Sample records for concurrent systemic chemotherapy

  1. [Hyperfractionated radiotherapy with concurrent chemotherapy for advanced esophageal cancer].

    PubMed

    Asakura, Hirofumi; Takashima, Hitoshi; Yokoe, Koiku; Togami, Taro; Mitani, Masahiro; Kiuchi, Takaaki; Hosokawa, Nobuyuki; Seo, Hiroyuki; Ohkawa, Motoomi

    2005-09-01

    The clinical efficacy and safety of hyperfractionated radiotherapy with concurrent chemotherapy were studied retrospectively in patients with primary advanced esophageal cancer. The subjects were 31 patients who were treated with hyperfractionated radiotherapy and concurrent chemotherapy in our institution between 1990 and 2001. The chemoradiotherapy consisted of cisplatin 70-80 mg/m2 on day one, and continuous infusion of 5-fluorouracil 700-800 mg/m2/24 hours on days 1 to 3, with concurrent hyperfractionated radiotherapy (57.6-72 Gy). Complete remission (CR) was observed in 17 cases, and partial response in 13 cases (response rate: 96. 7%). Three-year survival rate and 5-year survival rate were 35.5% and 26.3%, respectively. Grade 3/4 hematological toxicities included leukocytes in 7 patients (22.6%), hemoglobin in 6 patients (19.4%), and platelets in 4 patients (12.9%). Grade 3 dysphagia-esophageal related to radiation was observed in 3 patients (9.7%). Late toxicities occurred with the following incidences: hypothyroidism in 2 patients, benign esophageal strictures in 2 patients, pericardial effusion in 8 patients, and pleural effusion in 8 patients. The results suggest that combined chemotherapy and hyperfractionated radiotherapy is an effective and well-tolerated regimen. PMID:16184924

  2. [Concurrent proton therapy and chemotherapy for locally advanced cancers].

    PubMed

    Ishikawa, Hitoshi; Fukumitsu, Nobuyoshi; Ohnishi, Kayoko; Mizumoto, Masashi; Murofushi, Keiko; Numajiri, Haruko; Aihara, Teruhito; Okumura, Toshiyuki; Sakurai, Hideyuki

    2015-02-01

    Charged particles such as protons and carbon-ions offer advantageous physical properties to radiation therapy (RT) for the treatment of various cancers when compared with photons, because they exhibit a spread-out Bragg peak, and may be utilized to achieve a desirable dose distribution to the target volume by using specified beam modulation. Interestingly, the cytocidal effect of protons is almost equal to that of photons, because both protons and photons are considered low-linear energy transfer radiations. Hence, proton beam therapy (PBT) is an attractive RT option, especially in the treatment of locally advanced cancers, as irradiation doses can be safely escalated while sparing the surrounding normal tissues, and because PBT may be concurrently combined with chemotherapy for treating such cancers. Recent advances in PBT techniques including a spot scanning method, as well as an increase in the number of particle therapy institutes are anticipated to yield favorable results through future multi-institutional prospective studies. The University of Tsukuba has carried out several studies to validate the effectiveness of PBT for many types of cancers since 1983. Here, we present our findings on the clinical outcomes of PBT for esophageal cancer, non-small cell lung cancer, intrahepatic biliary tract cancer, pancreas cancer, and bladder cancer; future aspects of PBT concurrently combined with chemotherapy for treating locally advanced cancers are also discussed. PMID:25743133

  3. 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.

  4. 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.

  5. 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.

  6. Concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expanders after mastectomy for breast cancer

    Microsoft Academic Search

    Orazio Caffo; Daniela Cazzolli; Alberto Scalet; Bruno Zani; Gianni Ambrosini; Maurizio Amichetti; Daniele Bernardi; Sonia Brugnara; Gianni Ciaghi; Antonio Lucenti; Ninoo Natale; Silvio Agugiaro; Claudio Eccher; Enzo Galligioni

    2000-01-01

    Background. Immediate breast reconstruction (IBR) by means of skin expander is currently one of the most widely used methods of breast reconstruction in mastectomized patients. However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concerning possible cumulative toxicity. The present study reports our experience in the use of concurrent adjuvant chemotherapy

  7. Breast cancer local recurrence under the form of inflammatory carcinoma, treated with concurrent radiation and chemotherapy, a case report

    PubMed Central

    Reis, Isabel; Pereira, Helena; Azevedo, Isabel; Conde, Joăo; Bravo, Isabel; Craveiro, Rogéria; Pereira, Deolinda

    2013-01-01

    The authors present a case report of a patient with breast cancer diagnosed in 2005, treated with conservative surgery, adjuvant chemotherapy and radiotherapy, followed by hormonal therapy until 2010, who relapsed under the form of inflammatory breast cancer in 2011. After tumor progression detected during primary systemic therapy, a concurrent radiation and radiosensitizing chemotherapy were proposed. There was a significant clinical response to this treatment, enabling curative chance with total mastectomy. The histological examination of the breast and regional lymph nodes revealed a complete response, since there was no evidence of residual tumor. There are few reports concerning concurrent radiotherapy and chemotherapy in locally advanced breast cancer, but it could be a suitable “loco regional rescue therapy” to further reduce tumor progression and allow curative surgery. Study of this treatment strategy in randomized clinical trials is warranted. PMID:24936322

  8. Proton Beam Therapy and concurrent chemotherapy for esophageal cancer

    PubMed Central

    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.

    2014-01-01

    Purpose/Objective 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 at MD Anderson Cancer Center. Materials/Methods 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 2 or 3 field beam arrangement using 180–250 MV protons. We used the method of Kaplan and Meier 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 were males (82%), had adenocarcinomas (76%) and had stage II-III disease (84%). The median radiation dose was 50.4 Gray-Equivalence (Gy(RBE)) (range 36–57.6). The most common grade 2–3 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 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 rate (0–1% residual cells) was 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) as compared to the definitive CChT/PBT group (16/33) (log-rank test p=0.005), there were no differences in DM free interval or 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. PMID:22417808

  9. Nelarabine neurotoxicity with concurrent intrathecal chemotherapy: Case report and review of literature.

    PubMed

    Ngo, Dat; Patel, Samit; Kim, Eun Jeong; Brar, Rondeep; Koontz, Michael Z

    2015-08-01

    Severe nelarabine neurotoxicity in a patient who received concurrent intrathecal (IT) chemotherapy is reported. A 37-year-old Caucasian woman with a history of T-cell lymphoblastic lymphoma was admitted for relapsed disease. She was originally treated with induction chemotherapy followed by an autologous transplant. She developed relapsed disease 10 months later with leukemic involvement. She was re-induced with nelarabine 1500?mg/m(2) on days 1, 3, and 5 with 1 dose of IT cytarabine 100?mg on day 2 as central nervous system (CNS) prophylaxis. At the time of treatment, she was on continuous renal replacement therapy due to sequelae of tumor lysis syndrome (TLS). She tolerated therapy well, entered a complete remission, and recovered her renal function. She received a second cycle of nelarabine without additional IT prophylaxis one month later. A week after this second cycle, she noted numbness in her lower extremities. Predominantly sensory, though also motor and autonomic, peripheral neuropathy started in her feet, ascended proximally to the mid-thoracic region, and eventually included her distal upper extremities. A magnetic resonance imaging (MRI) of her spine demonstrated changes from C2 to C6 consistent with subacute combined degeneration. Nelarabine was felt to be the cause of her symptoms. Her neuropathy stabilized and showed slight improvement and ultimately received an unrelated, reduced-intensity allogeneic transplant while in complete remission, but relapsed disease 10 weeks later. She is currently being treated with best supportive care. To our knowledge, this is the first published case report of severe neurotoxicity caused by nelarabine in a patient who received concurrent IT chemotherapy. PMID:24664478

  10. Concurrency control in groupware systems

    Microsoft Academic Search

    C. A. Ellis; S. J. Gibbs

    1989-01-01

    Groupware systems are computer-based systems that support two or more users engaged in a common task, and that provide an interface to a shared environment. These systems frequently require fine-granularity sharing of data and fast response times. This paper distinguishes real-time groupware systems from other multi-user systems and discusses their concurrency control requirements. An algorithm for concurrency control in real-time

  11. Prognostic features and treatment outcome in locoregionally advanced nasopharyngeal carcinoma following concurrent chemotherapy and radiotherapy

    Microsoft Academic Search

    Skye Hongiun Cheng; James Jer-Min Jian; Stella Y. C. Tsai; Kwan-Yee Chan; Lawrence K. Yen; Nei-Min Chu; Tran-Der Tan; Mei-Hua Tsou; Andrew T. Huang

    1998-01-01

    Purpose: Concurrent chemotherapy and radiotherapy (CCRT) are effective in treatment of locoregionally advanced nasopharyngeal carcinoma (NPC). However, the prognostic factors after CCRT have not been evaluated. We therefore attempt to evaluate factors that influence treatment outcomes following CCRT.Methods and Materials: Seventy-four (5 in stage III and 69 in stage IV) patients with locoregionally advanced NPC were treated with CCRT. Radiotherapy

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

    SciTech Connect

    Nagar, Himanshu; Boothe, Dustin; Parikh, Amar; Yondorf, Menachem; Parashar, Bhupesh [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Gupta, Divya; Holcomb, Kevin; Caputo, Thomas [Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Chao, K. S. Clifford; Nori, Dattatreyudu [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Wernicke, A. Gabriella, E-mail: gaw9006@med.cornell.edu [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States)

    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.

  13. Concurrent image-guided intensity modulated radiotherapy and chemotherapy following neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma

    PubMed Central

    2011-01-01

    Background To evaluate the experience of induction chemotherapy followed by concurrent chemoradiationwith helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC). Methods Between August 2006 and December 2009, 28 patients with pathological proven nonmetastatic NPC were enrolled. All patients were staged as IIB-IVB. Patients were first treated with 2 to 3 cycles of induction chemotherapy with EP-HDFL (Epirubicin, Cisplatin, 5-FU, and Leucovorin). After induction chemotherapy, weekly based PFL was administered concurrent with HT. Radiation consisted of 70 Gy to the planning target volumes of the primary tumor plus any positive nodal disease using 2 Gy per fraction. Results After completion of induction chemotherapy, the response rates for primary and nodal disease were 96.4% and 80.8%, respectively. With a median follow-up after 33 months (Range, 13-53 months), there have been 2 primary and 1 nodal relapse after completion of radiotherapy. The estimated 3-year progression-free rates for local, regional, locoregional and distant metastasis survival rate were 92.4%, 95.7%, 88.4%, and 78.0%, respectively. The estimated 3-year overall survival was 83.5%. Acute grade 3, 4 toxicities for xerostomia and dermatitis were only 3.6% and 10.7%, respectively. Conclusion HT for locoregionally advanced NPC is feasible and effective in regard to locoregional control with high compliance, even after neoadjuvant chemotherapy. None of out-field or marginal failure noted in the current study confirms the potential benefits of treating NPC patients by image-guided radiation modality. A long-term follow-up study is needed to confirm these preliminary findings. PMID:21838917

  14. Concurrent systems for knowledge processing

    SciTech Connect

    Hewitt, C. (MIT (US)); Agha, G. (Yale Univ. (US))

    1989-01-01

    Actors have catalyzed the development of a new programming methodology and architecture for ultra-concurrent systems. This sourcebook on the development and impact of the actor paradigm brings together more than 20 milestone contributions on the actor concept and its application to knowledge processing. Each contribution is placed in its historical context and explained. This book is divided into four major areas: Foundations of Concurrent Systems covers actors, laws of concurrent systems and mathematical models. Languages takes up design principles, actor languages, meta-interpreters, and comparison with other programming languages. Systems and Architectures discusses monitoring and debugging environments, and multicomputers. Knowledge Processing examines the scientific community metaphor, open systems, and organizational semantics. Future prospects for actors and knowledge processing are discussed in the concluding section.

  15. Concurrent use of chemotherapy or novel agents in combination with radiation in breast cancer

    Microsoft Academic Search

    Kevin Kalinsky; Alice Ho; Christopher A. Barker; Andrew Seidman

    2009-01-01

    Treating breast cancer patients concurrently with chemotherapy and radiation is a potentially attractive approach. The goal\\u000a is to develop strategies that enhance the effects of each modality while minimizing toxicity. Most data evaluating the role\\u000a of simultaneous therapy have been generated from small phase 1 and 2 trials. As few prospective, randomized controlled trials\\u000a have been performed in this area,

  16. Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer

    Microsoft Academic Search

    Alberto Alvarado-Miranda; Oscar Arrieta; Carlos Gamboa-Vignolle; David Saavedra-Perez; Rafael Morales-Barrera; Enrique Bargallo-Rocha; Juan Zinser-Sierra; Victor Perez-Sanchez; Teresa Ramirez-Ugalde; Fernando Lara-Medina

    2009-01-01

    BACKGROUND: Despite broad advances in multimodal treatment of locally advanced breast cancer (LABC), 30 to 40% of patients develop loco-regional relapse. The aim of this study was to analyze in a retrospective manner the effectiveness of concurrent chemo-radiotherapy (CCRTh) after neoadjuvant chemotherapy (NCT) in patients with LABC. METHODS: One hundred twelve patients with LABC (stage IIB-IIIB) were treated with NCT

  17. Modification of the effects of continuous low dose rate irradiation by concurrent chemotherapy infusion

    SciTech Connect

    Fu, K.K.; Rayner, P.A.; Lam, K.N.

    1984-08-01

    The combined effects of continuous low dose rate irradiation (CLDRI) and concurrent infusion of bleomycin, cyclophosphamide, cis-platinum, 5-fluorouracil, actinomycin D, and mitomycin C were studied in the SCC VII/SF tumor, a squamous cell carcinoma and the jejunal crypt cells in the mouse. For the SCC VII/SF tumor, enhanced cell killing was seen with each of the six drugs when infused concurrently with CLDRI; the greatest enhancement was seen with mitomycin C and cis-platinum. For the jejunal crypt cells, enhanced cell killing was seen primarily with bleomycin. The authors results suggest a therapeutic gain with concurrent CLDRI and chemotherapy infusion for five of the six chemotherapeutic drugs studied with the exception of bleomycin.

  18. The rapid uptake of concurrent chemotherapy for cervix cancer patients treated with curative radiation

    SciTech Connect

    Barbera, Lisa [Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario (Canada) and Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) and Institute for Clinical Evaluative Studies, Toronto, Ontario (Canada)]. E-mail: lisa.barbera@sw.ca; Paszat, Lawrence [Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Institute for Clinical Evaluative Studies, Toronto, Ontario (Canada); Thomas, Gillian [Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Covens, Al [Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario (Canada); Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario (Canada); Fyles, Anthony [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Princess Margaret Hospital, University Health Network, Toronto, Ontario (Canada); Elit, Laurie [Hamilton Regional Cancer Centre, Hamilton, Ontario (Canada); Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario (Canada); Qiu Feng [Institute for Clinical Evaluative Studies, Toronto, Ontario (Canada)

    2006-04-01

    Purpose: In 1999, a series of clinical trials along with a clinical announcement from the National Cancer Institute (NCI) suggested that chemotherapy should be used concurrently with pelvic radiation in the management of cervical cancer. The purpose of this study is to examine the rate of chemotherapy use, in the province of Ontario, before and after these publications. Methods: All incident cases of cervix cancer diagnosed between January 1, 1995, and March 31, 2001, were identified using the provincial cancer registry. These records were electronically linked to billing claims data and inpatient discharge abstract data. Patients receiving brachytherapy within 6 months of diagnosis were identified. The proportion receiving at least one injection of chemotherapy before brachytherapy was identified and compared in the 'pre' and 'post' publication group (April 1, 1999, cutoff). Results: We identified 1039 cases as receiving curative radiation. In the pre cohort, 9.4% of patients received chemotherapy (95% CI, 7.3-11.4%) vs. 67.4% in the post cohort (95% CI, 61.8-73.0%). The change occurred abruptly in the first quarter of 1999. Conclusion: There was a significant increase in chemotherapy use after the publication of the NCI alert and related trials. Reasons for rapid uptake are discussed.

  19. 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. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Liao Zhongxing [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Cox, James D. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Guerrero, Thomas M. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Jeter, Melinda [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Borghero, Yerko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Wei Xiong [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Fossella, Frank [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Herbst, Roy S. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Blumenschein, George R. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Moran, Cesar [Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. 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.

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

    SciTech Connect

    Chang, Jee Suk [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Wang, Michael L.C. [Department of Radiation Oncology, National Cancer Centre (Singapore)] [Department of Radiation Oncology, National Cancer Centre (Singapore); Koom, Woong Sub; Yoon, Hong In; Chung, Yoonsun [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Song, Si Young [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of)] [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Seong, Jinsil, E-mail: jsseong@yuhs.ac [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    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.

  1. Intensity modulated radiotherapy with concurrent chemotherapy for larynx preservation of advanced resectable hypopharyngeal cancer

    PubMed Central

    2010-01-01

    Background To analyze the rate of larynx preservation in patients of locally advanced hypopharyngeal cancer treated with intensity modulated radiotherapy (IMRT) plus concurrent chemotherapy, and compare the results with patients treated with primary surgery. Methods Between January 2003 and November 2007, 14 patients were treated with primary surgery and 33 patients were treated with concurrent chemoradiotherapy (CCRT) using IMRT technique. Survival rate, larynx preservation rate were calculated with the Kaplan-Meier method. Multivariate analysis was conducted for significant prognostic factors with Cox-regression method. Results The median follow-up was 19.4 months for all patients, and 25.8 months for those alive. The 5-year overall survival rate was 33% and 44% for primary surgery and definitive CCRT, respectively (p = 0.788). The 5-year functional larynx-preservation survival after IMRT was 40%. Acute toxicities were common, but usually tolerable. The rates of treatment-related mucositis (? grade 2) and pharyngitis (? grade 3) were higher in the CCRT group. For multivariate analysis, treatment response and cricoid cartilage invasion strongly correlated with survival. Conclusions IMRT plus concurrent chemotherapy may preserve the larynx without compromising survival. Further studies on new effective therapeutic agents are essential. PMID:20470428

  2. Concurrency Control and Recovery in Database Systems

    Microsoft Academic Search

    Philip A. Bernstein; Vassos Hadzilacos; Nathan Goodman

    1987-01-01

    This book is an introduction to the design and implementation of concurrency control and recovery mechanisms for transaction management in centralized and distributed database systems. Concurrency control and recovery have become increasingly important as businesses rely more and more heavily on their on-line data processing activities. For high performance, the system must maximize concurrency by multiprogramming transactions. But this can

  3. Intensity-Modulated Radiotherapy With Concurrent Chemotherapy for Previously Irradiated, Recurrent Head and Neck Cancer

    SciTech Connect

    Biagioli, Matthew C. [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States)], E-mail: MCBiagioli@yahoo.com; Harvey, Mark [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Roman, Eloy; Raez, Luis E. [Department of Medicine, Division of Medical Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Wolfson, Aaron H. [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Mutyala, Subhakar [Department of Radiation Oncology, Albert Einstein Medical Center, New York, NY (United States); Han, Hyo S. [Department of Medicine, Division of Medical Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Markoe, Arnold [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States)

    2007-11-15

    Purpose: Primary treatment fails in >70% of locally advanced head and neck cancer patients. Salvage therapy has a 30-40% response rate, but few long-term survivors. Intensity-modulated radiotherapy (IMRT) has recently emerged as a new modality for salvage therapy. This retrospective study evaluated our experience using every-other-week IMRT with concurrent chemotherapy. Methods and Materials: Between 2001 and 2006, 41 patients underwent IMRT as repeat RT with concurrent chemotherapy. All but 6 patients received 60 Gy at 2 Gy/fraction. RT was delivered on an alternating week schedule. Results: With a median follow-up time of 14 months, the overall response rate was 75.6%, with a complete response and partial response rate of 58.5% and 17.1%, respectively. The Kaplan-Meier estimate of overall survival, disease-free survival, and progression-free survival at 24 months was 48.7%, 48.1%, and 38%, respectively. Patients who underwent surgery as a part of their salvage therapy had a mean estimated survival of 30.9 months compared with 22.8 months for patients who received only chemoradiotherapy (p = 0.126). Grade 3 or 4 acute toxicities occurred in 31.7% of patients, but all had resolved within 2 months of therapy completion. No deaths occurred during treatment, except for 1 patient, who died shortly after discontinuing treatment early because of previously undiagnosed metastatic disease; 6 patients had long-term complications. Conclusions: Concurrent chemotherapy with repeat radiotherapy with IMRT given every other week appears to be both well tolerated and feasible in patients treated with previous radiotherapy for recurrent head and neck cancer. IMRT represents a reasonable modality for reducing treatment-related toxicities in a repeat RT setting.

  4. 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.

  5. 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.

  6. Phase II Study of Consolidation Chemotherapy After Concurrent Chemoradiation in Cervical Cancer: Preliminary Results

    SciTech Connect

    Choi, Chel Hun [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jeong-Won [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Tae-Joong [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Woo Young [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Nam, Hee Rim [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Byoung-Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)]. E-mail: huna0@naver.com; Huh, Seung Jae [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Je-Ho [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Bae, Duk-Soo [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Purpose: Our aim was to determine the efficacy of consolidation chemotherapy after concurrent chemoradiation (CCRT) using high-dose-rate brachytherapy in patients with locally advanced cervical carcinoma. Methods and Materials: Patients with cervical carcinoma (FIGO stage IB2-IVA) were treated with external beam radiation therapy to the whole pelvis (50.4 Gy) and high-dose-rate brachytherapy (24 Gy to point A). Cisplatin 60 mg/m{sup 2} (Day 1) and 5-fluorouracil 1000 mg/m{sup 2} (Days 1-5) were given every 3 weeks starting concurrently with the radiation and followed by 3 more cycles of consolidation for a total of 6 cycles. Results: Thirty patients (94%) received 3 more cycles of post-CCRT consolidation chemotherapy and were evaluable for the toxicity and efficacy of consolidation. The most common toxicities of Grade 2 or higher were nausea or vomiting (47%) and anemia (33%). Late complications of the rectum and bladder occurred in 13% and 6% of the patients, respectively. The clinical complete response rate was 87% (95% CI, 75%-99%). During a median follow-up of 27 months (range, 6-58 months), 5 patients (17%) had recurrence; the sites of failure were 3 (10%) inside the radiation field and 2 (7%) outside the radiation field. The estimated 3-year progression-free survival rate was 83% (95% CI, 67%-99%) and overall survival rate was 91% (95% CI, 79%-100%). Conclusions: Consolidation chemotherapy after CCRT is well tolerated and effective in patients with locally advanced cervical carcinoma. A prospective randomized trial to compare this treatment strategy with standard CCRT seems to be worthwhile.

  7. The Concurrency Factory: A Development Environment for Concurrent Systems ?

    E-print Network

    Cleaveland, Rance

    design diagrams drawn by engineers but possesses a formal, process­algebra­based semantics. We into executable code. The current Factory prototype produces Facile [GMP89] code, a con­ current language of the burden of manually recoding their designs in the target language of their final system. The Concurrency

  8. [Adjuvant chemotherapy (nedaplatin/UFT) after concurrent chemoradiotherapy for locally advanced head and neck squamous cell carcinoma].

    PubMed

    Kubota, Akira; Furukawa, Madoka; Komatsu, Masanori; Hanamura, Hideaki; Sugiyama, Masato

    2006-03-20

    To evaluate the efficacy of adjuvant chemotherapy after concurrent chemoradiotherapy, 41 previously untreated patients with locally advanced and resectable head and neck squamous cancer were enrolled in a study to compare adjuvant chemotherapy (Nedaplatin/UFT) after concurrent chemoradiotherapy (CDDP/5-FU) and concurrent chemoradiation alone. Nine of the patients had stage III tumors and 32 had stage IV tumors. The primary tumor site was the hypopharynx in 14 patients, the larynx in 12 patients, the oral cavity in 9 patients, and the oropharynx in 6 patients. Treatment consisted of 6 courses of Nedaplatin (80 mg/m2) repeated at 4-week intervals and one year of the oral administration of UFTE (400 mg/day) after concurrent chemoradiotherapy at an outpatient clinic. Toxicities included leukopenia (grade 3, 15.4%) and thrombocytopenia (grade 3, 7.7%). One death from a gastric ulcer occurred. The median overall survival time was 30.1 months (5.5-50.1 months) for the adjuvant chemotherapy group and 21.7 months (4.0-48.8 months) for the control group. The progression-free survival period was 22.8 months (5.6-33.9 months) for the adjuvant chemotherapy group and 26.5 months (5.6-33.9 months) for the control group. The two-year overall survival rate was 73.3% for the adjuvant chemotherapy group and 55.7% for the control group. A significant difference was observed in the two-year progression-free survival rates: 66.9% for the adjuvant chemotherapy group and 27.8% for the control group (p = 0.03290). Among the patients with a partial response to concurrent chemoradiotherapy, in particular, a significant difference in the two-year progression-free survival rates was seen : 59.3% for the adjuvant chemotherapy group and 15.3% for the control group (p = 0.01102). The rate of loco-regional failure was 29.6% for the adjuvant chemotherapy group and 64.3% for the control group (p = 0.0716). Distant metastasis was not detected in either group. The rate of organ preservation was 66.7% for the adjuvant chemotherapy group and 35.7% for the control group (p = 0.1183). This adjuvant chemotherapy regimen might improve the loco-regional control rates after concurrent chemoradiotherapy. PMID:16615429

  9. Symbolic Diagnosis of Partially Observable Concurrent Systems

    Microsoft Academic Search

    Thomas Chatain; Claude Jard

    2004-01-01

    Monitoring large distributed concurrent systems is a challenging task. In this paper we formulate (model-based) diagnosis by means of hidden state history reconstruction, from event (e.g. alarm) observations. We follow a so-called true concurrency approach: the model denes explicitly the causal and concurrency relations between the observable events, pro- duced by the system under supervision on dieren t points of

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

    SciTech Connect

    Lee, Nancy Y. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)], E-mail: leen2@mskcc.org; O'Meara, William; Chan, Kelvin [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Della-Bianca, Cesar; Mechalakos, James G. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Zhung, Joanne; Wolden, Suzanne L.; Narayana, Ashwatha [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Kraus, Dennis; Shah, Jatin P. [Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Pfister, David G. [Department of Medicine, Division of Head and Neck Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    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.

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

    SciTech Connect

    Livi, Lorenzo [Department of Radiotherapy, University of Florence, Florence (Italy)], E-mail: l.livi@dfc.unifi.it; Saieva, Calogero [Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Centre (CSPO), Scientific Institute of Tuscany, Florence (Italy); Borghesi, Simona; Paoletti, Lisa; Meattini, Icro; Rampini, Andrea; Petrucci, Alessia; Scoccianti, Silvia; Paiar, Fabiola [Department of Radiotherapy, University of Florence, Florence (Italy); Cataliotti, Luigi [Department of Surgery, University of Florence, Florence (Italy); Leonulli, Barbara Grilli [Department of Radiotherapy, University of Florence, Florence (Italy); Bianchi, Simonetta [Department of Pathology, University of Florence, Florence (Italy); Biti, Gian Paolo [Department of Radiotherapy, University of Florence, Florence (Italy)

    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.

  12. Distributed Monitoring of Concurrent and Asynchronous Systems

    Microsoft Academic Search

    Eric Fabre; Albert Benveniste; Stefan Haar; Claude Jard

    2005-01-01

    In this paper we study the diagnosis of distributed asynchronous sys- tems with concurrency. Diagnosis is performed by a peer-to-peer dis- tributed architecture of supervisors. Our approach relies on Petri net unfoldings and event structures, as means to manipulate trajectories of systems with concurrency. This article is an extended version of the paper with same title, which appeared as a

  13. Counterpoint: test the value of hyperthermia in patients with carcinoma of the cervix being treated with concurrent chemotherapy and radiation.

    PubMed

    Prosnitz, L; Jones, E

    2002-01-01

    Major advances in the treatment of locally advanced cervical carcinoma were reported in 1999-2000 in five studies from the Gynecologic Oncology Group, Radiation Therapy Oncology Group and Southwestern Oncology Group. Collectively these trials reported a decrease in the risk of recurrence or death from cervical cancer ranging from 30-50% with the use of concurrent chemoradiation, as compared with radiation alone. On the basis of these trials the National Cancer Institute in 1999 issued a clinical alert concluding 'Strong consideration should be given to the incorporation of concurrent cisplatin-based chemotherapy with radiation therapy in women who require radiation therapy for treatment of cervical cancer.' Concurrently with these publications there appeared the publication in the Lancet in 2000 of the Dutch Deep Hyperthermia Group trial of radiotherapy alone versus combined radiation and hyperthermia for locally advanced pelvic tumors including carcinoma of the cervix. This multi-center phase III trial demonstrated an approximate doubling of the three year survival from 27 to 51% for the addition of hyperthermia to radiotherapy in patients with locally advanced cervical carcinoma. Additional trials to test the value of hyperthermia in patients with cervical carcinoma treated with concurrent chemotherapy and radiation are imperative and take precedence over a trial to investigate the value of chemotherapy in patients treated with hyperthermia and radiation. PMID:11820463

  14. Distributed Monitoring of Concurrent and Asynchronous Systems

    Microsoft Academic Search

    Albert Benveniste; Stefan Haar; Eric Fabre; Claude Jard

    2003-01-01

    Abstract. In this paper we study the diagnosis of distributed asynchronous,systems,with concurrency. Diagnosis is performed,by a peer-to-peer distributed architecture of supervisors. Our approach relies on Petri net unfoldings and event structures, as means to manipulate trajectories of systems with concurrency. This article is an extended version of the paper with same title, which appeared as a plenary address in the

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

    SciTech Connect

    Schoenfeld, Jonathan D., E-mail: jdschoenfeld@partners.org [Department of Radiation Oncology, Harvard Radiation Oncology Program, Boston, MA (United States); Sher, David J. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA (United States); Norris, Charles M. [Department of Surgery, Division of Otolaryngology, Brigham and Women's Hospital, Boston, MA (United States); Haddad, Robert I.; Posner, Marshall R. [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); Department of Medicine, Brigham and Women's Hospital, Boston, MA (United States); Balboni, Tracy A.; Tishler, Roy B. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA (United States)

    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.

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

    SciTech Connect

    Ogawa, Kazuhiko, E-mail: kogawa@med.u-ryukyu.ac.jp [Department of Radiology, University of the Ryukyus, Okinawa (Japan); Ito, Yoshinori [Department of Radiation Oncology, National Cancer Center, Tokyo (Japan); Hirokawa, Naoki [Department of Radiology, Sapporo Medical University, Sapporo (Japan); Shibuya, Keiko [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto (Japan); Kokubo, Masaki [Department of Radiation Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe (Japan); Ogo, Etsuyo [Department of Radiation Oncology, Kurume University, Kurume (Japan); Shibuya, Hitoshi [Department of Radiology, Tokyo Medical and Dental University, Tokyo (Japan); Saito, Tsutomu [Department of Radiation Oncology, Nihon University Itabashi Hospital, Tokyo (Japan); Onishi, Hiroshi [Department of Radiology, Yamanashi University, Yamanashi (Japan); Karasawa, Katsuyuki [Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Nemoto, Kenji [Department of Radiation Oncology, Yamagata University, Yamagata (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)

    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.

  17. Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer.

    PubMed

    Recchia, Francesco; Candeloro, Giampiero; Cesta, Alisia; DI Staso, Mario; Bonfili, Pierluigi; Gravina, Giovanni Luca; DI Cesare, Ernesto; Necozione, Stefano; Rea, Silvio

    2014-05-01

    The present study aimed to determine the toxicity and efficacy of 4 courses of anthracyclines-taxane (AT) chemotherapy followed by radiation therapy (XRT) concurrent with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in surgically resected axillary node-positive (N+) breast cancer. A total of 200 women with N+ breast cancer were treated with adriamycin and docetaxel followed by XRT concurrent with six courses of CMF. Two courses of dose-dense chemotherapy with ifosfamide, carboplatin and etoposide, supported by pegfilgrastim, were administered to patients with >5 histologically confirmed axillary lymph node metastases and patients with triple-negative disease. Additional treatments included 1 year of trastuzumab in human epidermal growth factor receptor 2-positive patients, 5 years of a luteinizing hormone-releasing hormone analogue in premenopausal women and 5 years of an aromatase inhibitor (AI) in estrogen receptor-positive (ER+) patients. The mean number of positive axillary lymph nodes was 4.4 (range, 2-37), 52% of the patients were premenopausal, 74% were ER+ and 26% had triple-negative disease. After a median follow-up of 73 months, grade 2 and 3 hematological toxicity was observed in 20% of the patients. The 10-year disease-free survival (DFS) and overall survival (OS) rates were 73 and 77%, respectively. There was no significant difference in DFS between ER+ and estrogen receptor-negative (ER-) patients (P>0.05), whereas the OS was better in ER+ vs. ER- patients (P<0.05) and in premenopausal vs. postmenopausal patients (P<0.005). In conclusion, induction AT concurrent CMF and XRT and dose-dense chemotherapy followed by AI in N+ high-risk breast cancer was associated with a low level of systemic and late cardiac toxicity and excellent local control, DFS and OS. PMID:24772320

  18. Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer

    PubMed Central

    RECCHIA, FRANCESCO; CANDELORO, GIAMPIERO; CESTA, ALISIA; DI STASO, MARIO; BONFILI, PIERLUIGI; GRAVINA, GIOVANNI LUCA; DI CESARE, ERNESTO; NECOZIONE, STEFANO; REA, SILVIO

    2014-01-01

    The present study aimed to determine the toxicity and efficacy of 4 courses of anthracyclines-taxane (AT) chemotherapy followed by radiation therapy (XRT) concurrent with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in surgically resected axillary node-positive (N+) breast cancer. A total of 200 women with N+ breast cancer were treated with adriamycin and docetaxel followed by XRT concurrent with six courses of CMF. Two courses of dose-dense chemotherapy with ifosfamide, carboplatin and etoposide, supported by pegfilgrastim, were administered to patients with >5 histologically confirmed axillary lymph node metastases and patients with triple-negative disease. Additional treatments included 1 year of trastuzumab in human epidermal growth factor receptor 2-positive patients, 5 years of a luteinizing hormone-releasing hormone analogue in premenopausal women and 5 years of an aromatase inhibitor (AI) in estrogen receptor-positive (ER+) patients. The mean number of positive axillary lymph nodes was 4.4 (range, 2–37), 52% of the patients were premenopausal, 74% were ER+ and 26% had triple-negative disease. After a median follow-up of 73 months, grade 2 and 3 hematological toxicity was observed in 20% of the patients. The 10-year disease-free survival (DFS) and overall survival (OS) rates were 73 and 77%, respectively. There was no significant difference in DFS between ER+ and estrogen receptor-negative (ER?) patients (P>0.05), whereas the OS was better in ER+ vs. ER? patients (P<0.05) and in premenopausal vs. postmenopausal patients (P<0.005). In conclusion, induction AT concurrent CMF and XRT and dose-dense chemotherapy followed by AI in N+ high-risk breast cancer was associated with a low level of systemic and late cardiac toxicity and excellent local control, DFS and OS. PMID:24772320

  19. [Proton beam therapy with concurrent chemotherapy for non-small cell lung cancer -- our experiences and future direction].

    PubMed

    Niho, Seiji; Motegi, Atsushi; Akimoto, Tetsuo

    2015-02-01

    Concurrent chemoradiotherapy is the gold standard of care for patients with unresectable locally advanced non-small cell lung cancer (NSCLC). Proton beam therapy (PBT) can reduce the doses for normal lungs because of the penetration energy peak. PBT with concurrent chemotherapy for locally advanced NSCLC has been introduced in National Cancer Center Hospital East since December 2011. Thirty-three patients received PBT with concurrent chemotherapy for 2 years. Nine patients received PBT because they were not suited for radical photon radiotherapy due to excessive V20 Gy or doses to the spinal cord. Thirty-one patients received cisplatin plus vinorelbine; the remaining 2 patients received weekly carboplatin and paclitaxel, or daily carboplatin. All but 1 patient received the planned PBT dose (60 GyE[n=15]or 66 GyE[n=17]). PBT was terminated in 1 patient after the delivery of 36 GyE because of the development of liver metastases. PBT was suspended in 8 patients because of the development of febrile neutropenia (n=6) and esophagitis (n=3). Two patients (6%) experienced grade 3 esophagitis. The grade 2 toxicities included esophagitis (n=12), dermatitis (n=10), and pneumonitis (n=2). Grade 3 pneumonitis was not observed. Disease progression was observed in 17 patients. In-field recurrence was observed in 4 patients, distant metastases were observed in 14 patients, and both types of recurrence were observed in 1 patient. With a median follow-up time of 6.0 months for censored cases, the median progression-free survival time was 9.9 months (95% confidence interval: 5.2-14.6). Our retrospective study demonstrates that PBT with concurrent chemotherapy is feasible, although the possible complications, such as radiation esophagitis and dermatitis, might be rather severe compared with standard chemoradiotherapy using photons. PMID:25743132

  20. Prospective Pilot Study of Consolidation Chemotherapy With Docetaxel and Cisplatin After Concurrent Chemoradiotherapy for Advanced Head and Neck Cancer

    SciTech Connect

    Lee, Kyun Chan; Lee, Seok Ho [Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Lee, Yuna [Department of Internal Medicine, Division of Hematology and Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Park, Se Hoon [Department of Internal Medicine, Division of Hematology and Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of)], E-mail: hematoma@gilhospital.com; Park, Jinny; Cho, Eun Kyung; Shin, Dong Bok; Lee, Jae Hoon [Department of Internal Medicine, Division of Hematology and Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Kim, Dong Young; Kim, Seon Tae [Department of Otolaryngology, Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2008-05-01

    Purpose: With the improvement concurrent chemoradiotherapy (CCRT) in the management of patients with locoregionally advanced head and neck squamous cell carcinoma (HNSCC), distant failures have become a more relevant problem in terms of survival. The primary objective of this Phase II study is to assess the feasibility of docetaxel and cisplatin consolidation after primary CCRT for patients with HNSCC. Methods and Materials: Patients with locoregionally advanced HNSCC received chemotherapy with three cycles of cisplatin, 100 mg/m{sup 2}, on Days 1, 22, and 43. Concurrent radiotherapy to the primary tumor and neck was given in a daily dose of 2 Gy to a total dose of 70-70.2 Gy over 7 weeks. After completion of CCRT, patients without evidence of disease progression received an additional four cycles of consolidation chemotherapy with docetaxel, 75 mg/m{sup 2}, and cisplatin, 75 mg/m{sup 2}, every 3 weeks. Results: Of 33 patients, 27 (81%) completed CCRT. After CCRT, three complete and 19 partial responses were recorded, giving an overall response rate of 67%. Of 19 patients who went to the consolidation phase, only 4 (21%) received all four cycles of docetaxel and cisplatin. Causes of failure of consolidation chemotherapy were toxicity in 11 patients, including three treatment-related deaths, and progression in 4 patients. Three patients died of sepsis during the consolidation phase. Median survival was 11 months for all patients and 8 months for those treated with consolidation chemotherapy. Conclusion: The poor compliance and high incidence of severe toxicities prompted no further evaluation of this consolidation chemotherapy after CCRT.

  1. Concurrent vs Sequential Adjuvant Chemotherapy and Hormone Therapy in Breast Cancer: A Multicenter Randomized Phase III Trial

    PubMed Central

    Sertoli, Mario Roberto; Pronzato, Paolo; Del Mastro, Lucia; Venturini, Marco; Taveggia, Paola; Zanardi, Elisa; Siffredi, Guido; Pastorino, Simona; Queirolo, Paola; Gardin, Giovanni; Wang, Ena; Monzeglio, Clara; Boccardo, Francesco; Bruzzi, Paolo

    2011-01-01

    Background The most appropriate timing of chemotherapy and hormone therapy administration is a critical issue in early breast cancer patients. The purpose of our study was to compare the efficacy of concurrent vs sequential administration of adjuvant chemotherapy and tamoxifen. Methods Women with node-positive primary breast cancer were randomly assigned to receive tamoxifen (20 mg/d for 5 years) during (concurrent arm) or after (sequential arm) adjuvant chemotherapy. Chemotherapy consisted of alternating regimens of cyclophosphamide, epidoxorubicin, and 5-fluorouracil and cyclophosphamide, methotrexate, and 5-fluorouracil every 21 days for a total of 12 cycles. The primary endpoint was overall survival (OS), and secondary endpoints were toxic effects and disease-free survival (DFS). No provision for interim analyses was made in the original study protocol. Survival curves were estimated by the Kaplan–Meier method. Multivariable Cox regression models, adjusted for age, menopausal status, tumor stage, and lymph node and hormone receptor status, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. Results From 1985 to 1992, 431 patients were randomly assigned and studied according to the intention-to-treat principle. After a maximum of 15.4 years of follow-up (median 12.3 years), the estimated actuarial 10-year OS was equivalent for the two study arms (concurrent arm: 111 patients, 66%, 95% CI = 59% to 72%; sequential arm: 114 patients, 65%, 95% CI = 59% to 72%, P = .86). No differences in DFS and toxic effects were evident. Four interim analyses were performed, but no alpha error adjustment was necessary because of the largely negative results of this final analysis (sequential vs concurrent arm: HR of death = 1.06, 95% CI = 0.78 to 1.44, P = .76; HR of relapse = 1.16, 95% CI = 0.88 to 1.52, P = .36). Conclusions No statistically significant differences in OS, DFS, and toxic effects between concurrent and sequential adjuvant chemo- and hormone therapies were observed. Our study does not support the superiority of one schedule of chemo- and hormone-therapy administration over the other. However, because of the limited statistical power of the study, these results must be considered with caution. PMID:21921285

  2. 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

  3. Graphical specifications for concurrent software systems

    Microsoft Academic Search

    Laura K. Dillon; G. Kutty; Louise E. Moser; P. M. Melliar-Smith; Y. S. Ramakrishna

    1992-01-01

    We present a description of a graphical interval logic that is the foundation of a toolset we are developing to support formal specification and verification of concurrent software systems. Experience has shown that most software engineers find standard temporal logics difficult to understand and to use. Our objective is to enable software engineers to specify and reason about temporal properties

  4. The Effect of Adjuvant Chemotherapy on Survival in Patients with Residual Nasopharyngeal Carcinoma after Undergoing Concurrent Chemoradiotherapy

    PubMed Central

    Fu, Qiang; Cai, Baizhen; Kong, Fei; Huang, Guang; Li, Fafen; Wang, Han

    2015-01-01

    Background Guidelines from the U.S. National Comprehensive Cancer Network have recommended use of concurrent chemoradiotherapy (CCRT), followed by a 3-cycles combination of platinum and 5-fluorouracil chemotherapy as standard treatment for nasopharyngeal carcinoma (NPC). The benefits of CCRT for treatment of locally advanced NPC have been established. Whether platinum and 5-fluorouracil chemotherapy should be routinely added to locally advanced NPC after CCRT is still open to debate. Whether adjuvant chemotherapy provides an additional survival benefit for the subgroup of patients with residual nasopharyngeal carcinoma who have undergone CCRT is also unclear. This retrospective study was initiated to determine the survival benefit of adjuvant chemotherapy (AC) in residual NPC patients who have undergone concurrent chemoradiotherapy. Methods The retrospective study included 155 nasopharyngeal carcinoma patients who had local residual lesions after the platinum-based CCRT without or with AC. Kaplan-Meier analysis and the log-rank test were used to estimate overall survival (OS), failure-free survival (FFS), local relapse-free survival (LRFS) and distant metastasis-free survival (DMFS). Results Median follow-up was 47 months. Adjuvant cisplatin or nedaplatin plus 5-fluorouracil chemotherapy did not significantly improve 3-year OS, LRFS, FFS, and DMFS for patients with residual nasopharyngeal carcinoma after undergoing CCRT. The 3-year OS rates for the no-AC group and AC group were 71.6% and 73.7%, respectively (P= 0.44). The 3-year FFS rates for no-AC group and AC group were 57.5% and 66.9%, respectively ((P= 0.19). The 3-year LRFS rates for no-AC group and AC group were 84.7% and 87.9%, respectively ((P= 0.51). The 3-year DMFS rates for no-AC group and AC group were 71.4% and 77.4%, respectively ((P= 0.23). Conclusions Since we did not find sufficient data to support significant survival in 3-year OS, LRFS, FFS, and DMFS, whether Adjuvant cisplatin or nedaplatin and 5-fluorouracil chemotherapy should be routinely added to residual nasopharyngeal carcinoma patients after undergoing CCRT remain uncertain. PMID:25799566

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

    SciTech Connect

    Lin, C.-C. [Department of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Department of Urology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Hsu, C.-H. [Department of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cheng, Jason C. [Department of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Huang, C.-Y. [Department of Urology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Tsai, Y.-C. [Department of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Hsu, F.-M. [Department of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Huang, K.-H. [Department of Urology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cheng, A.-L. [Department of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Pu, Y.-S. [Department of Urology, National Taiwan University College of Medicine, Taipei, Taiwan (China)], E-mail: yspu@ntu.edu.tw

    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.

  6. 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 [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Nam, Hee Rim; Huh, Seung Jae [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Je-Ho; Bae, Duk-Soo [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Byoung-Gie, E-mail: bksong.kim@samsung.com [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    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.

  7. 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 [State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China); Zong Jingfeng [Department of Radiation Oncology, Fujian Provincial Tumor Hospital, Fuzhou (China); Mao Yanping; Tang Linglong [State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China); Guo Ying [State Key Laboratory of Oncology in Southern China, Department of National Clinical Study Center for Anticancer Drugs, Cancer Center, Sun Yat-sen University, Guangzhou (China); Lin Aihua [Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou (China); Zeng Xiangfa [State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China); Ma Jun [State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China)], E-mail: majun2@mail.sysu.edu.cn

    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.

  8. Modified Weekly Cisplatin-Based Chemotherapy Is Acceptable in Postoperative Concurrent Chemoradiotherapy for Locally Advanced Head and Neck Cancer

    PubMed Central

    Lu, Hsueh-Ju; Yang, Chao-Chun; Wang, Ling-Wei; Chu, Pen-Yuan; Tai, Shyh-Kuan; Chen, Ming-Huang; Yang, Muh-Hwa; Chang, Peter Mu-Hsin

    2015-01-01

    Background. Triweekly cisplatin-based postoperative concurrent chemoradiotherapy (CCRT) has high intolerance and toxicities in locally advanced head and neck cancer (LAHNC). We evaluated the effect of a modified weekly cisplatin-based chemotherapy in postoperative CCRT. Methods. A total of 117 patients with LAHNC were enrolled between December 2007 and December 2012. Survival, compliance/adverse events, and independent prognostic factors were analyzed. Results. Median follow-up time was 30.0 (3.1–73.0) months. Most patients completed the entire course of postoperative CCRT (radiotherapy ? 60?Gy, 94.9%; ?6 times weekly chemotherapy, 75.2%). Only 17.1% patients required hospital admission. The most common adverse effect was grade 3/4 mucositis (28.2%). No patient died due to protocol-related adverse effects. Multivariate analysis revealed the following independent prognostic factors: oropharyngeal cancer, extracapsular spread, and total radiation dose. Two-year progression-free survival and overall survival rates were 70.9% and 79.5%, respectively. Conclusion. Modified weekly cisplatin-based chemotherapy is an acceptable regimen in postoperative CCRT for LAHNC. PMID:25793192

  9. Analysis of the Prognostic Factors for Distant Metastasis after Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Head and Neck Cancer

    PubMed Central

    Kim, Dong Hyun; Kim, Won Taek; Lee, Joo Hye; Ki, Yong Kan; Nam, Ji Ho; Lee, Byung Joo; Lee, Jin Choon; Choi, Young Jin; Seol, Young Mi; Kim, Dong Won

    2015-01-01

    Purpose The aim of this study is to identify the prognostic factors of distant metastasis (DM) after induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer (HNC). Materials and Methods A total of 321 patients with HNC who underwent IC followed by CRT treated between January 2005 and December 2010 were analyzed retrospectively. IC consisted of three courses of docetaxel (70 mg/m2) and cisplatin (75 mg/m2) every three weeks, followed by radiotherapy of 66-70 Gy/2 Gy per fraction/5 fractions per week concurrent with weekly cisplatin (40 mg/m2). Tumor/nodal stage, primary site, tumor differentiation, lower neck node involvement (level IV, VB, and supraclavicular regions), number of concurrent chemotherapy cycles, overall duration of radiotherapy, and response to IC were assessed as potential prognostic factors influencing DM and survival outcome. Results The five-year loco-regional recurrence and DM rates were 23.6% and 18.2%. N stage, overall duration of radiotherapy, lower neck node involvement, and response to IC were significant factors for DM. With a median follow-up period of 52 months (range, 4 to 83 months), the 5-year progression-free, DM-free, and overall survival rates were 41.2%, 50.7%, and 55.1%, respectively. Lower neck node involvement (p=0.008) and poor response to IC (p < 0.001) showed an association with significantly inferior DM-free survival. Conclusion Even with the addition of IC, the DM rate and survival outcome were poor when metastatic lower neck lymph nodes were present or when patients failed to respond after receiving IC. PMID:25327492

  10. Concurrency

    Microsoft Academic Search

    Josh Juneau; Jim Baker; Victor Ng; Leo Soto; Frank Wierzbicki

    \\u000a Supporting concurrency is increasingly important. In the past, mainstream concurrent programming generally meant ensuring\\u000a that the code interacting with relatively slow network, disk, database, and other I\\/O resources did not unduly slow things\\u000a down. Exploiting parallelism was typically only seen in such domains as scientific computing with the apps running on supercomputers.

