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1

Document Concurrence System  

NASA Technical Reports Server (NTRS)

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.

Muhsin, Mansour; Walters, Ian

2003-01-01

2

Document Concurrence System  

NASA Technical Reports Server (NTRS)

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.

Muhsin, Mansour; Walters, Ian

2003-01-01

3

Document Concurrence System  

NASA Technical Reports Server (NTRS)

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.

Muhsin, Mansour; Walters, Ian

2004-01-01

4

Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer  

Microsoft Academic Search

AIM: To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer. METHODS: A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this

Shu-Lian Wang; Zhongxing Liao; Helen Liu; Jaffer Ajani; Stephen Swisher; James D Cox; Ritsuko Komaki

5

Performance prediction of concurrent systems  

NASA Technical Reports Server (NTRS)

Concurrent systems are computers that use multiple processors to solve a single problem. A means to predict the application performance on these systems is a useful tool in many areas of concurrent system research. A computationally efficient and accurate method to predict performance for a class of parallel computations on concurrent systems is described. A parallel computation is modeled as a task system with precedence relationships expressed as a series parallel directed acyclic graph. Resources in concurrent systems are modeled as service centers in queueing network models. Using these two models as inputs, the method outputs predictions of both the time to complete the computation and the concurrent system utilization. The algorithm used is based on the approximate Mean Value Analysis in queueing network modeling with extensions to model concurrency in the computation. The new algorithm was validated against both detailed simulation and actual execution on a commercial multiprocessor.

Mak, Victor W. K.

1987-01-01

6

Proton Beam Therapy and concurrent chemotherapy for esophageal cancer  

PubMed Central

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

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

7

Proton Beam Therapy and Concurrent Chemotherapy for Esophageal Cancer  

SciTech Connect

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

Lin, Steven H., E-mail: shlin@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wei, Caimiao [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Myles, Bevan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Guo Xiaomao [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Palmer, Matthew [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen G.; Hofstetter, Wayne L. [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2012-07-01

8

EDITORIALS Radiotherapy and Concurrent Chemotherapy: a Strategy That Improves Locoregional Control and Survival in Oropharyngeal Cancer  

Microsoft Academic Search

In this issue of the Journal, Calais et al. (1), representing the French Groupe d'Oncologie Radiotherapie Tete et Cou (GORTEC), report a multicenter randomized comparison of ra- diotherapy and concurrent chemotherapy versus radiotherapy alone in patients with oropharyngeal cancer. Their results add to a growing list of trials that demonstrate superior survival and locoregional control with this combined-modality approach. A

Arlene A. Forastiere; Andy Trotti

2010-01-01

9

Multi-microprocessor system for concurrent LISP  

SciTech Connect

Recent advances of VLSI technologies have made multi-microprocessor systems feasible to construct. This paper presents a multi-microprocessor system for a LISP-based concurrent programming language, concurrent LISP. Concurrent LISP is designed for user oriented concurrent programs, especially for artificial intelligence programs. The authors had developed concurrent lisp on single processor systems. The multi-microprocessor system proposed is constructed on the basis of these experiences. The multi-microprocessor system is constructed using general purpose microprocessors and it has the language oriented system configuration. 5 references.

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

1983-01-01

10

Concurrency Control and Recovery in Database Systems  

Microsoft Academic Search

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

Philip A. Bernstein; Vassos Hadzilacos; Nathan Goodman

1987-01-01

11

Concurrent ultrasonic weld evaluation system  

DOEpatents

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.

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

1987-01-01

12

Concurrent ultrasonic weld evaluation system  

DOEpatents

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

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

1987-12-15

13

Concurrent ultrasonic weld evaluation system  

DOEpatents

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.

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

1985-09-04

14

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

SciTech Connect

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

Kwint, Margriet [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)] [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Uyterlinde, Wilma [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)] [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Nijkamp, Jasper; Chen, Chun; Bois, Josien de; Sonke, Jan-Jakob [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)] [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Heuvel, Michel van den [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)] [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Knegjens, Joost; Herk, Marcel van [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)] [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Belderbos, Jose, E-mail: j.belderbos@nki.nl [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)] [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

2012-10-01

15

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

SciTech Connect

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.

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

16

Automated Concurrent Blackboard System Generation in C++  

NASA Technical Reports Server (NTRS)

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

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

1999-01-01

17

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

PubMed Central

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

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

2013-01-01

18

Specifying the behavior of concurrent systems  

NASA Technical Reports Server (NTRS)

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

Furtek, F. C.

1984-01-01

19

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

SciTech Connect

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.

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

20

Concurrency control in heterogeneous distributed database systems  

E-print Network

CONCURRENCY CONTROL IN HETEROGENEOUS DISTRIBUTED DATABASE SYSTEMS A Thesis by MD. REZAUR RAHMAN Subnritted to the Office of Graduate Studies of Texas ARM University in partial fulfilln&ent of the requirements for the degree of MASTER... OF SCIENCE May 1992 Major Subject: Computer Science CONCURRENCY CONTROL IN HETEROGENEOUS DISTRIBUTED DATABASE SYSTEMS A Thesis by MD. REZAUR RAHMAN Approved as to style and content by: unguk L. Kim (Co-Chair of Committee) J. C. Liu (Co...

Rahman, Md. Rezaur

2012-06-07

21

Concurrent radiotherapy and weekly chemotherapy of 5-fluorouracil and platinum agents for postoperative locoregional recurrence of oesophageal squamous cell carcinoma  

PubMed Central

The most optimal management for postoperative locoregional recurrence of oesophageal squamous cell carcinoma is still controversial. Several studies have reported the feasibility and efficacy of concurrent chemoradiotherapy (CCRT), mostly with three-weekly or four-weekly schedule of chemotherapy. However, treatment compliance was not quite satisfactory, probably due to treatment-related toxicities. Since CCRT with weekly chemotherapy regimens have demonstrated a favorable toxicity profile as well as promising survival in certain types of cancer, we aimed to evaluate the efficacy and toxicity of radiotherapy concurrently with weekly chemotherapy with 5-fluorouracil (5-FU) and platinum agents for patients with postoperative locoregional recurrence of oesophageal squamous cell carcinoma in our center. Twenty-seven consecutive patients who were diagnosed with postoperative locoregional recurrence of oesophageal squamous cell carcinoma and received CCRT with weekly chemotherapy of 5-FU and platinum agents were retrospectively analyzed. Our data showed that the present protocol of radiotherapy combined concurrently with weekly chemotherapy of 5-FU and platinum agents was a safe and effective salvage treatment for postoperative locoregional recurrence of oesophageal squamous cell carcinoma. PMID:25627119

Zhang, Wen-Wen; Zhu, Yu-Jia; Yang, Han; Wang, Qiao-Xuan; Wang, Xiao-Hui; Xiao, Wei-Wei; Li, Qiao-Qiao; Liu, Meng-Zhong; Hu, Yong-Hong

2015-01-01

22

Mechanical Verification of Concurrent Systems with TLA  

Microsoft Academic Search

Abstract. We describe an initial version of a system for mechanically checking the correctness proof of a concurrent system.Input to the system consists of the correctness properties, expressed in TLA (the temporal logic of actions), and their proofs, written in a humanly readable, hierarchically structured form.The system uses a mechanical verifier to check each step of the proof, translating the

Urban Engberg; Peter Grønning; Leslie Lamport

1992-01-01

23

Methodologies and systems for heterogeneous concurrent computing  

NASA Technical Reports Server (NTRS)

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

Sunderam, V. S.

1994-01-01

24

Concurrent cerebellar and cervical intramedullary tuberculoma: Paradoxical response on antitubercular chemotherapy and need for surgery  

PubMed Central

Spinal intramedullary tuberculoma (SIT) is a rare manifestation of neurotuberculosis. Concurrent SIT and intracranial tuberculoma are further unusual. Most of these tuberculomas respond completely to medical therapy, and surgical excision is seldom required. In this report, we describe a 17-year-old boy who developed cervical intramedullary tuberculoma at C3-C6 level with a concurrent lesion involving the right cerebellar hemisphere while on treatment for tubercular meningitis. This patient had paradoxical increase in size of the cervical lesion even though the cerebellar lesion showed regression in size. In this article, we discuss the paradoxical response to anti-tubercular therapy in central nervous system tuberculosis, possible causes of nonresolution of tuberculoma on medical therapy and evaluate the role of surgery in these cases. PMID:25250077

Das, Kuntal Kanti; Jaiswal, Sushila; Shukla, Mukesh; Srivastava, Arun Kumar; Behari, Sanjay; Kumar, Raj

2014-01-01

25

A simple approach to specifying concurrent systems  

Microsoft Academic Search

Over the past few years, I have developed an approach to the formal specification of concurrent systems that I now call the transition axiom method. The basic formalism has already been described in [12] and [1], but the formal details tend to obscure the important concepts. Here, I attempt to explain these concepts without discussing the details of the underlying

Leslie Lamport

1989-01-01

26

Introduction to Concurrent Versions System  

E-print Network

Revisions Branching and Merging Multiple developers How to start to use our CVS server CVS Resource #12;Conceptual Overview What is CVS? CVS is a version control system. It is used to record the history of your source files. CVS also helps you if you are part of a group of people working on the same project What

Dudek, Gregory

27

GA optimization of Petri net-modeled concurrent service systems  

Microsoft Academic Search

This paper deals with the performance modeling and the optimization of concurrent service systems. In large and complex service systems, asynchronous and concurrently occurring activities are common. Petri nets are ideal tools for modeling concurrent systems. However, Petri nets are lacking in time duration concept, in data collecting mechanism and in conjunctive logic on the preconditions of an event. These

Tad Gonsalves; Kiyoshi Itoh

2011-01-01

28

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

PubMed

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

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

2014-10-01

29

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

SciTech Connect

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.

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

30

S-1 plus gemcitabine chemotherapy followed by concurrent radiotherapy and maintenance therapy with S-1 for unresectable pancreatic cancer  

PubMed Central

AIM: To investigate the feasibility and efficacy of the combination of S-1 with gemcitabine followed by oral S-1 with concurrent radiotherapy (intensity modulated radiotherapy, IMRT) and maintenance therapy with S-1 for locally advanced pancreatic cancer. METHODS: Subjects selected in the study were patients who had unresectable and locally advanced pancreatic cancer without distant metastases, adequate organ and marrow functions, an Eastern Cooperative Oncology Group performance status of 0-1 and no prior anticancer therapy. Initially the subjects received two cycles of chemotherapy, oral administration of S-1 40 mg/m2 twice daily from day 1 to day 14 of a 21-d cycle, with 30-min intravenous infusions of gemcitabine 1000 mg/m2 on day 1 and day 8. Two weeks after the completion of chemotherapy, S-1 was administered orally with concurrent IMRT. Oral S-1 was administered at a dose of 80 mg/m2 per day twice daily from day 1 to day 14 and from day 22 to day 35. Radiation was concurrently delivered at a dose of 50.4 Gy (1.8 Gy/d, 5 times per week, 28 fractions). One month after the completion of chemotherapy and radiotherapy, S-1 was administered orally at a dose of 80 mg/m2 per day twice daily for 14 d, followed by a 14-d rest period. This cycle was repeated as maintenance therapy, until unacceptable toxicity occurred or the disease worsened. Thirty-two patients were involved in this study. The median follow-up was 15.6 mo (range: 8.6-32.3 mo). RESULTS: Thirty-two patients completed the scheduled course of chemotherapy, while 30 patients (93.8%) received chemoradiotherapy with two patients ceasing to continue with radiotherapy. The major toxic effects were nausea and leukopenia. There was no grade 4 toxicity or treatment-related death. According to the Response Evaluation Criteria in Solid Tumors criteria, the objective tumor response was partial response in 17 (53.1%) patients, stable disease in 9 (28.1%), and progressive disease in 6 (18.8%). The median overall survival and median progression-free survival were 15.2 mo and 9.3 mo, respectively. The survival rates at 1 year and 2 years were 75% and 34.4%, respectively. CONCLUSION: The combination of S-1 with gemcitabine followed by oral S-1 with IMRT and maintenance therapy with S-1 alone in patients with locally advanced pancreatic cancer may be considered a well-tolerated, promising treatment regimen. PMID:25320537

Ke, Qing-Hua; Zhou, Shi-Qiong; Yang, Ji-Yuan; Du, Wei; Liang, Gai; Lei, Yong; Luo, Fei

2014-01-01

31

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

PubMed Central

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

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

32

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

Microsoft Academic Search

PURPOSE: To investigate the association between dose to various anatomical structures and dysphagia among patients with head and neck cancer treated by definitive intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy. METHODS AND MATERIALS: Thirty-nine patients with squamous cancer of the head and neck were treated by definitive concurrent chemotherapy and IMRT to a median dose of 70 Gy (range, 68 to

Baoqing Li; Dan Li; Derick H Lau; D Gregory Farwell; Quang Luu; David M Rocke; Kathleen Newman; Jean Courquin; James A Purdy; Allen M Chen

2009-01-01

33

Predictors of pulmonary toxicity in limited stage small cell lung cancer patients treated with induction chemotherapy followed by concurrent platinum-based chemotherapy and 70 Gy daily radiotherapy: CALGB 30904  

PubMed Central

Introduction Standard therapy for limited stage small cell lung cancer (L-SCLC) is concurrent chemotherapy and radiotherapy followed by prophylactic cranial radiotherapy. Predictors of post chemoradiotherapy pulmonary toxicity in limited stage (LS) small cell lung cancer (SCLC) patients are not well defined. Current guidelines are derived from non-small cell lung cancer regimens, and do not account for the unique biology of this disease. Therefore, we analyzed patients on three consecutive CALGB LS-SCLC trials treated with concurrent chemotherapy and daily high dose radiotherapy (70 Gy) to determine patient and treatment related factors predicting for post-treatment pulmonary toxicity. Methods Patients treated on CALGB protocols 39808, 30002, 30206 investigating two cycles of chemotherapy followed by concurrent chemotherapy and 70 Gy daily thoracic radiation therapy were pooled. Patient, tumor, and treatment related factors were evaluated to determine predictors of grade 3–5 pulmonary toxicities after concurrent chemoradiotherapy. Results 100 patients were included. No patient experienced grade 4–5 post-treatment pulmonary toxicity. Patients who experienced post-treatment pulmonary toxicity were more likely to be older (median age 69 vs 60, p=0.09) and have smaller total lung volumes (2565 cc vs 3530 cc, p=0.05).). Furthermore, exposure of larger volumes of lung to lower (median V5=70%, p=0.09, median V10=63%, p=0.07), intermediate (median V20=50, p=0.04) and high (median V60=25%, p=0.01) doses of radiation were all associated with post-treatment grade 3 pulmonary toxicity, as was a larger mean lung radiation dose (median 31 Gy) p=0.019. Conclusion Post-treatment pulmonary toxicity following the completion of 2 cycles of chemotherapy followed by concurrent chemotherapy and high dose daily radiation therapy was uncommon. Care should be taken to minimize mean lung radiation exposure, as well as volumes of low, intermediate and high doses of radiation. PMID:24396884

Salama, Joseph K.; Pang, Herbert; Bogart, Jeffery A.; Blackstock, A. William; Urbanic, James J.; Hodgson, Lydia; Crawford, Jeffery; Vokes, Everett E.

2013-01-01

34

ConcurrentMentor: A Visualization System for Distributed Programming Education  

E-print Network

ConcurrentMentor: A Visualization System for Distributed Programming Education Steve Carr is challenging for students. In order to assist in distributed systems instruction, we have developed Concurrent to the visualization system is generated by an accompanying communica- tion library that closely follows abstractions

Shene, Ching-Kuang

35

Concurrency Control in Distributed Database Systems  

Microsoft Academic Search

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

Philip A. Bernstein; Nathan Goodman

1981-01-01

36

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

SciTech Connect

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

Lu Jincheng, E-mail: lujincheng@msn.co [Department of Radiotherapy, Jiangsu Cancer Hospital, Nanjing (China); Kong Cheng; Tao Hua [Department of Radiotherapy, Jiangsu Cancer Hospital, Nanjing (China)

2010-11-01

37

Chemotherapy  

MedlinePLUS

... Central venous catheter with a port Percutaneously inserted central catheter (PICC) Different chemotherapy drugs may be given at the same time or after each other. Patients may receive radiation therapy before, after, or while ...

