immediately before SRS and 2 weeks later. Neurocognitive testing (Mini-Mental Status Exam, Trail Making Test A/B), Functional Assessment of Cancer Therapy-Brain (FACT-Br) quality-of-life assessment, physical exam, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were performed immediately before SRS and 1 week and 2 months following completion of SRS. The primary endpoint was central nervous system (CNS) toxicity. Secondary endpoints included survival, quality of life, microvascular properties as measured by DCE-MRI, steroid usage, and performance status. Results: One grade 3 (severe headache) and 2 grade 2 CNS toxicities were observed. No patients experienced grade 4 to 5 toxicity or intracranial hemorrhage. Neurocognition, quality of life, and Karnofsky performance status did not change significantly with treatment. DCE-MRI results suggest a significant decline in tumor perfusion and permeability 1 week after SRS and further decline by 2 months. Conclusions: Treatment of recurrent MG with concurrent SRS and BVZ was not associated with excessive toxicity in this prospective trial. A randomized trial of concurrent SRS/BVZ versus conventional salvage therapy is needed to establish the efficacy of this approach.

  12. Chemotherapy for Malignant Intraocular Tumors.

    PubMed

    Shah, Chirag P; Shields, Carol L; Shields, Jerry A

    2016-01-01

    Chemotherapeutic approaches, including chemoreduction (CRD), chemothermotherapy, as well as periocular, intravitreal, and intra-arterial chemotherapy, are effective tools in managing different types of ocular tumors. Treatments are often individualized to patient and tumor types to yield best possible outcomes. Due to space limitations, this chapter will focus on CRD and intra-arterial chemotherapy for retinoblastoma. PMID:26501748

  13. Cancer Chemotherapy - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... ???????) Chemotherapy (Arabic) ??????? Bilingual PDF Health Information Translations Handling Chemotherapy Safely (Arabic) ??????? ????? ?? ?????? ???????? - ??????? Bilingual PDF Health Information Translations Nausea and Vomiting with Cancer Treatment (Arabic) ??????? ...

  14. The effect of cytotoxic chemotherapy on female fertility.

    PubMed

    Chasle, Sharon; How, Christine C

    2003-06-01

    Nurses are now primarily responsible for the provision of patient information, and the administration of an escalating number of cytotoxic agents. This paper aims to provide nurses with key information concerning the adverse effects of cytotoxic chemotherapy on the reproductive system of women of childbearing age. The provision of information on gonadal function and fertility is vital, particularly with the increase in the survival of women treated for cancer, and the trend towards women starting a family later in life. Gonadal toxicity of the various cytotoxic agents, disruption of the menstrual cycle, premature menopause, avoidance of pregnancy, chemotherapy in pregnancy, and fertility prospects post-chemotherapy are addressed in this paper. PMID:12849562

  15. Chemotherapy-induced Cardiotoxicity

    PubMed Central

    FLORESCU, Maria; CINTEZA, Mircea; VINEREANU, Dragos

    2013-01-01

    ABSTRACT Breast cancer represents the most frequent form of neoplasia in women worldwide, being responsible of 1.6% of annual deaths. Therefore, it is a major public health issue and research in this field should be a priority. Chemoterapics drugs are extremly potent tools, which alone or in association to radiotherapy, increase survival and lower the reccurrence rate of cancer, but their use can be limited by cardiotoxicity. Cardiotoxicity can appear early or late after therapy, and may vary from subclinical myocardial dysfunction to irreversible heart failure. Currently, cardiac dysfunction induced by chemotherapy is diagnosed through classical echocardiographic parameters. However, these cannot detect subtle, early changes of cardiac structure and function. Consequently, description of new methods, which could detect cardiac dysfunction in an early stage, becomes essential for detecting the group of patients at risk for irreversible heart failure and for monitoring the treatment. PMID:24023601

  16. Promotora assisted depression care among predominately Hispanic patients with concurrent chronic illness: Public care system clinical trial design.

    PubMed

    Ell, Kathleen; Aranda, María P; Wu, Shinyi; Oh, Hyunsung; Lee, Pey-Jiuan; Guterman, Jeffrey

    2016-01-01

    Depression frequently negatively affects patient overall self-care and social stress management within United States safety net care systems. Rates of major depression are significantly high among low-income predominantly Hispanic/Latino with chronic illness, such as diabetes and heart disease. The study design of the A Helping Hand to Activate Patient-Centered Depression Care among Low-income Patients (AHH) randomized clinical trial aims to enhance patient depression care receipt and overall bio-psychosocial self-care management. The AHH trial is conducted in collaboration with three Los Angeles County Department of Health Services (DHS) safety net clinics that provide Patient-Centered Medical Home (PCMH) care. The study compares AHH intervention (AHH) in which community-based bilingual promotoras provide in-person or telephone patient engagement and intervention aimed to reduce the burden and strain on patients, families, and care providers by assessing, enhancing, and facilitating patient depression and co-morbid illness self-care management skill, and activating patient communication with clinic medical providers versus DHS PCMH team usual care (PCMHUC). AHH independent bilingual recruiters screened 1957 and enrolled 348 predominantly Hispanic/Latino patients, of whom 296 (85%) had diabetes, 14 (4%) with heart disease, and 38 (11%) with both diseases. Recruiters identified depressed patients by baseline Patient Health Questionnaire-9 scores of 10 or more, completed baseline assessments, and randomized patients to either AHH or PCMHUC study group. The comprehensive assessments will be repeated at 6 and 12months by an independent bilingual follow-up interviewer. Baseline and outcome data include mental health assessment and treatment receipt, co-morbid illness self-care, social relationships, and environmental stressor assessments. PMID:26600285

  17. Local and systemic chemotherapy with taurolidine and taurolidine/heparin in colon cancer-bearing rats undergoing laparotomy.

    PubMed

    Braumann, Chris; Ordemann, Jürgen; Kilian, Maik; Wenger, Frank A; Jacobi, Christoph A

    2003-01-01

    Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and intraperitoneal injection of 10(4) colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied intraperitoneally. Systemic and intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving intraperitoneal application of taurolidine (median 7.0 mg, P = 0.05) and of taurolidine/heparin (median 0 mg, P = 0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the intraperitoneal tumor growth (median 4 mg, P = 0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth and abdominal wound recurrences in rats undergoing midline laparotomy. Neither the intraperitoneal nor the intravenous application or the combination of the two agents influenced the subcutaneous tumor growth. The substances did not alter the changes of peripheral leukocytes. PMID:14524527

  18. CheckFence: Checking Consistency of Concurrent Data Types on Relaxed Memory Models

    E-print Network

    Plotkin, Joshua B.

    facilitate the development of multi- threaded programs by providing concurrent implementations of familiar such systems remains a challenge [44]. Concurrency libraries such as the java.util.concurrent This research JSR-166 [27] or the Intel Threading Building Blocks [22] support the development of safe and efficient

  19. Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial

    SciTech Connect

    Haffty, Bruce G. Vicini, Frank A.; Beitsch, Peter; Quiet, Coral; Keleher, Angela; Garcia, Delia; Snider, Howard; Gittleman, Mark; Zannis, Victor; Kuerer, Henry; Whitacre, Eric; Whitworth, Pat; Fine, Richard; Keisch, Martin

    2008-12-01

    Purpose: To evaluate cosmetic outcome and radiation recall in the American Society of Breast Surgeons registry trial, as a function of the interval between accelerated partial breast irradiation (APBI) and initiation of chemotherapy (CTX). Methods and Materials: A total of 1440 patients at 97 institutions participated in this trial. After lumpectomy for early-stage breast cancer, patients received APBI (34 Gy in 10 fractions) with MammoSite RTS brachytherapy. A total of 148 patients received CTX within 90 days of APBI. Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good or fair/poor. Results: Chemotherapy was initiated at a mean of 3.9 weeks after the final MammoSite procedure and was administered {<=}3 weeks after APBI in 54 patients (36%) and >3 weeks after APBI in 94 patients (64%). The early and delayed groups were well balanced with respect to multiple factors that may impact on cosmetic outcome. There was a superior cosmetic outcome in those receiving chemotherapy >3 weeks after APBI (excellent/good in 72.2% at {<=}3 weeks vs. excellent/good in 93.8% at >3 weeks; p = 0.01). Radiation recall in those receiving CTX at {<=}3 weeks was 9 of 50 (18%), compared with 6 of 81(7.4%) in those receiving chemotherapy at >3 weeks (p = 0.09). Conclusion: The majority of patients receiving CTX after APBI have excellent/good cosmetic outcomes, with a low rate of radiation recall. Chemotherapy initiated >3 weeks after the final MammoSite procedure seems to be associated with a better cosmetic outcome and lower rate of radiation recall. An excellent/good cosmetic outcome in patients receiving CTX after 3 weeks was similar to the cosmetic outcome of the overall patient population who did not receive CTX.

  20. Estimating concurrence via entanglement witnesses

    SciTech Connect

    Jurkowski, Jacek; Chruscinski, Dariusz

    2010-05-15

    We show that each entanglement witness detecting a given bipartite entangled state provides an estimation of its concurrence. We illustrate our result with several well-known examples of entanglement witnesses and compare the corresponding estimation of concurrence with other estimations provided by the trace norm of partial transposition and realignment.

  1. Assured Selection ---ARelaxedConcurrency

    E-print Network

    Assured Selection --- ARelaxedConcurrency Control Mechanism Supervisor: Esa Falkenroth, Nancy E Accademico 1998/99 Tesi di laurea Assured Selection --- A Relaxed Concurrency Control Mechanism Il Candidato. Assured Selection e' un meccanismo alternativo e ottimistico per il controllo della concorrenza basato

  2. Understanding resistance to combination chemotherapy

    E-print Network

    Pritchard, Justin R.

    The current clinical application of combination chemotherapy is guided by a historically successful set of practices that were developed by basic and clinical researchers 50–60 years ago. Thus, in order to understand how ...

  3. Managing Chemotherapy Side Effects: Diarrhea

    MedlinePLUS

    ... National Institutes of Health Managing Chemotherapy Side Effects Diarrhea What is diarrhea? Do you have bowel movements more often than ... 5° F (38° C) or higher ? You have diarrhea and cramps for more than a day ? Your ...

  4. Coexistence of squamous cell tracheal papilloma and carcinoma treated with chemotherapy and radiotherapy: a case report

    PubMed Central

    Paliouras, Dimitrios; Gogakos, Apostolos; Rallis, Thomas; Chatzinikolaou, Fotios; Asteriou, Christos; Tagarakis, Georgios; Organtzis, John; Tsakiridis, Kosmas; Tsavlis, Drosos; Zissimopoulos, Athanasios; Kioumis, Ioannis; Hohenforst-Schmidt, Wolfgang; Zarogoulidis, Konstantinos; Zarogoulidis, Paul; Barbetakis, Nikolaos

    2016-01-01

    Background Papillomatosis presents, most frequently, as multiple lesions of the respiratory tract, which are usually considered benign. Malignant degeneration into squamous cell carcinoma is quite common, although curative approaches vary a lot in modern literature. Case report We report a case of a 66-year-old male patient with the coexistence of multiple squamous cell papilloma and carcinoma in the upper trachea with severe airway obstruction that was diagnosed through bronchoscopy and treated by performing an urgent tracheostomy, followed by concurrent chemotherapy and radiotherapy. There was no evidence of recurrence after a 12-month follow-up period. Conclusion This study underlines the diagnostic and therapeutic value of bronchoscopy as well as multimodality palliative treatment in such cases. To the best of our knowledge, this is the first study to describe an immediate treatment protocol with tracheostomy and concurrent chemotherapy/radiotherapy in a patient with squamous cell tracheal papilloma and carcinoma.

  5. Comparison of Intrahepatic and Pancreatic Perfusion on Fusion Images Using a Combined SPECT/CT System and Assessment of Efficacy of Combined Continuous Arterial Infusion and Systemic Chemotherapy in Advanced Pancreatic Carcinoma

    SciTech Connect

    Ikeda, Osama Tamura, Yoshitaka; Nakasone, Yutaka; Shiraishi, Shinya; Kawanaka, Kouichi; Tomiguchi, Seiji; Yamashita, Yasuyuki; Takamori, Hiroshi; Kanemitsu, Keiichiro; Baba, Hideo

    2007-09-15

    Purpose. The purpose of this study was to compare intrahepatic and pancreatic perfusion on fusion images using a combined single-photon emission computed tomography (SPECT)/CT system and to evaluate the efficacy of combined continuous transcatheter arterial infusion (CTAI) and systemic chemotherapy in the treatment of advanced pancreatic carcinoma. Materials and Methods. CTAI was performed in 33 patients (22 men, 11 women; age range, 35-77 years; mean age, 60 years) with stage IV pancreatic cancer with liver metastasis. The reservoir was transcutaneously implanted with the help of angiography. The systemic administration of gemcitabine was combined with the infusion of 5-fluorouracil via the reservoir. In all patients we obtained fusion images using a combined SPECT/CT system. Pancreatic perfusion on fusion images was classified as perfusion presence or as perfusion absent in the pancreatic cancer. Using WHO criteria we recorded the tumor response after 3 months on multislice helical CT scans. Treatment effects were evaluated based on the pancreatic cancer, liver metastasis, and factors such as intrahepatic and pancreatic perfusion on fusion images. For statistical analysis we used the chi-square test; survival was evaluated by the Kaplan Meier method (log-rank test). Results. On fusion images, pancreatic and intrahepatic perfusion was recorded as hot spot and as homogeneous distribution, respectively, in 18 patients (55%) and as cold spot and heterogeneous distribution, respectively, in 15 (45%). Patients with hot spot in the pancreatic tumor and homogeneous distribution in the liver manifested better treatment results (p < 0.05 and p < 0.01, respectively). Patients with hot spot both in the pancreatic cancer and in the liver survived longer than those with cold spot in the pancreatic cancer and heterogeneous distribution in the liver (median {+-} SD, 16.0 {+-} 3.7 vs. 8.0 {+-} 1.4 months; p < 0.05). Conclusions. We conclude that in patients with advanced pancreatic cancer, CTAI with systemic chemotherapy appeared to be effective and may prolong their survival. The development of a reservoir port system allowing for the homogeneous distribution of anticancer drugs is necessary to improve the prognosis of patients with advanced pancreatic cancer.

  6. Software For Drawing Design Details Concurrently

    NASA Technical Reports Server (NTRS)

    Crosby, Dewey C., III

    1990-01-01

    Software system containing five computer-aided-design programs enables more than one designer to work on same part or assembly at same time. Reduces time necessary to produce design by implementing concept of parallel or concurrent detailing, in which all detail drawings documenting three-dimensional model of part or assembly produced simultaneously, rather than sequentially. Keeps various detail drawings consistent with each other and with overall design by distributing changes in each detail to all other affected details.

  7. Definitive radiotherapy with concurrent oncothermia for stage IIIB non-small-cell lung cancer: A case report

    PubMed Central

    YEO, SEUNG-GU

    2015-01-01

    Hyperthermia enhances the susceptibility of tumors to radiotherapy (RT) and chemotherapy. Oncothermia, also known as electro-hyperthermia, is a new treatment modality developed to overcome the problems of traditional hyperthermia by selectively delivering energy to the malignant tissues. The present study reports the outcome of combined oncothermia and RT in a 75-year-old patient with stage IIIB non-small-cell lung cancer (NSCLC). Due to the advanced age and the performance status of the patient, the combination of systemic chemotherapy and RT was deemed infeasible; therefore, the patient instead decided to undergo oncothermia concurrently with definitive RT. The RT was administered at a dose of 64.8 Gy in 36 fractions using a three-dimensional conformal plan technique. Oncothermia was started concomitantly with RT and was performed for 60 min per session, two sessions per week, for a total of 12 sessions. No severe toxicities developed, with the exception of mild odynophagia, which resolved soon after the treatments. Follow-up computed tomography showed complete tumor response, and the patient was alive with no evidence of the disease 18 months after the completion of the treatment. In conclusion, the present case report suggests that oncothermia combined with RT, with the former possessing radiosensitizing potential and no additional toxicities, may be a promising alternative for advanced-age and/or frail patients with locally advanced NSCLC. PMID:26622391

  8. Concurrent radiotherapy with gefitinib in elderly patients with esophageal squamous cell carcinoma: Preliminary results of a phase II study.

    PubMed

    Xu, Yaping; Zheng, Yuanda; Sun, Xiaojiang; Yu, Xinmin; Gu, Jialei; Wu, Wei; Zhang, Gu; Hu, Jinlin; Sun, Wenyong; Mao, Weimin

    2015-11-10

    The survival rate associated with esophageal cancer is very poor due to diagnosis at advanced stages of disease and insensitivity to chemotherapy. This study investigated the efficacy of gefitinib combination with radiation in 20 elderly patients with esophageal squamous cell carcinoma (ESCC) who were not eligible for platinum-based chemotherapy. Immunohistochemistry was performed to analyze epidermal growth factor receptor (EGFR) expression, and the amplified refractory mutation system was used to detect EGFR mutations. Treatment response was assessed by endoscopy and computed tomography. Treatment toxicity was evaluated using the National Cancer Institute's Common Toxicity Criteria. The data showed that among these 20 patients, 5 experienced a complete response (CR), 13 a partial response (PR), and 2 had stable disease. The overall response rate (CR + PR) was 90%, the median overall survival (OS) was 14.0 months (95% confidence interval [CI]: 10.0-17.9 months), and the median progression-free survival was 7.0 months (95% CI: 0-17.2 months). Patients with good Eastern Cooperative Oncology Group performance status, never smoking, and EGFR mutated tumors had the best OS (14.0, 14.0, and 17.0 months, respectively). Treatment-related grade 3/4 toxicity occurred in five patients. No case of grade 3/4 impaired liver function or hematological toxicity was observed. Concurrent radiotherapy with gefitinib is effective and tolerable in elderly ESCC patients. PMID:26392415

  9. Intel Concurrent Collections for Haskell

    E-print Network

    Newton, Ryan

    2011-03-22

    Intel Concurrent Collections (CnC) is a parallel programming model in which a network of steps (functions) communicate through message-passing as well as a limited form of shared memory. This paper describes a new ...

  10. Oral toxicity produced by chemotherapy: A systematic review

    PubMed Central

    2014-01-01

    Introduction: Antineoplastic chemotherapy remains one of the most widely used management strategies in cancer, either alone or in combination with other types of treatment. The main inconvenience of chemotherapy is its lack of selectivity, since it acts upon both tumor cells and rapidly multiplying normal cells such as bone marrow cells, hair follicle cells and oral and gastrointestinal mucosal cells. Material and method: An exhaustive search was made of the main oral toxic effects of chemotherapy in the PubMed-Medline, Cochrane Library and Scopus databases. A total of 1293 articles were identified, of which 333 met the study inclusion criteria. Results: The toxic effects of chemotherapy at oral mucosal level comprise mucositis, osteonecrosis of the jaws secondary to bisphosphonate use, susceptibility to infections, dental alterations, salivary and neurological disorders, dysgeusia and bleeding tendency. These complications have a negative impact upon patient quality of life, and in some cases can prove life-threatening. Conclusions: Evaluation of patient oral and dental health is essential before administering chemotherapy, in order to minimize the risk of oral and systemic complications of such treatment. Key words:Chemotherapy, oral complications, dental, saliva and osteonecrosis jaw. PMID:24596641

  11. A critical overview of concurrent chemoradiotherapy in cervical cancer.

    PubMed

    Sardi, Juan E; Boixadera, María A; Sardi, Juan J

    2004-11-01

    In February 1999, the National Cancer Institute of the US National Institutes of Health issued a communication stating that concurrent chemoradiotherapy should be considered as standard treatment for cervical cancer. This statement was based on the publication of five randomized prospective trials. On the basis of a critical review of these papers and others that identified different results, questions, doubts, and concerns have arisen about this therapeutic method. We analyzed the quality of the control groups managed with the standard treatment, noting data that may have altered these results, as well as analyzing the quality of chemotherapy, radiotherapy, and treatment compliance. In light of this analysis, we believe that further trials should be carried out with fairly balanced prognostic factors to demonstrate beyond a doubt that concurrent chemoradiotherapy is superior to radiotherapy alone. In developing countries where resources are scarce, this type of tumor is found frequently. Concurrent chemoradiotherapy would involve increased costs and supportive care, taking away resources from other vital areas. PMID:15485616

  12. Imperfect Information in Logic and Concurrent Games

    E-print Network

    Winskel, Glynn

    Imperfect Information in Logic and Concurrent Games Pierre Clairambault1 , Julian Gutierrez2 of Oxford Abstract. This paper builds on a recent definition of concurrent games as event structures and an application giving a concurrent-game model for predicate calculus. An extension to concurrent games

  13. Metronomic Adjuvant Chemotherapy Improves Treatment Outcome in Nasopharyngeal Carcinoma Patients With Postradiation Persistently Detectable Plasma Epstein-Barr Virus Deoxyribonucleic Acid

    SciTech Connect

    Twu, Chih-Wen; Wang, Wen-Yi; Chen, Chien-Chih; Liang, Kai-Li; Jiang, Rong-San; Wu, Ching-Te; Shih, Yi-Ting; Lin, Po-Ju; Liu, Yi-Chun; Lin, Jin-Ching

    2014-05-01

    Purpose: To investigate the effects of adjuvant chemotherapy in nasopharyngeal carcinoma (NPC) patients with persistently detectable plasma Epstein-Barr virus DNA (pEBV DNA) after curative radiation therapy plus induction/concurrent chemotherapy. Methods and Materials: The study population consisted of 625 NPC patients with available pEBV DNA levels before and after treatment. Eighty-five patients with persistently detectable pEBV DNA after 1 week of completing radiation therapy were eligible for this retrospective study. Of the 85 patients, 33 were administered adjuvant chemotherapy consisting of oral tegafur-uracil (2 capsules twice daily) for 12 months with (n=4) or without (n=29) preceding intravenous chemotherapy of mitomycin-C, epirubicin, and cisplatin. The remaining 52 patients who did not receive adjuvant chemotherapy served as the control group. Results: Baseline patient characteristics at diagnosis (age, sex, pathologic type, performance status, T classification, N classification, and overall stage), as well as previous treatment modality, were comparable in both arms. After a median follow-up of 70 months for surviving patients, 45.5% (15 of 33 patients) with adjuvant chemotherapy and 71.2% (37 of 52 patients) without adjuvant chemotherapy experienced tumor relapses (P=.0323). There were a significant reduction in distant failure (P=.0034) but not in local or regional recurrence. The 5-year overall survival rate was 71.6% for patients with adjuvant chemotherapy and 28.7% for patients without adjuvant chemotherapy (hazard ratio 0.27; 95% confidence interval 0.17-0.55; P<.0001). Conclusions: Our retrospective data showed that adjuvant chemotherapy can reduce distant failure and improve overall survival in NPC patients with persistently detectable pEBV DNA after curative radiation therapy plus induction/concurrent chemotherapy.

  14. Sphingolipids and response to chemotherapy.

    PubMed

    Dimanche-Boitrel, Marie-Thérèse; Rebillard, Amélie

    2013-01-01

    Chemotherapy is frequently used to treat primary or metastatic cancers, but intrinsic or acquired drug resistance limits its efficiency. Sphingolipids are important regulators of various cellular processes including proliferation, apoptosis, differentiation, angiogenesis, stress, and inflammatory responses which are linked to various aspects of cancer, like tumor growth, neoangiogenesis, and response to chemotherapy. Ceramide, the central molecule of sphingolipid metabolism, generally mediates antiproliferative and proapoptotic functions, whereas sphingosine-1-phosphate and other derivatives have opposing effects. Among the variety of enzymes that control ceramide generation, acid or neutral sphingomyelinases and ceramide synthases are important targets to allow killing of cancer cells by chemotherapeutic drugs. On the contrary, glucosylceramide synthase, ceramidase, and sphingosine kinase are other targets driving cancer cell resistance to chemotherapy. This chapter focuses on ceramide-based mechanisms leading to cancer therapy sensitization or resistance which could have some impacts on the development of novel cancer therapeutic strategies. PMID:23563652

  15. Managing Chemotherapy Side Effects: Nerve Changes

    MedlinePLUS

    ... anD human services national institutes of health Managing Chemotherapy Side Effects Nerve Changes “My fingers and toes ... I always wore shoes.” About nerve changes Some chemotherapy can cause nerve problems. You may have a ...

  16. Managing Chemotherapy Side Effects: Swelling (Fluid Retention)

    MedlinePLUS

    ... anD human services national institutes of health Managing Chemotherapy Side Effects Swelling (Fluid retention) “My hands and ... causes swelling? Swelling can be caused by the chemotherapy. Some types of cancer or hormone changes can ...

  17. Managing Chemotherapy Side Effects: Memory Changes

    MedlinePLUS

    ... C ancer I nstitute Managing Chemotherapy Side Effects Memory Changes What is causing these changes? Your doctor ... thinking or remembering things Managing Chemotherapy Side Effects: Memory Changes Get help to remember things. Write down ...

  18. Multitasking-Pascal extensions solve concurrency problems

    SciTech Connect

    Mackie, P.H.

    1982-09-29

    To avoid deadlock (one process waiting for a resource than another process can't release) and indefinite postponement (one process being continually denied a resource request) in a multitasking-system application, it is possible to use a high-level development language with built-in concurrency handlers. Parallel Pascal is one such language; it extends standard Pascal via special task synchronizers: a new data type called signal, new system procedures called wait and send and a Boolean function termed awaited. To understand the language's use the author examines the problems it helps solve.

  19. Fuzzy simulation in concurrent engineering

    NASA Technical Reports Server (NTRS)

    Kraslawski, A.; Nystrom, L.

    1992-01-01

    Concurrent engineering is becoming a very important practice in manufacturing. A problem in concurrent engineering is the uncertainty associated with the values of the input variables and operating conditions. The problem discussed in this paper concerns the simulation of processes where the raw materials and the operational parameters possess fuzzy characteristics. The processing of fuzzy input information is performed by the vertex method and the commercial simulation packages POLYMATH and GEMS. The examples are presented to illustrate the usefulness of the method in the simulation of chemical engineering processes.

  20. Foundations of Concurrent Kleene Algebra

    NASA Astrophysics Data System (ADS)

    Hoare, C. A. R.; Möller, Bernhard; Struth, Georg; Wehrman, Ian

    A Concurrent Kleene Algebra offers two composition operators, one that stands for sequential execution and the other for concurrent execution [10]. In this paper we investigate the abstract background of this law in terms of independence relations on which a concrete trace model of the algebra is based. Moreover, we show the interdependence of the basic properties of such relations and two further laws that are essential in the application of the algebra to a Jones style rely/guarantee calculus. Finally we reconstruct the trace model in a more abstract setting based on the notion of atoms from lattice theory.

  1. Mucositis Versus Tumor Control: The Therapeutic Index of Adding Chemotherapy to Irradiation of Head and Neck Cancer

    SciTech Connect

    Lee, Irwin H.; Eisbruch, Avraham

    2009-11-15

    Purpose: To determine whether the addition of concurrent chemotherapy to radiation for head and neck cancer (HNSCC) improves the therapeutic ratio regarding tumor control vs. mucositis. Methods and Materials: Data were taken from 14 randomized trials of radiation with or without concurrent chemotherapy for HNSCC. Mucositis-bioequivalent dose (mBED) was computed for each study using mBED = D [1 + d/(alpha/beta)] - 0.693(T - Tk)/Tp. An 'S-value,' relating the increase in the rate of Grade 3 (confluent) mucositis to the increase in mBED with radiation alone, was determined using data from trials of radiation alone with altered fractionation. We then determined the difference in the rate of mucositis and used the S-value to estimate the apparent difference in mBED in the chemoradiation and radiation alone arms for each trial. After accounting for differences in the radiation schedules, we estimated the mBED attributable to adding chemotherapy and compared it with previously published estimates of increases in tumor BED. Results: Computed S-values ranged from 0.4 to 1.7. For S = 1, the mean increase in mBED attributable to chemotherapy was 8.3 Gy{sub 10} (SD = 6.4). The average difference between tumor-BED and mBED was 2.8 Gy{sub 10} (SD = 6.0). Increasing the S-value decreases the estimated increase in mBED due to chemotherapy. Conclusions: Concurrent chemotherapy improves the therapeutic index for radiation of HNSCC. Further refinements are needed in quantifying the therapeutic gain attributable to specific radiosensitizing agents in clinical trials, notably better and more consistent reporting of treatment sequelae.

  2. Treatment of Nausea and Vomiting During Chemotherapy

    PubMed Central

    Mustian, Karen M; Devine, Katie; Ryan, Julie L; Janelsins, Michelle C; Sprod, Lisa K; Peppone, Luke J; Candelario, Grace D; Mohile, Supriya G; Morrow, Gary R

    2014-01-01

    Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment. PMID:24466408

  3. Visualization of Concurrent Program Executions

    NASA Technical Reports Server (NTRS)

    Artho, Cyrille; Havelund, Klaus; Honiden, Shinichi

    2007-01-01

    Various program analysis techniques are efficient at discovering failures and properties. However, it is often difficult to evaluate results, such as program traces. This calls for abstraction and visualization tools. We propose an approach based on UML sequence diagrams, addressing shortcomings of such diagrams for concurrency. The resulting visualization is expressive and provides all the necessary information at a glance.

  4. Concurrent Event Handling through Multithreading

    E-print Network

    Keckler, Stephen W.

    Concurrent Event Handling through Multithreading Stephen W. Keckler, Member, IEEE, Andrew Chang AbstractÐExceptions have traditionally been used to handle infrequently occurring and unpredictable events to increase the cost of event handling. Because of the deep pipelines and wide out-of-order superscalar

  5. Use of Concept of Chemotherapy-Equivalent Biologically Effective Dose to Provide Quantitative Evaluation of Contribution of Chemotherapy to Local Tumor Control in Chemoradiotherapy Cervical Cancer Trials

    SciTech Connect

    Plataniotis, George A. Dale, Roger G.