  11. Bounded Concurrent Time-Stamp Systems Are Constructible

    E-print Network

    Lynch, Nancy

    Bounded Concurrent Time-Stamp Systems Are Constructible Abstract Danny Dolev Concurrent time stamping is at the heart of solu tions to some of the most fundamental problems in distributed computing. Based on concurrent time-stamp-systems, elegant and simple solu tions to core problems such as fcf

  12. Treatment of Locally Advanced Cervical Cancer with Concurrent Radiation and Intra-arterial Chemotherapy

    Microsoft Academic Search

    Mitchell Morris; Patricia J. Eifel; Thomas W. Burke; Mary M. McNamara; Charles Levenback; John J. Kavanagh; David M. Gershenson

    1995-01-01

    The purpose of this study was to determine the maximum tolerated dose (MTD) and feasibility of treatment with sequential intra-arterial FUDR and cisplatin administered with concurrent whole pelvis radiation (XRT) to women with advanced cervical cancer. Sixteen patients with squamous carcinoma of the cervix were prospectively treated in a Phase I study. All tumors were stages IIb, IIIb, or IVa

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

    SciTech Connect

    Chen, William C. [Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH (United States); Kim, Janice [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Kim, Edward [Department of Radiation Oncology, Ohio State University Medical Center, Columbus, OH (United States); Silverman, Paula [Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH (United States); Overmoyer, Beth [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); Cooper, Brenda W. [Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH (United States); Anthony, Sue [Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH (United States); Shenk, Robert; Leeming, Rosemary [Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH (United States); Hanks, Shelli H. [Arizona Institute of Urology, Tucson, AZ (United States); Lyons, Janice A., E-mail: janice.lyons@uhhospitals.org [Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH (United States)

    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.

  14. [Chemotherapy].

    PubMed

    Kishi, Shinji; Ueda, Takanori

    2014-03-01

    The progress of cancer chemotherapy has made a large contribution to the significant improvement of cure rate in patients with hematological malignancy including malignant lymphoma. Interpatient variability characterizes the disposition of many drugs. In the case of drugs with a wide therapeutic index, such variability is unlikely to affect either clinical efficacy or toxicity. With anticancer drugs, however, there is much less margin for error, due to their very narrow therapeutic index. Therefore, it is crucially important to understanding the mechanism of action, pharmacokinetics and pharmacodynamics of each anticancer drug in order to give chemotherapy in safety. Overview of the pharmacological functions of anticancer agent using in malignant lymphoma is the subject of this chapter. PMID:24724404

  15. A feasibility study in oesophageal carcinoma using deep loco-regional hyperthermia combined with concurrent chemotherapy followed by surgery.

    PubMed

    Albregts, M; Hulshof, M C C M; Zum Vörde Sive Vörding, P J; van Lanschot, J J B; Richel, D J; Crezee, H; Fockens, P; van Dijk, J D P; González González, D

    2004-09-01

    This phase I-II study investigated the feasibility of external deep loco-regional hyperthermia in localized primarily operable carcinoma of the thoracic oesophagus and gastro-oesophageal junction. Toxicity when combining neo-adjuvant hyperthermia with concurrent chemotherapy (CDDP and etoposide) was evaluated. Hyperthermia was given with a four antenna array, operating at 70 MHz arranged around the thorax. Temperatures were monitored rectally, intra-oesophageal at tumour level and intramuscular near the spine. In four steps, a thermal dose escalation was performed from 15-60 min of heating to 41 degrees C with two patients in each step. The combined treatment courses were repeated every 3 weeks for a maximum of four courses. From January 1999-February 2002, 31 patients were included. Pre-treatment tumour stage mainly consisted of T3N1 (stage III) tumours, with a mean length of 6 cm. The maximum tumour temperature failed to reach at least 41 degrees C in five patients during the test session of hyperthermia alone. Combined hyperthermia and chemotherapy was given 55 times in 26 patients. The amplitude was set at a ratio between top:bottom:left:right = 1:3:3:3, with a power range of 800-1000 W. Thermal data showed that is was technically feasible to heat the oesophagus; the median results were T(90) = 39.3 degrees C, T(50) = 40 degrees C, T(10) = 40.7 degrees C and a median T(max) = 41.9 degrees C. In more distally located tumours higher temperatures were reached. In one patient, a transient grade 2 sensory neuropathy was seen. Further toxicity was mainly of haematological origin. Blisters or fat necrosis were not observed. Twenty-two patients underwent oesophageal-cardia resection with gastric tube reconstruction. There was no report of complications in the post-operative phase, which could be contributed to either the prior chemotherapy or the hyperthermia. PMID:15370820

  16. Induction chemotherapy with concurrent chemoradiotherapy versus concurrent chemoradiotherapy for locally advanced squamous cell carcinoma of head and neck: a meta-analysis.

    PubMed

    Zhang, Lijuan; Jiang, Nan; Shi, Yuexian; Li, Shipeng; Wang, Peiguo; Zhao, Yue

    2015-01-01

    Concurrent chemoradiotherapy (CCRT) has been considered to be the standard of care for locally advanced squamous cell carcinoma of head and neck (LA-SCCHN). Whether induction chemotherapy (IC) with CCRT will further improve the clinical outcomes or not is still unclear. We conducted a meta-analysis to compare the two regimens for LA-SCCHN. Literature searches were carried out in PubMed, Embase, Cochrane Library and Chinese Biology Medicine from inception to November 2014. Five prospective randomized controlled trials (RCTs) with 922 patients were included in meta-analysis. Results were expressed as hazard ratios (HRs) or relative risks (RRs) with 95% confidence intervals (CIs). Compared with CCRT, IC with CCRT showed no statistically significant differences in overall survival (OS), progression-free survival (PFS), overall response rate (ORR) or locoregional recurrence rate (LRR), but could increase risks of grade 3-4 febrile neutropenia (P?=?0.0009) and leukopenia (P?=?0.04). In contrast, distant metastasis rate (DMR) decreased (P?=?0.006) and complete response rate (CR) improved (P?=?0.010) for IC with CCRT. In conclusion, the current studies do not support the use of IC with CCRT over CCRT, and the further positioning of IC with CCRT as standard treatment for LA-SCCHN will come from more RCTs directly comparing IC followed by CCRT with CCRT. PMID:26041604

  17. Induction chemotherapy with concurrent chemoradiotherapy versus concurrent chemoradiotherapy for locally advanced squamous cell carcinoma of head and neck: a meta-analysis

    PubMed Central

    Zhang, Lijuan; Jiang, Nan; Shi, Yuexian; Li, Shipeng; Wang, Peiguo; Zhao, Yue

    2015-01-01

    Concurrent chemoradiotherapy (CCRT) has been considered to be the standard of care for locally advanced squamous cell carcinoma of head and neck (LA-SCCHN). Whether induction chemotherapy (IC) with CCRT will further improve the clinical outcomes or not is still unclear. We conducted a meta-analysis to compare the two regimens for LA-SCCHN. Literature searches were carried out in PubMed, Embase, Cochrane Library and Chinese Biology Medicine from inception to November 2014. Five prospective randomized controlled trials (RCTs) with 922 patients were included in meta-analysis. Results were expressed as hazard ratios (HRs) or relative risks (RRs) with 95% confidence intervals (CIs). Compared with CCRT, IC with CCRT showed no statistically significant differences in overall survival (OS), progression-free survival (PFS), overall response rate (ORR) or locoregional recurrence rate (LRR), but could increase risks of grade 3–4 febrile neutropenia (P?=?0.0009) and leukopenia (P?=?0.04). In contrast, distant metastasis rate (DMR) decreased (P?=?0.006) and complete response rate (CR) improved (P?=?0.010) for IC with CCRT. In conclusion, the current studies do not support the use of IC with CCRT over CCRT, and the further positioning of IC with CCRT as standard treatment for LA-SCCHN will come from more RCTs directly comparing IC followed by CCRT with CCRT. PMID:26041604

  18. 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. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah (United States); Bentz, Brandon G.; Hunt, Jason P.; Buchman, Luke O. [Division of Otolaryngology-Head Neck Surgery, Department of Surgery, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah (United States); Agarwal, Neeraj [Department of Internal Medicine, Oncology Division, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah (United States); Hitchcock, Ying J., E-mail: ying.hitchcock@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, Utah (United States)

    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.

  19. Chemotherapy

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program explains how chemotherapy works as a treatment for cancer and its common side effects. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

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

    SciTech Connect

    Herrera, Higmar; Yanez, Elvia; Lopez, Jesus [Centro Estatal de Cancerologia de Durango, Victoria de Durango, Durango (Mexico); ISSSTE General Hospital Dr. Santiago Ramon y Cajal, Victoria de Durango, Durango (Mexico)

    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.

  1. 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 [Department of Radiotherapy, Hospital Tenon AP-HP, Paris (France)]. E-mail: alain.toledano@gmail.com; Garaud, Pascal [Department of Radiotherapy Henry Kaplan, Hospital Bretonneau, Tours (France); Serin, Daniel [Department of Radiotherapy, Institut Sainte-Catherine, Avignon (France); Fourquet, Alain [Department of Radiotherapy, Institut Curie, Paris (France); Bosset, Jean-Francois [Department of Radiotherapy, Hospital Minjoz, Besancon (France); Breteau, Noel [Department of Radiotherapy, Hospital La Source, Orleans (France); Body, Gilles [Department of Gynecology, Hospital Bretonneau, Tours (France); Azria, David [Department of Radiotherapy, CRLCC Val d'Aurelle, Montpellier (France); Le Floch, Olivier [Department of Radiotherapy Henry Kaplan, Hospital Bretonneau, Tours (France); Calais, Gilles [Department of Radiotherapy Henry Kaplan, Hospital Bretonneau, Tours (France)

    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.

  2. Long-term outcome of concurrent chemotherapy and reirradiation for recurrent and second primary head-and-neck squamous cell carcinoma

    SciTech Connect

    Salama, Joseph K. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Vokes, Everett E. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Section of Hematology/Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Cancer Research Center, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Milano, Michael T. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Kao, Johnny [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Stenson, Kirsten M. [Cancer Research Center, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Section of Otolaryngology/Head and Neck Surgery, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Witt, Mary Ellyn R.N. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Haraf, Daniel J. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States) and Cancer Research Center, University of Chicago Pritzker School of Medicine, Chicago, IL (United States)]. E-mail: dharaf@radonc.uchicago.edu

    2006-02-01

    Purpose: To define favorable pretreatment characteristics for overall survival (OS), progression-free survival (PFS), locoregional control, and freedom from distant metastasis for patients with recurrent and second primary head-and-neck cancer treated with concomitant chemotherapy and reirradiation. Methods and Materials: Our study population comprised a subset of 115 previously irradiated patients without overt metastases from 304 poor-prognosis head-and-neck cancer patients treated in seven consecutive phase I-II protocols. Of the 115 patients, 49, who had undergone surgical resection, were treated with a median of four cycles of concurrent chemotherapy and reirradiation and 66, who had not undergone surgical resection, were treated with a median of five cycles. The following regimens were used: 5-fluorouracil and hydroxyurea concurrent with reirradiation (FHX) (n = 14), cisplatin plus FHX (n = 23), paclitaxel plus FHX (n = 42), gemcitabine plus paclitaxel and 5-fluorouracil concurrent with reirradiation (n = 26), and irinotecan plus FHX (n = 10). Results: The median lifetime radiation dose was 131 Gy. The median follow-up for surviving patients was 67.4 months (range, 18.5-158.7). The median OS and PFS was 11 and 7 months (range, 0.2-158.7), respectively. The 3-year OS, PFS, locoregional control, and freedom from distant metastasis rate was 22%, 33%, 51%, and 61%, respectively. Multivariate analysis identified reirradiation dose, triple agent (cisplatin-, paclitaxel-, or gemcitabine-containing chemotherapy), and surgery before protocol treatment as independently prognostic for OS, PFS, and locoregional control. Triple-agent chemotherapy was prognostic for freedom from distant metastasis. Nineteen patients died of treatment-related toxicity, five of these of carotid hemorrhage. Conclusion: For recurrent and second primary head-and-neck cancer, trimodality therapy with surgery, concurrent chemotherapy, and reirradiation for a full second dose offers potential for long-term survival. Owing to the substantial toxicity and lack of an optimal regimen, reirradiation of recurrent head-and-neck cancer should be limited to clinical trials.

  3. Oracles for Checking Temporal Properties of Concurrent Systems

    Microsoft Academic Search

    Laura K. Dillon; Qing Yu

    1994-01-01

    Verifying that test executions are correct is a crucial step in the testing process. Unfortunately, it can be a very arduous and error-prone step, especially when testing a concurrent system. System developers can therefore benefit from oracles automating the verification of test executions.This paper examines the use of Graphical Interval Logic (GIL) for specifying temporal properties of concurrent systems and

  4. Software Design Methods for Concurrent and Real-Time Systems

    Microsoft Academic Search

    Hassan Gomaa

    1994-01-01

    This tutorial surveys the state of the art in software design methods for concurrent and real-time systems. The important concepts of concurrent tasking, fundamental to the design of this class of system, information hiding, fundamental to the design of modifiable and reusable components, finite state machines, for addressing the behavioral aspects of a system, and object-oriented concepts, for the systematic

  5. Hematopoietic toxicity of regional radiation therapy. Correlations for combined modality therapy with systemic chemotherapy

    SciTech Connect

    Abrams, R.A.; Lichter, A.S.; Bromer, R.H.; Minna, J.D.; Cohen, M.H.; Deisseroth, A.B.

    1985-04-01

    Using circulating granulocyte-monocyte precursor colony-forming units in culture (CFUc) numbers as a probe along with standard blood count (CBC), the authors have quantitatively examined the hematopoietic toxicity of conventionally fractionated radiation therapy (RT) when combined with concurrent systemic chemotherapy or when used alone. Among 20 patients with limited stage small cell lung cancer receiving systemic chemotherapy with cyclophosphamide, CCNU, and methotrexate, the addition of involved field chest RT resulted in increased hematopoietic toxicity as judged by increased need for platelet transfusion (P less than 0.05) and decreased frequency of measurable CFUc (P less than 0.04). Among 22 patients receiving regional radiotherapy alone consistent hematopoietic toxicity was also observed. This toxicity, although generally of only mild to moderate clinical significance, was detected earlier and to a greater degree in patients who required radiation to larger treatment volumes, who had significant amounts of bone marrow in the port, and who had a high percentage of cardiac output flowing through the port. These data suggest that the hematopoietic toxicity of regional radiotherapy may be additive to that of concurrent systemic chemotherapy and may occur more promptly and to a greater degree when treatment volumes are larger or incorporate increased amounts of marrow volume or cardiac output.

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

    SciTech Connect

    Yau, T.K. [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China)]. E-mail: tkokyau@gmail.com; Lee, Anne [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Wong, Dominique [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Pang, Ellie S.Y. [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Ng, W.T. [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Yeung, Rebecca [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Soong, Inda S. [Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China)

    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.

  7. 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

  8. Acute Myeloid Leukemia: Nanomedicine drug delivery system could improve chemotherapy

    E-print Network

    Pfeifer, Holger

    Acute Myeloid Leukemia: Nanomedicine drug delivery system could improve chemotherapy Chemotherapy is still the backbone of today's cancer treatment. This is exemplified by acute myeloid leukemia (AML generation anti-leukemia treatments. The results have been published in the Journal of Advanced Healthcare

  9. Accelerated radiotherapy and concurrent chemotherapy for patients with contralateral central or mediastinal lung cancer relapse after pneumonectomy

    PubMed Central

    Abu Jawad, Jehad; Gkika, Eleni; Freitag, Lutz; Lübcke, Wolfgang; Welter, Stefan; Gauler, Thomas; Schuler, Martin; Eberhardt, Wilfried Ernst Erich; Stamatis, Georgios; Stuschke, Martin

    2015-01-01

    Background Treatment options are very limited for patients with lung cancer who experience contralateral central or mediastinal relapse following pneumonectomy. We present results of an accelerated salvage chemoradiotherapy regimen. Methods Patients with localized contralateral central intrapulmonary or mediastinal relapse after pneumonectomy were offered combined chemoradiotherapy including concurrent weekly cisplatin (25 mg/m2) and accelerated radiotherapy [accelerated fractionated (AF), 60 Gy, 8×2 Gy per week] to reduce time for repopulation. Based on 4D-CT-planning, patients were irradiated using multifield intensity-modulated radiotherapy (IMRT) or helical tomotherapy. Results Between 10/2011 and 12/2012, seven patients were treated. Initial stages were IIB/IIIA/IIIB: 3/1/3; histopathological subtypes scc/adeno/large cell: 4/1/2. Tumour relapses were located in mediastinal nodal stations in five patients with endobronchial tumour in three patients. The remaining patients had contralateral central tumour relapses. All patients received 60 Gy (AF), six patients received concurrent chemotherapy. Median dose to the remaining contralateral lung, esophagus, and spinal cord was 6.8 (3.3-11.4), 8.0 (5.1-15.5), and 7.6 (2.8-31.2) Gy, respectively. With a median follow-up of 29 [17-32] months, no esophageal or pulmonary toxicity exceeding grade 2 [Common terminology criteria for adverse events (CTC-AE) v. 3] was observed. Median survival was 17.2 months, local in-field control at 12 months 80%. Only two local recurrences were observed, both in combination with out-field metastases. Conclusions This intensified accelerated chemoradiotherapy schedule was safely applicable and offers a curative chance in these pretreated frail lung cancer patients. PMID:25922702

  10. Predictors of Acute Esophagitis in Lung Cancer Patients Treated With Concurrent Three-Dimensional Conformal Radiotherapy and Chemotherapy

    SciTech Connect

    Rodriguez, Nuria [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain); Department of Medicine, Universitat Autonoma de Barcelona, Barcelona (Spain)], E-mail: nrodriguez@imas.imim.es; Algara, Manuel [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain); Universitat Pompeu Fabra, Barcelona (Spain); Foro, Palmira [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain); Lacruz, Marti [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain); Universitat Pompeu Fabra, Barcelona (Spain); Reig, Anna; Membrive, Ismael; Lozano, Joan; Lopez, Jose Luis [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain); Quera, Jaime [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain); Universitat Pompeu Fabra, Barcelona (Spain); Fernandez-Velilla, Enric; Sanz, Xavier [Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona (Spain)

    2009-03-01

    Purpose: To evaluate the risk factors for acute esophagitis (AET) in lung cancer patients treated with concurrent 3D-CRT and chemotherapy. Methods and Materials: Data from 100 patients treated with concurrent chemoradiotherapy with a mean dose of 62.05 {+-} 4.64 Gy were prospectively evaluated. Esophageal toxicity was graded according to criteria of the Radiation Therapy Oncology Group. The following dosimetric parameters were analyzed: length and volume of esophagus in treatment field, percentage of esophagus volume treated to {>=}10, {>=}20, {>=}30, {>=}35, {>=}40, {>=}45, {>=}50, {>=}55, and {>=}60 Gy, and the maximum (D{sub max}) and mean doses (D{sub mean}) delivered to the esophagus. Also, we developed an esophagitis index (EI) to account the esophagitis grades over treatment time. Results: A total of 59 patients developed AET (Grade 1, 26 patients; Grade 2, 29 patients; and Grade 3, 4 patients). V50 was associated with AET duration (p = 0.017), AET Grade 1 duration (p = 0.016), maximum analgesia (p = 0.019), esophagitis index score (p = 0.024), and AET Grade {>=}1 (p = 0.058). If V50 is <30% there is a 47.3% risk of AET Grade {>=}1, which increases to 73.3% if V50 is {>=}30% (p = 0.008). The predictive abilities of models (sensitivity and specificity) were calculated by receiver operating characteristic curves. Conclusions: According to the receiver operating characteristic curve analysis, the 30% of esophageal volume receiving {>=}50 Gy was the most statistically significant factor associated with AET Grade {>=}1 and maximum analgesia (A{sub max}). There was an association with AET Grade {>=}2 but it did not achieve statistical significance (p = 0.076)

  11. Concurrency Control in Distributed Database Systems

    Microsoft Academic Search

    Philip A. Bernstein; Nathan Goodman

    1981-01-01

    In this paper we survey, consolidate, and present the state of the art in distributed database concurrency control. The heart of our analysts is a decomposition of the concurrency control problem into two major subproblems: read-write and write-write synchronization. We describe a series of synchromzation techniques for solving each subproblem and show how to combine these techniques into algorithms for

  12. A graphical interval logic for specifying concurrent systems

    Microsoft Academic Search

    Laura K. Dillon; G. Kutty; Louise E. Moser; P. M. Melliar-Smith; Y. S. Ramakrishna

    1994-01-01

    This article describes a graphical interval logic that is the foundation of a tool set supporting formal specification and verification of concurrent software systems. Experience has shown that most software engineers find standard temporal logics difficult to understand and use. The objective of this article is to enable software engineers to specify and reason about temporal properties of concurrent systems

  13. Decentralized Modular Control of Concurrent Discrete Event Systems

    E-print Network

    Kumar, Ratnesh

    Decentralized Modular Control of Concurrent Discrete Event Systems Changyan Zhou, Ratnesh Kumar, and Ramavarapu S. Sreenivas Abstract-- The paper studies decentralized modular control of concurrent discrete event systems that are composed of multiple interacting modules. A modular supervisor consists of a set

  14. System level concurrency control for distributed database systems

    Microsoft Academic Search

    Daniel J. Rosenkrantz; Richard Edwin Stearns; Philip M. Lewis II

    1978-01-01

    A distributed database system is one in which the database is spread among several sites and application programs “move” from site to site to access and update the data they need. The concurrency control is that portion of the system that responds to the read and write requests of the application programs. Its job is to maintain the global consistency

  15. Concurrence Vectors for Entanglement of High-dimensional Systems

    E-print Network

    You-Quan Li; Guo-Qiang Zhu

    2005-08-08

    The concurrence vectors are proposed by employing the fundamental representation of $A_n$ Lie algebra, which provides a clear criterion to evaluate the entanglement of bipartite system of arbitrary dimension for both pure and mixed states. Accordingly, a state is separable if the norm of its concurrence vector vanishes. The state vectors related to SU(3) states and SO(3) states are discussed in detail. The sign situation of nonzero components of concurrence vectors of entangled bases presents a simple criterion to judge whether the whole Hilbert subspace spanned by those bases is entangled, or there exists entanglement edge. This is illustrated in terms of the concurrence surfaces of several concrete examples.

  16. [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

  17. 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., E-mail: allen.chen@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA (United States); Farwell, D. Gregory [Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA (United States); Lau, Derick H. [Department of Medical Oncology, University of California Davis School of Medicine, Sacramento, CA (United States); Li Baoqing [Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA (United States); Luu, Quang; Donald, Paul J. [Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA (United States)

    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.

  18. 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.

  19. A Case Study in Transformational Design of Concurrent Systems

    Microsoft Academic Search

    Ernst-rüdiger Olderog; Stephan Rössig

    1993-01-01

    . We explain a transformationalapproach to the design and verification ofcommunicating concurrent systems. Thetransformations start form specifications thatcombine trace-based with state-based assertionalreasoning about the desired communicationbehaviour, and yield concurrent implementations.We illustrate our approach by acase study proving correctness of implementationsof safe and regular registers allowingconcurrent writing and reading phases, originallydue to Lamport.1...

  20. Concurrency control in heterogeneous distributed database systems 

    E-print Network

    Rahman, Md. Rezaur

    1992-01-01

    database systein (HDDBS) is a challenge to the &searcher because of the autonomy requirement of the component DBMSs which is needed to preserve the investment already made on these ilatabases. Because of the local auton- i. ~rr&y, maintaining global... consistency is complicated, since the global transaction manager cannot be aware of the concurrently executing local transactions which are accessing the &asne database as the global transactions. In this thesis, we identify the problem of concurrency...

  1. Concurrent intensive chemotherapy and imatinib before and after stem cell transplantation in newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia. Final results of the CSTIBES02 trial

    PubMed Central

    Ribera, Josep-Maria; Oriol, Albert; González, Marcos; Vidriales, Belén; Brunet, Salut; Esteve, Jordi; del Potro, Eloy; Rivas, Concepción; Moreno, Maria-José; Tormo, Mar; Martín-Reina, Victoria; Sarrá, Josep; Parody, Ricardo; de Oteyza, Jaime Pérez; Bureo, Encarna; Bernal, Maria-Teresa

    2010-01-01

    Background Imatinib, given concurrently or alternating with chemotherapy, has improved the response and survival of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) but relapses are still frequent. The aim of this study was to evaluate the feasibility and results of giving imatinib concurrently with intensive chemotherapy, stem cell transplantation and post-transplant imatinib maintenance therapy in patients with newly diagnosed Ph+ ALL. Design and Methods This was a phase II study of patients with newly diagnosed Ph+ ALL given standard chemotherapy, together with imatinib (400 mg/day) until stem cell transplantation, followed by imatinib maintenance therapy for all patients regardless of the molecular status of the disease. Results Of the 30 patients included, 27 (90%) achieved complete remission, one was resistant to treatment and two died during induction therapy. The percentages of major and complete molecular responses were 86% and 21% after induction, and 81% and 65% after consolidation, respectively. Similar results were observed assessing minimal residual disease by flow cytometry. Of the 27 patients who achieved complete remission, 21 underwent stem cell transplantation (16 allogeneic, 5 autologous). Imatinib (400 mg/day) could be administered after transplantation for a median of 3.9 months in 12 patients, although it was interrupted in 10 patients (in 2 cases because of side effects of the drug). Nine patients relapsed, four before and five after stem cell transplantation and eight patients died of transplant-related causes. With a median follow-up of 4.1 years, the probabilities (95% CI) of disease-free and overall survival were 30% (15% to 45%) and 30% (16% to 45%), respectively. Conclusions These results confirm that imatinib is an effective first-line treatment for adult Ph+ ALL when given concurrently with chemotherapy, making stem cell transplantation feasible in a high proportion of patients. However, post-transplantation imatinib administration was limited, mainly because of transplantation-derived complications rather than drug-specific toxicity. PMID:19797728

  2. The efficacy of concurrent cisplatin and 5-flurouracil chemotherapy and radiation therapy for locally advanced cancer of the uterine cervix

    PubMed Central

    Choi, Il Jung; Park, Eunku Seul; Han, Myung Seok; Choi, Youngmin; Je, Goo Hwa; Kim, Hyun Ho

    2008-01-01

    Objective To evaluate the efficacy of concurrent chemoradiation (CCRT) using 5-flurouracil (5-FU) and cisplatin for locally advanced cervical cancer. Methods We reviewed the medical records of 57 patients with locally advanced cervical cancer (stage IIB-IVA and bulky IB2-IIA tumor) who underwent the CCRT at Dong-A University Hospital from January 1997 to June 2007. The CCRT consisted of 5-FU, cisplatin and pelvic radiation. Every three weeks, 75 mg/m2 cisplatin was administered on the first day of each cycle and 5-FU was infused at the dose of 1,000 mg/m2/d from the second day to the fifth day of each cycle. Radiation was administered to the pelvis at a daily dose of 1.8 Gy for five days per week until a medium accumulated dose reached to 50.4 Gy. If necessary, the radiation field was extended to include paraaortic lymph nodes. Consolidation chemotherapy was performed using 5-FU and cisplatin. Results Fifty-seven patients were enrolled and the median follow-up duration was 53 months (range 7-120 months). The overall response rate was 91.5% (74% complete response and 17.5% partial response). The 5-year overall survival and 3-year progression free survival rates were 69.4% and 74.9%, respectively. During the follow-up period (median 23 months, range 7-60 months), fourteen patients were diagnosed as recurrent disease. Conclusion CCRT with 5-FU and cisplatin which is the primary treatment for patients with locally advanced cervical cancer was effective and well tolerated. PMID:19471554

  3. Adjuvant sequential chemotherapy with doxorubicin plus cyclophosphamide, methotrexate, and fluorouracil (ACMF) with concurrent radiotherapy in resectable advanced breast cancer.

    PubMed

    Hsieh, C I; Liu, M C; Cheng, S H; Liu, T W; Chen, C M; Chen, C M; Tsou, M H; Huang, A T

    2000-04-01

    Doxorubicin (Adriamycin) is an anthracycline effective in breast cancer. Despite a worldwide acceptance of Adriamycin in the adjuvant chemotherapy to maximize the survival benefit in the higher risk patients with breast cancer with promising results, oncologists in general do not favorably consider anthracyclines in the adjuvant treatment setting because of concern about the acute and chronic drug-related toxicity. For high-risk patients with breast cancer with more than three positive axillary lymph nodes, this series adopted a modified sequential regimen of ACMF first with Adriamycin (A) as a single agent in 3-weekly administration for three courses, and then a combination of cyclophosphamide, methotrexate, fluorouracil (CMF) every 3 to 4 weeks for six courses given in an outpatient setting concurrent with radiation therapy as an adjuvant treatment. A total of 56 patients underwent modified radical mastectomy and 3 others breast conservation surgery for their invasive breast cancer. Forty-seven (84%) patients completed the intended adjuvant treatment and 1 patient died of infection from treatment-related neutropenia. As a whole, the 3-year overall survival and disease-free survival rates of 56 patients analyzed were 82.3% and 64.4%, respectively. In this high-risk group, patients with four to nine positive nodes showed a slightly better trend of survival than those with 10 or more positive nodes without reaching statistically significant difference (36-month overall survival: 90.9% vs. 72.5%, p = 0.06; disease-free survival: 78.7% vs. 47.8%, p = 0.38). In this entire group of patients, locoregional recurrence was absent. A total of 55 episodes of grade III and IV hematologic toxicity were observed, with only one death from neutropenic sepsis. This modified ACMF regimen offers a good survival rate in breast cancer patients with more than three positive axillary lymph nodes. When these patients are carefully managed, the morbidity and mortality related to the treatment are low. PMID:10776970

  4. 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, E-mail: pianozmq@hotmail.co [Department of Gynecologic Oncology, Cancer Hospital, and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China); Liu Suping; Wang, Xiang-E. [Department of Gynecologic Oncology, Cancer Hospital, and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China)

    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.

  5. On Convergence of Concurrent Systems under Regular Interactions

    E-print Network

    Liberzon, Daniel

    On Convergence of Concurrent Systems under Regular Interactions Pavithra Prabhakar, Sayan Mitra, Mahesh Viswanathan University of Illinois at Urbana-Champaign Abstract. Convergence is often the key convergence (asymptotic stability) have been extensively studied by con- trol theorists. In particular

  6. Concurrency control in a system for distributed databases (SDD1)

    Microsoft Academic Search

    Philip A. Bernstein; David W. Shipman; James B. Rothnie Jr.

    1980-01-01

    This paper presents the concurrency control strategy of SDD-1. SDD-1, a System for Distributed Databases, is a prototype distributed database system being developed by Computer Corporation of America. In SDD-1, portions of data distributed throughout a network may be replicated at multiple sites. The SDD-1 concurrency control guarantees database consistency in the face of such distribution and replication.This paper is

  7. PACT: An Experiment in Integrating Concurrent Engineering Systems

    Microsoft Academic Search

    Mark R. Cutkosky; Robert S. Engelmore; Richard E. Fikes; Michael R. Genesereth; Thomas R. Gruber; William S. Mark; Jay M. Tenenbaum; Jay C. Weber

    1993-01-01

    The Palo Alto Collaborative Testbed (PACT) is a laboratory for joint experimentation incomputer-aided concurrent engineering being pursued by research groups at Stanford University,Lockheed, Hewlett-Packard, and Enterprise Integration Technologies. The current prototypeintegrates four preexisting concurrent engineering systems into a common framework. Eachindividual system is used to model different aspects of a small robotic manipulator, and toreason about them from a different...

  8. 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.

  9. 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, E-mail: ryu@kcch.re.kr [Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Lee, Won-Moo; Kim, Kidong [Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Park, Sang-Il [Department of Gynecologic Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan (Korea, Republic of); Kim, Beob-Jong; Kim, Moon-Hong; Choi, Seok-Cheol [Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Cho, Chul-Koo [Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Nam, Byung-Ho [Cancer Biostatistics Branch, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Lee, Eui-Don [Department of Gynecologic Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan (Korea, Republic of)

    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.

  10. Radiation therapy for T2N0 laryngeal cancer: A retrospective analysis for the impact of concurrent chemotherapy on local control

    SciTech Connect

    Akimoto, Tetsuo [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan)]. E-mail: takimoto@showa.gunma-u.ac.jp; Nonaka, Tetsuo [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan); Kitamoto, Yoshizumi [Department of Radiology, Gunma Prefectural Gunma Cancer Center, Gunma (Japan); Ishikawa, Hitoshi [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan); Ninomiya, Hiroshi [Department of Otolaryngology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan); Chikamatsu, Kazuaki [Department of Otolaryngology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan); Furuya, Nobuhiko [Department of Otolaryngology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan); Hayakawa, Kazushige [Department of Radiology, Kitasato University, Kitasato (Japan); Mitsuhashi, Norio [Department of Radiology, Tokyo Women's Medical University, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma (Japan)

    2006-03-15

    Purpose: The impact of concurrent chemotherapy on the local control in patients with T2N0 laryngeal cancer who receive radiation therapy (RT) was evaluated. Methods and Materials: Sixty-three patients with T2N0 laryngeal cancer who were treated by definitive RT were analyzed. The primary site of the cancer was the glottis in 50 patients, the supraglottis in 9 patients, and the subglottis in 4 patients. Thirty-six patients were treated by RT alone and the remaining 27 patients received concurrent chemoradiotherapy (CRT). Results: Complete response (CR) was obtained in 92% of the patients who received RT alone and 100% of the patients who received CRT. Voice preservation in the group who received CRT (89%) was significantly higher than that in the group treated by RT alone (61%). The 5-year disease-free survival rates in those who received concurrent CRT was significantly superior to that in the patients who received RT alone, although no significant difference was seen in the cause-specific survival rate between the 2 groups. The multivariate analysis revealed that the treatment method (RT alone vs. CRT) was the most significant risk factor that predicted recurrence after RT. Conclusion: Concurrent CRT had a positive impact on the local control of T2N0 laryngeal cancer.

  11. Modeling Biological Systems in Stochastic Concurrent Constraint Programming

    E-print Network

    Bortolussi, Luca

    Modeling Biological Systems in Stochastic Concurrent Constraint Programming Luca Bortolussi AlbertoCCP) for modeling biological systems. We provide a library of sCCP processes that can be used to describe Computational Systems Biology is an extremely fertile field, where many different modeling techniques are used

  12. Modeling Biological Systems in Stochastic Concurrent Constraint Programming

    E-print Network

    Bortolussi, Luca

    Modeling Biological Systems in Stochastic Concurrent Constraint Programming Luca Bortolussi1 biological systems. We provide a library of sCCP processes that can be used to describe straightforwardly Systems Biology is a extremely fertile field, where many different mod- eling techniques are used [7

  13. EcliPSe: A System for High Performance Concurrent Simulation

    Microsoft Academic Search

    Vernon Rego

    1991-01-01

    SUMMARY A description of a system which provides for the concurrent execution of stochastic simulation applications is presented. The EcliPSe system provides high-level simulation primitives that enable common simulation tasks. An application programmer describes the simulation process in terms of these primitives using a sequential computation model. The system transparently replicates appropriate sections of the simulation when the program is

  14. The engineering of concurrent simulations of complex systems

    Microsoft Academic Search

    Fiona A. C. Polack; Paul S. Andrews; Adam T. Sampson

    2009-01-01

    Concurrent process-oriented programming is a natural medium for simulating complex systems, particularly systems where many simple components interact in an environ- ment (which may itself be complex). There is little guidance for engineering complex systems simulation. In the context of simulation work to support immunological research, we explore relevant approaches to modelling, and draw on concepts from dependable and high-integrity

  15. Simulating Concurrent Intrusions for Testing Intrusion Detection Systems

    E-print Network

    California at Davis, University of

    Simulating Concurrent Intrusions for Testing Intrusion Detection Systems: Parallelizing Intrusions For testing Intrusion Detection Systems (IDS), it is essen­ tial that we be able to simulate intrusions­ quential intrusive script into a set of parallel intrusive scripts (formed by a group of parallel threads

  16. Visual Programming of Concurrent Object-Oriented Systems

    Microsoft Academic Search

    Stephan Philippi

    2001-01-01

    In order to be able to understand the functionality of even small concurrent systems, visual and formally based notations for their description are needed. The handling of complex systems additionally demands for notations of- fering adequate structuring capabilities. From a theoreti- cal point of view the combination of Petri-Nets and object- oriented concepts is a promising approach in this area.

  17. Radiotherapy concurrently with weekly cisplatin, followed by adjuvant chemotherapy, for N2-3 nasopharyngeal cancer: a multicenter trial of the Forum for Nuclear Cooperation in Asia.

    PubMed

    Ohno, Tatsuya; Thinh, Dang Huy Quoc; Kato, Shingo; Devi, C R Beena; Tung, Ngo Thanh; Thephamongkhol, Kullathorn; Calaguas, Miriam Joy C; Zhou, Juying; Chansilpa, Yaowalak; Supriana, Nana; Erawati, Dyah; Banu, Parvin Akhter; Koo, Cho Chul; Kobayashi, Kunihiko; Nakano, Takashi; Tsujii, Hirohiko

    2013-05-01

    The purpose of this study was to evaluate the efficacy and toxicity of radiotherapy concurrently with weekly cisplatin, followed by adjuvant chemotherapy, for the treatment of N2-3 nasopharyngeal cancer (NPC) in Asian countries, especially regions of South and Southeast Asian countries where NPC is endemic. Between 2005 and 2009, 121 patients with NPC (T1-4 N2-3 M0) were registered from Vietnam, Malaysia, Indonesia, Thailand, The Philippines, China and Bangladesh. Patients were treated with 2D radiotherapy concurrently with weekly cisplatin (30 mg/m (2)), followed by adjuvant chemotherapy, consisting of cisplatin (80 mg/m(2) on Day 1) and fluorouracil (800 mg/m(2) on Days 1-5) for 3 cycles. Of the 121 patients, 56 patients (46%) required interruption of RT. The reasons for interruption of RT were acute non-hematological toxicities such as mucositis, pain and dermatitis in 35 patients, hematological toxicities in 11 patients, machine break-down in 3 patients, poor general condition in 2 patients, and others in 8 patients. Of the patients, 93% completed at least 4 cycles of weekly cisplatin during radiotherapy, and 82% completed at least 2 cycles of adjuvant chemotherapy. With a median follow-up time of 46 months for the surviving 77 patients, the 3-year locoregional control, distant metastasis-free survival and overall survival rates were 89%, 74% and 66%, respectively. No treatment-related deaths occurred. Grade 3-4 toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of the patients, respectively. In conclusion, further improvement in survival and locoregional control is necessary, although our regimen showed acceptable toxicities. PMID:23192700

  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. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina (United States); Wahlquist, Amy E. M.S. [Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina (United States); Shirai, Keisuke [Department of Medicine, Division of Hematology and Oncology, Medical University of South Carolina, Charleston, South Carolina (United States); Garrett-Mayer, Elizabeth [Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina (United States); Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina (United States); Aguero, Eric G.; Fortney, John A. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina (United States); Sherman, Carol A. [Department of Medicine, Division of Hematology and Oncology, Medical University of South Carolina, Charleston, South Carolina (United States); Sharma, Anand K. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina (United States)], E-mail: sharmaak@musc.edu

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

    SciTech Connect

    Prosnitz, Robert G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)]. E-mail: robert.prosnitz@duke.edu; Yao, Bin M.S. [Amgen, Inc. Thousand Oaks, CA (United States); Farrell, Catherine L. [Amgen, Inc. Thousand Oaks, CA (United States); Clough, Robert [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Brizel, David M. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    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.

  20. Performance of Concurrent Rendezvous Systems with Complex Pipeline Structures

    E-print Network

    Woodside, C. Murray

    Performance of Concurrent Rendezvous Systems with Complex Pipeline Structures Real February 11, 1998 Abstract The term ``complex pipeline'' describes a set of tasks which process incoming data in a sequence, like a pipeline, but have various kinds of parallel execution steps coupled

  1. A Graphical Interval Logic Toolset for Verifying Concurrent Systems

    Microsoft Academic Search

    G. Kutty; Y. S. Ramakrishna; Louise E. Moser; Laura K. Dillon; P. M. Melliar-smith

    1993-01-01

    Graphical Interval Logic is the foundation of a toolset we have developed to support formal specification and verification of concurrent systems. The logic is a discrete linear-time temporal logic with the distinguishing feature that formulas in the logic have an intuitive graphical representation. The toolset includes a graphical editor that allows the user to compose and edit graphical formulas on

  2. A Mechanically Verified Proof System for Concurrent Programs

    E-print Network

    Boyer, Robert Stephen

    , of Computational Logic, Inc., the Defense Advanced Research Projects Agency or the U.S. Government. #12; Abstract­9951 This work was supported in part at Computational Logic, Inc., by the Defense Advanced Research ProjectsA Mechanically Verified Proof System for Concurrent Programs David M. Goldschlag Technical Report

  3. A Mechanically Verified Proof System for Concurrent Programs

    E-print Network

    Boyer, Robert Stephen

    , of Computational Logic, Inc., the Defense Advanced Research Projects Agency or the U.S. Government. #12;Abstract-9951 This work was supported in part at Computational Logic, Inc., by the Defense Advanced Research ProjectsA Mechanically Verified Proof System for Concurrent Programs David M. Goldschlag Technical Report

  4. A system for design and concurrent engineering under imprecision

    Microsoft Academic Search

    Kyeongtaek Kim; Denis R. Cormier; Peter J. O'Grady; Robert E. Young

    1995-01-01

    This paper proposes an approach to handling imprecision in design and concurrent engineering systems by using interval analysis and constraint networks. By allowing design parameters to be specified with intervals rather than exact points, this approach permits designers to iteratively transform vague conceptual designs into detailed final designs. When a designer changes a variable's interval or assigns a value, the

  5. An Exercise in Formalizing the Description of a Concurrent System

    Microsoft Academic Search

    David W. Bustard; M. T. Norris; R. A. Orr; Adam C. Winstanley

    1992-01-01

    SUMMARY LOTOS is one of the most recent formal description languages to appear and one of very few with a standard definition. It has both a process algebra and an abstract data-type component, and these facilities are used in combination to describe the behaviour of concurrent systems. The purpose of this paper is to examine, in a tutorial style, what

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

    SciTech Connect

    Sanghera, Paul [Cancer Centre, Queen Elizabeth Hospital, Birmingham (United Kingdom); McConkey, Chris [Clinical Trials Unit, University of Warwick, Coventry (United Kingdom); Ho, Kean-Fatt [Cancer Centre, Queen Elizabeth Hospital, Birmingham (United Kingdom); Glaholm, John [Cancer Centre, Queen Elizabeth Hospital, Birmingham (United Kingdom); Hartley, Andrew [Cancer Centre, Queen Elizabeth Hospital, Birmingham (United Kingdom)]. 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. 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

  8. Concurrent validity of a rule-based system.

    PubMed

    Hirsch, M; Chang, B L; Jensen, K

    1993-01-01

    The purpose of this project was to test the concurrent validity of the diagnoses recommended by a rule-based expert system. Concurrent validity was determined first by comparing the expert system's computerized diagnostic recommendations with that of a Clinical Nurse Specialist (CNS Assessor) who assessed the patient, and secondly by comparing the expert system's candidate diagnoses with those of a panel of 10 clinical nurse specialists (CNS Panel). The expert system rule base for generating diagnoses was programmed for some of the most common nursing diagnoses (Metzger & Hiltunen, 1987) including: alteration in comfort, acute pain; impaired physical mobility; sleep pattern disturbance; impairment of skin integrity and self-care deficit (bathing, feeding, toileting, and dressing). Activity intolerance and potential for infection were also programmed as diagnostic possibilities in the rule base. PMID:8069751

  9. Extended-field radiotherapy and high-dose-rate brachytherapy with concurrent and adjuvant cisplatin-based chemotherapy for locally advanced cervical cancer: a phase I\\/II study

    Microsoft Academic Search

    Yih-Lin Chung; James Jer-Min Jian; Skye Hongiun Cheng; Cheng-I Hsieh; Tran-Der Tan; Hui-Ju Chang; Chi-Feng Hung; Cheng-Fang Horng; Thomas Soong; Mei-Hua Tsou

    2005-01-01

    Objective.The purpose of this prospective study was to investigate the toxicity and efficacy of integrating extended-field para-aortic and pelvic external radiation, high-dose-rate intracavity brachytherapy, and concurrent and adjuvant cisplatin-based chemotherapy for locally advanced cervical cancer.

  10. Abstractions for safe concurrent programming in networked embedded systems

    Microsoft Academic Search

    William P. Mccartney; Nigamanth Sridhar

    2006-01-01

    Over the last several years, large-scale wireless mote net- works have made possible the exploration of a new class of highly-concurrent and highly-distributed applications. As the horizon of what kinds of applications can be built on these networked embedded systems keeps expanding, there is a need to keep the activity of programming such systems easy, efficient, and scalable. We make

  11. Linear Type Systems for Concurrent Languages

    E-print Network

    Sumii, Eijiro

    ) andalso recv(c1) end (* evaluation gets stuck! *) #12;Our Approach Identify deterministic/deadlock-free of the Type System z Subject Reduction: "Reduction preserves well-typedness" , c:bt 1 int chan; p,,Ą (spawn

  12. Formally Verifying Information Flow Type Systems for Concurrent and Thread Systems

    E-print Network

    Paris-Sud XI, Université de

    -interference, concurrency, machine-checked proofs 1. INTRODUCTION 1.1 Background Security models for mobile and embeddedFormally Verifying Information Flow Type Systems for Concurrent and Thread Systems Gilles Barthe.Prensa@loria.fr ABSTRACT Information flow type systems provide an elegant means to enforce confidentiality of programs

  13. Design for control-a concurrent engineering approach for mechatronic systems design

    Microsoft Academic Search

    Q. Li; W. J. Zhang; L. Chen

    2001-01-01

    The well-accepted basis for developing a mechatronic system is a synergetic concurrent design process that integrates different engineering disciplines. In this paper, a general model is derived to mathematically describe the concurrent design of a mechatronic system. Based on this model, a concurrent engineering approach, called design for control (DFC), is formally presented for mechatronic systems design. Compared to other

  14. Phase II trial: concurrent radio-chemotherapy with weekly docetaxel for advanced squamous cell carcinoma of head and neck

    Microsoft Academic Search

    A. Biete Solŕ; J. Marruecos Querol; F. A. Calvo Manuel; E. Verger Fransoy; Ŕ. Rovirosa Casino; J. J. Grau de Castro; M. de las Heras González; A. Ramos Aguerri; A. Palacios Eito; C. Veiras Candal

    2007-01-01

    Introduction:  Standard fractionation radiation therapy (RT) combined with concomitant chemotherapy (CT) based on cisplatin schemes is actually\\u000a the standard treatment for locally advanced non-resectable squamous cell carcinoma of head and neck (SCCHN). The appearance\\u000a of taxoids has introduced a new kind of treatment with high antitumoral power. The aim of this study is to add more information\\u000a about the role of

  15. A concurrent Rapid Manufacturing advice system

    Microsoft Academic Search

    J. Munguia; C. Riba

    2008-01-01

    This paper assesses the possibility of using Rapid Manufacturing (RM) as a final manufacturing route through a comparison of RM processes capabilities vs. conventional manufacturing processes. This is done by means of a computer-aided system intended to guide the designer in the selection of optimum production parameters according to typical requirements of the first design stages. A number of Artificial

  16. 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 [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Nam, Joo-Hyun; Kim, Young-Tak; Kim, Yong-Man; Kim, Jong-Hyeok [Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Eun Kyung [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)], E-mail: ekchoi@amc.seoul.kr

    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.