38

Cooperative Robot Control and Concurrent Synchronization of Lagrangian Systems  

Microsoft Academic Search

Concurrent synchronization is a regime where di- verse groups of fully synchronized dynamic systems stably coex- ist. We study global exponential synchronization and concurrent synchronization in the context of Lagrangian systems control. In a network constructed by adding diffusive couplings to robot manipulators or mobile robots, a decentralized tracking control law globally exponentially synchronizes an arbitrary number of robots, and

Soon-Jo Chung; Jean-Jacques E. Slotine

2009-01-01

39

System level concurrency control for distributed database systems  

Microsoft Academic Search

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

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

1978-01-01

40

External beam radiation plus concurrent intra-arterial chemotherapy with low dose cisplatin for muscle invasive bladder cancer  

PubMed Central

Introduction: We aimed to investigate the long-term outcome of trimodality therapy consisting of transurethral resection of bladder tumor, external beam radiation therapy, and concurrent intra-arterial low dose cisplatin for patients with muscle invasive bladder cancer. Materials and Methods: We retrospectively reviewed the medical records of 37 consecutive patients (28 men and 9 women) who underwent trimodality therapy for T2-3N0M0 bladder cancer at our hospital between 1996 and 2011. A total of 60Gy of external beam radiation therapy was administered. A daily low dose of cisplatin was administered intra-arterially through a subcutaneously placed reservoir on the days of radiation therapy. Complete response was defined as no residual cancer in transurethral resection specimens and negative cytology. When a complete response could not be achieved, patients underwent additional intra-arterial chemotherapy. Results: Five-year cause specific, disease free, and overall survival rates were 86.4%, 69.7%, and 69.6%, respectively, with a mean follow-up period of 56.5 ± 6.1 months. Five-year cause specific survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 100% (n = 21), 85.9% (n = 9) and 0% (n = 7), respectively. Five-year overall survivals of the complete response group after the trimodality therapy, the complete response group after additional intra-arterial chemotherapy and the non-complete response group were 82.8%, 85.3% and 0%, respectively. Conclusions: This trimodality therapy for muscle invasive bladder cancer could achieve favorable survival rates with bladder preservation and minimal adverse events. This trimodality therapy can be one of the useful treatment options. PMID:25624577

Matsumoto, Yoshihiro; Samma, Shoji; Fukui, Shinji; Nakai, Yasushi; Kagebayashi, Yoriaki; Torimoto, Kazumasa

2015-01-01

41

Induction and concurrent chemotherapy with concomitant boost radiotherapy in non-small cell lung cancer  

Microsoft Academic Search

This study was designed to evaluate the tolerability and therapeutic activity of paclitaxel and carboplatin combination therapy\\u000a followed by radical thoracic radiotherapy with a concomitant boost technique with concurrent weekly paclitaxel in good performance\\u000a status of patients with stage IIIA and IIIB non-small cell lung cancer. Patients with newly diagnosed inoperable non-small\\u000a cell lung cancer received paclitaxel (100 mg\\/m2) as

Ethem Nezih Oral; Adnan Aydiner; Ye?im Eralp; Erkan Topuz

2005-01-01

42

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

SciTech Connect

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.

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

43

Concurrent Systems Need Both Sequences And Serializers  

E-print Network

Contemporary concurrent programming languages fall roughly into two classes. Languages in the first class support the notion of a sequence of values and some kind of pipelining operation over the sequence of values. Languages ...

Hewitt, Carl

44

Automated Analysis of Concurrent Systems With the Constrained Expression Toolset  

Microsoft Academic Search

The constrained expression approach to analysis of concurrent softwaresystems has several attractive features, including the facts that itcan be used with a variety of design and programming languages and thatit does not require a complete enumeration of the set of reachable statesof the concurrent system. This paper reports on the construction of atoolset automating the main constrained expression analysis techniquesand

George S. Avrunin; Ugo A. Buy; James C. Corbett; Laura K. Dillon; Jack C. Wileden

1991-01-01

45

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

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.

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

46

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

NASA Astrophysics Data System (ADS)

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

Herrera, Higmar; Yañez, Elvia; López, Jesús

2012-10-01

47

[Chemotherapy].  

PubMed

Chemotherapy for colorectal cancer has improved greatly and survival rate is improving. Now, we have many effective but toxic regimens (FOLFOX, CapeOX, FOLFIRI, FOLFOXIRI with or without bevacizumab or cetuximab or panitumumab) and regorafenib, a multikinase inhibitor, can be used for third- or forth-line treatment. Treatments should be tailored to an individual patient according to tumor characteristics and patient conditions. Conversion therapy is secondary surgery after most active induction chemotherapy, e.g., FOLFOX with cetuximab. Conversion rate is about 10%. Adjuvant chemotherapy is indicated for stage III patients. 5FU+LV, UFT+LV, capecitabine, FOLFOX, CapeOX and S-1 are available in the adjuvant setting. Regimens including oxaliplatin should be prescribed to high-risk stage III patients, because of oxaliplatin toxicity. PMID:24597356

Fujita, Shin; Kotake, Kenjiro

2014-01-01

48

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

SciTech Connect

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.

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

49

Induction chemotherapy followed by concurrent chemoradiotherapy in stage III unresectable non-small cell lung cancer.  

PubMed

The favourable experience with the combination regimen of vinorelbine, ifosfamide and cisplatin (NIP) in patients with metastatic non-small cell lung cancer (NSCLC) has led to a protocol assessing this regimen as an induction treatment in patients with stage III unresectable NSCLC, followed by thoracic radiotherapy with concurrent daily cisplatin as a radiosensitizer. Two cycles of NIP were administered 21 days apart; each cycle comprised i.v. vinorelbine 25 mg/m2 on days 1 and 8, i.v. ifosfamide 3 g/m2 on day 1 with MESNA as uroprotection, and i.v. cisplatin 50 mg/m2 on day 1. Radical thoracic radiotherapy commenced on day 43 to a total dose of 64 Gy and i.v. cisplatin 6 mg/m2 was given concurrently prior to each fraction of radiation as a sensitiser. Two more cycles of NIP were given to patients who responded favourably to the induction treatment about 2 weeks after completion of radiation. Between July 1995 and July 1997, 44 patients were treated with this protocol. This treatment schedule was generally well tolerated. Grade 3-4 neutropenia occurred in 50% of the patients and neutropenic sepsis was seen in 8. Grade 3-4 oesophagitis was uncommon. Most of the patients were able to complete the induction and concurrent chemoradiotherapy phase. Major response occurred in 75% of the patients with 2 (4.5%) complete responses (CR). A total of 6 patients achieved CR after chemoradiotherapy. At a median follow-up of 35 months, the median overall survival for all patients was 15 months with a 3-year survival rate of 24%. The median overall survival for stage IIIA patients was 19 months with a 3-year survival rate of 39% in contrast to 13 months' median overall survival and only 15% 3-year survival rate for stage IIIB. The NIP regimen results in a high response rate in NSCLC and this treatment programme seems to benefit selected patients with stage III disease. PMID:10665753

Tan, E H; Wee, J; Ang, P T; Fong, K W; Leong, S S; Khoo, K S; Tan, T; Lee, K S; Eng, P; Hsu, A; Tan, Y K; Chua, E J; Ong, Y Y

1999-01-01

50

Computational simulation for concurrent engineering of aerospace propulsion systems  

NASA Technical Reports Server (NTRS)

Results are summarized for an investigation to assess the infrastructure available and the technology readiness in order to develop computational simulation methods/software for concurrent engineering. These results demonstrate that development of computational simulation methods for concurrent engineering is timely. Extensive infrastructure, in terms of multi-discipline simulation, component-specific simulation, system simulators, fabrication process simulation, and simulation of uncertainties--fundamental to develop such methods, is available. An approach is recommended which can be used to develop computational simulation methods for concurrent engineering of propulsion systems and systems in general. Benefits and issues needing early attention in the development are outlined.

Chamis, C. C.; Singhal, S. N.

1993-01-01

51

Phase II Selection Design Trial of Concurrent Chemotherapy and Cetuximab Versus Chemotherapy Followed by Cetuximab in Advanced-Stage Non–Small-Cell Lung Cancer: Southwest Oncology Group Study S0342  

PubMed Central

Purpose Randomized clinical trials failed to show a survival benefit for epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors plus concurrent chemotherapy in patients with metastatic non–small-cell lung cancer (NSCLC), with preclinical data suggesting potential negative interactions. In contrast, pilot trials of the EGFR-targeted antibody, cetuximab, plus chemotherapy suggested enhanced antitumor activity. This randomized phase II trial was designed to select a cetuximab plus chemotherapy regimen for phase III evaluation. Patients and Methods Treatment-naive patients with advanced-stage NSCLC were randomly assigned to receive paclitaxel (225 mg/m2) and carboplatin (area under the curve, 6) every 3 weeks plus concurrent cetuximab (400 mg/m2 loading dose followed by 250 mg/m2 weekly) for four cycles followed by maintenance cetuximab or sequential paclitaxel-carboplatin for four cycles followed by cetuximab. Results Of 242 patients enrolled, 224 were eligible and assessable for response (106 and 118 patients in the concurrent and sequential arms, respectively). With a median follow-up time of 32 months, the median overall survival was 10.9 months (95% CI, 9.2 to 13.0 months) for patients receiving concurrent therapy and 10.7 months (95% CI, 8.5 to 12.8 months) for patients receiving sequential therapy (P = .57); 1-year survival rates were 45% (95% CI, 36% to 54%) and 44% (95% CI, 35% to 53%), respectively. Response rates and progression-free survival times were similar in both arms, as was grade 3 rash, whereas sensory neuropathy was higher in the concurrent arm (15% v 5% in the sequential arm; P = .036). Conclusion Although both regimens met the efficacy criterion for continued evaluation, the concurrent regimen of paclitaxel/carboplatin plus cetuximab was chosen. PMID:20921467

Herbst, Roy S.; Kelly, Karen; Chansky, Kari; Mack, Philip C.; Franklin, Wilbur A.; Hirsch, Fred R.; Atkins, James N.; Dakhil, Shaker R.; Albain, Kathy S.; Kim, Edward S.; Redman, Mary; Crowley, John J.; Gandara, David R.

2010-01-01

52

Concurrent engineering of an infrared telescope system  

NASA Astrophysics Data System (ADS)

A concurrent engineering approach to the design and analysis of a space-borne Electro-Optical (EO) sensor is presented. A detailed design of an infrared telescope payload is developed by an interdisciplinary team of mechanical, structural, thermal, and optical engineers using a Simulation Driven Engineering (SDE) software environment. The telescope payload design is also integrated with a conceptual level design of the space segment of a mission that incorporates the payload. The flow of the concurrent design process is described, and design outputs are provided.

Geis, Jason; Lang, Jeffrey; Peterson, Leslie; Roybal, Francisco; Tanzillo, Jennifer; Thomas, David; Warren, David

2011-10-01

53

Early Clinical Outcome With Concurrent Chemotherapy and Extended-Field, Intensity-Modulated Radiotherapy for Cervical Cancer  

SciTech Connect

Purpose: To assess the early clinical outcomes with concurrent cisplatin and extended-field intensity-modulated radiotherapy (EF-IMRT) for carcinoma of the cervix. Methods and Materials: Thirty-six patients with Stage IB2-IVA cervical cancer treated with EF-IMRT were evaluated. The pelvic lymph nodes were involved in 19 patients, and of these 19 patients, 10 also had para-aortic nodal disease. The treatment volume included the cervix, uterus, parametria, presacral space, upper vagina, and pelvic, common iliac, and para-aortic nodes to the superior border of L1. Patients were assessed for acute toxicities according to the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 3.0. All late toxicities were scored with the Radiation Therapy Oncology Group late toxicity score. Results: All patients completed the prescribed course of EF-IMRT. All but 2 patients received brachytherapy. Median length of treatment was 53 days. The median follow-up was 18 months. Acute Grade {>=}3 gastrointestinal, genitourinary, and myelotoxicity were seen in 1, 1, and 10 patients, respectively. Thirty-four patients had complete response to treatment. Of these 34 patients, 11 developed recurrences. The first site of recurrence was in-field in 2 patients (pelvis in 1, pelvis and para-aortic in 1) and distant in 9 patients. The 2-year actuarial locoregional control, disease-free survival, overall survival, and Grade {>=}3 toxicity rates for the entire cohort were 80%, 51%, 65%, and 10%, respectively. Conclusion: Extended-field IMRT with concurrent chemotherapy was tolerated well, with acceptable acute and early late toxicities. The locoregional control rate was good, with distant metastases being the predominant mode of failure. We are continuing to accrue a larger number of patients and longer follow-up data to further extend our initial observations with this approach.

Beriwal, Sushil [Department of Radiation Oncology, Pittsburgh, PA (United States)]. E-mail: beriwals@upmc.edu; Gan, Gregory N. [University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Heron, Dwight E. [Department of Radiation Oncology, Pittsburgh, PA (United States); Selvaraj, Raj N. [Department of Radiation Oncology, Pittsburgh, PA (United States); Kim, Hayeon [Department of Radiation Oncology, Pittsburgh, PA (United States); Lalonde, Ron [D3 Advanced Radiation Planning, Pittsburgh, PA (United States); Kelley, Joseph L. [Division of Gynecologic Oncology, Department of Gynecology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Edwards, Robert P. [Division of Gynecologic Oncology, Department of Gynecology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

2007-05-01

54

Creating and standardizing annual chemotherapy competencies throughout a healthcare system.  

PubMed

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

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

2015-01-01

55

Concurrent Cycle Collection in Reference Counted Systems  

Microsoft Academic Search

Automatic storage reclamation via reference counting has important advantages, but has always suffered from a major weakness due to its inability to reclaim cyclic data structures. We describe a novel cycle collection algorithm that is both concurrent — it is capable of collecting garbage even in the presence of simultaneous mutation — and localized — it never needs to perform

David F. Bacon; V. T. Rajan

2001-01-01

56

Database Concurrency Control in Multilevel Secure Database Management Systems  

Microsoft Academic Search

Concurrent execution of transactions in database management systems (DBMSs) may lead to contention for access to data, which in a multilevel secure DBMS (MLS\\/DBMS) may lead to insecurity. Security issues involved in database concurrency control for MLS\\/DBMSs are examined, and it is shown how a scheduler can affect security. Data conflict security, (DC-security), a property that implies a system is

Thomas F. Keefe; Wei-tek Tsai; Jaideep Srivastava

1993-01-01

57

PACT: An Experiment in Integrating Concurrent Engineering Systems  

Microsoft Academic Search

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...

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

58

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

SciTech Connect

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.

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

1985-04-01

59

[Superselective intraarterial chemotherapy using low dose CBDCA and Pirarubicin with concurrent radiotherapy for head and neck cancer].  

PubMed

To study the effects of superselective intraarterial chemotherapy with low-dose CBDCA, Pirarubicin, and concurrent radiotherapy on head and neck cancer, we compared primary cancer response and histopathological effective grades in 66 patients (more than T2) divided into radical and preoperative radiotherapy groups. The radical group (n=33) showed a 75.7% response in primary cancer, i.e. 54.5% complete remission and 21.2% partial remission. The preoperative group (n = 33) showed 39.4% complete remission when the histopathological effective grade was higher, and 57.6% partial remission when the grade was lower. Cancer response was better in the oral cavity, mesopharynx, and hypopharynx than in the parasinus. In the preoperative group, 5-year overall survival was 84.4% when the effective grade was higher, and 29.4% when the grade was lower. Survival differed significantly (P<0.01) between higher and lower grades. Additional postoperative therapy is thus essential in patients with lower grades of histopathological effectiveness. PMID:15828284

Ito, Kazuyuki; Shiba, Hiromi; Fujiwara, Kazunori; Kunimoto, Yasuomi; Tanimoto, Shunji; Higami, Yumiko; Kitano, Hiroya

2005-03-01

60

Concurrent Design and Manufacturing for Mechanical Systems  

Microsoft Academic Search

The conventional product development process employs a design-build-break philosophy. The sequentially executed product development process often results in a prolonged lead-time and an elevated product cost. The proposed concurrent design and manu facturing (CDM) paradigm employs physics-based computational methods together with computer graphics techniques for product de sign. This proposed approach employs Virtual Prototyping (VP) technology to support a cross-functional

Kuang-Hua Chang; Javier Silva; Ira Bryant

1999-01-01

61

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

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.

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

62

The role of concurrent chemotherapy to intensity-modulated radiotherapy (IMRT) after neoadjuvant docetaxel and cisplatin treatment in locoregionally advanced nasopharyngeal carcinoma.  