    2008-12-01

    Purpose: To express the magnitude of the contribution of chemotherapy to local tumor control in chemoradiotherapy cervical cancer trials in terms of the concept of the biologically effective dose. Methods and Materials: The local control rates of both arms of each study (radiotherapy vs. radiotherapy plus chemotherapy) reported from randomized controlled trials of concurrent chemoradiotherapy for cervical cancer were reviewed and expressed using the Poisson model for tumor control probability (TCP) as TCP = exp(-exp E), where E is the logarithm of cell kill. By combining the two TCP values from each study, we calculated the chemotherapy-related log cell kill as Ec = ln[(lnTCP{sub Radiotherapy})/(lnTCP{sub Chemoradiotherapy})]. Assuming a range of radiosensitivities ({alpha} = 0.1-0.5 Gy{sup -1}) and taking the calculated log cell kill, we calculated the chemotherapy-BED, and using the linear quadratic model, the number of 2-Gy fractions corresponding to each BED. The effect of a range of tumor volumes and radiosensitivities ({alpha} Gy{sup -1}) on the TCP was also explored. Results: The chemotherapy-equivalent number of 2-Gy fractions range was 0.2-4 and was greater in tumors with lower radiosensitivity. In those tumors with intermediate radiosensitivity ({alpha} = 0.3 Gy{sup -1}), the equivalent number of 2-Gy fractions was 0.6-1.3, corresponding to 120-260 cGy of extra dose. The opportunities for clinically detectable improvement are only available in tumors with intermediate radiosensitivity with {alpha} = 0.22-0.28 Gy{sup -1}. The dependence of TCP on the tumor volume decreases as the radiosensitivity increases. Conclusion: The results of our study have shown that the contribution of chemotherapy to the TCP in cervical cancer is expected to be clinically detectable in larger and less-radiosensitive tumors.

  6. The role of intravitreal chemotherapy for retinoblastoma

    PubMed Central

    Manjandavida, Fairooz P; Shields, Carol L

    2015-01-01

    Targeted therapy in retinoblastoma (RB) is widely accepted as the current management tool with an aim of increasing drug availability at the tumor location. Inevitably the effect is several times higher compared to systemic delivery of chemotherapeutic drugs and carries less systemic toxicity. Despite tremendous advancement in saving life, eye salvage in advanced RB especially with active vitreous seeds remains a challenge. The hypoxic environment of the vitreous and reduced vitreous concentration of the drugs delivered makes these tumor seeds resistant to chemotherapy. Direct delivery of chemotherapeutic drugs into the vitreous cavity aids to overcome these challenges and is progressively being accepted worldwide. However, intraocular procedure in RB was abandoned due to high risk of extraocular tumor dissemination. Recently, the forbidden therapeutic technique was re-explored and modified for safe use. Although eye salvage rate has tremendously improved after intravitreal chemotherapy (IVitC), retinal toxicity, and vision salvage are yet to be validated. In our preliminary report of intravitreal melphalan in 11 eyes, we reported 100% eye salvage and 0% recurrence with an extended 15 months mean follow-up. In this review, we analyzed published reports on IVitC in RB via PubMed, Medline, and conference proceedings citation index, electronic database search, without language restriction that included case series and reports of humans and experimental animal eyes with RB receiving IVitC. PMID:25827545

  7. Postoperative Chemotherapy Followed by Conformal Concomitant Chemoradiotherapy in High-Risk Gastric Cancer

    SciTech Connect

    Quero, Laurent; Bouchbika, Zineb; Kouto, Honorine; Baruch-Hennequin, Valerie; Gornet, Jean-Marc; Munoz, Nicolas; Cojean-Zelek, Isabelle; Houdart, Remi; Panis, Yves; Valleur, Patrice; Aparicio, Thomas; Maylin, Claude; Hennequin, Christophe

    2012-06-01

    Purpose: To analyze the efficacy, toxicity, and pattern of relapse after adjuvant cisplatin-based chemotherapy followed by three-dimensional irradiation and concomitant LV5FU2 chemotherapy (high-dose leucovorin and 5-fluorouracil bolus plus continuous infusion) in the treatment of completely resected high-risk gastric cancer. Methods and Materials: This was a retrospective analysis of 52 patients with high-risk gastric cancer initially treated by total/partial gastrectomy and lymphadenectomy between January 2002 and June 2007. Median age was 54 years (range, 36-75 years). Postoperative treatment consisted of 5-fluorouracil and cisplatin chemotherapy. Adjuvant chemotherapy was followed by three-dimensional conformal radiotherapy in the tumor bed and regional lymph nodes at 4500 cGy/25 fractions in association with concomitant chemotherapy. Concomitant chemotherapy consisted of a 2-h infusion of leucovorin (200 mg/m Superscript-Two ) followed by a bolus of 5-fluorouracil (400 mg/m Superscript-Two ) and then a 44-h continuous infusion of 5-fluorouracil (2400-3600 mg/m Superscript-Two ) given every 14 days, for three cycles (LV5FU2 protocol). Results: Five-year overall and disease-free survival were 50% and 48%, respectively. Distant metastases and peritoneal spread were the most frequent sites of relapse (37% each). After multivariate analysis, only pathologic nodal status was significantly associated with disease-free and overall survival. Acute toxicities were essentially gastrointestinal and hematologic. One myocardial infarction and one pulmonary embolism were also reported. Eighteen patients had a radiotherapy program interruption because of acute toxicity. All patients but 2 have completed radiotherapy. Conclusion: Postoperative cisplatin-based chemotherapy followed by conformal radiotherapy in association with concurrent 5-fluorouracil seemed to be feasible and resulted in successful locoregional control.

  8. Hemophagocytic Lymphohistiocytosis After Initiation of Chemotherapy for Bilateral Adrenal Neuroblastoma.

    PubMed

    Nascimento, Fábio A; Nery, Juliane; Trennepohl, Joanna; Pianovski, Mara A D

    2016-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a rare and aggressive syndrome characterized by overactivation of the immune system. Although secondary HLH has been frequently associated with malignancies, this entity is rarely triggered by solid tumors, such as neuroblastomas. Herein, we describe a 14-month-old girl with a late diagnosis of bilateral adrenal neuroblastoma who developed HLH 6 days after the initiation of chemotherapy. On the basis of the large tumoral mass and the time of onset of her symptoms suggestive of HLH, we hypothesize that tumor cell destruction induced by chemotherapy drugs was the trigger to the development of hematophagocytic lymphohistiocytosis syndrome. PMID:26583611

  9. Metastatic hidradenocarcinoma: Surgery and chemotherapy

    PubMed Central

    Amel, Trabelsi; Olfa, Gharbi; Faten, Hammedi; Makrem, Hochlef; Slim, Ben Ahmed; Moncef, Mokni

    2009-01-01

    Context: Hidradenocarcinoma is a rare carcinoma of high malignant potential. It most metastasizes to regional lymph nodes and distant viscera. Case report: We report a case of 52-year-old woman who presented with an invasive hidradenocarcinoma of the finger, treated with surgical excision. The patient presented with skin and lymph node metastases four years after, treated by chemotherapy. Conclusion: Hidradenocarcinoma is an aggressive tumor. It seems important to use adjuvant therapies particularly for recurrent and metastatic forms. PMID:22666726

  10. 29 CFR 502.17 - Concurrent actions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations... AND NATIONALITY ACT (SUSPENDED 6-29-2009) Enforcement of Work Contracts § 502.17 Concurrent actions. The taking of any one of the actions referred to above shall not be a bar to the concurrent taking...

  11. 29 CFR 502.17 - Concurrent actions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations... AND NATIONALITY ACT (SUSPENDED 6-29-2009) Enforcement of Work Contracts § 502.17 Concurrent actions. The taking of any one of the actions referred to above shall not be a bar to the concurrent taking...

  12. 29 CFR 502.17 - Concurrent actions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations... AND NATIONALITY ACT (SUSPENDED 6-29-2009) Enforcement of Work Contracts § 502.17 Concurrent actions. The taking of any one of the actions referred to above shall not be a bar to the concurrent taking...

  13. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one of the actions referred to in § 500.140 shall not be a bar to the concurrent taking of any other action... 29 Labor 3 2013-07-01 2013-07-01 false Concurrent actions. 500.141 Section 500.141...

  14. 78 FR 41078 - Acceptance of Concurrent Jurisdiction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... National Park Service Acceptance of Concurrent Jurisdiction AGENCY: National Park Service, Interior. ACTION: Notice of Concurrent Jurisdiction. SUMMARY: On behalf of the United States, the National Park Service has accepted concurrent legislative jurisdiction from the State of Michigan over lands and waters...

  15. 29 CFR 502.17 - Concurrent actions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations... AND NATIONALITY ACT (SUSPENDED 6-29-2009) Enforcement of Work Contracts § 502.17 Concurrent actions. The taking of any one of the actions referred to above shall not be a bar to the concurrent taking...

  16. 29 CFR 502.17 - Concurrent actions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations... AND NATIONALITY ACT (SUSPENDED 6-29-2009) Enforcement of Work Contracts § 502.17 Concurrent actions. The taking of any one of the actions referred to above shall not be a bar to the concurrent taking...

  17. 29 CFR 541.106 - Concurrent duties.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Concurrent duties. 541.106 Section 541.106 Labor... Executive Employees § 541.106 Concurrent duties. (a) Concurrent performance of exempt and nonexempt work... otherwise met. Whether an employee meets the requirements of § 541.100 when the employee performs...

  18. 37 CFR 2.42 - Concurrent use.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.42 Concurrent use. An application for registration as a lawful concurrent user shall specify and contain all the elements required by... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Concurrent use. 2.42...

  19. 29 CFR 541.106 - Concurrent duties.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Concurrent duties. 541.106 Section 541.106 Labor... Executive Employees § 541.106 Concurrent duties. (a) Concurrent performance of exempt and nonexempt work... otherwise met. Whether an employee meets the requirements of § 541.100 when the employee performs...

  20. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one of the actions referred to in § 500.140 shall not be a bar to the concurrent taking of any other action... 29 Labor 3 2010-07-01 2010-07-01 false Concurrent actions. 500.141 Section 500.141...

  1. 37 CFR 2.42 - Concurrent use.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.42 Concurrent use. An application for registration as a lawful concurrent user shall specify and contain all the elements required by... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Concurrent use. 2.42...

  2. 37 CFR 2.42 - Concurrent use.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.42 Concurrent use. An application for registration as a lawful concurrent user shall specify and contain all the elements required by... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Concurrent use. 2.42...

  3. 29 CFR 541.106 - Concurrent duties.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Concurrent duties. 541.106 Section 541.106 Labor... Executive Employees § 541.106 Concurrent duties. (a) Concurrent performance of exempt and nonexempt work... otherwise met. Whether an employee meets the requirements of § 541.100 when the employee performs...

  4. 37 CFR 2.42 - Concurrent use.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.42 Concurrent use. An application for registration as a lawful concurrent user shall specify and contain all the elements required by... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Concurrent use. 2.42...

  5. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one of the actions referred to in § 500.140 shall not be a bar to the concurrent taking of any other action... 29 Labor 3 2011-07-01 2011-07-01 false Concurrent actions. 500.141 Section 500.141...

  6. 29 CFR 541.106 - Concurrent duties.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Concurrent duties. 541.106 Section 541.106 Labor... Executive Employees § 541.106 Concurrent duties. (a) Concurrent performance of exempt and nonexempt work... otherwise met. Whether an employee meets the requirements of § 541.100 when the employee performs...

  7. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one of the actions referred to in § 500.140 shall not be a bar to the concurrent taking of any other action... 29 Labor 3 2014-07-01 2014-07-01 false Concurrent actions. 500.141 Section 500.141...

  8. 37 CFR 2.42 - Concurrent use.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.42 Concurrent use. An application for registration as a lawful concurrent user shall specify and contain all the elements required by... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Concurrent use. 2.42...

  9. 78 FR 8189 - Acceptance of Concurrent Jurisdiction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ... National Park Service Acceptance of Concurrent Jurisdiction AGENCY: National Park Service, Interior. ACTION: Notice of Concurrent Jurisdiction. SUMMARY: On behalf of the United States, the National Park Service has accepted concurrent legislative jurisdiction from the State of Washington over lands and...

  10. 29 CFR 541.106 - Concurrent duties.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Concurrent duties. 541.106 Section 541.106 Labor... Executive Employees § 541.106 Concurrent duties. (a) Concurrent performance of exempt and nonexempt work... otherwise met. Whether an employee meets the requirements of § 541.100 when the employee performs...

  11. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one of the actions referred to in § 500.140 shall not be a bar to the concurrent taking of any other action... 29 Labor 3 2012-07-01 2012-07-01 false Concurrent actions. 500.141 Section 500.141...

  12. Concurrent Initialization for Bearing-Only SLAM

    PubMed Central

    Munguía, Rodrigo; Grau, Antoni

    2010-01-01

    Simultaneous Localization and Mapping (SLAM) is perhaps the most fundamental problem to solve in robotics in order to build truly autonomous mobile robots. The sensors have a large impact on the algorithm used for SLAM. Early SLAM approaches focused on the use of range sensors as sonar rings or lasers. However, cameras have become more and more used, because they yield a lot of information and are well adapted for embedded systems: they are light, cheap and power saving. Unlike range sensors which provide range and angular information, a camera is a projective sensor which measures the bearing of images features. Therefore depth information (range) cannot be obtained in a single step. This fact has propitiated the emergence of a new family of SLAM algorithms: the Bearing-Only SLAM methods, which mainly rely in especial techniques for features system-initialization in order to enable the use of bearing sensors (as cameras) in SLAM systems. In this work a novel and robust method, called Concurrent Initialization, is presented which is inspired by having the complementary advantages of the Undelayed and Delayed methods that represent the most common approaches for addressing the problem. The key is to use concurrently two kinds of feature representations for both undelayed and delayed stages of the estimation. The simulations results show that the proposed method surpasses the performance of previous schemes. PMID:22294884

  13. Unusually Located Stroke After Chemotherapy in Testicular Germ Cell Tumors

    PubMed Central

    Martinez, Braulio Alexander

    2015-01-01

    Testicular cancer is a type of malignancy that affects young adults and has high rates of cure; however, as any malignancy, it is associated with an increased risk of ischemic or hemorrhagic cerebrovascular disease, given the systemic tumor effects or side effects of chemotherapy, which in turn increases morbidity, functional impairment, and additional risk of early death. PMID:26425644

  14. Principles and major agents in clinical oncology chemotherapy

    SciTech Connect

    Weller, R.E.

    1991-10-01

    This paper provides a brief classification of drugs available for veterinary chemotherapy, as well as justifications for their use. Some common neoplasia and the drugs of choice for their treatment are described. A listing by class of systemic chemotherapeutic agents, their mode of action, tumors responsive to the drugs, precautions and common adverse effects and mode of administration is provided. 2 tabs. (MHB)

  15. Concurrent engineering teams. Volume 2: Annotated bibliography

    NASA Astrophysics Data System (ADS)

    Richter, Karen J.; Dierolf, David A.

    1990-11-01

    Specific concurrent engineering practices vary among organizations. There are, however, various management practices that appear to work well for most organizations. This paper presents the reader with specific, useful examples from several defense contractors illustrating how multifunctional concurrent engineering teams are being organized and managed and how concurrent engineering team meetings are conducted and supported. The types of computer support that could be used to enhance the efficiency and effectiveness of concurrent engineering team meetings are identified. The general findings are that there exists a direct relationship between total quality management (TQM) and concurrent engineering, and that many applications of computer-aided group problem solving are possible and practical today for the concurrent engineering team meetings. Areas identified for additional research are the documentation of the decision process and rationale during the product and process definition, the capturing of lessons learned during the implementation of concurrent engineering, and the performance evaluation and training of team members.

  16. Chemotherapy-associated paronychia treated with a dilute povidone-iodine/dimethylsulfoxide preparation

    PubMed Central

    Capriotti, Kara; Capriotti, Joseph A

    2015-01-01

    Background Nail changes associated with chemotherapy in general, and particularly with taxane and epidermal growth factor receptor inhibitor-based regimens, are common presentations in our clinical population. Currently, there are no consensuses about therapies supported by clinical trials nor are there any US Food and Drug Administration-approved treatments for this indication. Findings A 42-year-old woman with stage 2A breast cancer presented to our clinic with chemotherapy-induced paronychia. Symptoms were severe enough that cessation of chemotherapy was being considered. The patient’s chemotherapy regimen included doxorubicin, cyclophosphamide, and docetaxel. Conclusion The topical povidone-iodine/dimethylsulfoxide system is very effective in alleviating the signs and symptoms of severe paronychia associated with chemotherapy. This novel combination warrants further investigation in randomized, controlled trials to further elucidate its clinical utility. PMID:26445556

  17. Palladium interstitial implant in combination with external beam radiotherapy and chemotherapy for the definitive treatment of a female urethral carcinoma

    PubMed Central

    Bagshaw, Hilary P.; Williams, Ned L.; Huang, Y. Jessica; Tward, Jonathan D.; Gaffney, David K.

    2015-01-01

    Primary urethral cancer is a rare diagnosis, especially in females. This report presents the utilization of a palladium interstitial implant and a review of the retrospective data published on the management of female urethral cancer. Excellent local control and survival has been obtained with the use of a palladium interstitial implant in combination with external beam radiotherapy and concurrent chemotherapy. This modality represents a novel and effective way to treat primary urethral cancer in females. PMID:26425719

  18. Prospective Phase I-II Trial of Helical Tomotherapy With or Without Chemotherapy for Postoperative Cervical Cancer Patients

    SciTech Connect

    Schwarz, Julie K.; Wahab, Sasa; Grigsby, Perry W.

    2011-12-01

    Purpose: To investigate, in a prospective trial, the acute and chronic toxicity of patients with cervical cancer treated with surgery and postoperative intensity-modulated radiotherapy (RT) delivered using helical tomotherapy, with or without the administration of concurrent chemotherapy. Patients and Methods: A total of 24 evaluable patients entered the study between March 2006 and August 2009. The indications for postoperative RT were tumor size, lymphovascular space invasion, and the depth of cervical stromal invasion in 15 patients; 9 patients underwent postoperative RT because of surgically positive lymph nodes. All patients underwent pelvic RT delivered with helical tomotherapy and intracavitary high-dose-rate brachytherapy. Treatment consisted of concurrent weekly platinum in 17, sequential carboplatin/Taxol in 1, and RT alone in 6. The patients were monitored for acute and chronic toxicity using the Common Toxicity Criteria, version 3.0. Results: The median follow-up was 24 months (range, 4-49). At the last follow-up visit, 23 patients were alive and disease free. Of the 24 patients, 12 (50%) experienced acute Grade 3 gastrointestinal toxicity (anorexia in 5, diarrhea in 4, and nausea in 3). One patient developed acute Grade 4 genitourinary toxicity (vesicovaginal fistula). For patients treated with concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 71% and 24%, respectively. For patients treated without concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 29% and 14%, respectively. Two long-term toxicities occurred (vesicovaginal fistula at 25 months and small bowel obstruction at 30 months). The overall and progression-free survival rate at 3 years for all patients was 100% and 89%, respectively. Conclusion: The results of our study have shown that postoperative external RT for cervical cancer delivered with helical tomotherapy and high-dose-rate brachytherapy and with or without chemotherapy is feasible, with acceptable acute and chronic toxicity.

  19. Cyclophosphamide, epirubicin and fluorouracil chemotherapy-induced alteration of haemostasis markers in breast cancer patients

    PubMed Central

    WANG, ZHI; DANG, CHENGXUE; ZHU, KUN; ZHANG, YONG; CHANG, DONGMIN; XIA, PENG; SONG, YONGCHUN; LI, KANG

    2015-01-01

    The occurrence of chemotherapy-induced alterations in markers of haemostasis during chemotherapy has been reported previously. However, the change of the haemostasis markers in the cyclophosphamide, epirubicin and fluorouracil (CEF) regimen remains unclear. The aim of the present study was to identify the change of the haemostasis markers during systemic chemotherapy (600 mg/m2 cyclophosphamide, 80 mg/m2 epirubicin and 500 mg/m2 fluorouracil; four courses over 21 days) to investigate its influence on the haemostasis markers of breast cancer patients and to discuss the requirement of anticoagulation therapy. D-dimer, activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen (FIB) values were obtained before chemotherapy and on days 1, 4, 7 and 21. The results show that PT, D-dimer and FIB were not prolonged prior to chemotherapy compared to that under the control. APTT was prolonged until day 4. The levels of D-dimer and APTT were significantly higher compared to those of the breast cancer patients before receiving chemotherapy and controls on days 1, 4, 7 and 21 after chemotherapy. Alteration of the haemostasis markers occurred in the breast cancer patients under the CEF chemotherapy regimen. As there is an increased risk of deep vein thrombosis and pool prognosis of cancer patients, anticoagulant therapy should be considered. PMID:26623056

  20. MemC3: Compact and Concurrent MemCache with Dumber Caching and Smarter Hashing

    E-print Network

    that substantially improve both its memory e ciency and throughput. These techniques-- optimistic cuckoo hashing in a system we call MemC3--Memcached with CLOCK and Concurrent Cuckoo hashing--but believe that they also]. This paper presents MemC3 (Memcached with CLOCK and Concurrent Cuckoo Hashing), a complete redesign

  1. Chemotherapy

    MedlinePLUS

    ... change - Use this tool to play your goals. Hot Topics Can I Prevent Acne? Managing Your Weight ... temperature beverages may be easier to drink than hot or cold liquids. Get on a medication schedule. ...

  2. Chemotherapy

    MedlinePLUS

    Collins JM. Cancer pharmacology. Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 29. National Cancer Institute. ...

  3. Chemotherapy

    MedlinePLUS

    ... of Directors Committees/Working Groups By-Laws Committee Cervical Cancer Working Group Clinical Trials Working Group Communications Committee ... Connected About Gynecologic Cancers Types of Gynecologic Cancers Cervical Cancer Screening and Prevention Primary Prevention with Cervical Cancer ...

  4. How Formal Dynamic Verification Tools Facilitate Novel Concurrency Visualizations

    NASA Astrophysics Data System (ADS)

    Aananthakrishnan, Sriram; Delisi, Michael; Vakkalanka, Sarvani; Vo, Anh; Gopalakrishnan, Ganesh; Kirby, Robert M.; Thakur, Rajeev

    With the exploding scale of concurrency, presenting valuable pieces of information collected by formal verification tools intuitively and graphically can greatly enhance concurrent system debugging. Traditional MPI program debuggers present trace views of MPI program executions. Such views are redundant, often containing equivalent traces that permute independent MPI calls. In our ISP formal dynamic verifier for MPI programs, we present a collection of alternate views made possible by the use of formal dynamic verification. Some of ISP’s views help pinpoint errors, some facilitate discerning errors by eliminating redundancy, while others help understand the program better by displaying concurrent even orderings that must be respected by all MPI implementations, in the form of completes-before graphs. In this paper, we describe ISP’s graphical user interface (GUI) capabilities in all these areas which are currently supported by a portable Java based GUI, a Microsoft Visual Studio GUI, and an Eclipse based GUI whose development is in progress.

  5. Concurrent algorithms for autonomous robot navigation in an unexplored terrain

    SciTech Connect

    Rao, S.V.N.; Iyengar, S.S.; Jorgensen, C.C.; Weisbin, C.R.

    1986-01-01

    Navigation planning is one of the vital aspects of any autonomous mobile robot. In this paper, we present concurrent algorithms for an autonomous robot navigation system that does not require a pre-learned obstacle terrain model. The terrain model is gradually built by integrating the information from multiple journeys. The available information is used to the maximum extent in navigation planning, and global optimality is gradually achieved. It is shown that these concurrent algorithms are free from deadlocks and starvation. The performance of the concurrent algorithms is analyzed in terms of the planning time, travel time, scanning time, and update time. A modified adjacency list is proposed as the data structure for the spatial graph that represents an obstacle terrain. The time complexities of various algorithms that access, maintain, and update the spatial graph are estimated, and the effectiveness of the implementation is illustrated.

  6. Recombine Endostatin With Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiation in Advanced Nasopharynx Cancer

    ClinicalTrials.gov

    2013-03-11

    1?Enough Cases; 2?Elekta Precise 1343 Digital Control Electron Linear Accelerator; Can Undertake Nasopharyngeal Carcinoma Specimens in the Materia?; Image Department of Nose Pharynx Ministry MRI Dynamic Testing,

  7. Hepatic imaging response to radioembolization with yttrium-90-labeled resin microspheres for tumor progression during systemic chemotherapy in patients with colorectal liver metastases

    PubMed Central

    Ball, David S.; Cohen, Steven J.; Cohn, Michael; Coldwell, Douglas M.; Drooz, Alain; Ehrenwald, Eduardo; Kanani, Samir; Nutting, Charles W.; Moeslein, Fred M.; Putnam, Samuel G.; Rose, Steven C.; Savin, Michael A.; Schirm, Sabine; Sharma, Navesh K.; Wang, Eric A.

    2015-01-01

    Background To assess response and the impact of imaging artifacts following radioembolization with yttrium-90-labeled resin microspheres (90Y-RE) based on the findings from a central independent review of patients with liver-dominant metastatic colorectal cancer (mCRC). Methods Patients with mCRC who received 90Y-RE (SIR-Spheres®; Sirtex Medical, Sydney, Australia) at nine US institutions between July 2002 and December 2011 were included in the analysis. Tumor response was assessed at baseline and 3 months using either the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.0 or 1.1. For each lesion, known artifacts affecting the interpretation of response (peri-tumoral edema and necrosis) were documented. Survivals (Kaplan-Meier analyses) were compared in responders [partial response (PR)] and non-responders [stable (SD) or progressive disease (PD)]. Results Overall, 195 patients (mean age 62 years) received 90Y-RE after a median of 2 (range, 1-6) lines of prior chemotherapy. Using RECIST 1.0 and RECIST 1.1, 7.6% and 6.9% of patients were partial responders, 47.3% and 48.1% had SD, and 55.0% and 55.0% PD, respectively. RECIST 1.0 and RECIST 1.1 showed excellent agreement {Kappa =0.915 [95% confidence interval (CI): 0.856-0.975]}. Peri-tumoral edema was documented in 32.8%, necrosis in 48.1% and both in 57.3% of cases (using RECIST 1.0). Although baseline characteristics were similar in responders and non-responders (P>0.05), responders survived significantly longer in an analysis according to RECIST 1.0: PR median (95% CI) 25.2 (range, 9.2-49.4) months vs. SD 15.8 (range, 9.3-21.1) months vs. PD 7.1 (range, 6.0-9.5) months (P<0.0001). Conclusions RECIST 1.0 and RECIST 1.1 imaging responses provide equivalent interpretations in the assessment of hepatic tumors following 90Y-RE. Radiologic lesion responses at 3 months must be interpreted with caution due to the significant proportion of patients with peri-tumoral edema and necrosis, which may lead to an under-estimation of PR/SD. Nevertheless, 3-month radiologic responses were predictive of prolonged survival. PMID:26697190

  8. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review.

    PubMed

    Osman, Mohammed

    2014-09-23

    Cervical cancer is the second most common cancer in women. Neoadjuvant chemotherapy for patients with locally advanced cervix cancer has comparable benefits to concurrent chemoradiotherapy (CCRT), but with fewer side effects. This systematic review aims to provide a comprehensive summary of the benefits of neoadjuvant chemotherapy for the management of locally advanced cervix cancer from stage IB2 (tumor >4.0 cm) to IIIB (tumor extending to the pelvic wall and/or hydronephrosis). Our primary objective was to assess benefits in terms of survival. The data source included the USA national library of medicine, Medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systematic review included studies published between January 1997 and December 2012. In terms of histology, they had to be focused on squamous cell carcinoma, adenosquamous carcinoma, and/or adenocarcinoma. Patients should be either chemotherapy naïve or cervix cancer chemotherapy naïve, and have a performance status ?2. The search in the above-mentioned scientific websites led to identify 49 publications, 19 of which were excluded, as they did not meet the inclusion criteria of this systematic review. Therefore only 30 studies were deemed eligible. Data was collected from 1760 patients enrolled in the current systematic review study. The mean age was 45.2 years. The mean tumor size was 4.7 cm. The most commonly used chemotherapies were cisplatin doublets. Paclitaxel was the most commonly used chemotherapeutic agent in the doublets. The mean chemotherapy cycles were 2.7. After chemotherapy, patients underwent surgery after a mean time of 2.5 weeks. The standard operation was radical hysterectomy with pelvic lymphadenectomy. Chemotherapy achieved an objective response rate of 84%. The 5-year progression-free survival and overall survival were 61.9% and 72.8% respectively. The treatment protocol was associated with a mild early toxicity profile. Leucopenia and neutropenia were the most common side effects. Late toxicity was also generally mild and mainly associated with bladder dysfunction and vaginal dehiscence. The quality of the studies was assessed using the Newcastle-Ottawa quality assessment scale. Neoadjuvant chemotherapy achieved comparable survival results to CCRT, and was associated with less toxicity. PMID:25992238

  9. Leptomeningeal carcinomatosis in relapsed non-seminoma testis: a 1-year complete remission with high-dose chemotherapy.