  17. 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.

  18. 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...

  19. Design and analysis tools for concurrent blackboard systems

    NASA Technical Reports Server (NTRS)

    Mcmanus, John W.

    1991-01-01

    A set of blackboard system design and analysis tools that consists of a knowledge source organizer, a knowledge source input/output connectivity analyzer, and a validated blackboard system simulation model is discussed. The author presents the structure and functionality of the knowledge source input/output connectivity analyzer. An example outlining the use of the analyzer to aid in the design of a concurrent tactical decision generator for air-to-air combat is presented. The blackboard system design and analysis tools were designed for generic blackboard systems and are application independent.

  20. Concurrent certifications by intervals of timestamps in distributed database systems

    SciTech Connect

    Boksenbaum, C.; Cart, M.; Ferrie, J.; Pons, J.F.

    1987-04-01

    This paper introduces, an an optimistic concurrency control method, a new certification method by means of intervals of time-stamps, usable in a distributed database system. The main advantage of this method is that it allows a chronological commit order which differs from the serialization one (thus avoiding rejections or delays of transactions which occur in usual certification methods or in classical locking or timestamping ones). The use of the dependency graph permits both classifying this method among existing ones and proving it. The certification protocol is first presented under the hypothesis that transactions' certifications are processed in the same order on all the concerned sites; it is then extended to allow concurrent certifications of transactions.

  1. Multi-microprocessor system for concurrent lisp>language oriented system architecture

    SciTech Connect

    Sugimoto, S.; Agusa, K.; Tabata, K.; Ohno, Y.

    1983-01-01

    The authors present a multi-microprocessor system for a LISP-based concurrent programming language, concurrent LISP, which had been developed as a user-oriented programming language for artificial intelligence problems. The system is composed of multiple processor elements whose processing unit is MC68000, and a very large common memory area. The system architecture, including both hardware and software, is strongly language oriented. The system uses distributed management software designed to minimize the system overhead for housekeeping tasks. 7 references.

  2. Risk factors for acute esophagitis in non-small-cell lung cancer patients treated with concurrent chemotherapy and three-dimensional conformal radiotherapy

    SciTech Connect

    Wei Xiong [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Liu, H. Helen [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: hliu@mdanderson.org; Tucker, Susan L. [Department of Biostatistics and Applied Mathematics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Liao Zhongxing [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hu Chaosu [Cancer Hospital, Fudan University, Shanghai (China); Mohan, Radhe [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Cox, James D. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2006-09-01

    Purpose: To determine the risk factors for acute esophagitis (AE) in non-small-cell lung cancer (NSCLC) patients treated with concurrent chemotherapy (CCT) and three-dimensional conformal radiotherapy (3D-CRT). Methods and Materials: Clinical data were retrospectively analyzed for 215 NSCLC patients treated with CCT and 3D-CRT during 2000-2003, 127 of whom also had induction chemotherapy (ICT). Carboplatin and paclitaxel were the most commonly used agents for both ICT and CCT. The median prescription dose of radiotherapy was 63.5 Gy in 35 fractions. AE was graded during each treatment week and 1-month follow-up visits. The factors related to clinical and disease characteristics, CCT and 3D-CRT treatments, and treatment planning were reviewed and analyzed for their association with Grade {>=}3 AE using univariate and multivariate logistic tests. Results: The rate of any grade AE was 93.0% and of Grade {>=}3 was 20.5%. Univariate analyses showed that none of the clinical factors was significantly associated with Grade {>=}3 AE. However, the mean radiation dose to the esophagus, the absolute esophageal volume treated above 15 Gy (aV15) through aV45 Gy, and the relative esophagus volume treated above 10 Gy (rV10) through rV45 Gy were significant risk factors for Grade {>=}3 AE. Only rV20 was retained as the single risk factor in multivariate analyses. Conclusions: The risk of AE in the NSCLC patients treated with CCT and 3D-CRT was primarily determined by dosimetric factors. These factors should be carefully considered during treatment planning to minimize the incidence of AE.

  3. Preliminary results of concurrent radiotherapy and chemotherapy with cis-platinum, vincristine, and bleomycin in bulky, advanced cervical carcinoma: a pilot study.

    PubMed

    Chang, H C; Lai, C H; Chen, M S; Chao, A S; Chen, L H; Soong, Y K

    1992-02-01

    Twenty-four patients with bulky (greater than 4 cm), advanced (stages IIB-IVA) carcinoma of the uterine cervix were prospectively treated with a concurrent combination of radiotherapy (RT) and chemotherapy (CT). RT consisted of 4400 cGy (22 fractions) to the whole pelvis and a 1400-cGy boost to the parametrium. This was followed by two to three intracavitary brachytherapy courses. CT consisted of one to four course (median, three) of cisplatin (50 mg/m2) on Day 1, vincristine (1 mg/m2) on Day 2, and bleomycin (25 mg/m2) on Days 2-4. CT was started on the first day of external radiation and the scheduled course interval was 21 days. Among the 20 evaluable patients who completed at least one course of chemotherapy and a full course of radiation, 13 (65%) achieved complete response and 5 (25%) had partial response. Fatal complication occurred in 1 patient with stationary disease who died of septic shock due to ruptured pyometra. The other patient with primary stage IVA disease had progressive disease with ascites appearance after two courses of CT and later expired. Transient drug fever occurred in 19 (40.4%) of the 47 bleomycin-containing CT cycles. Grade 2 or 3 hematological toxicities occurred in 16 (30.2%) of a total of 53 CT cycles. Treatment delays of 1 to 7 days occurred in 15 (28.3%) CT cycles. Except for the case of septic shock, all of the other toxicities were generally tolerable and reversible. From this preliminary result we concluded that this particular combination of RT and CT in bulky, advanced cervical carcinoma is effective in enhancing local pelvic tumor control and well tolerated if strict selection of accrued patients is applied. Further investigation to assess its impact on long-term survival is in progress. PMID:1371978

  4. 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. [Department of Radiation and Cellular Oncology, University of Chicago and University of Illinois at Chicago, Chicago, IL (United States)], E-mail: lmell@radonc.uchicago.edu; Schomas, David A. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Salama, Joseph K. [Department of Radiation and Cellular Oncology, University of Chicago and University of Illinois at Chicago, Chicago, IL (United States); The Cancer Research Center, University of Chicago, Chicago, IL (United States); Devisetty, Kiran; Aydogan, Bulent [Department of Radiation and Cellular Oncology, University of Chicago and University of Illinois at Chicago, Chicago, IL (United States); Miller, Robert C. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Jani, Ashesh B. [Department of Radiation Oncology, Emory University, Atlanta, GA (United States); Kindler, Hedy L. [Section of Hematology/Oncology, University of Chicago, Chicago, IL (United States); Mundt, Arno J. [Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Roeske, John C.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago and University of Illinois at Chicago, Chicago, IL (United States)

    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.

  5. Concurrent design of an RTP chamber and advanced control system

    SciTech Connect

    Spence, P. [Sandia National Labs., Livermore, CA (United States); Schaper, C. [Microelectronics Control and Sensing, Inc., Mountain View, CA (United States); Kermani, A. [CVC Products, Inc., Fremont, CA (United States)

    1995-12-31

    A concurrent-engineering approach is applied to the development of an axisymmetric rapid-thermal-processing (RTP) reactor and its associated temperature controller. Using a detailed finite-element thermal model as a surrogate for actual hardware, the authors have developed and tested a multi-input multi-output (MIMO) controller. Closed-loop simulations are performed by linking the control algorithm with the finite-element code. Simulations show that good temperature uniformity is maintained on the wafer during both steady and transient conditions. A numerical study shows the effect of ramp rate, feedback gain, sensor placement, and wafer-emissivity patterns on system performance.

  6. 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.

  7. 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., E-mail: jwong@coh.org [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Forman, Stephen; Somlo, George [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States)] [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Rosenthal, Joseph [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States) [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Department of Pediatrics, City of Hope National Medical Center, Duarte, California (United States); Liu An; Schultheiss, Timothy; Radany, Eric [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States)] [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Palmer, Joycelynne [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States)] [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Stein, Anthony [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States)] [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States)

    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.

  8. Experience with an implantable venous access system for chemotherapy.

    PubMed

    Pettengell, R; Davies, A J; Harvey, V J

    1991-07-10

    Seventy-one patients receiving prolonged outpatient chemotherapy for solid tumours had a totally implanted venous access system inserted (Port-A-Cath--Pharmacia). These remained in situ for a mean of 278 days. In 98.6% of patients the catheter functioned throughout treatment. This high reliability reflects low rates of sepsis (11%) and occlusion (1.4%). Six catheters were removed because of complications; for sepsis (2), catheter occlusion (1), erosion (2), and wound dehiscence (1). An implanted system may be more economical than external exiting systems for patients requiring a catheter for longer than two months despite a high capital cost, because of lower costs during use. The Port-A-Cath is safe, reliable and acceptable to patients. PMID:1852329

  9. Analysis of Patient Safety: Converting Complex Pediatric Chemotherapy Ordering Processes from Paper to Electronic Systems

    Microsoft Academic Search

    Donald K. Baker; James M. Hoffman; Gregory A. Hale; Sheri L. Spunt; Donald Sanderlin; John H. Rodman; Jerry L. Shenep

    2010-01-01

    Objective: The objective of this project was to evaluate the risks associated with converting a paper-based pediatric chemotherapy ordering process to a fully electronic system. Methods: Formal process redesign and systems analysis, primarily through Failure Mode and Effects Analysis (FMEA), was used to evaluate the current, paper-based chemotherapy medications process. A commercial software system designed to accomplish computerized provider order

  10. SCONE: Using Concurrent Objects for Low-level Operating System Programming

    Microsoft Academic Search

    Jun-ichiro Itoh; Yasuhiko Yokote; Mario Tokoro

    1995-01-01

    This paper proposes a methodology for making low-level system code of operating systems be replaceable at runtime. Our approach is to use concurrent objects as a basic programming unit for low-level system programs. To realize the different need for each type of system code and to execute these concurrent objects sufficiently efficient, we use a combination of dedicated system service

  11. 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 Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China) [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, School of Medicine, Taoyuan, Taiwan (China); Lai, Chyong-Huey [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China)] [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Huang, Yi-Ting [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China)] [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Chao, Angel; Chou, Hung-Hsueh [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China)] [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China) [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, School of Medicine, Taoyuan, Taiwan (China)

    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.

  12. 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 [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Han, Ji-Youn [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Cho, Kwan Ho [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Pyo, Hong Ryull [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Kim, Hyae Young [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Yoon, Sung Jin B.S. [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Lee, Jin Soo [Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of)]. 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.

  13. Time Supervision of Concurrent Systems Using Symbolic Unfoldings of Time Petri Nets

    Microsoft Academic Search

    Thomas Chatain; Claude Jard

    2005-01-01

    Monitoring real-time concurrent systems is a challenging task. In this paper we formulate (model-based) supervision by means of hidden state history reconstruction, from event (e.g. alarm) observations. We follow a so-called true concurrency approach using time Petri nets: the model defines explicitly the causality and concurrency relations between the observable events, produced by the system under supervision on different points

  14. Knowledge-Based Automation of a Design Method for Concurrent Systems

    E-print Network

    Knowledge-Based Automation of a Design Method for Concurrent Systems Kevin L. Mills, Senior Member to automate a software design method for concurrent systems. The approach uses multiple paradigms to represent-system shell, compose CODA, an automated designer's assistant. Other forms of automated reasoning

  15. 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 [Department of Radiation Oncology, Nashville, TN (United States); Koehler, Elizabeth [Division of Cancer Biostatistics, Department of Biostatistics, Nashville, TN (United States); Phillips, John G.; Stinson, Scott [Department of Radiation Oncology, Nashville, TN (United States); Gilbert, Jill; Chung, Christine H.; Murphy, Barbara A. [Section of Hematology/Oncology, Department of Medicine, Nashville, TN (United States); Yarbrough, Wendell G. [Department of Otorynolaryngology, Vanderbilt University Medical Center, Nashville, TN (United States); Murphy, Patrick B. [Tennessee Oncology, Franklin, TN (United States); Shyr, Yu [Division of Cancer Biostatistics, Department of Biostatistics, Nashville, TN (United States); Cmelak, Anthony J., E-mail: anthony.cmelak@vanderbilt.ed [Department of Radiation Oncology, Nashville, TN (United States)

    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.

  16. Product design simplification system for concurrent engineering environment

    NASA Astrophysics Data System (ADS)

    Lin, Grier C. I.; Hsu, Hung-Yao

    1995-08-01

    Product design is the most important stage in the course of product development. All the important decision-making regarding manufacturing and assembly is made during this period. Concurrent engineering (CE) has been proposed to facilitate the whole development processes by using multi-disciplinary team-work. Under the concept of CE there is a need to provide the designers an expert system to investigate their design in the early stage of design. In this paper the construction of a product design simplification system has been explored and a prototype system has been developed. The system can be used to evaluate product design on the basis of design for assembly (DFA) principles. Design simplification can be accomplished by three approaches. The first uses the three criteria of Boothroyd and Dewhurst's Methodology, the second examines the functional implication of parts and the third considers if a part is secured after assembly. The system will give the designer advice according to the evaluation results. All the rules in the rule-base are derived from the expertise in DFA field. On the basis of the implementation of this prototype system further research directions are also suggested.

  17. Knowledge-Based System Integration in a Concurrent Engineering Environment

    Microsoft Academic Search

    Michael W. Sobolewski

    1993-01-01

    The systematic integration of humans with the tools, resources, and information assets of an organization is fundamental to concurrent engineering (CE). In an integrated environment, all entities must first be connected, and they then must work cooperatively. Services that support concurrency — through communication, team coordination, information sharing, and integration — in an interactive and formerly serial product development process

  18. Computer Aided Methods Supporting Concurrent Engineering when designing Mechatronic Systems Controlled by a PLC

    Microsoft Academic Search

    Jens BATHELT

    A successful concurrent start of the interdisciplinary design team is crucial when designing mechatronic systems in order to ensure consistent data throughout the development process and establish rapid development. The aim of this work is to enable a concurrent conceptual design and to initiate the domain-specific embodiment design when developing mechatronic systems controlled by a PLC. The work results in

  19. Concurrent loglisp

    SciTech Connect

    Nayak, H.R.

    1989-01-01

    The subject of this dissertation is the implementation of OR parallelism in the execution of Loglisp programs and the various issues arising in the exploitation of OR parallelism. The design of this parallel Loglisp uses concurrent searches, the existing sequential Loglisp developed at Syracuse University by Robinson and Sibert, and the Scheme based concurrent Lisp called Multilisp developed at MIT by Halstead. The implementation exploits lexical scope rules and closures. The hardware computing context is a fixed number of processors with shard memory architecture. The basic mode of execution is an invocation of a concurrent Logic call, and recursive invocations of Logic, but a capability for invoking concurrent calls of Logic with user's concurrent Lisp programs has also been provided. The concurrent implementation is somewhat transparent to Loglisp users, that is, no special syntax or commands are needed to use this new system. However, when all the results of a query are requested, the order of results in the list returned is not predictable. Also there is no defined rule for selecting a subset of all instances when less than all are requested. The present implementation does not yield very useful performance. Nonetheless, it provides a reasonable framework for investigating concurrent logic implementations, and offers a useful degree of concurrency. The author presents empirical evidence that the present implementation, if run on a high-performance, concurrent Lisp system, can yield desired performance improvements. Indeed the system sometimes shows super linear speedup when a parallel search finds a solution early on.

  20. Transdermal evaporation delivery system of praziquantel for schistosomiasis japonicum chemotherapy.

    PubMed

    Wang, Lei; Zheng, Xinsheng; Fang, Yan; Wang, Yi; Duan, Cunzheng; Yao, Baoan

    2011-07-01

    A transdermal evaporation delivery system (TEDS) of praziquantel (PZQ) was developed by selecting ethylene glycol monophenyl ether as a nonvolatile component solvent and ethanol as a volatile component solvent to control efficiently the transmission and morbidity of the global schistosomiasis, providing a convenient administration system of PZQ for both humans and domestic animals. The solubility of PZQ in TEDS was more than 400 mg/mL when the ethanol concentration was 50% (w/w) in the solvent mixture at 32 °C, enabling to adapt requirements for the treatment of schistosomiasis. The highest serum drug concentration reached 35.93 µg/mL after transdermal administration of TEDS of PZQ in rabbits, being 6.3-fold higher than that after oral administration at the same dose. The TEDS of PZQ achieved treatment efficacy with the worm reduction of 100% when it was applied in the experimental treatment of Schistosoma japonicum in rabbits. The TEDS of PZQ that provides passive and nonocclusive delivery, having the inexpensive cost, low skin irritation rates, and precise dose of administration, should find application in the transmission control and chemotherapy of global schistosomiasis. PMID:21319162

  1. Negative Impact of Skeletal Muscle Loss after Systemic Chemotherapy in Patients with Unresectable Colorectal Cancer

    PubMed Central

    Miyamoto, Yuji; Baba, Yoshifumi; Sakamoto, Yasuo; Ohuchi, Mayuko; Tokunaga, Ryuma; Kurashige, Junji; Hiyoshi, Yukiharu; Iwagami, Shiro; Yoshida, Naoya; Watanabe, Masayuki; Baba, Hideo

    2015-01-01

    Background Skeletal muscle depletion (sarcopenia) is closely associated with limited physical ability and high mortality. This study evaluated the prognostic significance of skeletal muscle status before and after chemotherapy in patients with unresectable colorectal cancer (CRC). Methods We conducted a retrospective analysis of 215 consecutive patients with unresectable CRC who underwent systemic chemotherapy. Skeletal muscle cross-sectional area was measured by computed tomography. We evaluated the prognostic value of skeletal muscle mass before chemotherapy and the rate of skeletal muscle change in cross-sectional area after chemotherapy. Results One-hundred-eighty-two patients met our inclusion criteria. There were no significant differences in progression-free survival (PFS) or overall survival (OS) associated with skeletal muscle mass before chemotherapy. However, 22 patients with skeletal muscle loss (>5%) after chemotherapy showed significantly shorter PFS and OS compared with those without skeletal muscle loss (PFS, log-rank p = 0.029; OS, log-rank p = 0.009). Multivariate Cox regression analysis revealed that skeletal muscle loss after chemotherapy (hazard ratio, 2.079; 95% confidence interval, 1.194–3.619; p = 0.010) was independently associated with OS. Conclusions Skeletal muscle loss after chemotherapy was an independent, negative prognostic factor in unresectable CRC. PMID:26069972

  2. Symbolic Model Checking of Concurrent Probabilistic Systems Using MTBDDs and Simplex

    Microsoft Academic Search

    Marta Kwiatkowska; Gethin Norman; David Parker; Roberto Segala

    1999-01-01

    Symbolic model checking for purely probabilistic processes using MTBDDs (12) was introduced in (4) and further developed in (20, 3). In this paper we consider models for concurrent probabilistic systems similar to those of (28, 7, 5) and the concurrent Markov chains of (35, 13), which extend the purely probabilistic processes through the addition of nondeterministic choice. As a specification

  3. Deadlock avoidance in flexible manufacturing systems with concurrently competing process flows

    Microsoft Academic Search

    Z. A. Banaszak; B. H. Krogh

    1990-01-01

    The concurrent flow of multiple jobs through a FMS can lead to deadlock conditions due to competition for limited resources in the system. The authors develop a Petri net (PN) model of concurrent job flow and dynamic resource allocation in an FMS and define deadlock in terms of transition enabling in the PN model. The problem of deadlock avoidance is

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

    E-print Network

    Lee, Jason Daniel

    2012-02-14

    lifetimes. However, smaller transistors will also allow SoC to contain hundreds of processing cores and other infrastructure components with the potential for increased reliability through massive structural redundancy. Concurrent online testing (COLT) can...

  5. 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 [Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon; Nam, Soon Yuhl; Choi, Seung-Ho; Roh, Jong-Lyel [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Lee, Sang-wook; Song, Si Yeol [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Lee, Jeong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Cho, Kyung-Ja [Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sung-Bae, E-mail: sbkim3@amc.seoul.kr [Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    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.

  6. 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.

  7. A case of advanced intrahepatic cholangiocarcinoma successfully treated with chemosensitivity test-guided systemic chemotherapy

    PubMed Central

    Abe, Kazumichi; Wakatsuki, Takeru; Katsushima, Fumiko; Monoe, Kyoko; Kanno, Yukiko; Takahashi, Atsushi; Yokokawa, Junko; Ohira, Hiromasa

    2009-01-01

    Intrahepatic cholangiocarcinoma (ICC) is a relatively rare and highly fatal neoplasm that arises from the biliary epithelium. Prognosis is generally poor and survival is limited to a few months. Here we present a case of advanced ICC successfully treated by chemosensitivity test-guided systemic chemotherapy combining S-1 and cisplatin (CDDP). A 65-year-old woman with a liver tumor was referred to our hospital on November 21, 2007. Abdominal ultrasonography and computed tomography (CT) showed low-density masses of 50 and 15 mm in diameter, respectively in segment VIII of the liver and in the enlarged lymph node in the para-aorta. Ultrasonography-guided fine needle biopsy diagnosed the tumors as ICC. Since the patient was inoperable for lymph node metastasis, she underwent systemic chemotherapy with gemcitabine. Six months after initiation of chemotherapy, CT revealed ICC progression in the liver and pleural dissemination with pleural effusion. The patient was admitted to our hospital for anticancer drug sensitivity testing on June 9, 2008. Based on the sensitivity test results, we elected to administer systemic chemotherapy combining S-1 and CDDP. Two months into the second chemotherapy treatment, CT revealed a reduction of the tumors in the liver and lymph node and a decrease in pleural effusion. After eight cycles of the second chemotherapy, 17 mo after ICC diagnosis, she is alive and well with no sign of recurrence. We conclude that chemosensitivity testing may effectively determine the appropriate chemotherapy regimen for advanced ICC. PMID:19891026

  8. 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, E-mail: hokeanfatt@hotmail.com [Academic Radiation Oncology, The Christie NHS Foundation Trust, Manchester (United Kingdom); Marchant, Tom; Moore, Chris; Webster, Gareth; Rowbottom, Carl [North Western Medical Physics, The Christie NHS Foundation Trust, Manchester (United Kingdom); Penington, Hazel [Wade Radiotherapy Research Centre, The Christie NHS Foundation Trust, Manchester (United Kingdom); Lee, Lip; Yap, Beng; Sykes, Andrew; Slevin, Nick [Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester (United Kingdom)

    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.

  9. 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., E-mail: joseph.salama@duke.edu [Duke University Medical Center, Durham, NC (United States); Stinchcombe, Thomas E. [University of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Gu Lin; Wang Xiaofei [CALGB Statistical Center, Duke University Medical Center, Durham, NC (United States); Morano, Karen [Quality Assurance Review Center, Lincoln, RI (United States); Bogart, Jeffrey A. [State University of New York Upstate Medical University, Syracuse, NY (United States); Crawford, Jeffrey C. [Duke University Medical Center, Durham, NC (United States); Socinski, Mark A. [University of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Blackstock, A. William [Wake Forest University School of Medicine, Winston-Salem, NC (United States); Vokes, Everett E. [University of Chicago, Chicago, IL (United States)

    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.

  10. A graphical environment for the design of concurrent real-time systems

    Microsoft Academic Search

    Louise E. Moser; Y. S. Ramakrishna; G. Kutty; P. M. Melliar-Smith; Laura K. Dillon

    1997-01-01

    Concurrent real-time systems are among the most difficult systems to design because of the many possible interleavings of events and because of the timing requirements that must be satisfied. We have developed a graphical environment based on Real-Time Graphical Interval Logic (RTGIL) for specifying and reasoning about the designs of concurrent real-time systems. Specifications in the logic have an intuitive

  11. Esophagogastric cancer: integration of targeted therapies into systemic chemotherapy.

    PubMed

    Moehler, M; Schwarz, S; Wagner, A D

    2011-07-01

    Although combination chemotherapy has been shown to be more effective than single agents in advanced esophagogastric cancer, the better response rates have not fulfilled their promise as overall survival times from best combination still range between 8 to 11 months. So far, the development of targeted therapies stays somewhat behind their integration into treatment concepts compared to other gastrointestinal diseases. Thus, the review summarizes the recent advances in the development of targeted therapies in advanced esophagogastric cancer. The majority of agents tested were angiogenesis inhibitors or agents targeting the epidermal growth factor receptors EGFR1 and HER2. For trastuzumab and bevacizumab, phase III trial results have been presented recently. While addition of trastuzumab to cisplatin/5-fluoropyrimidine-based chemotherapy results in a clinically relevant and statistically significant survival benefit in HER 2+ patients, the benefit of the addition of bevacizumab to chemotherapy was not significant. Thus, all patients with metastatic disease should be tested for HER-2 status in the tumor. Trastuzumab in combination with cisplatin/5-fluoropyrimidine-based chemotherapy is the new standard of care for patients with HER2-positive advanced gastric cancer. PMID:21651462

  12. Towards a Lambda-Calculus for Concurrent and Communicating Systems

    Microsoft Academic Search

    Gérard Boudol

    1989-01-01

    We introduce a calculus for concurrent and communicating processes, which is a direct and simple extension of the -calculus. The communication mechanism we use is that of Milner's calculus CCS: to communicate consists in synchronously sending and receiving a value through a shared port. Then the calculus is parameterized on a given set of port names, which are used in

  13. Pavane: A System for Declarative Visualization of Concurrent Computations

    Microsoft Academic Search

    Gruia-Catalin Roman; Kenneth C. Cox; C. Donald Wilcox; Jerome Y. Plun

    1991-01-01

    This paper describes the conceptual model and specification method for a visualization environmentconcerned with exploring, monitoring, and presenting concurrent computations. The model is declarative inthe sense that visualization is treated as a mapping from program states to a three-dimensional world ofgeometric objects. The latter is rendered in full color and may be examined freely by a viewer who isallowed to

  14. Test Plan Generation for Concurrent Real-Time Systems Based on Zone Coverage Analysis

    Microsoft Academic Search

    Farn Wang; Geng-dian Huang

    2008-01-01

    The state space explosion due to concurrency and timing constraints of concurrent real-time systems (CRTS) presents significant\\u000a challenges to the verification engineers. In this paper, we investigate how to use coverage techniques to generate efficient\\u000a test plans for such systems. We first discuss how to use communicating timed automata to model CRTS. We present a new coverage\\u000a technique, AZC (active

  15. A concurrent distributed system for aircraft tactical decision generation

    Microsoft Academic Search

    John W. McManus

    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

  16. Synthesis of concurrent system interface modules with automatic protocol conversion generation

    Microsoft Academic Search

    Bill Lin; Steven Vercauteren

    1994-01-01

    We describe a new high-level compiler called Integral for designing system interface modules. The input is a high-level concurrent algorithmic specification that can model complex concurrent control flow, logical and arithmetic computations, abstract communication, and low-level behavior. For abstract communication between two communicating modules that obey different I\\/O protocols, the necessary protocol conversion behaviors are automatically synthesized using a Petri

  17. Semantics of concurrent systems: a modular fixed-point trace approach

    Microsoft Academic Search

    Antoni W. Mazurkiewicz; Warszawa Poland

    1984-01-01

    A method for finding the set of processes generated by a concurrent system (the behaviour of a system) in modular way is presented. A system is decomposed into modules with behaviours assumed to be known and then the behaviours are successively put together giving finally the initial system behaviour. It is shown that there is much of freedom in choice

  18. Dose escalation of accelerated hypofractionated three-dimensional conformal radiotherapy (at 3 Gy/fraction) with concurrent vinorelbine and carboplatin chemotherapy in unresectable stage III non-small-cell lung cancer: a phase I trial

    PubMed Central

    2013-01-01

    Background Accelerated hypofractionated radiotherapy can shorten total treatment time and overcome the accelerated repopulation of tumour cells during radiotherapy. This therapeutic approach has demonstrated good efficacy in the treatment of locally advanced non-small-cell lung cancer (NSCLC). However, the optimal fractionation scheme remains uncertain. The purpose of this phase I trial was to explore the maximum tolerated dose (MTD) of accelerated hypofractionated three-dimensional conformal radiotherapy (3-DCRT) (at 3 Gy/fraction) administered in combination with concurrent vinorelbine (NVB) and carboplatin (CBP) chemotherapy for unresectable stage III NSCLC. Methods Previously untreated cases of unresectable stage III NSCLC received accelerated hypofractionated 3-DCRT, delivered at 3 Gy per fraction, once daily, with five fractions per week. The starting dose was 66 Gy and an increment of 3 Gy was utilized. Higher doses continued to be tested in patient groups until the emergence of dose-limiting toxicity (DLT). The MTD was regarded as the dose that was one step below the dose at which DLT occurred. Patients received at least one cycle of a concurrent two-drug chemotherapy regimen of NVB and CBP. Results A total of 13 patients were enrolled and progressed through three dose escalation groups: 66 Gy, 69 Gy, and 72 Gy. No treatment-related deaths occurred. The major adverse events included radiation oesophagitis, radiation pneumonitis, and neutropenia. Nausea, fatigue, and anorexia were commonly observed, although the magnitude of these events was typically relatively minor. Among the entire group, four instances of DLT were observed, including two cases of grade 3 radiation oesophagitis, one case of grade 3 radiation pneumonitis, and one case of grade 4 neutropenia. All of these cases of DLT occurred in the 72 Gy group. Therefore, 72 Gy was designated as the DLT dose level, and the lower dose of 69 Gy was regarded as the MTD. Conclusions For unresectable stage III NSCLC 69 Gy (at 3 Gy/fraction) was the MTD of accelerated hypofractionated 3-DCRT administered in combination with concurrent NVB and CBP chemotherapy. The toxicity of this chemoradiotherapy regimen could be tolerated. A phase II trial is recommended to further evaluate the efficacy and safety of this regimen. PMID:23957889

  19. Dynamic priority ceilings: A concurrency control protocol for real-time systems

    Microsoft Academic Search

    Min-Ih Chen; Kwei-Jay Lin

    1990-01-01

    Real-time systems have stringent deadline requirements for their tasks. To meet the requirements, a real-time system must use scheduling algorithms that ensure a predictable response even in the face of mutually exclusive accesses to critical sections. We present a concurrency control protocol for systems using the earliest deadline first scheduling algorithm. The protocol specifies a dynamic priority ceiling for each

  20. Evaluation of Concurrency Control Strategies for Mixed Soft Real-Time Database Systems

    E-print Network

    Cheng, Reynold Cheng Chun

    1 Evaluation of Concurrency Control Strategies for Mixed Soft Real-Time Database Systems Kam soft real-time database systems (MSRTDBS), in which both non-real-time and soft real-time transactions of both soft real-time and non-real-time transactions under different real-time supports in the system

  1. Intracavitary chemotherapy

    SciTech Connect

    Markman, M.

    1985-01-01

    Pharmacokinetic modeling has suggested, and clinical investigations have confirmed, that intracavitary drug administration can result in a much greater drug exposure for the cavity into which the agent is instilled compared to the plasma. Both the safety and the efficacy of several agents administered individually or in combination have now been demonstrated. Several malignancies, in particular ovarian carcinoma and malignant mesothelioma, which remain confined to body cavities for much of their natural history, might be most rationally treated by the intracavitary treatment approach. Early clinical trials have demonstrated significant activity of intracavitary chemotherapy in both of these malignancies. Optimal drugs and dosages as well as appropriate scheduling for the various tumors involving body cavities remain to be defined. Whether or not combination intracavitary chemotherapy will significantly improve survival of patients with malignant disease confined to body cavities must await carefully controlled clinical trials comparing this treatment approach to standard systemically administered chemotherapy. 144 references.

  2. Multidisciplinary treatment including systemic chemotherapy for a malignant phyllodes tumour of the prostate

    PubMed Central

    Murakami, Yasukiyo; Tabata, Ken-ichi; Sugita, Atsushi; Mochizuki, Kohei; Maeyama, Ryota; Okazaki, Miyoko; Nishi, Morihiro; Matsumoto, Kazumasa; Fujita, Tetsuo; Satoh, Takefumi; Jiang, Shi-Xu; Saegusa, Makoto; Iwamura, Masatsugu

    2014-01-01

    A 22-year-old man was referred to our hospital with macroscopic hematuria and consistent anal pain. Magnetic resonance imaging revealed an enlarged prostate tumour invading the bladder and rectum. A biopsy revealed an unclassified spindle cell sarcoma. Subsequently, radical cystoprostatectomy and resection of the rectum were performed. A histopathological examination revealed a prostatic malignant phyllodes tumour with a negative surgical margin. However, a local recurrence was identified 2 months after surgery. Induction therapy included 4 cycles of systemic chemotherapy comprising etoposide with ifosfamide and cisplatin. Although a partial response was observed at the local site, lung metastasis developed. Second-line chemotherapy with ifosfamide and doxorubicin with radiotherapy to the pelvis was administered and led to complete regression; however, its efficacy was transient. Although additional chemotherapy was administered, the patient eventually died due to the rapidly growing, recurrent tumour. PMID:24839496

  3. A Robust Concept Exploration Method for Enhancing Productivity in Concurrent Systems Design

    Microsoft Academic Search

    Wei Chen; Janet K. Allen; Farrokh Mistree

    1997-01-01

    Productivity is of major economic significance in the current competitive global market. Due to growing costs and globalization of the marketplace, improvements in productivity require the creation of a reliable design through concurrent systems analysis in the shortest possible time. This is particularly important for designing complex engineering systems such as aircraft, automobiles and ships. The Robust Concept Exploration Method

  4. Incremental Architectural Modeling and Verification of Real-Time Concurrent Systems

    Microsoft Academic Search

    Yi Deng; Jiacun Wang; Rakesh Sinha

    1998-01-01

    An incremental approach for architectural modeling and analysis of real-time concurrent systems is pre sented. The approach integrates existing formal methods, mo re specifically time Petri nets and real-time computat ional tree logic, and leverages their complementary stren gths in a way that allows us to systematically enforce that architectural design meets the system's timing requirements, and to incrementally verify

  5. Task\\/Scheduler Logic: Reasoning about Concurrency in Component-Based Systems Software

    Microsoft Academic Search

    Alastair Reid; John Regehr

    2002-01-01

    Although component-based software development promises increased reuse and faster development time, it has proven difficult to build component-based systems software. One obstacle is that the concurrency structure in systems soft- ware tends to be complex. First, instead of a single sched- uler, there is a hierarchy of schedulers: the processor sched- ules interrupts, the OS schedules software interrupts and threads,

  6. Knowledge intensive Petri net framework for concurrent intelligent design of automatic assembly systems

    Microsoft Academic Search

    X. F Zha; H Du; Y. E Lim

    2001-01-01

    The integration of design and planning of flexible assembly system has been recognized as a tool for achieving efficient assembly in a production environment that demands assembly with a high degree of flexibility. This paper proposes a concurrent intelligent approach and framework for the design of robotic flexible assembly systems. The principle of the proposed approach is based on the

  7. 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, E-mail: junsaito@sannet.ne.jp [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Sakai, Hiroshi; Kurimoto, Futoshi [Division of Respiratory Disease, Saitama Cancer Center, Saitama (Japan); Kato, Shingo [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Shibuya, Kei [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan)

    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.

  8. Phase I study of thoracic radiation dose escalation with concurrent chemotherapy for patients with limited small-cell lung cancer: Report of Radiation Therapy Oncology Group (RTOG) protocol 97-12

    SciTech Connect

    Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: rkomaki@mdanderson.org; Swann, R. Suzanne [Radiation Therapy Oncology Group, Philadelphia, PA (United States); Ettinger, David S. [Kimmel Comp Cancer Center at Johns Hopkins, Baltimore, MD (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Sandler, Alan B. [Vanderbilt University Medical Center, Nashville, TN (United States); Movsas, Benjamin [Fox Chase Cancer Center, Philadelphia, PA (United States); Suh, John [Cleveland Clinic Foundation, Cleveland, OH (United States); Byhardt, Roger W. [Medical College of Wisconsin, Milwaukee, WI (United States)

    2005-06-01

    Purpose: The purpose of RTOG 97-12 was to determine the maximum tolerated dose (MTD) of thoracic radiation therapy (RT) with concurrent chemotherapy for patients with limited-stage small-cell lung cancer. Patients and Methods: Sixty-four patients received four cycles of cisplatin (60 mg/m{sup 2} i.v.) and etoposide (120 mg/m{sup 2} i.v. Days 1-3) (PE), with concurrent thoracic RT starting on Day 1. Thoracic RT was given during the first two cycles with 1.8 Gy/fraction daily to the clinical target volume, followed by thoracic RT to the gross tumor volume b.i.d. for the last 3, 5, 7, 9, or 11 treatment days (total dose 50.4, 54.0, 57.6, 61.2, or 64.8 Gy, respectively). The MTD was based on the dose that produced Grades 3-4 nonhematologic toxicity (mainly esophagitis and pneumonitis) in greater than 50% of patients. Results: After the first 8 patients were enrolled in Arm 1, administration of etoposide was changed from 120 mg/m{sup 2} i.v. on Days 2 and 3 of each cycle to 240 mg/m{sup 2} p.o. for patient convenience as outpatients. Total thoracic RT doses from 50.4 Gy to 61.2 Gy over 5 weeks given with PE were well tolerated. Three of the first 5 patients in the 64.8 Gy arm developed Grade 3 acute esophagitis; the MTD was determined to be 61.2 Gy. Fifty-four (87%) of the 62 evaluable patients achieved a complete (68%) or partial (19%) tumor response. The 18-month survival was 25% for patients receiving 50.4 Gy and 82% for those receiving 61.2 Gy. Conclusions: The MTD for this accelerated thoracic RT regimen with concurrent PE was 61.2 Gy over 5 weeks.

  9. Discrete Analysis of Continuous Behaviour in Real-Time Concurrent Systems

    E-print Network

    Ouaknine, Joël

    and an operational perspective. The continuous-time model we use is the timed fail- ures model; on the discrete-time crossing case study. We also construct a second, more sophisticated discrete- time model which re ects this second model as well. Discrete Analysis of Continuous Behaviour in Real-Time Concurrent Systems Jo

  10. Discrete Analysis of Continuous Behaviour in Real-Time Concurrent Systems

    E-print Network

    Oxford, University of

    and an operational perspective. The continuous-time model we use is the timed fail- ures model; on the discrete-time crossing case study. We also construct a second, more sophisticated discrete- time model which reflects this second model as well. Discrete Analysis of Continuous Behaviour in Real-Time Concurrent Systems Jo

  11. Real-time Property Preservation in Concurrent Real-time Systems?

    Microsoft Academic Search

    Jinfeng Huang; Jeroen Voeten; Marc Geilen

    A key step in concurrent real-time system development is to build a model from which the implementation is synthesized. It is thus important to un- derstand the relation between the properties of a model and its corresponding implementation. In this paper, we first build two relations: 1) †-weakening rela- tions on MITLR formulas, which are used to express real-time properties

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

    E-print Network

    de Weck, Olivier L.

    -phase A of space missions and programs. Effective systems architecting requires comprehensive analysis of the value [1]. When new space missions are defined, concurrent design infrastructures are used of requirements analysis, where mission stakeholders and design engineers meet in plenary meetings to scope

  13. Improving the Reliability of Cooperative Concurrent Systems with Exception Flow Analysis

    E-print Network

    Newcastle upon Tyne, University of

    Analysis Fernando Castor Filho, Alexander Romanovsky, Cecilia Mary F. Rubira TECHNICAL REPORT SERIES No. CS of Cooperative Concurrent Systems with Exception Flow Analysis Fernando Castor Filho, Alexander Romanovsky;Bibliographical details CASTOR FILHO, F., ROMANOVSKY, A., RUBIRA, C. M. F. Improving the Reliability

  14. Model-based Testing for Concurrent Systems: Unfolding-based Test Selection

    E-print Network

    Paris-Sud XI, Université de

    .e. independence of actions) by an example coming from the field of security protocols. When designing a security and thus threaten the privacy of the user. It has been shown that the security protocol of the French RFIDModel-based Testing for Concurrent Systems: Unfolding-based Test Selection Hern´an Ponce de Le

  15. Feasibility and Efficacy of Induction Docetaxel, Cisplatin, and 5-Fluorouracil Chemotherapy Combined With Cisplatin Concurrent Chemoradiotherapy for Nonmetastatic Stage IV Head-and-Neck Squamous Cell Carcinomas

    SciTech Connect

    Prestwich, Robin J., E-mail: Robin.Prestwich@leedsth.nhs.uk [Department of Clinical Oncology, St. James's Institute of Oncology, Leeds (United Kingdom); Oeksuez, Didem Colpan; Dyker, Karen; Coyle, Catherine; Sen, Mehmet [Department of Clinical Oncology, St. James's Institute of Oncology, Leeds (United Kingdom)

    2011-11-15

    Purpose: To report the experience of treating selected fit patients with locally advanced head-and-neck squamous cell carcinoma with three cycles of induction TPF (docetaxel 75 mg/m{sup 2}, cisplatin 75 mg/m{sup 2}, 5-fluorouracil 750 mg/m{sup 2}, Days 2-5) followed by concurrent three-weekly bolus cisplatin 100 mg/m{sup 2} chemoradiotherapy. Methods and Materials: Between March 2006 and February 2010, 66 patients with nonmetastatic Stage IV head-and-neck squamous cell carcinoma were treated in a single institution with three cycles of induction TPF, followed by radical radiotherapy with concurrent cisplatin 100 mg/m{sup 2}. Results: Median age was 54 years (range, 33-69 years). Median follow-up was 21 months (range, 4-55 months). During TPF, Grade 3 toxicity occurred in 18 patients (27%), dose modifications in 10 (15%), delays in 3 (5%), and unplanned admissions in 6 (9%); a clinical tumor response was documented in 60 patients (91%). Median time from the final cycle of TPF to commencing radiotherapy was 22 days. Sixty-two patients (94%) received radical radiotherapy, and all completed treatment with no delays {>=}3 days. One, two, and three cycles of concurrent cisplatin were delivered to 18 patients (29%), 38 patients (61%), and 3 patients (5%), respectively. Ninety-two percent of patients received enteral feeding; median weight loss during treatment was 7%. Forty-two patients (68%) had unplanned admissions with no on-treatment deaths. Three unrelated deaths occurred after treatment. At 1 year after treatment, 21% of patients without disease progression remained gastrostomy dependent. Of 58 assessable patients, 50 (86%) achieved a complete response after treatment. One- and 2-year progression-free survival, cause-specific survival, and overall survival were 88%, 92%, and 86% and 80%, 85%, and 80%, respectively. Conclusion: The combination of induction TPF with concurrent cisplatin chemoradiotherapy in patients with locally advanced head and neck squamous cell carcinoma is tolerable, with encouraging efficacy.

  16. Property Preserving Abstractions for the Verification of Concurrent Systems

    Microsoft Academic Search

    Claire Loiseaux; Susanne Graf; Joseph Sifakis; Ahmed Bouajjani; Saddek Bensalem; David Probst

    1995-01-01

    We study property preserving transformations for reactive systems. The main idea isthe use of simulations parameterizedby Galois connections (ff; fl), relating the lattices of propertiesof two systems. We propose and study a notion of preservation of properties expressed by formulasof a logic, by a function ff mapping sets of states of a system S into sets of states of a

  17. Concurrent related validity of the GAITRite® walkway system for quantification of the spatial and temporal parameters of gait

    Microsoft Academic Search

    Belinda Bilney; Meg Morris; Kate Webster

    2003-01-01

    The GAITRite® is a portable gait analysis tool for automated measurement of spatiotemporal gait parameters. Although frequently used for clinical and research purposes, the concurrent validity of GAITRite® has not been validated against a criterion measure. The aim of this experiment was to investigate the concurrent validity and test retest reliability of the GAITRite® carpet walkway system for quantification of

  18. SARA (System ARchitects Apprentice): Modeling, analysis, and simulation support for design of concurrent systems

    SciTech Connect

    Estrin, G.; Fenchel, R.S.; Razouk, R.R.; Vernon, M.K.

    1986-02-01

    An environment to support designers in the modeling, analysis and simulation of concurrent systems is described. It is shown how a fully nested structure model supports multilevel design and focuses attention on the interfaces between the modules which serve to encapsulate behavior. Using simple examples the paper indicates how a formal graph model can be used to model behavior in three domains: control flow, data flow, and interpretation. The effectiveness of the explicity environment model in SARA is discussed and the capability to analyze correctness and evaluate performance of a system model are demonstrated. A description of the integral help designed into SARA shows how the designer can be offered consistent use of any new tool introduced to support the design process.

  19. Metastatic medullary thyroid cancer: a dramatic response to a systemic chemotherapy (temozolomide and capecitabine) regimen

    PubMed Central

    Lacin, Sahin; Esin, Ece; Karakas, Yusuf; Yalcin, Suayib

    2015-01-01

    A 40-year-old male patient presented with increasing serum levels of calcitonin and CEA. He underwent potential curative surgery for medullary thyroid carcinoma, 3 years ago and then 7 months later he had metastasectomy and cervical lymph node dissection for recurrent disease. On admission he had multiple metastatic skin nodules on the chest wall and positron emission tomography–computed tomography revealed multiple visceral metastases as well. The patient had not received any systemic treatment up to that time; therefore, we considered systemic treatment with the new tyrosine kinase inhibitors (vandetanib, cabozantinib, etc). However, since these drugs are only available after cytotoxic chemotherapy, we started temozolomide and capecitabine chemotherapy. After two courses of the treatment all skin nodules disappeared and CEA and calcitonin levels normalized, radiological imaging showed a good partial response. PMID:25999738

  20. Metastatic medullary thyroid cancer: a dramatic response to a systemic chemotherapy (temozolomide and capecitabine) regimen.

    PubMed

    Lacin, Sahin; Esin, Ece; Karakas, Yusuf; Yalcin, Suayib

    2015-01-01

    A 40-year-old male patient presented with increasing serum levels of calcitonin and CEA. He underwent potential curative surgery for medullary thyroid carcinoma, 3 years ago and then 7 months later he had metastasectomy and cervical lymph node dissection for recurrent disease. On admission he had multiple metastatic skin nodules on the chest wall and positron emission tomography-computed tomography revealed multiple visceral metastases as well. The patient had not received any systemic treatment up to that time; therefore, we considered systemic treatment with the new tyrosine kinase inhibitors (vandetanib, cabozantinib, etc). However, since these drugs are only available after cytotoxic chemotherapy, we started temozolomide and capecitabine chemotherapy. After two courses of the treatment all skin nodules disappeared and CEA and calcitonin levels normalized, radiological imaging showed a good partial response. PMID:25999738

  1. Principles of Systemic Chemotherapy for Squamous Cell Head and Neck Cancer

    Microsoft Academic Search

    Cristina P. Rodriguez; David J. Adelstein

    \\u000a Head and neck squamous cell carcinomas are a group of malignancies that are sensitive to systemic therapy, in part due to\\u000a the complexity of the molecular aberrations in these malignancies that impair DNA repair mechanisms. Administration of chemotherapy\\u000a in the treatment of head and neck cancers is guided by treatment goals and patient factors unique to this patient population.\\u000a The

  2. The analysis of chemotherapy resistance in human lung cancer cell line with microchip-based system

    Microsoft Academic Search

    Wang Ying-yan; Wang Tao; Liu Xin; Gai Hong-wei; Lin Bing-cheng; Wang Qi

    2008-01-01

    Microchip-based systems have many desirable characteristics and can be used in much cellular biochemical analysis. Glucose-regulated\\u000a protein 78 (GRP78), an endoplasmic reticulum chaperone, has a critical role in chemotherapy resistance of some cancers. This\\u000a work aimed at analyzing the correlation between the expression of GRP78 and an anticancer drug, topoisomerase II inhibitor-VP-16,\\u000a in human lung cancer cell line NCI-H460 using

  3. SARA aided design of software for concurrent systems

    Microsoft Academic Search

    I. M. Campos; G. Estrin

    2008-01-01

    A set of tools to support a structured multilevel design procedure for software or hardware development is described. This interactive computer-aided system, called SARA (Systems ARchitect's Apprentice), provides languages to help a designer form useful abstractions that can be manipulated and tested in a disciplined way. SARA supports both a bottom-up (abstraction) procedure and a top-down partitioning (refinement) procedure. The

  4. Applications Considerations in the System Design of Highly Concurrent Multiprocessors

    Microsoft Academic Search

    Stephen F. Lundstrom

    1987-01-01

    A five-year series of studies led to the system design of a very large, very high-speed multiprocessor. This system was intended to solve large scientific problems, especially modeling problems such as those in computational aerodynamics. The performance objective was to sustain execution rates up to one billion floating-point operations per second with problems requiring 40 million words of main memory.