PubMed

The goal of this study was to assess the efficacy of concurrent chemotherapy to intensity-modulated radiotherapy (IMRT) after neoadjuvant chemotherapy (NACT) in locoregionally advanced nasopharyngeal carcinoma (NPC). A total of 120 patients with stage III-IVB NPC treated with NACT followed by IMRT alone (39 patients, arm 1) or CCRT (81 patients, arm 2) between May 2009 and June 2012 were eligible for study inclusion. NACT consisted of docetaxe (DOC, 60 mg/m(2), day 1) and cisplatin (DDP, 100 mg/m(2), days 1-5, every 3 weeks). Concurrent chemotherapy was nedaplatin (NDP, 25 mg/m(2), days 1-3, every 3 weeks). The median follow-up period was 41 (range 5-52) months, and the 3-year overall survival, distant metastases-free survival, locoregional relapse-free survival, and progression-free survival rates of arm 1 and arm 2 were 83.3 and 87.4 % (P = 0.516), 81.7 and 79.6 % (P = 0.596), 86 and 92.3 % (P = 0.920), 76.4 and 76.4 % (P = 0.709), respectively. During radiotherapy, the most commonly recorded grade 3/4 adverse events were anemia (7.7 vs. 4.9 %), leucopenia (10.2 vs. 3.7 %), thrombocytopenia (12.8 vs. 3.7 %), neutropenia (15.4 vs. 6.2 %), nausea/vomiting (7.7 vs. 12.3 %), stomatitis/mucositis (38.5 vs. 46.9 %), xerostomia (35.9 vs. 30.8 %), dermatitis (7.7 vs. 7.4 %), and fatigue(15.4 vs. 17.2 %) for arm 1 and arm 2. The results of this study indicated that added concurrent chemotherapy to IMRT after neoadjuvant DOC and DDP treatment for locoregionally advanced NPC was probably not be necessary. PMID:25631634

Zhang, Lei; Shan, Guo-Ping; Li, Pu; Cheng, Ping-Jing

2015-03-01

63

EcliPSe: A System for High Performance Concurrent Simulation  

Microsoft Academic Search

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

Vernon Rego

1991-01-01

64

SFWR ENG 3BB4 --Software Design 3 --Concurrent System Design 2 SFWR ENG 3BB4 --Software Design 3 --Concurrent System Design 6.1 3  

E-print Network

selected process #12;SFWR ENG 3BB4 -- Software Design 3 -- Concurrent System Design 6.65 67 PCB ComponentsSFWR ENG 3BB4 -- Software Design 3 -- Concurrent System Design 2 Chapter 6 Processes SFWR ENG 3BB4 -- Software Design 3 -- Concurrent System Design 6.1 3 Read... · BLP: Chapter 11 · Background on Processes

Carette, Jacques

65

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

SciTech Connect

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.

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

66

Retrospective analysis of the impact of HPV status and smoking on mucositis in patients with oropharyngeal squamous cell carcinoma treated with concurrent chemotherapy and radiotherapy  

PubMed Central

SUMMARY Objectives The standard concurrent radiotherapy and chemotherapy regimens for patients with oropharyngeal cancer are highly toxic. Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) has recently emerged as a distinct biological and clinical entity with improved response to treatment and prognosis. A tailored therapeutic approach is needed to optimize patient care. The aim of our study was to investigate the impact of HPV and smoking status on early toxicities (primarily mucositis) associated with concurrent chemotherapy and radiotherapy in patients with OPSCC. Materials and methods We retrospectively evaluated 72 consecutive patients with OPSCC and known HPV status treated with concurrent radiotherapy and chemotherapy at our institution. Treatment-related toxicities were stratified by smoking and HPV status and compared using univariate and multivariate logistic regression. Results HPV-positive patients had a 6.86-fold increase in the risk of having severe, grade 3–4 mucositis. This effect was preserved after adjusting for patient smoking status, nodal stage, radiotherapy technique and radiotherapy maximum dose. Additionally, HPV status had significant effect on the objective weight loss during treatment and at three months after treatment. Consistently, non-smokers had a significant 2.70-fold increase in the risk of developing severe mucositis. Conclusion Risk factors for OPSCC modify the incidence of treatment-related early toxicities, with HPV-positive and non-smoking status correlating with increased risk of high grade mucositis and associated outcomes. Retrospective single-institution studies need to be interpreted cautiously. However, this finding is important to consider when designing therapeutic strategies for HPV-positive patients and merits further investigation in prospective clinical trials. PMID:24998139

Vatca, M.; Lucas, J.T.; Laudadio, J.; D’Agostino, R.B.; Waltonen, J.D.; Sullivan, C.A.; Rouchard-Plasser, R.; Matsangou, M.; Browne, J.D.; Greven, K.M.; Porosnicu, M.

2014-01-01

67

Systemic chemotherapy, intrathecal chemotherapy, and symptom management in the treatment of leptomeningeal metastasis  

Microsoft Academic Search

Metastasis to the leptomeninges occurs in many common cancers, including leukemia; lung, breast, and gastrointestinal cancers;\\u000a and tumors of the brain. By way of the flow of cerebrospinal fluid, leptomeningeal metastasis spreads throughout the neuraxis.\\u000a Consequently, therapy for leptomeningeal metastasis must be directed to the entire central nervous system (CNS). Treatment\\u000a often consists of involved-field radiotherapy, systemic chemotherapy, and intrathecal

Stacey L. Berg; Marc C. Chamberlain

2003-01-01

68

Concurrent chemoradiotherapy followed by L-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma: CISL08-01 phase II study.  

PubMed

We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of L-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40-44 Gy of radiotherapy with weekly administration of 30 mg/m(2) of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m(2)), ifosfamide (1,200 mg/m(2)), and dexamethasone (40 mg) from days 1 to 3, and L-asparaginase (4,000 IU/m(2)) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and L-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n?=?4) and distant (n?=?7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by L-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL. PMID:24947798

Kim, Seok Jin; Yang, Deok-Hwan; Kim, Jin Seok; Kwak, Jae-Yong; Eom, Hyeon-Seok; Hong, Dae Sik; Won, Jong Ho; Lee, Jae Hoon; Yoon, Dok Hyun; Cho, Jaeho; Nam, Taek-Keun; Lee, Sang-Wook; Ahn, Yong Chan; Suh, Cheolwon; Kim, Won Seog

2014-11-01

69

Integrated Information Systems for Electronic Chemotherapy Medication Administration  

PubMed Central

Introduction: Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. Methods: We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. Results: We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. Conclusion: Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations. PMID:22043185

Levy, Mia A.; Giuse, Dario A.; Eck, Carol; Holder, Gwen; Lippard, Giles; Cartwright, Julia; Rudge, Nancy K.

2011-01-01

70

Towards a Benchmark for Model Checkers of Asynchronous Concurrent Systems  

E-print Network

parallel model checkers. Pel´anek [38] also recog- nises the need for benchmarking and suggestsTowards a Benchmark for Model Checkers of Asynchronous Concurrent Systems Diyaa­Addein Atiya, N,catano,luettgen}@cs.york.ac.uk Abstract. Benchmarks, such as the established ISCAS benchmarks of digital circuits, have been successfully

Lüttgen, Gerald

71

Performance of Concurrent Rendezvous Systems with Complex Pipeline Structures  

E-print Network

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

Woodside, C. Murray

72

ACTORS: A model of concurrent computation in distributed systems  

Microsoft Academic Search

The transition from sequential to parallel computation is an area of critical concern in today's computer technology, particularly in architecture, programming languages, systems, and artificial intelligence. This book addresses issues in concurrency, and by producing both a syntactic definition and a denotational model of Hewitt's actor paradigm - a model of computation specifically aimed at constructing and analyzing distributed large-scale

G. Agha

1986-01-01

73

Concurrent algorithms for a mobile robot vision system  

SciTech Connect

The application of computer vision to mobile robots has generally been hampered by insufficient on-board computing power. The advent of VLSI-based general purpose concurrent multiprocessor systems promises to give mobile robots an increasing amount of on-board computing capability, and to allow computation intensive data analysis to be performed without high-bandwidth communication with a remote system. This paper describes the integration of robot vision algorithms on a 3-dimensional hypercube system on-board a mobile robot developed at Oak Ridge National Laboratory. The vision system is interfaced to navigation and robot control software, enabling the robot to maneuver in a laboratory environment, to find a known object of interest and to recognize the object's status based on visual sensing. We first present the robot system architecture and the principles followed in the vision system implementation. We then provide some benchmark timings for low-level image processing routines, describe a concurrent algorithm with load balancing for the Hough transform, a new algorithm for binary component labeling, and an algorithm for the concurrent extraction of region features from labeled images. This system analyzes a scene in less than 5 seconds and has proven to be a valuable experimental tool for research in mobile autonomous robots. 9 refs., 1 fig., 3 tabs.

Jones, J.P.; Mann, R.C.

1988-01-01

74

Hybrid Concurrent Constraint Simulation Models of Several Systems  

NASA Technical Reports Server (NTRS)

This distribution contains several simulation models created for the hybrid simulation language, Hybrid Concurrent Constraint (HCC). An HCC model contains the information specified in the widely-accepted academic definition of a hybrid system: this includes expressions for the modes of the systems to be simulated and the differential equations that apply in each mode. These expressions are written in the HCC syntax. The models included here were created by either applying basic physical laws or implementing equations listed in previously published papers.

Sweet, Adam

2003-01-01

75

A concurrent Rapid Manufacturing advice system  

Microsoft Academic Search

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

J. Munguia; C. Riba

2008-01-01

76

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

SciTech Connect

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.

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

77

A Pooled Analysis of Limited Stage Small Cell Lung Cancer Patients Treated with Induction Chemotherapy Followed by Concurrent Platinum-based Chemotherapy and 70 Gy Daily Radiotherapy: CALGB 30904  

PubMed Central

Introduction Standard therapy for limited stage small cell lung cancer (L-SCLC) is concurrent chemotherapy and radiotherapy followed by prophylactic cranial radiotherapy. Although many consider the standard radiotherapy regimen to be 45 Gray (Gy) in 1.5 Gy twice-daily fractions, this has failed to gain widespread acceptance. We pooled data for patients assigned to receive daily radiotherapy to 70 Gy on three consecutive prospective CALGB L-SCLC cancer trials and report the results here. Methods All patients on consecutive CALGB L-SCLC trials (39808, 30002, and 30206) utilizing high dose daily radiotherapy with concurrent chemotherapy were included, and analyzed for toxicity, disease control and survival. Overall survival (OS) and Progression-free survival (PFS) were modeled using Cox proportional hazards models. Prognostic variables for OS-rate and PFS-rate were assessed using logistic regression model. Results 200 patients were included. The median follow-up was 78 months. Grade 3 or greater esophagitis was 23%. The median OS for pooled population was 19.9 months (95% CI: 16.7-22.3), and 5-year OS rate was 20% (95% CI: 16-27%). The 2 year progression free survival was 26% (95% CI: 21-32%). Multivariate analysis found younger age p=0.02 (HR: 1.023, 95% CI: (1.00,1.04), and female sex p=0.02 (HR:0.69, 95% CI: 0.50-0.94) independently associated with improved overall survival. Conclusion 2 Gy daily radiotherapy to a total dose of 70 Gy was well tolerated with similar survival to 45 Gy (1.5 Gy twice daily). This experience may aid practitioners decide whether high dose daily radiotherapy with platinum based chemotherapy is appropriate outside of a clinical trial. PMID:23715301

Salama, Joseph K.; Hodgson, Lydia; Pang, Herbert; Urbanic, James J.; Blackstock, A. William; Schild, Steven E.; Crawford, Jeffrey; Bogart, Jeffrey A; Vokes, Everett E.

2013-01-01

78

A modified Phase I trial of radiation dose escalation in 3D conformal radiation therapy with concurrent vinorelbine and carboplatin chemotherapy for non-small-cell lung cancer  

PubMed Central

The Radiation Therapy Oncology Group reported a maximum tolerated dose of 74 Gy for patients with non-small cell lung cancer (NSCLC); however, it was unclear whether this dose could be safely administered to Asian patients due to differences in their physique compared to Western patients. We therefore conducted a modified Phase I trial to determine whether 70 Gy could be safely delivered to Chinese patients with NSCLC undergoing 3D-conformal radiation therapy (3D-CRT) with concurrent chemotherapy. Previously untreated NSCLC patients received 3D-CRT (2 Gy/day, 5 fractions per week). Three dose levels were examined: 62, 66 and 70 Gy. Two cycles of concurrent chemotherapy (vinorelbine and carboplatin) were started on the first day of radiation therapy. Dose-limiting toxicity (DLT) was defined as severe or life-threatening side effects that altered the continued implementation of chemoradiotherapy. Among the 19 patients recruited in this study, most of the haematologic and non-haematologic toxicities were mild to moderate and clinically manageable. Only one patient, in the 70 Gy cohort, experienced a DLT of Grade 3 radiation-induced pneumonia. The overall response rate was 77.8% (14/18). The median progression-free survival (PFS) was 12 months, and the 1-year PFS was 37.6%. Our results support both the feasibility of incorporating 3D-CRT with concurrent vinorelbine and carboplatin and a dose escalation to 70 Gy for Chinese patients with NSCLC, based on the acceptable toxicity and encouraging overall response and survival rates. A further evaluation of this regimen in a prospective Phase II trial is ongoing. PMID:22988282

Lin, Qiang; Liu, Yue'e; Wang, Na; Huang, Yuehua; Ge, Xiaohui; Ren, Xiaocang; Chen, Xueji; Hu, Jing; Guo, Zhijun; Zhao, Yannan; Asaumi, Junichi

2013-01-01

79

8Year Follow-up of Randomized Trial: Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy Versus Systemic Chemotherapy in Patients with Peritoneal Carcinomatosis of Colorectal Cancer  

Microsoft Academic Search

Introduction  The treatment of peritoneal carcinomatosis is based on cytoreduction followed by hyperthermic intraperitoneal chemotherapy\\u000a and combined with adjuvant chemotherapy. In 2003, a randomized trial was finished comparing systemic chemotherapy alone with\\u000a cytoreduction followed by hyperthermic intraperitoneal chemotherapy and systemic chemotherapy. This trial showed a positive\\u000a result favoring the studied treatment. This trial has now been updated to a minimal follow-up

Vic J. Verwaal; Sjoerd Bruin; Henk Boot; Gooike van Slooten; Harm van Tinteren

2008-01-01

80

Effectiveness of integration of system-level optimization in concurrent engineering for rocket design  

E-print Network

Integrated concurrent engineering is a method for rapid conceptual design. Previous study has suggested that integration of system-level optimization techniques into integrated concurrent engineering can benefit the design ...

Bairstow, Brian Kenichi

2006-01-01

81

FEASIBILITY AND DOSE DISCOVERY ANALYSIS OF ZOLEDRONIC ACID WITH CONCURRENT CHEMOTHERAPY IN THE TREATMENT OF NEWLY DIAGNOSED METASTATIC OSTEOSARCOMA: A REPORT FROM THE CHILDEREN’S ONCOLOGY GROUP  

PubMed Central

Aim Patients with metastatic osteosarcoma (OS) have a poor outcome with conventional therapies. Zoledronic acid (ZA) is a third-generation bisphosphonate that reduces skeletal-related events in many adult cancers, and preclinical data suggests a possible benefit in OS. This study assessed the maximum tolerated dose (MTD) and feasibility of ZA when combined with chemotherapy in patients with metastatic OS. Patients and Methods Patients with a histologic diagnosis of OS were eligible if they were <40 years of age, had initially metastatic disease, and met organ function requirements. Treatment combined surgery and a conventional chemotherapy regimen. ZA was given concurrent with chemotherapy for a total 8 doses over 36 weeks. Three dose levels of ZA were tested: 1.2 mg/m2 [max 2 mg], 2.3 mg/m2 [max 4 mg] and 3.5 mg/m2 [max 6 mg]. The MTD was determined during induction. Six patients were to be treated at each dose level, with an additional 6 patients treated at the MTD to help assess post-induction feasibility. Results Twenty-four patients (median age 13.5 years [range, 7-22]; 16 females) were treated. Five patients experienced dose limiting toxicities (DLTs) during induction, including 3 patients treated with 3.5 mg/m2. DLTs included hypophosphatemia, hypokalemia, hyponatremia, mucositis, limb pain and limb edema. There were no reports of excessive renal toxicity or osteonecrosis of the jaw. The MTD was defined as 2.3 mg/m2 (max 4 mg). Conclusions ZA can be safely combined with conventional chemotherapy with the MTD of 2.3 mg/m2 (max 4 mg) for patients with metastatic osteosarcoma. PMID:23664013

Goldsby, Robert E.; Fan, Timothy M.; Villaluna, Doojduen; Wagner, Lars M.; Isakoff, Michael S.; Meyer, James; Randall, R. Lor; Lee, Sharon; Kim, Grace; Bernstein, Mark; Gorlick, Richard; Krailo, Mark; Marina, Neyssa

2013-01-01

82

Bortezomib and Chemotherapy for Systemic Light-Chain Amyloidosis  

Cancer.gov

In this trial, patients with previously untreated systemic light-chain amyloidosis will be randomly assigned to receive melphalan and dexamethasone with or without bortezomib. Doctors will assess the overall hematologic response rates to these chemotherapy regimens, as well as organ responses.

83

Dynamic systems-engineering process - The application of concurrent engineering  

NASA Technical Reports Server (NTRS)

A system engineering methodology is described which enables users, particulary NASA and DOD, to accommodate changing needs; incorporate emerging technologies; identify, quantify, and manage system risks; manage evolving functional requirements; track the changing environment; and reduce system life-cycle costs. The approach is a concurrent, dynamic one which starts by constructing a performance model defining the required system functions and the interrelationships. A detailed probabilistic risk assessment of the system elements and their interrelationships is performed, and quantitative analysis of the reliability and maintainability of an engineering system allows its different technical and process failure modes to be identified and their probabilities to be computed. Decision makers can choose technical solutions that maximize an objective function and minimize the probability of failure under resource constraints.