    PubMed

    Denissen, N H A M; van Spronsen, D J; Smilde, T J; De Mulder, P H M

    2005-09-01

    A 1-year complete remission could be achieved with high-dose systemic chemotherapy in a 33-year-old patient with relapsed germ cell tumor presenting with leptomeningeal carcinomatosis (LC). Although LC in general has a very poor prognosis for patients with chemosensitive malignancies, systemic chemotherapy should be considered. PMID:16096440

  10. Method of concurrently filtering particles and collecting gases

    DOEpatents

    Mitchell, Mark A; Meike, Annemarie; Anderson, Brian L

    2015-04-28

    A system for concurrently filtering particles and collecting gases. Materials are be added (e.g., via coating the ceramic substrate, use of loose powder(s), or other means) to a HEPA filter (ceramic, metal, or otherwise) to collect gases (e.g., radioactive gases such as iodine). The gases could be radioactive, hazardous, or valuable gases.

  11. Concurrency in Biological Modeling: Behavior, Execution and Visualization

    E-print Network

    Harel, David

    -term goal is to comprehensively model an entire organism, which can be viewed as a very complex system the complexity of the problem by modeling particular organs of the complete organism [4]. We then can combine reduce the organ's complexity by modeling its basic concurrent elements, molecules and cells. Again

  12. Concurrent Direct Network Access for Virtual Machine Monitors Paul Willmann

    E-print Network

    Concurrent Direct Network Access for Virtual Machine Monitors Paul Willmann Jeffrey Shafer David running within a virtual machine monitor. In a conventional virtual machine monitor, each operating system running within a virtual machine must access the network through a software-virtualized network interface

  13. Chemotherapy of advanced gastric cancer.

    PubMed

    Rivera, Fernando; Vega-Villegas, M Eugenia; López-Brea, Marta F

    2007-06-01

    Gastric cancer is the second most frequent cancer in the world. Approximately 84% of patients with gastric cancer will have advanced disease and median survival of these patients without chemotherapy is only 3-4 months. "Classical" chemotherapy regimens, mainly CF (cisplatin plus infusional 5FU) and ECF (cisplatin plus infusional 5FU plus Epirubicin) obtain responses in 20-40% of the patients and improve quality of life. Nevertheless, duration of these responses is short with very few complete responses. Median time to tumor progression (TTP) with these regimens is only about 4-5 months and median survival does not exceed 7-10 months. Moreover, benefit seems to be limited to patients with good performance status and treatment toxicity and discomfort are not negligible, specially that of regimens with cisplatin or infusional 5FU. Trying to improve these results, the incorporation of new drugs has been explored. Among the new combinations, the more developed ones are those with Docetaxel (DCF), oxaliplatin (EOX, FLO), Capecitabine (EOX, cisplatin-Xeloda) and irinotecan (ILF). We have final results from Phase III trials that suggest that all these regimens could have a role in the treatment of these patients but survival is still very poor and toxicity remains important. It would be interesting to investigate other new combinations and the incorporation of drugs directed against new therapeutic targets in this setting. It would be of utmost interest that these clinical trials would also explore clinical and molecular prognostic and predictive factors. PMID:17376598

  14. CT staging of esophageal carcinoma in patients treated by primary radiation therapy and chemotherapy.

    PubMed

    Unger, E C; Coia, L; Gatenby, R; Kessler, H; Hartz, W; Clair, M; Broder, G

    1992-01-01

    Primary radiation therapy with concurrent chemotherapy is under study as definitive and palliative therapy for patients with esophageal carcinoma. To evaluate the correlation between CT staging and outcome, we retrospectively reviewed the CT scans of 48 patients treated with primary radiation therapy and concurrent chemotherapy and correlated CT staging with disease-free survival, overall survival, and site of relapse. Excluding one patient who was understaged and six patients who died of problems unrelated to esophageal carcinoma, mean survival of CT stage I, II, and III patients was 14.7, 21.3, and 5.2 months, respectively. When the CT stage is modified by the presence of nodal involvement on CT, the mean survival of stage IIn and IIIn (nodes greater than 1.5 cm in diameter) and stage IV patients (distant metastases) was 16.4, 19.2, and 10.6 months, respectively. Despite thickening of the esophageal wall greater than 3.0 cm in five patients with stage IIn cancer, mean survival was still 19.2 months. Patients with pericardial effusion had the worst survival of only 4.3 months. Stage II patients had a significantly longer (p less than 0.05) disease-free period than all other groups and the difference between stage II and III patients was highly significant (p less than 0.01). Stage II patients were also more likely to be disease-free at the time of death or last follow-up (p less than 0.05). Computed tomographic staging of esophageal carcinoma is useful in radiation therapy treatment planning and predicting outcome of patients managed with a nonsurgical technique of concurrent radiation and chemotherapy. PMID:1545019

  15. Concurrence of superpositions of many states

    SciTech Connect

    Akhtarshenas, Seyed Javad

    2011-04-15

    In this paper, we use the concurrence vector as a measure of entanglement, and investigate lower and upper bounds on the concurrence of a superposition of bipartite states as a function of the concurrence of the superposed states. We show that the amount of entanglement quantified by the concurrence vector is exactly the same as that quantified by I concurrence, so that our results can be compared to those given in Phys. Rev. A 76, 042328 (2007). We obtain a tighter lower bound in the case in which the two superposed states are orthogonal. We also show that when the two superposed states are not necessarily orthogonal, both lower and upper bounds are, in general, tighter than the bounds given in terms of the I concurrence. An extension of the results to the case with more than two states in the superpositions is also given.

  16. Preparing HEP software for concurrency

    NASA Astrophysics Data System (ADS)

    Clemencic, M.; Hegner, B.; Mato, P.; Piparo, D.

    2014-06-01

    The necessity for thread-safe experiment software has recently become very evident, largely driven by the evolution of CPU architectures towards exploiting increasing levels of parallelism. For high-energy physics this represents a real paradigm shift, as concurrent programming was previously only limited to special, well-defined domains like control software or software framework internals. This paradigm shift, however, falls into the middle of the successful LHC programme and many million lines of code have already been written without the need for parallel execution in mind. In this paper we have a closer look at the offline processing applications of the LHC experiments and their readiness for the many-core era. We review how previous design choices impact the move to concurrent programming. We present our findings on transforming parts of the LHC experiment reconstruction software to thread-safe code, and the main design patterns that have emerged during the process. A plethora of parallel-programming patterns are well known outside the HEP community, but only a few have turned out to be straightforward enough to be suited for non-expert physics programmers. Finally, we propose a potential strategy for the migration of existing HEP experiment software to the many-core era.

  17. Axioms for concurrent objects. Interim report

    SciTech Connect

    Herlihy, M.P.; Wing, J.M.

    1987-12-01

    Specification and verification techniques for abstract data types that have been successful for sequential programs can be extended in a natural way to provide the same benefits for concurrent programs. An approach is proposed to specifying and verifying concurrent objects based on a novel correctness condition, called linearizability. Linearizability provides the illusion that each operation takes effect instantaneously at some point between its invocation and its response, implying that the meaning of a concurrent objects operations can still be given by pre- and post conditions. This paper defines and discusses linearizability, and then give examples of how to reason about concurrent objects and verify their implementations based on their (sequential) axiomatic specifications.

  18. Light protection of chemotherapy drugs for infusion.

    PubMed

    Clarkson, Douglas McG; Harvey, Roger; Sheepy, Dave

    2015-02-01

    Specific chemotherapy drugs which require to be delivered by continuous infusion over time can have their effectiveness impaired by exposure to optical radiation. Mechanisms and processes of drug preparation and patient administration associated with light sensitive drugs were monitored within a Chemotherapy Unit. Levels of ambient light at locations of drug preparation/administration and levels of protection afforded by optical filter elements such as infusion lines were determined using a double grating Bentham Dmc150 spectroradiometer. Models of light exposure were developed for separate components of drug preparation and infusion delivery systems where the latter included the fluid bag with protective light cover, drip chamber and giving set line. In addition, the attenuation coefficient of Dacarbazine at the concentration typically used in patient treatments was determined using specially manufactured measurement cells. The relative contributions to light absorption of the drug bag, drip chamber and patient line were identified for specific types of giving sets, spectral content/intensity of light exposure and specific drug light absorption profiles. This indicated significant differences in the level of light protection afforded by specific giving sets and either single or double layer protection of the drug bag reservoir. It is not clear, however, if these variations could lead to significant differences of levels of drug de-activation and/or creation of undesirable photo-products such as in the case of Dacarbazine. Such techniques, however, provide a means of identifying how light exposure can be maintained at levels as low as reasonably possible as a precautionary measure. PMID:25556147

  19. Survey Of Concurrent-Processors For Signal Processing Applications

    NASA Astrophysics Data System (ADS)

    Bond, J. Walter

    1980-12-01

    This paper summarizes a survey of concurrent-processing computer systems, particularly their descriptive differences and performance. The motivation is the high data processing rates required by ever-larger applications of infrared sensors and radar for data accumula-tion and the speed constraints of technology. The scope of the application and the technological limitations have caused consideration of alternative computer systems architectures for signal processing. In support of this, a survey was done of installations which are built and functioning, first to assess the architecture's application to signal processing, and second, to understand the difficulties inherent in developing an operational concurrent-processing computer system. The surveyed systems include C.mmp, Cm*, PLURIBUS, S-1, ILLIAC IV, STARAN, PEPE, CDC *100, TIASC, CRI - CR1, and the fault tolerant systems JPL-STAR and SRI-Sift. Some systems have been excluded from this paper because they either are not completed to an operational stage or are classified. In this investigation of system architectural issues for signal processing applications, it became evident that no effective systems characterizations for concurrent processors exist. Furthermore, performance measures for these systems are awkward and poorly related to the characterizations. The performance mea-sures thus need refinement. A descriptor is proposed which contains the elements of data flow, control and reliability and to which the performance measures can be properly related.

  20. Macrocell design for concurrent signal processing

    SciTech Connect

    Pope, S.P.; Brodersen, R.W.

    1983-01-01

    Macrocells serve as subsystems at the top level of the hardware design hierarchy. The authors present the macrocell design technique as applied to the implementation of real-time, sampled-data signal processing functions. The design of such circuits is particularly challenging due to the computationally intensive nature of signal-processing algorithms and the constraints of real-time operation. The most efficient designs make use of a high degree of concurrency-a property facilitated by the microcell approach. Two circuit projects whose development resulted largely from the macrocell methodology described are used as examples throughout the report: a linear-predictive vocoder circuit, and a front-end filter-bank chip for a speech recognition system. Both are monolithic multiprocessor implementations: the lpc vocoder circuit contains three processors, the filter-bank chip two processors. 10 references.

  1. Modification of chemotherapy by nitroimidazoles

    SciTech Connect

    Siemann, D.W.

    1984-09-01

    The potentiation of chemotherapeutic agents by radiation sensitizers has been extensively studied for several years. There is little doubt that the effectiveness of certain anti-cancer drugs, primarily alkylating agents, can readily be enhanced both in vitro and in vivo through the addition of a sensitizer. While enhanced effects have been observed in certain critical normal tissues, in general most animal model studies have demonstrated a therapeutic gain at large sensitizer doses. This approach to combination therapies therefore appears promising. Yet many questions concerning the interaction between chemotherapeutic agents and radiosensitizers, particularly in the aspects of modification of chemotherapy by nitroimidazoles are reviewed and discussed. These address the importance in chemopotentiation of (i) hypoxia, (ii) alterations in DNA damage and/or repair, (iii) depletion of intracellular sulfhydryls and (iv) modification of drug pharmacokinetics.

  2. Phase 3 Trial of Postoperative Chemotherapy Alone Versus Chemoradiation Therapy in Stage III-IV Gastric Cancer Treated With R0 Gastrectomy and D2 Lymph Node Dissection

    SciTech Connect

    Kim, Tae Hyun; Park, Sook Ryun; Ryu, Keun Won; Kim, Young-Woo; Bae, Jae-Moon; Lee, Jun Ho; Choi, Il Ju; Kim, Yeon-Joo; Kim, Dae Yong

    2012-12-01

    Purpose: To compare chemotherapy alone with chemoradiation therapy in stage III-IV(M0) gastric cancer treated with R0 gastrectomy and D2 lymph node dissection. Methods and Materials: The chemotherapy arm received 5 cycles of fluorouracil and leucovorin (FL), and the chemoradiation therapy arm received 1 cycle of FL, then radiation therapy of 45 Gy concurrently with 2 cycles of FL, followed by 2 cycles of FL. Intent-to-treat analysis and per-protocol analyses were performed. Results: Between May 6, 2002 and June 29, 2006, a total of 90 patients were enrolled. Forty-four were randomly assigned to the chemotherapy arm and 46 to the chemoradiation therapy arm. Treatment was completed as planned by 93.2% of patients in the chemotherapy arm and 87.0% in the chemoradiation therapy arm. Overall intent-to-treat analysis showed that addition of radiation therapy to chemotherapy significantly improved locoregional recurrence-free survival (LRRFS) but not disease-free survival. In subgroup analysis for stage III, chemoradiation therapy significantly prolonged the 5-year LRRFS and disease-free survival rates compared with chemotherapy (93.2% vs 66.8%, P=.014; 73.5% vs 54.6%, P=.056, respectively). Conclusions: Addition of radiation therapy to chemotherapy could improve the LRRFS in stage III gastric cancer treated with R0 gastrectomy and D2 lymph node dissection.

  3. Does Concurrent Radiochemotherapy Affect Cosmetic Results in the Adjuvant Setting After Breast-Conserving Surgery? Results of the ARCOSEIN Multicenter, Phase III Study: Patients' and Doctors' Views

    SciTech Connect

    Toledano, Alain H. . E-mail: alain.toledano@gmail.com; Bollet, Marc A.; Fourquet, Alain; Azria, David; Gligorov, Joseph; Garaud, Pascal; Serin, Daniel; Bosset, Jean-Francois; Miny-Buffet, Joelle; Favre, Anne; Le Foch, Olivier; Calais, Gilles

    2007-05-01

    Purpose: To evaluate the cosmetic results of sequential vs. concurrent adjuvant chemotherapy with radiotherapy after breast-conserving surgery for breast cancer, and to compare ratings by patients and physicians. Methods and Materials: From 1996 to 2000, 716 patients with Stage I-II breast cancers were included in a multicenter, Phase III trial (the ARCOSEIN study) comparing, after breast-conserving surgery with axillary dissection, sequential treatment with chemotherapy first followed by radiotherapy vs. chemotherapy administered concurrently with radiotherapy. Cosmetic results with regard to both the overall aspect of the breast and specific changes (color, scar) were evaluated in a total of 214 patients (107 in each arm) by means of questionnaires to both the patient and a physician whose rating was blinded to treatment allocation. Results: Patients' overall satisfaction with cosmesis was not statistically different between the two arms, with approximately 92% with at least satisfactory results (p = 0.72), although differences between the treated and untreated breasts were greater after the concurrent regimen (29% vs. 14% with more than moderate differences; p 0.0015). Physician assessment of overall cosmesis was less favorable, with lower rates of at least satisfactory results in the concurrent arm (60% vs. 85%; p = 0.001). Consequently, the concordance for overall satisfaction with cosmesis between patients and doctors was only fair ({kappa} = 0.62). Conclusion: After breast-conserving surgery, the concurrent use of chemotherapy with radiotherapy is significantly associated with greater differences between the breasts. These differences do not translate into patients' lessened satisfaction with cosmesis.

  4. Hepatic Arterial Infusion Chemotherapy through a Port-Catheter System as Preoperative Initial Therapy in Patients with Advanced Liver Dysfunction due to Synchronous and Unresectable Liver Metastases from Colorectal Cancer

    SciTech Connect

    Iguchi, Toshihiro; Arai, Yasuaki; Inaba, Yoshitaka Yamaura, Hidekazu; Sato, Yozo; Miyazaki, Masaya; Shimamoto, Hiroshi

    2008-01-15

    Purpose. We retrospectively evaluated the safety and efficacy of preoperative initial hepatic arterial infusion chemotherapy (HAIC) through a port-catheter system in patients with liver dysfunction due to synchronous and unresectable liver metastases. The aim of HAIC was to improve patients' clinical condition for later surgical removal of primary colorectal cancer. Methods. Port-catheter systems were placed radiologically in 21 patients (mean age 58.6 {+-} 8.1 years) with liver dysfunction due to synchronous liver metastases from colorectal cancer. Initial HAIC of 1,000 mg/m{sup 2} 5-fluorouracil was administered weekly as a 5 hr continuous infusion through this system. Surgical removal of the primary lesion was planned after HAIC improved the liver function. Results. Port-catheter system placement was successful in all patients without severe complications. Patients were followed up for a median of 309 days (range 51-998 days). After starting HAIC, no severe adverse events that caused drug loss and treatment postponement or suspension were observed in any of the patients. HAIC was performed a mean of 4.5 {+-} 3.0 times and the liver function improved in all patients. Curative (n = 18) or palliative (n = 1) surgical removal of the primary lesion was performed. The remaining 2 patients died because extrahepatic metastases developed and their performance status worsened; thus, surgery could not be performed. The median survival times of all patients and the operated patients were 309 and 386 days, respectively. Conclusion. Initial HAIC administration is a safe and efficacious method for improving liver function prior to operative resection of primary colorectal cancer in patients with liver dysfunction due to synchronous and unresectable liver metastases.

  5. Resistance, remission, and qualitative differences in HIV chemotherapy.

    PubMed Central

    Kirschner, D. E.; Webb, G. F.

    1997-01-01

    To understand the role of qualitative differences in multidrug chemotherapy for human immunodeficiency virus (HIV) infection in virus remission and drug resistance, we designed a mathematical system that models HIV multidrug chemotherapy including uninfected CD4+ T cells, infected CD4+ T cells, and virus populations. The model, which includes the latent and progressive stages of the disease and introduces chemotherapy, is a system of differential equations describing the interaction of two distinct classes of HIV (drug-sensitive [wild type] and drug-resistant [mutant]) with lymphocytes in the peripheral blood; the external lymphoid system contributes to the viral load. The simulations indicate that to preclude resistance, antiviral drugs must be strong enough and act fast enough to drive the viral population below a threshold level. The threshold depends upon the capacity of the virus to mutate to strains resistant to the drugs. Above the threshold, mutant strains rapidly replace wild-type strains. Below the threshold, resistant strains do not become established, and remission occurs. An important distinction between resistance and remission is the reduction of viral production in the external lymphoid system. Also the virus population rapidly rebounds when treatment is stopped even after extended periods of remission. PMID:9284371

  6. A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer

    SciTech Connect

    Arcangeli, Giorgio . E-mail: arcangeli@ifo.it; Pinnaro, Paola; Rambone, Rita; Giannarelli, Diana; Benassi, Marcello

    2006-01-01

    Purpose: To compare two different timings of radiation treatment in patients with breast cancer who underwent conservative surgery and were candidates to receive adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy. Methods and Materials: A total of 206 patients who had quadrantectomy and axillary dissection for breast cancer and were planned to receive adjuvant CMF chemotherapy were randomized to concurrent or sequential radiotherapy. Radiotherapy was delivered only to the whole breast through tangential fields to a dose of 50 Gy in 20 fractions over 4 weeks, followed by an electron boost of 10-15 Gy in 4-6 fractions to the tumor bed. Results: No differences in 5-year breast recurrence-free, metastasis-free, disease-free, and overall survival were observed in the two treatment groups. All patients completed the planned radiotherapy. No evidence of an increased risk of toxicity was observed between the two arms. No difference in radiotherapy and in the chemotherapy dose intensity was observed in the two groups. Conclusions: In patients with negative surgical margins receiving adjuvant chemotherapy, radiotherapy can be delayed to up to 7 months. Concurrent administration of CMF chemotherapy and radiotherapy is safe and might be reserved for patients at high risk of local recurrence, such as those with positive surgical margins or larger tumor diameters.

  7. To appear in the Journal of Concurrency And Computation: Practice And Experience, 2007 Provenance Trails in the Wings/Pegasus System

    E-print Network

    Gil, Yolanda

    Trails in the Wings/Pegasus System Jihie Kim, Ewa Deelman, Yolanda Gil, Gaurang Mehta, Varun Ratnakar 90292, U.S.A. {jihie,deelman,gil,gmehta,varunr}@isi.edu Abstract Our research focuses on creating resources for efficient execution. Our approach is implemented in the Wings/Pegasus workflow system and has

  8. Chemotherapy side-effect management using mobile phones.

    PubMed

    Larsen, Mark E; Rowntree, Joanna; Young, Annie M; Pearson, Sarah; Smith, Justine; Gibson, Oliver J; Weaver, Andrew; Tarassenko, Lionel

    2008-01-01

    Colorectal cancer is a major health problem in developed countries, accounting for a significant proportion of deaths in the population. Advances in chemotherapy treatment have led to therapy being delivered in the home-setting, which presents challenges in ensuring that treatment-related side-effects are detected and reported to clinical staff in an appropriate time-frame. A telemedicine system has been developed using a mobile-phone platform to allow patients to complete symptom diaries which trigger alerts paged to their nurse in the event of severe side-effects. Six patients used this system for two cycles of oral chemotherapy. Two cases of moderate symptoms deteriorating to more severe conditions were observed, and individual self-care and treatment advice were presented to these patients. PMID:19163877

  9. Reducing Concurrency Bottlenecks in Parallel I/O Workloads

    SciTech Connect

    Manzanares, Adam C.; Bent, John M.; Wingate, Meghan

    2011-01-01

    To enable high performance parallel checkpointing we introduced the Parallel Log Structured File System (PLFS). PLFS is middleware interposed on the file system stack to transform concurrent writing of one application file into many non-concurrently written component files. The promising effectiveness of PLFS makes it important to examine its performance for workloads other than checkpoint capture, notably the different ways that state snapshots may be later read, to make the case for using PLFS in the Exascale I/O stack. Reading a PLFS file involved reading each of its component files. In this paper we identify performance limitations on broader workloads in an early version of PLFS, specifically the need to build and distribute an index for the overall file, and the pressure on the underlying parallel file system's metadata server, and show how PLFS's decomposed components architecture can be exploited to alleviate bottlenecks in the underlying parallel file system.

  10. Options for Making Concurrency More Multimodal

    E-print Network

    Options for Making Concurrency More Multimodal Response to SHB 1565 (2005 Session) Prepared by for Making Concurrency More Multimodal Response to SHB 1565 (2005 Session) Prepared by: Mark E. Hallenbeck of this study. Legislative Consultation Group for Multimodal Advisory Committee · Senator Mary Margaret Haugen

  11. Concurrency control for transactions with priorities

    NASA Technical Reports Server (NTRS)

    Marzullo, Keith

    1989-01-01

    Priority inversion occurs when a process is delayed by the actions of another process with less priority. With atomic transations, the concurrency control mechanism can cause delays, and without taking priorities into account can be a source of priority inversion. In this paper, three traditional concurrency control algorithms are extended so that they are free from unbounded priority inversion.

  12. Concurrence control for transactions with priorities

    NASA Technical Reports Server (NTRS)

    Marzullo, Keith

    1989-01-01

    Priority inversion occurs when a process is delayed by the actions of another process with less priority. With atomic transactions, the concurrency control mechanism can cause delays, and without taking priorities into account can be a source of priority inversion. Three traditional concurrency control algorithms are extended so that they are free from unbounded priority inversion.

  13. Breakthrough therapy for peritoneal carcinomatosis of gastric cancer: Intraperitoneal chemotherapy with taxanes

    PubMed Central

    Yamaguchi, Hironori; Kitayama, Joji; Ishigami, Hironori; Kazama, Shinsuke; Nozawa, Hiroaki; Kawai, Kazushige; Hata, Keisuke; Kiyomatsu, Tomomichi; Tanaka, Toshiaki; Tanaka, Junichiro; Nishikawa, Takeshi; Otani, Kensuke; Yasuda, Koji; Ishihara, Soichiro; Sunami, Eiji; Watanabe, Toshiaki

    2015-01-01

    The effect of chemotherapy on peritoneal carcinomatosis (PC) of gastric cancer remains unclear. Recently, the intraperitoneal (IP) administration of taxanes [e.g., paclitaxel (PTX) and docetaxel (DOC)] during the perioperative period has shown promising results. Herein, we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results. IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h. The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects, making it ideal for IP chemotherapy. There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy (SPIC). In SPIC, patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery (CRS) until disease progression. Usually, a taxane dissolved in 500-1000 mL of saline at ordinary temperature is administered through an IP access port on an outpatient basis. According to phase?I?studies, the recommended doses (RD) are as follows: IP DOC, 45-60 mg/m2; IP PTX [without intravenous (IV) PTX], 80 mg/m2; and IP PTX (with IV PTX), 20 mg/m2. Phase II studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%. A phase III study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011. The prognosis of patients who underwent CRS was better than that of those who did not; however, this was partly due to selection bias. Although several phase II studies have shown promising results, a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer. PMID:26600928

  14. Effect of induction chemotherapy on estimated risk of radiation pneumonitis in bulky non–small cell lung cancer

    SciTech Connect

    Amin, Neha P.; Miften, Moyed; Thornton, Dale; Ryan, Nicole; Kavanagh, Brian; Gaspar, Laurie E

    2013-10-01

    Patients with bulky non–small cell lung cancer (NSCLC) may be at a high risk for radiation pneumonitis (RP) if treated with up-front concurrent chemoradiation. There is limited information about the effect of induction chemotherapy on the volume of normal lung subsequently irradiated. This study aims to estimate the reduction in risk of RP in patients with NSCLC after receiving induction chemotherapy. Between 2004 and 2009, 25 patients with Stage IV NSCLC were treated with chemotherapy alone (no surgery or radiation therapy [RT]) and had computed tomography (CT) scans before and after 2 cycles of chemotherapy. Simulated RT plans were created for the prechemotherapy and postchemotherapy scans so as to deliver 60 Gy to the thoracic disease in patients who had either a >20% volumetric increase or decrease in gross tumor volume (GTV) from chemotherapy. The prechemotherapy and postchemotherapy scans were analyzed to compare the percentage of lung volume receiving?20 Gy (V20), mean lung dose (MLD), and normal tissue complication probability (NTCP). Eight patients (32%) had a GTV reduction >20%, 2 (8%) had GTV increase >20%, and 15 (60%) had stable GTV. In the 8 responders, there was an absolute median GTV decrease of 88.1 cc (7.3 to 351.6 cc) or a 48% (20% to 62%) relative reduction in tumor burden. One had >20% tumor progression during chemotherapy, yet had an improvement in dosimetric parameters postchemotherapy. Among these 9 patients, the median decrease in V20, MLD, and NTCP was 2.6% (p<0.01), 2.1 Gy (p<0.01), and 5.6% (p<0.01), respectively. Less than one-third of patients with NSCLC obtain >20% volumetric tumor reduction from chemotherapy alone. Even with that amount of volumetric reduction, the 5% reduced risk of RP was only modest and did not convert previously ineligible patients to safely receive definitive thoracic RT.

  15. A Concurrent Smalltalk Compiler for the Message-Driven Processor

    E-print Network

    Horwat, Waldemar

    1988-05-01

    This thesis describes Optimist, an optimizing compiler for the Concurrent Smalltalk language developed by the Concurrent VLSI Architecture Group. Optimist compiles Concurrent Smalltalk to the assembly language of the ...

  16. Power Minimization in a Backlit TFT-LCD Display by Concurrent Brightness and Contrast Scaling

    E-print Network

    Pedram, Massoud

    -Chung Cheng, Yu Hou, Massoud Pedram Department of EE-Systems, University of Southern California Los Angeles, CA 90089, USA {wccheng, yhou, massoud}@sahand.usc.edu Abstract This paper presents a Concurrent

  17. 76 FR 76037 - Office of the Attorney General; Assumption of Concurrent Federal Criminal Jurisdiction in Certain...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-06

    ...Department of Justice, United States...Manual, tit. 9, Criminal Resource Manual...in that tribe's justice system, such as...publicly available criminal codes, procedural...concurrent Federal criminal jurisdiction will...The Department of Justice thus believes...

  18. Multi-data-base concurrency control

    SciTech Connect

    Thompson, G.R.

    1987-01-01

    The problem of managing heterogeneous distributed data bases is becoming an increasingly difficult problem due to an ever increasing number of different data base management systems utilized in many corporations. A multi-data-base transaction processing algorithm, based on a site protocol concurrency control mechanism, is proposed as a solution to this problem. A model of a centralized multi-data-base system is described in this study to provide a foundation for the multi-data-base transaction processing algorithm. An architecture for a distributed multi-data-base system is also presented and solutions to the problems of distributed-data dictionary and network management are proposed. The proposed multi-data-base transaction processing algorithm is shown to maintain global data-base consistency in the presence of global and permitted local transactions. The algorithm also eliminates the possibility of global-transaction deadlock. The notion of a test/production data dictionary provides a flexible and efficient means for dictionary management in a distributed multi-data-base system. The concept of a logical network provides an effective means of integrating heterogeneous networks.