  5. Applications considerations in the system design of highly concurrent multiprocessors

    SciTech Connect

    Lundstrom, S.F.

    1987-11-01

    A five-year series of studies led to the system design of a very large, very high-speed multiprocessor. This system was intended to solve large scientific problems, especially modeling problems such as those in computational aerodynamics. The performance objective was to sustain execution rates up to one billion floating-point operations per second with problems requiring 40 million words of main memory. The viability of this design depended on an in-depth understanding of the projected applications of the system. An overview of the project objectives and the resulting 128 processor design is presented showing the local private memories available to each processor, the 64 million word shared memory, the dual-omega interconnection network, and the important programming concepts. During the design of the system, studies were conducted which determined the number of processors, the memory organization, and the structure of the networks used to interconnect the processor and memory resources. These studies and the important application-related considerations are presented.

  6. Markov Nets: Probabilistic Models for distributed and concurrent systems

    E-print Network

    Paris-Sud XI, Université de

    with a partial order model of time. Our basic mathematical tool is that of Petri net unfoldings. Keywords: distributed discrete event systems, Petri nets, proba- bilistic models, unfoldings. I. Motivations is that of safe Petri nets. These are introduced in Section II, where the associated structure of runs is also

  7. Order and Containment in Concurrent System Design Copyright Fall 2000

    E-print Network

    in Engineering-Electrical Engineering and Computer Science University of California at Berkeley Professor Edward- nicating components. The term complex is used here to mean a system consisting of components with different models of computation such that the communication between different components has different semantics

  8. Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome

    PubMed Central

    Diaz, Juan; Micaily, Bizhan; Ferriss, J. Stuart

    2014-01-01

    Objective. To assess the effectiveness and toxicity of carboplatin concurrent with pelvic external beam radiation and low-dose rate brachytherapy and to assess the impact that adherence to the treatment plan has on outcomes. Methods. Retrospective chart review of 56 patients treated from January 2001 to December 2010. Results. Median follow-up was 68 months. Optimal dose of radiation (ORT) was defined as a minimal cervical dose exceeding 70?Gy, point A dose of 80–90?Gy, and duration not exceeding 56 days. Only 50% received ORT. In multivariable analyses we only found ORT to be statistically significant predictor for progression-free survival (PFS) and overall survival (OS) (HR [95% CI] for non-ORT vs. ORT: 2.4 [1.2, 5.1], P = 0.014 for PFS and 2.2 [1.1, 4.6], P = 0.035 for OS). The 5-year PFS in patients who received ORT was better than that in patients who received non-ORT, 56% vs. 22% (95% CI: [36%, 72%] vs. [9%, 39%]). Patients who received ORT had a better 5-year OS as well (59% vs. 33%; 95% CI: [38%, 75%] vs. [16%, 51%]). Conclusion. Patients with locally advanced cervical cancer treated with weakly carboplatin or cisplatin, teletherapy, and low dose-dose rate brachytherapy have poorer outcomes when treatment duration is prolonged. PMID:25431594

  9. Preoperative Concurrent Radiation Therapy and Chemotherapy for Bulky Stage IB2, IIA, and IIB Carcinoma of the Uterine Cervix With Proximal Parametrial Invasion

    SciTech Connect

    Huguet, Florence; Cojocariu, Oana-Maria [Department of Radiation Oncology, Tenon Hospital A.P.-H.P., Cancerest, GHU Est, Paris VI University, Paris (France); Levy, Pierre [Department of Public Health, Tenon Hospital A.P.-H.P., Cancerest, GHU Est, Paris VI University, Paris (France); Lefranc, Jean-Pierre [Department of Gynecologic Surgery, Pitie-Salpetriere Hospital A.P.-H.P., Paris (France); Darai, Emile [Department of Gynecology and Obstetrics, Tenon Hospital A.P.-H.P., Cancerest, GHU Est, Paris VI University, Paris (France); Jannet, Denis; Ansquer, Yan [Department of Gynecology and Obstetrics, Saint-Antoine Hospital A.P.-H.P., Paris (France); Lhuillier, Pierre-Eugene [Department of Gynecology and Obstetrics, Fontainebleau Hospital, Fontainebleau (France); Benifla, Jean-Louis [Department of Gynecology and Obstetrics, Rothschild Hospital A.P.-H.P., Paris (France); Seince, Nathalie [Department of Gynecology and Obstetrics, Jean Verdier Hospital, Bondy (France); Touboul, Emmanuel [Department of Radiation Oncology, Tenon Hospital A.P.-H.P., Cancerest, GHU Est, Paris VI University, Paris (France)], E-mail: emmanuel.touboul@tnn.aphp.fr

    2008-12-01

    Purpose: To evaluate toxicity, local tumor control, and survival after preoperative chemoradiation for operable bulky cervical carcinoma. Methods and Materials: Between December 1991 and July 2006, 92 patients with operable bulky stage IB2, IIA, and IIB cervical carcinoma without pelvic or para-aortic nodes on pretreatment imaging were treated. Treatment consisted of preoperative external beam pelvic radiation therapy (EBRT) and concomitant chemotherapy (CT) during the first and fourth weeks of radiation combining 5-fluorouracil and cisplatin. The pelvic radiation dose was 40.5 Gy over 4.5 weeks. EBRT was followed by low-dose rate uterovaginal brachytherapy with a total dose of 20 Gy in 62 patients. After a median rest period of 44 days, all patients underwent Class II modified radical hysterectomy with bilateral pelvic lymphadenectomy. Thirty patients who had not received preoperative uterovaginal brachytherapy underwent postoperative low-dose-rate vaginal brachytherapy at a dose of 20 Gy. The mean follow-up was 46 months. Results: Pathologic residual tumor was observed in 43 patients. After multivariate analysis, additional preoperative uterovaginal brachytherapy was the single significant predictive factor for pathologic complete response rate (p = 0.019). The 2- and 5-year disease-free survival (DFS) rates were 80.4% and 72.2%, respectively. Pathologic residual cervical tumor was the single independent factor decreasing the probability of DFS (p = 0.020). Acute toxicities were moderate. Two severe ureteral complications requiring surgical intervention were observed. Conclusions: Concomitant chemoradiation followed by surgery for operable bulky stage I-II cervical carcinoma without clinical lymph node involvement can be used with acceptable toxicity. Pathologic complete response increases the probability of DFS.

  10. Trastuzumab-based chemotherapy modulates systemic redox homeostasis in women with HER2-positive breast cancer.

    PubMed

    Lemos, L G T; Victorino, V J; Herrera, A C S A; Aranome, A M F; Cecchini, A L; Simăo, A N C; Panis, C; Cecchini, R

    2015-07-01

    Trastuzumab is an immunotargeting therapeutic against breast tumors with amplification of the human epithelial growth factor receptor 2 (HER2). HER2 patients naturally exhibit disruption in the pro-oxidant inflammatory profiling; however, the impact of trastuzumab-based chemotherapy in modulating this process is still unknown. Here we determined the systemic pro-inflammatory profile of women diagnosed with HER2-amplified tumors, undergoing trastuzumab-based chemotherapy (TZ), and compared the results with that of healthy controls (CTR) and untreated patients with HER2-amplified breast cancer (CA). The plasmatic inflammatory profile was assessed by evaluating pro-oxidant parameters such as lipid peroxidation, total antioxidant capacity (TRAP), levels of advanced oxidation protein products (AOPPs), nitric oxide (NO), C-reactive protein (CRP), and total thiol content. Markers of cardiac damage were also assessed. Our findings showed increased NO levels in TZ than that in either CA or CTR groups. Furthermore, TZ augmented TRAP and reduced total thiol than that of the CA group. Our data also revealed that AOPP levels were significantly higher in the TZ than the CA group. AOPP and the MB fraction of creatine-kinase (CKMB) levels were positively correlated in TZ patients. These findings suggest that trastuzumab-associated chemotherapy can modulate the pro-inflammatory markers of HER2-positive breast cancer patients to the levels found in healthy controls. PMID:25937481

  11. 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, E-mail: rkomaki@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Ettinger, David S. [Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States); Videtic, Gregory M.M. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Bradley, Jeffrey D. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Langer, Corey J. [Thoracic Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Sause, William T. [Radiation Center, LDS Hospital, Salt Lake City, Utah (United States); Curran, Walter J. [Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pennsylvania (United States); Choy, Hak [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas (United States)

    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).

  12. Chemotherapy Effects

    MedlinePLUS

    ... chemotherapy and managing some of its side effects. Chemo Brain The mental cloudiness some people notice before, during, and after chemotherapy is commonly called chemo brain. Here you can find information on chemo brain ...

  13. Long-term Follow-up of the RTOG 9501/Intergroup Phase III Trial: Postoperative Concurrent Radiation Therapy and Chemotherapy in High-Risk Squamous Cell Carcinoma of the Head and Neck

    SciTech Connect

    Cooper, Jay S., E-mail: jcooper@maimonidesmed.org [Maimonides Cancer Center, New York, New York (United States); Zhang Qiang; Pajak, Thomas F. [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States)] [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Forastiere, Arlene A. [Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States)] [Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States); Jacobs, John [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States)] [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States); Saxman, Scott B. [Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland (United States)] [Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland (United States); Kish, Julie A. [H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Kim, Harold E. [Wayne State University Medical Center, Detroit, Michigan (United States)] [Wayne State University Medical Center, Detroit, Michigan (United States); Cmelak, Anthony J. [Vanderbilt Cancer Center, Nashville, Tennessee (United States)] [Vanderbilt Cancer Center, Nashville, Tennessee (United States); Rotman, Marvin [SUNY Health Center at Brooklyn, Brooklyn, New York (United States)] [SUNY Health Center at Brooklyn, Brooklyn, New York (United States); Lustig, Robert [Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States)] [Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ensley, John F. [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States)] [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States); Thorstad, Wade [Washington University, St. Louis, Missouri (United States)] [Washington University, St. Louis, Missouri (United States); Schultz, Christopher J. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States)] [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Yom, Sue S. [University of California, San Francisco, California (United States)] [University of California, San Francisco, California (United States); Ang, K. Kian [University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-12-01

    Purpose: Previous analysis of this Intergroup trial demonstrated that with a median follow-up among surviving patients of 45.9 months, the concurrent postoperative administration of cisplatin and radiation therapy improved local-regional control and disease-free survival of patients who had high-risk resectable head-and-neck carcinomas. With a minimum of 10 years of follow-up potentially now available for all patients, these results are updated here to examine long-term outcomes. Methods and Materials: A total of 410 analyzable patients who had high-risk resected head-and-neck cancers were prospectively randomized to receive either radiation therapy (RT: 60 Gy in 6 weeks) or identical RT plus cisplatin, 100 mg/m{sup 2}i.v. on days 1, 22, and 43 (RT + CT). Results: At 10 years, the local-regional failure rates were 28.8% vs 22.3% (P=.10), disease-free survival was 19.1% vs 20.1% (P=.25), and overall survival was 27.0% vs 29.1% (P=.31) for patients treated by RT vs RT + CT, respectively. In the unplanned subset analysis limited to patients who had microscopically involved resection margins and/or extracapsular spread of disease, local-regional failure occurred in 33.1% vs 21.0% (P=.02), disease-free survival was 12.3% vs 18.4% (P=.05), and overall survival was 19.6% vs 27.1% (P=.07), respectively. Conclusion: At a median follow-up of 9.4 years for surviving patients, no significant differences in outcome were observed in the analysis of all randomized eligible patients. However, analysis of the subgroup of patients who had either microscopically involved resection margins and/or extracapsular spread of disease showed improved local-regional control and disease-free survival with concurrent administration of chemotherapy. The remaining subgroup of patients who were enrolled only because they had tumor in 2 or more lymph nodes did not benefit from the addition of CT to RT.

  14. Complications in advanced or recurrent gastric cancer patients with peritoneal metastasis during and after palliative systemic chemotherapy

    PubMed Central

    HAMAMOTO, YASUO

    2015-01-01

    Peritoneal metastasis (PM) in gastric cancer (GC) is often the cause of several complications, including ascites and bowel obstruction. The prognosis of patients with extensive PM is poor. There are only limited data available on clinical characteristics regarding the period between the initiation of chemotherapy until the death of the patient. We conducted a retrospective study to determine the frequency of major events during and after palliative chemotherapy in advanced GC patients with PM. The records of patients who received first-line palliative chemotherapy at the Tochigi Cancer Center for locally advanced or metastatic disease were reviewed. The extracted information included treatments received and emerging complications. Overall survival was compared between patients with and those without PM. A total of 97 patients were reviewed and the prevalence of complications with or without concurrent PM were as follows: bowel obstruction: PM, 37% (16/43) and non-PM, 20% (11/54) (P=0.0664); ascites: PM, 49% (21/43) and non-PM, 7% (4/54) (P<0.0001). The clinical characteristics of patients with PM from GC are unique. Therefore, it is crucial to consider PM as a predictive sign and an important factor when making clinical decisions and developing treatment strategies.

  15. 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, E-mail: isekine@ncc.go.jp [Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Ito, Yoshinori [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Horinouchi, Hidehito; Nokihara, Hiroshi; Yamamoto, Noboru; Kunitoh, Hideo; Ohe, Yuichiro; Kubota, Kaoru; Tamura, Tomohide [Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan)

    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.

  16. Multivariate analysis of brain metabolism reveals chemotherapy effects on prefrontal cerebellar system when related to dorsal attention network

    PubMed Central

    2013-01-01

    Background Functional brain changes induced by chemotherapy are still not well characterized. We used a novel approach with a multivariate technique to analyze brain resting state [18?F]FDG-PET in patients with lymphoma, to explore differences on cerebral metabolic glucose rate between chemotherapy-treated and non-treated patients. Methods PET/CT scan was performed on 28 patients, with 14 treated with systemic chemotherapy. We used a support vector machine (SVM) classification, extracting the mean metabolism from the metabolic patterns, or networks, that discriminate the two groups. We calculated the correct classifications of the two groups using the mean metabolic values extracted by the networks. Results The SVM classification analysis gave clear-cut patterns that discriminate the two groups. The first, hypometabolic network in chemotherapy patients, included mostly prefrontal cortex and cerebellar areas (central executive network, CEN, and salience network, SN); the second, which is equal between groups, included mostly parietal areas and the frontal eye field (dorsal attention network, DAN). The correct classification membership to chemotherapy or not chemotherapy-treated patients, using only one network, was of 50% to 68%; however, when all the networks were used together, it reached 80%. Conclusions The evidenced networks were related to attention and executive functions, with CEN and SN more specialized in shifting, inhibition and monitoring, DAN in orienting attention. Only using DAN as a reference point, indicating the global frontal functioning before chemotherapy, we could better classify the subjects. The emerging concept consists in the importance of the investigation of brain intrinsic networks and their relations in chemotherapy cognitive induced changes. PMID:23557152

  17. 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.

  18. New NP-complete problems in performance evaluation of concurrent systems using Petri nets

    SciTech Connect

    Magott, J.

    1987-05-01

    Timed Petri nets are useful in performance evaluation of concurrent systems. The maximum computation rate is achieved for minimal cycle time of timed Petri net. It is known that minimal cycle time problem for P-invariant Petri nets is NP-complete. In this paper the authors prove that the minimal cycle time problem, for non-P-invariant Petri nets and for a small subclass of P-invariant Petri nets called free-choice nets having live and safe marking, is NP-complete.

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

    E-print Network

    Kim Lee, Hyunsoon

    1993-01-01

    , the values in the write set of transaction T; are copied into nonvolatile storage in the related sites while the validation test is applied. During the validation test, all the data items in the base set of T;, the set of data item in either read or write... for the degree of MASTER OF SCIENCE May 1993 Major Subject: Computer Science PERFORMANCE STUDY OF OPTIMISTIC CONCURRENCY CONTROL SCHEMES FOR DISTRIBUTED DATABASE SYSTEMS A Thesis by HYUNSOON KIM LEE Approved as to style and content by: unguk L. Kim...

  20. Phase II study of central nervous system (CNS)-directed chemotherapy including high-dose chemotherapy with autologous stem cell transplantation for CNS relapse of aggressive lymphomas

    PubMed Central

    Korfel, Agnieszka; Elter, Thomas; Thiel, Eckhard; Hänel, Matthias; Möhle, Robert; Schroers, Roland; Reiser, Marcel; Dreyling, Martin; Eucker, Jan; Scholz, Christian; Metzner, Bernd; Röth, Alexander; Birkmann, Josef; Schlegel, Uwe; Martus, Peter; Illerhaus, Gerard; Fischer, Lars

    2013-01-01

    The prognosis of patients with central nervous system relapse of aggressive lymphoma is very poor with no therapy established so far. In a prospective multicenter phase II study, we evaluated a potentially curative chemotherapy-only regimen in these patients. Adult immunocompetent patients 65 years of age or under received induction chemotherapy with MTX/IFO/DEP (methotrexate 4 g/m2 intravenously (i.v.) Day 1, ifosfamide 2 g/m2 i.v. Days 3– 5 and liposomal cytarabine 50 mg intrathecally (i.th) Day 6) and AraC/TT/DEP (cytarabine 3g/m2 i.v. Days 1–2, thiotepa 40 mg/m2 i.v. Day 2 and i.th. liposomal cytarabine 50 mg i.th. Day 3) followed by high-dose chemotherapy with carmustine 400 mg/m2 i.v. Day ?5, thiotepa 2×5 mg/kg i.v. Days ?4 to ?3 and etoposide 150 mg/m2 i.v. Days ?5 to ?3, and autologous stem cell transplantation Day 0 (HD-ASCT). Thirty eligible patients (median age 58 years) were enrolled. After HD-ASCT (n=24), there was a complete remission in 15 (63%), partial remission in 2 (8%) and progressive disease in 7 (29%) patients. Myelotoxicity was the most adverse event with CTC grade 3/4 infections in 12% of MTX/IFO/DEP courses, 21% of AraC/TT/DEP courses and 46% of HD-ASCT courses. The 2-year time to treatment failure was 49%±19 for all patients and 58%±22 for patients completing HD-ASCT. The protocol assessed proved feasible and highly active with long-lasting remissions in a large proportion of patients. (ClinicalTrials.govIdentifier NCT01148173) PMID:23242601

  1. Outcomes in 24 selected patients with stage IVB cervical cancer and excellent performance status treated with radiotherapy and chemotherapy

    Microsoft Academic Search

    Israel Zighelboim; Nicholas P. Taylor; Matthew A. Powell; Randall K. Gibb; Janet S. Rader; David G. Mutch; Perry W. Grigsby

    2006-01-01

    Purpose  We sought to review outcomes in patients with stage IVB carcinoma of the cervix treated with irradiation in combination with\\u000a chemotherapy.\\u000a \\u000a \\u000a \\u000a Materials and methods  We report outcomes of 24 consecutive patients with good performance status treated from 1998 to 2005. Most of these patients\\u000a underwent concurrent irradiation with platinum-based chemotherapy. Some patients received subsequent systemic chemotherapy.\\u000a \\u000a \\u000a \\u000a Results  All patients underwent external beam

  2. 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.

  3. Methotrexate based chemotherapy and deferred radiotherapy for primary central nervous system lymphoma (PCNSL): single institution experience

    Microsoft Academic Search

    A. Silvani; A. Salmaggi; M. Eoli; E. Lamperti; G. Broggi; C. E. Marras; L. Fariselli; I. Milanesi; A. Fiumani; P. Gaviani; A. Erbetta; A. R. Giovagnoli; B. Pollo; A. Botturi; A. Boiardi

    2007-01-01

    In the following study, we present our experience in the treatment of PCNSL patients using a multi-step schedule combining\\u000a chemotherapy and deferred radiotherapy. Patients were treated with two modified M-BACOD cycles and then differently according\\u000a to radiological response For PR, SD and PD patients, chemotherapy was interrupted and radiotherapy initiated immediately (45 Gy\\u000a Whole-brain RT). With CR patients, chemotherapy was continued

  4. 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

  5. A Comparison of the Concurrence and the Quantum Discord in a Two-Qubit System

    NASA Astrophysics Data System (ADS)

    Yang, Guo-Hui; Wang, Rong

    2015-02-01

    The quantum correlation dynamics in an anisotropic Heisenberg XYZ model under decoherence are investigated with the use of concurrence C and quantum discord (QD). There is a remarkable difference between the time evolution behaviors of these two correlation measures: there is a entanglement-sudden-death phenomenon in the concurrence while there is none in QD, which is valid for all of the initial states of this system, and the interval time of the entanglement death is found to be strongly dependent on the initial states and the parameters B and ?. With the long-time limit the steady entanglement (SC) and steady quantum discord (SQD) can be obtained. The magnitudes of SC and SQD are closely related to the parameters B and ?, while the strength of the Dzyaloshinskii—Moriya interaction, D, has no influence. In addition, the effects of the parameters B and ? on SC and SQD display such different and complicated features that one cannot obtain a uniform law about them, thus we give an analytical explanation of this phenomenon. Lastly, it can be noted that the value of SC is not always larger than SQD, which is strongly dependent on the parameters B and ?.

  6. Block copolymer carrier systems for translymphatic chemotherapy of lymph node metastases.

    PubMed

    Dünne, Anja A; Boerner, Hans G; Kukula, Hildegard; Schlaad, Helmut; Wiegand, Susanne; Werner, Jochen A; Antonietti, Markus

    2007-01-01

    The presence of lymph node metastases relevantly and significantly impairs disease-specific survival in patients suffering from squamous cell carcinoma of the upper aerodigestive tract. In a VX2 animal tumor model, we present an interstitial translymphatic therapeutic approach using cis-diaminedichloro-platinum(II) (CDDP) conjugated to a poly(ethylene oxide)-block-poly(lysine) (PEO-b-PLys) block copolymer tracking systems for the successful treatment of lymph node metastases. Most effective was the application of a high cargo-load CDDP tracking system (48 wt. % CDDP) curing 90% of the animals and causing only minor local side-effects. Systems containing 1 or 10 wt. % of CDDP were less effective but still cured 50% of the animals. Moreover, the administration of 1 or 10 wt. % of CDDP consistently limited tumor growth to the draining lymph nodes (50%) and prevented systemic distribution of the metastasis even'with 1 wt. % CDDP load. The systems contained 0.25-0.003 mg/kg per body weight CDDP compared to 1 ml/kg per body weight as usually used for intravenous administration. This approach encourages further and more detailed research of a CDDP-based interstitial translymphatic administration of chemotherapy for lymphogenic metastasizing carcinomas in different body regions. PMID:18225553

  7. Local and systemic chemotherapy in the management of periodontal disease: an opinion and review of the concept.

    PubMed

    Addy, M; Renton-Harper, P

    1996-04-01

    Periodontal disease appears to arise from the interaction of pathogenic bacteria with a susceptible host. The main aims of disease management have been to establish a high standard of oral hygiene and to professionally and thoroughly debride the root surface Chemical agents could be considered for both aspects of management. Chemoprevention using supragingivally delivered agents such as chlorhexidine may be questioned for value in the pre-treatment hygiene phase but have well-established efficacy immediately preoperatively and during the post-operative weeks. Long-term maintenance use of chlorhexidine is problematic due to local side effects. Antiplaque toothpastes show modest benefits to gingivitis but are not proven to prevent recurrence of periodontitis. Chemotherapy may be directed at subgingival plaque, using antimicrobials, or at the host response using anti-inflammatory agents. Antimicrobials can be locally or systemically delivered. In most cases antimicrobial chemotherapy should be considered adjunctive to mechanical debridement. The advantages of local and systemic chemotherapy must be balanced against the disadvantages and potential side effects of agents. Antimicrobial chemotherapy offers little or no benefit to the treatment of most chronic adult periodontitis patients and should be reserved for the more rapid or refractory types of disease, and after the debridement phase. Despite the large number of studies there are insufficient comparative data to support any one local delivery system or systemic regimen as superior to another. Systemic versus local antimicrobials have not been compared to date. Host response modifying drugs such as non-steriodal anti-inflammatory drugs (NSAIDS) offer the potential to reduce breakdown and promote healing, including bone regeneration. However until more data are available, NSAIDs should not be used in the management of chronic periodontal diseases, there being no specific agent(s) or regimen established for use. Chemotherapy has an important place in the management of chronic periodontal diseases but routine use must be considered as an over prescription of these valuable agents. PMID:8730268

  8. 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 ...

  9. Proceeding of International Conference on Application of Concurrency to System Design, p. 3440, 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 discrete­event (DE) concurrency domains in Ptolemy. In this heterogeneous combination, the seman­ tics

  10. 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

    -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

  11. Design for improved maintenance of the fiber-optic cable system (As carried out in a concurrent engineering environment)

    Microsoft Academic Search

    P. C. Tremoulet

    1992-01-01

    The author describes a number of maintenance improvements in the Fiber Optic Cable System (FOCS). They were achieved during a production phase pilot concurrent engineering program. Listed in order of importance (saved maintenance time and material) by maintenance level, they are: (1) organizational level: improved fiber optic converter (FOC) BITE; (2) Intermediate level: reduced FOC adjustments from 20 to 2;

  12. A Multiobjective Evolutionary Approach to Concurrently Learn Rule and Data Bases of Linguistic Fuzzy-Rule-Based Systems

    Microsoft Academic Search

    Rafael Alcalá; Pietro Ducange; Francisco Herrera; Beatrice Lazzerini; Francesco Marcelloni

    2009-01-01

    In this paper, we propose the use of a multiobjective evolutionary approach to generate a set of linguistic fuzzy-rule-based systems with different tradeoffs between accuracy and interpretability in regression problems. Accuracy and interpretability are measured in terms of approximation error and rule base (RB) complexity, respectively. The proposed approach is based on concurrently learning RBs and parameters of the membership

  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. Surviving Chemotherapy

    NSDL National Science Digital Library

    Dr. Margaret A McMichael (Baton Rouge Community College Biological Sciences)

    2008-08-15

    Lecture outlinne, with embedded notes, to serve as a starting point for in-class discussion, student research and presentation. Lecture provides a review of cancer, chemotherapy, risk factors for cancer, and correlations between all and nutrition.

  15. 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 ...

  16. 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, E-mail: msuntha@umm.edu [Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland (United States)] [Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland (United States); Paulus, Rebecca [Radiation Therapy Oncology Group, Philadelphia, Pennsylvania (United States)] [Radiation Therapy Oncology Group, Philadelphia, Pennsylvania (United States); Edelman, Martin J. [Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland (United States)] [Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland (United States); Krasna, Mark [Cancer Center at St. Joseph Medical Center, Towson, Maryland (United States)] [Cancer Center at St. Joseph Medical Center, Towson, Maryland (United States); Burrows, Whitney [Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland (United States)] [Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland (United States); Gore, Elizabeth [Dept of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)] [Dept of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wilson, Lynn D. [Dept of Radiation Oncology, Yale School of Medicine, New Haven, Connecticut (United States)] [Dept of Radiation Oncology, Yale School of Medicine, New Haven, Connecticut (United States); Choy, Hak [Dept of Radiation Oncology, University of Texas Southwestern, Dallas, Texas (United States)] [Dept of Radiation Oncology, University of Texas Southwestern, Dallas, Texas (United States)

    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.

  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 [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Axelrod, Rita [Department of Medical Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Andrews, David [Department of Neurosurgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Dicker, Adam P., E-mail: adam.dicker@jeffersonhospital.or [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States)

    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. Methodology for Examining the Operator and the System Concurrently: Pilot Interaction with Automation

    NASA Technical Reports Server (NTRS)

    Austin, David; Degani, Asaf; Heymann, Michael; Moodi, Mike; Remington, Roger (Technical Monitor)

    1998-01-01

    Complex system description is problematic when considering operator task activities interacting with system dynamics. Engineering languages have matured sufficiently to allow machine system description at various levels of depth and breadth but without operator synergy. Concurrently, Task Analysis methods have evolved along diverse lines enabling a description of the operator in the system from various paradigms but not describing the system. A void exists when attempting to view the system and the operator in the same plane. We propose a methodology employing descriptive languages from different domains viewed in a single dimension. Finite Automata (FA) languages describe the machine system in the proposed approach. Operator task specifications, a form of task analysis output, examine the operator activities within the system. Operator task specifications were then selected for discrete task activities and overlaid on the system description to examine operator inputs and subsequently view system responses. Unexpected (surprise) and undesirable system behavior was expected to emerge from this analysis. In this paper we shall first describe the methodology and show how the two perspectives, machine model and operator task specifications are integrated. Following we describe the process of doing such analysis using an example from cockpit automation. The methodology was employed in the analysis of a new function that was added to an existing automatic flight control system. We begin by defining a flight scenario involving all aspects of pilot interaction with the new function. Then, we proceed to develop a basic model of the machine behavior, in the context of pilot actions. Finally we superimpose the operator task specification on the machine model and perform the analysis. The proposed methodology may have broad appeal to system designers and human factors specialists. A common language for engineers of diverse domains is a strong point of this approach. Systems engineers may not fully understand operational considerations and human limitations, and human factors specialists may not be exposed to the full extent of system behavior. We hope the proposed methodology is adopted by both disciplines and in the process each assimilates a common language to address potential shortcomings of either approach separately.

  19. 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)

    Microsoft Academic Search

    Shulian Wang; Zhongxing Liao; Xiong Wei; Helen H. Liu; Susan L. Tucker; Chao-su Hu; Rodhe Mohan; James D. Cox; Ritsuko Komaki

    2006-01-01

    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

  20. Behavioral approach system (BAS)-relevant cognitive styles and bipolar spectrum disorders: concurrent and prospective associations.

    PubMed

    Alloy, Lauren B; Abramson, Lyn Y; Walshaw, Patricia D; Gerstein, Rachel K; Keyser, Jessica D; Whitehouse, Wayne G; Urosevic, Snezana; Nusslock, Robin; Hogan, Michael E; Harmon-Jones, Eddie

    2009-08-01

    The authors examined concurrent and prospective associations of behavioral approach system (BAS)-relevant and non-BAS-relevant cognitive styles with bipolar spectrum disorders. Controlling for depressive and hypomanic/manic symptoms, 195 individuals with bipolar spectrum disorders scored higher than 194 demographically similar normal controls on BAS sensitivity and BAS-relevant cognitive dimensions of performance concerns, autonomy, and self-criticism, but not on behavioral inhibition system sensitivity and non-BAS-relevant dimensions of approval seeking, sociotropy, and dependency. Moreover, group differences on autonomy fully mediated the association between higher BAS sensitivity and bipolar status. In addition, only BAS-related cognitive dimensions predicted the likelihood of onset of depressive and hypomanic/manic episodes among the bipolar individuals over a 3.2-year follow-up, controlling for initial symptoms and past history of mood episodes. Higher autonomy and self-criticism predicted a greater likelihood of hypomanic/manic episodes, and higher autonomy predicted a lower likelihood of major depressive episodes. In addition, autonomy mediated the associations between BAS sensitivity and prospective hypomanic/manic episodes. These findings suggest that individuals with bipolar spectrum disorders may exhibit a unique profile of BAS-relevant cognitive styles that influence the course of their mood episodes. PMID:19685944

  1. Request Window: an Approach to Improve Throughput of RDBMS-based Data Integration System by Utilizing Data Sharing Across Concurrent Distributed Queries

    Microsoft Academic Search

    Rubao Lee; Minghong Zhou; Huaming Liao

    2007-01-01

    This paper focuses on the problem of improving distributed query throughput of the RDBMS-based data integration system that has to inherit the query execution model of the underlying RDBMS: execute each query independently and utilize a global buffer pool mechanism to provide disk page sharing across concurrent query execution processes. However, this model is not suitable for processing concurrent distributed

  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. 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

  4. BOUNDED CONCURRENT TIME-STAMPING DANNY DOLEV AND NIR SHAVIT

    E-print Network

    Lynch, Nancy

    BOUNDED CONCURRENT TIME-STAMPING DANNY DOLEV AND NIR SHAVIT SIAM J. COMPUT. c 1997 Society concurrent time-stamping, a paradigm that allows processes to tem- porally order concurrent events in an asynchronous shared-memory system. Concurrent time-stamp systems are powerful tools for concurrency control

  5. 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.

  6. A web-based advisory system for process and material selection in concurrent product design for a manufacturing environment

    Microsoft Academic Search

    Xuan F. Zha

    2005-01-01

    This paper reports the work of selecting suitable manufacturing processes and materials in concurrent design for manufacturing environment. In the paper, a fuzzy knowledge-based decision support method is proposed for multi-criteria decision-making in evaluating and selecting possible manufacturing process\\/material combinations in terms of the total production cost. Based on the proposed method, a prototype Web-based knowledge-intensive manufacturing consulting service system

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

    Microsoft Academic Search

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

    2009-01-01

    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˛\\/dose) on Days 1, 4, 8, and 11 of a

  8. Behavioral Approach System (BAS) Sensitivity and Bipolar Spectrum Disorders: A Retrospective and Concurrent Behavioral High-Risk Design

    Microsoft Academic Search

    Lauren B. Alloy; Lyn Y. Abramson; Patricia D. Walshaw; Alex Cogswell; Jeannette M. Smith; Amy M. Neeren; Megan E. Hughes; Brian M. Iacoviello; Rachel K. Gerstein; Jessica Keyser; Snezana Urosevic; Robin Nusslock

    2006-01-01

    In this article, we tested the vulnerability hypothesis of the behavioral approach system (BAS) hypersensitivity model of\\u000a bipolar disorders. We examined whether self-reported BAS sensitivity predicts lifetime bipolar spectrum diagnoses as well\\u000a as symptoms and personality characteristics associated with bipolar disorder using a retrospective and concurrent behavioral\\u000a high-risk design. Participants with high (HBAS; n=28) or moderate (MBAS; n=24) BAS sensitivity

  9. 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.

  10. Carcinoembryonic antigen in monitoring of response to systemic chemotherapy in patients with metastatic colorectal cancer

    Microsoft Academic Search

    Wei-Shu Wang; Jen-Kou Lin; Tzu-Chen Lin; Tzeon-Jye Chiou; Jin-Hwang Liu; Frank S. Fan; Chueh-Chuan Yen; Wei-Shone Chen; Jeng-Kae Jiang; Shung-Haur Yang; Huann-Sheng Wang; Po-Min Chen

    2001-01-01

    The response to chemotherapy of solid tumors is generally assessed by measuring tumors visualized by imaging. However, the response assessment based on imaging is not always feasible because patients often have disease not measurable by imaging, such as diffuse peritoneal dissemination. We evaluated the correlation between the change on imaging and change in CEA levels for assessing chemotherapeutic response of

  11. Regional Intra-Arterial vs. Systemic Chemotherapy for Advanced Pancreatic Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Sun, Junwei; Yuan, Zhanna; Li, Shasha; Sheng, Jun; Ren, He; Hao, Jihui

    2012-01-01

    Objective To investigate the efficacy and safety of regional intra-arterial chemotherapy (RIAC) versus systemic chemotherapy for stage III/IV pancreatic cancer. Methods Randomized controlled trials of patients with advanced pancreatic cancer treated by regional intra-arterial or systemic chemotherapy were identified using PubMed, ISI, EMBASE, Cochrane Library, Google, Chinese Scientific Journals Database (VIP), and China National Knowledge Infrastructure (CNKI) electronic databases, for all publications dated between 1960 and December 31, 2010. Data was independently extracted by two reviewers. Odds ratios and relative risks were pooled using either fixed- or random-effects models, depending on I2 statistic and Q test assessments of heterogeneity. Statistical analysis was performed using RevMan 5.0. Results Six randomized controlled trials comprised of 298 patients met the standards for inclusion in the meta-analysis, among 492 articles that were identified. Eight patients achieved complete remission (CR) with regional intra-arterial chemotherapy (RIAC), whereas no patients achieved CR with systemic chemotherapy. Compared with systemic chemotherapy, patients receiving RIAC had superior partial remissions (RR?=?1.99, 95% CI: 1.50, 2.65; 58.06% with RIAC and 29.37% with systemic treatment), clinical benefits (RR?=?2.34, 95% CI: 1.84, 2.97; 78.06% with RAIC and 29.37% with systemic treatment), total complication rates (RR?=?0.72, 95% CI: 0.60, 0.87; 49.03% with RIAC and 71.33% with systemic treatment), and hematological side effects (RR?=?0.76, 95% CI: 0.63, 0.91; 60.87% with RIAC and 85.71% with systemic treatment). The median survival time with RIAC (5–21 months) was longer than for systemic chemotherapy (2.7–14 months). Similarly, one year survival rates with RIAC (28.6%?41.2%) were higher than with systemic chemotherapy (0%?12.9%.). Conclusion Regional intra-arterial chemotherapy is more effective and has fewer complications than systemic chemotherapy for treating advanced pancreatic cancer. PMID:22815840

  12. Proving Ptolemy Right: The Environment Abstraction Framework for Model Checking Concurrent Systems

    Microsoft Academic Search

    Edmund M. Clarke; Muralidhar Talupur; Helmut Veith

    2008-01-01

    The parameterized verification of concurrent algorithms an d protocols has been addressed by a variety of recent methods. Experience shows that there is a trade-off between techniques which are widely applicable but depend on non- trivial human guidance, and fully automated approaches which are tailored for narrow classes of applications. In this spectrum, we propose a new framework based on

  13. Designing Concurrent and Distributed Control Systems: an Approach Based on Design Patterns

    Microsoft Academic Search

    Amund Aarsten; Davide Brugali; Giuseppe Menga

    1996-01-01

    Developing large control architectures is complex. It usually requires a decomposition in subsystems or control modules, which have to communicate in complex patterns in order to achieve a common objective. Furthermore, control modules operate concurrently, and are usually installed on a distributed computer platform. Analysis of the relationships between elements is of the utmost importance in the design of the

  14. The Impact of Initial Gefitinib or Erlotinib versus Chemotherapy on Central Nervous System Progression in Advanced Non–Small Cell Lung Cancer with EGFR Mutations

    PubMed Central

    Heon, Stephanie; Yeap, Beow Y.; Lindeman, Neal I.; Joshi, Victoria A.; Butaney, Mohit; Britt, Gregory J.; Costa, Daniel B.; Rabin, Michael S.; Jackman, David M.; Johnson, Bruce E.

    2013-01-01

    Purpose This retrospective study was undertaken to investigate the impact of initial gefitinib or erlotinib (EGFR tyrosine kinase inhibitor, EGFR-TKI) versus chemotherapy on the risk of central nervous system (CNS) progression in advanced non–small cell lung cancer (NSCLC) with EGFR mutations. Experimental Design Patients with stage IV or relapsed NSCLC with a sensitizing EGFR mutation initially treated with gefitinib, erlotinib, or chemotherapy were identified. The cumulative risk of CNS progression was calculated using death as a competing risk. Results One hundred and fifty-five patients were eligible (EGFR-TKI: 101, chemotherapy: 54). Twenty-four patients (24%) in the EGFR-TKI group and 12 patients (22%) in the chemotherapy group had brain metastases at the time of diagnosis of advanced NSCLC (P = 1.000); 32 of the 36 received CNS therapy before initiating systemic treatment. Thirty-three patients (33%) in the EGFR-TKI group and 26 patients (48%) in the chemotherapy group developed CNS progression after a median follow-up of 25 months. The 6-, 12-, and 24-month cumulative risk of CNS progression was 1%, 6%, and 21% in the EGFR-TKI group compared with corresponding rates of 7%, 19%, and 32% in the chemotherapy group (P = 0.026). The HR of CNS progression for upfront EGFR-TKI versus chemotherapy was 0.56 [95% confidence interval (CI), 0.34–0.94]. Conclusions Our data show lower rates of CNS progression in EGFR-mutant advanced NSCLC patients initially treated with an EGFR-TKI compared with upfront chemotherapy. If validated, our results suggest that gefitinib and erlotinib may have a role in the chemoprevention of CNS metastases from NSCLC. PMID:22733536

  15. Care network Coordination for Chemotherapy at Home: A Case Study

    E-print Network

    Paris-Sud XI, Université de

    Care network Coordination for Chemotherapy at Home: A Case Study Tian Zhang1 , Eric Marcon1 , Maria.di-mascolo@g-scop.grenoble-inp.fr Abstract. This paper deals with a system of chemotherapy at home which is managed by a Home Care Services organization of chemotherapy at home. In this work, we model a real system of chemotherapy at home managed

  16. On Optimistic Methods for Concurrency Control

    Microsoft Academic Search

    H. T. Kung; John T. Robinson

    1979-01-01

    Most current approaches to concurrency control in database systems rely on locking of data objects as a control mechanism. In this paper, two families of nonlocking concurrency controls are presented. The methods used are \\

  17. Chemotherapy targeting cancer stem cells

    PubMed Central

    Liu, Haiguang; Lv, Lin; Yang, Kai

    2015-01-01

    Conventional chemotherapy is the main treatment for cancer and benefits patients in the form of decreased relapse and metastasis and longer overall survival. However, as the target therapy drugs and delivery systems are not wholly precise, it also results in quite a few side effects, and is less efficient in many cancers due to the spared cancer stem cells, which are considered the reason for chemotherapy resistance, relapse, and metastasis. Conventional chemotherapy limitations and the cancer stem cell hypothesis inspired our search for a novel chemotherapy targeting cancer stem cells. In this review, we summarize cancer stem cell enrichment methods, the search for new efficient drugs, and the delivery of drugs targeting cancer stem cells. We also discuss cancer stem cell hierarchy complexity and the corresponding combination therapy for both cancer stem and non-stem cells. Learning from cancer stem cells may reveal novel strategies for chemotherapy in the future. PMID:26045975

  18. Concurrent, Overlapping Development and the Dynamic System Analysis of a Software Project

    Microsoft Academic Search

    Jaideep Ghosh

    2010-01-01

    In recent years concurrent, overlapping development activities of engineering tasks have proved to be a cost-effective and time-efficient way to build products geared toward meeting the demands of a competitive and quality-conscious market. In this study, we examine the structure and dynamics of a software project in information technology industrial research and development that has this methodology as its foundation.

  19. Self-healing components in robust software architecture for concurrent and distributed systems

    Microsoft Academic Search

    Michael E. Shin

    2005-01-01

    This paper describes an approach to designing self-healing components for robust, concurrent and distributed software architecture. A self-healing component is able to detect object anomalies inside of the component, reconfigure inter-component and intra-components before and after repairing the sick object, repair it, and then test the healed object. For this, each self-healing component is structured to the layered architecture with

  20. 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, E-mail: hseki@niigata-cc.jp; Ozaki, Toshirou; Shiina, Makoto [Niigata Cancer Center Hospital, Department of Radiology (Japan)

    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.

  1. The Concurrency Column

    Microsoft Academic Search

    Luca Aceto

    Process calculi like ACP, CCS, CSP and various flavours of the ?-calculus are popular specification formalisms for concurrent, distribu ted and possibly mo- bile systems. The semantic theory of process calculi has been the subject of extensive investigation for about twenty five years now, and several robust, general principles and results applying to a variety of different formalisms have been

  2. Dynamic Scheduling and Synchronization Synthesis of Concurrent Digital Systems under System-Level Constraints

    E-print Network

    De Micheli, Giovanni

    and quantifiers of the design are determined. This algebraic system is then analyzed and the design space not optimal) controllers. However, when considering more complex design and synchronization constraints component or data-flow graph at a time. In order to satisfy these complex design and synchro- nization

  3. Methotrexate based chemotherapy and deferred radiotherapy for primary central nervous system lymphoma (PCNSL): single institution experience.

    PubMed

    Silvani, A; Salmaggi, A; Eoli, M; Lamperti, E; Broggi, G; Marras, C E; Fariselli, L; Milanesi, I; Fiumani, A; Gaviani, P; Erbetta, A; Giovagnoli, A R; Pollo, B; Botturi, A; Boiardi, A

    2007-05-01

    In the following study, we present our experience in the treatment of PCNSL patients using a multi-step schedule combining chemotherapy and deferred radiotherapy. Patients were treated with two modified M-BACOD cycles and then differently according to radiological response For PR, SD and PD patients, chemotherapy was interrupted and radiotherapy initiated immediately (45 Gy Whole-brain RT). With CR patients, chemotherapy was continued with a combination of HMTX, VCZ, PCB and HD Ara-C up to a total of nine cycles. In 36 patients suitable for evaluation (2 patients had undergone tumour resection): 69.4% (25 of 36) had a complete response (CR), 19.4% (7 of 36) had a partial response(PR), 8.3% (3 of 36) had stable disease(SD), and 2.7% (one of 36) had progressive disease (PD). The PR, SD and PD patients were immediately treated by radiotherapy. In this cohort of patients, we observed 6 CR, 4 PR and 2 PD, respectively, following radiotherapy. At first relapse, a total of 16 CR patients were treated by radiotherapy for a total dose of 45 Gy. The OS was 42.1 months for the entire group of patients. In CR patients treated at the moment of recurrence by salvage radiotherapy, the TTP (time lasting from histological diagnosis until recurrence of disease before RT) was 28.3 months, with a 43.4% of disease free patients observed at 2 years. The median disease-free time observed after complete response to radiotherapy was 10.5 months. In 16 patients (34%), further progression of disease was observed following radiotherapy. Two patients developed extra-CNS disease in the breast and testis. When taking into account the patients with radiotherapy delayed at recurrence, the OS was 48 months and the survival rates were 70% and 60% at 2 years and 5 years, respectively. PMID:17111190

  4. Hyperthermia as Adjunct to Intravesical Chemotherapy for Bladder Cancer

    PubMed Central

    Owusu, Richmond A.; Abern, Michael R.; Inman, Brant A.

    2013-01-01

    Nonmuscle invasive bladder cancer remains a very costly cancer to manage because of high recurrence rates requiring long-term surveillance and treatment. Emerging evidence suggests that adjunct and concurrent use of hyperthermia with intravesical chemotherapy after transurethral resection of bladder tumor further reduces recurrence risk and progression to advanced disease. Hyperthermia has both direct and immune-mediated cytotoxic effect on tumor cells including tumor growth arrest and activation of antitumor immune system cells and pathways. Concurrent heat application also acts as a sensitizer to intravesical chemotherapy agents. As such the ability to deliver hyperthermia to the focus of tumor while minimizing damage to surrounding benign tissue is of utmost importance to optimize the benefit of hyperthermia treatment. Existing chemohyperthermia devices that allow for more localized heat delivery continue to pave the way in this effort. Current investigational methods involving heat-activated drug delivery selectively to tumor cells using temperature-sensitive liposomes also offer promising ways to improve chemohyperthermia efficacy in bladder cancer while minimizing toxicity to benign tissue. This will hopefully allow more widespread use of chemohyperthermia to all bladder cancer patients, including metastatic bladder cancer. PMID:24073396

  5. Symptom management in patients with cancer of the female reproductive system receiving chemotherapy.

    PubMed

    Phianmongkhol, Yupin; Suwan, Natthawan

    2008-01-01

    This study was conducted to examine the feelings, symptom management, and needs of patients with gynecological cancer receiving chemotherapy at Chiang Mai University Hospital, Chiang Mai, Thailand. During the period July 2006 and June 2007, 286 patients were recruited. The most common chemotherapeutic regimen was paclitaxel and carboplatin followed by single carboplatin and weekly cisplatin. Five severe and frequent complications were as follows: alopecia, anorexia, fatigue, nausea, and vomiting. Some 41.9% could well tolerate with such complications but 50.3% had various feelings including irritability, boredom, dejection, fear, stress, and anxiety. Anorexia was the symptom that the majority of them could best manage, 17.4% by eating as much as they can and 32.6% by selecting different foods from normal, such as fruit, sweetmeats, noodles, milk. For nausea and vomiting, 31.3% managed by eating fruit, drinking sour juice, and holding sour fruit in mouth, and 16.0% used the breathing method, eating something cold, such as ice-cream, or hot food like noodles. For health needs, 41.0% needed encouragement, care, health education, and information from doctors and nurses, and 5.0% needed care and encouragement from their family, and sympathy from neighbors and colleagues. In conclusion, gynecological cancer patients receiving chemotherapy experience a variety of feelings, symptom management. and health needs. Nurses need to explain the pathology of the occurring symptoms so that the patients can understand and accept the symptoms to lessen their negative impact. PMID:19256770

  6. Sensing materials with a concurrent sensitivity: design, synthesis and application in multisensory systems

    NASA Astrophysics Data System (ADS)

    Lvova, Larisa; Pomarico, Giuseppe; Spiridonov, Igor; Mednova, Olga; Kirsanov, Dmitry; Legin, Andrey; Di Natale, Corrado; D'Amico, Arnaldo; Paolesse, Roberto

    2011-09-01

    A series of novel sensing materials with concurrent sensitivity, namely the porphyrins [free-base, Mn(III) and Fe(III) complexes], functionalized with crown-ether or aza-crown (cyclam) pendant groups, were synthesized and tested as ionophores for polymeric membrane electrodes. Several aspects were studied in order to evaluate the functionality and the desired sensitivity of resulting crown-porphyrins hyphenated ionophores, among them the nature and the size of crown fragment cavity, the length of the alkyl pendant incorporating the crown-ether unit, the presence and the nature of central metal ion both in porphyrin and crown macrocycles.