Wiskerchen, Michael J.; Pittman, R. Bruce

1989-01-01

84

A meta-analysis of randomized controlled trials comparing early and late concurrent thoracic radiotherapy with etoposide and cisplatin/carboplatin chemotherapy for limited-disease small-cell lung cancer.  

PubMed

The aim of the present study was to determine the optimal time for concurrent thoracic radiotherapy (TRT) with etoposide and cisplatin/carboplatin (EP/EC) chemotherapy for the treatment of limited-disease small-cell lung cancer (LD SCLC). Randomized controlled trials comparing early and late concurrent TRT with EP/EC chemotherapy for the treatment of patients with LD SCLC were identified through searching databases such as MEDLINE, the Cochrane Central Register of Controlled Trials and Embase. Early thoracic radiotherapy (ERT) was defined as initiating irradiation within 30 days after chemotherapy initiation. A total of 3 eligible randomized controlled trials were identified. No significant differences in the objective response rate were detected between early and late concurrent TRT [risk ratio (RR)=1.01; 95% confidence interval (CI): 0.86-1.18; P=0.90]. Similar results were observed in the 1-, 2-, 3- and 5-year survival rates between early and late concurrent TRT (RR=1.06, 95% CI: 0.88-1.27, P=0.56; RR=1.15, 95% CI: 0.77-1.71, P=0.49; RR=0.90, 95% CI: 0.66-1.22, P=0.49; and RR=1.18, 95% CI: 0.64-2.16, P=0.60, respectively). The total incidence of grade 3-4 adverse events, including anemia, leukopenia, neutropenia, thrombocytopenia, nausea and vomiting, infection, esophageal toxicity, pulmonary toxicity, alopecia and hemorrhage with early concurrent TRT was significantly higher compared to that with late concurrent TRT (RR=1.21, 95% CI: 1.03-1.43, P=0.02). Thus, the results of our study indicated that the prognosis of LD SCLC treated with late concurrent TRT and EP/EC chemotherapy is similar to that with early concurrent TRT, although the incidence of grade 3-4 adverse events was lower in LD SCLC patients treated with late concurrent TRT combined with EP/EC chemotherapy. PMID:25054049

Lu, Hongyang; Fang, Luo; Wang, Xiaojia; Cai, Jufen; Mao, Weimin

2014-09-01

85

Chemotherapy of central nervous system tumours in infants  

Microsoft Academic Search

The development of curative strategies for infants and children with central nervous system tumours or acute lymphoblastic\\u000a leukaemia involve similar clinical research principles. Both areas of paediatric oncology research focus on cancers with a\\u000a broad range of sensitivity to chemotherapy and radiation therapy, together with concerns about the neurodevelopmental, neuroendocrine\\u000a and growth outcomes of survivors. These considerations have influenced the

Stewart J. Kellie

1999-01-01

86

Chemotherapy in newly diagnosed primary central nervous system lymphoma  

PubMed Central

Primary central nervous system lymphoma (PCNSL) accounts for only 3% of brain tumors. It can involve the brain parenchyma, leptomeninges, eyes and the spinal cord. Unlike systemic lymphoma, durable remissions remain uncommon. Although phase III trials in this rare disease are difficult to perform, many phase II trials have attempted to define standards of care. Treatment modalities for patients with newly diagnosed PCNSL include radiation and/or chemotherapy. While the role of radiation therapy for initial management of PCNSL is controversial, clinical trials will attempt to improve the therapeutic index of this modality. Routes of chemotherapy administration include intravenous, intraocular, intraventricular or intra-arterial. Multiple trials have outlined different methotrexate-based chemotherapy regimens and have used local techniques to improve drug delivery. A major challenge in the management of patients with PCNSL remains the delivery of aggressive treatment with preservation of neurocognitive function. Because PCNSL is rare, it is important to perform multicenter clinical trials and to incorporate detailed measurements of long-term toxicities. In this review we focus on different chemotherapeutic approaches for immunocompetent patients with newly diagnosed PCNSL and discuss the role of local drug delivery in addition to systemic therapy. We also address the neurocognitive toxicity of treatment. PMID:21789140

Hashemi-Sadraei, Nooshin; Peereboom, David M.

2010-01-01

87

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

PubMed Central

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

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

2014-01-01

88

Perioperative Systemic Chemotherapy for Appendiceal Mucinous Carcinoma Peritonei Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy  

PubMed Central

Background The role of systemic chemotherapy (SC) in conjunction with cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in appendiceal mucinous carcinoma peritonei (MCP) is unknown. Methods A retrospective review (1999–2011) of MCP patients who had undergone CS/HIPEC with or without perioperative SC. Results Twenty-two low-grade MCP patients treated with CS/HIPEC and SC were matched to patients who received CS/HIPEC alone. Median overall survival (OS) was 107 months for patients treated with perioperative SC compared to 72 without (P = 0.46). CS/HIPEC was performed on 109 patients with high-grade MCP: 70 were treated with perioperative SC, while 39 were not. Median OS (22.1 vs. 19.6 months, P = 0.74) and progression-free survival (PFS) (10.9 vs. 7.0 months, P = 0.47) were similar in patients treated with SC compared to CS/HIPEC alone. Progression while on pre-operative SC was seen in eight patients (17%), while four (8%) had a partial response. Treatment with postoperative SC was associated with longer PFS (13.6 months) compared to pre-operative SC (6.8 months, P < 0.01) and CS/HIPEC alone (7.0 months, P = 0.03). Conclusions Post-operative SC appears to improve PFS in patients with high-grade appendiceal MCP treated with CS/HIPEC. In contrast, there is no evidence to support the routine use of perioperative SC in low-grade disease. PMID:24375188

Blackham, Aaron U.; Swett, Katrina; Eng, Cathy; Sirintrapun, Joseph; Bergman, Simon; Geisinger, Kim R; Votanopoulos, Konstantinos; Stewart, John H.; Shen, Perry; Levine, Edward A.

2014-01-01

89

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

SciTech Connect

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

Chen, Junqiang; Pan, Jianji [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China)] [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Liu, Jian, E-mail: liujianfj@yahoo.com.cn [Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fuzhou (China)] [Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fuzhou (China); Li, Jiancheng [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China)] [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Zhu, Kunshou [Department of Surgery, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China)] [Department of Surgery, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Zheng, Xiongwei [Department of Pathology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China)] [Department of Pathology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Chen, Mingqiang [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China)] [Department of Radiation Oncology, Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou (China); Chen, Ming [School of Graduate, Fujian University of Traditional Chinese Medicine, Fuzhou (China)] [School of Graduate, Fujian University of Traditional Chinese Medicine, Fuzhou (China); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2013-07-15

90

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

SciTech Connect

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.

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

91

Concurrent neoadjuvant chemotherapy is an independent risk factor of stroke, all-cause morbidity, and mortality in patients undergoing brain tumor resection.  

PubMed

Neoadjuvant chemotherapy (NC) may be utilized for treatment of various tumors, and a proportion of patients on active NC may require resection of a primary or secondary brain tumor. The objective of this study is to examine the impact of NC on postoperative neurosurgical outcomes. Elective cranial neurosurgical patient data was obtained from the American College of Surgeons National Surgical Quality Improvement Program database between 2006 and 2012. The impact of NC on 30day stroke, all-cause postoperative morbidity, and mortality were assessed. Adjusted odds ratios (OR) were estimated for stroke, overall morbidity, and mortality using a multivariable logistic regression model, accomplished in stepwise fashion, for patients receiving NC versus those not receiving NC. This study analyzed 3812 patients undergoing elective cranial surgery, with 152 on concurrent NC. NC patients had a complication rate of 23.68%, while patients not receiving NC had a lower complication rate at 17.65% (p=0.057). Multivariable regression analysis revealed that patients who received NC had significantly increased odds of developing a stroke with neurological deficit (OR 3.39; 95% confidence interval [CI] 1.37-8.40) and all-cause postoperative morbidity (OR 1.57; 95% CI 1.04-2.37) over the control group. Finally, the NC cohort demonstrated higher odds of mortality following surgery than their non-NC counterparts (OR 3.81; 95% CI 1.81-8.02). Ninety-two patients (2.41%) died within 30days, of whom 10 (6.58%) were receiving NC versus 82 non-NC (2.24%) patients (p=0.001). Concurrent NC is associated with an increased risk of short-term stroke with neurological deficit, all-cause morbidity, and mortality in patients undergoing brain tumor resection. PMID:25065847

Abt, Nicholas B; Bydon, Mohamad; De la Garza-Ramos, Rafael; McGovern, Kelly; Olivi, Alessandro; Huang, Judy; Bydon, Ali

2014-11-01

92

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

SciTech Connect

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.

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

93

Modular and decentralized supervisory control of concurrent discrete event systems using reduced system models  

Microsoft Academic Search

This paper investigates the supervisor synthesis for concurrent systems based on reduced system models with the intention of complexity reduction. It is assumed that the expected behavior (specification) is given on a subset of the system alphabet, and the system behavior is reduced to this alphabet. Supervisors are computed for each reduced subsystem employing the modular approach in Komenda et

Klaus Schmidt; Herve Marchand; Benoit Gaudin

2006-01-01

94

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

E-print Network

Proving Ptolemy Right: The Environment Abstraction Framework for Model Checking Concurrent Systems software are derived from the "Ptolemaic" perspective of a human engineer who focuses on a single reference. 1 Introduction In many areas of system engineering, distributed concurrent computation has become

Clarke, Edmund M.

95

Concurrency Control in Real-Time Object-Oriented Systems: The Affected Set Priority Ceiling Protocols  

Microsoft Academic Search

This paper presents the Affected Set Priority Ceiling Protocols (ASPCP) for concurrency control in real-time object-oriented systems. These protocols are basedonacombination of semantic locking and priority ceiling techniques. This paper shows that the ASPCP protocols provide higher potential concurrency for object-oriented systems than existing Priority Ceiling protocols, while still bounding priority inversion and preventing deadlock.

Michael Squadrito; Levon Esibov; Lisa Cingiser Dipippo; Victor Fay Wolfe; Gregory Cooper; Bhavani M. Thuraisingham; Peter C. Krupp; Michael Milligan; Russell Johnston

1998-01-01

96

Real time groupware as a distributed system: concurrency control and its effect on the interface  

Microsoft Academic Search

This paper exposes the concurrency control problem in groupware when it is implemented as a distributed system. Traditional concurrency control methods cannot be applied directly to groupware because system interactions include people as well as computers. Methods, such as locking, serialization, and their degree of optimism, are shown to have quite different impacts on the interface and how operations are

Saul Greenberg; David Marwood

1994-01-01

97

Real Time Groupware as a Distributed System: Concurrency Control and its  

E-print Network

Real Time Groupware as a Distributed System: Concurrency Control and its Effect on the Interface Saul Greenberg David Marwood 1993 Cite as: Greenberg, S. and Marwood, D. (1994) "Real time groupware Groupware as a Distributed System: Concurrency Control and its Effect on the Interface Saul Greenberg David

Greenberg, Saul

98

Real Time Groupware as a Distributed System: Concurrency Control and its  

E-print Network

Real Time Groupware as a Distributed System: Concurrency Control and its Effect on the Interface Saul Greenberg David Marwood 1994 Cite as: Greenberg, S. and Marwood, D. (1994) "Real time groupware Groupware as a Distributed System: Concurrency Control and its Effect on the Interface Saul Greenberg

Greenberg, Saul

99

Intratumoral chemotherapy with paclitaxel liposome combined with systemic chemotherapy: a new method of neoadjuvant chemotherapy for stage III unresectable non-small cell lung cancer.  

PubMed

The aim of the study was to evaluate the efficacy and safety of intratumoral chemotherapy with paclitaxel liposome combined with systemic chemotherapy as induction therapy in clinical stage III unresectable non-small cell lung cancer (NSCLC). Between January 2011 and July 2014, 48 patients, stage III, performance status 0-1, with unresectable clinical stage IIIA or IIIB NSCLC suitable for definitive radiation treatment, were included in the study. Patients with T3N1M0 and T4 (ipsilateral lung nodules) N0-1M0 were not included. Patients were given 3 cycles of chemotherapy every 3 weeks. Carboplatin (AUC5 by i.v. on day 1) and gemcitabine (i.v. 1,000 mg/m(2) on days 1 and 8) were administered. Paclitaxel liposome was injected at 1-3 mg/ml concentration into the tumor lesion by computed tomography-guided percutaneous fine-needle intratumoral injection and proven malignant lymph nodes according to pretreatment histological/cytological results by endobronchial ultrasound drug delivery with a needle on day 1 and day 8. Toxicity was assessed on days 8 and 22 in each cycle. Overall response rate (ORR) evaluation was performed at the end of cycle 3. Out of the 48 enrolled patients, 28 were males and 20 females, 19 patients had stage IIIA and 29 stage IIIB NSCLC. Thirty-six partial responses and two complete responses were observed, for an ORR of 81 %. The most frequent G3-G4 toxicity included neutropenia (in 15 % of cases), hypertransaminasemia (6 %), and diarrhea (4 %). A median PFS of 16.5 months (95 % CI 13.7-19.2) and median OS of 23.2 months (95 % CI 20.0-26.3) were observed. Eleven stage IIIA patients underwent surgery, for a resection rate of 58 %. Intratumoral chemotherapy with paclitaxel liposome combined with systemic chemotherapy demonstrated a considerable disease response and resection rate, with acceptable toxicity. PMID:25429832

Lu, Bei; Sun, Lixin; Yan, Xi; Ai, Zhenzhong; Xu, Jinzhi

2015-01-01

100

Role of systemic peri-operative chemotherapy in management of transitional cell carcinoma of bladder  

PubMed Central

Bladder cancer has variable biological behavior pattern in different individuals and the debate regarding peri-operative use of systemic chemotherapy with the surgical management remains. The optimal treatment strategy, regimen and the timing of peri-operative chemotherapy are not yet known. Here we review the existing literature for the use of systemic peri-operative chemotherapy in management of advanced bladder cancer. PMID:21814319

Nayyar, Rishi; Gupta, Narmada P.

2011-01-01

101

Concurrent IMRT and weekly cisplatin followed by GDP chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell lymphoma.  

PubMed

On the basis of the benefits of frontline radiation in early-stage, extranodal natural killer (NK)/T-cell lymphoma (ENKTL), we conducted the trial of concurrent chemoradiotherapy (CCRT) followed by three cycles of gemcitabine, dexamethasone and cisplatin (GDP). Thirty-two patients with newly diagnosed, stage IE to IIE, nasal ENKTL received CCRT (that is, all patients received intensity-modulated radiotherapy 56 Gy and cisplatin 30 mg/m(2) weekly, 3-5 weeks). Three cycles of GDP (gemcitabine 1000 mg/m(2) intravenously (i.v.) on days 1 and 8, dexamethasone 40 mg orally on days 1-4 and cisplatin 75 mg/m(2) i.v. on day 1 (GDP), every 21 days as an outpatient were scheduled after CCRT. All patients completed CCRT, which resulted in 100% response that included 24 complete responses (CRs) and eight partial responses. The CR rate after CCRT was 75.0% (that is, 24 of 32 responses). Twenty-eight of the 32 patients completed the planned three cycles of GDP, whereas four patients did not because they withdrew (n = 1) or because they had an infection (n = 3). The overall response rate and the CR rate were 90.6% (that is, 29 of 32 responses) and 84.4% (that is, 27 of 32 responses), respectively. Only two patient experienced grade 3 toxicity during CCRT (nausea), whereas 13 of the 30 patients experienced grade 4 neutropenia. The estimated 3-year overall survival and progression-free rates were 87.50% and 84.38%, respectively. In conclusion, CCRT followed by GDP chemotherapy can be a feasible and effective treatment strategy for stage IE to IIE nasal ENKTL. PMID:25501024

Ke, Q-H; Zhou, S-Q; Du, W; Liang, G; Lei, Y; Luo, F

2014-01-01

102

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

SciTech Connect

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.

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

103

Nanoscale particulate systems for multidrug delivery: towards improved combination chemotherapy.  