  19. Utility of gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage in premenopausal women with breast cancer: a systematic review and meta-analysis

    PubMed Central

    Shen, Yan-Wei; Zhang, Xiao-Man; Lv, Meng; Chen, Ling; Qin, Tian-Jie; Wang, Fan; Yang, Jiao; Liu, Pei-Jun; Yang, Jin

    2015-01-01

    Background Premature ovarian failure and infertility following chemotherapy are major concerns for premenopausal women with breast cancer. A potential ovarian function preservation strategy is administration of gonadotropin-releasing hormone (GnRH) agonists during adjuvant chemotherapy; however, studies of the clinical efficacy of GnRH agonists to protect chemotherapy-induced ovarian damage have shown mixed results. Objective This meta-analysis study was designed to estimate the efficacy of GnRH agonists administered concurrently with chemotherapy to prevent chemotherapy-induced ovarian damage in premenopausal women with breast cancer. Methods Electronic literature databases (PubMed, EMBASE, MEDLINE, Cochrane Library databases searching, China National Knowledge Infrastructure, Web of Science, and the Wanfang Data) were searched for relevant randomized controlled trials (RCTs) published until September 2015. Only RCTs that examined the effect of GnRH agonists for chemotherapy-induced ovarian failure in premenopausal women with breast cancer were selected. The rate of spontaneous resumption of menses and spontaneous pregnancy were collected. All data were analyzed by RevMan 5.3 (Cochrane Collaboration, Copenhagen, Denmark) and Stata 12.0 (StataCorp, College Station, TX, USA). Results Eleven RCTs with a total of 1,062 participants (GnRH agonists administered concurrently with chemotherapy, n=541; chemotherapy alone, n=521) were included in the meta-analysis. A significantly greater number of women treated with GnRH agonist experienced spontaneous resumption of menses after the adjuvant chemotherapy, yielding a pooled odds ratio of 2.57 (versus chemotherapy alone, 95% confidence interval (CI)=1.65, 4.01; P<0.0001). A subgroup analysis showed that addition of GnRH agonists significantly improved the resumption of menses rate in patients who were hormone-insensitive. However, the two treatment groups experienced similar spontaneous pregnancy (odds ratio =0.177; 95% CI=0.92, 1.40; P=0.09). Conclusion GnRH agonists cotreatment with chemotherapy in premenopausal women with breast cancer plays a beneficial role in resumption of ovarian function, with a higher rate of resumption of menses. However, treatment with GnRH agonists does not appear to exhibit its protective effects in fertility. PMID:26622183

  20. Managing Chemotherapy Side Effects: Hair Loss (Alopecia)

    MedlinePLUS

    ... C ancer I nstitute Managing Chemotherapy Side Effects Hair Loss (Alopecia) “Losing my hair was hard at first. ... and anywhere on your body may fall out. Hair loss is called alopecia. When will my hair start ...

  1. Novel Combination Chemotherapy for Localized Ewing Sarcoma

    Cancer.gov

    In this clinical trial, researchers will test whether the addition of the drug combination vincristine, topotecan, and cyclophosphamide to a standard chemotherapy regimen improves overall survival in patients with extracranial Ewing

  2. Management of Chemotherapy Induced Nausea and Vomiting in Patients on Multiday Cisplatin Based Combination Chemotherapy

    PubMed Central

    Ranganath, Praveen; Einhorn, Lawrence; Albany, Costantine

    2015-01-01

    Introduction of cisplatin based chemotherapy has revolutionized the treatment of germ cell tumors. A common side effect of multiday cisplatin chemotherapy is severe nausea and vomiting. Considerable progress has been made in the control of these side effects since the introduction of cisplatin based chemotherapy in the 1970s. Germ cell tumor which is a model for a curable neoplasm has also turned into an excellent testing ground to develop effective strategies to prevent chemotherapy induced nausea and vomiting (CINV) in multiday cisplatin based regimens. The use of combination of a 5-hydroxytryptamine (HT)3 receptor antagonist, a neurokinin-1 (NK1) antagonist, and dexamethasone has greatly improved our ability to prevent and control acute and delayed CINV. Mechanism and pattern of CINV with multiday chemotherapy may differ from those in single day chemotherapy and therefore efficacy of antiemetic drugs as observed in single day chemotherapy may not be applicable. There are only few randomized clinical trials with special emphasis on multiday chemotherapy. Further studies are essential to determine the efficacy, optimal dose, and duration of the newer agents and combinations in multiday cisplatin based chemotherapy. PMID:26425563

  3. A clinical trial of neoadjuvant concurrent chemoradiotherapy followed by resection for esophageal carcinoma

    PubMed Central

    Anvari, Kazem; Aledavood, Seyed Amir; Toussi, Mehdi Seilanian; Forghani, Mohammad Naser; Mohtashami, Samira; Rajabi, Mohammad Taghi; Shandiz, Fatemeh Homaee; Nosrati, Fatemeh; Nowferesti, Gholamhossein; Salek, Roham

    2015-01-01

    Background: Esophageal carcinoma is a common malignancy in the North East of Iran. Combined modality treatments have been adopted to improve survival in patients with esophageal carcinoma. In this trial, we evaluated the efficacy and toxicity of a preoperative concurrent chemoradiotherapy protocol in the patients with locally advanced esophageal carcinoma. Materials and Methods: Between 2006 and 2011, eligible patients with locally advanced esophageal carcinoma underwent concurrent radiotherapy and chemotherapy and 3-4 weeks later, esophagectomy. Pathologic response, overall survival rate, toxicity, and feasibility were evaluated. Results: One hundred ninety-seven patients with a median age of 59 (range: 27-70) entered the protocol. One hundred ninety-four cases (98.5%) had esophageal squamous cell carcinoma. Grades 3-4 of toxicity in patients undergoing neoadjuvant chemoradotherapy were as follows: Neutropenia in 21% and esophagitis in 2.5% of cases. There were 11 (5.6%) early death probably due to the treatment-related toxicities. One hundred twenty-seven patients underwent surgery with postsurgical mortality of 11%. In these cases, the complete pathological response was shown in 38 cases (29.9%) with a 5-year overall survival rates of 48.2% and median overall survival of 44 months (95% confidence interval, 24.46-63.54). Conclusion: The pathological response rate and the overall survival rate are promising in patients who completed the protocol as receiving at least one cycle of chemotherapy. However, the treatment toxicities were relatively high.

  4. Programming Models for Concurrency and Real-Time

    NASA Astrophysics Data System (ADS)

    Vitek, Jan

    Modern real-time applications are increasingly large, complex and concurrent systems which must meet stringent performance and predictability requirements. Programming those systems require fundamental advances in programming languages and runtime systems. This talk presents our work on Flexotasks, a programming model for concurrent, real-time systems inspired by stream-processing and concurrent active objects. Some of the key innovations in Flexotasks are that it support both real-time garbage collection and region-based memory with an ownership type system for static safety. Communication between tasks is performed by channels with a linear type discipline to avoid copying messages, and by a non-blocking transactional memory facility. We have evaluated our model empirically within two distinct implementations, one based on Purdue’s Ovm research virtual machine framework and the other on Websphere, IBM’s production real-time virtual machine. We have written a number of small programs, as well as a 30 KLOC avionics collision detector application. We show that Flexotasks are capable of executing periodic threads at 10 KHz with a standard deviation of 1.2us and have performance competitive with hand coded C programs.

  5. Natural products for cancer chemotherapy

    PubMed Central

    Demain, Arnold L.; Vaishnav, Preeti

    2011-01-01

    Summary For over 40 years, natural products have served us well in combating cancer. The main sources of these successful compounds are microbes and plants from the terrestrial and marine environments. The microbes serve as a major source of natural products with anti?tumour activity. A number of these products were first discovered as antibiotics. Another major contribution comes from plant alkaloids, taxoids and podophyllotoxins. A vast array of biological metabolites can be obtained from the marine world, which can be used for effective cancer treatment. The search for novel drugs is still a priority goal for cancer therapy, due to the rapid development of resistance to chemotherapeutic drugs. In addition, the high toxicity usually associated with some cancer chemotherapy drugs and their undesirable side?effects increase the demand for novel anti?tumour drugs active against untreatable tumours, with fewer side?effects and/or with greater therapeutic efficiency. This review points out those technologies needed to produce the anti?tumour compounds of the future. PMID:21375717

  6. Tuberculosis chemotherapy: current drug delivery approaches

    PubMed Central

    du Toit, Lisa Claire; Pillay, Viness; Danckwerts, Michael Paul

    2006-01-01

    Tuberculosis is a leading killer of young adults worldwide and the global scourge of multi-drug resistant tuberculosis is reaching epidemic proportions. It is endemic in most developing countries and resurgent in developed and developing countries with high rates of human immunodeficiency virus infection. This article reviews the current situation in terms of drug delivery approaches for tuberculosis chemotherapy. A number of novel implant-, microparticulate-, and various other carrier-based drug delivery systems incorporating the principal anti-tuberculosis agents have been fabricated that either target the site of tuberculosis infection or reduce the dosing frequency with the aim of improving patient outcomes. These developments in drug delivery represent attractive options with significant merit, however, there is a requisite to manufacture an oral system, which directly addresses issues of unacceptable rifampicin bioavailability in fixed-dose combinations. This is fostered by the need to deliver medications to patients more efficiently and with fewer side effects, especially in developing countries. The fabrication of a polymeric once-daily oral multiparticulate fixed-dose combination of the principal anti-tuberculosis drugs, which attains segregated delivery of rifampicin and isoniazid for improved rifampicin bioavailability, could be a step in the right direction in addressing issues of treatment failure due to patient non-compliance. PMID:16984627

  7. Light-Controlled Histone Deacetylase (HDAC) Inhibitors: Towards Photopharmacological Chemotherapy.

    PubMed

    Szymanski, Wiktor; Ourailidou, Maria E; Velema, Willem A; Dekker, Frank J; Feringa, Ben L

    2015-11-01

    Cancer treatment suffers from limitations that have a major impact on the patient's quality of life and survival. In the case of chemotherapy, the systemic distribution of cytotoxic drugs reduces their efficacy and causes severe side effects due to nonselective toxicity. Photopharmacology allows a novel approach to address these problems because it employs external, local activation of chemotherapeutic agents by using light. The development of photoswitchable histone deacetylase (HDAC) inhibitors as potential antitumor agents is reported herein. Analogues of the clinically used chemotherapeutic agents vorinostat, panobinostat, and belinostat were designed with a photoswitchable azobenzene moiety incorporated into their structure. The most promising compound exhibits high inhibitory potency in the thermodynamically less stable cis form and a significantly lower activity for the trans form, both in terms of HDAC activity and proliferation of HeLa cells. This approach offers a clear prospect towards local photoactivation of HDAC inhibition to avoid severe side effects in chemotherapy. PMID:26418117

  8. Concurrent Acoustic Activation of the Medial Olivocochlear System Modifies the After-Effects of Intense Low-Frequency Sound on the Human Inner Ear.

    PubMed

    Kugler, Kathrin; Wiegrebe, Lutz; Gürkov, Robert; Krause, Eike; Drexl, Markus

    2015-12-01

    >Human hearing is rather insensitive for very low frequencies (i.e. below 100 Hz). Despite this insensitivity, low-frequency sound can cause oscillating changes of cochlear gain in inner ear regions processing even much higher frequencies. These alterations outlast the duration of the low-frequency stimulation by several minutes, for which the term 'bounce phenomenon' has been coined. Previously, we have shown that the bounce can be traced by monitoring frequency and level changes of spontaneous otoacoustic emissions (SOAEs) over time. It has been suggested elsewhere that large receptor potentials elicited by low-frequency stimulation produce a net Ca(2+) influx and associated gain decrease in outer hair cells. The bounce presumably reflects an underdamped, homeostatic readjustment of increased Ca(2+) concentrations and related gain changes after low-frequency sound offset. Here, we test this hypothesis by activating the medial olivocochlear efferent system during presentation of the bounce-evoking low-frequency (LF) sound. The efferent system is known to modulate outer hair cell Ca(2+) concentrations and receptor potentials, and therefore, it should modulate the characteristics of the bounce phenomenon. We show that simultaneous presentation of contralateral broadband noise (100 Hz-8 kHz, 65 and 70 dB SPL, 90 s, activating the efferent system) and ipsilateral low-frequency sound (30 Hz, 120 dB SPL, 90 s, inducing the bounce) affects the characteristics of bouncing SOAEs recorded after low-frequency sound offset. Specifically, the decay time constant of the SOAE level changes is shorter, and the transient SOAE suppression is less pronounced. Moreover, the number of new, transient SOAEs as they are seen during the bounce, are reduced. Taken together, activation of the medial olivocochlear system during induction of the bounce phenomenon with low-frequency sound results in changed characteristics of the bounce phenomenon. Thus, our data provide experimental support for the hypothesis that outer hair cell calcium homeostasis is the source of the bounce phenomenon. PMID:26264256

  9. Mechanisms of chemotherapy-induced behavioral toxicities

    PubMed Central

    Vichaya, Elisabeth G.; Chiu, Gabriel S.; Krukowski, Karen; Lacourt, Tamara E.; Kavelaars, Annemieke; Dantzer, Robert; Heijnen, Cobi J.; Walker, Adam K.

    2015-01-01

    While chemotherapeutic agents have yielded relative success in the treatment of cancer, patients are often plagued with unwanted and even debilitating side-effects from the treatment which can lead to dose reduction or even cessation of treatment. Common side effects (symptoms) of chemotherapy include (i) cognitive deficiencies such as problems with attention, memory and executive functioning; (ii) fatigue and motivational deficit; and (iii) neuropathy. These symptoms often develop during treatment but can remain even after cessation of chemotherapy, severely impacting long-term quality of life. Little is known about the underlying mechanisms responsible for the development of these behavioral toxicities, however, neuroinflammation is widely considered to be one of the major mechanisms responsible for chemotherapy-induced symptoms. Here, we critically assess what is known in regards to the role of neuroinflammation in chemotherapy-induced symptoms. We also argue that, based on the available evidence, neuroinflammation is unlikely the only mechanism involved in the pathogenesis of chemotherapy-induced behavioral toxicities. We evaluate two other putative candidate mechanisms. To this end we discuss the mediating role of damage-associated molecular patterns (DAMPs) activated in response to chemotherapy-induced cellular damage. We also review the literature with respect to possible alternative mechanisms such as a chemotherapy-induced change in the bioenergetic status of the tissue involving changes in mitochondrial function in relation to chemotherapy-induced behavioral toxicities. Understanding the mechanisms that underlie the emergence of fatigue, neuropathy, and cognitive difficulties is vital to better treatment and long-term survival of cancer patients. PMID:25954147

  10. Bilateral subdural hygromas following administration of intrathecal methotrexate chemotherapy.

    PubMed

    Lewis, Heledd; Mahdi, Ali Jassem; Rowntree, Clare

    2015-01-01

    We report the case of a previously well 58-year-old man who presented with headache and confusion 4?days postadministration of intrathecal methotrexate. He was undergoing intensive chemotherapy (CODOX-M/IVAC, cyclophosphamide, doxorubicin, vincristine, methotrexate, etoposide, ifosfamide, cytarabine) for the treatment of leukaemic phase CD20 negative diffuse large B-cell lymphoma. A CT of the head demonstrated the presence of bilateral subdural hygromas complicated by haemorrhage resulting from coexisting chemotherapy induced thrombocytopenia. Surgical drainage of the hygroma was undertaken but the patient died of overwhelming sepsis. In patients with high-risk lymphoma, directed central nervous system (CNS) therapy is administered either systemically or intrathecally. It is thought that subdural hygromas result from cerebrospinal fluid (CSF) accumulation in the inner dural layers of the cerebral convexities from CSF leak and reduction in CSF pressure post-lumbar puncture. We describe a rare but potentially fatal complication of intrathecal chemotherapy that haemato-oncologists need to be mindful of. PMID:26002663

  11. Managing thrombocytopenia associated with cancer chemotherapy.

    PubMed

    Kuter, David J

    2015-04-01

    Thrombocytopenia is a common problem in cancer patients. Aside from bleeding risk, thrombocytopenia limits chemotherapy dose and frequency. In evaluating thrombocytopenic cancer patients, it is important to assess for other causes of thrombocytopenia, including immune thrombocytopenia, coagulopathy, infection, drug reaction, post-transfusion purpura, and thrombotic microangiopathy. The incidence of chemotherapy-induced thrombocytopenia varies greatly depending on the treatment used; the highest rates of this condition are associated with gemcitabine- and platinum-based regimens. Each chemotherapy agent differs in how it causes thrombocytopenia: alkylating agents affect stem cells, cyclophosphamide affects later megakaryocyte progenitors, bortezomib prevents platelet release from megakaryocytes, and some treatments promote platelet apoptosis. Thrombopoietin is the main regulator of platelet production. In numerous studies, recombinant thrombopoietin raised the platelet count nadir, reduced the need for platelet transfusions, reduced the duration of thrombocytopenia, and allowed maintenance of chemotherapy dose intensity. Two thrombopoietin receptor agonists now available, romiplostim and eltrombopag, are potent stimulators of platelet production. Although few studies have been completed to demonstrate their ability to treat chemotherapy-induced thrombocytopenia, these agents may be useful in treating this condition in some situations. Chemotherapy dose reduction and platelet transfusions remain the major treatments for affected patients. PMID:25952492

  12. Chemotherapy for Stage II Colon Cancer.

    PubMed

    Varghese, Anna

    2015-12-01

    The adjuvant treatment of patients with stage II colon cancer is an area of controversy in medical oncology. Adjuvant chemotherapy aims to eradicate micrometastatic disease present at the time of surgery, preventing the development of distant metastatic disease and thereby curing those patients of their cancer. National and international guidelines for the adjuvant treatment of stage II colon cancer recommend a range of treatment options from observation to chemotherapy with single-agent or combination regimens, depending on the presence or absence of high-risk features (poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, report of?chemotherapy in stage II colon cancer, a small but statistically significant benefit in overall survival was seen for those patients who received adjuvant chemotherapy; however, multiple meta-analyses and retrospective subgroup analyses have called these findings into question. Though there may be a role for adjuvant chemotherapy in the treatment of patients with stage II colon cancer, its incremental benefit is small, at best, and comes with the risks of real and rarely fatal complications of chemotherapy. PMID:26648796

  13. Long-Term Results of Concurrent Chemoradiotherapy for Advanced N2-3 Stage Nasopharyngeal Carcinoma

    PubMed Central

    Wang, Xue; Chen, Meng; Wu, Jing; Xu, Jian-Hua; Qian, Pu-Dong; Guo, Wen-Jie; Jiang, Xue-Song; Zhu, Huan-Feng; Gu, Jia-Jia; Wu, Jian-Feng; Zhang, Ye-wei; He, Xia

    2015-01-01

    Background N-stage is related to distant metastasis in nasopharyngeal carcinoma (NPC) patients. The purpose of this study was to evaluate the efficacy and toxicity of different nedaplatin-based chemotherapy regimens in advanced N2-3 stage NPC patients treated with intensity modulated radiation therapy (IMRT). Patients and Methods Between April 2005 and December 2009, a total of 128 patients with N2-3 advanced NPC were retrospectively analyzed. Patients were treated with IMRT concurrent with 2 cycles of chemotherapy consisting of either nedaplatin plus paclitaxel (NP group, n = 67) or nedaplatin plus fluorouracil and paclitaxel (NFP group, n = 61). Two to four cycles of adjuvant chemotherapy were then administered every 21 days following concurrent chemoradiotherapy. Results With a median follow-up of 60 months, the 5-year overall survival (OS), progression-free survival (PFS), local-regional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) for all patients were 81.4%, 71.5%, 87.8% and 82.0%, respectively. No significant difference in PFS (66.6% vs. 76.7%, P = 0.212) and LRRFS rates (89.0% vs. 86.3%, P = 0.664) was observed between the NP and NFP groups. The 5-year OS (75.4% vs. 88.5%, P = 0.046) and DMFS (75.1% vs. 89.0%, P = 0.042) rate were superior in the NFP group compared with the NP group. The NFP group had a higher incidence of grade 3–4 acute toxicities including bone marrow suppression (leukopenia: ?2 = 3.935, P = 0.047; anemia: ?2 = 9.760, P = 0.002; thrombocytopenia: ?2 = 8.821, P = 0.003), and both liver and renal dysfunction (?2 = 5.206, P = 0.023) compared with the NP group. Late toxicities were moderate and no difference was observed between the two groups. Conclusion IMRT concurrent with nedaplatin-based chemotherapy is an advocated regimen for patients with advanced N2-3 stage NPC. Patients with advanced N2-3 stage may be better candidates for the NFP regimen although this regimen was associated with a high acute toxicity rate. PMID:26367317

  14. Gaudi components for concurrency: Concurrency for existing and future experiments

    NASA Astrophysics Data System (ADS)

    Clemencic, M.; Funke, D.; Hegner, B.; Mato, P.; Piparo, D.; Shapoval, I.

    2015-05-01

    HEP experiments produce enormous data sets at an ever-growing rate. To cope with the challenge posed by these data sets, experiments’ software needs to embrace all capabilities modern CPUs offer. With decreasing memory/core ratio, the one-process-per-core approach of recent years becomes less feasible. Instead, multi-threading with fine-grained parallelism needs to be exploited to benefit from memory sharing among threads. Gaudi is an experiment-independent data processing framework, used for instance by the ATLAS and LHCbexperiments at CERN's Large Hadron Collider. It has originally been designed with only sequential processing in mind. In a recent effort, the frame work has been extended to allow for multi-threaded processing. This includes components for concurrent scheduling of several algorithms - either processingthe same or multiple events, thread-safe data store access and resource management. In the sequential case, the relationships between algorithms are encoded implicitly in their pre-determined execution order. For parallel processing, these relationships need to be expressed explicitly, in order for the scheduler to be able to exploit maximum parallelism while respecting dependencies between algorithms. Therefore, means to express and automatically track these dependencies need to be provided by the framework. In this paper, we present components introduced to express and track dependencies of algorithms to deduce a precedence-constrained directed acyclic graph, which serves as basis for our algorithmically sophisticated scheduling approach for tasks with dynamic priorities. We introduce an incremental migration path for existing experiments towards parallel processing and highlight the benefits of explicit dependencies even in the sequential case, such as sanity checks and sequence optimization by graph analysis.

  15. Clinical applications of continuous infusion chemotherapy ahd concomitant radiation therapy

    SciTech Connect

    Rosenthal, C.J.; Rotman, M.

    1986-01-01

    This book presents information on the following topics: theoretical basis and clinical applications of 5-FU as a radiosensitizer; treatment of hepatic metastases from gastro intestingal primaries with split course radiation therapy; combined modality therapy with 5-FU, Mitomycin-C and radiation therapy for sqamous cell cancers; treatment of bladder carcinoma with concomitant infusion chemotherapy and irradiation; a treatment of invasiv bladder cancer by the XRT/5FU protocol; concomitant radiation therapy and doxorubicin by continuous infusion in advanced malignancies; cis platin by continuous infusion with concurrent radiation therapy in malignant tumors; combination of radiation with concomitant continuous adriamycin infusion in a patient with partially excised pleomorphic soft tissue sarcoma of the lower extremeity; treatment of recurrent carcinoma of the paranasal sinuses using concomitant infusion cis-platinum and radiation therapy; hepatic artery infusion for hepatic metastases in combination with hepatic resection and hepatic radiation; study of simultaneous radiation therapy, continuous infusion, 5FU and bolus mitomycin-C; cancer of the esophagus; continuous infusion VP-16, bolus cis-platinum and simultaneous radiation therapy as salvage therapy in small cell bronchogenic carcinoma; and concomitant radiation, mitomycin-C and 5-FU infusion in gastro intestinal cancer.

  16. Split-Field Helical Tomotherapy With or Without Chemotherapy for Definitive Treatment of Cervical Cancer

    SciTech Connect

    Chang, Albert J.; Richardson, Susan; Grigsby, Perry W.; Schwarz, Julie K.

    2012-01-01

    Objective: The objective of this study was to investigate the chronic toxicity, response to therapy, and survival outcomes of patients with cervical cancer treated with definitive pelvic irradiation delivered by helical tomotherapy (HT), with or without concurrent chemotherapy. Methods and Materials: There were 15 patients with a new diagnosis of cervical cancer evaluated in this study from April 2006 to February 2007. The clinical stages of their disease were Stage Ib1 in 3 patients, Ib2 in 3, IIa in 2, IIb in 4, IIIb in 2, and IVa in 1 patient. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) simulation was performed in all patients. All patients received pelvic irradiation delivered by HT and high-dose-rate (HDR) brachytherapy. Four patients also received para-aortic irradiation delivered by HT. Thirteen patients received concurrent chemotherapy. Patients were monitored for chronic toxicity using the Common Terminology Criteria for Adverse Events version 3.0 criteria. Results: The median age of the cohort was 51 years (range, 29-87 years), and the median follow-up for all patients alive at time of last follow-up was 35 months. The median overall radiation treatment time was 54 days. One patient developed a chronic Grade 3 GI complication. No other Grade 3 or 4 complications were observed. At last follow-up, 3 patients had developed a recurrence, with 1 patient dying of disease progression. The 3-year progression-free and cause-specific survival estimates for all patients were 80% and 93%, respectively. Conclusion: Intensity-modulated radiation therapy delivered with HT and HDR brachytherapy with or without chemotherapy for definitive treatment of cervical cancer is feasible, with acceptable levels of chronic toxicity.

  17. Finite elements and the method of conjugate gradients on a concurrent processor

    NASA Technical Reports Server (NTRS)

    Lyzenga, G. A.; Raefsky, A.; Hager, B. H.

    1984-01-01

    An algorithm for the iterative solution of finite element problems on a concurrent processor is presented. The method of conjugate gradients is used to solve the system of matrix equations, which is distributed among the processors of a MIMD computer according to an element-based spatial decomposition. This algorithm is implemented in a two-dimensional elastostatics program on the Caltech Hypercube concurrent processor. The results of tests on up to 32 processors show nearly linear concurrent speedup, with efficiencies over 90% for sufficiently large problems.

  18. Finite elements and the method of conjugate gradients on a concurrent processor

    NASA Technical Reports Server (NTRS)

    Lyzenga, G. A.; Raefsky, A.; Hager, G. H.

    1985-01-01

    An algorithm for the iterative solution of finite element problems on a concurrent processor is presented. The method of conjugate gradients is used to solve the system of matrix equations, which is distributed among the processors of a MIMD computer according to an element-based spatial decomposition. This algorithm is implemented in a two-dimensional elastostatics program on the Caltech Hypercube concurrent processor. The results of tests on up to 32 processors show nearly linear concurrent speedup, with efficiencies over 90 percent for sufficiently large problems.

  19. Reform of the Buy-and-Bill System for Outpatient Chemotherapy Care Is Inevitable: Perspectives from an Economist, a Realpolitik, and an Oncologist

    PubMed Central

    Polite, Blase; Conti, Rena M.; Ward, Jeffery C.

    2015-01-01

    OVERVIEW Treating patients with cancer with infused or injected oncolytics is a core component of outpatient oncology practice. Currently, practices purchase drugs and then bill insurers, colloquially called “buy and bill.” Reimbursement for these drugs is the largest source of gross revenue for oncology practices, and as the prices of cancer drugs have grown over time, these purchases have had significant impact on the financial health of practices and pose a risk that jeopardizes the ability of many practices to operate and provide patient care. Medicare Part B spending on drugs is under political scrutiny because of federal spending pressures, and the margin between buy and bill, lowered to 6% by the Medicare Modernization Act and further decreased to 4.3% by sequestration, is a convenient and popular target of budgetary discussions and proposals, scored to save billions of dollars over 10-year budget windows for each percentage-point reduction. Alternatives to the buy-and-bill system have been proposed to include invoice pricing, least costly alternative reimbursement, bundling of drugs into episode-of-care payments, shifting Part B drugs to the Medicare Part D benefit, and revision of the failed Competitive Acquisition Program. This article brings the perspectives of policy makers, health care economists, and providers together to discuss this major challenge in oncology payment reform. PMID:25993241

  20. Recognition and chemotherapy of oculomycosis

    PubMed Central

    Jones, Barrie R.; Clayton, Yvonne M.; Oji, Erasmus O.

    1979-01-01

    Oculomycosis may be divided into the orbital infections of phycomycosis of Aspergillus and other species and the infections of the globe. The latter comprise endogenous, post-surgical or traumatic intra-ocular infections and direct infections of the cornea: these are the commonest form of oculomycosis. They are not easy to differentiate from other, more common causes of septic infection of the eye. The early recognition of fungal infections of the eye thus rests on maintaining an efficient service for all septic infections of the eye. Candida albicans and other dimorphic fungal infections are best treated with flucytosine combined with either polyenes such as amphotericin B and natamycin or combined with imidazoles such as clotrimazole or miconazole. Aspergillus spp. account for about 50% of the cases of filamentous fungal infection of the cornea but more than 100 species of varying pathogenicity and drug sensitivity have been implicated. Econazole, clotrimazole or miconazole combined with thiabendazole are recommended for Aspergillus spp. Econazole, thiabendazole or miconazole combined with flucytosine for Cladosporium sp. For Fusarium solani and other species econazole is the best drug but some isolates are sensitive to thiabendazole or other imidazoles. Alternatively, filamentous fungal infections may be treated with natamycin which has a broad spectrum of activity; but does not penetrate well and, like other polyenes, should not be combined with imidazole antifungal chemotherapy because of antagonistic drug interaction. Overall, econazole emerges as the most widely acting drug; but successful results are dependent on rather complex investigation with intensive and protracted care that can best be provided in a few centres of referral. PMID:523353

  1. Modified FLOX as first-line chemotherapy for metastatic colorectal cancer patients in the public health system in Brazil: Effectiveness and cost-utility analysis

    PubMed Central

    NEBULONI, DANIELA R.; MAK, MILENA P.; SOUZA, FABIANO HAHN; SARAGIOTTO, DANIEL F.; JÚLIO, THIAGO; DE CASTRO, GILBERTO; SABBAGA, JORGE; HOFF, PAULO M.