  7. Concurrent aircraft design and trip assignment under uncertainty as a system of systems problem

    NASA Astrophysics Data System (ADS)

    Mane, Muharrem

    Better techniques for reducing operating costs of on-demand air service providers are continuously investigated in the field of operations research. Problem formulations and algorithms that reduce computational time are considered to solve the resource allocation, trip assignment, crew assignment, or maintenance scheduling problems. Efficient tools to solve these problems are especially critical for on-demand air service providers, who operate in an uncertain environment with demand changing daily and who need to generate high quality, feasible solutions to these allocation problems. Similarly, designing better and more efficient aircraft -- better fuel consumption, lower emissions, etc. -- is the goal of aircraft manufacturers. This can take the shape of better computational tools to reduce designing and testing costs or better technologies to increase aircraft performance and efficiency. This study investigates the issues that arise from combining these fields and the interactions of discipline specific variables and their effects on the operations of on-demand air transportation. Operations are a collection of independently-operating entities (aircraft, airports, maintenance facilities, etc, if appropriate) that provide a capability (on-demand air transportation). Because this is a collection of independently-operating entities, the problem has features of a system of systems. The work presented here considers a series of problems that capture the basic characteristics of aircraft design and resource allocation and presents an approach for the formulation and solution to this multidisciplinary design problem as a single problem. Because uncertainty is an important aspect of on-demand service, it is included in the problem formulation of this research. This is a departure from past representations that consider the solution to allocation problems and the solution to aircraft design problems separately.

  8. A Comparison of Entecavir and Lamivudine for the Prophylaxis of Hepatitis B Virus Reactivation in Solid Tumor Patients Undergoing Systemic Cytotoxic Chemotherapy

    PubMed Central

    Chen, Wen-Chi; Cheng, Jin-Shiung; Chiang, Po-Hung; Tsay, Feng-Woei; Chan, Hoi-Hung; Chang, Hsueh-Wen; Yu, Hsien-Chung; Tsai, Wei-Lun; Lai, Kwok-Hung; Hsu, Ping-I

    2015-01-01

    Background Nucleos(t)ide analogues reduce the incidence of hepatitis B virus (HBV) reactivation in cancer patients undergoing systemic cytotoxic chemotherapy but the experience of solid tumors remains limited. Aims. The aim of this study was to compare the efficacy of entecavir and lamivudine in the prophylaxis of HBV reactivation in solid tumor patients undergoing systemic cytotoxic chemotherapy. Methods HBsAg seropositive patients undergoing systemic cytotoxic chemotherapy for solid tumors with prophylactic entecavir and lamivudine between January 2006 and June 2013 were retrospectively investigated. The incidence of HBV reactivation and outcome of the patients were analyzed. The risk factors of HBV reactivation were examined. Results A total of 213 patients (entecavir group, 70 patients; lamivudine group, 143 patients) were evaluated. Less incidence of HBV reactivation was noticed in entecavir group than in lamivudine group (0% vs. 7.0%, P = 0.02). No HBV reactivation was noticed in the patients with a baseline HBV DNA level < 2000 IU/mL. A baseline HBV DNA level ? 2000 IU/mL, HBeAg, and lamivudine were significantly associated with HBV reactivation. Subgroup analysis of the patients with a baseline HBV DNA level ? 2000 IU/mL found that lamivudine was significantly associated with HBV reactivation. Most of the reactivation events were properly managed by using tenofovir disoproxil fumarate. The incidence of hepatitis during chemotherapy and disruption of chemotherapy was similar between patients using entecavir and lamivudine with a baseline HBV DNA level ? or < 2000 IU/mL. Conclusions A baseline HBV DNA level ? 2000 IU/mL, HBeAg, and lamivudine were the risk factors of HBV reactivation during systemic cytotoxic chemotherapy in solid tumor patients. Entecavir was superior to lamivudine in terms of less incidence of reactivation in the patients with a baseline HBV DNA level ? 2000 IU/mL. Both agents were equally efficacious in the patients with HBV DNA levels < 2000 IU/mL. PMID:26121480

  9. SFWR ENG 3BB4 --Software Design 3 --Concurrent System Design 2 SFWR ENG 3BB4 --Software Design 3 --Concurrent System Design 4.1 3

    E-print Network

    Carette, Jacques

    user classifications: · Owner (u -- user): usually creator, identified by user ID · Group (g of characters ­ sequence of lines ­ sequence of records · Meaning of stored information is defined by creator): identified by a group ID · Universe (o -- other): all other users in the system Three kinds of access: Files

  10. 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.

  11. Concurrent multiaxis differential optical absorption spectroscopy system for the measurement of tropospheric nitrogen dioxide.

    PubMed

    Leigh, Roland J; Corlett, Gary K; Friess, Udo; Monks, Paul S

    2006-10-01

    The development of a new concurrent multiaxis (CMAX) sky viewing spectrometer to monitor rapidly changing urban concentrations of nitrogen dioxide is detailed. The CMAX differential optical absorption spectroscopy (DOAS) technique involves simultaneous spectral imaging of the zenith and off-axis measurements of spatially resolved scattered sunlight. Trace-gas amounts are retrieved from the measured spectra using the established DOAS technique. The potential of the CMAX DOAS technique to derive information on rapidly changing concentrations and the spatial distribution of NO2 in an urban environment is demonstrated. Three example data sets are presented from measurements during 2004 of tropospheric NO2 over Leicester, UK (52.62 degrees N, 1.12 degrees W). The data demonstrate the current capabilities and future potential of the CMAX DOAS method in terms of the ability to measure real-time spatially disaggregated urban NO2. PMID:16983440

  12. Evaluation of the Efficacy of Combined Continuous Arterial Infusion and Systemic Chemotherapy for the Treatment of Advanced Pancreatic Carcinoma

    SciTech Connect

    Ikeda, O., E-mail: osamu-3643ik@do9.enjoy.ne.jp; Kusunoki, S.; Kudoh, K. [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan); Takamori, H.; Tsuji, T.; Kanemitsu, K. [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Gastroenterological Surgery (Japan); Yamashita, Y. [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan)

    2006-06-15

    Purpose. To evaluate the effects of combined continuous transcatheter arterial infusion (CTAI) and systemic chemotherapy in patients with advanced pancreatic carcinoma. Methods. CTAI was performed in 17 patients with stage IV pancreatic cancer with (n = 11) or without (n = 6) liver metastasis. The reservoir was transcutaneously implanted with the help of angiography. The inferior pancreatic artery (IPA) was embolized to achieve delivery of the pancreatic blood supply through only the celiac artery. The systemic administration of gemcitabine was combined with the infusion of 5-fluorouracil via the reservoir. Treatment effects were evaluated based on the primary tumor size, liver metastasis, and survival time and factors such as tumor size, tumor location, and stage of pancreatic carcinoma; the embolized arteries were analyzed with respect to treatment effects and prognosis. Results. A catheter was fixed in the gastroduodenal artery and splenic artery in 10 and 7 patients, respectively. Complete peripancreatic arterial occlusion was successful in 10 patients. CT showed a decrease in tumor size in 6 of 17 (35%) patients and a decrease in liver metastases in 6 of 11 (55%) patients. The survival time ranged from 4 to 18 months (mean {+-} SD, 8.8 {+-} 1.5 months). Complete embolization of arteries surrounding the pancreas was achieved in 10 patients; they manifested superior treatment effects and prognoses (p < 0.05). Conclusion. In patients with advanced pancreatic cancer, long-term CTAI with systemic chemotherapy appeared to be effective not only against the primary tumor but also against liver metastases. Patients with successfully occluded peripancreatic arteries tended to survive longer.

  13. Feasibility and Response of Concurrent Weekly Docetaxel with Radical Radiotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma

    PubMed Central

    I, Rajesh; B, Rajesh; B, Selvamani; John, Subhashini

    2015-01-01

    Objective: (1) To study the feasibility, adverse effects and response of concurrent weekly Docetaxel with radical radiotherapy in inoperable locally advanced head and neck squamous cell carcinoma. (2) To assess the compliance and tolerance of weekly Docetaxel with radiotherapy. Material and Methods: Twenty one patients with stage III and IV head and neck squamous cell carcinoma satisfying inclusion criteria were selected and treated with conventional external radiotherapy of 70Gy in 35 fractions with weekly concurrent Docetaxel (15mg/sqm), administered one hour before radiotherapy. Assessment of toxicities and evaluationof response was carried out. Results: Majority of patients had stage IV diseaseand 17/21 (81%) received the planned radiotherapydose of 70Gy and ?4 cycles of weekly chemotherapy. Duration of treatment ranged from 7.1to 11.2 weeks. The toxicities noted were Grade III mucositis in 57% and grade III skin reaction in 23%, grade III dysphagia in 38% and grade II weight loss in 23% of patients. Systemic toxicities associated with chemotherapy were minimal and there was no dose limiting toxicities. The overall locoregional response at first follow up was 85%, with complete response of 70% and partial response of 15%. Conclusion: Concurrent Docetaxel is a feasible and suitable alternate to Cisplatin and 5-Fluorouracil chemotherapy with good patient compliance. The late toxicities and survival need to be followed up. PMID:25954690

  14. 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 [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Myers, Thomas [Genzyme Inc., Cambridge, MA (United States); Ramirez, Michael [Department of Medical Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Andrews, David [Department of Neurosurgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Curran, Walter J. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States); Dicker, Adam P. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA (United States)], E-mail: Adam.dicker@jeffersonhospital.org

    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.

  15. French multicenter phase III randomized study testing concurrent twice-a-day radiotherapy and cisplatin/5-fluorouracil chemotherapy (BiRCF) in unresectable pharyngeal carcinoma: Results at 2 years (FNCLCC-GORTEC)

    SciTech Connect

    Bensadoun, Rene-Jean [Department of Radiation Oncology, Centre Antoine Lacassagne, Nice (France)]. E-mail: rene-jean.bensadoun@nice.fnclcc.fr; Benezery, Karen [Department of Radiation Oncology, Centre Antoine Lacassagne, Nice (France); Dassonville, Olivier [Department of Head and Neck Surgery, Centre Antoine Lacassagne, Nice (France); Magne, Nicolas [Department of Radiation Oncology, Centre Antoine Lacassagne, Nice (France); Poissonnet, Gilles [Department of Head and Neck Surgery, Centre Antoine Lacassagne, Nice (France); Ramaioli, Alain [Department of Statistics Unit, Centre Antoine Lacassagne, Nice (France); Lemanski, Claire [Centre Val d'Aurelle-Paul Lamarque, Montpellier (France); Bourdin, Sylvain [Centre Rene-Gauducheau, Nantes (France); Tortochaux, Jacques [Centre Jean-Perrin, Clermont-Ferrand (France); Peyrade, Frederic [Department of Medical Oncology, Centre Antoine Lacassagne, Nice (France); Marcy, Pierre-Yves [Department of Radiology, Centre Antoine Lacassagne, Nice (France); Chamorey, Emmanuel Phar [Department of Statistics Unit, Centre Antoine Lacassagne, Nice (France); Vallicioni, Jacques [Department of Head and Neck Surgery, Centre Antoine Lacassagne, Nice (France); Seng Hang [Centre Henri-Becquerel, Rouen (France); Alzieu, Claude [Institut Paoli-Calmettes, Marseille (France); Gery, Bernard [Centre Francois-Baclesse, Caen (France); Chauvel, Pierre [Department of Radiation Oncology, Centre Antoine Lacassagne, Nice (France); Schneider, Maurice [Department of Medical Oncology, Centre Antoine Lacassagne, Nice (France); Santini, Jose [Department of Otolaryngology, University Hospital, Nice (France); Demard, Francois [Department of Head and Neck Surgery, Centre Antoine Lacassagne, Nice (France); Calais, Gilles [Hopital Jean Bretonneau, Tours (France)

    2006-03-15

    Background: Unresectable carcinomas of the oropharynx and hypopharynx still have a poor long-term prognosis. Following a previous phase II study, this phase III multicenter trial was conducted between November 1997 and March 2002. Methods: Nontreated, strictly unresectable cases were eligible. Twice-daily radiation: two fractions of 1.2 Gy/day, 5 days per week, with no split (D1{sup {yields}}D46). Total tumor doses: 80.4 Gy/46 day (oropharynx), 75.6 Gy/44 day (hypopharynx). Chemotherapy (arm B): Cisplatin 100 mg/m{sup 2} (D1, D22, D43); 5FU, continuous infusion (D1{sup {yields}}D5), 750 mg/m{sup 2}/day cycle 1; 430 mg/m{sup 2}/day cycles 2 and 3. Results: A total of 163 evaluable patients. Grade 3-4 acute mucositis 82.6% arm B/69.5% arm A (NS); Grade 3-4 neutropenia 33.3% arm B/2.4% arm A (p < 0.05). Enteral nutrition through gastrostomy tube was more frequent in arm B before treatment and at 6 months (p < 0.01). At 24 months, overall survival (OS), disease-free survival (DFS), and specific survival (SS) were significantly better in arm B. OS: 37.8% arm B vs. 20.1% arm A (p = 0.038); DFS: 48.2% vs. 25.2% (p = 0.002); SS: 44.5% vs. 30.2% (p 0.021). No significant difference between the two arms in the amount of side effects at 1 and 2 years. Conclusion: For these unresectable cases, chemoradiation provides better outcome than radiation alone, even with an 'aggressive' dose-intensity radiotherapy schedule.

  16. 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

  17. 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 [Department of Radiation Oncology, University of Cologne, Cologne (Germany)]. E-mail: Robert.Semrau@uk-koeln.de; Mueller, Rolf-Peter [Department of Radiation Oncology, University of Cologne, Cologne (Germany); Stuetzer, Hartmut [Department of Medical Statistics and Epidemiology, University of Cologne, Cologne (Germany); Staar, Susanne [Department of Radiation Oncology, Krankenhaus-St-Juergens, Bremen (Germany); Schroeder, Ursula [ENT Department, University of Cologne, Cologne (Germany); Guntinas-Lichius, Orlando [ENT Department, University of Cologne, Cologne (Germany); Kocher, Martin [Department of Radiation Oncology, University of Cologne, Cologne (Germany); Eich, Hans Theodor [Department of Radiation Oncology, University of Cologne, Cologne (Germany); Dietz, Andreas [ENT Department, University of Leipzig, Leipzig (Germany); Flentje, Michael [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany); Rudat, Volker [Department of Radiation Oncology, University of Hamburg, Hamburg (Germany); Volling, Peter [ENT Department, Evangelisches Krankenhaus Oldenburg, Oldenburg (Germany); Schroeder, Michael [ENT Department, Klinikum Kassel, Kassel (Germany); Eckel, Hans Edmund [ENT Department, Landeskrankenhaus Klagenfurt, Klagenfurt (Austria)

    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.

  18. Prophylactic ciprofloxacin treatment prevented high mortality, and modified systemic and intestinal immune function in tumour-bearing rats receiving dose-intensive CPT-11 chemotherapy

    PubMed Central

    Xue, H; Field, C J; Sawyer, M B; Dieleman, L A; Baracos, V E

    2009-01-01

    Infectious complications are a major cause of morbidity and mortality from dose-intensive cancer chemotherapy. In spite of the importance of intestinal bacteria translocation in these infections, information about the effect of high-dose chemotherapy on gut mucosal immunity is minimal. We studied prophylactic ciprofloxacin (Cipro) treatment on irinotecan (CPT-11) toxicity and host immunity in rats bearing Ward colon tumour. Cipro abolished chemotherapy-related mortality, which was 45% in animals that were not treated with Cipro. Although Cipro reduced body weight loss and muscle wasting, it was unable to prevent severe late-onset diarrhoea. Seven days after CPT-11, splenocytes were unable to proliferate (stimulation index=0.10±0.02) and produce proliferative and inflammatory cytokines (i.e., Interleukin (IL)-2, interferon-? (IFN-?), tumour necrosis factor-? (TNF-?) IL-1?, IL-6) on mitogen stimulation in vitro (P<0.05 vs controls), whereas mesenteric lymph node (MLN) cells showed a hyper-proliferative response and a hyper-production of pro-inflammatory cytokines on mitogen stimulation. This suggests compartmentalised effects by CPT-11 chemotherapy on systemic and intestinal immunity. Cipro normalised the hyper-responsiveness of MLN cells, and in the spleen, it partially restored the proliferative response and normalised depressed production of IL-1? and IL-6. Taken together, Cipro prevented infectious challenges associated with immune hypo-responsiveness in systemic immune compartments, and it may also alleviate excessive pro-inflammatory responses mediating local gut injury. PMID:19401694

  19. Cognition, Concurrency Theory and Reverberations in the Brain: in Search of a Calculus of Communicating (Recurrent) Neural Systems

    E-print Network

    Kent, University of

    1 Cognition, Concurrency Theory and Reverberations in the Brain: in Search of a Calculus that so dominates current Cognitive Neuroscience. We take concurrency theory methods, especially Process substrate level, would seem to be broadly distributed. In addition, many theories of cognition

  20. Examination for Concurrent Systems May 2009, 9.00 to 12.00 Room P0.19

    E-print Network

    Jesshope, Chris

    architectures [25%]: 1. TRIPS 2. Wavescaler 3. DRSIC microgrids The brief report should include details commodity processors. Describe why it is desirable to incorporate concurrency controls into the instruction set of a control-flow processor. What is a minimum set of concurrency controls that need

  1. Systems for Offering Concurrent Enrollment at High Schools and Community Colleges. New Directions for Community Colleges, Number 113. The Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Robertson, Piedad F., Ed.; Chapman, Brian G., Ed.; Gaskin, Fred, Ed.

    2001-01-01

    The spring 2001 issue of "New Directions for Community Colleges" discusses concurrent enrollment programs and the challenges and issues associated with developing and maintaining such programs. Chapters include: (1) "State Policy and Postsecondary Enrollment Options: Creating Seamless Systems" (Katherine Boswell); (2) "A Model for Implementing a…

  2. Intraperitoneal chemotherapy: rationale, applications, and limitations.

    PubMed

    Al-Quteimat, Osama M; Al-Badaineh, Mariam A

    2014-10-01

    Intraperitoneal chemotherapy, involving the administration of certain chemotherapeutic agents directly to the intraperitoneal cavity, was developed as a novel therapeutic strategy early in the 1950s. Intraperitoneal administration of chemotherapy results in higher intraperitoneal concentration of the cytotoxic medications and minimal systemic exposure than observed with intravenous administration, which in turn may increase the efficacy of these agents with substantial reduction in systemic toxicity. Intraperitoneal chemotherapy was used successfully in peritoneal surface malignancies, including malignant peritoneal mesothelioma, pseudomyxoma peritonei, malignant ascites, sarcomatosis, and peritoneal carcinomatosis from gastrointestinal and ovarian cancers. Pharmacists may play a major role in optimizing intraperitoneal chemotherapy through verification of chemotherapy order for proper doses, dilution, preparation, and administration. Moreover, pharmacists are medication experts who can provide other health care professionals with the necessary drug information. Despite the local application of chemotherapy, intraperitoneal chemotherapy is not free of systemic side effects and can be associated with serious complications. The benefits of intraperitoneal chemotherapy should be weighed against its potential harm to maximize efficacy and to minimize morbidity and mortality as much as possible. The aim of this article is to review the current available literature regarding the safety and efficacy of intraperitoneal chemotherapy in cancer treatment. PMID:24166789

  3. (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.

  4. Concurrent hybrid switching for massively parallel systems-on-chip: the CYBER architecture

    Microsoft Academic Search

    Francesca Palumbo; Danilo Pani; Andrea Congiu; Luigi Raffo

    2012-01-01

    Massively Parallel Systems-on-chip represent the new frontier of integrated computing systems for general purpose computing. The integration of a huge number of cores poses several issues such as the efficiency and flexibility of the interconnection network in order to serve in the best way the different traffic patterns that can arise. In this paper we present the CYBER architecture, an

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

    E-print Network

    Dechev, Damian

    2010-07-14

    otherwise possible when relying on the traditional run-time based techniques. Shared data in a real-time cyber-physical system can often be polymorphic (as is the case with a number of components part of the Mission Data System's Data Management Services...

  6. A design space for multimodal systems: concurrent processing and data fusion

    Microsoft Academic Search

    Laurence Nigay; Joëlle Coutaz

    1993-01-01

    Multimodal interaction enables the user to employ different modalities such as voice, gesture and typing for communicating with a computer. This paper presents an analysis of the integration of multiple communication modalities within an interactive system. To do so, a software engineering perspective is adopted. First, the notion of “multimodal system” is clarified. We aim at proving that two main

  7. Secure concurrency control protocol with timeliness guarantees in real-time database systems

    Microsoft Academic Search

    Ying Yuan Xiao; Kevin Lü

    Real-time database systems (RTDBSs) are usually applied in the time-critical applications with security constraints. For these applications, RTDBSs must simultaneously satisfy two requirements in guaranteeing data security and minimizing the deadline miss ratio for admitted transactions. Multilevel secure database systems based on mandatory access control can prevent direct unlawful information flows between transactions. However, they cannot be free from illegal

  8. Tornado: Maximizing Locality and Concurrency in a Shared Memory Multiprocessor Operating System

    Microsoft Academic Search

    Benjamin Gamsa; Orran Krieger; Jonathan Appavoo; Michael Stumm

    1999-01-01

    We describe the design and implementation of Tornado, a new operating system designed from the ground up specifically for today's shared memory multiprocessors. The need for im- proved locality in the operating system is growing as multipro- cessor hardware evolves, increasing the costs for cache misses and sharing, and adding complications due to NUMAness. Tor- nado is optimized so that

  9. MUSE: a Message Passing Concurrent Computer for On-Board Space Systems

    Microsoft Academic Search

    Jean-yves Le Gall; François Simon

    1994-01-01

    Space systems of the near future will raise the need of very powerful and dependable computers. Applications such as realtime synthetic aperture radar imaging (SAR) or stereo-vision need high capability of digital signal processing and then high computing power. Moreover, like any satellite component, these systems must be long-life ones and remotely repairable. Due to cost, weight, energy and environment

  10. On Optimal Concurrency Control for Optimistic Replication

    Microsoft Academic Search

    Weihan Wang; Cristiana Amza

    2009-01-01

    Concurrency control is a core component in optimistic replication systems. To detect concurrent updates, the system associates each replicated object with metadata, such as, version vectors or causal graphs exchanged on synchro- nization opportunities. However, the size of such metadata increases at least linearly with the number of active sites. With recent trends in cloud computing, multi-regional col- laboration, and

  11. 3D Radiotherapy Can Be Safely Combined With Sandwich Systemic Gemcitabine Chemotherapy in the Management of Pancreatic Cancer: Factors Influencing Outcome

    SciTech Connect

    Spry, Nigel [Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA (Australia)], E-mail: Nigel.Spry@health.wa.gov.au; Harvey, Jennifer [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); MacLeod, Craig [Department of Radiation Oncology, Murray Valley Private Hospital, Wodonga, Victoria (Australia); Borg, Martin [Adelaide Radiotherapy Centre, Adelaide, SA (Australia); Ngan, Samuel Y. [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Millar, Jeremy L. [Department of Radiation Oncology, The Alfred, Prahran, Victoria (Australia); Graham, Peter [Department of Radiation Oncology, St. George Hospital, Kogarah, NSW (Australia); Zissiadis, Yvonne [Department of Radiation Oncology, Royal Perth Hospital, Perth, WA (Australia); Kneebone, Andrew [Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW (Australia); Carroll, Susan [Department of Radiation Oncology, Prince of Wales Hospital, Randwick, NSW (Australia); Davies, Terri; Reece, William H.H. [Eli Lilly Australia, West Ryde, NSW (Australia); Iacopetta, Barry [School of Surgery and Pathology, University of Western Australia, Nedlands, WA (Australia); Goldstein, David [Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW (Australia)

    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.

  12. Multi-targeting cancer chemotherapy using temperature-responsive drug carrier systems

    Microsoft Academic Search

    Masamichi Nakayama; Teruo Okano

    2011-01-01

    Recently, a growing number of nano-scale drug carrier systems (e.g., drug–polymer conjugates, liposomes, and polymeric micelles) attract great attention for targeting cancer therapy due to a passively selective accumulation at solid tumor tissues and a subsequent anti-cancer activity. However, for the present drug targeting carrier systems, the target-selective delivery and release of loaded drugs are incapable to control completely. To

  13. Aplastic anemia with concurrent temozolomide treatment in a patient with glioblastoma multiforme

    PubMed Central

    Oh, J.; Kutas, G.J.; Davey, P.; Morrison, M.; Perry, J.R.

    2010-01-01

    Temozolomide (tmz) is an oral alkylating agent used during concurrent and adjuvant chemotherapy for newly diagnosed glioblastoma multiforme. Temozolomide is generally well tolerated and improves survival; however, severe adverse events have occasionally been reported. Here, we report the case of a patient who developed aplastic anemia with related complications in the setting of concurrent tmz treatment with radiotherapy. This case illustrates that aplastic anemia is a rare side effect of tmz that can occur relatively early in the course of concurrent chemotherapy, and underscores the importance of clinician awareness of this potentially devastating side effect. PMID:20697524

  14. A laser/EMAT (electromagnetic-acoustic transducer) concurrent weld inspection system

    SciTech Connect

    Johnson, J.A.; Carlson, N.M.

    1990-01-01

    A noncontacting ultrasonic sensor system is being developed for on-line inspection of thick section welds made by a robotic gas metal arc welding (GMAW) system. The sensor system consists of a pulsed laser for generating the ultrasound and an electromagnetic-acoustic transducer (EMAT) for receiving it. The sensor will follow closely behind the weld head and inspect the solidified weld bead for flaws. The main advantage of this technique is that flaws can be found and repaired before they are covered by subsequent welding passes. This is expected to be much simpler and less likely to induce further flaws than current practice since a large amount of otherwise good weld metal need not be removed to reach and repair a flaw. The system also monitors the welding process, i.e., detection of a large number of flaws indicates that the process is no longer operating as planned. In this paper, the technique for detecting incomplete sidewall penetration is demonstrated and methods for improving the system are discussed. 12 refs., 3 figs., 1 tab.

  15. Concurrence of superpositions

    NASA Astrophysics Data System (ADS)

    Yu, Chang-Shui; Yi, X. X.; Song, He-Shan

    2007-02-01

    Bounds on the concurrence of the superposition state in terms of the concurrences of the states being superposed are found in this paper. The bounds on concurrence are quite different from those on the entanglement measured by von Neumann entropy [Linden , Phys. Rev. Lett. 97, 100502 (2006)]. In particular, a nonzero lower bound can be provided if the states being superposed are properly constrained.

  16. American Institute of Aeronautics and Astronautics Integrated System-Level Optimization for Concurrent Engineering

    E-print Network

    de Weck, Olivier L.

    's Team X. Simultaneously, advances in computing power have given rise to a host of potent numerical is described in detail and applied to the multiobjective design of a simplified Space Shuttle external fuel mass (kg) ISLOCE Integrated System-Level Opt. for Conc. Eng. pn = Nominal tank payload (kg) MATE Multi

  17. Synthesis of distributed testers from true-concurrency models of reactive systems

    Microsoft Academic Search

    Claude Jard

    2003-01-01

    Abstract: Automatic synthesis of test cases for conformance,testing has been principally developed with the objective of generating sequential test cases. In the distributed system context, it is worth extending the synthesis techniques to the generation of multiple testers. We base our work on our experience in using model- checking techniques, as successfully implemented in the TGV tool. Continuing the works

  18. Concurrency control strategies for ordered data broadcast in mobile computing systems

    Microsoft Academic Search

    Kam-yiu Lam; Edward Chan; Hei-wing Leung; Mei-wai Au

    2004-01-01

    Although data broadcast has been shown to be an efficient method for disseminating data items in mobile computing systems, the issue on how to ensure consistency and currency of data items provided to mobile transactions (MT), which are generated by mobile clients, has not been examined adequately. While data items are being broadcast, update transactions may install new values for

  19. Concurrent Computing

    NSDL National Science Digital Library

    Amy Apon

    * a preliminary introduction to essential networking concepts, * parallel computing and types of parallel computers, * basics of message-passing parallel computing,* embarrassingly parallel computations,* partitioning and divide-and-conquer strategies,* pipelined computations, * synchronous computations,* programming with shared memory, pthreads,* parallel sorting algorithms,* numerical algorithms,* searching and optimization,* distributed computing using grids,* networks for high-performance cluster computing, and * parallel I/O and parallel file systems.

  20. Manufacturing modeling architectures: architectural concepts for a system simulator for concurrent prototypng of equipment and controls

    Microsoft Academic Search

    K. Preston White; Ryan Fritz; Stephen Horvath; Carlos Orellana II; Jonathan Wohlers; Richard G. Fairbrother; William S. Terry

    2002-01-01

    AutoMod® is a leading discrete-event simulation package widely applied in the modeling and analysis of distribution systems. Included in the AutoMod software suite is the Model Communications Module (MCM), which allows an executing simulation to open socket connections and to send and receive messages via TCP\\/IP network protocol. In this paper we report on a pilot study which explores the

  1. Architectural concepts for a system simulator for concurrent prototyping of equipment and controls

    Microsoft Academic Search

    Ryan Fritz; Stephen Horvath; Carlos Orellana; Jonathan Wohlers; R. G. Fairbrother; W. S. Terry

    2002-01-01

    AutoMod® is a leading discrete-event simulation package widely applied in the modeling and analysis of distribution systems. Included in the AutoMod software suite is the Model Communications Module (MCM), which allows an executing simulation to open socket connections and to send and receive messages via TCP\\/IP network protocol. In this paper we report on a pilot study which explores the

  2. 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. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Issa Laack, Nadia N., E-mail: laack.nadia@mayo.ed [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Buckner, Jan C. [Department of Oncology, Mayo Clinic, Rochester, MN (United States); Schomberg, Paula J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Wetmore, Cynthia J. [Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

    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.

  3. Minimizing Systemic Leakage of Cisplatin during Percutaneous Isolated Pancreas Perfusion Chemotherapy: A Pilot Study.

    PubMed

    Murata, Satoru; Onozawa, Shiro; Mine, Takahiko; Ueda, Tatsuo; Sugihara, Fumie; Yasui, Daisuke; Kumita, Shin-Ichiro; Shimizu, Akira; Satake, Mitsuo

    2015-07-01

    Purpose To evaluate the feasibility of percutaneous isolated pancreas perfusion (PIPP) by using a pig model. Materials and Methods All experiments were approved by the institutional Animal Experiment Ethics Committee. Fifteen pigs were assigned to five groups, and PIPP was performed. Angiographic and dye injection studies were performed to confirm the patency of the PIPP system (group 1). Blood that contained cisplatin (1.5 mg per kilogram of body weight) in an extracorporeal circuit was circulated through the pancreas at three infusion rates (40, 60, and 80 mL/min) to determine the optimal infusion rate in terms of safety and pharmacologic effectiveness (groups 2, 3, and 4, respectively). Chronological laboratory data and histologic findings were assessed in group 5, which received the optimal infusion rate. Maximum platinum concentration (Cmax) and area under the platinum concentration-time curve were compared by using the Kruskal-Wallis and Mann-Whitney U tests. Results Angiography and dye injection confirmed the patency of the PIPP system. Histopathologic examinations showed no abnormalities in the pancreas or other organs at a 40 mL/min infusion rate of cisplatin. However, edematous changes in the pancreas were observed at higher infusion rates. The pharmacologic effectiveness did not differ significantly among groups; therefore, the optimal infusion rate of 40 mL/min was selected. The median pancreatic-to-systemic exposure ratios were 71.8 for Cmax and 54.8 for the area under the curve. All laboratory data remained normal or returned to pretreatment levels within 1 week. Conclusion PIPP at a 40 mL/min infusion rate appears to be safe and feasible for perfusion of the pancreas. (©) RSNA, 2015. PMID:25734552

  4. 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.

  5. 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

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

    SciTech Connect

    Laack, Nadia N. [Department of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); O'Neill, Brian Patrick, E-mail: boneill@mayo.edu [Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); Ballman, Karla V.; O'Fallon, Judith Rich; Carrero, Xiomara W. [Division of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); Kurtin, Paul J.; Scheithauer, Bernd W. [Department of Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); Brown, Paul D. [Department of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); Habermann, Thomas M.; Colgan, Joseph P. [Division of Hematology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); Gilbert, Mark R. [Department of Neuro-Oncology, The M.D. Anderson Cancer Center, Houston, Texas (United States); Hawkins, Roland B. [Oschner CCOP, New Orleans, Louisiana (United States); Morton, Roscoe F. [Iowa Oncology Research Association CCOP, Des Moines, Iowa (United States); Windschitl, Harry E. [CentraCare Clinic, St. Cloud, Minnesota (United States); Fitch, Tom R. [Division of Hematology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States); Pajon, Eduardo R. [Colorado Cancer Research Program, Denver, Colorado (United States)

    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.

  7. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14...23, U.S.C. (Interstate and Defense Highway System) § 14.56 Concurrence by Federal Highway Administration. The appropriate...

  8. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14...23, U.S.C. (Interstate and Defense Highway System) § 14.56 Concurrence by Federal Highway Administration. The appropriate...

  9. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14...23, U.S.C. (Interstate and Defense Highway System) § 14.56 Concurrence by Federal Highway Administration. The appropriate...

  10. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14...23, U.S.C. (Interstate and Defense Highway System) § 14.56 Concurrence by Federal Highway Administration. The appropriate...

  11. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14...23, U.S.C. (Interstate and Defense Highway System) § 14.56 Concurrence by Federal Highway Administration. The appropriate...

  12. Hierarchical Concurrent Finite State Machines in Ptolemy

    Microsoft Academic Search

    Bilung Lee; Edward A. Lee

    1998-01-01

    We implement a finite state machine (FSM) domain for specifying and simulating control functionality of a system within 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 of FSM, concurrency and hierarchy are naturally sup- ported in a manner similar

  13. Modle probabiliste de systmes distribus et concurrents

    E-print Network

    of concurrency models Timed approaches (Continuous time Markov chains) Stochastic Petri nets based on race of concurrency models Timed approaches (Continuous time Markov chains) Transform the model, e.g. the Petri net of safe Petri nets No global clock t 0 randomize the set of maximal executions of the system randomize

  14. Enhancement of Aerosol Cisplatin Chemotherapy with Gene Therapy Expressing ABC10 protein in Respiratory System

    PubMed Central

    Hohenforst-Schmidt, Wolfgang; Zarogoulidis, Paul; Linsmeier, Bernd; Kioumis, Ioannis; Li, Qiang; Huang, Haidong; Sachpatzidou, Despoina; Lampaki, Sofia; Organtzis, John; Domvri, Kalliopi; Sakkas, Leonidas; Zachariadis, George A.; Archontas, Konstantinos N.; Kallianos, Anastasios; Rapti, Aggeliki; Yarmus, Lonny; Zarogoulidis, Konstantinos; Brachmann, Johannes

    2014-01-01

    Inhaled therapy for lung cancer is a local form of treatment. Currently inhaled non-specific cytotoxic agents have been evaluated as a future treatment for local disease control and distant metastasis control. There are few information regarding the influence of local transporters and gene expression of the respiratory epithelium to the absorption of administered drugs. In the current work we used adenoviral-type 5(dE1/E3) (Cytomegalovirus promoter) with human ABCA10 transgene (Ad-h-ABCA10) purchased from Vector Labs® in order to investigate whether gene therapy can be used as a pre-treatment to enhance the efficiency of inhaled cisplatin. We included the following groups to our work: a) control, b) aerosol vector, c) aerosol vector plus cisplatin, d) aerosol cisplatin, e) intratumoral cisplatin administration, f) intratumoral vector plus cisplatin administration. The results indicate that the aerosol cisplatin group had a long term survival with the intratumoral cisplatin group following. The enhancement of the ABCA family locally to the respiratory system prior to the aerosol cisplatin administration can be used safely and efficiently. Future treatment design of local therapies should include the investigation of local transporters and genes. PMID:24723977

  15. Enhancement of Aerosol Cisplatin Chemotherapy with Gene Therapy Expressing ABC10 protein in Respiratory System.

    PubMed

    Hohenforst-Schmidt, Wolfgang; Zarogoulidis, Paul; Linsmeier, Bernd; Kioumis, Ioannis; Li, Qiang; Huang, Haidong; Sachpatzidou, Despoina; Lampaki, Sofia; Organtzis, John; Domvri, Kalliopi; Sakkas, Leonidas; Zachariadis, George A; Archontas, Konstantinos N; Kallianos, Anastasios; Rapti, Aggeliki; Yarmus, Lonny; Zarogoulidis, Konstantinos; Brachmann, Johannes

    2014-01-01

    Inhaled therapy for lung cancer is a local form of treatment. Currently inhaled non-specific cytotoxic agents have been evaluated as a future treatment for local disease control and distant metastasis control. There are few information regarding the influence of local transporters and gene expression of the respiratory epithelium to the absorption of administered drugs. In the current work we used adenoviral-type 5(dE1/E3) (Cytomegalovirus promoter) with human ABCA10 transgene (Ad-h-ABCA10) purchased from Vector Labs(®) in order to investigate whether gene therapy can be used as a pre-treatment to enhance the efficiency of inhaled cisplatin. We included the following groups to our work: a) control, b) aerosol vector, c) aerosol vector plus cisplatin, d) aerosol cisplatin, e) intratumoral cisplatin administration, f) intratumoral vector plus cisplatin administration. The results indicate that the aerosol cisplatin group had a long term survival with the intratumoral cisplatin group following. The enhancement of the ABCA family locally to the respiratory system prior to the aerosol cisplatin administration can be used safely and efficiently. Future treatment design of local therapies should include the investigation of local transporters and genes. PMID:24723977

  16. Aggressive local therapy combined with systemic chemotherapy provides long-term control in grade II stage 2 canine mast cell tumour: 21 cases (1999-2012)(*)

    PubMed

    Lejeune, A; Skorupski, K; Frazier, S; Vanhaezebrouck, I; Rebhun, R B; Reilly, C M; Rodriguez, C O

    2013-05-31

    This retrospective case series evaluates the outcome of 21 dogs with grade II stage 2 mast cell tumour (MCT) treated with adequate local therapy and adjuvant systemic chemotherapy (prednisone, vinblastine and CCNU). The median survival for all dogs was 1359?days (range, 188-2340). Median disease-free interval was 2120?days (149-2325?days). Dogs treated with surgery and chemotherapy had shorter survival (median, 1103?days; 188-2010?days) than those that underwent surgery, radiation therapy and chemotherapy as part of their treatment (median, 2056?days; 300-2340?days). Two patients had local recurrence in the radiation field and four patients had de novo MCT. Distant metastasis was not observed in any dogs. The results of this study suggest that, in the presence of loco-regional lymph node metastasis in grade II MCT, the use of prednisone, vinblastine and CCNU after adequate local-regional therapy can provide a median survival in excess of 40?months. PMID:23721492

  17. 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

  18. 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

  19. Combination of systemic chemotherapy with local stem cell delivered S-TRAIL in resected brain tumors.

    PubMed

    Redjal, Navid; Zhu, Yanni; Shah, Khalid

    2015-01-01

    Despite advances in standard therapies, the survival of glioblastoma multiforme (GBM) patients has not improved. Limitations to successful translation of new therapies include poor delivery of systemic therapies and use of simplified preclinical models which fail to reflect the clinical complexity of GBMs. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis specifically in tumor cells and we have tested its efficacy by on-site delivery via engineered stem cells (SC) in mouse models of GBM that mimic the clinical scenario of tumor aggressiveness and resection. However, about half of tumor lines are resistant to TRAIL and overcoming TRAIL-resistance in GBM by combining therapeutic agents that are currently in clinical trials with SC-TRAIL and understanding the molecular dynamics of these combination therapies are critical to the broad use of TRAIL as a therapeutic agent in clinics. In this study, we screened clinically relevant chemotherapeutic agents for their ability to sensitize resistant GBM cell lines to TRAIL induced apoptosis. We show that low dose cisplatin increases surface receptor expression of death receptor 4/5 post G2 cycle arrest and sensitizes GBM cells to TRAIL induced apoptosis. In vivo, using an intracranial resection model of resistant primary human-derived GBM and real-time optical imaging, we show that a low dose of cisplatin in combination with synthetic extracellular matrix encapsulated SC-TRAIL significantly decreases tumor regrowth and increases survival in mice bearing GBM. This study has the potential to help expedite effective translation of local stem cell-based delivery of TRAIL into the clinical setting to target a broad spectrum of GBMs. PMID:25186100

  20. STU attractors from vanishing concurrence

    SciTech Connect

    Levay, Peter; Szalay, Szilard [Department of Theoretical Physics, Institute of Physics, Budapest University of Technology and Economics, H-1521 Budapest (Hungary)

    2011-02-15

    Concurrence is an entanglement measure characterizing the mixed state bipartite correlations inside of a pure state of an n-qubit system. We show that after organizing the charges and the moduli in the STU model of N=2, d=4 supergravity to a three-qubit state, for static extremal spherically symmetric Bogomolny-Prasad-Sommerfield (BPS) black-hole solutions the vanishing condition for all of the bipartite concurrences on the horizon is equivalent to the attractor equations. As a result of this, the macroscopic black hole entropy given by the three-tangle can be reinterpreted as a linear entropy characterizing the pure state entanglement for an arbitrary bipartite split. Both for the BPS and non-BPS cases, explicit expressions for the concurrences are obtained, with their vanishing on the horizon is demonstrated.

  1. Side Effects of Chemotherapy

    MedlinePLUS

    ... My Bridge 4 Life Clinical Trials Guides Newsletters Nutrition & Wellness PCF Spotlight Glossary African American Men Living with Prostate Cancer Side Effects of Chemotherapy Side Effects Urinary Dysfunction ...

  2. Nail changes during docetaxel containing combination chemotherapy.

    PubMed

    Woo, In Sook; Shim, Kon Ho; Kim, Gi Young; Lee, Myung Ah; Kang, Jin Hyoung; Hong, Young Seon; Lee, Kyung Shik

    2004-06-01

    Nail toxicity following systemic chemotherapy is common. Onychopathy during the period of neutropenia following chemotherapy may cause subungual abscesses and serious infection. Despite taxoid-related toxicity being increasingly reported since 2000, there are still phase II systemic chemotherapy studies using taxoid that have never mentioned nail changes. Recently, new criteria for the evaluation of nail toxicity have been suggested. The present report is the first of its kind, in Korea, to describe a case of docetaxel-associated onychopathy, which improved following a reduction in the docetaxel dose. PMID:15366647

  3. 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.

  4. Chemotherapy alone for organ preservation in advanced laryngeal cancer

    PubMed Central

    Divi, Vasu; Worden, Francis P.; Prince, Mark E.; Eisbruch, Avraham; Lee, Julia S.; Bradford, Carol R.; Chepeha, Douglas B.; Teknos, Theodoros N.; Hogikyan, Norman D.; Moyer, Jeffrey S.; Tsien, Christina I.; Urba, Susan G.; Wolf, Gregory T.

    2009-01-01

    Background: For patients with advanced laryngeal cancer, a trial was designed to determine if chemotherapy alone, in patients achieving a complete histologic tumor response (HCR) after a single neoadjuvant cycle, was an effective treatment with less morbidity than concurrent chemoradiation (CRT). Methods: Thirty-two patients with advanced laryngeal or hypopharyngeal cancer received 1 cycle of induction chemotherapy and subsequent treatment was decided based on response. Results: A HCR was achieved in 4 patients and were treated with chemotherapy alone. All four patients relapsed in the neck and required surgery and postoperative RT. Twenty-five patients were treated with concomitant chemoradiation. Three patients were treated with surgery. Overall survival and disease specific survival at 3 years were 68% and 78%, respectively. Conclusions: Chemotherapy alone is not feasible for long term control of regional disease in patients with advanced laryngeal cancer even when they achieve a histologic complete response at the primary site. PMID:19953609

  5. The application of real-time PCR technique to detect rare cell clones with primary T790M Substitution of EGFR gene in metastases of non-small cell lung cancer to central nervous system in chemotherapy naive patients.

    PubMed

    Powrózek, Tomasz; Krawczyk, Pawe?; Jarosz, Bo?ena; Mlak, Rados?aw; Wojas-Krawczyk, Kamila; Sawicki, Marek; Stencel, Dariusz; Trojanowski, Tomasz; Milanowski, Janusz

    2014-10-01

    The time-limited efficacy of reversible EGFR-TKIs in patients with advanced non-small cell lung cancer (NSCLC) with EGFR gene activating mutations is associated with development of treatment resistance after some period of therapy. This resistance predominantly results from secondary mutations located in EGFR gene, especially T790M substitution. There is limited information available concerning the prevalence of primary T790M mutations in patients with metastatic NSCLC tumors before treatment with EGFR-TKIs. The aim of work was to assess the prevalence of de novo T790M mutations in EGFR gene in tissue samples from NSCLC metastatases in central nervous system (CNS) in both chemotherapy and EGFR-TKI naive NSCLC patients. We analyzed DNA samples isolated from paraffin-embedded tissue from CNS metastases for T790M mutations using real-time PCR and TaqMan probe against the T790M mutant sequence. The tissue samples were taken during palliative neurosurgery in 143 NSCLC patients. Amplification of the T790M-specific sequence was detected in 25 patients (17.5 %). The quantity of mutated DNA was less than 1 % in all samples with amplification, and in vast majority (20 patients, 14 % of all samples) it was even less that 0.1 %. In 5 patients (3.5 %) quantity of mutated DNA ranged from 0.1 to 1 % and true positive results of T790M mutation presence in these patients were most possible. Amplification of this sequence was not concurrent with common EGFR mutations and was not associated with sex, smoking status and pathological type of cancer. There is a possibility to detect the primary T790M mutation in brain metastases of NSCLC in EGFR-TKIs naďve patients. PMID:24789720

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

    E-print Network

    Huynh, Cuong Phu Minh 1976-

    2012-11-21

    -band impedance matching networks and technique for synthesizing them are presented together with a 25.5/37-GHz concurrent dual-band PA. These matching networks enable simultaneous matching of two arbitrary loads to two arbitrary sources at two different...

  7. Gefitinib Compared with Systemic Chemotherapy as First-line Treatment for Chemotherapy-naive Patients with Advanced Non-small Cell Lung Cancer: A Meta-analysis of Randomised Controlled Trials

    Microsoft Academic Search

    F. Wang; L. D. Wang; B. Li; Z. X. Sheng

    To define the efficacy of gefitinib in chemotherapy-naive patients with advanced non-small cell lung cancer, we carried out a meta-analysis of randomised controlled trials. Medline, Embase, the Cochrane controlled trials register and the Science Citation Index were searched. Seven trials were identified, covering a total of 4656 subjects. As compared with chemotherapy, gefitinib was effective in the selected patients: the

  8. Concurrent planning and execution for autonomous robots

    NASA Technical Reports Server (NTRS)

    Simmons, Reid G.

    1992-01-01

    The Task Control Architecture (TCA) provides communication and coordination facilities to construct distributed, concurrent robotic systems. The use of TCA in a system that walks a legged robot through rugged terrain is described. The walking system, as originally implemented, had a sequential sense-plan-act control cycle. Utilizing TCA features for task sequencing and monitoring, the system was modified to concurrently plan and execute steps. Walking speed improved by over 30 percent, with only a relatively modest conversion effort.

  9. Staged concurrent program analysis

    Microsoft Academic Search

    Nishant Sinha; Chao Wang

    2010-01-01

    Concurrent program verification is challenging because it involves exploring a large number of possible thread interleavings together with complex sequential reasoning. As a result, concurrent program verifiers resort to bi-modal reasoning, which alternates between reasoning over intra-thread (sequential) semantics and inter-thread (concurrent) semantics. Such reasoning often involves repeated intra-thread reasoning for exploring each interleaving (inter-thread reasoning) and leads to inefficiency.

  10. Concurrence of superpositions

    SciTech Connect

    Yu, Chang-shui; Yi, X. X.; Song, He-shan [Department of Physics, Dalian University of Technology, Dalian 116024 (China)

    2007-02-15

    Bounds on the concurrence of the superposition state in terms of the concurrences of the states being superposed are found in this paper. The bounds on concurrence are quite different from those on the entanglement measured by von Neumann entropy [Linden et al., Phys. Rev. Lett. 97, 100502 (2006)]. In particular, a nonzero lower bound can be provided if the states being superposed are properly constrained.