PubMed

While combination chemotherapy has led to measurable improvements in cancer treatment outcomes, its full potential remains to be realized. Nanoscale particles such as liposomes, nanoparticles and polymer micelles have been shown to increase delivery to the tumor site while bypassing many drug resistance mechanisms that limit the effectiveness of conventional therapies. Recent efforts in drug delivery have focused on coordinated, controlled delivery of multiple anticancer agents encapsulated within a single particle system. In this review, we analyze recent progress made in multidrug delivery in three main areas of interest: co-delivery of antineoplastic agents with drug sensitizers, sequential delivery via temporal release particles and simultaneous delivery of multiple agents. Future directions of the field, in light of recent advances with molecularly targeted agents, are suggested and discussed. PMID:24483194

Liboiron, Barry D; Mayer, Lawrence D

2014-02-01

104

An Algebra for the Detection and Prediction of Malicious Activity in Concurrent Systems  

Microsoft Academic Search

The specification, verification, and validation of concurrent systems pose a number of challenges that are increasingly commonplace as multi-core and multi-processor systems are becoming ubiquitous. Any such system, particularly when actively exploiting concurrency, will experience variations up to non-determinism in some aspects of its behavior such as when awaiting I\\/O events or interacting with operation scheduling. We argue that this

Thomas Richard McEvoy; Stephen D. Wolthusen

2010-01-01

105

Formally Verifying Information Flow Type Systems for Concurrent and Thread Systems ?  

E-print Network

1 and Leonor Prensa 2 ?? 1 INRIA Sophia-Antipolis, France Gilles.Barthe@inria.fr 2 LORIA, France of Boudol and Castel- lani [4], which de#12;nes an information ow type system for a concurrent language, we are able to deal with a more general language than the one studied by Boudol and Castel- lani

Parrow, Joachim

106

Concurrent engineering: an expert system for fixture design  

Microsoft Academic Search

Concurrent engineering is based on the organisation of the different stages of the production cycle in order to shorten the time to market. Within this context, fixture design is crucial: the fixture is the major link between the machined part and the machine tool with a strong influence on the part quality, manufacturing delays and costs. Production process difficulties are

E. Caillaudli; D. Noyes; G. Anglerot; P. Padilla

1995-01-01

107

A specification-based approach to concurrent structure verification in multiprocessor systems  

NASA Technical Reports Server (NTRS)

A recently initiated research project concerned with the concurrent detection of software errors and errors due to physical failures in the hardware of multiprocessor systems is described in this paper. An approach to error detection is described, which is specification based and relies on the structural verification of program control flow and data structure integrity. The techniques discussed utilize the hardware redundancy inherent in parallel processing systems to provide verification of both program structure and data concurrently with program execution.

Fuchs, W. Kent

1986-01-01

108

The long term effects of chemotherapy on the central nervous system  

Microsoft Academic Search

Cranial radiotherapy is known to have adverse effects on intelligence. A new study shows that chemotherapy is also toxic to\\u000a the central nervous system, especially to neural progenitor cells and oligodendrocytes. By identifying the cell populations\\u000a at risk, these results may help explain the neurological problems previously seen after chemotherapy.

Patricia K Duffner

2006-01-01

109

A concurrent distributed system for aircraft tactical decision generation  

Microsoft Academic Search

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

John W. McManus

1990-01-01

110

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

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.

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

111

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

SciTech Connect

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

Lee, Nancy Y. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)]. E-mail: leen2@mskcc.org; Arruda, Fernando F. de [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Puri, Dev R. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Wolden, Suzanne L. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Narayana, Ashwatha [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Mechalakos, James [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Venkatraman, Ennapadam S. [Department of Biostatics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Kraus, Dennis [Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shaha, Ashok [Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); 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 Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Zelefsky, Michael J. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2006-11-15

112

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

SciTech Connect

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.

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

113

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

NASA Technical Reports Server (NTRS)

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

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

1993-01-01

114

Comprehensive treatment of malignant mesothelioma patients after the failure of systemic chemotherapy.  

PubMed

Malignant mesothelioma (MM) is an aggressive neoplasm usually arising from the mesothelial surfaces of the pleural or peritoneal cavity. Currently, no standard therapy is available. The most commonly used therapy is cytoreductive surgery combined with systematic chemotherapy, but the median overall survival (OS) is less than 12 months; moreover, treatments are lacking for patients in whom chemotherapy has failed and/or who cannot withstand surgery. We investigated multiple minimally invasive therapies (cryosurgery, photodynamic therapy and intracavity chemotherapy) for the treatment of MM patients in whom systemic chemotherapy had failed. Twenty-seven patients were divided into comprehensive (combination of the three therapies) and palliative (intracavity chemotherapy only) treatment groups. The OS of patients who received comprehensive treatment was significantly longer than that of those who received palliative treatment (median OS: 64 vs. 9 months, P<0.001). This interesting result was not associated with treatment timing, but was closely associated with repeated treatments. PMID:22939880

Chen, Jibing; Liang, Bing; Yuan, Yuanying; Liu, Chunyan; Li, Li; Li, Haibo; Mu, Feng; Zuo, Jiansheng; Xu, Kecheng

2012-12-01

115

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

Microsoft Academic Search

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

Antoni W. Mazurkiewicz; Warszawa Poland

1984-01-01

116

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

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.

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

117

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  

PubMed Central

Purpose CALGB 30105 tested two different concurrent chemoradiotherapy platforms with high dose (74 Gy) 3-D conformal radiotherapy (3DCRT) following two cycles of induction chemotherapy for stage IIIA/IIIB 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 3DCRT was not feasible due to treatment related toxicity. However, induction and concurrent carboplatin/paclitaxel with 74 Gy 3DCRT 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 PTV1, smaller TLV/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 grade 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 3DCRT with concurrent chemotherapy. Further studies may use these metrics in considering patients for these treatments. PMID:21477940

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

2011-01-01

118

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

NASA Technical Reports Server (NTRS)

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

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

2005-01-01

119

Penn researchers repair immune system in leukemia patients following chemotherapy:  

Cancer.gov

A new treatment using leukemia patients’ own infection-fighting cells appears to protect them from infections and cancer recurrence following treatment with fludarabine-based chemotherapy, according to new research from the Perelman School of Medicine at the University of Pennsylvania.

120

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

SciTech Connect

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

Bradley, Jeffrey D., E-mail: jbradley@wustl.ed [Washington University School of Medicine, St. Louis, Missouri (United States); Moughan, Jennifer [RTOG Statistical Headquarters, Philadelphia, Pennsylvania (United States); Graham, Mary V. [Phelps County Medical Center, Rolla, Missouri (United States); Byhardt, Roger [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Govindan, Ramaswamy [Washington University School of Medicine, St. Louis, Missouri (United States); Fowler, Jack [University of Wisconsin, Madison, Wisconsin (United States); Purdy, James A. [University of California at Davis, Davis, California (United States); Michalski, Jeff M. [Washington University School of Medicine, St. Louis, Missouri (United States); Gore, Elizabeth [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Choy, Hak [University of Texas Southwestern, Dallas, Texas (United States)

2010-06-01

121

Phase II Study of Consolidation Chemotherapy after Adjuvant or Primary Concurrent Chemoradiation Using Paclitaxel and Carboplatin to Treat High-Risk Early-Stage or Locally Advanced Cervical Cancer  

PubMed Central

Purpose This study investigated the efficacy and toxicity associated with consolidation chemotherapy using paclitaxel and carboplatin after concurrent chemoradiation (CCR) in cervical cancer patients. Materials and Methods From a total of 37 patients, 19 with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer (group 1) underwent surgery followed by consolidation chemotherapy after CCR, and 18 with stage IIB-IVA disease (group 2) received consolidation chemotherapy after primary CCR. Three cycles of chemotherapy using paclitaxel (135 mg/m2) and carboplatin (AUC 5.0) were administered every 3 weeks for CCR therapy, and three cycles of consolidation chemotherapy using paclitaxel (175 mg/m2) and carboplatin (AUC 5.0) were used every 3 weeks after CCR. Results The complete and partial response rates were 77.8% and 22.2% in group 2. Moreover, the 3-year progression-free and overall survival rates were 62.7% and 90.9% in group 1, and 51.9% and 60% in group 2, respectively. The most common grade 3 or 4 hematologic toxicities observed were leukopenia (group 1, 10.5%; group 2, 13.0%) and neutropenia (group 1, 7.0%; group 2, 14.8%), and grade 3 or 4 diarrhea (group 1, 1.8%) and febrile illness (group 2, 1.9%) were the most frequently observed non-hematologic toxicities. When we compared these results with previous reports, consolidation chemotherapy after CCR using paclitaxel and carboplatin revealed a relatively lower complete response rate (77.8% vs. 87-100%, respectively) and shorter progression-free survival (51.9-62.7% vs. 81-86%, respectively) and overall survival (60-90.9% vs. 81-95%, respectively) in spite of similar toxicity findings. Conclusion Due to low efficacy results, consolidation chemotherapy using paclitaxel and carboplatin after CCR is not a feasible treatment regimen for high-risk early-stage or locally advanced cervical cancer. PMID:22802747

Kim, Hee Seung; Kim, Mi-Kyung; Kim, Hak Jae; Han, Seung-Su

2012-01-01

122

Systemic Chemotherapy for Metastatic Tumors of the Central Nervous System  

Microsoft Academic Search

The incidence of brain metastases exceeds 100,000 per year in the United States (21), thus making tumor metastasis to the central nervous system (CNS) a significant challenge in the management of patients\\u000a with solid tumors. To put this into perspective, brain metastases occur at almost one order of magnitude greater than primary\\u000a malignant brain tumors. Metastatic tumors to the brain

Charles A. Conrad; W. K. Alfred Yung

123

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

Microsoft Academic Search

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

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

2001-01-01

124

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

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

2013-01-01

125

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

Microsoft Academic Search

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

Jinfeng Huang; Jeroen Voeten; Marc Geilen

126

MODULAR SUPERVISORY CONTROL OF A CLASS OF CONCURRENT DISCRETE EVENT SYSTEMS  

Microsoft Academic Search

In this paper, we are interested in the control of a particular class of Concurrent Discrete Event Systems defined by a collection of components that interact with each other. We investigate the computation of the supremal controllable language contained in the one of the specification. We do not adopt the decentralized approach. Instead, we have chosen to perform the control

B. Gaudin; H. Marchand

2004-01-01

127

Concurrent Testing of Droplet-Based Microfluidic Systems for Multiplexed Biomedical Assays*  

E-print Network

structure. The feasibility of performing real-time biomedical assays, e.g., the colorimetric enzymeConcurrent Testing of Droplet-Based Microfluidic Systems for Multiplexed Biomedical Assays* Fei Su-based microfluidic array that was fabricated and used to perform multiplexed glucose and lactate assays. The test

Chakrabarty, Krishnendu

128

Certifying the Concurrent State Table Implementation in a Surgical Robotic System (Extended Version)  

E-print Network

Certifying the Concurrent State Table Implementation in a Surgical Robotic System (Extended Version developed program logic (HLRG) to help reduce defects in the Surgical Assistant Workstation (SAW. The target of our analysis is a software framework called the Surgical Assistant Workstation (SAW), created

129

Multimodality Treatment Including Postoperative Radiation and Concurrent Chemotherapy with Weekly Docetaxel is Feasible and Effective in Patients with Oral and Oropharyngeal Cancer  

Microsoft Academic Search

Background: To examine the feasibility and efficacy of weekly docetaxel with concurrent radiation as postoperative treatment in a multimodality approach to oral and oropharyngeal cancer. Patients and Methods: 94 patients (Table 1) with primary resectable squamous cell carcinoma of the oral cavity and oropharynx (UICC stage I 14%, II 15%, III 18%, IV 53%; Table 2) were treated with a

Adorján F. Kovács; Stephan Mose; Heinz D. Böttcher; Klaus Bitter

2005-01-01

130

[Selective intraarterial infusion chemotherapy using a combined MRI-angiography system for head and neck cancers].  

PubMed

We performed selective intraarterial infusion chemotherapy using a combined MRI-angiography system for head and neck cancers. In three patients, three or five infusions of CDDP (100 mg/body) were administered to the feeding arteries selectively. For the evaluation of drug distribution, MRI during arteriography through the infusion pump was performed before CDDP administration. When a distribution mismatch was found, arterial selection was attempted again under a mechanically unstable C-arm system, and further evaluation under an MR system was carried out. Thus, more ideal treatment could be provided. We consider MRI during arteriography to be useful in assessing for distribution during intraarterial chemotherapy. PMID:11857953

Mori, Harushi; Hayashi, Naoto; Aoki, Shigeki; Masumoto, Tomohiko; Yoshikawa, Takeharu; Abe, Osamu; Ohtomo, Kuni; Yuge, Tadashi; Kaga, Kimitaka

2002-01-01

131

Multicenter retrospective analysis of systemic chemotherapy for advanced neuroendocrine carcinoma of the digestive system.  

PubMed

This study analyzed outcomes of systemic chemotherapy for advanced neuroendocrine carcinoma (NEC) of the digestive system. Clinical data from 258 patients with unresectable or recurrent NEC of the gastrointestinal tract (GI) or hepato-biliary-pancreatic system (HBP), who received chemotherapy, were collected from 23 Japanese institutions and analyzed retrospectively. Patients had primary sites in the esophagus (n = 85), stomach (n = 70), small bowel (n = 6), colorectum (n = 31), hepato-biliary system (n = 31) and pancreas (n = 31). Median overall survival (OS) was 13.4 months the esophagus, 13.3 months for the stomach, 29.7 months for the small bowel, 7.6 months for the colorectum, 7.9 months for the hepato-biliary system and 8.5 months for the pancreas. Irinotecan plus cisplatin (IP) and etoposide plus cisplatin (EP) were most commonly selected for GI-NEC and HBP-NEC. For patients treated with IP/EP (n = 160/46), the response rate was 50/28% and median OS was 13.0/7.3 months. Multivariate analysis among patients treated with IP or EP showed that the primary site (GI vs HBP; hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.35-0.97) and baseline serum lactate dehydrogenase levels (not elevated vs elevated; HR 0.65, 95% CI 0.46-0.94) were independent prognostic factors for OS, while the efficacy of IP was slightly better than for EP (HR 0.80, 95% CI 0.48-1.33; P = 0.389). IP and EP are the most common treatment regimens for NEC of the digestive system. HBP primary sites and elevated lactate dehydrogenase levels are unfavorable prognostic factors for survival. A randomized controlled trial is required to establish the appropriate chemotherapy regimen for advanced NEC of the digestive system. This study was registered at UMIN as trial number 000005176. PMID:24975505

Yamaguchi, Tomohiro; Machida, Nozomu; Morizane, Chigusa; Kasuga, Akiyoshi; Takahashi, Hideaki; Sudo, Kentaro; Nishina, Tomohiro; Tobimatsu, Kazutoshi; Ishido, Kenji; Furuse, Junji; Boku, Narikazu; Okusaka, Takuji

2014-09-01

132

Intraarterial chemotherapy for head and neck cancer, Part 1: Theoretical considerations and drug delivery systems.  

PubMed

The principal objective of regional chemotherapy is tumor cell kill. The rationale for regional delivery is based on the steep dose/response curve exhibited by most antineoplastic agents. Intraarterial (IA) chemotherapy has the potential advantage of increased drug concentration at the tumor site, decreased systemic drug levels, and continuous tumor cell exposure to an antineoplastic agent. Despite these advantages, the use of IA chemotherapy has not been universally accepted. This is in part due to the difficulties associated with establishing and maintaining arterial access. Considerable improvement in the techniques and efficacy of regional therapy for head and neck cancer will be necessary before there is widespread clinical acceptance. These improvements must be based on anatomic and pharmacologic factors that ensure success of regional therapy. In addition, the development of safe, reliable delivery systems will be necessary. Part 1 of this two-part article will review these factors and discuss delivery systems. PMID:6358134

Baker, S R; Wheeler, R

1983-01-01

133

Concurrency Theory Alban Ponse  

E-print Network

University of Amsterdam http://www.science.uva.nl/~alban/ 2013 - 2014 Alban Ponse (TCS, UvA) Concurrency, UvA) Concurrency Theory - Lecture 6 2013 - 2014 2 / 22 #12;Motivation1 Virtually all designed systems of serious - yet to be uncovered - bugs. Alban Ponse (TCS, UvA) Concurrency Theory - Lecture 6 2013 - 2014 3

Ponse, Alban

134

A concurrent system for the computation of higher-order moments  

Microsoft Academic Search

The cumulants defined in terms of moments are basic to the study of higher-order statistics (HOS) of a stationary stochastic process. This paper presents a concurrent systolic array system for the computation of higher-order moments. The system allows for the simultaneous computation of the second-, third-, and fourth-order moments. The architecture achieves good speedup through its excellent exploitation of parallelism,

Mohammad A. Al-Turaigi; Rana Ejaz Ahmed; Saleh A. Alshebeili

1999-01-01

135

Concurrent validity of a trunk tri-axial accelerometer system for gait analysis in older adults  

Microsoft Academic Search

The aim of this study was (1) to determine the concurrent validity of a trunk tri-axial accelerometer system (DynaPort®MiniMod) with the GAITRite® system for spatio-temporal gait parameters at preferred, slow and fast self-selected walking speed that were recorded for averaged and individual step data in an older adult population and (2) to compare the levels of agreement for averaged step

Antonia Hartmann; Susanna Luzi; Kurt Murer; Rob A. de Bie; Eling D. de Bruin

2009-01-01

136

Cactis: a self-adaptive, concurrent implementation of an object-oriented database management system  

Microsoft Academic Search

Cactis is an object-oriented, multiuser DBMS developed at the University of Colorado. The system supports functionally-defined data and uses techniques based on attributed graphs to optimize the maintenance of functionally-defined data. The implementation is self-adaptive in that the physical organization and the update algorithms dynamically change in order to reduce disk access. The system is also concurrent. At any given

Scott E. Hudson; Roger King

1989-01-01

137

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

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.