    2013-01-01

    Incorporation of new drugs for treatment of metastatic colorectal cancer (mCRC) has led to a clear improvement in overall patient survival, the added cost of treatment, however, is a major concern worldwide. The cost-effectiveness of using a modified FLOX (mFLOX) regimen for treating mCRC patients was delineated. In this study, 82 consecutive mCRC patients were treated with leucovorin (LV) at 20 mg/m2 in combination with weekly bolus of 5-fluorouracil (5-FU) (500 mg/m2) for 6 consecutive weeks and oxaliplatin (85 mg/m2) at weeks 1, 3 and 5, every 8 weeks. Overall survival (OS) and toxicity were evaluated. A Markov Model with a 2-year time horizon and 2-week cycles was developed, comparing mFLOX and mFOLFOX6 in a Brazilian environment. Health outcomes were measured in quality-ajusted life years (QALYs). The median overall period of survival was 19 months, while the estimated 1-year survival was 75%. Response by RECIST was assessed in 33 patients. Partial response was observed in 39.4% of patients, while 36.3% were stable. The mFLOX regimen cost was BRL 9,000, while the mFOLFOX6 BRL 22,000 (1 EUR=2.29 BRL), leading to an incremental costed of BRL 13,000, considering a 20-week period of first-line therapy. The incremental effect of the mFOLFOX was of 0,117 QALY. The incremental cost-effectiveness ratio of mFOLFOX6 was of BRL 110,344/QALY. The sensitivity analysis detected no differences in the outcome measures. In conclusion, the mFLOX is an active regimen in mCRC patients, possibly providing a cost-effective option in public health systems. PMID:24649143

  2. Modified FLOX as first-line chemotherapy for metastatic colorectal cancer patients in the public health system in Brazil: Effectiveness and cost-utility analysis.

    PubMed

    Nebuloni, Daniela R; Mak, Milena P; Souza, Fabiano Hahn; Saragiotto, Daniel F; Júlio, Thiago; DE Castro, Gilberto; Sabbaga, Jorge; Hoff, Paulo M

    2013-01-01

    Incorporation of new drugs for treatment of metastatic colorectal cancer (mCRC) has led to a clear improvement in overall patient survival, the added cost of treatment, however, is a major concern worldwide. The cost-effectiveness of using a modified FLOX (mFLOX) regimen for treating mCRC patients was delineated. In this study, 82 consecutive mCRC patients were treated with leucovorin (LV) at 20 mg/m(2) in combination with weekly bolus of 5-fluorouracil (5-FU) (500 mg/m(2)) for 6 consecutive weeks and oxaliplatin (85 mg/m(2)) at weeks 1, 3 and 5, every 8 weeks. Overall survival (OS) and toxicity were evaluated. A Markov Model with a 2-year time horizon and 2-week cycles was developed, comparing mFLOX and mFOLFOX6 in a Brazilian environment. Health outcomes were measured in quality-ajusted life years (QALYs). The median overall period of survival was 19 months, while the estimated 1-year survival was 75%. Response by RECIST was assessed in 33 patients. Partial response was observed in 39.4% of patients, while 36.3% were stable. The mFLOX regimen cost was BRL 9,000, while the mFOLFOX6 BRL 22,000 (1 EUR=2.29 BRL), leading to an incremental costed of BRL 13,000, considering a 20-week period of first-line therapy. The incremental effect of the mFOLFOX was of 0,117 QALY. The incremental cost-effectiveness ratio of mFOLFOX6 was of BRL 110,344/QALY. The sensitivity analysis detected no differences in the outcome measures. In conclusion, the mFLOX is an active regimen in mCRC patients, possibly providing a cost-effective option in public health systems. PMID:24649143

  3. A randomized study to compare sequential chemoradiotherapy with concurrent chemoradiotherapy for unresectable locally advanced esophageal cancer

    PubMed Central

    Gupta, Arunima; Roy, Somnath; Majumdar, Anup; Hazra, Avijit; Mallik, Chandrani

    2014-01-01

    Background: Chemotherapy combined with radiotherapy can improve outcome in locally advanced esophageal cancer. Aim: This study aimed to compare efficacy and toxicity between concurrent chemoradiotherapy (CCRT) and sequential chemoradiotherapy (SCRT) in unresectable, locally advanced, esophageal squamous cell carcinoma (ESSC). Materials and Methods: Forty-one patients with unresectable, locally advanced ESCC were randomized into two arms. In the CCRT arm (Arm A), 17 patients received 50.4 Gy at 1.8 Gy per fraction over 5.6 weeks along with concurrent cisplatin (75 mg m-2 intravenously on day 1 and 5-fluorouracil (1000 mg m-2 continuous intravenous infusion on days 1-4 starting on the first day of irradiation and given after 28 days. In the SCRT arm (Arm B), 20 patients received two cycles of chemotherapy, using the same schedule, followed by radiotherapy fractionated in a similar manner. The endpoints were tumor response, acute and late toxicities, and disease-free survival. Results: With a median follow up of 12.5 months, the complete response rate was 82.4% in Arm A and 35% in Arm B (P = 0.003). Statistically significant differences in frequencies of acute skin toxicity (P = 0.016), gastrointestinal toxicity (P = 0.005) and late radiation pneumonitis (P = 0.002) were found, with greater in the CCRT arm. A modest but non-significant difference was observed in median time to recurrence among complete responders in the two arms (Arm A 13 months and Arm B 15.5 months, P = 0.167) and there was also no significant difference between the Kaplan Meier survival plots (P = 0.641) of disease-free survival. Conclusions: Compared to sequential chemoradiotherapy, concurrent chemoradiotherapy can significantly improve local control rate but with greater risk of adverse reactions. PMID:25006285

  4. Performance analysis of a scheme for concurrency/synchronization using queueing network models

    SciTech Connect

    Almeida, V.A.F.; Dowdy, L.W.

    1986-12-01

    Queueing network models have been used extensively to analyze performance of computer systems. However, queueing network models with product form solutions are not directly applicable to systems that process programs with internal concurrency/synchronization. An exact solution of system systems is often not feasible because of its large state space. Approximation techniques, based on queueing network theory, are presented which analyze the performance of closed systems with a specific scheme of concurrency/synchronization. The techniques are applicable to multitasking systems, distributed database systems, packet routing environments, and fork/join situations.

  5. Concurrent Image Processing Executive (CIPE). Volume 1: Design overview

    NASA Technical Reports Server (NTRS)

    Lee, Meemong; Groom, Steven L.; Mazer, Alan S.; Williams, Winifred I.

    1990-01-01

    The design and implementation of a Concurrent Image Processing Executive (CIPE), which is intended to become the support system software for a prototype high performance science analysis workstation are described. The target machine for this software is a JPL/Caltech Mark 3fp Hypercube hosted by either a MASSCOMP 5600 or a Sun-3, Sun-4 workstation; however, the design will accommodate other concurrent machines of similar architecture, i.e., local memory, multiple-instruction-multiple-data (MIMD) machines. The CIPE system provides both a multimode user interface and an applications programmer interface, and has been designed around four loosely coupled modules: user interface, host-resident executive, hypercube-resident executive, and application functions. The loose coupling between modules allows modification of a particular module without significantly affecting the other modules in the system. In order to enhance hypercube memory utilization and to allow expansion of image processing capabilities, a specialized program management method, incremental loading, was devised. To minimize data transfer between host and hypercube, a data management method which distributes, redistributes, and tracks data set information was implemented. The data management also allows data sharing among application programs. The CIPE software architecture provides a flexible environment for scientific analysis of complex remote sensing image data, such as planetary data and imaging spectrometry, utilizing state-of-the-art concurrent computation capabilities.

  6. Concurrence of turner's syndrome and anorexia nervosa.

    PubMed

    Theilgaard, A; Philip, J

    1975-07-01

    The ninth known case of the concurrence of anorexia nervosa and Turner's syndrome is presented. The question whether the presence of Turner's syndrome represents a greater risk for a patient to develop anorexia nervosa is considered. PMID:1155200

  7. Equivalence semantics for concurrency: comparison and application 

    E-print Network

    Galpin, Vashti C

    Since the development of CCS and other process algebras, many extensions to these process algebras have been proposed to model different aspects of concurrent computation. It is important both theoretically and practically ...

  8. Cortical activation patterns of affective speech processing depend on concurrent demands on the subvocal rehearsal system. A DC-potential study.

    PubMed

    Pihan, H; Altenmüller, E; Hertrich, I; Ackermann, H

    2000-11-01

    In order to delineate brain regions specifically involved in the processing of affective components of spoken language (affective or emotive prosody), we conducted two event-related potential experiments. Cortical activation patterns were assessed by recordings of direct current components of the EEG signal from the scalp. Right-handed subjects discriminated pairs of declarative sentences with either happy, sad or neutral intonation. Each stimulus pair was derived from two identical original utterances that, due to digital signal manipulations, slightly differed in fundamental frequency (F0) range or in duration of stressed syllables. In the first experiment, subjects were asked: (i) to denote the original emotional category of each sentence pair and (ii) to decide which of the two items displayed stronger emotional expressiveness. Participants in the second experiment were asked to repeat the utterances using inner speech during stimulus presentation in addition to the discrimination task. In the absence of inner speech, a predominant activation of right frontal regions was observed, irrespective of emotional category. In the second experiment, a bilateral activation with left frontal preponderance emerged from discrimination during additional performance of inner speech. Compared with the first experiment, a new pattern of acoustic signal processing arose. A relative decrease of brain activity during processing of F0 stimulus variants was observed together with increased activation during discrimination of duration-manipulated sentence pairs. Analysis of behavioural data revealed no significant differences in evaluation of expressiveness between the two experiments. We conclude that the topographical shift of cortical activity originates from left hemisphere (LH) mechanisms of speech processing that centre around the subvocal rehearsal system as an articulatory control component of the phonological loop. A strong coupling of acoustic input and (planned) verbal output channel in the LH is initiated by subvocal articulatory activity like inner speech. These neural networks may provide interpretations of verbal acoustic signals in terms of motor programs and facilitate continuous control of speech output by comparing the signal produced with that intended. Most likely, information on motor aspects of suprasegmental signal characteristics contributes to the evaluation of affective components of spoken language. In consequence, the right hemisphere (RH) holds a merely relative dominance, both for processing of F0 and for evaluation of emotional significance of sensory input. Psychophysically, an important determinant on expression of lateralization patterns seems to be given by the degree of communicative demands such as solely perceptive (RH) or perceptive and verbal-expressive (RH and LH). PMID:11050033

  9. Evaluation of the efficacy and safety of a neoadjuvant gemcitabine and nedaplatin regimen followed by radiotherapy or concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma

    PubMed Central

    JIN, TING; CHEN, XIAO-ZHONG; LIU, JIAN-JIANG

    2015-01-01

    The aim of the present study was to evaluate the efficacy and safety of a neoadjuvant gemcitabine and nedaplatin chemotherapy regimen, followed by concurrent chemoradiotherapy or radiotherapy alone, in locoregionally advanced nasopharyngeal carcinoma (NPC). Eighty-six patients with stage III, IVA or IVB NPC, who received neoadjuvant chemotherapy [gemcitabine, 1,000 mg/m2 on day 1 (d1) and d5; nedaplatin, 25 mg/m2 on d 1–3] every 3 weeks for at least two cycles, followed by intensity-modulated radiotherapy every 3 weeks, with or without concurrent nedaplatin (25 mg/m2, d1-3) between September 2010 and December 2013, were retrospectively analyzed. By comparing pretreatment and post-treatment MRI images, it was shown that seven patients achieved a complete response (8.5%), while 66 achieved a partial response (80.5%), following completion of neoadjuvant chemotherapy (combined response rate, 89.0%). Grade 3–4 toxicities following neoadjuvant chemotherapy included neutropenia (29.1%), leukopenia (11.6%), liver dysfunction (9.3%), thrombocytopenia (9.3%) and nausea/vomiting (8.1%). The median follow-up was 18 months (range, 5–44 months). The 2-year relapse-free survival, distant metastasis-free survival, progression-free survival and overall survival rates were 96.6, 85.4, 83.3 and 96.1%, respectively. Compared with alternative neoadjuvant chemotherapy regimens in combination with radiotherapy or concurrent chemoradiotherapy, the present gemcitabine and nedaplatin did not provide additional survival benefit and led to a higher frequency of liver dysfunction. Therefore, neoadjuvant gemcitabine and nedaplatin should be used with caution in locoregionally advanced NPC. PMID:26622637

  10. The D2/D3-receptor antagonist tiapride impairs concurrent but not sequential taste aversion learning.

    PubMed

    Mediavilla, Cristina; Mahía, Javier; Bernal, Antonio; Puerto, Amadeo

    2012-02-10

    Taste aversion learning (TAL) is a learning modality in which the animals reject a gustatory stimulus associated with the administration of noxious visceral substances. This learning can be established by concurrent or sequential procedures that involve different anatomical and functional mechanisms and may constitute distinct learning modalities. The dopaminergic system has been related to various learning processes and goal-directed behaviours. The present study examined the effect of the administration of tiapride, a D(2)/D(3) dopaminergic antagonist, on concurrent and sequential TAL. Results obtained showed that pre-treatment with tiapride blocks the acquisition of concurrent TAL but does not affect sequential TAL, including reversal learning tasks. These results demonstrate the involvement of the D(2)/D(3) dopaminergic receptors in the former but not the latter learning process. The dopaminergic system appears to participate in concurrent TAL, an "implicit" learning modality, but not in sequential TAL, which is considered a relational/explicit acquisition process. PMID:22085742

  11. Characterizing Distributed Concurrent Engineering Teams: A Descriptive Framework for Aerospace Concurrent Engineering Design Teams

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Debarati; Hihn, Jairus; Warfield, Keith

    2011-01-01

    As aerospace missions grow larger and more technically complex in the face of ever tighter budgets, it will become increasingly important to use concurrent engineering methods in the development of early conceptual designs because of their ability to facilitate rapid assessments and trades in a cost-efficient manner. To successfully accomplish these complex missions with limited funding, it is also essential to effectively leverage the strengths of individuals and teams across government, industry, academia, and international agencies by increased cooperation between organizations. As a result, the existing concurrent engineering teams will need to increasingly engage in distributed collaborative concurrent design. This paper is an extension of a recent white paper written by the Concurrent Engineering Working Group, which details the unique challenges of distributed collaborative concurrent engineering. This paper includes a short history of aerospace concurrent engineering, and defines the terms 'concurrent', 'collaborative' and 'distributed' in the context of aerospace concurrent engineering. In addition, a model for the levels of complexity of concurrent engineering teams is presented to provide a way to conceptualize information and data flow within these types of teams.

  12. [Rectal cancer and adjuvant chemotherapy: which conclusions?].

    PubMed

    Bachet, J-B; Rougier, P; de Gramont, A; André, T

    2010-01-01

    Adenocarcinoma of the rectum represents about a third of cases of colorectal cancer, with an annual incidence of 12,000 cases in France. On the contrary of colon cancer, the benefice of adjuvant chemotherapy in rectal cancer has not been definitively proved, more because this question was assessed in few recent studies than because negative results. Preoperative radiochemotherapy is now the reference treatment for mid and lower rectal cancers, and allow to increase the local control without improvement of progression free survival and overall survival. The data of the "historical studies" of adjuvant treatment in rectal cancer published before 1990, of the meta-analysis of adjuvant trials in rectal cancer and of the QUASAR study suggest that adjuvant chemotherapy with fluoropyrimidines (intravenous or oral), in absence of pre-operative treatment, decrease the risk of metastatic relapse after curative surgery for a rectal cancer of stage II or III. This benefice seems similar to the one observed in colon cancer. In the EORTC radiotherapy group trial 22921, an adjuvant chemotherapy with 5-fluorouracil and low dose of leucovorin was not associated with a significantly improvement of overall survival but, despite the fact that only 42.9% of patients received all planed cycles, the progression free survival was increased (not significantly) in groups receiving adjuvant chemotherapy. The French recommendations are to discuss the indication of adjuvant chemotherapy by fluoropyrimidines in cases of stage III rectal cancer on histopathologic reports and no chemotherapy in case of stade II. Despite the fact that none study have assessed a combination of fluoropyrimidines and oxaliplatin in adjuvant setting in rectal cancer, like in colon cancer, the Folfox4, modified Folfox6 or Xelox regimens are valid options in stage III (experts opinion). In cases of pathologic complete remission or in absence of involved nodes, the benefice of adjuvant chemotherapy is not assessed. In all cases, the decision of adjuvant chemotherapy has to be taken during a multidisciplinary meeting. The interest of a combination of fluoropyrimidine and oxaliplatin is assessed in currently adjuvant trials (PETTAC-6 and CAO/ARO/AIO-04), and future trials will assess the interest of neoadjuvant chemotherapy. PMID:19965305

  13. 48 CFR 36.208 - Concurrent performance of firm-fixed-price and other types of construction contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Concurrent performance of...-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 36.208 Concurrent performance of firm-fixed-price and other types of construction contracts. In view of potential labor and...

  14. 48 CFR 36.208 - Concurrent performance of firm-fixed-price and other types of construction contracts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Concurrent performance of...-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 36.208 Concurrent performance of firm-fixed-price and other types of construction contracts. In view of potential labor and...

  15. 48 CFR 36.208 - Concurrent performance of firm-fixed-price and other types of construction contracts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Concurrent performance of...-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 36.208 Concurrent performance of firm-fixed-price and other types of construction contracts. In view of potential labor and...

  16. 48 CFR 36.208 - Concurrent performance of firm-fixed-price and other types of construction contracts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Concurrent performance of...-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 36.208 Concurrent performance of firm-fixed-price and other types of construction contracts. In view of potential labor and...

  17. 48 CFR 36.208 - Concurrent performance of firm-fixed-price and other types of construction contracts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Concurrent performance of...-ENGINEER CONTRACTS Special Aspects of Contracting for Construction 36.208 Concurrent performance of firm-fixed-price and other types of construction contracts. In view of potential labor and...

  18. Verifying Safety Properties of Concurrent Heap-Manipulating Programs

    E-print Network

    Sagiv, Shmuel "Mooly"

    Verifying Safety Properties of Concurrent Heap-Manipulating Programs Eran Yahav and Mooly Sagiv We provide a parametric framework for verifying safety properties of concurrent heap-manipulating programs to successfully verify the following properties of a concurrent program: --Concurrent manipulation of linked

  19. Load Performance Evaluation of the SSD According to the Number of Concurrent Users

    NASA Astrophysics Data System (ADS)

    Cheong, Seung-Kook; Ko, Dae-Sik

    In this paper, we designed DRAM-SSD and analyzed the load performance of DRAM-SSD and HDD according to the number of concurrent users. In experimental results, we showed that load performance of DRAM-SSD is about 20times more than that of the HDD. DRAM-SSD is useful for application which has many concurrent users such as first come first served system.

  20. 11yalecancercenter.org | centerpoint magazine chemotherapy, most patients have little

    E-print Network

    O'Hern, Corey S.

    . Unlike chemotherapy and other targeted treatments, nivolumab fights cancer by harnessing the body's immune system. Normally, the immune system detects invaders such as viruses or cancer, and attacks them into passivity as cells mutate. Immuno-drugs strip off cancer's disguise, revealing it to the immune system

  1. Interventionally implanted port catheter systems for hepatic arterial infusion of chemotherapy in patients with colorectal liver metastases: A phase II-study and historical comparison with the surgical approach

    PubMed Central

    Hildebrandt, Bert; Pech, Maciej; Nicolaou, Annett; Langrehr, Jan M; Kurcz, Jacek; Bartels, Birgit; Miersch, Alexandra; Felix, Roland; Neuhaus, Peter; Riess, Hanno; Dörken, Bernd; Ricke, Jens

    2007-01-01

    Background The high complication rates of surgically implanted port catheter systems (SIPCS) represents a major drawback in the treatment of isolated liver neoplasms by hepatic arterial infusion (HAI) of chemotherapy. Interventionally implanted port catheter systems (IIPCS) have evolved into a promising alternative that enable initiation of HAI without laparatomy, but prospective data on this approach are still sparse. Aim of this study was to evaluate the most important technical endpoints associated with the use of IIPCS for the delivery of 5-fluorouracil-based HAI in patients with colorectal liver metastases in a phase 2-study, and to perform a non-randomised comparison with a historical group of patients in which HAI was administered via SIPCS. Methods 41 patients with isolated liver metastases of colorectal cancer were enrolled into a phase II-study and provided with IIPCS between 2001 and 2004 (group A). The primary objective of the trial was defined as evaluation of device-related complications and port duration. Results were compared with those observed in a pre-defined historical collective of 40 patients treated with HAI via SIPCS at our institution between 1996 and 2000 (group B). Results Baseline characteristics were balanced between both groups, except for higher proportions of previous palliative pre-treatment and elevated serum alkaline phosphatase in patients of group A. Implantation of port catheters was successful in all patients of group A, whereas two primary failures were observed in group B. The frequency of device-related complications was similar between both groups, but the secondary failure rate was significantly higher with the use of surgical approach (17% vs. 50%, p < 0.01). Mean port duration was significantly longer in the interventional group (19 vs. 14 months, p = 0.01), with 77 vs. 50% of devices functioning at 12 months (p < 0.01). No unexpected complications were observed in both groups. Conclusion HAI via interventionally implanted port catheters can be safely provided to a collective of patients with colorectal liver metastases, including a relevant proportion of preatreated individuals. It appears to offer technical advantages over the surgical approach. PMID:17456240

  2. Long-term quality of life after intensified multi-modality treatment of oral cancer including intra-arterial induction chemotherapy and adjuvant chemoradiation

    PubMed Central

    Kovács, Adorján F.; Stefenelli, Ulrich; Thorn, Gerrit

    2015-01-01

    Background: Quality of life (QoL) studies are well established when accompanying trials in head and neck cancer, but studies on long-term survivors are rare. Aims: The aim was to evaluate long-term follow-up patients treated with an intensified multi-modality therapy. Setting and Design: Cross-sectional study, tertiary care center. Patients and Methods: A total of 135 oral/oropharyngeal cancer survivors having been treated with an effective four modality treatment (intra-arterial induction chemotherapy, radical surgery, adjuvant radiation, concurrent systemic chemotherapy) filled European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and HN35 questionnaires. Mean distance to treatment was 6.1 (1.3–16.6) years. Results were compared with a reference patient population (EORTC reference manual). In-study group comparison was also carried out. Statistical Analysis: One-sample t-test, Mann–Whitney-test, Kruskal–Wallis analysis. Results: QoL scores of both populations were well comparable. Global health status, cognitive and social functioning, fatigue, social eating, status of teeth, mouth opening and dryness, and sticky saliva were significantly worse in the study population; pain and need for pain killers, cough, need for nutritional support, problems with weight loss and gain were judged to be significantly less. Patients 1-year posttreatment had generally worse scores as compared to patients with two or more years distance to treatment. Complex reconstructive measures and adjuvant (chemo) radiation were main reasons for significant impairment of QoL. Conclusion Subjective disease status of patients following a maximized multi-modality treatment showed an expectable high degree of limitations, but was generally comparable to a reference group treated less intensively, suggesting that the administration of an intensified multi-modality treatment is feasible in terms of QoL/effectivity ratio. PMID:26389030

  3. Concurrent planning and execution for a walking robot

    NASA Astrophysics Data System (ADS)

    Simmons, Reid

    1990-07-01

    The Planetary Rover project is developing the Ambler, a novel legged robot, and an autonomous software system for walking the Ambler over rough terrain. As part of the project, we have developed a system that integrates perception, planning, and real-time control to navigate a single leg of the robot through complex obstacle courses. The system is integrated using the Task Control Architecture (TCA), a general-purpose set of utilities for building and controlling distributed mobile robot systems. The walking system, as originally implemented, utilized a sequential sense-plan-act control cycle. This report describes efforts to improve the performance of the system by concurrently planning and executing steps. Concurrency was achieved by modifying the existing sequential system to utilize TCA features such as resource management, monitors, temporal constraints, and hierarchical task trees. Performance was increased in excess of 30 percent with only a relatively modest effort to convert and test the system. The results lend support to the utility of using TCA to develop complex mobile robot systems.

  4. [Induction chemotherapy for locally advanced cervical cancer].

    PubMed

    Morkhov, K Yu; Nechushkina, V M; Kuznetsov, V V

    2015-01-01

    The main methods of treatment for cervical cancer are surgery, radiotherapy or their combination. During past two decades chemotherapy are increasingly being used not only in patients with disseminated forms of this disease but also in patients undergoing chemoradiotherapy or as induction therapy. Possibilities of adjuvant chemotherapy for cervical cancer are being studied. According to A.D.Kaprin and V.V. Starinskiy in 2013 in Russia, 32% of patients with newly diagnosed cervical cancer underwent only radiation therapy, 32%--combined or complex treatment, 27.3%--only surgery, and just 8.7%--chemoradiotherapy. PMID:26087600

  5. Phase I Study of Celecoxib with Concurrent Irinotecan, Cisplatin, and Radiation Therapy for Patients with Unresectable Locally Advanced Non-Small Cell Lung Cancer

    PubMed Central

    Komaki, Ritsuko; Wei, Xiong; Allen, Pamela K.; Liao, Zhongxing; Milas, Luka; Cox, James D.; O’Reilly, Michael S.; Chang, Joe Y.; McAleer, Mary Frances; Jeter, Melenda; Blumenschein, George R.; Kies, Merrill S.

    2011-01-01

    Purpose: Preclinical findings suggest that adding targeted therapies to combination radiation-chemotherapy can enhance treatment efficacy; however, this approach may enhance normal tissue toxicity. We investigated the maximum tolerated dose, dose-limiting toxicities, and response rate when the selective cyclooxygenase-2 inhibitor celecoxib is added to concurrent irinotecan, cisplatin, and radiation therapy for patients with inoperable stage II–III non-small cell lung cancer (NSCLC). Methods and Materials: Eighteen patients were analyzed in a phase I clinical dose-escalation trial. Celecoxib was given daily beginning 5?days before radiation followed by maintenance doses for 12?weeks. Toxicity was graded with the Common Terminology Criteria for Adverse Events V3.0 and response with the World Health Organization system. Primary endpoints were maximum tolerated dose of celecoxib and treatment toxicity; secondary endpoints were response and survival rates. Results: The maximum tolerated dose of celecoxib was not reached, in part owing to discontinuation of the drug supply. At doses of 200 or 400?mg/day, no patients experienced any dose-limiting toxicity (acute grade ?4 esophagitis or pneumonitis, neutropenic fever or thrombocytopenia requiring transfusion, or acute grade ?3 diarrhea). Grade 3 toxicities were leukopenia (five patients), fatigue (3), pneumonitis (2), dyspnea (1), pain (1), and esophageal stricture (1). Interestingly, pulmonary fibrosis (a late toxicity) was no more severe in the higher-dose (400-mg) group and may have been less common than in the lower-dose group. The clinical response rate was 100% (8 complete, 10 partial). Two-year rates were: overall survival 65%; local-regional control 69%; distant metastasis-free survival 71%; and disease-free survival 64%. Conclusion: Although preliminary, our results suggest that adding celecoxib to concurrent chemoradiation for inoperable NSCLC is safe and can improve outcome without increasing normal tissue toxicity. PMID:22649768

  6. Reallocating Resources to Focused Factories: A Case Study in Chemotherapy

    E-print Network

    Hurink, Johann

    Reallocating Resources to Focused Factories: A Case Study in Chemotherapy Peter T. Vanberkel a centralized chemotherapy department to a breast cancer focused factory. Using a slotted queueing model we show

  7. Managing Chemotherapy Side Effects: Skin and Nail Changes

    MedlinePLUS

    ... anD human services national institutes of health Managing Chemotherapy Side Effects Skin and Nail Changes “I was ... brands you should use on your skin. Managing Chemotherapy Side Effects: Skin and Nail Changes Protect your ...

  8. Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Men

    MedlinePLUS

    ... of health Managing Chemotherapy Side Effects Sexual and Fertility Changes in Men “I talked with my doctor ... may last. Managing Chemotherapy Side Effects: Sexual and Fertility Changes in Men How can I get help ...

  9. Side Effects of Chemotherapy and Radiation (For Parents)

    MedlinePLUS

    ... What to Expect Side Effects of Chemotherapy and Radiation KidsHealth > Parents > Diseases & Conditions > Cancer & Tumors > Side Effects of Chemotherapy and Radiation Print A A A Text Size What's in ...