  11. Chemotherapy of eyelid and peritorbital tumors.

    PubMed

    Luxenberg, M N; Guthrie, T H

    1985-01-01

    Eight patients with nine histologically proven BCC or SCC involving the eyelids and periorbital tissues were treated with systemic and/or local (iontophoresis) chemotherapy using cisplatin and doxorubicin. All patients had either refused surgery, would have required extensive procedures, or had medical problems contraindicating surgery. Systemic chemotherapy induced a CR or PR in eight of nine lesions. No patient has required maintenance chemotherapy and no significant toxic side effects were encountered. The length of follow-up ranges from 2 to 50 months. Iontophoretic therapy with cisplatin was used to treat five small foci of new, recurrent or persistent tumor(s) in three of these patients, and resulted in a partial response in all five lesions. Systemic or local chemotherapy offers an alternative to current standard forms of treatment for BCC and SCC in selected cases. PMID:3832525

  12. Concurrent Zero Knowledge with Logarithmic Round-Complexity Manoj Prabhakaran

    E-print Network

    Sahai, Amit

    Concurrent Zero Knowledge with Logarithmic Round-Complexity Manoj Prabhakaran Princeton University language in NP has a (black-box) concurrent zero-knowledge proof system using ~O(log n) rounds- quires at least ~(log n) rounds of interaction in order to be proved in black-box concurrent zero

  13. Concurrent Zero Knowledge with Logarithmic RoundComplexity Manoj Prabhakaran #

    E-print Network

    Rosen, Alon

    Concurrent Zero Knowledge with Logarithmic Round­Complexity Manoj Prabhakaran # Princeton that every language in NP has a (black­box) concurrent zero­knowledge proof system using � O(log n) rounds­ quires at least �#11 n) rounds of interaction in order to be proved in black­box concurrent zero

  14. 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.

  15. The role of systemic chemotherapy and multidisciplinary management in improving the overall survival of patients with metastatic squamous cell carcinoma of the anal canal

    PubMed Central

    Eng, Cathy; Chang, George J.; Nancy You, Y.; Das, Prajnan; Rodriguez-Bigas, Miguel; Xing, Yan; Vauthey, Jean-Nicolas; Rogers, Jane E.; Ohinata, Aki; Pathak, Priyanka; Sethi, Salil; Phillips, Jonathan K.; Crane, Christopher H.; Wolff, Robert A.

    2014-01-01

    Metastatic squamous cell carcinoma (SCCA) of the anal canal is a rare malignancy for which no standard treatment algorithm exists. To determine the best approach, all patients diagnosed with metastatic SCCA of the anal canal treated at a single institution were evaluated for choice of chemotherapy and treatment outcome. A retrospective study from January 2000 to May 2012 was conducted. Electronic medical records were reviewed for diagnosis of metastatic SCCA of the anal canal. All patients were treatment naďve for metastatic disease and completed all radiographic imaging at our institution. The purpose of this study was to evaluate outcomes among patients who received systemic chemotherapy and if appropriate were referred for multidisciplinary intervention (e.g., surgery, radiofrequency ablation, etc.). Seventy-seven patients fulfilled eligibility criteria. Forty-two patients (55%) received 5-fluorouracil (5-FU) + cisplatin (PF); 24 patients (31%) received carboplatin + paclitaxel (CP); 11 patients (14%) received an alternative regimen. After a median follow-up of 42 months, the median progression-free survival (PFS) for all patients was 7 months; the median overall survival (OS) was 22 months. Thirty-three patients (43%) underwent multidisciplinary management for metastatic disease resulting in a median PFS of 16 months (95% CI: 9·2 ?22·8) and median OS of 53 months (95% CI: 28·3 – 77·6). Systemic chemotherapy provides durable survival for patients with surgically unresectable metastatic SCCA of the anal canal. Multidisciplinary management for select patients with metastatic disease effectively improves survival and should be considered whenever possible. PMID:25373735

  16. Treatment factors affecting breast cancer-related lymphedema after systemic chemotherapy and radiotherapy in stage II/III breast cancer patients.

    PubMed

    Jung, So-Youn; Shin, Kyung Hwan; Kim, Myungsoo; Chung, Seung Hyun; Lee, Seeyoun; Kang, Han-Sung; Lee, Eun Sook; Kwon, Youngmee; Lee, Keun Seok; Park, In Hae; Ro, Jungsil

    2014-11-01

    We evaluated whether the sequence or regimen of systemic chemotherapy could be a risk factor for breast cancer-related lymphedema (LE). We retrospectively analyzed 848 patients with stage II/III breast cancer who underwent curative surgery with adequate systemic therapy from 2004 to 2009. Adjuvant chemotherapy (ACT) was performed in 552 patients (65.1 %) and neoadjuvant chemotherapy (NAC) in 296 (34.9 %). We evaluated the incidence of LE based on clinicopathological factors and treatments. At a median follow-up of 5.1 years, 358 patients (42.2 %) had experienced LE and 243 (28.7 %) had retained (persistent LE) [120/552 (21.7 %) with ACT vs. 123/296 (41.6 %) with NAC; P < 0.001]. The incidence of LE in patients with taxane was greater than in those without taxane [233/704 (33.1 %) vs. 10/144 (6.9 %); P < 0.001]. Multivariate analysis showed that NAC [hazard ratio (HR), 1.63 in LE event; P < 0.001; HR, 1.39 in persistent LE; P = 0.02] and RT including supraclavicular area (SCRT) (HR 1.55; P = 0.02; HR 1.93; P = 0.006), number of dissected axillary lymph nodes (N-ALNs) >10 (HR, 1.37; P = 0.01; HR, 1.71; P = 0.001), advanced stage (HR, 1.31; P = 0.03; HR, 1.60; P = 0.002), and taxane (HR, 1.69; P = 0.03; HR, 2.07; P = 0.04) were independent risk factors for the LE occurrence. In addition to advanced stage, N-ALNs and SCRT, NAC, and taxane were shown to increase the risk of LE, which could help clinicians identify patients at risk for LE. PMID:25253173

  17. Radical cystectomy for historical and pathologic T1, N0, M0 (stage A) transitional cell cancer. Need for adjuvant systemic chemotherapy?

    PubMed

    Siref, L E; Zincke, H

    1988-04-01

    Of 695 patients who, in a five-year period, underwent cystectomy for bladder cancer, 32 (4.6%) proved to have historical and pathologic Stage T1 (Stage A) transitional cell cancer. Of these, 23 (72%) had grade 3 disease or higher. Overall, in 17 (53%) progression developed after follow-up of greater than or equal to 5 years. Moreover, in 10 (31%) of the patients systemic progression developed during follow-up; less than 50 per cent of the patients were projected to be free of systemic progression at ten years. DNA ploidy pattern analysis did not prove helpful in predicting disease outcome. Because effective systemic chemotherapy has become available in the form of M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin), it seems justifiable that patients who are considered to be candidates for cystectomy because of high-grade, multifocal T1 transitional cell cancer of the bladder also could be candidates for effective neo-adjuvant chemotherapy, in addition to those who usually are part of these protocols--namely, those with greater than or equal to T2 disease. PMID:3354121

  18. 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, E-mail: andres.ferreri@hsr.i [Unit of Lymphoid Malignancies, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Medical Oncology Unit, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Verona, Chiara [Unit of Lymphoid Malignancies, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Internal Medicine Unit, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Politi, Letterio Salvatore [Neuroradiology Unit, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Chiara, Anna [Unit of Radiotherapy and Tomotherapy, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Perna, Lucia [Medical Physics Unit, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy); Villa, Eugenio; Reni, Michele [Medical Oncology Unit, Department of Oncology, San Raffaele Scientific Institute, Milan (Italy)

    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.

  19. Systemic combined chemotherapy with low dose of 5-fluorouracil, cisplatin, and interferon-alpha for advanced hepatocellular carcinoma: a pilot study.

    PubMed

    Komorizono, Yasuji; Kohara, Kazunori; Oketani, Makoto; Maeda, Masahiko; Shibathou, Toshihiko; Shigenobu, Shuhou; Hiramine, Yasusi; Yamasaki, Naruhiro; Arima, Takushi; Kazuaki, Ishibashi; Arima, Terukatsu

    2003-05-01

    The purpose of this pilot study was to evaluate the efficacy and adverse events of systemic combined chemotherapy with low dose of 5-fluorouracil (250 mg/m2, 5 days), cisplatin (10 mg/m2, 5 days), and interferon-alpha (2.5 million units, three times weekly) for advanced hepatocellular carcinoma (HCC) underlying liver cirrhosis. Six patients who had advanced HCC with tumor thrombi in the main portal trunk were enrolled in this study. Partial response was achieved in 2, stable disease in 1, and disease progressed in 3. Objective responses were achieved in 2 (33%), however, marked decreases of alpha-fetoprotein protein and protein-induced vitamin K antagonist or absence (PIVKAII) levels were also seen in one patient (stable disease). Four patients showed hematologic or renal toxicity, which were well tolerated and managed. Our systemic combined chemotherapy resulted in favorable response and was well tolerated in those with advanced HCC underlying liver cirrhosis, complicated by leukocytopenia and thromobocytopenia. PMID:12772783

  20. Intrathecal chemotherapy for hematologic malignancies: drugs and toxicities

    Microsoft Academic Search

    Yok-Lam Kwong; Dominic Y. M. Yeung; Joyce C. W. Chan

    2009-01-01

    Intrathecal (IT) chemotherapy is an important component of the prophylaxis or treatment of hematologic malignancies in the\\u000a central nervous system (CNS), especially in patients with acute lymphoblastic leukemia and aggressive lymphomas. Different\\u000a regimens of IT chemotherapies have been formulated, often in conjunction with systemic high-dose chemotherapy leading to penetration\\u000a of the drugs into the cerebrospinal fluid (CSF). The three commonest

  1. Multicomputers: Message-passing concurrent computers

    SciTech Connect

    Athas, W.C.; Seitz, C.L.

    1988-08-01

    Highly concurrent computers achieve remarkable performance on the broad class of computations that can be formulated and expressed as concurrent programs. This performance is scalable in the number of computing elements, open-ended with technology advances, and low in cost. Several high concurrent or highly parallel systems are now commercially available, and innovative programmers are applying them successfully to a great variety of demanding computing problems. This article provides a status report on the architecture and programming of a family of message-passing concurrent computers that have evolved out of the research of the DARPA-sponsored Submicron Systems Architecture Project in the Caltech Computer Science Department. These systems are organized as ensembles of small programmable computers, called nodes, connected by a message-passing network. This multiple-computer structure has fittingly come to be known as a multicomputer.

  2. Chemotherapy in glioma.

    PubMed

    Taal, Walter; Bromberg, Jacoline Ec; van den Bent, Martin J

    2015-05-01

    SUMMARY? The treatment of glial brain tumors begins with surgery, and standard adjuvant treatment at the end of the past millennium for high-grade glioma and high-risk low-grade glioma was radiotherapy and chemotherapy was given at recurrence. However, over the past 10 years much has changed regarding the role of chemotherapy in gliomas and it is now clear that chemotherapy has a role in the treatment of almost all newly diagnosed diffuse gliomas (WHO grade II-IV). This is the result of several prospective studies that showed survival benefit after combined chemoradiotherapy with temozolomide in glioblastoma (WHO grade IV) or after procarbazine, CCNU (lomustine) and vincristine chemotherapy in diffuse low-grade (WHO grade II) and anaplastic (WHO grade III) glioma. The current standard of treatment for diffuse gliomas is described in this overview and in addition some attention is given to targeted therapies. PMID:25906059

  3. 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

  4. Dosimetric predictors of acute hematologic toxicity in cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy

    SciTech Connect

    Mell, Loren K. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States) and Department of Radiation and Cellular Oncology, University of Illinois at Chicago, Chicago, IL (United States)]. E-mail: lmell@radonc.uchicago.edu; Kochanski, Joel D. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Department of Radiation and Cellular Oncology, University of Illinois at Chicago, Chicago, IL (United States); Roeske, John C. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Department of Radiation and Cellular Oncology, University of Illinois at Chicago, Chicago, IL (United States); Haslam, Josh J. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Department of Radiation and Cellular Oncology, University of Illinois at Chicago, Chicago, IL (United States); Mehta, Neil [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Department of Radiation and Cellular Oncology, University of Illinois at Chicago, Chicago, IL (United States); Yamada, S. Diane [Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Hurteau, Jean A.; Collins, Yvonne C. [Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Illinois at Chicago, Chicago, IL (United States); Lengyel, Ernst [Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States); Mundt, Arno J. [Department of Radiation Oncology, University of California, San Diego, School of Medicine, La Jolla, CA (United States)

    2006-12-01

    Purpose: To identify dosimetric parameters associated with acute hematologic toxicity (HT) and chemotherapy delivery in cervical cancer patients undergoing concurrent chemotherapy and intensity-modulated pelvic radiotherapy. Methods and Materials: We analyzed 37 cervical cancer patients receiving concurrent cisplatin (40 mg/m{sup 2}/wk) and intensity-modulated pelvic radiotherapy. Pelvic bone marrow (BM) was contoured for each patient and divided into three subsites: lumbosacral spine, ilium, and lower pelvis. The volume of each region receiving 10, 20, 30, and {>=}40 Gy (V{sub 1}, V{sub 2}, V{sub 3}, and V{sub 4}, respectively) was calculated. HT was graded according to Radiation Therapy Oncology Group system. Multivariate regression models were used to test associations between dosimetric parameters and HT and chemotherapy delivery. Results: Increased pelvic BM V{sub 1} (BM-V{sub 1}) was associated with an increased Grade 2 or worse leukopenia and neutropenia (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.24-3.53; p = 0.006; and OR, 1.41; 95% CI, 1.02-1.94; p = 0.037, respectively). Patients with BM-V{sub 1} {>=}90% had higher rates of Grade 2 or worse leukopenia and neutropenia than did patients with BM-V{sub 1} <90% (11.1% vs. 73.7%, p < 0.01; and 5.6% vs. 31.6%, p = 0.09) and were more likely to have chemotherapy held on univariate (16.7% vs. 47.4%, p = 0.08) and multivariate (OR, 32.2; 95% CI, 1.67-622; p = 0.02) analysis. No associations between HT and V{sub 3} and V{sub 4} were observed. Dosimetric parameters involving the lumbosacral spine and lower pelvis had stronger associations with HT than did those involving the ilium. Conclusion: The volume of pelvic BM receiving low-dose radiation is associated with HT and chemotherapy delivery in cervical cancer patients undergoing concurrent chemoradiotherapy.

  5. Design of Concurrent Software Based on Problem Concurrency

    Microsoft Academic Search

    Bo Sanden

    1995-01-01

    Two main approaches to the design of concurrent real-time software exist. One approach looks at how input data is transformed into output. The transformations essentially become the tasks. The other approach models the concurrency of the software on concurrency inherent in the problem. One example of this approach, entity-life modeling, starts by partitioning the events in the problem into concurrent

  6. 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.

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

    PubMed

    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

  8. 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

  9. Concurrent zero-knowledge

    Microsoft Academic Search

    Cynthia Dlvork; Moni Naori; Amit Sahai

    1998-01-01

    Concurrent executions of a zero-knowledge protocol by asingle prover (with one or more verifiers) may leak informationand may not be zero-knowledge in toto; for example, inthe case of zero-knowledge interactive proofs or arguments,the interactions remain proofs but may fail to remain zeroknowledge.This paper addresses the problem of achievingconcurrent zero-knowledge.We introduce timing in order to obtain zero-knowledgein concurrent executions. We assume

  10. A Unique Case of a Patient with Rectal Cancer Who Developed Benign Esophageal Stenosis after Localized Rectal Radiation and Systemic Chemotherapy

    PubMed Central

    Chahla, Elie; Cheesman, Antonio; Hammami, Muhammad; Taylor, Jason R.; Poddar, Nishant; Garrett, Robert W.; Alkaade, Samer

    2015-01-01

    Acute esophagitis and esophageal strictures typically occur after local radiation therapy to the thoracic field. Toxicity is usually limited to the field of radiation and potentially augmented by concomitant use of chemotherapy, however esophageal stricturing due to chemotherapy alone is exceedingly rare. Gastrointestinal toxicity has been previously reported in the setting of 5-fluorouracil (5-FU)-based chemotherapy with abnormal thymidylate synthase or dihydropyrimidine dehydrogenase activities. We present a unique case of isolated chemotherapy-induced esophageal stricture in the setting of stage IIIa rectal adenocarcinoma which presented shortly after initiation of treatment with 5-FU-based chemotherapy in a patient with normal thymidylate synthase and dihydropyrimidine dehydrogenase assays. These findings prompt further investigation of pathways and potential risk factors leading to esophageal toxicity in patients treated with 5-FU-based chemotherapy. PMID:25802497

  11. Intraperitoneal chemotherapy with taxanes for ovarian cancer with peritoneal dissemination

    Microsoft Academic Search

    E. de Bree; H. Rosing; J. Michalakis; J. Romanos; K. Relakis; P. A. Theodoropoulos; J. H. Beijnen; V. Georgoulias; D. D. Tsiftsis

    2006-01-01

    Paclitaxel and docetaxel are currently the two clinically available taxanes. The combination of a taxane and a platinum compound has become the systemic chemotherapy of choice for primary ovarian cancer. Despite the high activity of these drugs in systemic chemotherapy, the majority of patients with advanced ovarian cancer will develop recurrent disease and ultimately decease of this disease. Therefore, more

  12. Neurotoxicity of cancer chemotherapy?

    PubMed Central

    Yang, Miyoung; Moon, Changjong

    2013-01-01

    There is accumulating clinical evidence that chemotherapeutic agents induce neurological side effects, including memory deficits and mood disorders, in cancer patients who have undergone chemotherapeutic treatments. This review focuses on chemotherapy-induced neurodegeneration and hippocampal dysfunctions and related mechanisms as measured by in vivo and in vitro approaches. These investigations are helpful in determining how best to further explore the causal mechanisms of chemotherapy-induced neurological side effects and in providing direction for the future development of novel optimized chemotherapeutic agents. PMID:25206457

  13. 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. ...

  14. Chemotherapy Operations Planning and Scheduling

    E-print Network

    2010-02-13

    Feb 12, 2010 ... cells in all phases of the cell cycle and are most effective against slow ... years, demand for chemotherapy has been increasing due to the aging population and .... Chemotherapy nurses play an essential role in administering ...

  15. Using Diffuse Optical Tomography to Monitor Tumor Response to Neoadjuvant Chemotherapy in Breast Cancer Patients

    E-print Network

    Hielscher, Andreas

    Using Diffuse Optical Tomography to Monitor Tumor Response to Neoadjuvant Chemotherapy in Breast ABSTRACT Breast cancer patients often undergo neoadjuvant chemotherapy to reduce the size of the tumor of breast cancer patients to neoadjuvant chemotherapy. Our breast imaging system is a continuous wave system

  16. Concurrency and network disassortativity.

    PubMed

    Khor, Susan

    2010-01-01

    The relationship between a network's degree-degree correlation and a loose version of graph coloring is studied on networks with broad degree distributions. We find that, given similar conditions on the number of nodes, number of links, and clustering levels, fewer colors are needed to color disassortative than assortative networks. Since fewer colors create fewer independent sets, our finding implies that disassortative networks may have higher concurrency potential than assortative networks. This in turn suggests another reason for the disassortative mixing pattern observed in biological networks such as those of protein-protein interaction and gene regulation. In addition to the functional specificity and stability suggested by Maslov and Sneppen, a disassortative network topology may also enhance the ability of cells to perform crucial tasks concurrently. Hence, increased concurrency may also be a driving force in the evolution of biological networks. PMID:20586579

  17. Development of tumor-specific caffeine-potentiated chemotherapy using a novel drug delivery system with Span 80 nano-vesicles.

    PubMed

    Nakata, Hiroshi; Miyazaki, Tatsuhiko; Iwasaki, Tomoyuki; Nakamura, Atsushi; Kidani, Teruki; Sakayama, Kenshi; Masumoto, Junya; Miura, Hiromasa

    2015-04-01

    In recent years, chemotherapy with caffeine has manifested potently high efficacy against osteosarcoma, although adverse effects have been observed. Recently, we developed a novel drug delivery system (DDS) with nonionic vesicles prepared from Span 80 which have promising physicochemical properties as an attractive possible alternative to commonly used liposomes. Herein, we demonstrated that tumor-specific caffeine-potentiated chemotherapy for murine osteosarcoma administered by a novel DDS with Span 80 nano-vesicles showed significant antitumor effects as well as limited adverse effects. The osteosarcoma cell line, LM8, was transplanted into C3H/HeJ mice which then were administered therapeutic agents. Ifosfamide (IFO) was employed as well as caffeine as an enhancer. Span 80 vesicles containing IFO and/or caffeine were freshly prepared. On days 0, 2 and 4, different combinations of the agents were administered to mice: IFO alone (direct i.v.), IFO vesicles (IV), IV+caffeine, IV+caffeine vesicles (CV), PBS alone vesicles (PV), and PBS alone as negative control (PBS i.v.). Then, the mice were sacrificed on day 7. Antitumor effects of the reagents were also analyzed in vitro. Moreover, fertility examination was performed. In vitro, a combination of IV+CV showed significant induction of apoptosis in the early phase. Tumor volumes in the IV+CV group were significantly reduced compared with the other groups. Histological analyses showed that the IV and IV+CV groups had significantly lower viable tumor areas. The IFO direct i.v. group showed a certain grade of renal injury as well as marked suppression of spermatogenesis, while the IV or IV+CV group showed no marked changes. The fertility test revealed that the male mice with IV+CV administration had normal fertility, and no malformations were detected in their progeny. This DDS model is of potential importance for clinical application in the therapy of metastatic osteosarcoma. PMID:25633802

  18. nab-Paclitaxel in Combination With Weekly Carboplatin With Concurrent Radiotherapy in Stage III Non-Small Cell Lung Cancer

    PubMed Central

    Lu, Bo; Horn, Leora; Shyr, Yu; Keedy, Vicki

    2015-01-01

    Lessons Learned The concomitant use of weekly nab-paclitaxel and carboplatin with concurrent radiotherapy was demonstrated to be a safe therapeutic approach in this phase I trial of 10 evaluable patients with stage III NSCLC. Despite the lack of systemic glucocorticoids, there were no reported infusion reactions or cases of peripheral neuropathy in this trial, both of which are known to occur with the use of paclitaxel. Background. Unresectable stage III non-small cell lung cancer (NSCLC) has a 5-year survival rate of 20%, and concurrent chemoradiotherapy results in significant toxicity with the use of current chemotherapeutic agents. nab-Paclitaxel was approved by the U.S. Food and Drug Administration in October 2012 for use along with carboplatin in advanced NSCLC. This study was undertaken to determine the maximum tolerated dose and dose-limiting toxicities (DLTs) of weekly nab-paclitaxel given in combination with carboplatin and concurrent radiotherapy in patients with unresectable stage III NSCLC. Methods. Escalating doses of once-weekly nab-paclitaxel were given along with once-weekly carboplatin area under the plasma concentration time curve (AUC) of 2 and concurrent radiotherapy 66 Gy in 33 fractions, followed by 2 cycles of carboplatin and nab-paclitaxel consolidation chemotherapy. Results. Eleven patients were enrolled and received treatment per protocol, with 10 evaluable for efficacy and toxicity. At dose level 1 (nab-paclitaxel 60 mg/m2), 2 DLTs were observed: esophagitis and radiation dermatitis. Six patients were enrolled at dose level 0 (nab-paclitaxel 40 mg/m2) with no DLTs. Nine of 10 evaluable patients had a partial response. Conclusion. Concurrent chemoradiotherapy with nab-paclitaxel 40 mg/m2 and carboplatin AUC 2 is a safe and well-tolerated therapeutic regimen in patients with stage III NSCLC. A separate phase I/II study to evaluate the efficacy of this regimen is under way. PMID:25845992

  19. Abdominal complications of chemotherapy: findings at computed tomography.

    PubMed

    Liu, Yueyi I; Jha, Priyanka; Wang, Zhen J; Yeh, Benjamin M; Poder, Liina; Westphalen, Antonio C; Coakley, Fergus V

    2012-01-01

    Modern chemotherapy may result in an array of complications that can produce computed tomography (CT) findings in the hepatobiliary, gastrointestinal and urinary systems. This article describes the CT findings that may be seen in abdominal complications of contemporary chemotherapy. Knowledge of the varying CT appearances that can be encountered may facilitate both diagnosis and management in such cases. PMID:22226444

  20. Neoadjuvant cisplatin chemotherapy before chemoradiation: a flawed paradigm?

    PubMed

    Glynne-Jones, Rob; Hoskin, Peter

    2007-11-20

    Effective chemotherapy (CT) treatment of solid tumors emerged with the introduction of anthracyclines and platinum CT in the late 1970s, at first with palliative intent, and later extended into the adjuvant setting. High response rates led to the belief that systemic CT might improve locoregional control and also decrease the risk of distant metastases. A new strategy advocated cisplatin-based neoadjuvant CT (NACT) before definitive local treatment-either surgery or radiotherapy (RT). Response to NACT was viewed as a favorable prognostic sign, which allows the selection of patients most likely to benefit from RT or chemoradiotherapy (CRT). The aim of this discussion is to raise the debate regarding NACT in reducing metastases, improving local control and selecting out good responders for nonsurgical treatment in the following sites: head and neck, esophagus, cervix, anus, nasopharynx, and bladder; as well as non-small-cell lung cancer. NACT has almost invariably failed to deliver an improved outcome in terms of disease-free survival (DFS) or overall survival (OS) when delivered before RT or CRT in all solid tumor sites. The evidence that NACT may improve outcome in terms of DFS or OS is strongest when it is administered before surgical resection, but remains scant before RT or CRT. Taxane-containing regimens look more promising than does cisplatin NACT, but have not been shown to improve on concurrent CRT. Future meta-analyses should compare induction CT followed by RT and induction followed by CRT versus RT or CRT alone. PMID:18024876

  1. Phase I trial using the proteasome inhibitor Bortezomib and concurrent chemoradiotherapy for head and neck malignancies

    Microsoft Academic Search

    Gregory J. Kubicek; Rita S. Axelrod; Mitchell Machtay; Peter H. Ahn; Pramila R Anne; Shannon Fogh; David Cognietti; Thomas Myers; Walter J. Curran; Adam P. Dicker

    PurposeAdvanced head and neck cancer (HNC) remains a difficult disease to cure. Proteasome inhibitors such as bortezomib have potential to improve survival over chemoradiotherapy alone. This phase I dose escalation study examined the potential of bortezomib in combination with cisplatin chemotherapy and concurrent radiation in the treatment of locally advanced and recurrent HNC.

  2. Development of a New Subclavian Arterial Infusion Chemotherapy Method for Locally or Recurrent Advanced Breast Cancer Using an Implanted Catheter-Port System After Redistribution of Arterial Tumor Supply

    SciTech Connect

    Takizawa, Kenji, E-mail: taki-lrl@vy.catv.ne.jp; Shimamoto, Hiroshi, E-mail: hshima@k8.dion.ne.jp; Ogawa, Yukihisa, E-mail: yukky-p406c@nifty.com; Yoshimatsu, Misako, E-mail: misako_yosh@yahoo.co.jp; Yagihashi, Kunihiro, E-mail: yagiku@hotmail.com; Nakajima, Yasuo, E-mail: y3naka@marianna-u.ac.j [St. Marianna University School of Medicine, Department of Radiology (Japan); Kitanosono, Takashi, E-mail: tkita1@mac.co [University of Rochester Medical Center, Department of Vascular/Interventional Radiology (United States)

    2009-09-15

    Locally or recurrent advanced breast cancers can receive arterial blood supply from various arteries, such as the internal thoracic artery (ITA), the lateral thoracic artery, and the other small arterial branches originating from the subclavian artery. Failure to catheterize and subsequent formation of collateral arterial blood supply from various arteries are some of the reasons why the response to conventional selective transarterial infusion chemotherapy is limited and variable. To overcome this problem, we developed a new subclavian arterial infusion chemotherapy method using an implanted catheter-port system after redistribution of arterial tumor blood supply by embolizing the ITA. We named this technique ('redistributed subclavian arterial infusion chemotherapy' (RESAIC)). Using RESAIC, patients can be treated on an outpatient basis for extended periods of time. Eleven patients underwent RESAIC, and the complete remission and partial response rate in 10 evaluable patients was 90%: complete remission [CR] n = 4, partial remission n = 4, stable disease n = 1, and not evaluable n = 1. Three of four patients with CR had no distant metastasis, and modified radical mastectomy was performed 1 month after conclusion of RESAIC. The resected specimens showed no residual cancer cells, and pathologically confirmed complete remission was diagnosed in each of these cases. Although temporary grade-3 myelosuppression was seen in three patients who were previously treated by systemic chemotherapy, there was no other drug-induced toxicity or procedure-related complications. RESAIC produced a better response and showed no major complications compared with other studies despite the advanced stage of the cancers.

  3. A stochastic non-deterministic temporal concurrent constraint calculus

    Microsoft Academic Search

    Carlos Olarte; Camilo Rueda

    2005-01-01

    We propose sntcc, a stochastic extension of the ntcc calculus, a model of temporal concurrent constraint programming with the capability of modeling asynchronous and non-deterministic timed behavior. We argue that such an extension is needed to faithfully model concurrent systems in real-life situations. We provide a suitable temporal logic and proof system for sntcc and illustrate how to use them

  4. -PTOLEMY II -HETEROGENEOUS CONCURRENT

    E-print Network

    -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

  5. Verifying concurrent programs

    Microsoft Academic Search

    Aarti Gupta

    2011-01-01

    The proliferation of multi-core hardware has led to widespread use of concurrent programs. However, these programs are notoriously difficult to get right and to debug for developers. Even for automated verification, it is a big challenge to reason about subtle synchronization between communicating threads or processes, combined with an exponential number of interleavings. This tutorial will focus on the main

  6. Concurrent reading and writing

    Microsoft Academic Search

    Leslie Lamport

    1977-01-01

    The problem of sharing data among asynchronous processes is considered. It is assumed that only one process at a time can modify the data, but concurrent reading and writing is permitted. Two general theorems are proved, and some algorithms are presented to illustrate their use. These include a solution to the general problem in which a read is repeated if

  7. Concurrent Reading While Writing

    Microsoft Academic Search

    Gary L. Peterson

    1983-01-01

    The problem of asynchronous processes reading shared data while the data are being modified by another process is considered. This problem differs from the standard readers\\/writers problem in that concurrent reading while writing is allowed. The model used here strongly limits the use and size of the shared variables. If multiple copies of the shared data are allowed, then simple,

  8. [Chemotherapy of brain tumors in aduts].

    PubMed

    Roth, P; Weller, M

    2015-04-01

    The treatment of patients with brain tumors has long been the domain of neurosurgery and radiotherapy but chemotherapy is now well established as an additional treatment option for many tumor entities in neuro-oncology. This is particularly true for patients with newly diagnosed and relapsing glioblastoma and anaplastic glioma as well as the treatment of medulloblastoma and primary lymphoma of the central nervous system (CNS). In addition to purely histopathological features, treatment decisions including those for chemotherapy are now based increasingly more on molecular tumor profiling. Within the group of gliomas these markers include the methylation status of the O-6-methylguanine-DNA methyltransferase (MGMT) promoter and the 1p/19q status, which reflects the loss of genetic material on chromosome arms 1p and 19q. The presence of a 1p/19q codeletion is associated with a better prognosis and increased sensitivity to alkylating chemotherapy in patients with anaplastic gliomas. PMID:25783972

  9. Concurrent Bisimulations in Petri Nets

    Microsoft Academic Search

    Eike Best; Raymond R. Devillers; Astrid Kiehn; Lucia Pomello

    1991-01-01

    Summary After various attempts, an equivalence relation is defined for labelled Petri nets, on the base of the concurrency semantics of net theory. This relation, called Fully Concurrent bisimulation and abbreviated FC-bisimulation, preserves the level of concurrency of visible operations and, under some conditions, allows to enforce injective labelling on them. Refinements of a visible operation are also defined and

  10. 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.

  11. 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

  12. Management of chemotherapy-induced peripheral neuropathy.

    PubMed

    Stillman, Mark; Cata, Juan P

    2006-08-01

    Recent advances in the development and administration of chemotherapy for malignant diseases have been rewarded with prolonged survival rates. The cost of progress has come at a price and the nervous system is frequently the target of chemotherapy-induced neurotoxicity. Unlike more immediate toxicities that effect the gastrointestinal tract and bone marrow, chemotherapy-induced neurotoxicity is frequently delayed in onset and may progress over time. In the peripheral nervous system, the major brunt of the toxicity is directed against the peripheral nerve, resulting in chemotherapy-induced peripheral neuropathy (CIPN). Chemotherapeutic agents used to treat hematologic and solid tumors target a variety of structures and functions in the peripheral nervous system, including the neuronal cell body, the axonal transport system, the myelin sheath, and glial support structures. Each agent exhibits a spectrum of toxic effects unique to its mechanism of toxic injury, and recent study in this field has yielded clearer ideas on how to mitigate injury. Combined with the call for a greater recognition of the potentially devastating ramifications of CIPN on quality of life, basic and clinical researchers have begun to investigate therapy to prevent neurotoxic injury. Preliminary studies have shown promise for some agents including glutamine, glutathione, vitamin E, acetyl-L-carnitine, calcium, and magnesium infusions, but final recommendations await prospective confirmatory studies. PMID:16834943

  13. Neoadjuvant (induction) chemotherapy in advanced bladder carcinoma.

    PubMed

    Türkeri, L; Ilker, Y; Sim?ek, F; Akda?, A

    1993-01-01

    Traditional approaches for the treatment of locally advanced bladder tumours may not be sufficient enough. Neoadjuvant chemotherapy, a new modality, may be beneficial by enhancing the local and systemic control of the disease. The background of this new modality and early results of various trials are discussed. PMID:8225827

  14. Chemotherapy of medulloblastoma

    Microsoft Academic Search

    Amar Gajjar; Joachim Kühl; Sidnei Epelman; Clifford Bailey; Jeffery Allen

    1999-01-01

    Recent advances in neurosurgical techniques and diagnostic imaging capabilities have facilitated gross total resection and\\u000a accurate staging of disease extent in a greater proportion of patients. The addition of chemotherapy to surgery and craniospinal\\u000a radiation has improved the outcome of patients diagnosed with medulloblastoma. Long-term follow-up studies have documented\\u000a the neuroendocrine and neuropsychological deficits seen in the survivors. This paper

  15. Concurrent zero-knowledge

    Microsoft Academic Search

    Cynthia Dwork; Moni Naor; Amit Sahai

    2004-01-01

    Concurrent executions of a zero-knowledge protocol by a single prover (with one or more verifiers) may leak information and may not be zero-knowledge in toto. In this article, we study the problem of maintaining zero-knowledge.We introduce the notion of an (?, ?) timing constraint: for any two processors P1 and P2, if P1 measures ? elapsed time on its local

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

    SciTech Connect

    Bourgier, Celine, E-mail: bourgier@igr.fr [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Pessoa, Eduardo Lima [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Dunant, Ariane [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Heymann, Steve [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Spielmann, Marc [Department of Medical Oncology, Institut Gustave Roussy, Villejuif (France); Uzan, Catherine [Department of Breast Surgery, Institut Gustave Roussy, Villejuif (France); Mathieu, Marie-Christine [Department of Pathology, Institut Gustave Roussy, Villejuif (France); Arriagada, Rodrigo [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Department of Radiation Oncology, Karolinska Institutet, Stockholm (Sweden); Marsiglia, Hugo [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Radiation Department University of Florence, Florence (Italy)

    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.

  17. A concurrent reactive Esterel processor based on multi-threading

    Microsoft Academic Search

    Xin Li; Reinhard Von Hanxleden

    2006-01-01

    Esterel is a concurrent synchronous language for developing reactive systems. As an alternative to the classical software and hardware synthesis paths, the reactive processing ap- proach uses a specialized processor with an instruction set tailored to Esterel. A principal diculty when compiling onto a reactive processor is the faithful, ecient implemen- tation of concurrency. This paper presents a novel reactive

  18. Generating Fast Code from Concurrent Program Dependence Graphs

    E-print Network

    of concurrently-running processes and implemented using a real-time operating system (RTOS). While the functionality pro- vided by an RTOS is very flexible, the overhead incurred by such a general-purpose mechanism with an RTOS. Instead, successful techniques "compile away" the concurrency through a variety of mechanisms

  19. Codelivery of curcumin and doxorubicin by MPEG-PCL results in improved efficacy of systemically administered chemotherapy in mice with lung cancer

    PubMed Central

    Wang, Bi-Lan; Shen, Yong-mei; Zhang, Qiong-wen; Li, Yu-li; Luo, Min; Liu, Ze; Li, Yan; Qian, Zhi-yong; Gao, Xiang; Shi, Hua-shan

    2013-01-01

    Systemic administration of chemotherapy for cancer often has toxic side effects, limiting the doses that can be used in its treatment. In this study, we developed methoxy poly(ethylene glycol)-poly(caprolactone) (MPEG-PCL) micelles loaded with curcumin and doxorubicin (Cur-Dox/MPEG-PCL) that were tolerated by recipient mice and had enhanced antitumor effects and fewer side effects. It was shown that these Cur-Dox/MPEG-PCL micelles could release curcumin and doxorubicin slowly in vitro. The long circulation time of MPEG-PCL micelles and the slow rate of release of curcumin and doxorubicin in vivo may help to maintain plasma concentrations of active drug. We also demonstrated that Cur-Dox/MPEG-PCL had improved antitumor effects both in vivo and in vitro. The mechanism by which Cur-Dox/MPEG-PCL micelles inhibit lung cancer might involve increased apoptosis of tumor cells and inhibition of tumor angiogenesis. We found advantages using Cur-Dox/MPEG-PCL micelles in the treatment of cancer, with Cur-Dox/MPEG-PCL achieving better inhibition of LL/2 lung cancer growth in vivo and in vitro. Our study indicates that Cur-Dox/MPEG-PCL micelles may be an effective treatment strategy for cancer in the future. PMID:24101869

  20. An AS1411 aptamer-conjugated liposomal system containing a bubble-generating agent for tumor-specific chemotherapy that overcomes multidrug resistance.

    PubMed

    Liao, Zi-Xian; Chuang, Er-Yuan; Lin, Chia-Chen; Ho, Yi-Cheng; Lin, Kun-Ju; Cheng, Po-Yuan; Chen, Ko-Jie; Wei, Hao-Ji; Sung, Hsing-Wen

    2015-06-28

    Recent research in chemotherapy has prioritized overcoming the multidrug resistance (MDR) of cancer cells. In this work, liposomes that contain doxorubicin (DOX) and ammonium bicarbonate (ABC, a bubble-generating agent) are prepared and functionalized with an antinucleolin aptamer (AS1411 liposomes) to target DOX-resistant breast cancer cells (MCF-7/ADR), which overexpress nucleolin receptors. Free DOX and liposomes without functionalization with AS1411 (plain liposomes) were used as controls. The results of molecular dynamic simulations suggest that AS1411 functionalization may promote the affinity and specific binding of liposomes to the nucleolin receptors, enhancing their subsequent uptake by tumor cells, whereas plain liposomes enter cells with difficulty. Upon mild heating, the decomposition of ABC that is encapsulated in the liposomes enables the immediate activation of generation of CO2 bubbles, creating permeable defects in their lipid bilayers, and ultimately facilitating the swift intracellular release of DOX. In vivo studies in nude mice that bear tumors demonstrate that the active targeting of AS1411 liposomes can substantially increase the accumulation of DOX in the tumor tissues relative to free DOX or passively targeted plain liposomes, inhibiting tumor growth and reducing systemic side effects, including cardiotoxicity. The above findings indicate that liposomes that are functionalized with AS1411 represent an attractive therapeutic alternative for overcoming the MDR effect, and support a potentially effective strategy for cancer therapy. PMID:25637705

  1. Treatment of small cell carcinoma of lung with combined high dose mediastinal irradiation, whole brain prophylaxis and chemotherapy

    SciTech Connect

    Shank, B.; Natale, R.B.; Hilaris, B.S.; Wittes, R.E.

    1981-04-01

    Survival of patients with small cell carcinoma of lung, treated on a new combined radiotherapy-chemotherapy protocol, compares favorably with other regimens in the literature and our own previous combined approaches. Radiation, given after induction chemotherapy, consisted of whole brain prophylaxis in all 44 evaluable patients. Patients with limited disease were also treated to the primary and mediastinum to a high dose (5000 rad equivalent) using multiple fields. The new chemotherapy regimen consisted of induction with cyclophosphamide, doxorubicin, and vincristine alternated with cis-platinum and VP-16 (an epipodophyllotoxin) for two cycles, followed by consolidation with low dose cyclophosphamide and vincristine concurrent with irradiation. Patients with limited disease who achieved less than complete response, and all patients with extensive disease were not continued on maintenance chemotherapy. Out of 24 evaluable patients with limited disease, there was 73% survival at 1 year by life-table analysis, measured from treatment initiation. After induction, 16/24 of these limited disease patients were CR (complete responders): 20/24 were CR at completion of their irradiation. Out of 20 evaluable patients with extensive disease, there was 59% survival at 1 year by life-table analysis. Only 4/44 (9%) brain parenchymal relapses occurred, one at 3 months and one at 6 months after local failure and two in patients who did not become CRs, implicating a possible re-seeding mechanism. Five patients had central nervous system relapses outside of brain parenchyma (spinal epidural and leptomeningeal); in three patients this was the initial site of failure. Significant complications included leukopenia (50%) and thrombocytopenia (24%) primarily during induction, and chronic pulmonary fibrosis (25%), possibly contributing to two deaths.

  2. Curare: Restructuring lisp programs for concurrent execution

    SciTech Connect

    Larus, J.R.

    1987-01-01

    This paper describes the techniques used by CURARE, a program transformer, to restructure Lisp programs for concurrent execution in multiprocessor Lisp systems. CURARE tries to eliminate control and data-dependencies that prevent concurrent execution of the invocations of recursive functions. CURARE also inserts a variety of synchronization devices to ensure that unremovable dependencies do not impair execution of a program. The product of this process is semantically equivalent to the original Lisp program, but executes faster on a multiprocessor than would the original program.

  3. Object-Oriented Concurrent Reflective Architectures

    Microsoft Academic Search

    Satoshi Matsuoka; Takuo Watanabe; Yuuji Ichisugi; Akinori Yonezawa

    1991-01-01

    \\u000aReflection provides the abilities to reason and alter the dynamic behavior of computation from within the language framework. It is a practical scheme that offers a new perspective in constructing a malleable, large-scale system such as programming languages, operating systems, and window systems. Reflection is more beneficial in object-oriented concurrent\\/distributed computing, where the complexity of the system is much greater

  4. Network based high performance concurrent computing

    SciTech Connect

    Sunderam, V.S.

    1991-01-01

    The overall objectives of this project are to investigate research issues pertaining to programming tools and efficiency issues in network based concurrent computing systems. The basis for these efforts is the PVM project that evolved during my visits to Oak Ridge Laboratories under the DOE Faculty Research Participation program; I continue to collaborate with researchers at Oak Ridge on some portions of the project.

  5. MULTIPLE CONCURRENT RECURSIVE LEAST SQUARES IDENTIFICATION

    Microsoft Academic Search

    Edward Wilson; David W. Sutter; Robert W. Mah

    2004-01-01

    A new algorithm, multiple concurrent recursive least squares (MCRLS) is developed for parameter estimation in a system having a set of governing equations describing its behavior that cannot be manipulated into a form allowing (direct) linear regression of the unknown parameters. In this algorithm, the single nonlinear problem is segmented into two or more separate linear problems, thereby enabling the

  6. MULTIPLE CONCURRENT RECURSIVE LEAST SQUARES IDENTIFICATION

    Microsoft Academic Search

    Edward Wilson; David W. Sutter; Robert W. Mah

    A new algorithm, multiple concurrent recursive least squares (MCRLS) is developed for parameter estimation in a system having a set of governing equations describing its behavior that cannot be manipulated into a form allowing (direct) linear regression of the unknown parameters. In this algorithm, the single nonlinear problem is segmented into two or more separate linear problems, thereby enabling the

  7. Mechatronics-a powerful concurrent engineering framework

    Microsoft Academic Search

    Hendrik M. J. Van Brussel

    1996-01-01

    Mechatronics is emerging as a concurrent-engineering thinking framework in the process of designing complex machines. It is argued that mechatronics can be defined as the science of motion control. The different steps in the evolution from smart machines to intelligent autonomous systems are discussed and illustrated with many examples, mainly taken from the author's research experience.

  8. Effects of chemotherapy on ultrastructure of oesophageal adenocarcinoma.

    PubMed Central

    Darnton, S. J.; Antonakopoulos, G. N.; Newman, J.; Matthews, H. R.

    1992-01-01

    AIMS: To compare and contrast the ultrastructural appearance of resected oesophageal adenocarcinomas treated with preoperative chemotherapy with that of non-treated resected controls; and to determine the usefulness of this method in the assessment of the effectiveness of the chemotherapeutic regimen. METHODS: Ten resected oesophageal adenocarcinomas treated with preoperative chemotherapy--mitomycin-C, ifosfamide, and cisplatin (MIC)--were examined by transmission electron microscopy and their appearance compared with that of 13 concurrent untreated resected oesophageal adenocarcinomas. RESULTS: The treated adenocarcinomas showed cytotoxic damage although complete tumour eradication was not achieved. In all 10 treated cases a variable proportion of the neoplastic cells showed unusual degenerative and necrotic changes not seen in untreated cases. In the most affected carcinomas the stroma contained increased numbers of inflammatory cells. CONCLUSIONS: This ultrastructural method is useful for the assessment of the in vivo effect of MIC. Images PMID:1452793

  9. Why chemotherapy can fail?

    PubMed

    Król, M; Paw?owski, K M; Majchrzak, K; Szyszko, K; Motyl, T

    2010-01-01

    There are many reasons that lead to failure of cancer chemotherapy. Cancer has the ability to become resistant to many different types of drugs. Increased efflux of drug, enhanced repair/increased tolerance to DNA damage, high antiapoptotic potential, decreased permeability and enzymatic deactivation allow cancer cell survive the chemotherapy. Treatment can lead to the death of most tumor cells (drug-sensitive), but some of them (drug-resistant) survive and grow again. These tumor cells may arise from stem cells. There are many studies describing human experiments with multidrug resistance, especially in breast cancer. Unfortunately, studies of canine or feline ABC super family members are not as extensive as in human or mice and they are limited to several papers describing PGP in mammary cancer, cutaneous mast cell tumors and lymphoma. Multidrug resistance is one of the most significant problems in oncology today. The involvement of many different, not fully recognized, mechanisms in multidrug resistance of cancer cells makes the development of effective methods of therapy very difficult. Understanding the mechanisms of drug resistance in cancer cells may improve the results of treatment. This review article provides a synopsis of all aspects that refer to cancer cell resistance to antitumor drugs. PMID:20731201

  10. Chemotherapy of leishmaniasis.

    PubMed

    Croft, Simon L; Yardley, Vanessa

    2002-01-01

    Leishmaniasis, in its variety of visceral (VL), cutaneous (CL) and mucocutaneous (MCL) forms, directly affects about 2 million people per annum, with approximately 350 million individuals at risk worldwide. During the last 10 years there have been extensive epidemics of the visceral form of the disease, which is also emerging as an important opportunistic infection in immunocompromised patients, especially those co-infected with HIV. The control of leishmaniasis remains a problem principally a zoonotic infection, except in epidemics where it is anthroponotic, interruption of transmission is difficult, though not impossible. No vaccines exist for either VL, CL or MCL and chemotherapy is inadequate and expensive. Current regimes use pentavalent antimony as primary therapy, which must be administered parenterally. Should this fail, a number of other drugs may be employed, depending upon the species of Leishmania concerned and the resources available to the health professionals involved. Recommended secondary treatment employs a variety of drugs, again depending on the nature of the infection. The most widely used of these is amphotericin B, which is highly active but has extensive toxicity complications. The newer formulations of this drug are too expensive to use for the majority of endemic countries. Pentamidine and paromomycin are used in some instances, and a new anti-leishmanial, miltefosine, may be used in the future. In short, there remains a pressing need for new anti-leishmanials and this chapter reviews the current status of chemotherapy, the various avenues being investigated by researchers and their potential application in the future. PMID:11860369

  11. Systmes concurrents Philippe Quinnec

    E-print Network

    Grigoras, .Romulus

    Spécication formelle : Hoare Dénition Un sémaphore S encapsule un entier cnt tel que init S.cnt 0 {S.cnt = k k > 0} S.down() {S.cnt = k - 1} {S.cnt = k} S.up() {S.cnt = k + 1} Systèmes concurrents Sémaphore 7 décrémente le compteur). invariant S.cnt = S.cntinit + #up - #down où #up et #down sont le nombre d

  12. 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 ...