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

138

Partial response after transcatheter arterial infusion chemotherapy in a patient with systemic chemotherapy-resistant unresectable colon cancer and hepatic metastasis: (case report).  

PubMed

We report here a case of partial response to hepatic arterial infusion chemotherapy in a patient who developed serious hepatic failure due to unresectable colorectal cancer and hepatic metastasis and showed resistance to systemic chemotherapy with molecular targeted drugs, mFOLFOX6, and FOLFIRI. The patient was a 60-year-old woman who underwent sigmoidectomy for sigmoid colon cancer, lateral posterior hepatic segmentectomy for metastatic liver cancer, and postoperative radiation therapy for metastatic lung cancer. As first-line systemic chemotherapy, mFOLFOX6 (oxaliplatin, 5-fluorouracil, and leucovorin), bevacizumab?+?FOLFIRI (irinotecan, 5-fluorouracil, leucovorin), and anti-epidermal growth factor receptor antibody ?+ irinotecan were administered, in that order. However, recurrent hepatic metastasis was exacerbated, which induced serious hepatic failure manifested by general malaise, jaundice, abnormal hepatic function, difficulty in walking due to bilateral lower extremity edema, and decreased appetite. The patient was admitted in a serious condition. After hospitalization, the patient received hepatic arterial infusion chemotherapy with 5-fluorouracil and l-leucovorin. After two complete courses, the symptoms improved. The patient's performance status also improved, and she was discharged from the hospital. Four months after discharge, the patient had continued outpatient chemotherapy and maintained excellent performance status. Although HAIC is not presently considered an alternative to systemic chemotherapy, it is sometimes effective in patients who show resistance to molecular targeted drug therapy, FOLFOX, and FOLFIRI, and in whom hepatic metastasis is a key factor in determining prognosis and serious hepatic failure. Further studies should be performed in the future to verify these findings. PMID:23957924

Sawai, Katsuji; Goi, Takanori; Koneri, Kenji; Katayama, Kanji; Yamaguchi, Akio

2013-01-01

139

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

NASA Technical Reports Server (NTRS)

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

Mcmanus, John William

1992-01-01

140

Circulating tumour cells as a predictive factor for response to systemic chemotherapy in patients with advanced colorectal cancer.  

PubMed

Circulating tumour cells (CTC) can be traced in patients with different types of cancer. The aim of this study was to detect CTC in patients with advanced colorectal cancer and whether CTC are still detectable after systemic chemotherapy. Blood from 34 patients with advanced colorectal cancer was analysed for the presence of CTC before chemotherapy was given and after 3 months. Eleven patients demonstrated a tumour remission after chemotherapy. In 6 cases CTC were detectable before but not after initiation of chemotherapy. Ten patients demonstrated a progression. In 5 cases CTC were detected before and after chemotherapy. Our data suggest that the detection of CTC will help to identify patients responding to chemotherapy or with a risk of a therapy failure. PMID:19383356

Lankiewicz, Silke; Zimmermann, Silke; Hollmann, Christiane; Hillemann, Tina; Greten, Tim F

2008-12-01

141

Sequential versus concurrent computation of complex model systems for medical decision support.  

PubMed

Medical Decision Support Systems employ mathematical models to optimize therapy settings. The mathematical models are used to predict patient reactions towards alteration in the therapy regime. This prediction should not be limited to one detail but should feature a broad picture. A previously proposed framework is able to dynamically combine submodels of three model families (respiratory mechanics, gas exchange and cardiovascular dynamics) to form a complex, interacting model system. When concurrent computation of the combined submodels is employed, tests exhibited high computing costs. Therefore, a sequential computing approach is introduced. Thereby, direct interaction between the submodels is not applicable as all submodels are computed individually. To simulate submodel interaction, interface signals that are normally present in the concurrent approach were precalculated using reduced models of respiratory mechanics and cardiovascular dynamics. Evaluation of the new approach showed that results feature a discrepancy lower than 2.5% compared to the results computed by the concurrent approach. Simulation error could be decreased to 2% by improving the precalculation of the interface signals. Computing costs have been decreased by a factor of 17. PMID:22254268

Kretschmer, Joern; Moeller, Knut

2011-01-01

142

Concurrent Circuit-Level/System-Level Optimization of a 24 GHz Mixer for Automotive Applications Using a Hybrid  

E-print Network

, mixer, hybrid/concurrent optimization, statistical tools, electromagnetic design. I. INTRODUCTIONConcurrent Circuit-Level/System-Level Optimization of a 24 GHz Mixer for Automotive Applications Using a Hybrid Electromagnetic/Statistical Technique Francesco Placentino', Daniela Staiculescu2, Symeon

Tentzeris, Manos

143

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

NASA Technical Reports Server (NTRS)

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.

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

2012-01-01

144

Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review.  

PubMed

With the recent advances in chemotherapy for colorectal cancer, the prognosis for patients with metastatic colorectal cancer has been significantly improved. The development of the implantable port system has also enabled patients to receive multiagent chemotherapy with a more satisfactory quality of life. Historically, chemotherapy using implantable port systems was begun to obtain an oncological benefit in the treatment of locoregional cancer. In the 1950s, there was an increasing interest in perfusion techniques for the application of chemotherapeutic agents, such as nitrogen mustard, in the locoregional treatment of metastatic cancer. Among them, the treatment of liver metastasis has interested oncologists for many years. On the other hand, implantable devices were developed during the intervening decades that have enabled patients with colorectal cancer with liver metastases to be treated effectively using hepatic arterial infusion; which became more common in the 1980s. The treatment of metastatic colorectal cancer increasingly requires a multimodal approach and multiple treatment options based not on convenience, but in terms of personalization and efficacy. Therefore, it is important to optimize the pharmacokinetics of chemotherapeutic agents. Implantable port systems for colorectal cancer patients have been essential for oncological practice, and the importance of these systems will remain unchanged in the near future. PMID:23893159

Inoue, Yasuhiro; Kusunoki, Masato

2014-08-01

145

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

E-print Network

Proposal for direct measurement of concurrence via visibility in a cavity QED system Sang Min Lee,1 Se-Wan Ji,1 Hai-Woong Lee,1 and M. Suhail Zubairy2,3 1Department of Physics, Korea Advanced Institute of Science and Technology, Daejeon 305...-701, Korea 2Department of Physics and Institute for Quantum Studies, Texas A&M University, College Station, Texas 77843-4242, USA 3Texas A&M University at Qatar, Education City, P.O. Box 23874, Doha, Qatar #1;Received 24 January 2008; published 22 April...

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

2008-01-01

146

Phase II Study of Accelerated High-Dose Radiation Therapy with Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: RTOG 0239  

PubMed Central

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 U.S. 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/m2 IV) was given on day 1 and etoposide (120 mg/m2 IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin+etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (CTC v 2.0) and treatment-related fatalities; response (RECIST); and local control. Results Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, overall survival rate was 36.6% (95% 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 (RTOG 0538/CALGB 30610). PMID:22560543

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

2012-01-01

147

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

SciTech Connect

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.

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

148

Concurrent comparability of automated systems and commercially prepared microdilution trays for susceptibility testing.  

PubMed Central

Susceptibility test results from 100 clinical isolates, using the AMS, MS-2, Autobac MTS, Micro-Media system, and Sensititre, were compared with results from the proposed National Committee for Clinical Laboratory Standards reference microdilution method for minimum inhibitory concentrations and with Bauer-Kirby results. Isolates were tested concurrently by each method on consecutive days to obtain duplicate results. The data were computer analyzed, using National Committee for Clinical Laboratory Standards guidelines for break point interpretation. Analysis was centered on drug-organism combinations and not on overall percent correlation. Data were analyzed for comparability to the reference methods and for reproducibility within each system. Commercial system results were very reproducible. Results from 4- to 8-h tests (AMS, MS-2, MTS) gave more very major discrepancies when compared with either reference method than did results from 15- to 18-h systems (Micro-Media, Sensititre). PMID:6863508

Hansen, S L; Freedy, P K

1983-01-01

149

Methods for design and evaluation of integrated hardware/software systems for concurrent computation  

NASA Technical Reports Server (NTRS)

Two testbed programming environments to support the evaluation of a large range of parallel architectures have been implemented under the program Parallel Implementation of Scientific Computing Environments (PISCES). The PISCES 1 environment was applied to two areas of aerospace interest: a sparse matrix iterative equation solver and a dynamic scene analysis system. Currently, the NICE/SPAR testbed system for structural analysis is being modified for parallel operation under PISCES 2; the PISCES 1 applications are also being adapted for PISCES 2. A new formal model of concurrent computation has been developed, based on the mathematical system known as H graph semantics together with a timed Petri net model of the parallel aspects of a system.

Pratt, Terrence W.

1987-01-01

150

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

SciTech Connect

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

Huang, Eng-Yen [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taiwan (China); Hsu, Hsuan-Chih [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); School of Medicine, Chang Gung University College of Medicine, Taiwan (China); Sun, Li-Min [Department of Radiation Oncology, Zuoying Armed Forces General Hospital, Kaohsiung City, Taiwan (China); Chanchien, Chan-Chao [School of Medicine, Chang Gung University College of Medicine, Taiwan (China); Department of Gynecologic Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); Lin, Hao [Department of Gynecologic Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); Chen, Hui-Chun [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); Tseng, Chih-Wen; Ou, Yu-Che; Chang, Hung-Yao [Department of Gynecologic Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); Fang, Fu-Min [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taiwan (China); Huang, Yu-Jie; Wang, Chang-Yu [Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); Lu, Hsien-Ming; Tsai, Ching-Chou [Department of Gynecologic Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan (China); and others

2011-11-15

151

[Three cases of liver metastasis of colon cancer responding to systemic combination chemotherapy utilizing CPT-11].  

PubMed

Though the first choice of treatment for liver metastasis in colon cancer is surgical resection of liver, 30-60% of such patients experience a recurrence of liver metastasis. Even if reoperation is done optimally, the surgical resection of liver metastasis may not be a definitely curative treatment. For cases of liver metastasis from colon cancer that are non-resectable due to multiple liver metastases, other organ metastases (lung, bone, brain etc.), the advanced age of the patient, or other complications (cerebrovascular disease, diabetes mellitus, heart disease etc.), hepatic arterial infusion or systemic combination chemotherapies are selected. In the present paper, we report 3 cases of effective systemic chemotherapy utilizing CPT-11 for liver metastases from colon cancers. The method was UFT + irinotecan (CPT-11), cisplatin (CDDP) + tegafur + CPT-11, UFT + CPT-11 + etoposide (ETP) + pirarubicin (THP). The result obtained was a partial response (PR) in each case. As there were few adverse effects, we could provide treatment during a short-term admission or an outpatient basis. We thus obtained good post-chemotherapeutic QOL, and these regimens may be effective forms of chemotherapies in the future. PMID:11142172

Kobayashi, A; Yamaguchi, M

2000-12-01

152

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

NASA Technical Reports Server (NTRS)

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

Yan, Jerry C.

1987-01-01

153

Concurrent Chemoradiation for Vaginal Cancer  

PubMed Central

Background It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT) or concurrent chemoradiation therapy (CRT). Methods Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS) and disease-free survival (DFS) rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. Results The median age at diagnosis was 61 years (range, 18–92 years) and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS?=?56% vs. 79%, log-rank p?=?0.037; 3-yr DFS?=?43% vs. 73%, log-rank p?=?0.011). Twenty-three patients (45%) in the RT group had a relapse at any site compared to 3 (15%) in the CRT group (p?=?0.027). With regard to the sites of first relapse, 10 patients (14%) had local only, 4 (6%) had local and regional, 9 (13%) had regional only, 1 (1%) had regional and distant, and 2 (3%) had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10–0.97; p?=?0.04)). Conclusions Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients. PMID:23762284

Miyamoto, David T.; Viswanathan, Akila N.

2013-01-01

154

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

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.

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

155

Tumor blood flow and systemic shunting in patients receiving intraarterial chemotherapy for head and neck cancer.  

PubMed

Radionuclide techniques have been used to estimate the systemic shunt and to quantitate blood flow to the tumor and a reference normal tissue in nine patients undergoing intraarterial chemotherapy for head and neck cancer. The systemic shunt was calculated as the percentage of pulmonary trapping of intraarterially injected 99mTc-labeled macroaggregated albumin. The mean systemic shunt in the 12 separate arteries studied was 23 +/- 13% (SE) (range 8-43%). Quantitative blood flow was determined from the slope of the washout curve of intraarterially injected 133Xe. The mean tumor blood flow was 13.6 +/- 6.7 ml/100 g/min, while the mean blood flow to the scalp was 4.2 +/- 2.1 ml/100 g/min providing a mean tumor/normal tissue ratio of 3.9 +/- 2.7. An estimate of blood flow distribution was obtained by calculating the ratio of counts/pixel in the tumor mass versus the remainder of the head as determined by single photon emission computed tomography following an intraarterial injection of 99mTc-labeled macroaggregated albumin. The mean ratio of tumor to normal tissue perfusion by this technique was 5.6 +/- 3.7. These techniques have allowed noninvasive determination of the blood flow parameters associated with intraarterial chemotherapy. At least part of the therapeutic advantage of regional chemotherapy in patients with head and neck cancer is due to a tumor/normal tissue blood flow ratio that favors drug delivery to the tumor contained within the infused volume. PMID:3488122

Wheeler, R H; Ziessman, H A; Medvec, B R; Juni, J E; Thrall, J H; Keyes, J W; Pitt, S R; Baker, S R

1986-08-01

156

Stabilization of a Percutaneously Implanted Port Catheter System for Hepatic Artery Chemotherapy Infusion  

SciTech Connect

A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

Shindoh, Noboru; Ozaki, Yutaka; Kyogoku, Shinsuke [Department of Radiology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021 (Japan); Yamana, Daigo [Department of Diagnostic Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470 (Japan); Sumi, Yukiharu; Katayama, Hitoshi [Department of Radiology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021 (Japan)

1999-07-15

157

Knowledge-Based Automation of a Design Method for Concurrent Systems  

E-print Network

to represent a design metamodel based on a design method, called COncurrent Design Approach for Real-Time designs for four real-time problems. The paper reports the degree of automation achieved by CODAÐAutomated software engineering, knowledge-based software engineering, software design, concurrent and real-time

158

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

159

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

­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

California at Berkeley, University of

160

Algorithms incorporating concurrency and caching  

E-print Network

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 ...

Fineman, Jeremy T

2009-01-01

161

A concurrent diagnosis of microbiological food safety output and food safety management system performance: Cases from meat processing industries  

Microsoft Academic Search

Stakeholder requirements force companies to analyse their food safety management system (FSMS) performance to improve food safety. Performance is commonly analysed by checking compliance against preset requirements via audits\\/inspections, or actual food safety (FS) output is analysed by microbiological testing. This paper discusses the usefulness of a concurrent diagnosis of FSMS performance and FS output using new tools; illustrated for

P. A. Luning; L. Jacxsens; J. Rovira; S. M. Osés; M. Uyttendaele; W. J. Marcelis

2011-01-01

162

Cancer Chemotherapy  

MedlinePLUS

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

163

Rhabdomyosarcoma: Chemotherapy  

MedlinePLUS

... Next Topic Radiation therapy for rhabdomyosarcoma Chemotherapy for rhabdomyosarcoma All patients with rhabdomyosarcoma (RMS) will get chemotherapy ... the remaining tumor completely. Drugs used to treat rhabdomyosarcoma A combination of chemo drugs is used to ...

164

Systemic toxoplasmosis and concurrent porcine circovirus-2 infection in a pig.  