  10. Radiotherapy- and Chemotherapy-Induced Myelodysplasia Syndrome

    PubMed Central

    Sun, Li-Min; Lin, Cheng-Li; Lin, Ming-Chia; Liang, Ji-An; Kao, Chia-Hung

    2015-01-01

    Abstract This study explored which kinds of cancer are related to a higher incidence of subsequent myelodysplastic syndrome (MDS) after radiotherapy (RT) and chemotherapy (CT). We performed a nested case–control study by using data from the Taiwanese National Health Insurance (NHI) system. The case group included cancer patients who developed MDS. For the control group, 4 cancer patients without MDS were frequency-matched with each MDS case by age, sex, year of cancer diagnosis, and MDS index year. A multivariable logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Overall, cancer patients who received RT or CT exhibited secondary MDS more frequently than did those who did not (RT: OR?=?1.53; 95% CI?=?1.33–1.77; CT: OR?=?1.51; 95% CI?=?1.25–1.82). Analysis by cancer site showed that RT increased the risk of MDS for patients with stomach, colorectal, liver, breast, endometrial, prostate, and kidney cancers. By contrast, CT was more likely to increase the risk of MDS for patients with lung, endometrial, and cervical cancers. Further analysis revealed that RT and CT seemed to have a positive interaction. The major limitation of this study was the lack of certain essential data in the NHI Research Database, such as data regarding cancer stage and treatment dose details. This population-based nested case–control study determined that RT and CT predisposed patients in Taiwan to the development of MDS. This effect was more prominent when both modalities were used. PMID:25929909

  11. Efficacy of intensity-modulated radiotherapy with concurrent carboplatin in nasopharyngeal carcinoma

    PubMed Central

    Songthong, Anussara; Chakkabat, Chakkapong; Kannarunimit, Danita; Lertbutsayanukul, Chawalit

    2015-01-01

    Background. The aim of the prospective phase II study was to evaluate the efficacy and toxicities of concurrent carboplatin with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma (NPC). Patients and methods. Between October 2005 and November 2011, 73 stage II–IVB NPC patients received IMRT 70 Gy concurrently with three cycles of carboplatin (AUC 5) every three weeks, followed by three cycles of adjuvant carboplatin (AUC 5) and 5-FU (1,000 mg/m2/day for four days) every four weeks. All patients were evaluated for tumour response using response evaluation criteria in solid tumour (RECIST) criteria, survival analysis using Kaplan-Meier methods, and toxicities according to common terminology criteria for adverse events (CTCAE) version 4.0. Results. At three months after chemoradiation, 82.2% and 17.8% of patients achieved complete and partial response, respectively. With a median follow-up of 48.1 months (1.3–97.8 months), 9.6% and 17.8% had local recurrence and distant metastasis, respectively. The median survival was not reached. A three-year overall survival was 83.6% and a progression-free survival was 65.3%. Regarding treatment compliance, 97.2%, 68.5% and 69.8% completed radiation treatment, concurrent carboplatin and adjuvant chemotherapy, respectively. Grade 3–4 acute toxicities were oral mucositis (16.4%), dysphagia (16.4%), xerostomia (15.1%) and haematotoxicity (6.8%). Conclusions. Carboplatin concurrently with IMRT provided excellent tumour response, manageable toxicities and good compliance. This should be considered as an alternative treatment for NPC patients. PMID:26029027

  12. Baboon syndrome and toxic erythema of chemotherapy: Fold (intertriginous) dermatoses.

    PubMed

    Wolf, Ronni; Tüzün, Yalç?n

    2015-01-01

    Three decades ago, researchers described an eruption with a very characteristic distribution pattern that was confined to the buttocks and the intertriginous and flexor areas. They gave this reaction pattern one of the most unforgettable names in dermatology, baboon syndrome (BS), due to the characteristic, bright-red, well-demarcated eruption predominantly on the buttocks and genital area, reminiscent of the red bottom of a baboon. The authors described three cases provoked by ampicillin, nickel, and mercury. They were convinced that BS represented a special form of hematogenous or systemic contact-type dermatitis, but several important papers that appeared during the past decade disagreed and suggested that BS should be distinguished from hematogenous or systemic contact-type dermatitis. A new acronym, SDRIFE (symmetrical drug-related intertriginous and flexoral exanthema), was proposed along with five diagnostic criteria: (1) exposure to a systemically administered drug at the time of first or repeated doses (contact allergens excluded), (2) sharply demarcated erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area, (3) involvement of at least one other intertriginous/flexural fold, (4) symmetry of affected areas, and (5) absence of systemic symptoms and signs. Although there are merits to the arguments in favor of SDRIFE, many of us still prefer to use the wittier name baboon syndrome, and even more authors use both terms. We confess that we find it difficult to relinquish the term BS, which has served us so well for years; however, recognition, familiarity, and knowledge of the characteristics of this form of drug eruption must supersede sentimental attachment to a certain nomenclature and so, however reluctantly, we must embrace change. Another intertriginous drug eruption is the one induced by chemotherapy. Toxic erythema of chemotherapy (TEC) is a useful clinical term that recently has been introduced to describe this group of chemotherapy-induced eruptions. This group of overlapping toxic reactions is characterized by areas of painful erythema often accompanied by edema usually involving the hands and feet, intertriginous zones (eg, axilla, groin), and, less often, the elbows, knees, and ears. Toxic erythema of chemotherapy is briefly discussed. PMID:26051062

  13. Cytoreduction with hyperthermic intraperitoneal chemotherapy: An anaesthetic challenge

    PubMed Central

    Murughan, Kavita; Tiwari, Malati; Balakrishnan, Kalpana

    2014-01-01

    Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy plays a considerable role as a treatment modality in surgical oncology in western countries. The advantage of this procedure is that the heated chemotherapeutic agent is circulated in the abdominal cavity and achieves high peritoneal concentration with limited systemic absorption. This procedure is complex not only to the surgical team, but also to the anaesthetist because apart from managing the usual physiologic changes associated with major surgery, one should also be prepared to manage the physiologic changes during the hyperthermic phase. Here, we present our experience with our first case. PMID:24700902

  14. Isolated Langerhans Histiocytosis in Thyroid: Thyroidectomy or Chemotherapy?

    PubMed Central

    Thorawade, Vandana; Jagade, Mohan; Kar, Rajesh; Parelkar, Kartik

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder of mononuclear phagocytic system whose clinical presentation varies from the localised involvement of a single bone to a widely disseminated disease. Langerhans cell histiocytosis rarely involves the thyroid gland and isolated involvement of thyroid is even rarer. We report a case of an eight-year-old male child diagnosed with Langerhans cell histiocytosis limited to thyroid gland with review of literature. Should thyroidectomy be done or proceed with chemotherapy? Our case report raises this question with a note on the role of 18 fluoro deoxy glucose positron emission tomography-computed tomography in the management of the same. PMID:26500997

  15. Radiation recall supraglottitis. A hazard in head and neck chemotherapy

    SciTech Connect

    Wallenborn, P.A.; Postma, D.S.

    1984-09-01

    The enhanced effects of chemotherapy on previously irradiated tissue have been well demonstrated. When chemotherapy is given some time after irradiation and elicits a tissue reaction in the radiation field, the reaction is termed radiation recall. We review known interactions between chemotherapy and radiotherapy and report, to our knowledge, the first case of a supraglottitis radiation recall reaction. Familiarity with this phenomenon and potential complications of chemotherapy following head and neck irradiation may expedite early diagnosis and appropriate lifesaving treatment.

  16. Intravenous Lidocaine Infusion to Treat Chemotherapy-Induced Peripheral Neuropathy.

    PubMed

    Papapetrou, Peter; Kumar, Aashish J; Muppuri, Rudram; Chakrabortty, Shushovan

    2015-11-01

    Chemotherapy-induced peripheral neuropathy is a debilitating side effect of chemotherapy, which manifests as paresthesias, dysesthesias, and numbness in the hands and feet. Numerous chemoprotective agents and treatments have been used with limited success to treat chemotherapy-induced peripheral neuropathy. We report a case in which a patient presenting with chemotherapy-induced peripheral neuropathy received an IV lidocaine infusion over the course of 60 minutes with complete symptomatic pain relief for a prolonged period of 2 weeks. PMID:26528700

  17. TGF? restores hematopoietic homeostasis after myelosuppressive chemotherapy

    PubMed Central

    Brenet, Fabienne; Kermani, Pouneh; Spektor, Roman; Rafii, Shahin

    2013-01-01

    Myelosuppression is a life-threatening complication of antineoplastic therapy, but treatment is restricted to a few cytokines with unilineage hematopoietic activity. Although hematopoietic stem cells (HSCs) are predominantly quiescent during homeostasis, they are rapidly recruited into cell cycle by stresses, including myelosuppressive chemotherapy. Factors that induce HSCs to proliferate during stress have been characterized, but it is not known how HSC quiescence is then reestablished. In this study, we show that TGF? signaling is transiently activated in hematopoietic stem and progenitor cells (HSPCs) during hematopoietic regeneration. Blockade of TGF? signaling after chemotherapy accelerates hematopoietic reconstitution and delays the return of cycling HSCs to quiescence. In contrast, TGF? blockade during homeostasis fails to induce cycling of HSPCs. We identified the cyclin-dependent kinase inhibitor Cdkn1c (p57) as a key downstream mediator of TGF? during regeneration because the recovery of chimeric mice, incapable of expressing p57 in HSPCs, phenocopies blockade of TGF? signaling after chemotherapy. This study demonstrates that context-dependent activation of TGF? signaling is central to an unrecognized counterregulatory mechanism that promotes homeostasis once hematopoiesis has sufficiently recovered from myelosuppressive chemotherapy. These results open the door to new, potentially superior, approaches to promote multilineage hematopoietic recovery by blocking the TGF? signaling that dampens regeneration. PMID:23440043

  18. Generalized eruptive lentiginosis induced by chemotherapy.

    PubMed

    De, D; Dogra, S; Kanwar, A J; Saikia, U N

    2010-06-01

    Lentigines are characterized by brown macules developing due to increased proliferation of melanocytes in the dermoepidermal junction. Many drugs, including immunosuppressants and immunomodulators, have been shown to cause generalized lentiginosis. We describe a case of lentiginosis induced by cancer chemotherapy, an extremely rare occurrence. PMID:19874348

  19. Adjuvant Chemotherapy in Rectal Cancer after Chemoradiotherapy.

    PubMed

    Boustani, J; Caubet, M; Bosset, J-F

    2016-02-01

    The aim of this overview was to investigate whether adjuvant chemotherapy has a favourable effect on the outcome of patients with rectal cancer who had preoperative (chemo)radiotherapy. A review of randomised clinical trials that allocated patients between fluorouracil-based and observation or between fluorouracil-based and oxaliplatin-based adjuvant chemotherapy after preoperative (chemo)radiotherapy was carried out, including their corresponding meta-analyses. None of the five randomised trials has shown a significant benefit of fluorouracil-based adjuvant chemotherapy for overall survival or disease-free survival. Also, the three corresponding meta-analyses failed to show a benefit of adjuvant treatment. Of three randomised trials - two phase III and one phase II with a 3-year disease-free survival end point - two showed a small benefit of adding oxaliplatin to fluorouracil, one failed. The corresponding meta-analyses showed that the pooled difference was not significant. In conclusion, the use of postoperative 5-fluorouracil-based chemotherapy with or without oxaliplatin in patients with rectal cancer after preoperative (chemo)radiotherapy is not scientifically proven. PMID:26698026

  20. Prolonged remission of recurrent cervical carcinoma following paclitaxel and carboplatin chemotherapy with paclitaxel maintenance chemotherapy.

    PubMed

    Micha, John P; Sassoon, Aaron F; Wong, Humberto; Goldstein, Bram H

    2015-08-01

    Cervical cancer recurs in ~30% of cases, for which a favorable prognosis is often unattainable. We describe a cervical cancer patient who developed metastatic disease ~5 years after her initial diagnosis. She was subsequently treated with six cycles of paclitaxel (175?mg/m) and carboplatin area under the curve (AUC) 5 chemotherapy every 21 days, and paclitaxel (135?mg/m) maintenance therapy every 21 days; the patient has remained in clinical remission after more than 5 years of follow-up. Chemotherapy has not historically been effective in managing recurrent, persistent, or metastatic cervical cancer. However, our case study involving paclitaxel and carboplatin chemotherapy with maintenance chemotherapy represents one of the longest documented remission rates in association with the management of recurrent cervical cancer. PMID:25933247

  1. Analysing PET scans data for predicting response to chemotherapy in

    E-print Network

    Sleeman, Derek

    Analysing PET scans data for predicting response to chemotherapy in breast cancer patients Elias to (neoadjunctive) chemotherapy. A group of 96 patients from the Aberdeen Royal Infirmary had the size of their tumours assessed by Positron Emission Tomography at various stages of their chemotherapy treatment

  2. Conditioned Emotional Distress in Women Receiving Chemotherapy for Breast Cancer.

    ERIC Educational Resources Information Center

    Jacobsen, Paul B.; And Others

    1995-01-01

    Investigated whether women undergoing outpatient chemotherapy for breast cancer can develop classically conditioned emotional distress. Patients' responses to a distinctive stimulus were assessed in a location not associated with chemotherapy administration. Results supported hypothesis that pairing a distinctive stimulus with chemotherapy would…

  3. Aggressive Chemotherapy and the Selection of Drug Resistant Pathogens

    E-print Network

    Read, Andrew

    Aggressive Chemotherapy and the Selection of Drug Resistant Pathogens Silvie Huijben1¤a *, Andrew S. Aggressive chemotherapy thus generates opposing evolutionary forces which together determine the rate of drug, Bell AS, Sim DG, Tomasello D, Mideo N, et al. (2013) Aggressive Chemotherapy and the Selection of Drug

  4. Cellular evaluation of oral chemotherapy carriers James Blanchette,1

    E-print Network

    Peppas, Nicholas A.

    Cellular evaluation of oral chemotherapy carriers James Blanchette,1 Nicholas A. Peppas1­3 1 cases im- proved, with oral administration.1­5 The advantages of oral chemotherapy go beyond survival, and an overall improvement in quality of life are additional benefits of oral chemotherapy. A recent study con

  5. G-CSF treatment of chemotherapy induced neutropenia -Online supplement

    E-print Network

    Rom-Kedar, Vered

    G-CSF treatment of chemotherapy induced neutropenia - Online supplement Eliezer Shochat and Vered under chemotherapy We use the following mathematical formulation to describe the G-CSF Neutrophils (GN-marrow to chemotherapy, we assume it is depleted by a certain rate (represented by 1), re- mains low (at Bnadir

  6. Chemotherapy and novel therapeutics before radical prostatectomy for high-risk clinically localized prostate cancer.

    PubMed

    Cha, Eugene K; Eastham, James A

    2015-05-01

    Although both surgery and radiation are potential curative options for men with clinically localized prostate cancer, a significant proportion of men with high-risk and locally advanced disease will demonstrate biochemical and potentially clinical progression of their disease. Neoadjuvant systemic therapy before radical prostatectomy (RP) is a logical strategy to improve treatment outcomes for men with clinically localized high-risk prostate cancer. Furthermore, delivery of chemotherapy and other systemic agents before RP affords an opportunity to explore the efficacy of these agents with pathologic end points. Neoadjuvant chemotherapy, primarily with docetaxel (with or without androgen deprivation therapy), has demonstrated feasibility and safety in men undergoing RP, but no study to date has established the efficacy of neoadjuvant chemotherapy or neoadjuvant chemohormonal therapies. Other novel agents, such as those targeting the vascular endothelial growth factor receptor, epidermal growth factor receptor, platelet-derived growth factor receptor, clusterin, and immunomodulatory therapeutics, are currently under investigation. PMID:25596644

  7. Immunomodulatory effect of DC/CIK combined with chemotherapy in multiple myeloma and the clinical efficacy

    PubMed Central

    Zhao, Xia; Ji, Chun-Yan; Liu, Guo-Qiang; Ma, Dao-Xin; Ding, Hui-Fang; Xu, Min; Xing, Jian

    2015-01-01

    To investigate the clinical efficacy of adoptive immunotherapy using dendritic cells (DC) and cytokine-induced killer (CIK) cells combined with chemotherapy in multiple myeloma. The immunomodulatory effect of the therapy was discussed by detecting the levels of peripheral blood T cell subsets and CD4+CD25+ regulatory cells (Treg). Fifty MM patients were randomly divided into two groups: 24 cases in the simple chemotherapy group and 26 cases in the combined therapy group (chemotherapy plus DC/CIK immunotherapy). The therapeutic efficacy and the proportions of peripheral blood T cell subsets and Treg cells were compared between the two groups. The cellular immunity indicators were also compared, including IL-2, IFN-?, IL-4, IL-10, AgNORs ratio and TGF-?. After 3 weeks of treatment, the life quality and clinical efficacy of the combined therapy group were superior to those of the simple chemotherapy group (P<0.05). CD3+CD8+ ratio, CD4+CD25+ ratio, CD4+CD25+/CD4+ ratio, CD4+CD25+FoxP3+/CD4+CD25+ ratio, IL-4, IL-10 and TGF-? levels of the combined therapy group were obviously lower than those of the simple chemotherapy group (P<0.05). The CD3+CD4+/CD3+CD8+ ratio, AgNOR ratio, IL-2 and IFN-? level and positive rate of NKG2D in the combined therapy group were significantly higher than those of the simple chemotherapy group (P<0.05). These results indicated better immunomodulatory effect of the combined therapy. DC/CIK immunotherapy combined with chemotherapy has a good clinical efficacy and prospect for MM, reversing the Th1 to Th2 shift and increasing the anti-tumor capacity of the immune system. PMID:26722513

  8. Access to Chemotherapy Services by Availability of Local and Visiting Oncologists

    PubMed Central

    Ward, Marcia M.; Ullrich, Fred; Matthews, Kevin; Rushton, Gerard; Tracy, Roger; Bajorin, Dean F.; Goldstein, Michael A.; Kosty, Michael P.; Bruinooge, Suanna S.; Hanley, Amy; Lynch, Charles F.

    2014-01-01

    Purpose: Geographic disparities have raised important questions about factors related to treatment choice and travel time, which can affect access to cancer care. Patients and Methods: Iowa residents who received chemotherapy regardless of where they were diagnosed or treated were identified through the Iowa Cancer Registry (ICR), a member of the SEER program. Oncologists and their practice locations, including visiting consulting clinics (VCCs), were tracked through the Iowa Physician Information System. Oncologists, VCCs, and patients were mapped to hospital service areas (HSAs). Results: Between 2004 and 2010, 113,885 newly diagnosed invasive cancers were entered into ICR; among patients in whom these cancers were diagnosed, 31.6% received chemotherapy as a first course of treatment. During this period, 106 Iowa oncologists practiced in 14 cities, and 82 engaged in outreach to 85 VCCs in 77 rural communities. Of patients receiving chemotherapy, 63.0% resided in an HSA that had a local oncologist and traveled 21 minutes for treatment on average. In contrast, 29.3% of patients receiving chemotherapy resided in an HSA with a VCC, and 7.7% resided in an HSA with no oncology provider. These latter two groups of patients traveled 58 minutes on average to receive chemotherapy. Availability of oncologists and VCCs affected where patients received chemotherapy. The establishment of VCCs increased access to oncologists in rural communities and increased the rate that chemotherapy was administered in rural communities from 10% to 24%, a notable increase in local access. Conclusion: Access to cancer care is dependent on the absolute number of providers, but it is also dependent on their geographic distribution. PMID:24443731

  9. Efficacy of contemporary chemotherapy in stage IIIC endometrial cancer: A histologic dichotomy

    PubMed Central

    Bakkum-Gamez, Jamie N.; Mariani, Andrea; Dowdy, Sean C.; Weaver, Amy L.; McGree, Michaela E.; Martin, Janice R.; Keeney, Gary L.; Jatoi, Aminah; Gostout, Bobbie S.; Podratz, Karl C.

    2015-01-01

    Background Treatment failures in stage IIIC endometrial carcinoma (EC) are predominantly due to occult extrapelvic metastases (EPM). The impact of chemotherapy on occult EPM was investigated according to grade (G), G1/2EC vs G3EC. Methods All surgical-stage IIIC EC cases from January 1, 1999, through December 31, 2008, from Mayo Clinic were included. Patient-, disease-, and treatment-specific risk factors were assessed for association with overall survival, cause-specific survival, and extrapelvic disease-free survival (DFS) using Cox proportional hazards regression. Results 109 cases met criteria, with 92 (84%) having systematic lymphadenectomy (>10 pelvic and >5 paraaortic lymph nodes resected). In patients with documented recurrence sites, occult EPM accounted for 88%. Among G1/2EC cases (n = 48), the sole independent predictor of extrapelvic DFS was grade 2 histology (hazard ratio [HR], 0.28; 95% CI, 0.08–0.91; P = .03) while receipt of adjuvant chemotherapy approached significance (HR 0.13; 95% CI, 0.02, 1.01; P = .0511). The 5-year extrapelvic DFS with and without adjuvant chemotherapy was 93% and 54%, respectively (log-rank, P = .02). Among G3EC (n = 61), the sole independent predictor of extrapelvic DFS was lymphovascular space involvement (HR, 2.63; 95% CI, 1.16–5.97; P = .02). Adjuvant chemotherapy did not affect occult EPM in G3EC; the 5-year extrapelvic DFS for G3EC with and without adjuvant chemotherapy was 43% and 42%, respectively (log-rank, P = .91). Conclusions Chemotherapy improves extrapelvic DFS for stage IIIC G1/2EC but not stage IIIC G3EC. Future efforts should focus on prospectively assessing the impact of chemotherapy on DFS in G3EC and developing innovative phase I and II trials of novel systemic therapies for advanced G3EC. PMID:24434057

  10. Five Fractions of Radiation Therapy Followed by 4 Cycles of FOLFOX Chemotherapy as Preoperative Treatment for Rectal Cancer

    SciTech Connect

    Myerson, Robert J.; Tan, Benjamin; Hunt, Steven; Olsen, Jeffrey; Birnbaum, Elisa; Fleshman, James; Gao, Feng; Hall, Lannis; Kodner, Ira; Lockhart, A. Craig; Mutch, Matthew; Naughton, Michael; Picus, Joel; Rigden, Caron; Safar, Bashar; Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea; Parikh, Parag

    2014-03-15

    Background: Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Methods and Materials: Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT < cT) and preoperative grade 3+ gastrointestinal morbidity equal to or better than that of historical controls. Results: 76 evaluable cases included 7 cT4 and 69 cT3; 59 (78%) cN+, and 7 cM1. Grade 3 preoperative GI morbidity occurred in 7 cases (9%) (no grade 4 or 5). Sphincter-preserving surgery was performed on 57 (75%) patients. At surgery, 53 patients (70%) had ypT0-2 residual disease, including 21 (28%) ypT0 and 19 (25%) ypT0N0 (complete response); 24 (32%) were ypN+. At 30 months, local control for all evaluable cases and freedom from disease for M0 evaluable cases were, respectively, 95% (95% confidence interval [CI]: 89%-100%) and 87% (95% CI: 76%-98%). Cases were subanalyzed by whether disease met requirements for the recently activated PROSPECT trial for intermediate-risk rectal cancer. Thirty-eight patients met PROSPECT eligibility and achieved 16 ypT0 (42%), 15 ypT0N0 (39%), and 33 ypT0-2 (87%). Conclusion: This regimen achieved response and morbidity rates that compare favorably with those of conventionally fractionated radiation therapy and concurrent chemotherapy.

  11. Prognostic nutritional index before adjuvant chemotherapy predicts chemotherapy compliance and survival among patients with non-small-cell lung cancer

    PubMed Central

    Shimizu, Katsuhiko; Okita, Riki; Saisho, Shinsuke; Yukawa, Takuro; Maeda, Ai; Nojima, Yuji; Nakata, Masao

    2015-01-01

    Background Adjuvant chemotherapy after the complete resection of non-small-cell lung cancer (NSCLC) is now the standard of care. To improve survival, it is important to identify risk factors for the continuation of adjuvant chemotherapy. In this study, we analyzed chemotherapy compliance and magnitude of the prognostic impact of the prognostic nutritional index (PNI) before adjuvant chemotherapy. Methods We conducted a retrospective review of data from 106 patients who had received adjuvant chemotherapy. The adjuvant chemotherapy consisted of an oral tegafur agent (OT) or platinum-based chemotherapy (PB). The correlations between the PNI values and recurrence-free survival (RFS) were then evaluated. Results In the PB group, the percentage of patients who completed the four planned cycles of chemotherapy was not correlated with the PNI. In the OT group, however, a significant difference was observed in the percentage of patients who completed the planned chemotherapy according to the PNI before adjuvant chemotherapy. The RFS of patients with a PNI <50 before adjuvant chemotherapy was significantly poorer than that of the patients with a PNI ?50. A multivariate analysis showed that nodal metastasis and PNI before chemotherapy were independent predictors of the RFS. However, PNI before surgery was not a predictor of the RFS. In the subgroup analysis, PNI before chemotherapy was independent predictor of the RFS in the OT group (P=0.019), but not in the PB group (P=0.095). Conclusion The PNI before adjuvant chemotherapy influenced the treatment compliance with the planned chemotherapy in the OT group, but not the PB group. In addition, a low PNI before adjuvant chemotherapy was associated with a poor RFS in a multivariate analysis, especially in the OT group. PMID:26504397

  12. Intratumoral chemotherapy for lung cancer: re-challenge current targeted therapies

    PubMed Central

    Hohenforst-Schmidt, Wolfgang; Zarogoulidis, Paul; Darwiche, Kaid; Vogl, Thomas; Goldberg, Eugene P; Huang, Haidong; Simoff, Michael; Li, Qiang; Browning, Robert; Turner, Francis J; Le Pivert, Patrick; Spyratos, Dionysios; Zarogoulidis, Konstantinos; Celikoglu, Seyhan I; Celikoglu, Firuz; Brachmann, Johannes

    2013-01-01

    Strategies to enhance the already established doublet chemotherapy regimen for lung cancer have been investigated for more than 20 years. Initially, the concept was to administer chemotherapy drugs locally to the tumor site for efficient diffusion through passive transport within the tumor. Recent advances have enhanced the diffusion of pharmaceuticals through active transport by using pharmaceuticals designed to target the genome of tumors. In the present study, five patients with non-small cell lung cancer epidermal growth factor receptor (EGFR) negative stage IIIa–IV International Union Against Cancer 7 (UICC-7), and with Eastern Cooperative Oncology Group (ECOG) 2 scores were administered platinum-based doublet chemotherapy using combined intratumoral-regional and intravenous route of administration. Cisplatin analogues were injected at 0.5%–1% concentration within the tumor lesion and proven malignant lymph nodes according to pretreatment histological/cytological results and the concentration of systemic infusion was decreased to 70% of a standard protocol. This combined intravenous plus intratumoral-regional chemotherapy is used as a first line therapy on this short series of patients. To the best of our knowledge this is the first report of direct treatment of involved lymph nodes with cisplatin by endobronchial ultrasound drug delivery with a needle without any adverse effects. The initial overall survival and local response are suggestive of a better efficacy compared to established doublet cisplatin–based systemic chemotherapy in (higher) standard concentrations alone according to the UICC 7 database expected survival. An extensive search of the literature was performed to gather information of previously published literature of intratumoral chemo-drug administration and formulation for this treatment modality. Our study shows a favorable local response, more than a 50% reduction, for a massive tumor mass after administration of five sessions of intratumoral chemotherapy plus two cycles of low-dose intravenous chemotherapy according to our protocol. These encouraging results (even in very sick ECOG 2 patients with central obstructive non-small cell lung cancer having a worse prognosis and quality of life than a non-small cell lung cancer in ECOG 0 of the same tumor node metastasis [TNM]-stage without central obstruction) for a chemotherapy-only protocol that differs from conventional cisplatin-based doublet chemotherapy by the route, target site, and dose paves the way for broader applications of this technique. Finally, future perspectives of this treatment and pharmaceutical design for intratumoral administration are presented. PMID:23898222

  13. Relevance Logic and Concurrent Composition 

    E-print Network

    Dam, Mads F

    Compositionality, i.e. that properties of composite systems are deduced in terms of those of their immediate constituents, is crucial to the tractability and practical usefulness of program logics. A general technique for ...

  14. Late Toxicity After Definitive Concurrent Chemoradiotherapy for Thoracic Esophageal Carcinoma

    SciTech Connect

    Morota, Madoka Gomi, Kotaro; Kozuka, Takuyo; Chin, Keisho; Matsuura, Masaaki; Oguchi, Masahiko; Ito, Hisao; Yamashita, Takashi

    2009-09-01

    Purpose: To evaluate late cardiopulmonary toxicities after concurrent chemoradiotherapy (CCRT) for esophageal carcinomas. Methods and Materials: From February 2002 through April 2005, 74 patients with clinical Stage I-IVB carcinoma of the esophagus were treated with CCRT. Sixty-nine patients with thoracic squamous cell carcinoma were the core of this analysis. Patients received 60 Gy of radiation therapy in 30 fractions over 8 weeks, including a 2-week break, and received 2 cycles of fluorouracil/cisplatin chemotherapy concomitantly. Initial radiation fields included primary tumors, metastatic lymph nodes, and supraclavicular, mediastinal, and celiac nodes areas. Late toxicities were assessed with the late radiation morbidity scoring scheme of the Radiation Therapy Oncology Group/European Organiation for Research and Treatment of Cancer. Results: The median age was 67 years (range, 45-83 years). The median follow-up time was 26.1 months for all patients and 51.4 months for patients still alive at the time of analysis. Five cardiopulmonary toxic events of Grade 3 or greater were observed in 4 patients, Grade 5 heart failure and Grade 3 pericarditis in 1 patient, and Grade 3 myocardial infarction, Grade 3 radiation pneumonitis, and Grade 3 pleural effusion. The 2-year cumulative incidence of late cardiopulmonary toxicities of Grade 3 or greater for patients 75 years or older was 29% compared with 3% for younger patients (p = 0.005). Conclusion: The CCRT used in this study with an extensive radiation field is acceptable for younger patients but is not tolerated by patients older than 75 years.

  15. Temperature Sensitive Magnetic Drug Carriers for Concurrent Gemcitabine Chemohyperthermia

    PubMed Central

    Guo, Yang; Zhang, Zhuoli; Procissi, Daniel; Nicolai, Jodi; Omary, Reed A.; Larson, Andrew C.