  13. Development of concept for concurrent biocide generation and water system purification. [with application to Skylab water tanks

    NASA Technical Reports Server (NTRS)

    1974-01-01

    An attempt was made to construct an electrochemical system, using iodine, for water purification in Skylab. Data cover measurements of iodine production rates, effect of electrode size and geometry on iodine production rates, and feasibility of using stainless steels as reference electrodes.

  14. Chemotherapy-associated renal dysfunction

    Microsoft Academic Search

    Vaibhav Sahni; Devasmita Choudhury; Ziauddin Ahmed

    2009-01-01

    The presence of renal dysfunction in a patient receiving chemotherapy can be devastating. Although many patients with cancer have underlying compromised renal function, some chemotherapeutic agents can actually induce renal abnormalities. An understanding of which traditional and newer chemotherapy agents can affect renal function is useful for physicians so that they can monitor patients for renal abnormalities and initiate preventive

  15. Why Events Are a Bad Idea (for High-Concurrency Servers)

    Microsoft Academic Search

    J. Robert Von Behren; Jeremy Condit; Eric A. Brewer

    2003-01-01

    Event-based programming has been highly touted in recent years as the best way to write highly concurrent applications. Having worked on several of these systems, we now believe this approach to be a mistake. Specifically, we believe that threads can achieve all of the strengths of events, including support for high concurrency, low overhead, and a simple concurrency model. Moreover,

  16. Thalidomide Combined with Neoadjuvant Chemotherapy in Angiosarcoma of the Breast with Complete Pathologic Response: Case Report and Review of Literature

    PubMed Central

    Alvarado-Miranda, Alberto; Bacon-Fonseca, Ludwing; Ulises Lara-Medina, Fernando; Maldonado-Martínez, Hector; Arce-Salinas, Claudia

    2013-01-01

    Summary Background Primary angiosarcoma of the breast is a rare malignancy. Case Report We report on a 41-year-old female patient who initially presented with locally advanced disease. Core biopsy showed angiosarcoma of the breast, grade 1, CD31-positive. The patient was treated with neoadjuvant systemic chemotherapy based on cisplatin, doxorubicin, and paclitaxel, given concurrently with thalidomide. After treatment completion, the patient underwent radical mastectomy. Pathologic complete response in the breast and axillary lymph nodes was achieved. The patient has no evidence of disease recurrence 6 months after her initial diagnosis. Conclusion Anti-angiogenic therapy may be considered as part of the management of primary angiosarcoma of the breast. PMID:24715848

  17. A Nanoparticle-Based Combination Chemotherapy Delivery System for Enhanced Tumor Killing by Dynamic Rewiring of Signaling Pathways

    PubMed Central

    Morton, Stephen W.; Lee, Michael J.; Deng, Zhou J.; Dreaden, Erik C.; Siouve, Elise; Shopsowitz, Kevin E.; Shah, Nisarg J.; Yaffe, Michael B.; Hammond, Paula T.

    2014-01-01

    Exposure to the EGFR (epidermal growth factor receptor) inhibitor erlotinib promotes the dynamic rewiring of apoptotic pathways, which sensitizes cells within a specific period to subsequent exposure to the DNA-damaging agent doxorubicin. A critical challenge for translating this therapeutic network rewiring into clinical practice is the design of optimal drug delivery systems. We report the generation of a nanoparticle delivery vehicle that contained more than one therapeutic agent and produced a controlled sequence of drug release. Liposomes, representing the first clinically approved nanomedicine systems, are well-characterized, simple, and versatile platforms for the manufacture of functional and tunable drug carriers. Using the hydrophobic and hydrophilic compartments of liposomes, we effectively incorporated both hydrophobic (erlotinib) and hydrophilic (doxorubicin) small molecules, through which we achieved the desired time sequence of drug release. We also coated the liposomes with folate to facilitate targeting to cancer cells. When compared to the time-staggered application of individual drugs, staggered release from tumor-targeted single liposomal particles enhanced dynamic rewiring of apoptotic signaling pathways, resulting in improved tumor cell killing in culture and tumor shrinkage in animal models. PMID:24825919

  18. Evaluation of Intrahepatic Perfusion on Fusion Imaging Using a Combined CT/SPECT System: Influence of Anatomic Variations on Hemodynamic Modification Before Installation of Implantable Port Systems for Hepatic Arterial Infusion Chemotherapy

    SciTech Connect

    Ikeda, Osamu, E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Shiraishi, Shinya; Kawanaka, Kouichi; Tomiguchi, Seiji [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan); Takamori, Hiroshi; Chikamoto, Akira; Kanemitsu, Keiichirou [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Gastroenterology Surgery (Japan); Yamashita, Yasuyuki [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan)

    2007-06-15

    Background. In some patients with hepatic tumors, anatomic variations in the hepatic arteries may require hemodynamic modification to render effective hepatic arterial infusion chemotherapy delivered via implantable port systems. We used a combined CT/SPECT system to obtain fused images of the intrahepatic perfusion patterns in patients with such anatomic variations and assessed their effects on the treatment response of hepatic tumors. Methods. Using a combined SPECT/CT system, we obtained fused images in 110 patients with malignant liver tumors (n = 75) or liver metastasis from unresectable pancreatic cancer (n = 35). Patients with anatomic hepatic arteries variations underwent hemodynamic modification before the placement of implantable port systems for hepatic arterial infusion chemotherapy. We evaluated their intrahepatic perfusion patterns and the initial treatment response of their liver tumors. The perfusion patterns on the fused images were classified as homogeneous, local hypoperfusion, and/or perfusion defect. Using the WHO criteria of complete response (CR), partial response (PR), no change (NC), and progressive disease (PD), we evaluated the patients' tumor responses after 3 months on multislice helical CT scans. The treatment was regarded as effective in patients who achieved a complete response or partial response. Results. Anatomic hepatic artery variations were present in 15 of the 110 patients (13.6%); 5 manifested replacement of the left hepatic artery (LHA), 8 of the right hepatic artery (RHA), and 1 each had replacement of the RHA and LHA, and replacement of the LHA plus an accessory RHA. In 13 of these 15 patients (87%), occlusion with metallic coils was successful. On fusion imaging, the perfusion patterns were recorded as homogeneous in 6 patients (43%), as hypoperfusion in 7 (50%), and 1 patient had a perfusion defect (7.1%) in the embolized arterial region. Of the 8 patients with RHA replacement, 4 manifested a homogeneous distribution and 3 hypoperfusion. In 2 of 5 patients with LHA replacement, the distribution was homogeneous. In 1 patient with RHA and LHA replacement, and in 1 patient with LHA replacement and an accessory RHA, we noted hypoperfusion in the RHA territory. All 6 patients with homogeneous distribution were classified as PR or NC on follow-up multidetector CT. Of the 7 patients manifesting hypoperfusion, 3 were classified as PD (43%), 3 as NC (43%), and 1 as PR (14%) on follow-up CT. Conclusion. Hemodynamic modification of anatomic hepatic artery variations resulted in hypoperfusion on fusion images. Differences in the intrahepatic perfusion patterns may affect the response to hepatic arterial infusion chemotherapy.

  19. Chromonychia Secondary to Chemotherapy

    PubMed Central

    Lopes, Marien; Jordăo, Clarice; Grynszpan, Rachel; Sodré, Celso; Ramos-e-Silva, Marcia

    2013-01-01

    Chemotherapy drugs can affect the skin and its appendages. Several clinical presentations can be observed, depending on the affected structure. The most common dermatological side effect is chromonychia. The main causative agents are: (1) cyclophosphamide, which can provoke a diffuse, black pigmentation, longitudinal striae and dark grey pigmentation located proximally on the nails; (2) doxorubicin, which promotes dark brown bands alternating with white striae and dark brown pigmentation in transverse bands, and (3) hydroxyurea, which produces a distal, diffuse, dark brown pigmentation. In the majority of cases, the effects are reversible after the suspension of the causative agent for a few months. We report a patient who developed chromonychia while undergoing treatment with cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate and cytarabine for acute lymphocytic leukemia. PMID:23874292

  20. Chromonychia secondary to chemotherapy.

    PubMed

    Lopes, Marien; Jordăo, Clarice; Grynszpan, Rachel; Sodré, Celso; Ramos-E-Silva, Marcia

    2013-05-01

    Chemotherapy drugs can affect the skin and its appendages. Several clinical presentations can be observed, depending on the affected structure. The most common dermatological side effect is chromonychia. The main causative agents are: (1) cyclophosphamide, which can provoke a diffuse, black pigmentation, longitudinal striae and dark grey pigmentation located proximally on the nails; (2) doxorubicin, which promotes dark brown bands alternating with white striae and dark brown pigmentation in transverse bands, and (3) hydroxyurea, which produces a distal, diffuse, dark brown pigmentation. In the majority of cases, the effects are reversible after the suspension of the causative agent for a few months. We report a patient who developed chromonychia while undergoing treatment with cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate and cytarabine for acute lymphocytic leukemia. PMID:23874292

  1. A staging system for renal outcome and early markers of renal response to chemotherapy in AL amyloidosis.

    PubMed

    Palladini, Giovanni; Hegenbart, Ute; Milani, Paolo; Kimmich, Christoph; Foli, Andrea; Ho, Anthony D; Vidus Rosin, Marta; Albertini, Riccardo; Moratti, Remigio; Merlini, Giampaolo; Schönland, Stefan

    2014-10-01

    The kidney is involved in 70% of patients with immunoglobulin light-chain (AL) amyloidosis, but little is known on progression or reversibility of renal involvement, and criteria for renal response have never been validated. Newly diagnosed patients from the Pavia (n = 461, testing cohort) and Heidelberg (n = 271, validation cohort) centers were included. Proteinuria >5 g/24 h and estimated glomerular filtration rate (eGFR) <50 mL/min predicted progression to dialysis best. Proteinuria below and eGFR above the thresholds indicated low risk (0 and 4% at 3 years in the testing and validation cohorts, respectively). High proteinuria and low eGFR indicated high risk (60% and 85% at 3 years). At 6 months, a ?25% eGFR decrease predicted poor renal survival in both cohorts and was adopted as criterion for renal progression. A decrease in proteinuria by ?30% or below 0.5 g/24 h without renal progression was the criterion for renal response, being associated with longer renal survival in the testing and validation populations. Hematologic very good partial or complete remission at 6 months improved renal outcome in both populations. We identified and validated a staging system for renal involvement and criteria for early assessment of renal response and progression in AL amyloidosis that should be used in clinical practice and trial design. PMID:25115890

  2. PMJ panel discussion overview on mask complexities, cost, and cycle time in 32-nm system LSI generation: conflict or concurrent?

    NASA Astrophysics Data System (ADS)

    Hosono, Kunihiro; Kato, Kokoro

    2008-10-01

    This is a report on a panel discussion organized in Photomask Japan 2008, where the challenges about "Mask Complexities, Cost, and Cycle Time in 32-nm System LSI Generation" were addressed to have a look over the possible solutions from the standpoints of chipmaker, commercial mask shop, DA tool vendor and equipments makers. The wrap-up is as follows: Mask complexities justify the mask cost, while the acceptable increase rate of 32nm-mask cost significantly differs between mask suppliers or users side. The efficiency progress by new tools or DFM has driven their cycle-time reductions. Mask complexities and cost will be crucial issues prior to cycle time, and there seems to be linear correlation between them. Controlling complexity and cycle time requires developing a mix of advanced technologies, and especially for cost reduction, shot prices in writers and processing rates in inspection tools have been improved remarkably by tool makers. In addition, activities of consortium in Japan (Mask D2I) are expected to enhance the total optimization of mask design, writing and inspection. The cycle-time reduction potentially drives the lowering of mask cost, and, on the other, the pattern complexities and tighter mask specifications get in the way to 32nm generation as well as the nano-economics and market challenges. There are still many difficult problems in mask manufacturing now, and we are sure to go ahead to overcome a 32nm hurdle with the advances of technologies and collaborations by not only technologies but also finance.

  3. Genetic Diversity of the KIR/HLA System and Outcome of Patients with Metastatic Colorectal Cancer Treated with Chemotherapy

    PubMed Central

    De Re, Valli; Caggiari, Laura; De Zorzi, Mariangela; Talamini, Renato; Racanelli, Vito; Andrea, Mario D’; Buonadonna, Angela; Zagonel, Vittorina; Cecchin, Erika; Innocenti, Federico; Toffoli, Giuseppe

    2014-01-01

    Objective To explore genes of the killer-cell immunoglobulin-like receptor (KIR) and of the HLA ligand and their relationship with the outcome of metastatic colorectal cancer (mCRC) patients treated with first-line 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI). Methods A total of 224 mCRC patients were screened for KIR/HLA typing. The determination of the KIR/HLA combinations was based upon the gene content and variants. Genetic associations with complete response (CR), time to progression (TTP) and overall survival (OS) were evaluated by calculating odds and hazard ratios. Multivariate modeling with prognostic covariates was also performed. Results For CR, the presence of KIR2DL5A, 2DS5, 2DS1, 3DS1, and KIR3DS1/HLA-Bw4-I80 was associated with increased CR rates, with median ORs ranging from 2.1 to 4.3, while the absence of KIR2DS4 and 3DL1 was associated with increased CR rates (OR 3.1). After univariate analysis, patients that underwent resective surgery of tumor, absence of KIR2DS5, and presence of KIR3DL1/HLA-Bw4-I80 showed a significant better OS (HR 1.5 to 2.8). Multivariate analysis identified as parameters independently related to OS the type of treatment (surgery; HR 2.0) and KIR3DL1/HLA-Bw4-I80 genotype (HR for T-I80 2.7 and for no functional KIR/HLA interaction 1.8). For TTP, no association with KIR/HLA genes was observed. Conclusion This study, for the first time, evidences that the genotyping for KIR-HLA pairs are found predictive markers associated with complete response and improves overall survival prediction of FOLFIRI treatment response in metastatic colorectal cancer. These results suggest a role of the KIR/HLA system in patient outcome, and guide new research on the immunogenetics of mCRC through mechanistic studies and clinical validation. PMID:24497922

  4. Concurrent Teacher Education Program Introduction

    E-print Network

    Wells, Mathew G. - Department of Physical and Environmental Sciences, University of Toronto

    1 Concurrent Teacher Education Program HANDBOOK Introduction The Concurrent Teacher Education Program (CTEP) is intended for students who wish to become school-teachers in selected areas of study upon, French, Mathematics and Physics. These are among the areas of highest demand for teachers in Ontario

  5. Estimating concurrence via entanglement witnesses

    SciTech Connect

    Jurkowski, Jacek; Chruscinski, Dariusz [Institute of Physics, Nicolaus Copernicus University ul. GrudziaPdzka 5/7, PL-87-100 Torun (Poland)

    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.

  6. Primary Vaginal Cancer Treated With Concurrent Chemoradiation Using Cis-Platinum

    SciTech Connect

    Samant, Rajiv [Department of Radiation Oncology, Ottawa Hospital Regional Cancer Centre, Ottawa, ON (Canada); Faculty of Medicine, University of Ottawa Hospital, Ottawa, ON (Canada)], E-mail: rsamant@ottawahospital.on.ca; Lau, Bedy [Department of Otolaryngology, University of British Columbia, Vancouver, BC (Canada); E, Choan [Department of Radiation Oncology, Ottawa Hospital Regional Cancer Centre, Ottawa, ON (Canada); Faculty of Medicine, University of Ottawa Hospital, Ottawa, ON (Canada); Le, Tien [Faculty of Medicine, University of Ottawa Hospital, Ottawa, ON (Canada); Department of Gynecologic Oncology, Ottawa Hospital, Ottawa, ON (Canada); Tam, Tiffany [Department of Radiation Oncology, McMaster University, Hamilton, ON (Canada)

    2007-11-01

    Purpose: To evaluate the feasibility of concurrent weekly Cis-platinum chemoradiation (CRT) in the curative treatment of primary vaginal cancer. Methods: A retrospective review was performed of all primary vaginal cancer patients treated with curative intent at the Ottawa Hospital Regional Cancer Centre between 1999 and 2004 using concurrent Cis-platinum CRT. Results: Twelve patients were treated with concurrent weekly CRT. The median age at diagnosis was 56 years (range, 34-69 years), and the median follow-up was 50 months (range, 11-75 months). Ten patients (83%) were diagnosed with squamous cell carcinoma and 2 patients (17%) with adenocarcinoma. The distribution according to stage was as follows: 6 (50%) Stage II, 4 (33%) Stage III, and 2 (17%) Stage IVA. All patients received pelvic external beam radiotherapy (EBRT) concurrently with weekly intravenous Cis-platinum chemotherapy (40 mg/m{sup 2}) followed by brachytherapy (BT). The median dose of EBRT was 4500 cGy given in 25 fractions over 5 weeks. Ten patients received interstitial BT, and 2 patients received intracavitary BT, with the median dose being 3000 cGy. The 5-year overall survival, progression-free survival, and locoregional progression-free survival rates were 66%, 75%, and 92%, respectively. Late toxicity requiring surgery occurred in 2 patients (17%). Conclusions: For the treatment of primary vaginal cancer, it is feasible to deliver concurrent weekly Cis-platinum chemotherapy with high-dose radiation, leading to excellent local control and an acceptable toxicity profile.

  7. SILVER LEAF NYLON DRESSING TO PREVENT RADIATION DERMATITIS IN PATIENTS UNDERGOING CHEMOTHERAPY AND EXTERNAL BEAM RADIOTHERAPY TO THE PERINEUM T

    Microsoft Academic Search

    E VUONG; EDUARDO FRANCO; SHIRLEY LEHNERT; CHRISTINE LAMBERT; LORRAINE PORTELANCE; ELIE NASR; SERGIO FARIA; JOHN HAY; STEPHAN LARSSON; GEORGE SHENOUDA; LUIS SOUHAMI; FRANCES WONG; CAROLYN FREEMAN

    2004-01-01

    Purpose: Silver-leaf nylon dressing (SLND) has been shown to have effective antimicrobial activity and to enhance healing in burns and skin grafts. The purpose of this study was to evaluate the value of SLND in preventing radiation dermatitis in patients undergoing radiotherapy to target volumes that included the perineum and concurrent chemotherapy. Methods and Materials: Fifteen consecutive patients with either

  8. Low neuropsychologic performance among adult cancer survivors treated with chemotherapy

    Microsoft Academic Search

    Robert J. Ferguson; Tim A. Ahles

    2003-01-01

    Decline in neuropsychologic test performance following adjuvant chemotherapy for various types of cancer has gained much research\\u000a attention over the past decade. From available data, about one fourth to one third of individuals undergoing systemic chemotherapy\\u000a exhibit measurable decrements in performance of standard tests of cognitive function. Many cancer survivors report that cognitive\\u000a problems interfere with function and compromise quality

  9. Excellent clinical outcomes and retention in care for adults with HIV-associated Kaposi sarcoma treated with systemic chemotherapy and integrated antiretroviral therapy in rural Malawi

    PubMed Central

    Herce, Michael E; Kalanga, Noel; Wroe, Emily B; Keck, James W; Chingoli, Felix; Tengatenga, Listern; Gopal, Satish; Phiri, Atupere; Mailosi, Bright; Bazile, Junior; Beste, Jason A; Elmore, Shekinah N; Crocker, Jonathan T; Rigodon, Jonas

    2015-01-01

    Introduction HIV-associated Kaposi sarcoma (HIV-KS) is the most common cancer in Malawi. In 2008, the non-governmental organization, Partners In Health, and the Ministry of Health established the Neno Kaposi Sarcoma Clinic (NKSC) to treat HIV-KS in rural Neno district. We aimed to evaluate 12-month clinical outcomes and retention in care for HIV-KS patients in the NKSC, and to describe our implementation model, which featured protocol-guided chemotherapy, integrated antiretroviral therapy (ART) and psychosocial support delivered by community health workers. Methods We conducted a retrospective cohort study using routine clinical data from 114 adult HIV-KS patients who received ART and ?1 chemotherapy cycle in the NKSC between March 2008 and February 2012. Results At enrolment 97% of patients (n/N=103/106) had advanced HIV-KS (stage T1). Most patients were male (n/N=85/114, 75%) with median age 36 years (interquartile range, IQR: 29–42). Patients started ART a median of 77 days prior to chemotherapy (IQR: 36–252), with 97% (n/N=105/108) receiving nevirapine/lamivudine/stavudine. Following standardized protocols, we treated 20 patients (18%) with first-line paclitaxel and 94 patients (82%) with bleomycin plus vincristine (BV). Of the 94 BV patients, 24 (26%) failed to respond to BV requiring change to second-line paclitaxel. A Division of AIDS grade 3/4 adverse event occurred in 29% of patients (n/N=30/102). Neutropenia was the most common grade 3/4 event (n/N=17/102, 17%). Twelve months after chemotherapy initiation, 83% of patients (95% CI: 74–89%) were alive, including 88 (77%) retained in care. Overall survival (OS) at 12 months did not differ by initial chemotherapy regimen (p=0.6). Among patients with T1 disease, low body mass index (BMI) (adjusted hazard ratio, aHR=4.10, 95% CI: 1.06–15.89) and 1 g/dL decrease in baseline haemoglobin (aHR=1.52, 95% CI: 1.03–2.25) were associated with increased death or loss to follow-up at 12 months. Conclusions The NKSC model resulted in infrequent adverse events, low loss to follow-up and excellent OS. Our results suggest it is safe, effective and feasible to provide standard-of-care chemotherapy regimens from the developed world, integrated with ART, to treat HIV-KS in rural Malawi. Baseline BMI and haemoglobin may represent important patient characteristics associated with HIV-KS survival in rural sub-Saharan Africa. PMID:26028156

  10. Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft-Tissue Sarcomas After Preoperative Concurrent Chemoradiotherapy

    SciTech Connect

    MacDermed, Dhara M. [Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL (United States); Miller, Luke L. [Pritzker School of Medicine, University of Chicago, Chicago, IL (United States); Peabody, Terrance D.; Simon, Michael A.; Luu, Hue H.; Haydon, Rex C. [Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago, IL (United States); Montag, Anthony G. [Department of Pathology, University of Chicago, Chicago, IL (United States); Undevia, Samir D. [Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL (United States); Connell, Philip P., E-mail: pconnell@radonc.uchicago.ed [Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL (United States)

    2010-03-15

    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 the University of Chicago. Methods and Materials: We treated 34 patients (28 Stage III and 6 Stage IV) with locally advanced soft-tissue sarcomas of an extremity between 1995 and 2008. All patients received preoperative therapy including ifosfamide (2.5 g/m2 per day for 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 rate was 42.3% for all patients and 45.2% for Stage III patients. For limb-preservation patients, the 5-year local control rate was 89.0% and reoperation was required for wound complications in 17.2%. The 5-year freedom-from-distant metastasis rate was 53.4% (Stage IV patients excluded), and freedom from distant metastasis was superior if treatment-induced tumor necrosis was 90% or greater (84.6% vs. 19.9%, p = 0.02). Conclusions: 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.

  11. [Late effects of cancer chemotherapy].

    PubMed

    Furue, H

    1987-04-01

    Patients with specific types of cancer have achieved substantial prolongation of survival after successful cancer chemotherapy. Furthermore, cancer chemotherapeutic agents are being widely used as immunosuppressive drugs in patients with benign conditions. Both of these patient populations are at risk for development of late complications of treatment. Though the late effects of chemotherapy are less well defined, they are insidious in onset and not manifested clinically until damage have become overt and irreversible. Many reports on the late effects of chemotherapy demonstrate the importance of assessing not only the therapeutic results of various treatment program but also of evaluating the long-term complications of therapy in order to maximize the benefit of the treatment. Thus, skillful and judicious application of chemotherapy produces a minimum of delayed consequences. PMID:3551847

  12. Managing Chemotherapy Side Effects: Anemia

    MedlinePLUS

    ... National Institutes of Health Managing Chemotherapy Side Effects Anemia Call your doctor or nurse if you feel: ? ... tired ? Your heart beating very fast What is anemia? Anemia is when your body doesn’t have ...

  13. Neoadjuvant chemotherapy for bladder cancer

    Microsoft Academic Search

    Peter C. Black; Gordon A. Brown; H. Barton Grossman; Colin P. Dinney

    2006-01-01

    The 30–45% failure rate after radical cystoprostatectomy mandates that we explore and optimize multimodal therapy to achieve better disease control in these patients. Cisplatin-based multi-agent combination chemotherapy has been used with success in metastatic disease and has therefore also been introduced in patients with high-risk but non-metastatic bladder cancer. There is now convincing evidence that chemotherapy given pre-operatively can improve

  14. Intensity-Modulated Radiation Therapy with Concurrent Carboplatin and Paclitaxel for Locally Advanced Head and Neck Cancer: Toxicities and Efficacy

    PubMed Central

    Vlacich, Gregory; Diaz, Roberto; Thorpe, Steven W.; Murphy, Barbara A.; Kirby, Wyndee; Sinard, Robert J.; Shakhtour, Bashar; Shyr, Yu; Murphy, Patrick; Netterville, James L.; Yarbrough, Wendell G.

    2012-01-01

    Background. Intensity-modulated radiation therapy (IMRT) and alternative chemotherapy regimens strive to maintain efficacy while minimizing toxicity in locally advanced head and neck cancer (LAHNC) treatment. Our experience with concurrent IMRT and taxane-based chemotherapy is presented. Methods. A retrospective review of 150 consecutive patients with LAHNC treated with IMRT and concurrent taxane-based chemotherapy with curative intent was performed. The IMRT fractionation regimen consisted of 69.3 Gy to gross disease (2.1 Gy/fraction) and 56.1 Gy to prophylactic nodal sites (1.7 Gy/fraction). Weekly paclitaxel (30 mg/m2) and carboplatin (area under the concentration–time curve [AUC], 1) were given concurrently to all patients, and 69% received weekly induction with paclitaxel (60 mg/m2) and carboplatin (AUC, 2). Results. Over 90% of patients received the prescribed radiation dose. Ninety-six percent completed five or more cycles of concurrent chemotherapy, with similar tolerability for induction chemotherapy. A percutaneous endoscopic gastrostomy (PEG) tube was required in 80 patients, with 10 maintaining PEG use >18 months. Acute grade 4 mucositis and dermatitis developed in 2.0% and 4.0% of patients, respectively. No patient experienced nadir sepsis, grade ?3 late xerostomia, or significant nephropathy or gastrointestinal toxicity. Median follow-up was 30 months. The 3-year locoregional control rate was 83.2% with disease-free survival and overall survival rates of 78.8% and 76.5%, respectively. Conclusion. Rates of acute and late toxicities were low, with excellent radiation dose delivery and impressive tumor control at 3 years, suggesting that concurrent carboplatin and paclitaxel with IMRT is a reasonable therapeutic option for the curative treatment of LAHNC. PMID:22550060

  15. Health-related quality of life assessment in prospective trials of systemic cytotoxic chemotherapy for metastatic castration-resistant prostate cancer: which instrument we need?

    Microsoft Academic Search

    Giuseppe CollocaPasquale Colloca; Pasquale Colloca

    2011-01-01

    Knowledge about psychological health of men with prostate cancer is still limited. HRQoL assessment adds value in symptom\\u000a management by allowing a broader understanding of the impact of symptom management beyond the targeted symptom, on functioning,\\u000a and on overall QoL. In this paper, the results of the commonly used HRQoL questionnaires in phase III randomized clinical\\u000a trials of chemotherapy in

  16. A Logic for True Concurrency

    NASA Astrophysics Data System (ADS)

    Baldan, Paolo; Crafa, Silvia

    We propose a logic for true concurrency whose formulae predicate about events in computations and their causal dependencies. The induced logical equivalence is hereditary history preserving bisimilarity, and fragments of the logic can be identified which correspond to other true concurrent behavioural equivalences in the literature: step, pomset and history preserving bisimilarity. Standard Hennessy-Milner logic, thus (interleaving) bisimilarity, is also recovered as a fragment. We believe that this contributes to a rational presentation of the true concurrent spectrum and to a deeper understanding of the relations between the involved behavioural equivalences.

  17. A UNIX concurrent I\\/O simulator

    Microsoft Academic Search

    Steven Robbins

    2006-01-01

    This paper describes a simulator that allows users to explore con- current I\\/O in UNIX. UNIX I\\/O provides an interesting example of how a shared variable, in this case the file offset, can be affected by concurrent access. The examples given can run on the simula- tor or a real UNIX-like system such as Linux, Solaris for Mac OS X.

  18. A Stochastic Pi Calculus for Concurrent Objects

    Microsoft Academic Search

    Céline Kuttler; Cédric Lhoussaine; Joachim Niehren

    2007-01-01

    We present SpiCO, a new modeling and simulation language for system biology, based on the stochastic ?-calculus. SpiCO supports higher level modeling via multi-profile concurrent objects with static inheritance. We present a semantics for SpiCO in terms of continuous time Markov chains, and show how to compile SpiCO back into the biochemical stochastic ?-calculus while preserving semantics. Modeling and simulation

  19. 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, E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Shiraishi, Shinya; Kawanaka, Kouichi; Tomiguchi, Seiji; Yamashita, Yasuyuki [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan); Takamori, Hiroshi; Kanemitsu, Keiichiro; Baba, Hideo [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Gastroenterological Surgery (Japan)

    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.

  20. LANGUAGES FOR CONCURRENCY Catuscia Palamidessi

    E-print Network

    Valencia, Frank D.

    LANGUAGES FOR CONCURRENCY Catuscia Palamidessi INRIA and LIX, Ă?cole Polytechnique catuscia@lix.polytechnique.fr Frank D. Valencia CNRS and LIX, Ă?cole Polytechnique frank.valencia@lix.polytechnique.fr Abstract

  1. LANGUAGES FOR CONCURRENCY Catuscia Palamidessi

    E-print Network

    Paris-Sud XI, Université de

    LANGUAGES FOR CONCURRENCY Catuscia Palamidessi INRIA and LIX, École Polytechnique catuscia@lix.polytechnique.fr Frank D. Valencia CNRS and LIX, École Polytechnique frank.valencia@lix.polytechnique.fr Abstract

  2. Concurrent vs. Conjoint Marital Therapy.

    ERIC Educational Resources Information Center

    Hefner, Charles W.; Prochaska, James O.

    1984-01-01

    Evaluated couples (N=27) randomly assigned to conjoint or concurrent therapy to compare treatment effectiveness with regard to intrapersonal and interpersonal problems. Results showed no differences between the two treatments on any of the outcome measures. (LLL)

  3. Concurrent radiochemotherapy for patients with stage III non-small–cell lung cancer (NSCLC): long-term results of a phase II study

    Microsoft Academic Search

    Branislav Jeremic; Yuta Shibamoto; Biljana Milicic; Nebojsa Nikolic; Aleksandar Dagovic; Slobodan Milisavljevic

    1998-01-01

    Purpose: To investigate the feasibility and activity of concurrent radiochemotherapy in patients with Stage III nonsmall-cell lung cancer (NSCLC).Materials and Methods: Forty-one patients were treated with hyperfractionated radiation therapy (HfxRT) using 1.2 Gy bid, to a total of 69.6 Gy and concurrent low-dose daily chemotherapy (CHT) consisting of 30 mg of carboplatin (CBDCA) and 30 mg of etoposide (VP-16) given

  4. Correctly Translating Concurrency Primitives Jan Schwinghammer

    E-print Network

    Paris-Sud XI, Université de

    to the whole compilation process from high-level to low-level concurrent languages. Categories and Subject Descriptors D.3.3 [Programming Lan- guages]: Language Constructs and Features ­ concurrent program- ming. Introduction Modern concurrent programming languages extend sequential lan- guages with concurrent threads

  5. Metastatic Colorectal Cancer Treated with Herbal Pharmacopuncture during FOLFIRI Chemotherapy: A Case Report

    PubMed Central

    Lee, Jung-Woo; Han, Jae-bok; Kim, Sung-su; Seong, Shin

    2014-01-01

    According to the 2008 World Cancer Report by the World Health Organization (WHO), colorectal cancer is one of the leading cancers worldwide. This case study evaluates the effectiveness of Korean medicine treatment, including herbal pharmacopuncture (HP), as a complementary treatment during FOLFIRI chemotherapy. A 73-year-old male who was diagnosed with metastatic colorectal cancer (mCRC) in September 2012 was treated concurrently with HP and FOLFIRI chemotherapy for 4 months. The effectiveness of the combined therapy was evaluated by CT. Furthermore, quality of life was assessed using a visual analogue scale. The tumor mass sizes of lung and lymph node metastases decreased, and the side effects caused by chemotherapy were mitigated. Based on these results, this case report suggests that Korean medicine treatment including HP therapy could be a complementary therapy for mCRC. PMID:24987356

  6. Metastatic Colorectal Cancer Treated with Herbal Pharmacopuncture during FOLFIRI Chemotherapy: A Case Report.

    PubMed

    Lee, Jung-Woo; Han, Jae-Bok; Kim, Sung-Su; Seong, Shin

    2014-05-01

    According to the 2008 World Cancer Report by the World Health Organization (WHO), colorectal cancer is one of the leading cancers worldwide. This case study evaluates the effectiveness of Korean medicine treatment, including herbal pharmacopuncture (HP), as a complementary treatment during FOLFIRI chemotherapy. A 73-year-old male who was diagnosed with metastatic colorectal cancer (mCRC) in September 2012 was treated concurrently with HP and FOLFIRI chemotherapy for 4 months. The effectiveness of the combined therapy was evaluated by CT. Furthermore, quality of life was assessed using a visual analogue scale. The tumor mass sizes of lung and lymph node metastases decreased, and the side effects caused by chemotherapy were mitigated. Based on these results, this case report suggests that Korean medicine treatment including HP therapy could be a complementary therapy for mCRC. PMID:24987356

  7. Symbolic Analysis of Concurrent Programs with Polymorphism

    NASA Technical Reports Server (NTRS)

    Rungta, Neha Shyam

    2010-01-01

    The current trend of multi-core and multi-processor computing is causing a paradigm shift from inherently sequential to highly concurrent and parallel applications. Certain thread interleavings, data input values, or combinations of both often cause errors in the system. Systematic verification techniques such as explicit state model checking and symbolic execution are extensively used to detect errors in such systems [7, 9]. Explicit state model checking enumerates possible thread schedules and input data values of a program in order to check for errors [3, 9]. To partially mitigate the state space explosion from data input values, symbolic execution techniques substitute data input values with symbolic values [5, 7, 6]. Explicit state model checking and symbolic execution techniques used in conjunction with exhaustive search techniques such as depth-first search are unable to detect errors in medium to large-sized concurrent programs because the number of behaviors caused by data and thread non-determinism is extremely large. We present an overview of abstraction-guided symbolic execution for concurrent programs that detects errors manifested by a combination of thread schedules and data values [8]. The technique generates a set of key program locations relevant in testing the reachability of the target locations. The symbolic execution is then guided along these locations in an attempt to generate a feasible execution path to the error state. This allows the execution to focus in parts of the behavior space more likely to contain an error.

  8. Effectiveness of intensified rotational combination chemotherapy for late hematologic relapse of childhood acute lymphoblastic leukemia.

    PubMed

    Rivera, G K; Hudson, M M; Liu, Q; Benaim, E; Ribeiro, R C; Crist, W M; Pui, C H

    1996-08-01

    Relapsed acute lymphoblastic leukemia (ALL) usually carries a dire prognosis. We evaluated the effectiveness and long-term complications of intensive rotational combination chemotherapy for late hematologic relapse (median, 16 months after elective cessation of therapy) among 34 children and young adults (ages 4 to 23 years). Concurrent central nervous system (CNS) relapse was present in 3 cases and testicular relapse in 4. Secondary therapy comprised an intensive five-drug reinduction (6 weeks) followed by continuation treatment with four drug pairs, rotated weekly in 4-week cycles over 120 weeks. Intrathecal chemotherapy (methotrexate, hydrocortisone, cytarabine) was given three times during reinduction and every 8 weeks during continuation. Treatment was electively discontinued at week 120 in the absence of detectable disease. Thirty-three patients (97%) attained a second complete remission. At a median follow-up of 9.3 years (range, 4.5 to 11.4), estimates of 5-year second event-free and overall survival (+/- SE) are 65% +/- 8% and 79% +/- 7%, respectively. Eleven patients had a second relapse (9 marrow, 2 testicular) and one developed secondary myeloid leukemia. There have been no CNS relapses or deaths in remission. Treatment was well-tolerated and was given largely on an outpatient basis. Late effects are primarily endocrinologic; one child had a second malignant solid tumor (presumed related to initial radiation therapy) that was treated successfully. Intensive treatment with alternating non-cross-resistant drug pairs for late hematologic relapses of ALL is effective and well-tolerated, and produces results similar to those achieved in patients with newly diagnosed ALL. Event-free survival compares favorably with reports of other relapse regimens, including those incorporating bone marrow transplantation. PMID:8704238

  9. Principles of chemotherapy safety procedures.

    PubMed

    Takada, Shawn

    2003-05-01

    With the ever-increasing demand in veterinary medicine to administer chemotherapy agents, it is imperative for the practitioner as well as the support staff to follow strict guidelines for the administration and disposal of cytotoxic drugs. Because of the possible reproductive risks associated with hazardous drugs, all employees who may be pregnant or trying to become pregnant should be excluded from the process. The long-term occupational effects of these agents are not known; therefore, a standard operating procedure including storage of chemotherapy drugs, protective attire, drug preparation, administration, waste disposal/management, hazardous drug spills, and emergency measures for personal contamination should be carefully implemented and documented. PMID:12831064

  10. Managing Chemotherapy Side Effects: Urination Changes

    MedlinePLUS

    ... anD human services national institutes of health Managing Chemotherapy Side Effects Urination Changes Call your doctor or ... urine to change color or smell different during chemotherapy. Talk with your doctor or nurse to learn ...

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

    MedlinePLUS

    ... institutes of health Managing Chemotherapy Side Effects Swelling (Fluid retention) “My hands and feet were swollen and ... at one time. Managing Chemotherapy Side Effects: Swelling (Fluid retention) Weigh yourself. l Weigh yourself at the ...

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

    SciTech Connect

    Lee, Irwin H., E-mail: ihlee@post.harvard.ed [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Eisbruch, Avraham [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    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.

  13. Multidrug resistance in cancer chemotherapy

    Microsoft Academic Search

    Nomita H. Patel; Mace L. Rothenberg

    1994-01-01

    Resistance to chemotherapy is the single most important reason for treatment failure in cancer patients. Over the past 15 years, we have gained significant insight into one of the mechanisms responsible for this process: multidrug resistance (MDR). Far from being a phenomenon limited to the laboratory, multidrug resistance has been identified in a wide variety of newly diagnosed and recurrent

  14. 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.

  15. Pathological complete response and residual DCIS following neoadjuvant chemotherapy for breast carcinoma

    Microsoft Academic Search

    R L Jones; S R Lakhani; A E Ring; S Ashley; G Walsh; I E Smith

    2006-01-01

    Patients who have no residual invasive cancer following neoadjuvant chemotherapy for breast carcinoma have a better overall survival than those with residual disease. Many classification systems assessing pathological response to neoadjuvant chemotherapy include residual ductal carcinoma in situ (DCIS) only in the definition of pathological complete response. The purpose of this study was to investigate whether patients with residual DCIS

  16. Prevention and treatment of chemotherapy- and radiotherapy-induced oral mucositis: a review

    Microsoft Academic Search

    P. Plevová

    1999-01-01

    Oral mucositis is a distressing toxic effect of systemic chemotherapy with many commonly utilized drugs and of head and neck irradiation in patients with cancer. The agents and methods that have been used and studied in chemotherapy- and radiotherapy-induced oral mucositis, their mechanisms of action, and the current knowledge of their efficiency to reduce the incidence, severity or shorten the

  17. 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. [Department of Oncology, Aberdeen Royal Infirmary, Aberdeen (United Kingdom)], E-mail: george.plataniotis@nhs.net; Dale, Roger G. [Imperial College Healthcare NHS Trust, Charing Cross Hospital, London (United Kingdom)

    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.

  18. Sensitization of malignant glioma to chemotherapy through dendritic cell vaccination.

    PubMed

    Liu, Gentao; Black, Keith L; Yu, John S

    2006-04-01

    Drug resistance represents a major cause of chemotherapy failure in patients with cancer. The characterization of the molecular pathways involved in drug resistance has provided new targets to circumvent or reverse chemotherapy resistance. Many of these target proteins are often overexpressed in human glioma and have been identified as tumor antigens, which implicate the development of immunotherapy as a therapeutic strategy. Dendritic cells (DCs) are the most potent antigen-presenting cells of the immune system and have been demonstrated to stimulate antibody and cell-mediated immune responses against tumor-associated antigens. Ex vivo-generated and tumor antigen-loaded DCs have been successfully introduced to clinical vaccination protocols, which have proven to be feasible and effective in some glioma patients. Most importantly, immunotherapy followed by chemotherapy could significantly increase 2-year survival in malignant glioma patients, which obviously demonstrates that DC vaccination could increase the sensitivity of tumor cells to chemotherapy. This review focuses on recent advances in the identification of tumor-associated antigen in glioma, as well as novel insights into their biological function related to drug resistance. These insights may provide the rationale for a novel strategy of a DC cancer vaccine that sensitizes tumor cells to chemotherapy. In addition, the current research status and the future direction of a DC-based vaccine to treat glioma in animal models and clinical trials will also be discussed. PMID:16608423

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

    SciTech Connect

    Quero, Laurent, E-mail: laurent.quero@sls.aphp.fr [Department of Radiation Oncology, Saint-Louis Hospital, Paris (France); Bouchbika, Zineb; Kouto, Honorine; Baruch-Hennequin, Valerie [Department of Radiation Oncology, Saint-Louis Hospital, Paris (France); Gornet, Jean-Marc [Department of Gastroenterology, Saint-Louis Hospital, Paris (France); Munoz, Nicolas [Department of General Surgery, Saint-Louis Hospital, Paris (France); Cojean-Zelek, Isabelle [Department of Medical Oncology, Croix Saint-Simon Hospital, Paris (France); Houdart, Remi [Department of Digestive Surgery, Croix Saint-Simon Hospital, Paris (France); Panis, Yves [Department of Colorectal Surgery, Beaujon Hospital, Clichy (France); Valleur, Patrice [Department of Digestive Surgery, Lariboisiere Hospital, Paris (France); Aparicio, Thomas [Department of Gastroenterology, Avicenne Hospital, Bobigny (France); Maylin, Claude; Hennequin, Christophe [Department of Radiation Oncology, Saint-Louis Hospital, Paris (France)

    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.

  20. Concurrent Haskell Simon Peyton Jones

    E-print Network

    Jones, Simon Peyton

    Concurrent Haskell Simon Peyton Jones University of Glasgow Andrew Gordon University of Cambridge/O (Gordon 1994a]; Pey- ton Jones & Wadler 1993]), and how the same idea could be generalised to accommodate securely encapsulated muta- ble state (Launchbury & Peyton Jones 1996]; Launchbury & Peyton Jones 1994

  1. Concurrent Haskell Simon Peyton Jones

    E-print Network

    Jones, Simon Peyton

    Concurrent Haskell Simon Peyton Jones University of Glasgow Andrew Gordon University of Cambridge/O (Gordon [1994a]; Pey­ ton Jones & Wadler [1993]), and how the same idea could be generalised to accommodate securely encapsulated muta­ ble state (Launchbury & Peyton Jones [1996]; Launchbury & Peyton Jones

  2. CONCURRENT PASCAL AND DISTRIBUTED PROCESSES

    E-print Network

    Filman, Robert E.

    in Concurrent Pascal is a program for printing the prime Fibonacci numbers. This program has two processes, one that generates suc- cessive Fibonacci numbers, and another that tests them for primeness. These processes that one of the Fibonacci numbers sent it is prime, it calls on a class object, a LinePrinter, to print it

  3. Universal Timed Concurrent Constraint Programming

    E-print Network

    Paris-Sud XI, Université de

    to verify security protocols. 1 Introduction Concurrent Constraint Programming (ccp) [3] is a well into finite state automata. Motivated in models for the analysis of security protocols where it is necessary through the shared store posting new constraints (tell(c) operator) or testing the structure of the store

  4. Concurrent Collections Zoran Budimlic1

    E-print Network

    Budimlić, Zoran

    University 2 Intel Corporation 3 UCLA Abstract We introduce the Concurrent Collections (CnC) programming model. CnC supports flexible combinations of task and data parallelism while retaining determinism. CnC that together form a CnC graph. We formally describe the execution semantics of CnC and prove that the model

  5. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Concurrent actions. 500.141 Section 500.141 Labor Regulations Relating to Labor (Continued...SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any...

  6. A journey to pediatric chemotherapy competence.

    PubMed

    Andam, Rachel; Silva, Melissa

    2008-08-01

    Chemotherapy and biotherapy use has increased due to its effectiveness as a treatment for childhood cancer. Nurses need to demonstrate knowledge of these agents' mechanism of action, adverse effects, safe handling, and monitoring parameters. Competence of nurses administering chemotherapy and biotherapy needs to be assessed to ensure safety and quality care. Review of literature reveals that a comprehensive education program and skills validation are the most thorough means of assessing chemotherapy competency. The chemotherapy competency program at the Children's National Medical Center (CNMC) was evaluated and was noted to be inadequate. Although a self-learning module on intravenous push chemotherapy administration and a 1-hour lecture on chemotherapy administration were offered during orientation, there was limited reevaluation of competence at regular intervals. As a result of a literature review, multi-institutional surveys, and intensive review of the CNMC chemotherapy administration module, a comprehensive chemotherapy/biotherapy competency program was developed for nurses administering chemotherapeutic agents. The CNMC chemotherapy competency program was formed with a didactic content course utilizing the Oncology Nursing Society Chemotherapy/Biotherapy Provider Course combined with initial and yearly skills validation. After offering both the didactic portion and three-part competency skills set, nurses have indicated improved satisfaction with the methodology of achieving chemotherapy competency. PMID:18638670

  7. Testing concurrent programs using value schedules

    Microsoft Academic Search

    Jun Chen; Steve Macdonald

    2007-01-01

    Concurrent programs are dicult to debug and verify be- cause of the nondeterministic nature of concurrent exe- cutions. A particular concurrency-related bug may only show up under certain rarely-executed thread interleavings. Therefore, commonly used debugging methodologies, such as inserting print statements, are no longer sucien t for un- covering concurrency-related bugs. However, many existing bug detection methods, such as dynamic

  8. Observational Determinism for Concurrent Program Security

    Microsoft Academic Search

    Steve Zdancewic; Andrew C. Myers

    2003-01-01

    Noninterference is a property of sequential programs that is useful for expressing security policies for data confiden- tiality and integrity. However, extending noninterference to concurrent programs has proved problematic. In this pa- per we present a relatively expressive secure concurrent lan- guage. This language, based on existing concurrent calculi, provides first-class channels, higher-order functions, and an unbounded number of threads.