PubMed

Systemic toxoplasmosis and concurrent infection with porcine circovirus-2 (PCV-2) was diagnosed in a fattening pig. Clinical examination of the herd showed that up to 30% of the pigs of this weight group suffered from severe respiratory signs including sneezing and coughing, with a mortality rate of up to 5%. Gross necropsy examination revealed severe interstitial pneumonia and generalized lymphadenopathy. On microscopical examination there was necrotizing inflammation of the lung, adrenal glands and lymph nodes, associated with lymphoid depletion, cytoplasmic basophilic botryoid inclusion bodies and protozoal microorganisms. Infection with Toxoplasma gondii was confirmed by immunohistochemistry (IHC). Polymerase chain reaction analysis, in-situ hybridization and IHC confirmed systemic PCV-2 infection. These findings, associated with the respiratory signs and lesions in lymphoid tissues, are characteristic for post-weaning multisystemic wasting syndrome (PMWS). In this case, immunosuppression by PCV-2 may have triggered systemic toxoplasmosis, or immune stimulation caused by coinfection with T. gondii may have caused extensive replication of PCV-2. PMID:19740479

Klein, S; Wendt, M; Baumgärtner, W; Wohlsein, P

2010-01-01

165

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

Microsoft Academic Search

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

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

166

Chemotherapy prescribing errors: an observational study on the role of information technology and computerized physician order entry systems  

PubMed Central

Background Chemotherapy administration is a high-risk process. Aim of this study was to evaluate the frequency, type, preventability, as well as potential and actual severity of outpatient chemotherapy prescribing errors in an Oncology Department where electronic prescribing is used. Methods Up to three electronic prescriptions per patient record were selected from the clinical records of consecutive patients who received cytotoxic chemotherapy between January 2007 and December 2008. Wrong prescriptions were classified as incomplete, incorrect or inappropriate. Error preventability was classified using a four-point scale. Severity was defined according to the Healthcare Failure Mode and Effect Analysis Severity Scale. Results Eight hundred and thirty-five prescriptions were eligible. The overall error rate was 20%. Excluding systematic errors (i.e. errors due to an initially faulty implementation of chemotherapy protocols into computerized dictionaries) from the analysis, the error rate decreased to 8%. Incomplete prescriptions were the majority. Most errors were deemed definitely preventable. According to error presumptive potential for damage, 72% were classified as minor; only 3% had the potential to produce major or catastrophic injury. Sixty-eight percent were classified as near misses; adverse drug events had no or little effect on clinical outcome. Conclusions Chemotherapy prescribing errors may arise even using electronic prescribing. Although periodic audits may be useful to detect common errors and guide corrective actions, it is crucial to get the computerized physician order entry system and set-ups correct before implementation. PMID:24344973

2013-01-01

167

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

NASA Technical Reports Server (NTRS)

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

Udomkesmalee, Suraphol

1991-01-01

168

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

NASA Astrophysics Data System (ADS)

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.

Häner, R.; Wächter, J.

2012-04-01

169

Prognosis of patients with primary central nervous system lymphoma after high-dose chemotherapy followed by autologous stem cell transplantation  

PubMed Central

High-dose chemotherapy followed by autologous stem cell transplantation has been shown to be feasible and highly effective in newly diagnosed primary central nervous system lymphoma. In this retrospective multicenter study, we investigated prognosis and baseline risk factors in patients with primary central nervous system lymphoma who underwent this treatment approach. We retrospectively analyzed 105 immunocompetent patients with primary central nervous system lymphoma who underwent high-dose chemotherapy followed by autologous stem cell transplantation with or without whole brain radiotherapy as first-line consolidation treated at 12 German centers between 1997 and 2011. We estimated survival rates and investigated the impact of age, performance status, serum lactate dehydrogenase level, and deep brain involvement on overall and progression-free survival. Patients were additionally categorized into three prognostic groups according to the Memorial Sloan Kettering Cancer Center prognostic model. After a median follow up of 47 months, median progression-free survival and overall survival was reached after 85 and 121 months; 2- and 5-year survival rates were 82% and 79%, respectively. The Memorial Sloan Kettering Cancer Center prognostic model did not predict survival. Only age revealed some evidence of prognostic relevance. Overall response rate was 95%; of those patients with progressive disease before high-dose chemotherapy, 7 of 20 achieved ongoing complete remission after therapy without whole brain radiation therapy. Transplantation-associated mortality was 2.8%. High-dose chemotherapy followed by autologous stem cell transplantation is a highly effective and safe treatment modality for selected primary central nervous system lymphoma patients. Superiority compared to standard chemotherapy still warrants further investigation. PMID:23300179

Schorb, Elisabeth; Kasenda, Benjamin; Atta, Johannes; Kaun, Stephan; Morgner, Anke; Hess, Georg; Elter, Thomas; von Bubnoff, Nikolas; Dreyling, Martin; Ringhoffer, Mark; Krause, Stefan W.; Derigs, Günter; Klimm, Beate; Niemann, D.; Fritsch, Kristina; Finke, Jürgen; Illerhaus, Gerald

2013-01-01

170

Prognosis of patients with primary central nervous system lymphoma after high-dose chemotherapy followed by autologous stem cell transplantation.  

PubMed

High-dose chemotherapy followed by autologous stem cell transplantation has been shown to be feasible and highly effective in newly diagnosed primary central nervous system lymphoma. In this retrospective multicenter study, we investigated prognosis and baseline risk factors in patients with primary central nervous system lymphoma who underwent this treatment approach. We retrospectively analyzed 105 immunocompetent patients with primary central nervous system lymphoma who underwent high-dose chemotherapy followed by autologous stem cell transplantation with or without whole brain radiotherapy as first-line consolidation treated at 12 German centers between 1997 and 2011. We estimated survival rates and investigated the impact of age, performance status, serum lactate dehydrogenase level, and deep brain involvement on overall and progression-free survival. Patients were additionally categorized into three prognostic groups according to the Memorial Sloan Kettering Cancer Center prognostic model. After a median follow up of 47 months, median progression-free survival and overall survival was reached after 85 and 121 months; 2- and 5-year survival rates were 82% and 79%, respectively. The Memorial Sloan Kettering Cancer Center prognostic model did not predict survival. Only age revealed some evidence of prognostic relevance. Overall response rate was 95%; of those patients with progressive disease before high-dose chemotherapy, 7 of 20 achieved ongoing complete remission after therapy without whole brain radiation therapy. Transplantation-associated mortality was 2.8%. High-dose chemotherapy followed by autologous stem cell transplantation is a highly effective and safe treatment modality for selected primary central nervous system lymphoma patients. Superiority compared to standard chemotherapy still warrants further investigation. PMID:23300179

Schorb, Elisabeth; Kasenda, Benjamin; Atta, Johannes; Kaun, Stephan; Morgner, Anke; Hess, Georg; Elter, Thomas; von Bubnoff, Nikolas; Dreyling, Martin; Ringhoffer, Mark; Krause, Stefan W; Derigs, Günter; Klimm, Beate; Niemann, D; Fritsch, Kristina; Finke, Jürgen; Illerhaus, Gerald

2013-05-01

171

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

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.

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

172

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer  

PubMed Central

Venous thromboembolism (VTE) following breast cancer chemotherapy is common. Chemotherapy-induced alterations in markers of haemostasis occur during chemotherapy. It is unclear how rapidly this occurs, whether this is upregulated in patients developing VTE and whether changes predict for VTE. Markers of haemostasis, functional clotting assays and vascular endothelial growth factor were measured before chemotherapy and at 24?h, 4 days, 8 days and 3 months following commencement of chemotherapy in early and advanced breast cancer patients and in age- and sex-matched controls. Duplex ultrasound imaging was performed after 1 month or if symptomatic. Of 123 patients, 9.8% developed VTE within 3 months. Activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer, fibrinogen, platelet count, VEGF and fibrinogen were increased in cancer. Fibrinogen, D-dimer, VEGF and tissue factor were increased, at baseline, in patients subsequently developing VTE. D-dimer of less than 500?ng?ml?1 has a negative predictive value of 97%. Activated partial thromboplastin time, PT and thrombin–antithrombin showed significantly different trends, as early as within 24?h, in response to chemotherapy in patients subsequently developing VTE. Markers of coagulation and procoagulants are increased, before chemotherapy, in patients who subsequently develop VTE. A group of patients at minimal risk of VTE can be identified, allowing targeted thrombopropylaxis to the higher risk group. PMID:18766191

Kirwan, C C; McDowell, G; McCollum, C N; Kumar, S; Byrne, G J

2008-01-01

173

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

Microsoft Academic Search

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

Edmund M. Clarke; Muralidhar Talupur; Helmut Veith

2008-01-01

174

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

E-print Network

are data structures that are designed to provide the flexibility and usability of the popular ISO C++ STL containers, while at the same time they are hand-crafted to guarantee domain-specific policies, such as conformance to a given concurrency model...

Dechev, Damian

2010-07-14

175

Methods for design and evaluation of integrated hardware-software systems for concurrent computation  

NASA Technical Reports Server (NTRS)

Research activities and publications are briefly summarized. The major tasks reviewed are: (1) VAX implementation of the PISCES parallel programming environment; (2) Apollo workstation network implementation of the PISCES environment; (3) FLEX implementation of the PISCES environment; (4) sparse matrix iterative solver in PSICES Fortran; (5) image processing application of PISCES; and (6) a formal model of concurrent computation being developed.

Pratt, T. W.

1985-01-01

176

Complications Encountered with a Transfemorally Placed Port-Catheter System for Hepatic Artery Chemotherapy Infusion  

SciTech Connect

A port-catheter system was implanted via femoral artery access for hepatic artery chemotherapy infusion. Implantation was attempted in 90 patients and was successful in 88. Blood flow redistribution was performed using embolization coils. In the first ten patients a soft heparin-coated infusion catheter was used. For the following 78 patients we used a stiffer catheter coated with fluorine-acryl-styrene-urethane-silicone (FASUS) copolymer. The catheter was connected to a port implanted subcutaneously below the level of the inguinal ligament. Complications during the procedure and after placement were observed in 7 of 90 patients and 24 of 88 patients, respectively. These included catheter obstruction (11%), dislocation of the catheter tip (10%), drug toxicity (5.7%), and catheter infection (3.4%). In 6 of 10 patients with catheter obstruction, recanalization of the port system was achieved. In 7 of 9 patients with dislocation of the indwelling catheter tip, replacement of the port system was successful. Our complications appear to be comparable with those encountered with the subclavian/brachial approach when the new catheter coating is used. Notable is the avoidance of cerebral infarcts.

Kuroiwa, Toshiro; Honda, Hiroshi; Yoshimitsu, Kengo; Irie, Hiroyuki; Aibe, Hitoshi; Tajima, Tsuyoshi; Shinozaki, Kenji; Masuda, Kouji [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

2001-03-15

177

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

E-print Network

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 ...

Eavarone, David A. (David Alan)

2009-01-01

178

[Case series of localized nasal NK/T-cell lymphoma treated with preceding intensified local radiation therapy before systemic chemotherapy].  

PubMed

Nasal NK/T-cell lymphoma is EB virus-associated aggressive lymphoma, which is more prevalent in Asia. Previously, this lymphoma which was recognized as lethal midline granuloma, commonly presents with midline facial destructive lesions. In early stage I/II disease, radiation therapy exerts a powerful treatment outcome, however, toxic adverse events are indispensable and the tolerability of radiation therapy with chemotherapy has not been fully studied. It is imperative to offer an appropriate treatment for cure of this disease. We report consecutive 4 cases of nasal NK/T-cell lymphoma, which was treated with 56 Gy intensified local radiation therapy followed by systemic chemotherapy. Two cases complicated with grade 3 stomatitis during the treatment course and 3 cases were hospitalized due to the decrease of oral intake. The scheduled radiation chemotherapy was completed and resulted in complete response of disease in all cases. High intensified radiation therapy followed by chemotherapy may be effective for localized nasal NK/T-cell lymphoma. PMID:16685174

Tamai, Yotaro; Imataki, Osamu; Abe, Yoshiaki; Hagiwara, Shotaro; Ito, Ichiro; Asakura, Hirofumi; Harada, Hideyuki; Kamata, Minoru; Nishimura, Tetsuo; Kawakami, Kimihiro

2006-05-01

179

Evaluation of concurrency control strategies for mixed soft real-time database systems  

Microsoft Academic Search

Previous research in real-time concurrency control mainly focuses on the schedulability guarantee of hard real-time transactions and the reducing of the miss rate of soft real-time transactions. Although many new database applications have significant response time requirements, not much work has been done in the joint scheduling of traditional non-real-time transactions and soft real-time transactions. In this paper, we study

Kam-yiu Lam; Tei-wei Kuo; Ben Kao; Tony S. H. Lee; Reynold Cheng

2002-01-01

180

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

NASA Technical Reports Server (NTRS)

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

Hines, J.

1999-01-01

181

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

SciTech Connect

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

Sunderam, V.S. (Emory Univ., Atlanta, GA (USA). Dept. of Mathematics and Computer Science); Geist, G.A. (Oak Ridge National Lab., TN (USA))

1991-01-01

182

[Induction chemotherapy for solid tumors].  

PubMed

Surgical treatment for solid malignancies, which is the gold standard for operable tumors, is being combined with nonsurgical modalities with an increasing frequency. Advanced cancers that are not curable by surgery alone are subjected to sophisticated multimodality regimens. Accordingly, the sequence and timing of integrated combined treatment modalities are essential. Traditionally, the common objective of induction chemotherapy has been to reduce the risk of distant disease recurrence. Administration of chemotherapy before other treatment has many theoretical advantages. Induction chemotherapy can result in tumor downstaging, thus increasing the rate of conservative surgery. In cases of more advanced disease, induction chemotherapy can render inoperable tumors resectable. Other advantages of induction chemotherapy include the ability to obtain information about tumor response, which can be used to study the biologic effects of chemotherapy and assess long-term disease-free survival(DFS)and overall survival(OS). Induction chemotherapy as a component of primary treatment has been shown in several studies and meta-analyses to decrease the incidence of metastatic disease. Currently, the terms induction, primary, preoperative, basal and neoadjuvant are all used to describe chemotherapy given as initial treatment. There are 2 methods of induction chemotherapy: intra-arterial induction chemotherapy and induction systemic chemotherapy. The clinical results of several trials of arterial infusion chemotherapy alone as induction chemotherapy for advanced cancer revealed that 20-30% higher response rates can be achieved. However, the benefits of prolonged survival rates and improved quality of life are not consistently realized. Induction arterial infusion chemotherapy did not gain enthusiastic support for several different malignancies. Induction systemic chemotherapy is mainly used in patients with stage II/III disease to improve surgical outcomes and increase the rate of breast-conserving surgery in the breast cancer case, although clinical studies have not revealed a significant improvement in DFS or OS. The favorable response rate and achievement of pathological complete response(pCR)have favorable effects on DFS in breast cancer patients. The available data suggest a minimal benefit for additional chemotherapy after surgery in patients with residual disease. New targets must be identified to develop non-cross-resistant agents for patients with residual disease after prior chemotherapy. New genomic and proteomic tools must be developed to identify predictive markers for response to primary systemic therapy that allow clinicians to develop more personalized therapy, new strategic options, and new biologic agents and avoid unnecessary regimens. The side effects of induction chemotherapy depend on the types of drugs, their doses, and the duration of treatment. PMID:23863642

Taguchi, Tetsuo

2013-06-01

183

Highly concurrent scalar processing  

Microsoft Academic Search

High speed scalar processing is an essential characteristic of high performance general purpose computer systems. Highly concurrent execution of scalar code is difficult due to data dependencies and conditional branches. This paper proposes an architectural concept called guarded instructions to reduce the penalty of conditional branches in deeply pipelined processors. A code generation heuristic, the decision tree scheduling technique, reorders

Peter Y.-T. Hsu; Edward S. Davidson

1986-01-01

184

Concurrent Digital Adaptive Decision Feedback Equalizer for 10GBase-LX4 Ethernet System  

Microsoft Academic Search

An all digital 3.5 Gbps blind adaptive decision feedback equalizer (ADFE) is designed for 10GBase-LX4 IEEE 802.3 ae standard. It uses 5 parallel equalization blocks each with 6 taps and 4 taps for each feed-forward equalizer (FFE) and feed-back equalizer (FBE). This concurrent ADFE has core area of 0.864times0.864 mm2 with operation up to 3.5 Gbps using 1.2-V supply in

Chi-Shiung Lin; Yu-Chun Lin; Shyh-Jye Jou; Mun-Tian Shiou

2007-01-01

185

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

NASA Astrophysics Data System (ADS)

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.

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

2011-09-01

186

Two Concurrent Facial Epidermal Nevi without Systemic Abnormalities: Nevus Sebaceus and Nevus Comedonicus  

PubMed Central

Epidermal nevi (EN) are hamartomatous lesions derived from epidermal components originating from pluripotent cell mutations. They have been categorized according to their predominant component. The existence of >2 types of EN concurrently within a single area or within contiguous areas has been rarely reported. This report describes the case of simultaneous presence of a yellowish plaque on the left medial canthus and an aggregation of closed comedo-like papules on the right side of the cheek of a 15-year-old girl. PMID:25143681

Jung, Han Jin; Cha, Hyun Wuk; Lim, Hyun Jung; Lee, Seok-Jong; Kim, Do Won

2014-01-01

187

Chemotherapy advances in locally advanced head and neck cancer.  

PubMed

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

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

2014-12-10

188

Conventional oral systemic chemotherapy for postoperative hepatocellular carcinoma: A systematic review.  