    2014-01-01

    We sought to improve the efficacy of gemcitabine (GEM) for the treatment of advanced pancreatic cancer via local hyperthermia potentiated via a multi-functional nanoplatform permitting both in vivo heating and drug delivery. Herein, we propose a chemohyperthermia approach to synergistically achieve high intra-tumoral drug concentrations while permitting concurrent hyperthermia for more effective tumor cell kill and growth inhibition. Drug delivery and hyperthermia were achieved using a hydroxypropyl cellulose (HPC) grafted porous magnetic drug carrier that is MRI visible to permit in vivo visualization of the biodistribution. These synthesized magnetic drug carriers produced strong T2 weighted image contrast and permitted efficient heating using low magnetic field intensities. The thermo-mechanical response of HPC permitted triggered GEM release confirmed during in vitro drug release studies. During in vitro studies, pancreatic cancer cell growth was significantly inhibited (~82% reduction) with chemohyperthermia compared to chemotherapy or hyperthermia alone. Using PANC-1 xenografts in nude mice, the delivery of injected GEM-loaded magnetic carriers (GEM-magnetic carriers) was visualized with both MRI and fluorescent imaging techniques. Chemohyperthermia with intra-tumoral injections of GEM-magnetic carriers (followed by heating) resulted in significant increases in apoptotic cell death compared to tumors treated with GEM-magnetic carriers injections alone. Chemohyperthermia with GEM-magnetic carriers offers the potential to significantly improve the therapeutic efficacy of gemcitabine for the treatment of pancreatic cancer. In vivo delivery confirmation with non-invasive imaging techniques could permit patient-specific adjustments therapeutic regimens for improve longitudinal outcomes. PMID:24574255

  16. Early detection of cardiotoxicity by 2D and 3D deformation imaging in patients receiving chemotherapy

    PubMed Central

    Stoebe, Stephan; Tuennemann, Jan; Baka, Zsuzsanna; Pfeiffer, Dietrich; Varga, Albert; Hagendorff, Andreas

    2015-01-01

    The aim of the present study was to find out whether early cardiac changes in patients receiving chemotherapy can be detected by the conventional and deformation parameters of 2D and 3D echocardiography. Twenty-five healthy subjects with normal regional left ventricular function (group 1) and 25 patients receiving chemotherapy (group 2) underwent 2D and 3D transthoracic echocardiography (Toshiba Artida Medical System). All patients (group 2) were examined before and during cardiotoxic chemotherapy at a 3-month follow-up. Left ventricular volumes, ejection fraction, muscle mass, global longitudinal, global radial, global circumferential strain, and rotation were analyzed with 2D and 3D echocardiography, while twist and time-to-peak-intervals were analyzed with 3D echocardiography. For left ventricular volumes and muscle mass, no significant differences were seen between the two study groups (P<0.05). According to our results, myocardial dysfunction induced by cardiotoxic chemotherapy can be detected by 2D global radial strain. Detecting myocardial dysfunction by global longitudinal and circumferential strain requires more than 3 months follow-up. Changes in rotation, twist or time-to-peak intervals could not be verified at the 3-month follow-up in the present study. 2D global radial strain seems to be the most sensitive and robust parameter to detect early myocardial damage during chemotherapy. 3D echocardiography is not yet an established method to detect myocardial damage in clinical practice due to lower spatial and temporal resolution.

  17. Concurrence of Lorentz-positive maps

    E-print Network

    Roland Hildebrand

    2006-12-08

    Let L_n be the n-dimensional Lorentz cone. A linear map M from R^m to R^n is called Lorentz-positive if M[L_m] is contained in L_n. We extend the notion of concurrence, which was initially introduced to quantify the entanglement of bipartite density matrices, to Lorentz-positive maps and provide an explicite formula for it. This allows us to obtain formulae for the concurrence of arbitrary positive operators taking 2 x 2 complex hermitian matrices as input and consequently of arbitrary bipartite density matrices of rank 2. Namely, let P: H(2) \\to H(d) be a positive operator, and let \\lambda_1,...,\\lambda_4 be the generalized eigenvalues of the pencil \\sigma_2(P(X)) - \\lambda det X, in decreasing order, where \\sigma_2 is the second symmetric function of the spectrum. Then the concurrence is given by the expression C(P;X) = 2\\sqrt{\\sigma_2(P(X)) - \\lambda_2 det X}. As an application, we compute the concurrences of the density matrices of all graphs with 2 edges. Similar results apply for a function which we call I-fidelity, with the second largest generalized eigenvalue \\lambda_2 replaced by the smallest eigenvalue \\lambda_4.

  18. Using Concurrent Verbalization to Measure Math Comprehension

    ERIC Educational Resources Information Center

    Lambeth, Cathryn Colley

    2012-01-01

    The current study investigated variability in student performance on a concurrent verbalization measure based on a grade-level sample math word problem and sought to determine to what extent the variability in verbalization scores is related to scores on a reliable measure of reading (DIBELS Next) and math (easyCBM) and to student factors (e.g.…

  19. 33 CFR 385.7 - Concurrency statements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Concurrency statements. 385.7 Section 385.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General...

  20. A concurrent dataflow algorithm for ray tracing

    E-print Network

    Nebel, Jean-Christophe

    A concurrent dataflow algorithm for ray tracing Jean-Christophe Nebel E-mail: jc@dcs.gla.ac.uk 17 efficiently for ray tracing. Here each pixel is processed independently, so a natural method of flow to use dynamically. This arose from the development of a parallel ray tracing algorithm

  1. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69...

  2. 29 CFR 503.21 - Concurrent actions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... described in § 503.1(b) and in 20 CFR part 655, Subpart A. The WHD has primary responsibility to make all....S.C. 1184(c), 20 CFR part 655, Subpart A, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR 655.73 or under § 503.24....

  3. 29 CFR 503.21 - Concurrent actions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... described in § 503.1(b) and in 20 CFR part 655, Subpart A. The WHD has primary responsibility to make all....S.C. 1184(c), 20 CFR part 655, Subpart A, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR 655.73 or under § 503.24....

  4. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69...

  5. 29 CFR 501.17 - Concurrent actions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in § 501.1(b) of this part and in 20 CFR part 655, subpart B. The WHD has primary responsibility to... any other action authorized by 8 U.S.C. 1188, 20 CFR part 655, subpart B, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR...

  6. 29 CFR 501.17 - Concurrent actions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in § 501.1(b) of this part and in 20 CFR part 655, subpart B. The WHD has primary responsibility to... any other action authorized by 8 U.S.C. 1188, 20 CFR part 655, subpart B, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR...

  7. 29 CFR 501.17 - Concurrent actions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in § 501.1(b) of this part and in 20 CFR part 655, subpart B. The WHD has primary responsibility to... any other action authorized by 8 U.S.C. 1188, 20 CFR part 655, subpart B, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR...

  8. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69...

  9. 29 CFR 501.17 - Concurrent actions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in § 501.1(b) of this part and in 20 CFR part 655, subpart B. The WHD has primary responsibility to... any other action authorized by 8 U.S.C. 1188, 20 CFR part 655, subpart B, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR...

  10. 29 CFR 501.17 - Concurrent actions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... in § 501.1(b) of this part and in 20 CFR part 655, subpart B. The WHD has primary responsibility to... any other action authorized by 8 U.S.C. 1188, 20 CFR part 655, subpart B, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR...

  11. 29 CFR 503.21 - Concurrent actions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... described in § 503.1(b) and in 20 CFR part 655, Subpart A. The WHD has primary responsibility to make all....S.C. 1184(c), 20 CFR part 655, Subpart A, or the regulations in this part. OFLC and the WHD have concurrent jurisdiction to impose a debarment remedy under 20 CFR 655.73 or under § 503.24....

  12. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69...

  13. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69...

  14. Circadian Clock, Cancer, and Chemotherapy

    PubMed Central

    2015-01-01

    The circadian clock is a global regulatory system that interfaces with most other regulatory systems and pathways in mammalian organisms. Investigations of the circadian clock–DNA damage response connections have revealed that nucleotide excision repair, DNA damage checkpoints, and apoptosis are appreciably influenced by the clock. Although several epidemiological studies in humans and a limited number of genetic studies in mouse model systems have indicated that clock disruption may predispose mammals to cancer, well-controlled genetic studies in mice have not supported the commonly held view that circadian clock disruption is a cancer risk factor. In fact, in the appropriate genetic background, clock disruption may instead aid in cancer regression by promoting intrinsic and extrinsic apoptosis. Finally, the clock may affect the efficacy of cancer treatment (chronochemotherapy) by modulating the pharmacokinetics and pharmacodynamics of chemotherapeutic drugs as well as the activity of the DNA repair enzymes that repair the DNA damage caused by anticancer drugs. PMID:25302769

  15. Short-course radiotherapy followed by neo-adjuvant chemotherapy in locally advanced rectal cancer – the RAPIDO trial

    PubMed Central

    2013-01-01

    Background Current standard for most of the locally advanced rectal cancers is preoperative chemoradiotherapy, and, variably per institution, postoperative adjuvant chemotherapy. Short-course preoperative radiation with delayed surgery has been shown to induce tumour down-staging in both randomized and observational studies. The concept of neo-adjuvant chemotherapy has been proven successful in gastric cancer, hepatic metastases from colorectal cancer and is currently tested in primary colon cancer. Methods and design Patients with rectal cancer with high risk features for local or systemic failure on magnetic resonance imaging are randomized to either a standard arm or an experimental arm. The standard arm consists of chemoradiation (1.8 Gy x 25 or 2 Gy x 25 with capecitabine) preoperatively, followed by selective postoperative adjuvant chemotherapy. Postoperative chemotherapy is optional and may be omitted by participating institutions. The experimental arm includes short-course radiotherapy (5 Gy x 5) followed by full-dose chemotherapy (capecitabine and oxaliplatin) in 6 cycles before surgery. In the experimental arm, no postoperative chemotherapy is prescribed. Surgery is performed according to TME principles in both study arms. The hypothesis is that short-course radiotherapy with neo-adjuvant chemotherapy increases disease-free and overall survival without compromising local control. Primary end-point is disease-free survival at 3 years. Secondary endpoints include overall survival, local control, toxicity profile, and treatment completion rate, rate of pathological complete response and microscopically radical resection, and quality of life. Discussion Following the advances in rectal cancer management, increased focus on survival rather than only on local control is now justified. In an experimental arm, short-course radiotherapy is combined with full-dose chemotherapy preoperatively, an alternative that offers advantages compared to concomitant chemoradiotherapy with or without postoperative chemotherapy. In a multi-centre setting this regimen is compared to current standard with the aim of improving survival for patients with locally advanced rectal cancer. Trial registration ClinicalTrials.gov NCT01558921 PMID:23742033

  16. Induction and Concurrent Taxanes Enhance Both the Pulmonary Metabolic Radiation Response and the Radiation Pneumonitis Response in Patients With Esophagus Cancer

    SciTech Connect

    McCurdy, Matthew; McAleer, Mary Frances; Wei Wei; Ezhil, Muthuveni; Johnson, Valen; Khan, Meena; Baker, Jamie; Luo Dershan; Ajani, Jaffer; Guerrero, Thomas

    2010-03-01

    Purpose: The primary aim of this study was to assess pulmonary radiation toxicity quantitatively in patients who received thoracic radiotherapy combined with induction and/or concurrent chemotherapy with or without taxanes for esophageal cancer. Methods and Materials: The study subjects were 139 patients treated at the University of Texas M.D. Anderson Cancer Center for esophageal cancer and who had undergone [{sup 18}F]-fluorodeoxyglucose positron emission tomography/computed tomography between November 1, 2003 and December 15, 2007 for disease restaging after chemoradiotherapy. The patients were grouped into those who had not received taxanes (Group 1), those who had received induction or concurrent taxanes (Group 2), and those who had received both induction and concurrent taxanes (Group 3). Clinical pulmonary toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. Linear regression was applied to the fluorodeoxyglucose uptake vs. radiation dose to determine the pulmonary metabolic radiation response (PMRR) for each case. The clinical toxicity scores and PMRR among the groups were evaluated for significance differences. Results: The crude rate of pneumonitis symptoms was 46%, 62%, and 74% for Group 1, 2, and 3, respectively. The analysis of variance test of log(PMRR) by treatment was significant (p = .0046). Group 3 had a 61% greater PMRR compared with Group 1 (p = .002). Group 2 had a 38% greater PMRR compared with Group 1 (p = .015). Finally, Group 3 had a 17% greater PMRR compared with Group 2 (p = .31). A PMRR enhancement ratio of 1.60 (95% confidence interval, 1.19-2.14) was observed for Group 3 vs. Group 1. Conclusion: Patients given induction and concurrent taxane chemotherapy had a significantly greater PMRR and clinical pneumonitis symptoms compared with the patients whose chemotherapy regimen did not include taxanes.

  17. Concurrent chemoradiotherapy using paclitaxel plus cisplatin in the treatment of elderly patients with esophageal cancer

    PubMed Central

    Song, Tao; Zhang, Xuebang; Fang, Min; Wu, Shixiu

    2015-01-01

    Objective This study aimed at assessing the efficiency and safety of concurrent chemoradiotherapy (CCRT) using paclitaxel (PTX) plus cisplatin (CDDP) in elderly (age ?70 years) esophageal cancer patients. Patients and methods Between July 2008 and June 2011, 82 esophageal cancer patients aged ?70 years were retrospectively analyzed. Chemotherapy consisted of CDDP for 3 days plus PTX given for 3 hours. The preplanned total dose of concurrent irradiation with 60 Gy/30 Fx was given at the 1st day of chemotherapy. Results The average age for the enrolled patients was 76.41 years (range: 70–87 years), and the clinical stages were stage I (two patients), stage II (23 patients), stage III (49 patients), and stage IV (eight patients). A total of 66 patients finished CCRT on schedule, including 55 (67.1%) patients in whom treatment regimen was not changed, and the clinical complete response was achieved in 29 patients. With a median follow-up time of 20.4 months, the median overall survival (OS) time and progression-free survival (PFS) time were 26.9 months and 18.2 months, respectively. The 2-year OS and PFS rates for stage I–II and III–IV were 76.0%, 64.0% and 38.6%, 21.2%, respectively. Grade ?3 leukopenia was observed in 25 patients, and the most common nonhematologic toxicity was esophagitis including five and two patients with grade 3 and 4, respectively. Multivariate analysis revealed that clinical stage was a strong factor for OS and PFS. Conclusion CCRT using PTX plus CDDP for selected elderly esophageal cancer patients resulted in encouraging survival outcomes and tolerable toxicities. Future prospective studies in large cohorts are highly warranted to confirm the findings in our report. PMID:26543377

  18. Generating a foundation for Concurrent Engineering. Final report

    SciTech Connect

    Christensen, N.C.

    1997-03-01

    Both Concurrent Engineering and the Agile Enterprise require as a foundation the low cost, timely sharing of information. Described is a cost-effective way to generate this foundation from the product data International Standard 10303 (informally called STEP). Also described is a prototype implementation. AlliedSignal, Federal Manufacturing and Technologies (FM and T), was the first facility in the world to manufacture a mechanical part using the then draft international standard (DIS) ISO 10303 STEP. The Advanced Manufacturing Development System (AMDS) enabled this accomplishment.

  19. Phase II Study of Concurrent Capecitabine and External Beam Radiotherapy for Pain Control of Bone Metastases of Breast Cancer Origin

    PubMed Central

    Kundel, Yulia; Nasser, Nicola J.; Purim, Ofer; Yerushalmi, Rinat; Fenig, Eyal; Pfeffer, Raphael M.; Stemmer, Salomon M.; Rizel, Shulamith; Symon, Zvi; Kaufman, Bella; Sulkes, Aaron; Brenner, Baruch

    2013-01-01

    Background Pain from bone metastases of breast cancer origin is treated with localized radiation. Modulating doses and schedules has shown little efficacy in improving results. Given the synergistic therapeutic effect reported for combined systemic chemotherapy with local radiation in anal, rectal, and head and neck malignancies, we sought to evaluate the tolerability and efficacy of combined capecitabine and radiation for palliation of pain due to bone metastases from breast cancer. Methodology/Principal Findings Twenty-nine women with painful bone metastases from breast cancer were treated with external beam radiation in 10 fractions of 3 Gy, 5 fractions a week for 2 consecutive weeks. Oral capecitabine 700 mg/m2 twice daily was administered throughout radiation therapy. Rates of complete response, defined as a score of 0 on a 10-point pain scale and no increase in analgesic consumption, were 14% at 1 week, 38% at 2 weeks, 52% at 4 weeks, 52% at 8 weeks, and 48% at 12 weeks. Corresponding rates of partial response, defined as a reduction of at least 2 points in pain score without an increase in analgesics consumption, were 31%, 38%, 28%, 34% and 38%. The overall response rate (complete and partial) at 12 weeks was 86%. Side effects were of mild intensity (grade I or II) and included nausea (38% of patients), weakness (24%), diarrhea (24%), mucositis (10%), and hand and foot syndrome (7%). Conclusions/Significance External beam radiation with concurrent capecitabine is safe and tolerable for the treatment of pain from bone metastases of breast cancer origin. The overall and complete response rates in our study are unusually high compared to those reported for radiation alone. Further evaluation of this approach, in a randomized study, is warranted. Trial Registration ClinicalTrials.gov NCT01784393NCT01784393 PMID:23874586

  20. Interstitial chemotherapy for malignant glioma: Future prospects in the era of multimodal therapy

    PubMed Central

    Mangraviti, Antonella; Tyler, Betty; Brem, Henry

    2015-01-01

    The advent of interstitial chemotherapy has significantly increased therapeutic options for patients with malignant glioma. Interstitial chemotherapy can deliver high concentrations of chemotherapeutic agents, directly at the site of the brain tumor while bypassing systemic toxicities. Gliadel, a locally implanted polymer that releases the alkylating agent carmustine, given alone and in combination with various other antitumor and resistance modifying therapies, has significantly increased the median survival for patients with malignant glioma. Convection enhanced delivery, a technique used to directly infuse drugs into brain tissue, has shown promise for the delivery of immunotoxins, monoclonal antibodies, and chemotherapeutic agents. Preclinical studies include delivery of chemotherapeutic and immunomodulating agents by polymer and microchips. Interstitial chemotherapy was shown to maximize local efficacy and is an important strategy for the efficacy of any multimodal approach. PMID:25722936

  1. Hemorrhage associated with hepatic artery pseudoaneurysms after regional chemotherapy with floxuridine: case report

    PubMed Central

    Samaras, Panagiotis; Pfammatter, Thomas; Pestalozzi, Bernhard C

    2008-01-01

    Pseudoaneurysms of the hepatic artery are a rare complication in patients with primary or secondary liver tumors treated with intra-arterial chemotherapy. We present two patients who developed this complication after placement of a catheter system into the gastroduodenal artery and initiation of regional chemotherapy with floxuridine. Diagnosis was made after symptomatic bleeding occurred, necessitating emergency angiography with coil embolization. Pseudoaneurysms usually occur after mechanical damage of the vessel wall, but the chemical toxicity of floxuridine may add to the development of vascular impairment. PMID:18620556

  2. Hemorrhage associated with hepatic artery pseudoaneurysms after regional chemotherapy with floxuridine: case report.

    PubMed

    Samaras, Panagiotis; Pfammatter, Thomas; Pestalozzi, Bernhard C

    2008-01-01

    Pseudoaneurysms of the hepatic artery are a rare complication in patients with primary or secondary liver tumors treated with intra-arterial chemotherapy. We present two patients who developed this complication after placement of a catheter system into the gastroduodenal artery and initiation of regional chemotherapy with floxuridine. Diagnosis was made after symptomatic bleeding occurred, necessitating emergency angiography with coil embolization. Pseudoaneurysms usually occur after mechanical damage of the vessel wall, but the chemical toxicity of floxuridine may add to the development of vascular impairment. PMID:18620556

  3. Chemotherapy-Induced Amenorrhea – An Update

    PubMed Central

    Liedtke, C.; Kiesel, L.

    2012-01-01

    Because of the heterogeneity in the definition of chemotherapy-induced amenorrhea (CIA) there are distinct differences in the literature with regard to its incidence as well as its dependence on various influencing factors. The occurrence of CIA varies greatly depending on the applied chemotherapy. The pathogenesis of CIA is especially based on a reduction of ovarian reserves. Various sonographic and biochemical factors can be used to exclude or confirm CIA. This is particularly important when an endocrine therapy with tamoxifen is not possible and the use of aromatase inhibitors is under consideration. CIA and especially the frequently thereby resulting early menopause can lead to pronounced restrictions in the quality of life of the affected patients, not least due to the resulting infertility. On the other hand, various studies have shown that CIA may have a positive prognostic significance. Thus, the identification of measures to prevent CIA (for example, through the use of GnRH analogues) is of particular importance.

  4. Using Epigenetic Therapy to Overcome Chemotherapy Resistance.

    PubMed

    Strauss, Julius; Figg, William D

    2016-01-01

    It has been known for decades that as cancer progresses, tumors develop genetic alterations, making them highly prone to developing resistance to therapies. Classically, it has been thought that these acquired genetic changes are fixed. This has led to the paradigm of moving from one cancer therapy to the next while avoiding past therapies. However, emerging data on epigenetic changes during tumor progression and use of epigenetic therapies have shown that epigenetic modifications leading to chemotherapy resistance have the potential to be reversible with epigenetic therapy. In fact, promising clinical data exist that treatment with epigenetic agents can diminish chemotherapy resistance in a number of tumor types including chronic myelogenous leukemia, colorectal, ovarian, lung and breast cancer. The potential for epigenetic-modifying drugs to allow for treatment of resistant disease is exciting and clinical trials have just begun to evaluate this area. PMID:26722021

  5. Solving Finite-Element Problems on a Concurrent Processor

    NASA Technical Reports Server (NTRS)

    Lyzenga, G. A.; Raefsky, A.; Hager, B. H.

    1987-01-01

    By use of "conjugate gradients" technique, concurrent efficiency greater than 90 percent. Algorithm applies method of conjugate gradients to iterative solution of finite-element problems on concurrent processor. With algorithm, iteration rates nearly proportional to number of processors. For sufficiently large problems, fraction of proportional speedup achieved, called concurrent efficiency, exceeds 90 percent. Results indicate future application of this and related algorithms to large finite-element problems depend primarily upon applicability of iteratiave techniques, not upon issues of concurrency or efficiency.

  6. Phase I trial of tirapazamine, cisplatin, and concurrent accelerated boost reirradiation in patients with recurrent head and neck cancer

    SciTech Connect

    Cohen, Ezra E.W.; Haraf, Daniel J.; Loh, Elwyn; Shen, Liji; Lusinchi, Antoine; Vokes, Everett E.; Bourhis, Jean

    2007-03-01

    Purpose: Reirradiation (re-RT) with concurrent chemotherapy offers a therapeutic option in patients who have locoregional recurrence of head and neck cancer (HNC). The hypoxic cell sensitizer, tirapazamine (TPZ), has demonstrated promising results in first-line therapy for HNC. This phase I trial was designed to test the feasibility of giving TPZ in the re-RT setting. Methods and Materials: Patients with recurrent HNC who received prior radiotherapy (RT) were enrolled and received TPZ (260 mg/m{sup 2}) and cisplatin (50 mg/m{sup 2}) Weeks 1, 3, and 5 concurrently with RT (72 Gy, 42 fractions over 6 weeks). TPZ (160 mg/m{sup 2}) alone was added on Days 1, 3, and 5 of Week 2 (cohort 1) or Weeks 2 and 4 (cohort 2). Results: Twenty-five subjects were enrolled, 7 and 18 on cohorts 1 and 2, respectively. Significant toxicities included Grade 3 dermatitis (20%) and Grade 3 mucositis (40%). Dose-limiting toxicity was observed on cohort 2 (1 patient with aspiration pneumonia). Four deaths occurred during treatment. Two fatalities occurred after completing therapy as a result of carotid artery rupture. With a minimum and median follow-up of 14 and 24 months, respectively, median overall survival was 14 months with actuarial 1-year and 2-year survival of 56% and 27%, respectively. Conclusion: Reirradiation with concomitant chemotherapy including TPZ in patients with unresectable recurrent HNC is feasible and results in long-term survival in a significant proportion of patients.

  7. Success of Chemotherapy in Soft Matter

    E-print Network

    Trifonova, I; Stefanov, S Z

    2014-01-01

    The success of chemotharapy in soft matter as a survival is found in the paper. Therefore, it is found the analogous tumor stretching force in soft matter; ultrasonography is performed for this tumor; restoration in soft matter with such a tumor is found; Bayes estimate of the probability of chemotherapy success is derived from the transferred chemical energy and from soft matter entropy; survival probability is juxtaposed to this probability of success.

  8. A New mouthwash for Chemotherapy Induced Stomatitis

    PubMed Central

    Miranzadeh, Sedigheh; Adib-Hajbaghery, Mohsen; Soleymanpoor, Leyla; Ehsani, Majid

    2014-01-01

    Background: Stomatitis is a disturbing side-effect of chemotherapy that disturbs patients and causes difficulties in patient’s drinking, eating and talking, and may results in infection and bleeding. Objectives: This study aimed to investigate the effect of Yarrow distillate in the treatment of chemotherapy-induced stomatitis. Patients and Methods: This randomized controlled trial study was conducted during 2013. The study population consisted of all cancer patients with chemotherapy-induced oral stomatitis referred to Shahid Beheshti Medical Center, Kashan, Iran. The data collection instrument had two-part; a demographic part and another part recording the severity of the stomatitis at the first, seventh, and 14th days of the intervention based on a WHO criteria checklist in 2005. In this study, 56 patients diagnosed with cancer were randomly assigned into control and experimental groups in similar blocks according to their stomatitis severity. The experimental group gargled 15 mL of a routine solution mixed with Yarrow distillate 4 times a day for 14 days while the control group gargled 15 mL of routine solution. The severity of stomatitis was assessed at the beginning of the intervention, and then after 7 and 14 days of the study. Data were analyzed using chi-square and Fisher exact test, Mann-Whitney U, Kruskal-Wallis, and Friedman tests using SPSS 11.5 software. Results: At first, the median score of stomatitis in the experimental group was 2.50 that significantly reduced to 1 and 0 in days 7 and 14 of the intervention, respectively (P value < 0.001). However, in the control group, the median score of stomatitis was 2.50, which significantly increased to 3 in days 7 and 14 (P value < 0.001). Conclusions: Yarrow distillate-contained solution reduced stomatitis severity more than the routine solution. Therefore, we suggest using it in patients with chemotherapy-induced stomatitis. PMID:25699281

  9. Chemotherapy of breast cancer in the elderly.

    PubMed

    Rossi, A; Colantuoni, G; Maione, P; Ferrara, C; Airoma, G; Barzelloni, M L; Castaldo, V; Gridelli, C

    2005-01-01

    Breast cancer arises in about 48% of patients older than 65 years and more than 30% occurs in those over 70 years being the leading cause of cancer-related death in women older than 65. Elderly patients tolerate chemotherapy poorly compared to their younger counterpart because of progressive reduction of organ function and comorbidities related to age. For this reason, the elderly have been excluded from or underrepresented in most cancer studies and, in clinical practice, they often receive inadequate and untested treatments. For adjuvant chemotherapy, a low percentage of patients over 70 years of age were included in few trials and always in a proportion much lower than the prevalence of cancer in that age group. Adjuvant chemotherapy, preferably including an anthracycline especially in patients with HER-2/neu-positive tumours, seems to be beneficial in older women who have substantial risk of dying of breast cancer. To date even if there is no specifically randomised study, single-agent chemotherapy probably might be considered a reasonable treatment for advanced breast cancer in the elderly. One of the actual main field of clinical research in the treatment of breast cancer is the role of targeted therapies. Chronologic age is a risk factor for toxicities such as myelosuppression and mucositis, and older patients may require more supportive care. In order to plan medical treatment in breast cancer elderly patients is mandatory to practice a comprehensive geriatric assessment that includes evaluation of comorbidities, functional dependence, socio-economic, emotional and cognitive conditions, an estimate of life expectancy and recognition of frailty. The authors review the literature regarding age-specific chemotherapeutic issues in the management of breast cancer elderly patients. PMID:15723620

  10. [Diffuse superficial nephroblastomatosis. Chemotherapy. 1 case].

    PubMed

    Lutz, P; Kleinklaus, D; Matter, D; Touitou, D; Clavert, J M; Berland, H; Vetter, P; Levy, J M

    1983-10-01

    A case of superficial diffuse nephroblastomatosis involving both kidneys in a 14-months old child is reported. Urographic and arteriographic results as well as the still little-known ultrasonographic images made it possible to determine pre-operatively the nature of the tumour and to exclude the initial diagnosis of Wilm's tumour. A relatively non-aggressive chemotherapy resulted in complete involution of the subcapsular tumoral envelope. The close embryogenic and oncogenic relationship between nephroblastoma and nephroblastomatosis is recalled. PMID:6194525

  11. [Progress in chemotherapy for advanced gastric cancer].

    PubMed

    Xu, Rui-Hua; Teng, Kai-Yuan

    2009-10-01

    With the rapid development in cytotoxic agents and molecular targeting drugs, some progress in palliative chemotherapy for advanced gastric cancer has been achieved and the median survival of advanced gastric cancer patients is prolonged to about one year. In this review, we summarized the application of new agents, such as docetaxel, paclitaxel, oxaliplatin, irinotecan, capecitabine, S1 and targeting drugs in the treatment of patients with advanced gastric cancer. We focused on the results of phase III clinical trials and concluded that till now no standard regimens for the treatment of advanced gastric cancer are available. New combination regimens such as docetaxel-cisplatin-fluorouracil (DCF), epirubicin-oxaliplatin-capecitabine (EOX), fluorouracil-leucovorine-oxaliplatin (FLO), irinotecan, leucovorin and 5-FU (ILF), cispaltin plus xeloda, S1 plus cisplatin are considered as new options for the first-line chemotherapy of advanced gastric cancer. Due to uncertain efficacy and safety concerns, the role of molecular targeting agents in the treatment of advanced gastric cancer needs further investigation. It is suggested that neoadjuvant chemotherapy is a suitable choice for locally advanced gastric cancer. PMID:19799823

  12. 28 CFR 0.56 - Exclusive or concurrent jurisdiction.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... JUSTICE Criminal Division § 0.56 Exclusive or concurrent jurisdiction. The Assistant Attorney General in... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Exclusive or concurrent jurisdiction. 0... Government has exclusive or concurrent jurisdiction over offenses committed upon lands acquired by the...

  13. 28 CFR 0.56 - Exclusive or concurrent jurisdiction.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... JUSTICE Criminal Division § 0.56 Exclusive or concurrent jurisdiction. The Assistant Attorney General in... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Exclusive or concurrent jurisdiction. 0... Government has exclusive or concurrent jurisdiction over offenses committed upon lands acquired by the...