  9. Concurrent Breakpoints Chang-Seo Park

    E-print Network

    Sen, Koushik

    breakpoints, a light-weight and programmatic way to make a concurrency bug reproducible. We describe the bug. In this paper, we propose a simple light-weight technique called concurrent breakpoints, reproducibility of bugs is a key requirement. Unfortunately, bugs in concurrent programs are notoriously diffi

  10. Concurrent initialization for Bearing-Only SLAM.

    PubMed

    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

  11. Therapeutic Silencing of Bcl-2 by Systemically Administered siRNA Nanotherapeutics Inhibits Tumor Growth by Autophagy and Apoptosis and Enhances the Efficacy of Chemotherapy in Orthotopic Xenograft Models of ER (?) and ER (+) Breast Cancer

    PubMed Central

    Tekedereli, Ibrahim; Alpay, S Neslihan; Akar, Ugur; Yuca, Erkan; Ayugo-Rodriguez, Cristian; Han, He-Dong; Sood, Anil K; Lopez-Berestein, Gabriel; Ozpolat, Bulent

    2013-01-01

    Bcl-2 is overexpressed in about a half of human cancers and 50–70% of breast cancer patients, thereby conferring resistance to conventional therapies and making it an excellent therapeutic target. Small interfering RNA (siRNA) offers novel and powerful tools for specific gene silencing and molecularly targeted therapy. Here, we show that therapeutic silencing of Bcl-2 by systemically administered nanoliposomal (NL)-Bcl-2 siRNA (0.15?mg siRNA/kg, intravenous) twice a week leads to significant antitumor activity and suppression of growth in both estrogen receptor-negative (ER(?)) MDA-MB-231 and ER-positive (+) MCF7 breast tumors in orthotopic xenograft models (P < 0.05). A single intravenous injection of NL-Bcl-2-siRNA provided robust and persistent silencing of the target gene expression in xenograft tumors. NL-Bcl-2-siRNA treatment significantly increased the efficacy of chemotherapy when combined with doxorubicin in both MDA-MB-231 and MCF-7 animal models (P < 0.05). NL-Bcl-2-siRNA treatment-induced apoptosis and autophagic cell death, and inhibited cyclin D1, HIF1? and Src/Fak signaling in tumors. In conclusion, our data provide the first evidence that in vivo therapeutic targeting Bcl-2 by systemically administered nanoliposomal-siRNA significantly inhibits growth of both ER(?) and ER(+) breast tumors and enhances the efficacy of chemotherapy, suggesting that therapeutic silencing of Bcl-2 by siRNA is a viable approach in breast cancers. PMID:24022053

  12. [Cerebral metastases: radiotherapy and chemotherapy].

    PubMed

    Helfre, S; Pierga, J

    1999-12-01

    Brain metastases are common events in adult patients with solid tumors. The choice of the optimal therapy is still challenging and controversial. Whole brain radiotherapy (WBRT) is a standard practice in most patients with an excellent palliative effect. Boost to gross disease has also been advocated without a clear benefit. Moreover following extended irradiation, a substantial proportion of the long term survivors (>6 months), will present documented cognitive impairments. Patients with favorable prognostic factors can benefit from more aggressive therapy: local resection, mono or multifractionated irradiation with or without radiosensitizing agents, stereotactic radiotherapy, brachytherapy. Although brain metastases of solid tumors occur in the presence of progressive widespread disease, chemotherapy has played a limited role in their treatment. Poor drug penetration across the normal blood-brain barrier of chemotherapy agents is not a limiting factor because of the neovascularization in the tumor. The few prospective studies that have addressed this issue, especially in lung and breast tumors, are reviewed. PMID:10717587

  13. 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)

  14. Impact of Neoadjuvant Chemotherapy on Breast Reconstruction

    PubMed Central

    Hu, Yue-Yung; Weeks, Christine M.; In, Haejin; Dodgion, Christopher M.; Golshan, Mehra; Chun, Yoon S.; Hassett, Michael J.; Corso, Katherine A.; Gu, Xiangmei; Lipsitz, Stuart R.; Greenberg, Caprice C.

    2011-01-01

    BACKGROUND With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about reconstruction. METHODS The authors identified 665 patients with stage I through III breast cancer who received chemotherapy and underwent mastectomy at Dana-Farber/Brigham & Women’s Cancer Center from 1997 to 2007. By using multivariate logistic regression, reconstruction rates were compared between patients who received neoadjuvant chemotherapy (n = 180) and patients who underwent mastectomy before chemotherapy (n = 485). The rate of postoperative complications after mastectomy was determined for patients who received neoadjuvant chemotherapy compared with those who did not. RESULTS Reconstruction was performed immediately in 44% of patients who did not receive neoadjuvant chemotherapy but in only 23% of those who did. Twenty-one percent of neoadjuvant chemotherapy recipients and 14% of adjuvant-only chemotherapy recipients underwent delayed reconstruction. After controlling for age, receipt of radiotherapy, and disease stage, neoadjuvant recipients were less likely to undergo immediate reconstruction (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37, 0.87) but were no more likely to undergo delayed reconstruction (OR, 1.29; 95% CI, 0.75, 2.20). Surgical complications occurred in 30% of neoadjuvant chemotherapy recipients and in 31% of adjuvant chemotherapy recipients. CONCLUSIONS The current results suggest that patients who receive neoadjuvant chemotherapy are less likely to undergo immediate reconstruction and are no more likely to undergo delayed reconstruction than patients who undergo surgery before they receive chemotherapy. PMID:21264833

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

    SciTech Connect

    Schwarz, Julie K., E-mail: jschwarz@radonc.wustl.edu [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Cell Biology and Physiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Wahab, Sasa [Cobb Center for Radiation Oncology Center, Austell, GA (United States); Grigsby, Perry W. [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States)

    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.

  16. Preoperative concurrent 5Fluorouracil infusion, Mitomycin C and pelvic radiation therapy in tethered and fixed rectal carcinoma

    Microsoft Academic Search

    Alexander Chan; Alfred Wong; James Langevin; Robert Khoo

    1993-01-01

    This is a Phase 1\\/2 study of preoperative concurrent radiation and chemotherapy in tethered and fixed rectal carcinoma. This study examined the curative resectability, the acute toxicities during chemo-radiation and the surgical complications. Between 1986 and 1990, 46 patients were treated with preoperative pelvic radiation (4,000 cGy in 20 fractions in 4 weeks), 5-Fluorouracil infusion (20 mg\\/m[sup 2], days 1--4

  17. Response to Chemotherapy and Predictors of Survival in Adult Rhabdomyosarcoma

    PubMed Central

    Esnaola, Nestor F.; Rubin, Brian P.; Baldini, Elizabeth H.; Vasudevan, Naren; Demetri, George D.; Fletcher, Christopher D. M.; Singer, Samuel

    2001-01-01

    Objective To assess outcome and identify predictors of survival of adults with rhabdomyosarcoma. Summary Background Data The literature on adult rhabdomyosarcoma is limited. Few studies have identified predictors of long-term survival in this patient population. Methods Thirty-nine adults with rhabdomyosarcoma were treated between 1973 and 1996 and prospectively followed. Outcomes were assessed with respect to patient and tumor characteristics, local treatment, and response to chemotherapy. Results Twenty-six patients had localized/locoregional disease and 13 patients had metastatic disease at presentation. Twenty-one patients underwent attempted curative resection, 27 received radiotherapy, and 37 received chemotherapy. Median follow-up for surviving patients was 152 months. The overall 5- and 10-year survival rates were 31% and 27%, respectively. Five-year survival rates for patients with tumors less than 5 cm, 5 to 10 cm, and more than 10 cm were 60%, 14%, and 0%, respectively. Patients with localized/locoregional disease at presentation had a 44% 5-year survival rate; there were no 5-year survivors among patients with metastatic disease. Patients who had a complete response to chemotherapy had a 5-year survival rate of 57%, compared with a rate of only 7% for poor responders. Metastatic disease at presentation and poor response to chemotherapy were independent predictors of death on multivariate analysis. Conclusions Age, location, nodal status, and histologic subtype do not appear be associated with survival in adults with rhabdomyosarcoma treated with multimodal therapy. Metastatic disease at presentation and poor response to chemotherapy are strongly associated with poor prognosis. Future systemic therapies should be targeted to patients with localized/locoregional disease and partial responders to conventional chemotherapy. PMID:11505068

  18. 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.

  19. Concurrency and discrete event control

    NASA Technical Reports Server (NTRS)

    Heymann, Michael

    1990-01-01

    Much of discrete event control theory has been developed within the framework of automata and formal languages. An alternative approach inspired by the theories of process-algebra as developed in the computer science literature is presented. The framework, which rests on a new formalism of concurrency, can adequately handle nondeterminism and can be used for analysis of a wide range of discrete event phenomena.

  20. Preprint No. 4825 A Real Time DSP Kernel for Concurrent Audio Tasks

    E-print Network

    Maher, Robert C.

    Preprint No. 4825 A Real Time DSP Kernel for Concurrent Audio Tasks David Reinhardt and Robert C://www.euphonics.com Abstract: It is desirable to share the resources of a single DSP microprocessoramong multiple concurrent-purpose operating systems are contrasted with the needs of typical audio DSP processes, andthe architecture

  1. MINIUM: A Permission Based Concurrent-by-Default Programming Language Approach

    E-print Network

    Aldrich, Jonathan

    A ĆMINIUM: A Permission Based Concurrent-by-Default Programming Language Approach Sven Stork permissions, permissions, data groups, concurrency ACM Reference Format: Stork,S. Naden, K., Sunshine, J on Programming Languages and Systems, Vol. V, No. N, Article A, Publication date: January YYYY. #12;A:2 Stork et

  2. ERCC1 and ERCC2 Polymorphisms Predict Clinical Outcomes of Oxaliplatin-based Chemotherapies in Gastric and Colorectal Cancer: A Systemic Review and Meta-analysis

    PubMed Central

    Yin, Ming; Yan, Jingrong; Martinez-Balibrea, Eva; Graziano, Francesco; Lenz, Heinz-Josef; Kim, Hyo-Jin; Robert, Jacques; Im, Seock-Ah; Wang, Wei-Shu; Etienne-Grimaldi, Marie-Christine; Wei, Qingyi

    2011-01-01

    Purpose Nucleotide excision repair (NER) modulates platinum-based chemotherapeutic efficacy by removing drug-produced DNA damage. To summarize published data on the association between polymorphisms of NER genes (ERCC1 and ERCC2) and responses to oxaliplatin-based chemotherapies, we performed a meta-analysis of gastric and colorectal cancer for commonly studied polymorphisms ERCC1 rs11615C>T and ERCC2 rs13181T>G. Patients and methods In 17 previous published studies, 1787 cancer patients were treated with the oxaliplatin-based regimen. Primary outcomes included therapeutic response (TR) (i.e., complete response + partial response vs. stable disease + progressive disease), progression-free survival (PFS) and overall survival (OS). We calculated odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI) to estimate the risk or hazard. Results We found consistent and clinically substantial risk or hazard for TR, PFS and OS in the oxaliplatin-treated gastric and colorectal cancer patients with an ethnic discrepancy. For ERCC1 rs11615C>T, the T allele was associated with reduced response, PFS and OS in Asians (TR: OR, 0.53 and 95% CI, 0.35–0.81; PFS: HR, 1.69 and 95% CI, 1.05–2.70; and OS: HR, 2.03 and 95% CI, 1.60–2.59). For ERCC2 rs13181T>G, the G allele was associated with reduced response, PFS and OS in Caucasians (TR: OR, 0.56 and 95% CI, 0.35–0.88; PFS: HR, 1.41 and 95% CI, 1.02–1.95; and OS: HR, 1.42 and 95% CI, 1.11–1.81). Conclusions NER ERCC1 rs11615C>T and ERCC2 rs13181T>G polymorphisms are useful prognostic factors in oxaliplatin treatment of gastric and colorectal cancer. Larger studies and further clinical trials are warranted to confirm these findings. PMID:21278243

  3. Cancer Chemotherapy - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... ????) French (français) Hindi (??????) Japanese (???) Korean (???) Portuguese (portuguęs) Russian (???????) Somali (af Soomaali) ... ???????????? - ??? (Japanese) Bilingual PDF Health Information Translations Korean (???) Chemotherapy ???? - ??? (Korean) Bilingual PDF Health ...

  4. The Role of Neoadjuvant Chemotherapy in the Management of Locally Advanced Cervix Cancer: A Systematic Review

    PubMed Central

    Osman, Mohammed

    2014-01-01

    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 naďve or cervix cancer chemotherapy naďve, 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

  5. Virtual Sensor Networks -A Resource Efficient Approach for Concurrent Applications

    E-print Network

    Han, Qi "Chee"

    @mines.edu Abstract Current focus of sensor networks is on systems dedi- cated for a specific application. Wide sensor networks in- clude the limited sensing, processing, and communication abilities of the nodesVirtual Sensor Networks - A Resource Efficient Approach for Concurrent Applications Anura P

  6. Factorization law for two lower bounds of concurrence

    SciTech Connect

    Mirafzali, Sayyed Yahya; Sargolzahi, Iman; Ahanj, Ali; Javidan, Kurosh; Sarbishaei, Mohsen [Department of Physics, Ferdowsi University of Mashhad, Mashhad (Iran, Islamic Republic of); Khayyam Institute of Higher Education, Mashhad, Iran and School of Physics, Institute for Research in Fundamental Science (IPM), P. O. Box 19395-5531, Tehran (Iran, Islamic Republic of); Department of Physics, Ferdowsi University of Mashhad, Mashhad (Iran, Islamic Republic of)

    2010-09-15

    We study the dynamics of two lower bounds of concurrence in bipartite quantum systems when one party goes through an arbitrary channel. We show that these lower bounds obey the factorization law similar to that of [Konrad et al., Nat. Phys. 4, 99 (2008)]. We also discuss the application of this property in an example.

  7. Designing application specific circuits with concurrent C# programs

    Microsoft Academic Search

    David J. Greaves; Satnam Singh

    2010-01-01

    This paper presents an investigation into the possibility of using a regular concurrent programming language for modeling and implementing digital circuits. Some of the reasons for using an existing language include the ability to use existing compilers and analysis tools for circuit design and verification. Another important reason is the ever increasing need to model complete systems that comprise interacting

  8. Network based high performance concurrent computing. Progress report, [FY 1991

    SciTech Connect

    Sunderam, V.S.

    1991-12-31

    The overall objectives of this project are to investigate research issues pertaining to programming tools and efficiency issues in network based concurrent computing systems. The basis for these efforts is the PVM project that evolved during my visits to Oak Ridge Laboratories under the DOE Faculty Research Participation program; I continue to collaborate with researchers at Oak Ridge on some portions of the project.

  9. The role of product safety and liability in concurrent engineering

    Microsoft Academic Search

    S Dowlatshahi

    2001-01-01

    This paper explores the role of product safety and liability in the early stages of product design in a concurrent engineering environment. The paper presents an overview of literature pertaining to the significance of product liability for manufacturers. Further, the paper presents a system approach to product safety, a conceptual framework for design for safety and liability, and a product

  10. Scalable nonblocking concurrent objects for mission critical code

    Microsoft Academic Search

    Damian Dechev; Bjarne Stroustrup

    2009-01-01

    The high degree of complexity and autonomy of future robotic space missions, such as Mars Science Laboratory (MSL), poses serious challenges in assuring their reliability and efficiency. Pro- viding fast and safe concurrent synchronization is of critical im- portance to such autonomous embedded software systems. The ap- plication of nonblocking synchronization is known to help elimi- nate the hazards of

  11. Integrated Data Exchange and Concurrent Design for Engineered Facilities1

    E-print Network

    Keller, Arthur M.

    Integrated Data Exchange and Concurrent Design for Engineered Facilities1 Professor H. Craig Howard, Stanford, CA 94305-2140 5 Center for Integrated Facility Engineering, Stanford University, Stanford, CA of designs, provide a spatial reference system for the automated control of construction machines, represent

  12. Integrated Data Exchange and Concurrent Design for Engineered Facilities 1

    E-print Network

    Keller, Arthur M.

    Integrated Data Exchange and Concurrent Design for Engineered Facilities 1 Professor H. Craig, Stanford, CA 94305­2140 5 Center for Integrated Facility Engineering, Stanford University, Stanford, CA of designs, provide a spatial reference system for the automated control of construction machines, represent

  13. A C++ Thread Package for Concurrent and Parallel Programming

    SciTech Connect

    Jie Chen; William Watson

    1999-11-01

    Recently thread libraries have become a common entity on various operating systems such as Unix, Windows NT and VxWorks. Those thread libraries offer significant performance enhancement by allowing applications to use multiple threads running either concurrently or in parallel on multiprocessors. However, the incompatibilities between native libraries introduces challenges for those who wish to develop portable applications.

  14. Performance-Driven Concurrent Placement and Gate Sizing for

    E-print Network

    Pedram, Massoud

    1 Performance-Driven Concurrent Placement and Gate Sizing for Deep Submicron Circuits Wei Chen feature sizes (transistors) ! More complex designs ! Faster systems ! Interconnect delay can no longer be ignored Interconnect Delay (ITRS 99) #12;3 Effects of Placement and Gate Sizing ! Placement ! Assign

  15. EGFR inhibitor and chemotherapy combinations for acquired TKI resistance in EGFR-mutant NSCLC models.

    PubMed

    Laurila, Niina; Koivunen, Jussi P

    2015-07-01

    Acquired resistance to EGFR TKIs is the most important limiting factor for treatment efficiency in EGFR-mutant NSCLC. Although the continuation of EGFR TKI beyond disease progression in combination with chemotherapy is often suggested as a strategy for treating acquired resistance, the optimal treatment sequence for EGFR TKI and chemotherapy is unknown. In the current work, NSCLC cell lines PC9ER, H1975 and HCC827GR, representing the acquired TKI resistance genotypes (T790M, cMET), were exposed to a chemotherapeutic agent, cisplatin or paclitaxel, in combination with EGFR TKIs (erlotinib, WZ4002) in vitro and analysed for cytotoxicity and apoptotic response. The result showed that all the combinations of EGFR TKIs with a chemotherapeutic agent tested had a synergistic effect on cytotoxicity and increased the apoptotic response. The sequences involving a chemotherapeutic agent concurrently with an EGFR TKI or preceding it were the most efficient strategies. Our in vitro models suggest that the combination of an EGFR TKI and chemotherapy is beneficial in cases of acquired EGFR TKI resistance. Furthermore, the sequence of chemotherapy followed by EGFR TKI is significantly more powerful than the reversed order, so that an intercalated approach is likely to be the most active strategy in clinical use and ought to be tested in a randomized clinical trial. PMID:26081015

  16. Chemotherapy

    MedlinePLUS

    ... Financials Board of Directors Scientific Advisory Council & Reviewers Leadership News Careers Brain Tumor Information Brain Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors Tumor Grade Risk Factors Brain Tumor ...

  17. Chemotherapy

    MedlinePLUS

    ... catheter or IV needle is put in the skin. Chemo treatments may also cause nerve problems and burning, numbness, tingling, or shooting pain in ... therapy before having chemo might notice that the skin involved may turn red, ... Hair loss and scalp problems. Many people who get chemo lose their hair. ...

  18. Chemotherapy

    MedlinePLUS

    ... recipients of its 2014-2015 Research Grant and Prizes. View the PDF . Education The next Gynecologic Cancer ... 2015 Research Awards Current Year Research Grants and Prizes Current Year Important Dates Research Grants & Awards Committee ...

  19. 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,

  20. Factors Associated With Receipt of Breast Cancer Adjuvant Chemotherapy in a Diverse Population-Based Sample

    PubMed Central

    Griggs, Jennifer J.; Hawley, Sarah T.; Graff, John J.; Hamilton, Ann S.; Jagsi, Reshma; Janz, Nancy K.; Mujahid, Mahasin S.; Friese, Christopher R.; Salem, Barbara; Abrahamse, Paul H.; Katz, Steven J.

    2012-01-01

    Purpose Disparities in receipt of adjuvant chemotherapy may contribute to higher breast cancer fatality rates among black and Hispanic women compared with non-Hispanic whites. We investigated factors associated with receipt of chemotherapy in a diverse population-based sample. Patients and Methods Women diagnosed with breast cancer between August 2005 and May 2007 (N = 3,252) and reported to the Detroit, Michigan, or Los Angeles County Surveillance, Epidemiology, and End Results (SEER) registry were recruited to complete a survey. Multivariable analyses examined factors associated with chemotherapy receipt. Results The survey was sent to 3,133 patients; 2,290 completed a survey (73.1%), and 1,403 of these patients were included in the analytic sample. In multivariable models, disease characteristics were significantly associated with the likelihood of receiving chemotherapy. Low-acculturated Hispanics were more likely to receive chemotherapy than non-Hispanic whites (odds ratio [OR], 2.00; 95% CI, 1.31 to 3.04), as were high-acculturated Hispanics (OR, 1.43; 95% CI, 1.03 to 1.98). Black women were less likely to receive chemotherapy than non-Hispanic whites, but the difference was not significant (OR, 0.83; 95% CI, 0.64 to 1.08). Increasing age (even in women age < 50 years) and Medicaid insurance were associated with lower rates of chemotherapy receipt. Conclusion In this population-based sample, disease characteristics were strongly associated with receipt of chemotherapy, indicating that clinical benefit guides most treatment decisions. We found no compelling evidence that black women and Hispanics receive chemotherapy at lower rates. Interventions that address chemotherapy use rates according to age and insurance status may improve quality of systemic treatment. PMID:22869890

  1. 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

  2. Concurrence of superpositions of many states

    SciTech Connect

    Akhtarshenas, Seyed Javad [Department of Physics, University of Isfahan, Isfahan, Iran and Quantum Optics Group, University of Isfahan, Isfahan (Iran, Islamic Republic of)

    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.

  3. Childbearing after hyperthermic intraperitoneal chemotherapy: results from an international survey

    E-print Network

    Boyer, Edmond

    1 Childbearing after hyperthermic intraperitoneal chemotherapy: results from an international having undergone previous cytoreductive surgery and hyperthermic intraperitoneal chemotherapy surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) can improve survival in selected patients

  4. Regional Chemotherapy and Local Cryotherapy for Cancer

    Microsoft Academic Search

    J. W. Benson

    1972-01-01

    The rationale for freezing carcinoma adjunctively with chemotherapy is synthesized from published data on tumor cytokinetics, regional chemotherapy, cryopathology, and the microvascular hemodynamics of proliferating tumors. Acute cryolesions in the dog’s tongue, arterially infused with methylene blue solution demonstrated early central ischemia, increasing porosity of marginal circulation and extravascular trapping of dye for 5 h. The dog intestine tolerated transmural

  5. Fatigue patterns in Chinese patients receiving chemotherapy

    Microsoft Academic Search

    A. Molassiotis; C. W. H. Chan

    2001-01-01

    A descriptive study was conducted to explore the patterns, risk factors and experience of fatigue in Chinese cancer patients receiving chemotherapy. Forty-two adult patients from an out-patient clinic of a university hospital in Hong Kong participated in the study. They were asked to complete a diary over a period of 2 weeks from the beginning of their chemotherapy cycle. The

  6. Radiotherapy and chemotherapy of brain metastases

    Microsoft Academic Search

    R. Soffietti; A. Costanza; E. Laguzzi; M. Nobile; R. Rudŕ

    2005-01-01

    Summary The authors have reviewed the results, the indications and the controversies regarding radiotherapy and chemotherapy of patients with newly diagnosed and recurrent brain metastases. Whole-brain radiotherapy, radiosurgery, hypofractionated stereotactic radiotherapy, brachytherapy and chemotherapy are the available options. New radiosensitizers and cytotoxic or cytostatic agents are being investigated. Adjuvant whole brain radiotherapy, either after surgery or radiosurgery, and prophylactic cranial

  7. Effects of neo-adjuvant chemotherapy for oesophago-gastric cancer on neuro-muscular gastric function.

    PubMed

    Sung, E Z H; Arasaradnam, R P; Jarvie, E M; James, S; Goodyear, S J; Borman, R A; Snead, D; Sanger, G J; Nwokolo, C U

    2012-12-01

    Delayed gastric emptying symptoms are often reported after chemotherapy. This study aims to characterise the effects of chemotherapy on gastric neuro-muscular function. Patients undergoing elective surgery for oesophago-gastric cancer were recruited. Acetylcholinesterase, nNOS, ghrelin receptor and motilin expressions were studied in gastric sections from patients receiving no chemotherapy (n = 3) or oesophageal (n = 2) or gastric (n = 2) chemotherapy. A scoring system quantified staining intensity (0-3; no staining to strong). Stomach sections were separately suspended in tissue baths for electrical field stimulation (EFS) and exposure to erythromycin or carbachol; three patients had no chemotherapy; four completed cisplatin-based chemotherapy within 6 weeks prior to surgery. AChE expression was markedly decreased after chemotherapy (scores 2.3 ± 0.7, 0.5 ± 0.2 and 0 ± 0 in non-chemotherapy, oesophageal- and gastric-chemotherapy groups (p < 0.03 each) respectively. Ghrelin receptor and motilin expression tended to increase (ghrelin: 0.7 ± 0.4 vs 2.0 ± 0.4 and 1.2 ± 0.2 respectively; p = 0.04 and p = 0.2; motilin: 0.7 ± 0.5 vs 2.2 ± 0.5 and 2.0 ± 0.7; p = 0.06 and p = 0.16). Maximal contraction to carbachol was 3.7 ± 0.7 g and 1.9 ± 0.8 g (longitudinal muscle) and 3.4 ± 0.4 g and 1.6 ± 0.6 (circular) in non-chemotherapy and chemotherapy tissues respectively (p < 0.05 each). There were loss of AChE and reduction in contractility to carbachol. The tendency for ghrelin receptors to increase suggests an attempt to upregulate compensating systems. Our study offers a mechanism by which chemotherapy markedly alters neuro-muscular gastric function. PMID:22744429

  8. Chemotherapy of basal cell and squamous cell carcinoma of the eyelids and periorbital tissues.

    PubMed

    Luxenberg, M N; Guthrie, T H

    1986-04-01

    Eight patients, aged 62 to 85 years, with nine instances of histologically proven basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) involving the eyelids and periorbital tissues, were treated with systemic and/or local (iontophoresis) chemotherapy using cisplatin (Platinol) and doxorubicin (Adriamycin). All patients had either refused surgery, would have required extensive procedures, or had medical problems contraindicating surgery. Systemic chemotherapy induced a complete or partial remission in eight of nine lesions. No patient has required maintenance chemotherapy and no significant toxic side effects were encountered. The length of follow-up ranged from 2 to 50 months. Iontophoretic therapy with cisplatin was used to treat five small foci of new, recurrent or persistent tumor(s) in three of these patients and resulted in a partial response in all five lesions. Systemic or local chemotherapy offers an alternative to current standard forms of treatment for BCC and SCC in selected cases. PMID:3703526

  9. The Effect of Radiation Dose and Chemotherapy on Overall Survival in 237 Patients With Stage III Non-Small-Cell Lung Cancer

    SciTech Connect

    Wang Li [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI (United States); Department of Radiation Oncology, Cancer Center, Fudan University, Shanghai (China); Correa, Candace R.; Zhao Lujun; Hayman, James [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI (United States); Kalemkerian, Gregory P.; Lyons, Susan; Cease, Kemp; Brenner, Dean [Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI (United States); Kong Fengming [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI (United States); Department of Radiation Oncology, Veterans Administration Health Center, Ann Arbor, MI (United States)], E-mail: Fengkong@med.umich.edu

    2009-04-01

    Purpose: To study the effects of radiation dose, chemotherapy, and their interaction in patients with unresectable or medically inoperable Stage III non-small-cell lung cancer (NSCLC). Methods and Materials: A total of 237 consecutive Stage III NSCLC patients were evaluated. Median follow-up was 69.0 months. Patients were treated with radiation therapy (RT) alone (n = 106), sequential chemoradiation (n = 69), or concurrent chemoradiation (n = 62). The primary endpoint was overall survival (OS). Radiation dose ranged from 30 to 102.9 Gy (median 60 Gy), corresponding to a bioequivalent dose (BED) of 39 to 124.5 Gy (median 72 Gy). Results: The median OS of the entire cohort was 12.6 months, and 2- and 5-year survival rates were 22.4% and 10.0%, respectively. Multivariable Cox regression model demonstrated that Karnofsky performance status (p = 0.020), weight loss < 5% (p = 0.017), chemotherapy (yes vs. no), sequence of chemoradiation (sequential vs. concurrent; p < 0.001), and BED (p < 0.001) were significant predictors of OS. For patients treated with RT alone, sequential chemoradiation, and concurrent chemoradiation, median survival was 7.4, 14.9, and 15.8 months, and 5-year OS was 3.3%, 7.5%, and 19.4%, respectively (p < 0.001). The effect of higher radiation doses on survival was independent of whether chemotherapy was given. Conclusion: Radiation dose and use of chemotherapy are independent predictors of OS in Stage III NSCLC, and concurrent chemoradiation is associated with the best survival. There is no interaction between RT dose and chemotherapy.

  10. 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 [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)] [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Bae, Jae-Moon [Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)] [Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jun Ho; Choi, Il Ju; Kim, Yeon-Joo [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)] [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Dae Yong, E-mail: radiopiakim@hanmail.net [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    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.

  11. 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.

  12. 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 [Regina Elena National Cancer Institute, Rome (Italy)]. E-mail: arcangeli@ifo.it; Pinnaro, Paola [Regina Elena National Cancer Institute, Rome (Italy); Rambone, Rita [Regina Elena National Cancer Institute, Rome (Italy); Giannarelli, Diana [Regina Elena National Cancer Institute, Rome (Italy); Benassi, Marcello [Regina Elena National Cancer Institute, Rome (Italy)

    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.

  13. Reducing Concurrency Bottlenecks in Parallel I/O Workloads

    SciTech Connect

    Manzanares, Adam C. [Los Alamos National Laboratory; Bent, John M. [Los Alamos National Laboratory; Wingate, Meghan [Los Alamos National Laboratory

    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.

  14. A randomized study of inpatient versus outpatient continuous infusion chemotherapy for patients with locally advanced head and neck cancer.

    PubMed

    Vokes, E E; Schilsky, R L; Choi, K E; Magid, D M; Guarnieri, C M; Whaling, S M; Ratain, M J; Weichselbaum, R R; Panje, W R

    1989-01-01

    This study was designed to evaluate the safety, reliability, and patient acceptance of outpatient continuous intravenous infusion (CVI) chemotherapy. Twenty-two patients with locally advanced head and neck cancer received induction chemotherapy with methotrexate, cisplatin and a 5-day CVI of 5-fluorouracil (5-FU). Patients were randomized to receive the 5-FU portion of cycle 1 either by a standard inpatient CVI chemotherapy delivery device (standard pump) or by the Infusor (Baxter Healthcare Corporation, Deerfield, IL), a portable chemotherapy delivery system that provides a constant flow of drug over a period of 24 hours. For cycle 2, patients crossed over to the alternative drug delivery method. Patients receiving chemotherapy via the Infusor could choose to be either inpatients or outpatients. Daily plasma concentrations of 5-FU were determined during the first two cycles of chemotherapy. There was no significant difference in the mean steady state plasma 5-FU levels achieved with either drug delivery method (329.7 +/- 95.8 ng/ml for infusor cycles vs. 352.8 +/- 114.9 ng/ml for standard pump cycles). Clinical toxicities consisted primarily of mucositis for both methods of drug delivery. Eight patients declined to receive CVI chemotherapy as outpatients citing as reasons fear of malfunction of the device, inconvenience of the frequent clinic visits necessitated by daily monitoring of plasma 5-FU concentrations, and restrictions in daily home activities. Eleven patients underwent CVI chemotherapy via Infusor as outpatients. All reported outpatient CVI chemotherapy as convenient and effective and, when eligible, chose it again in subsequent cycles. A comparison of estimated costs revealed reductions in daily costs of +366.00 (+2,200.00 per cycle) for outpatient chemotherapy. Outpatient CVI chemotherapy is a reliable drug delivery method that was accepted by a majority of patients in this study. These factors may help to establish outpatient CVI chemotherapy as a viable alternative to hospitalization. PMID:2910422

  15. 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 [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Arai, Yasuaki [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Inaba, Yoshitaka, E-mail: 105824@aichi-cc.jp; Yamaura, Hidekazu; Sato, Yozo; Miyazaki, Masaya; Shimamoto, Hiroshi [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan)

    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.

  16. D.E.Corpet 1986 -Author's Version 127 Journal of Antimicrobial Chemotherapy (1986) 18, Suppl. C, 127-132

    E-print Network

    Boyer, Edmond

    1986-01-01

    D.E.Corpet 1986 - Author's Version 127 Journal of Antimicrobial Chemotherapy (1986) 18, Suppl. C by the anaerobes. In the systems cited under (I), above, donor and recipient bacteria grow actively and reach high in "Journal of Antimicrobial Chemotherapy 18, Suppl. C (1986) 127-132" #12;D.E.Corpet 1986 - Author's Version

  17. Concurrent Engineering in the Construction Industry

    Microsoft Academic Search

    Peter E. D. Love; A. Gunasekaran

    1997-01-01

    The construction industry has been suffering from low productivity and poor performance In an attempt to improve its performance, industry practitioners and researchers have looked at the manufacturing industry as a point of reference and a source of innovation Conse quently, the industry has acquired and adapted the Concurrent Engineering (CE) approach to manufacturing, to construction Concurrent Con struction (CC)

  18. Towards a Framework for Characterising Concurrent Comprehension

    ERIC Educational Resources Information Center

    Hughes, Connor; Buckley, Jim; Exton, Chris; O'Carroll, Des

    2005-01-01

    This paper proposes an evaluation framework for assessing students' comprehension of concurrent programs. The need for such a framework is illustrated by a review of various Computer Science Education forums. This review suggests that there is little pedagogical research in the area of concurrent software, particularly with respect to assessing…

  19. Views: object-inspired concurrency control

    E-print Network

    Bae, Doo-Hwan

    Views: object-inspired concurrency control 2011. 05. 04. (Wed) Donghwan Shin KAIST SE LAB 2011 ACM · Developer needs many fine-grained locks 3 KAIST SE LAB 2011 Intro Background View spec Step 1 Step 2 Step 3 Experience Related work Conclusion Discussion /27 #12;Concurrency control with views 9 KAIST SE LAB 2011

  20. Concurrent Chemoradiotherapy Improves Survival in Patients With Hypopharyngeal Cancer

    SciTech Connect

    Paximadis, Peter, E-mail: ppaximad@med.wayne.edu [Department of Radiation Oncology, Wayne State University, Detroit, MI (United States); Yoo, George; Lin, Ho-Sheng; Jacobs, John [Department of Otolaryngology, Barbara Ann Karmanos Cancer Institute, Detroit, MI (United States); Sukari, Ammar [Department of Medical Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI (United States); Dyson, Greg [Department of Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI (United States); Christensen, Michael; Kim, Harold [Department of Radiation Oncology, Wayne State University, Detroit, MI (United States)

    2012-03-15

    Purpose: To retrospectively review our institutional experience with hypopharyngeal carcinoma with respect to treatment modality. Methods and Materials: A total of 70 patients with hypopharyngeal cancer treated between 1999 and 2009 were analyzed for functional and survival outcomes. The treatments included surgery alone (n = 5), surgery followed by radiotherapy (RT) (n = 3), surgery followed by chemoradiotherapy (CRT) (n = 13), RT alone (n = 2), CRT alone (n = 22), induction chemotherapy followed by RT (n = 3), and induction chemotherapy followed by CRT (n = 22). Results: The median follow-up was 18 months. The median overall survival and disease-free survival for all patients was 28.3 and 17.6 months, respectively. The 1- and 2-year local control rate for all patients was 87.1% and 80%. CRT, given either as primary therapy or in the adjuvant setting, improved overall survival and disease-free survival compared with patients not receiving CRT. The median overall survival and disease-free survival for patients treated with CRT was 36.7 and 17.6 months vs. 14.0 and 8.0 months, respectively (p < .01). Of the patients initially treated with an organ-preserving approach, 4 (8.2%) required salvage laryngectomy for local recurrence or persistent disease; 8 (16.3%) and 12 (24.5%) patients were dependent on a percutaneous gastrostomy and tracheostomy tube, respectively. The 2-year laryngoesophageal dysfunction-free survival rate for patients treated with an organ-preserving approach was estimated at 31.7%. Conclusions: Concurrent CRT improves survival in patients with hypopharyngeal cancer. CRT given with conventional radiation techniques yields poor functional outcomes, and future efforts should be directed at determining the feasibility of pharyngeal-sparing intensity-modulated radiotherapy in patients with hypopharyngeal tumors.

  1. Administration of chemotherapy in patients on dialysis.

    PubMed

    Kuo, James C; Craft, Paul S

    2015-08-01

    The prevalence of patients on dialysis has increased and these patients present a challenge for chemotherapy administration when diagnosed with cancer. A consensus on the dosage and timing of different chemotherapeutic agents in relation to dialysis has not been established. We describe the pattern of care and treatment outcome for cancer patients on dialysis in our institution. The dataset from the Australia and New Zealand Dialysis and Transplant Registry of patients on dialysis who had a diagnosis of cancer was obtained and matched to the pharmacy records in our institution to identify patients who had received chemotherapy while on dialysis. Relevant clinical information including details of the dialysis regimen, chemotherapy administration and adverse events was extracted for analysis. Between July 1999 and July 2014, 21 patients on dialysis were included for analysis. Five (23.8%) received chemotherapy, most of which was administered before dialysis sessions. As a result of adverse events, one patient discontinued treatment; two other patients required dose reduction or treatment delay. Chemotherapy administration was feasible in cancer patients on dialysis, but chemotherapy usage was low. Better understanding of the altered pharmacokinetics in patients on dialysis may improve chemotherapy access and practice. PMID:25933244

  2. A Framework of Concurrent Task Scheduling and Dynamic Voltage and Frequency Scaling in Real-Time Embedded Systems with Energy Harvesting

    E-print Network

    Pedram, Massoud

    achieve full energy autonomy (i.e., perpetual, battery-free operation) of a real-time embedded system loop performing real-time task scheduling and setting the voltage and frequency level in the embedded, photovoltaic, real-time embedded system, supercapacitor 1. Introduction Minimizing power consumption remains

  3. Concurrent Engineering: A Partnership Approach

    NSDL National Science Digital Library

    Barton, Russell R.

    This paper describes the development of a new course in concurrent engineering. Teaching concepts in product development benefits greatly from a hands-on approach. The authors have attempted to establish this goal in three ways: by developing and using a number of laboratories and demonstrations, by inviting speakers from industry who can make classroom lessons concrete, and by using cases as the basis for class discussion. This paper includes a discussion of the curriculum, of existing teaching materials, and of specific methods and materials developed for the course. The course was developed jointly by faculty and research assistants at the University of Washington (UW), the University of Puerto Ricos Mayagez campus (UPRM), and at Penn State (PSU), as part of the Manufacturing Engineering Education Partnership (MEEP), funded through the ARPA Technology Reinvestment Program.

  4. MOPP regimen as primary chemotherapy for brain tumors in infants

    Microsoft Academic Search

    Jan van Eys; Ayten Cangir; Deborah Coody; Beth Smith

    1985-01-01

    Seventeen infants with central nervous system malignancies, all with tissue diagnosis, were treated with the combination chemotherapy nitrogen mustard, vincristine, procarbazine and a steroid (MOPP) as primary therapy following surgery. Diagnoses include: 7 astrocytomas (grade: 3-I, 3-II, 1-III), 6 medulloblastomas, 2 ependymoma\\/astrocytoma mixed, 1 ependymoma and 1 primitive neuroectodermal tumor. Fourteen were under 2 years of age, 2 between 2

  5. A Monte Carlo evaluation of dose enhancement by cisplatin and titanocene dichloride chemotherapy drugs in brachytherapy with photon emitting sources.

    PubMed

    Yahya Abadi, Akram; Ghorbani, Mahdi; Mowlavi, Ali Asghar; Knaup, Courtney

    2014-06-01

    Some chemotherapy drugs contain a high Z element in their structure that can be used for tumour dose enhancement in radiotherapy. In the present study, dose enhancement factors (DEFs) by cisplatin and titanocene dichloride agents in brachytherapy were quantified based on Monte Carlo simulation. Six photon emitting brachytherapy sources were simulated and their dose rate constant and radial dose function were determined and compared with published data. Dose enhancement factor was obtained for 1, 3 and 5 % concentrations of cisplatin and titanocene dichloride chemotherapy agents in a tumour, in soft tissue phantom. The results of the dose rate constant and radial dose function showed good agreement with published data. Our results have shown that depending on the type of chemotherapy agent and brachytherapy source, DEF increases with increasing chemotherapy drug concentration. The maximum in-tumour averaged DEF for cisplatin and titanocene dichloride are 4.13 and 1.48, respectively, reached with 5 % concentrations of the agents, and (125)I source. Dose enhancement factor is considerably higher for both chemotherapy agents with (125)I, (103)Pd and (169)Yb sources, compared to (192)Ir, (198)Au and (60)Co sources. At similar concentrations, dose enhancement for cisplatin is higher compared with titanocene dichloride. Based on the results of this study, combination of brachytherapy and chemotherapy with agents containing a high Z element resulted in higher radiation dose to the tumour. Therefore, concurrent use of chemotherapy and brachytherapy with high atomic number drugs can have the potential benefits of dose enhancement. However, more preclinical evaluations in this area are necessary before clinical application of this method. PMID:24706342

  6. Are lock-free concurrent algorithms practically wait-free?

    E-print Network

    Alistarh, Dan

    Lock-free concurrent algorithms guarantee that some concurrent operation will always make progress in a finite number of steps. Yet programmers prefer to treat concurrent code as if it were wait-free, guaranteeing that all ...

  7. Resolving Conflicts Among Actions in Concurrent Behaviors: Learning to Coordinate

    E-print Network

    Hexmoor, Henry

    Resolving Conflicts Among Actions in Concurrent Behaviors: Learning to Coordinate Henry Hexmoor coordinate its coupled concurrent behaviors to produce a coherent response to stimuli. Reinforcement learning in learning individual behaviors for coordination among coupled concurrent behaviors. 1 Introduction

  8. 37 CFR 1.989 - Merger of concurrent reexamination proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Merger of concurrent reexamination proceedings. 1.989 Section 1.989 Patents...After November 29, 1999 Concurrent Proceedings Involving Same Patent in Inter Partes... Merger of concurrent reexamination proceedings. (a) If any reexamination is...

  9. 37 CFR 1.989 - Merger of concurrent reexamination proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Merger of concurrent reexamination proceedings. 1.989 Section 1.989 Patents...After November 29, 1999 Concurrent Proceedings Involving Same Patent in Inter Partes... Merger of concurrent reexamination proceedings. (a) If any reexamination is...

  10. 37 CFR 1.989 - Merger of concurrent reexamination proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Merger of concurrent reexamination proceedings. 1.989 Section 1.989 Patents...After November 29, 1999 Concurrent Proceedings Involving Same Patent in Inter Partes... Merger of concurrent reexamination proceedings. (a) If any reexamination is...

  11. 37 CFR 1.989 - Merger of concurrent reexamination proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Merger of concurrent reexamination proceedings. 1.989 Section 1.989 Patents...After November 29, 1999 Concurrent Proceedings Involving Same Patent in Inter Partes... Merger of concurrent reexamination proceedings. (a) If any reexamination is...

  12. 37 CFR 1.989 - Merger of concurrent reexamination proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Merger of concurrent reexamination proceedings. 1.989 Section 1.989 Patents...After November 29, 1999 Concurrent Proceedings Involving Same Patent in Inter Partes... Merger of concurrent reexamination proceedings. (a) If any reexamination is...

  13. E-Mail karger@karger.com Experimental Chemotherapy

    E-print Network

    Terasaki, Mark

    E-Mail karger@karger.com Experimental Chemotherapy Chemotherapy 2013;59:14­23 DOI: 10 Center, Farmington, Conn., USA Introduction The goal of present-day chemotherapy is to kill cancer cells in a patient [5, 6]. However, neither broad- based chemotherapy nor more specific drug targeting has proved

  14. Improvement of local control by regional hyperthermia combined with systemic chemotherapy (ifosfamide plus etoposide) in advanced sarcomas: updated report on 65 patients

    Microsoft Academic Search

    Rolf D. Issels; Johann Mittermiiller; Arthur Gerl; Wolfgang Simon; Alfred Ortmaier; Claudio Denzlinger; Hansjoerg Sauer; Wolfgang Wilmanns

    1991-01-01

    Summary From July 1986 to 1990, 65 patients with deepseated, advanced sarcomas (43 soft-tissue sarcomas, 12 Ewing's sarcomas, 7 chondrosarcomas and 3 osteosarcomas) were entered in a protocol involving regional hyperthermia (RHT) combined with systemic ifosfamide and etoposide. RHT was produced by an electromagnetic deep regional heating device (BSD Medical Corporation, Salt Lake City, Utah). Of these patients, 62% (40

  15. Reliability and concurrent validity of a peripheral pulse oximeter and health-app system for the quantification of heart rate in healthy adults.

    PubMed

    Losa-Iglesias, Marta Elena; Becerro-de-Bengoa-Vallejo, Ricardo; Becerro-de-Bengoa-Losa, Klark Ricardo

    2014-07-18

    There are downloadable applications (Apps) for cell phones that can measure heart rate in a simple and painless manner. The aim of this study was to assess the reliability of this type of App for a Smartphone using an Android system, compared to the radial pulse and a portable pulse oximeter. We performed a pilot observational study of diagnostic accuracy, randomized in 46 healthy volunteers. The patients' demographic data and cardiac pulse were collected. Radial pulse was measured by palpation of the radial artery with three fingers at the wrist over the radius; a low-cost portable, liquid crystal display finger pulse oximeter; and a Heart Rate Plus for Samsung Galaxy Note®. This study demonstrated high reliability and consistency between systems with respect to the heart rate parameter of healthy adults using three systems. For all parameters, ICC was > 0.93, indicating excellent reliability. Moreover, CVME values for all parameters were between 1.66-4.06 %. We found significant correlation coefficients and no systematic differences between radial pulse palpation and pulse oximeter and a high precision. Low-cost pulse oximeter and App systems can serve as valid instruments for the assessment of heart rate in healthy adults. PMID:25038201

  16. Chemotherapy induced liver abnormalities: an imaging perspective

    PubMed Central

    Houshyar, Roozbeh; Bhosale, Priya; Choi, Joon-Il; Gulati, Rajesh; Lall, Chandana

    2014-01-01

    Treating patients undergoing chemotherapy who display findings of liver toxicity, requires a solid understanding of these medications. It is important for any clinician to have an index of suspicion for liver toxicity and be able to recognize it, even on imaging. Cancer chemotherapy has evolved, and newer medications that target cell biology have a different pattern of liver toxicity and may differ from the more traditional cytotoxic agents. There are several hepatic conditions that can result and keen clinical as well as radiographic recognition are paramount. Conditions such as sinusoidal obstructive syndrome, steatosis, and pseudocirrhosis are more commonly associated with chemotherapy. These conditions can display clinical signs of acute hepatitis, liver cirrhosis, and even liver failure. It is important to anticipate and recognize these adverse reactions and thus appropriate clinical action can be taken. Often times, patients with these liver manifestations can be managed with supportive therapies, and liver toxicity may resolve after discontinuation of chemotherapy. PMID:25320738

  17. Breast Cancer Chemotherapy and Your Heart

    MedlinePLUS

    ... Cardiology Patient Page Breast Cancer Chemotherapy and Your Heart Christine Unitt , BS ; Kamaneh Montazeri , MD ; Sara Tolaney , ... in remission. Previous Section Next Section What Is Heart Failure? Heart failure or cardiomyopathy occurs when the ...

  18. Lipid nanocarriers and molecular targets for malaria chemotherapy.

    PubMed

    Jain, Kunal; Sood, Sumeet; Gowthamarajan, Kuppusamy

    2014-03-01

    Malaria is the most serious tropical disease of humankind and a cause of much debilitation and morbidity throughout the world especially in endemic areas like India and Africa. The development of drug resistance may be due to insufficient drug concentration in presence of high parasite load. In addition, the present pharmaceutical dosage forms are ineffective thereby necessitating the development of novel dosage forms which are effective, safe and affordable to underprivileged population of the developing world. The rapid advancement of nanotechnology has raised the possibility of using lipid nanocarriers that interact within biological environment for treatment of infectious diseases. Thus, lipid based nano-delivery systems offer a platform to formulate old and toxic antimalarial drugs thereby modifying their pharmacokinetic profile, biodistribution and targetability. Further, there is a need to develop new chemotherapy based approaches for inhibiting the parasite-specific metabolic pathways. The present review highlights the advances in lipid nanocarriers and putative molecular targets for antimalarial chemotherapy. PMID:24160438

  19. jpf-concurrent: An extension of Java PathFinder for java.util.concurrent

    E-print Network

    Ujma, Mateusz

    2012-01-01

    One of the main challenges when verifying multi-threaded Java applications is the state space explosion problem. Due to thread interleavings, the number of states that the model checker has to verify can grow rapidly and impede the feasibility of verification. In the Java language, the source of thread interleavings can be the system under test as well as the Java Development Kit (JDK) itself. In our paper, we propose a method to minimize the state space explosion problem for applications verified under the Java PathFinder (JPF) model checker. Our method is based on abstracting the state of the application to a smaller domain and implementing application behavior using the Model Java Interface (MJI) of JPF. To show the capabilities of our approach, we have created a JPF extension called jpf-concurrent which abstracts classes from the Java Concurrency Utilities. Several benchmarks proved the usefulness of our approach. In all cases, our implementation was faster than the JDK implementation when running under t...

  20. 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