  14. 28 CFR 0.56 - Exclusive or concurrent jurisdiction.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... JUSTICE Criminal Division § 0.56 Exclusive or concurrent jurisdiction. The Assistant Attorney General in... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Exclusive or concurrent jurisdiction. 0... Government has exclusive or concurrent jurisdiction over offenses committed upon lands acquired by the...

  15. 28 CFR 0.56 - Exclusive or concurrent jurisdiction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... JUSTICE Criminal Division § 0.56 Exclusive or concurrent jurisdiction. The Assistant Attorney General in... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exclusive or concurrent jurisdiction. 0... Government has exclusive or concurrent jurisdiction over offenses committed upon lands acquired by the...

  16. 28 CFR 0.56 - Exclusive or concurrent jurisdiction.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... JUSTICE Criminal Division § 0.56 Exclusive or concurrent jurisdiction. The Assistant Attorney General in... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Exclusive or concurrent jurisdiction. 0... Government has exclusive or concurrent jurisdiction over offenses committed upon lands acquired by the...

  17. Metronomic Chemotherapy for Myxosarcoma Treatment in a Kori Bustard (Ardeotis kori).

    PubMed

    Sander, Samantha J; Hope, Katharine L; McNeill, Conor J; Roberts, John F; Boedeker, Nancy C; Murray, Suzan Z

    2015-09-01

    A 22-year-old, wild-caught male kori bustard (Ardeotis kori) developed a large, slow-growing subcutaneous mass over the keel. The mass was surgically debulked and histopathologically described as a myxosarcoma. Surgical dehiscence and concurrent local tumor regrowth, with no evidence of metastasis, occurred over the subsequent 3 months, necessitating 2 additional surgical procedures to close the wound. At 19 weeks after the initial procedure, a second debulking surgical procedure was performed, at which time carboplatin-impregnated matrix beads were placed in the lesion. Moderate local tumor regrowth was clinically appreciable 4 weeks after surgery, at which time an oral metronomic chemotherapeutic protocol consisting of daily cyclophosphamide (10 mg/m(2)) and meloxicam (0.1 mg/kg) was initiated. Four months later, the tumor was no longer palpable. While oral therapy was discontinued during the breeding season, mass regrowth was observed, and the mass was surgically debulked before reinitiating oral chemotherapy. Treatment was extended for over 1 year with no hematologic evaluation or serum biochemical abnormalities, and the bird otherwise remained clinically healthy. To our knowledge, this is the first report of a myxosarcoma in a bustard species and the first report of successful clinical application of metronomic chemotherapy in an avian species. PMID:26378667

  18. Concurrent and predictive validation of robotic simulator Tube 3 module

    PubMed Central

    Kim, Jae Yoon; Kim, Seung Bin; Pyun, Jong Hyun; Kim, Hyung Keun; Cho, Seok; Lee, Jeong Gu; Kim, Je Jong; Cheon, Jun; Kang, Seok Ho

    2015-01-01

    Purpose We previously described a new procedure specific module (Tube 3) to allow the practice of vesicourethral anastomosis after robot-assisted radical prostatectomy. Herein, we report a predetermined proficiency level of Tube 3 and preliminary validation to explore whether this new module can lead to performance improvement in the da Vinci system. Materials and Methods Eight urology residents and three urology fellows performed the Tube 3 module 1 hour daily for 7 days. The learning curve was depicted through a scatterplot and the stable point was identified through the cumulative sum chart. Concurrent and predictive validations were performed with the da Vinci system. The mean time to complete the task and end product rating score between Tube 3 training group and no Tube 3 training group were compared. Results Concerning the learning curve, about 41 repetitions comprising about 5 hours were needed to achieve this stable point when the mean time to complete Tube of 384 seconds was set as a target. With regarding to the concurrent and predictive validation, there significant differences were evident in the mean time to complete 16 needle passages and the vesicourethral anastomosis and the end product rating score. Conclusions The virtual reality (VR) simulator can yield sufficient improvement in technical performance in Tube 3 within 5 hours. The acquired proficiency can be transferable to the vesicourethral anastomosis using the da Vinci system. PMID:26568793

  19. Resource Management and Contingencies in Aerospace Concurrent Engineering

    NASA Technical Reports Server (NTRS)

    Karpati, Gabe; Hyde, Tupper; Peabody, Hume; Garrison, Matthew

    2012-01-01

    significant concern in designing complex systems implementing new technologies is that while knowledge about the system is acquired incrementally, substantial financial commitments, even make-or-break decisions, must be made upfront, essentially in the unknown. One practice that helps in dealing with this dichotomy is the smart embedding of contingencies and margins in the design to serve as buffers against surprises. This issue presents itself in full force in the aerospace industry, where unprecedented systems are formulated and committed to as a matter of routine. As more and more aerospace mission concepts are generated by concurrent design laboratories, it is imperative that such laboratories apply well thought-out contingency and margin structures to their designs. The first part of this publication provides an overview of resource management techniques and standards used in the aerospace industry. That is followed by a thought provoking treatise on margin policies. The expose presents the actual flight telemetry data recorded by the thermal discipline during several recent NASA Goddard Space Flight Center missions. The margins actually achieved in flight are compared against pre-flight predictions, and the appropriateness and the ramifications of having designed with rigid margins to bounding stacked worst case conditions are assessed. The second half of the paper examines the particular issues associated with the application of contingencies and margins in the concurrent engineering environment. In closure, a discipline-by-discipline disclosure of the contingency and margin policies in use at the Integrated Design Center at NASA s Goddard Space Flight Center is made.

  20. Conventional Cisplatin-Based Combination Chemotherapy Is Effective in the Treatment of Metastatic Spermatocytic Seminoma with Extensive Rhabdomyosarcomatous Transformation.

    PubMed

    Jeong, Yumun; Cheon, Jaekyung; Kim, Tae-Oh; Lim, Doo-Ho; Lee, Sunpyo; Cho, Young-Mi; Hong, Jun Hyuk; Lee, Jae Lyun

    2015-10-01

    A 52-year-old man was presented with a huge left testicular mass and palpable cervical lymphadenopathy with retroperitoneal lymph node enlargement on an abdominal computed tomography. A left radical orchiectomy and an ultrasound-guided neck node biopsy were performed. A pathological examination revealed spermatocytic seminoma with extensive rhabdomyosarcomatous transformation, a condition known to be highly resistant to platinum-based chemotherapy. The patient received four cycles of etoposide, ifosfamide and cisplatin (VIP) chemotherapy. A repeat computed tomography revealed a substantial regression consistent with a partial response. Retroperitoneal lymph node dissection was attempted, which revealed rhabdomyosarcoma; however, complete microscopic resection was not achieved. After surgery, the residual abdominal lymph node progressed and salvage paclitaxel, ifosfamide and cisplatin (TIP) chemotherapy was employed, which again achieved a partial response. Here, we present a first case report of a spermatocytic seminoma with extensive rhabdomyosarcomatous transformation and multiple metastatic lymphadenopathies that showed a favorable response to platinum-based systemic chemotherapy. PMID:25381827

  1. Simulation-assisted materials design for the concurrent design of materials and products

    NASA Astrophysics Data System (ADS)

    McDowell, David L.

    2007-09-01

    Engineering design has historically been taught using the paradigm of selecting materials on the basis of tabulated databases of properties (mechanical, physical, chemical, etc.). Recent trends have moved toward concurrent design of material composition and microstructure together with the component/system level. The goal is to tailor materials to meet specifi ed ranges of performance requirements of the overall system. Often these multiple performance requirements are in confl ict in terms of their demands on composition and microstructure. This paper explores the elements of a decision-based robust design framework for concurrent design of materials and products, focusing on enhancing the fraction of decisions supported by modeling and simulation.

  2. Concurrent array-based queue

    DOEpatents

    Heidelberger, Philip; Steinmacher-Burow, Burkhard

    2015-01-06

    According to one embodiment, a method for implementing an array-based queue in memory of a memory system that includes a controller includes configuring, in the memory, metadata of the array-based queue. The configuring comprises defining, in metadata, an array start location in the memory for the array-based queue, defining, in the metadata, an array size for the array-based queue, defining, in the metadata, a queue top for the array-based queue and defining, in the metadata, a queue bottom for the array-based queue. The method also includes the controller serving a request for an operation on the queue, the request providing the location in the memory of the metadata of the queue.

  3. Intensified High-Dose Chemoradiotherapy With Induction Chemotherapy in Patients With Locally Advanced Non-Small-Cell Lung Cancer-Safety and Toxicity Results Within a Prospective Trial

    SciTech Connect

    Poettgen, Christoph; Eberhardt, Wilfried E.; Gauler, Thomas; Krbek, Thomas; Berkovic, Katharina; Abu Jawad, Jehad; Korfee, Soenke; Teschler, Helmut; Stamatis, Georgios; Stuschke, Martin

    2010-03-01

    Purpose: To analyze the toxicity profile of an intensified definitive chemoradiotherapy (CRT) schedule in patients with locally advanced non-small-cell lung cancer (Stage IIIA N2/selected IIIB) treated within a prospective multicenter trial. Patients and Methods: After mediastinoscopy and routine staging procedures, three cycles of induction chemotherapy (cisplatin 50 mg/m{sup 2}, Days 1 and 8; paclitaxel 175 mg/m{sup 2} Day 1, every 21 days) were planned, followed by concurrent CRT (accelerated-hyperfractionated regimen, 45 Gy, 2 x 1.5 Gy/d, cisplatin 50 mg/m{sup 2}, Days 64 and 71, vinorelbine 20 mg/m{sup 2}, Days 64 and 71). At 45 Gy, a multidisciplinary panel decision was made regarding operability. Inoperable patients received definitive radiotherapy (total dose 65 or 71 Gy, depending on the mean lung dose) with additional concurrent chemotherapy (cisplatin 40 mg/m{sup 2}, Day 85; vinorelbine 15 mg/m{sup 2}, Days 85 and 92). Results: A total of 28 patients (23 men and 5 women; median age, 58 years; range 41-73; Stage IIIA in 3 and Stage IIIB in 25) were judged ineligible for surgery by the multidisciplinary panel and underwent definitive CRT (75% of the patients received 71 Gy). The maximum toxicity (Grade 3 or greater) during induction chemotherapy included leukopenia (11%) and anemia (4%). During concurrent CRT, leukopenia (Grade 3 or greater) was observed in 39% of the patients. The maximal nonhematologic toxicity during concurrent CRT included esophagitis (Grade 3 or greater) in 18% and pneumonitis (Grade 3 or greater) in 4% of the patients. At 3 years, the locoregional control rate was 52% (95% confidence interval, 29-75%) and the overall survival rate was 31% (95% confidence interval, 12-50%). Conclusion: This intensified treatment protocol with induction chemotherapy and concurrent CRT, including hyperfractionated-accelerated RT, showed only moderate toxicity and proved feasible. This treatment represents the definitive CRT arm of our ongoing multicenter randomized trial comparing definitive CRT and trimodality treatment.

  4. 6.9 Concurrent and Dual Credit Enrollment Programs Page 1 of 1 Concurrent and Dual Credit Enrollment Programs

    E-print Network

    Hung, I-Kuai

    6.9 Concurrent and Dual Credit Enrollment Programs Page 1 of 1 Concurrent and Dual Credit Enrollment Programs Original Implementation: July 27, 1999 Last Revision: April 15, 2014 High school students) and enroll in college courses while completing their high school studies under the concurrent and dual credit

  5. Phase II study of nedaplatin and irinotecan with concurrent thoracic radiotherapy in patients with locally advanced non-small-cell lung cancer

    PubMed Central

    Oshita, F; Ohe, M; Honda, T; Murakami, S; Kondo, T; Saito, H; Noda, K; Yamashita, K; Nakayama, Y; Yamada, K

    2010-01-01

    Background: Current international guidelines recommend the use of platinum-based chemotherapy with thoracic radiotherapy (TRT) for patients with locally advanced non-small-cell lung cancer (NSCLC). Methods: Patients with unresectable stage IIIA or IIIB NSCLC were treated with nedaplatin (NP) at 50?mg?m?2 and irinotecan (CPT) at 60?mg?m?2 on days 1 and 8 every 4 weeks for two to four cycles with concurrent TRT (2?Gy per day, total 60?Gy). Results: All 35 patients were able to receive a total of 60?Gy. Adverse effects and events in chemotherapy with TRT were grade 3 or 4 anaemia, neutropenia and thrombocytopenia, which occurred in 3.0%, 32.8% and 6.0% of patients, respectively. There was no grade 3 pneumonitis or oesophagitis. Adverse effects and events in chemotherapy alone were mild. There was no treatment-related death. An overall response rate was 94.3%. The median progression-free and overall survivals were 13.0 and 36.0 months, respectively. The 5-year disease-free and overall survival rates were 25.7% and 40.0%, respectively. Conclusion: NP and CPT treatment with concurrent TRT is effective and safe for patients with unresectable, locally advanced NSCLC. PMID:20940720

  6. Knowledge Management tools integration within DLR's concurrent engineering facility

    NASA Astrophysics Data System (ADS)

    Lopez, R. P.; Soragavi, G.; Deshmukh, M.; Ludtke, D.

    The complexity of space endeavors has increased the need for Knowledge Management (KM) tools. The concept of KM involves not only the electronic storage of knowledge, but also the process of making this knowledge available, reusable and traceable. Establishing a KM concept within the Concurrent Engineering Facility (CEF) has been a research topic of the German Aerospace Centre (DLR). This paper presents the current KM tools of the CEF: the Software Platform for Organizing and Capturing Knowledge (S.P.O.C.K.), the data model Virtual Satellite (VirSat), and the Simulation Model Library (SimMoLib), and how their usage improved the Concurrent Engineering (CE) process. This paper also exposes the lessons learned from the introduction of KM practices into the CEF and elaborates a roadmap for the further development of KM in CE activities at DLR. The results of the application of the Knowledge Management tools have shown the potential of merging the three software platforms with their functionalities, as the next step towards the fully integration of KM practices into the CE process. VirSat will stay as the main software platform used within a CE study, and S.P.O.C.K. and SimMoLib will be integrated into VirSat. These tools will support the data model as a reference and documentation source, and as an access to simulation and calculation models. The use of KM tools in the CEF aims to become a basic practice during the CE process. The settlement of this practice will result in a much more extended knowledge and experience exchange within the Concurrent Engineering environment and, consequently, the outcome of the studies will comprise higher quality in the design of space systems.

  7. A Biomathematical Model of Human Erythropoiesis under Erythropoietin and Chemotherapy Administration

    PubMed Central

    Schirm, Sibylle; Engel, Christoph; Loeffler, Markus; Scholz, Markus

    2013-01-01

    Anaemia is a common haematologic side effect of dose-dense multi-cycle cytotoxic polychemotherapy requiring erythrocyte transfusions or erythropoietin (EPO) administration. To simulate the effectiveness of different EPO application schedules, we performed both modelling of erythropoiesis under chemotherapy and pharmacokinetic and dynamic modelling of EPO applications in the framework of a single comprehensive biomathematical model. For this purpose, a cell kinetic model of bone marrow erythropoiesis was developed that is based on a set of differential compartment equations describing proliferation and maturation of erythropoietic cell stages. The system is regulated by several feedback loops comprising those mediated by EPO. We added a model of EPO absorption after injection at different sites and a pharmacokinetic model of EPO derivatives to account for the effects of external EPO applications. Chemotherapy is modelled by a transient depletion of bone marrow cell stages. Unknown model parameters were determined by fitting the predictions of the model to data sets of circulating erythrocytes, haemoglobin, haematocrit, percentage of reticulocytes or EPO serum concentrations derived from the literature or cooperating clinical study groups. Parameter fittings resulted in a good agreement of model and data. Depending on site of injection and derivative (Alfa, Beta, Delta, Darbepoetin), nine groups of EPO applications were distinguished differing in either absorption kinetics or pharmacokinetics. Finally, eight different chemotherapy protocols were modelled. The model was validated on the basis of scenarios not used for parameter fitting. Simulations were performed to analyze the impact of EPO applications on the risk of anaemia during chemotherapy. We conclude that we established a model of erythropoiesis under chemotherapy that explains a large set of time series data under EPO and chemotherapy applications. It allows predictions regarding yet untested EPO schedules. Prospective clinical studies are needed to validate model predictions and to explore the feasibility and effectiveness of the proposed schedules. PMID:23755260

  8. A declarative approach to visualizing concurrent computations

    SciTech Connect

    Roman, G.C.; Cox, K.C. )

    1989-10-01

    That visualization can play a key role in the exploration of concurrent computations is central to the ideas presented. Equally important, although given less emphasis, is concern that the full potential of visualization may not be reached unless the art of generating beautiful pictures is rooted in a solid, formally technical foundation. The authors show that program verification provides a formal framework around which such a foundation can be built. Making these ideas a practical reality will require both research and experimentation.

  9. Postoperative Capecitabine with Concurrent Intensity-Modulated Radiotherapy or Three-Dimensional Conformal Radiotherapy for Patients with Stage II and III Rectal Cancer

    PubMed Central

    Lu, Ning-Ning; Jin, Jing; Wang, Shu-Lian; Wang, Wei-Hu; Song, Yong-Wen; Liu, Yue-Ping; Ren, Hua; Fang, Hui; Liu, Xin-Fan; Yu, Zi-Hao; Li, Ye-Xiong

    2015-01-01

    Background The aim of this study was to evaluate the survival outcomes and toxicity of postoperative chemoradiotherapy with capecitabine and concurrent intensity-modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3D-CRT) in patients with stage II and III rectal cancer. Patients We recruited 184 patients with pathologically proven, stage II or III rectal cancer. Following total mesorectal excision (TME), the patients were treated with capecitabine and concurrent IMRT/3D-CRT. The treatment regimen consisted of two cycles of oral capecitabine (1600 mg/m2/day), administered twice daily from day 1–14 of radiotherapy, followed by a 7-day rest. The median pelvic dose was 50 Gy in 25 fractions. Oxaliplatin-based adjuvant chemotherapy was administered after the chemoradiotherapy. Results The 5-year overall survival, disease-free survival and locoregional control (LRC) rates were 85.1%, 80% and 95.4%, respectively. Grade 3 and 4 toxicities were observed in 28.3% of patients during treatment. Grade 3 or 4 late toxicity, including neurotoxicity or gastrointestinal toxicity, was only observed in nine patients (4.9%). Conclusions This study demonstrated that capecitabine chemotherapy with concurrent IMRT/3D-CRT following TME is safe, is well tolerated and achieves superior LRC and favorable survival rates, with acceptable toxicity. PMID:25915948

  10. Quality-of-Life-Adjusted Survival Analysis of Concurrent Chemo Radiotherapy for Locally Advanced (Nonmetastatic) Nasopharyngeal Cancer

    SciTech Connect

    Gao Fei; Wee, Joseph; Wong, Hwee Bee; Machin, David

    2010-10-01

    Purpose: To assess whether the benefits of adding cisplatin (CDDP) concurrent with radiotherapy, followed by adjuvant CDDP and fluorouracil, justifies the toxicity cost for nasopharyngeal cancer (NPC) using the quality-adjusted time without symptoms or toxicity (Q-TWiST) approach. Methods and Materials: One hundred seven patients treated with radiotherapy (RT) and 111 with concurrent chemotherapy and radiotherapy (CRT) were analyzed. The overall survival was divided into three health states: time on active treatment only, during which any subjective nonhematologic toxic event of grade > = 3 was reported; time without symptoms of disease relapse; or treatment and time following first disease RELapse. The relative advantage of CRT and RT was examined by conducting the analysis cumulatively at restriction times 3, 6, 24, 36, 48 months. Results: At 48 months, the improvement in disease-free survival was 14.4% for CRT, whereas that for overall survival was 18.9%. The differences in Q-TWiST were -0.4, -0.7, 0.1, 1.6, and 3.6 months at 3, 6, 24, 36, and 48 months, respectively, with positive differences favoring CRT. At 24 months, the difference in Q-TWiST began to favor CRT. At 36 months, CRT may be the preferred option from the patient's viewpoint if the time spent in the REL state is valued to be <0.83, with the value of perfect health being 1. Finally, Q-TWiST accumulated within 48 months indicated a significant advantage in quality-adjusted survival time for CRT (p = 0.020). Conclusion: Irrespective of how patients valued periods of toxicity and delayed disease progression, concurrent chemotherapy and radiotherapy offered NPC patients significantly more quality-adjusted survival than radiotherapy alone in the long term.

  11. Adjuvant chemotherapy for rectal cancer: Is it needed?

    PubMed Central

    Milinis, Kristijonas; Thornton, Michael; Montazeri, Amir; Rooney, Paul S

    2015-01-01

    Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However, controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy, despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However, concerns exist regarding the quality of the studies including inadequate staging modalities, out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies. PMID:26677436

  12. Chemotherapy beyond second-line in advanced gastric cancer

    PubMed Central

    Kim, Sung Min; Park, Se Hoon

    2015-01-01

    Patients with advanced gastric cancer (AGC) can be treated with multiple lines of chemotherapy. Although several randomized trials have demonstrated the benefit of second-line chemotherapy compared with best supportive care, there is no evidence that further lines of chemotherapy will result in substantial prolongation of survival. Despite this, the practice of offering chemotherapy beyond second-line agents to AGC patients is not uncommon if their performance status is well-preserved and they are willing to receive subsequent active treatments. The choice of chemotherapeutic agents depends on the patient’s prior regimens. However, there are important controversial issues in the salvage setting of AGC, including a subset of patients who may benefit from chemotherapy, that still remain unanswered. This report reviews the available evidence regarding the impact of third- and subsequent lines of chemotherapy on survival and quality of life in patients with AGC. PMID:26269670

  13. Chemotherapy beyond second-line in advanced gastric cancer.

    PubMed

    Kim, Sung Min; Park, Se Hoon

    2015-08-01

    Patients with advanced gastric cancer (AGC) can be treated with multiple lines of chemotherapy. Although several randomized trials have demonstrated the benefit of second-line chemotherapy compared with best supportive care, there is no evidence that further lines of chemotherapy will result in substantial prolongation of survival. Despite this, the practice of offering chemotherapy beyond second-line agents to AGC patients is not uncommon if their performance status is well-preserved and they are willing to receive subsequent active treatments. The choice of chemotherapeutic agents depends on the patient's prior regimens. However, there are important controversial issues in the salvage setting of AGC, including a subset of patients who may benefit from chemotherapy, that still remain unanswered. This report reviews the available evidence regarding the impact of third- and subsequent lines of chemotherapy on survival and quality of life in patients with AGC. PMID:26269670

  14. Adjuvant chemotherapy for rectal cancer: Is it needed?

    PubMed

    Milinis, Kristijonas; Thornton, Michael; Montazeri, Amir; Rooney, Paul S

    2015-12-10

    Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However, controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy, despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However, concerns exist regarding the quality of the studies including inadequate staging modalities, out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies. PMID:26677436

  15. Concurrent enhancement of percolation and synchronization in adaptive networks

    E-print Network

    Eom, Young-Ho; Caldarelli, Guido

    2015-01-01

    Co-evolutionary adaptive mechanisms are not only ubiquitous in nature, but also beneficial for the functioning of a variety of systems. We here consider an adaptive network of oscillators with a stochastic, fitness-based, rule of connectivity, and show that it self-organizes from fragmented and incoherent states to connected and synchronized ones. The synchronization and percolation are associated to abrupt transitions, and they are concurrently (and significantly) enhanced as compared to the non-adaptive case. Finally we provide evidence that only partial adaptation is sufficient to determine these enhancements. Our study, therefore, indicates that inclusion of simple adaptive mechanisms can efficiently describe some emergent features of networked systems' collective behaviors, and suggests also self-organized ways to control synchronization and percolation in natural and social systems.

  16. Worksheets with embedded checklists support IV chemotherapy safer practice.

    PubMed

    Dobish, Roxanne; Shultz, Jonas; Neilson, Sheena; Raven, Amanda; Chambers, Carole R

    2016-02-01

    Following a review of a chemotherapy medication adverse event where the incorrect medication was prepared by a pharmacy, a number of steps were taken to review the literature and best practice information related to checking processes for the preparation of parenteral chemotherapy. Concepts such as identification of critical stop check points, independent double checks, and human factors principles were reviewed and incorporated into newly designed chemotherapy preparation worksheets with embedded checklists. Usability testing and staff feedback during implementation revealed a number of key learning points that resulted in additional work to further improve the chemotherapy worksheets with embedded checklists and highlighted the need for a culture of continuous quality improvement. PMID:25316612

  17. Mastering chemotherapy dose reduction in elderly cancer patients.

    PubMed

    Wildiers, Hans

    2007-10-01

    Cancer is mainly a disease of the elderly but clinical studies have generally excluded the elderly population for various reasons. Chemotherapy is one of the strongest weapons against (metastatic) cancer, but its use in the elderly has been limited due to fear of inducing toxicity. This review points out 10 recommendations that need to be taken into account when prescribing chemotherapy to elderly patients: aim of chemotherapy, specific pharmacological data for specific chemotherapeutics, treatment individualisation, alternatives to cytotoxic chemotherapy, comprehensive geriatric assessment, supportive therapy, hydration status, drug interactions, and compliance. Each of these topics will be reviewed here trying to give concrete recommendations for clinical practice. PMID:17686626

  18. Expression of Excision Repair Cross-Complementation Group 1 as Predictive Marker for Nasopharyngeal Cancer Treated With Concurrent Chemoradiotherapy

    SciTech Connect

    Sun, Jong-Mu; Ahn, Myung-Ju; Park, Min Jae; Lee, Hui-Young; Ahn, Jin Seok; Lee, Seungkoo; Kang, Gu; Han, Joungho; Son, Young-Ik; Baek, Chung-Hwan; Ahn, Yong Chan; Park, Keunchil

    2011-07-01

    Purpose: Cisplatin-based concurrent chemoradiotherapy is the standard treatment of nasopharyngeal cancer. The expression of excision repair cross-complementation group 1 (ERCC1) has been reported to be associated with resistance to platinum-based chemotherapy. We evaluated whether ERCC1 expression could predict the treatment response and survival outcome of patients with locally advanced nasopharyngeal cancer who were treated with cisplatin-based concurrent chemoradiotherapy. Methods and Materials: Immunohistochemistry was used to examine the expression of ERCC1 in nasopharyngeal tumor tissue. Patients were categorized into either a resistant or sensitive group depending on their treatment response outcome. A total of 77 patients were assessed in the present study. Results: The resistant and sensitive groups included 25 and 52 patients, respectively. ERCC1 expression was positive in the tumor tissue for 39 of the 77 patients (51%). Significantly more ERCC1-negative tumors were in the sensitive group than in the resistant group (p = .035). In terms of survival outcome, univariate analysis determined that patients with ERCC1-negative tumors had longer disease-free survival (p = .076) and overall survival (p = .013) than patients with ERCC1-positive tumors. Multivariate analysis determined that negative ERCC expression in tumors was an independent predictor for prolonged overall survival (hazard ratio, 0.14; 95% confidence interval, 0.03-0.71). Conclusion: These results suggest that ERCC1 expression might be a useful predictive marker in patients with locally advanced nasopharyngeal cancer who are under consideration for cisplatin-based concurrent chemoradiotherapy.

  19. Magnetic nanoparticle hyperthermia as an adjuvant cancer therapy with chemotherapy

    NASA Astrophysics Data System (ADS)

    Petryk, Alicia Ailie

    Magnetic nanoparticle hyperthermia (mNPH) is an emerging cancer therapy which has shown to be most effective when applied in the adjuvant setting with chemotherapy, radiation or surgery. Although mNPH employs heat as a primary therapeutic modality, conventional heat may not be the only cytotoxic effect. As such, my studies have focused on the mechanism and use of mNPH alone and in conjunction with cisplatinum chemotherapy in murine breast cancer cells and a related in vivo model. MNPH was compared to conventional microwave tumor heating, with results suggesting that mNPH (mNP directly injected into the tumor and immediately activated) and 915 MHz microwave hyperthermia, at the same thermal dose, result in similar tumor regrowth delay kinetics. However, mNPH shows significantly less peri-tumor normal tissue damage. MNPH combined with cisplatinum also demonstrated significant improvements in regrowth delay over either modality applied as a monotherapy. Additional studies demonstrated that a relatively short tumor incubation time prior to AMF exposure (less than 10 minutes) as compared to a 4-hour incubation time, resulted in faster heating rates, but similar regrowth delays when treated to the same thermal dose. The reduction of heating rate correlated well with the observed reduction in mNP concentration in the tumor observed with 4 hour incubation. The ability to effectively deliver cytotoxic mNPs to metastatic tumors is the hope and goal of systemic mNP therapy. However, delivering relevant levels of mNP is proving to be a formidable challenge. To address this issue, I assessed the ability of cisplatinum to simultaneously treat a tumor and improve the uptake of systemically delivered mNPs. Following a cisplatinum pretreatment, systemic mNPs uptake was increased by 3.1 X, in implanted murine breast tumors. Additional in vitro studies showed the necessity of a specific mNP/ Fe architecture and spatial relation for heat-based cytotoxicity in cultured cells.

  20. Chemotherapy Induced Acute Pericarditis in a Child.

    PubMed

    Khan, Muhammad Arif; Rahman, Abdul; Almoukirish, S; Jadoon, Shehla; Momenah, Tarek S

    2015-10-01

    A9 years boy diagnosed with nasopharyngeal carcinoma was started on chemotherapy protocol including 5-fluorouracil. After 90 hours of 5-fluorouracil infusion, he developed severe retrosternal chest pain. Electrocardiography showed signs of acute pericarditis and was managed with ibuprofen and 5-fluorouracil was discontinued. The 5-fluorouracil rarely causes cardiac complications such as angina pectoris and pericarditis in adult patients. We report acute myopericarditis in a child caused by 5-fluorouracil, which is a very rare complication of 5-fluorouracil in pediatric age group. PMID:26522211