PubMed

The findings of randomized clinical trials (RCTs) regarding the efficacy of adjuvant conventional oral systemic chemotherapy (COSC) for patients with hepatocellular carcinoma (HCC) following curative hepatic resection (HR) are contradictory. Therefore, a systematic review of RCTs is required to evaluate the clinical efficacy of adjuvant COSC. Sources such as Medline, Embase and the Cochrane Library were systematically searched and all the RCTs comparing curative HR alone to HR plus COSC for HCC were identified. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. No treatment-related mortality was reported by the included RCTs and the adverse effects of COSC were generally mild. However, adjuvant COSC did not achieve a statistically significant improvement in the 1-, 3- and 5-year overall survival (OR=1.43, 95% CI: 0.58-3.56, P=0.44; OR=1.39, 95% CI: 0.75-2.55, P=0.29; and OR=1.20, 95% CI: 0.46-3.16, P=0.71, respectively). In addition, adjuvant COSC did not achieve a statistically significant decrease in the incidence of 1-, 3- and 5-year tumor recurrence, with pooled ORs of 0.92 (95% CI: 0.26-1.35, P=0.66); 0.82 (95% CI: 0.66-1.01, P=0.06); and 0.84 (95% CI: 0.71-1.01, P=0.06), respectively. Narrative reviews offer no evidence supporting the use of COSC. Adjuvant COSC has provided marginal benefits for HCC patients following curative HR. Considering the efficacy of sorafenib for advanced HCC and the results of this systematic review, no further trials should be performed to assess the efficacy of adjuvant COSC. PMID:25279203

Zhong, Jianhong; Xiang, Bangde; Ma, Liang; Li, Lequn

2014-11-01

189

Liposomal-lupane system as alternative chemotherapy against cutaneous leishmaniasis: macrophage as target cell.  

PubMed

Leishmania amazonensis causes human diseases that range from self-healing to diffusion cutaneous lesions. The chemotherapy of leishmaniasis requires long-term treatment and has been based on the use of pentavalent antimonials. Liposomes have been used as antileishmanial drug carries and have adjuvant activity in vaccines against several microorganisms, representing an important option to the development of new therapeutics for the disease. In this study, we developed a liposomal formulation containing lupane [3?,6?,16?-trihydroxylup-20(29)-ene], isolated from fruits of Combretum leprosum with pharmacological properties as antinociceptive, anti-inflammatory, antiulcerogenic and antileishmanial activities. The aim of the present study was to evaluate the efficacy of liposomal-lupane in L. amazonensis-infection model. Liposomes were prepared by the extrusion method with DPPC, DPPS and cholesterol at 5:1:4 weight ratio. The lupane (2 mg/mL) was added to the lipid mixture, solubilized in chloroform and dried under nitrogen flow. The activity of liposomal-lupane was conducted in vitro with mouse peritoneal infected macrophages. Furthermore, mice were infected in the right hind footpad with 10(5) stationary growth phase of L. amazonensis promastigotes. After 6 weeks, animals were treated with liposomal-lupane for 15 days by intraperitoneal injection. The evolution of disease was monitored weekly by measuring footpad thickness with a caliper. Three days after the treatment, peritoneal macrophages were collected, plated and production of the cytokines IL-10 and IL-12 was evaluated in supernatants of the cultures after 24 h. The results indicate that the liposomal system containing lupane achieved here is a promising tool to confer antileishmanial activity to infected macrophages. PMID:23933281

Barros, Neuza B; Migliaccio, Vanessa; Facundo, Valdir A; Ciancaglini, Pietro; Stábeli, Rodrigo G; Nicolete, Roberto; Silva-Jardim, Izaltina

2013-10-01

190

Muscle Atrophy in Response to Cytotoxic Chemotherapy Is Dependent on Intact Glucocorticoid Signaling in Skeletal Muscle  

PubMed Central

Cancer cachexia is a syndrome of weight loss that results from the selective depletion of skeletal muscle mass and contributes significantly to cancer morbidity and mortality. The driver of skeletal muscle atrophy in cancer cachexia is systemic inflammation arising from both the cancer and cancer treatment. While the importance of tumor derived inflammation is well described, the mechanism by which cytotoxic chemotherapy contributes to cancer cachexia is relatively unexplored. We found that the administration of chemotherapy to mice produces a rapid inflammatory response. This drives activation of the hypothalamic-pituitary-adrenal axis, which increases the circulating level of corticosterone, the predominant endogenous glucocorticoid in rodents. Additionally, chemotherapy administration results in a significant loss of skeletal muscle mass 18 hours after administration with a concurrent induction of genes involved with the ubiquitin proteasome and autophagy lysosome systems. However, in mice lacking glucocorticoid receptor expression in skeletal muscle, chemotherapy-induced muscle atrophy is completely blocked. This demonstrates that cytotoxic chemotherapy elicits significant muscle atrophy driven by the production of endogenous glucocorticoids. Further, it argues that pharmacotherapy targeting the glucocorticoid receptor, given in concert with chemotherapy, is a viable therapeutic strategy in the treatment of cancer cachexia. PMID:25254959

Braun, Theodore P.; Szumowski, Marek; Levasseur, Peter R.; Grossberg, Aaron J.; Zhu, XinXia; Agarwal, Anupriya; Marks, Daniel L.

2014-01-01

191

Combined modality treatment of oral and oropharyngeal cancer including neoadjuvant intraarterial cisplatin and radical surgery followed by concurrent radiation and chemotherapy with weekly docebaxel – three year results of a pilot study  

Microsoft Academic Search

Background: A new four-modality treatment of primary oral and oropharyngeal squamous cell carcinomas was evaluated with regard to feasibility, tolerance, and survival. Patients and methods: Seventy three operable patients (100%) with histologically proven untreated stage I to stage IV disease received at least one cycle of neoadjuvant intraarterial chemotherapy with 150 mg\\/m2 cisplatin neutralized with sodium thiosulphate, followed by radical

Adorján F. Kovács; Mirko Schiemann; Bernd Turowski

2002-01-01

192

Cognitive Performance and Magnetic Resonance Imaging Findings After High-Dose Systemic and Intraventricular Chemotherapy for Primary Central Nervous System Lymphoma  

Microsoft Academic Search

Background: Long-term neurotoxicity is a frequent com- plication of combined radiotherapy and chemotherapy in patients with primary central nervous system lym- phoma. Treatment protocols without radiotherapy have been implemented to avoid this; however, little detailed neuropsychologic and neuroradiologic data exist to as- sess the frequency of long-term treatment sequelae in this patient group. Objective: To determine whether a polychemo- therapy

Klaus Fliessbach; Horst Urbach; Christoph Helmstaedter; Hendrik Pels; Axel Glasmacher; Jurgen A. Kraus; Thomas Klockgether; Ingo Schmidt-Wolf; Uwe Schlegel

2003-01-01

193

Preliminary Results of a Randomized Study on Therapeutic Gain by Concurrent Chemotherapy for Regionally-Advanced Nasopharyngeal Carcinoma: NPC9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group  

Microsoft Academic Search

Purpose This randomized study compared the results achieved by concurrent chemoradiotherapy (CRT) versus radiotherapy (RT) alone for nasopharyngeal carcinoma (NPC) with advanced nodal disease. Patients and Methods Patients with nonkeratinizing\\/undifferentiated NPC staged T1-4N2-3M0 were randomized to CRT or RT. Both arms were treated with the same RT technique and dose fractionation. The CRT patients were given cisplatin 100 mg\\/m2 on

Anne W. M. Lee; W. H. Lau; Stewart Y. Tung; Daniel T. T. Chua; Rick Chappell; L. Xu; Lillian Siu; W. M. Sze; T. W. Leung; Jonathan S. T. Sham; Roger K. C. Ngan; Stephen C. K. Law; T. K. Yau; Joseph S. K. Au; Brian O'Sullivan; Ellie S. Y. Pang; Joseph T. Lau

194

Improving Electronic Oral Chemotherapy Prescription: Can We Build a Safer System?  

PubMed Central

Introduction: To prevent oral chemotherapy prescription errors, we enhanced a prescription-writing module in an ambulatory electronic medical record. We sought to describe the enhancement, examine its performance to date, and identify opportunities for improvement. Methods: Enhancements to the oral chemotherapy writing module included weight- and body surface area–based dosing, fields for cancer diagnosis and intent of therapy (curative v palliative), and dose-limit warnings. We studied all prescriptions for 18 oral chemotherapies generated by oncology clinicians during the first 17 months after the safe prescribing enhancements were introduced, from May 1, 2010, to October 1, 2011. We examined the frequency with which clinicians used the new features, the number and type of alerts generated, and clinician actions in response to alerts. Results: Six hundred clinicians generated 6,673 prescriptions for 2,043 patients. Six drugs—temozolomide, capecitabine, lenalidomide, hydroxyurea, imatinib, and erlotinib—accounted for 5,512 of all oral chemotherapy prescriptions (83%). Prescribers indicated the intent of therapy 13% of the time and listed the patient's cancer diagnosis 46% of the time. Prescribers customized their instructions using a free-text field in 64% of prescriptions. Clinicians' 6,673 prescription attempts triggered 395 dose-limit warnings (5%), mostly for temozolomide. Clinicians ignored most (96%) warnings, because current dosing recommendations exceeded the dose-limit warnings for the alerted medications. Conclusion: Oncology clinicians readily accepted features designed to enhance oral chemotherapy safety. Additional enhancements are needed to facilitate prescriptions with complex dosing regimens and to provide dose-limit warnings that reflect current clinical practice. PMID:23598852

Weingart, Saul N.; Mattsson, Thea; Zhu, Junya; Shulman, Lawrence N.; Hassett, Michael

2012-01-01

195

Multiple arm coordination using concurrent processing  

NASA Technical Reports Server (NTRS)

The use of concurrent processing for robot arm coordination is considered, and a hierarchically structured set of routines for the completion of coordinated tasks is discussed. Concurrent programming controls interacting concurrent processes by providing techniques to handle the problems of mutual exclusion, synchronization, and communication. The process is demonstrated for the example of the producer-consumer problem. Software supporting a concurrent environment to control a robotic system is being developed in which parallel rather than sequential thought processes are used.

Basta, Robert A.

1987-01-01

196

Understanding Chemotherapy  

MedlinePLUS

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

197

Recovery of CD8+ T-Cell Function During Systemic Chemotherapy in Advanced Ovarian Cancer  

Microsoft Academic Search

Immunologic approaches are emerging as new treatment options in several types of cancer. However, whereas the ability of patients to develop potent CD8+ T-cell responses is crucial for efficient antitumor responses, immunocompetence and T-cell function are not tested routinely in patients entering immunotherapy. The objective of our study was to monitor T-cell function in advanced cancer and during chemotherapy. CD8+

Sharon Coleman; Aled Clayton; Malcolm D. Mason; Bharat Jasani; Malcolm Adams; Zsuzsanna Tabi

198

Intra-arterial induction high-dose chemotherapy with cisplatin for oral and oropharyngeal cancer: long-term results  

Microsoft Academic Search

Intra-arterial (IA) chemotherapy for curative treatment of head and neck cancer experienced a revival in the last decade. Mainly, it was used in concurrent combination with radiation in organ-preserving settings. The modern method of transfemoral approach for catheterisation, superselective perfusion of the tumour-feeding vessel, and high-dose (150 mg m?2) administration of cisplatin with parallel systemic neutralisation with sodium thiosulphate (9

A F Kovács

2004-01-01

199

Central Nervous System Injury, Neurocognitive and Quality of Life Outcomes in Children with Brain Tumors Treated with Chemotherapy  

E-print Network

Dutta, V. (2011). Chemotherapy, neurotoxicity, and cognitiveChemotherapy-induced cell death in primary cerebellar granule neurons but not in astrocytes: in vitro paradign of differential neurotoxicity.Chemotherapy-induced cell death in primary cerebellar granule neurons but not in astrocytes: in vitro paradign of differential neurotoxicity.

Baron Nelson, Mary Christine

2012-01-01

200

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

PubMed

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

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

2014-11-01

201

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

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.

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

2009-07-15

202

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

PubMed Central

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

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

2014-01-01

203

Surgical adjuvant chemotherapy.  

PubMed

The evidence that the principles of surgical adjuvant chemotherapy developed in experimental animal systems also apply to a variety of neoplastic diseases in man has been clearly demonstrated. Micrometastatic disease can be eradicated with effective chemotherapy in several diseases. Prolongation of disease-free interval, if not cure, is now possible in diseases in which curative surgery alone or in combination with radiotherapy does not achieve these goals. The previously fatal childhood solid tumors--Wilms', Ewings' sarcoma, embryonal rhabdomyosarcoma--are curable in a high percentage of patients appropriately treated with combinations of surgery, radiotherapy, and chemotherapy. The prolongation of the disease-free interval in osteogenic sarcoma has permitted consideration of entirely new surgical approaches for this tumor in which radical amputation has traditionally been employed. The spectacular results achieved in the treatment of Stage II breast cancer may potentially save hundreds of thousands of lives in the coming decade. Clinically recognizable metastatic disease is rarely curable by any currently available treatment modality. The prolongation of disease-free intervals and production of cures when surgical adjuvant chemotherapy is employed may be partly explained by relatively more circulation, and thus drug delivery to each tumor cell, more favorable cellular kinetics, and a healthier and more immunocompetent host who is better able to withstand drug effects on normal tissues, and to participate in tumor destruction. Cures of certain patients with neoplastic diseases using surgical adjuvant chemotherapy has increased the incentive to learn more about new and old drugs and their effective use alone and in combination. Chemotherapy, in appropriate combinations with surgery, radiotherapy, and immunotherapy, may well be more efficacious in many clinical situations than the traditional use of single-modality treatment. The data presented in this paper relate solid evidence that the possibility of cure in a variety of neoplastic diseases is real. PMID:193434

Perloff, M; Holland, J F

1977-01-01

204

Multi-drug delivery system based on alginate/calcium carbonate hybrid nanoparticles for combination chemotherapy.  

PubMed

A facile strategy to prepare nano-sized drug carriers for co-delivery of multiple types of drugs in combination chemotherapy was developed. Inorganic/organic hybrid alginate/CaCO3 nanoparticles were prepared by co-precipitation in an aqueous solution under very mild conditions. A hydrophilic drug (doxorubicin hydrochloride, DOX) and a hydrophobic drug (paclitaxel, PTX) were co-encapsulated in the hybrid nanoparticles. For comparison, PTX loaded nanoparticles and DOX loaded nanoparticles were also prepared. The measurement based on dynamic light scattering indicated all nanoparticles had a mean size less than 200 nm with a relatively narrow size distribution. The morphology of the nanoparticles was observed by TEM. The in vitro drug release study showed that the release of DOX and PTX from the dual drug loaded nanoparticles could be effectively sustained. The tumor cell inhibitory effect of the drug loaded nanoparticles was evaluated in HeLa cells and MCF-7/ADR cells. The dual drug loaded nanoparticles exhibited significantly enhanced cell uptake and nuclear localization as compared with the single drug loaded nanoparticles. As a result, the dual drug loaded nanoparticles had a significantly enhanced cell inhibitory effect, especially for drug resistant tumor cells. These results indicated that alginate/CaCO3 hybrid nanoparticles have promising applications for the co-delivery of drugs with different physicochemical properties in combination chemotherapy to overcome multidrug resistance. PMID:25315499

Wu, Jin-Long; Wang, Chao-Qun; Zhuo, Ren-Xi; Cheng, Si-Xue

2014-11-01

205

Risk Factors for Severe Neutropenia following Intra-Arterial Chemotherapy for Intra-Ocular Retinoblastoma  

PubMed Central

Purpose Intra-arterial chemotherapy is a promising strategy for intra-ocular retinoblastoma. Neutropenia is the most commonly encountered systemic toxicity and in this study we aimed to determine the risk factors associated with the development of severe (?grade 3) neutropenia. Methods Retrospective review of 187 evaluable cycles of melphalan-containing intra-arterial chemotherapy from the first three cycles administered to 106 patients with intra-ocular retinoblastoma from May 2006 to June 2011. Cycles were considered to be evaluable if (1) blood count results were available in the 7 to 14 days post-treatment interval and (2) concurrent intravenous chemotherapy was not administered. Toxicity was assessed via the Common Terminology Criteria for Adverse Events version 4.0. Results 54 cycles (29%) were associated with grade 3 (n?=?43) or grade 4 (n?=?11) neutropenia. Multivariate stepwise logistic regression revealed that a higher melphalan dose (>0.40 mg/kg) was significantly associated with severe neutropenia during all 3 cycles (odds ratio during cycle one 4.11, 95% confidence interval 1.33–12.73, p?=?0.01), but the addition of topotecan and/or carboplatin were not. Prior treatment with systemic chemotherapy was not associated with severe neutropenia risk in any analysis. Conclusions Intra-arterial melphalan-based chemotherapy can cause severe neutropenia, especially when a dose of greater than 0.40 mg/kg is administered. Further study with a larger sample may be warranted. PMID:25303673

Dunkel, Ira J.; Shi, Weiji; Salvaggio, Kim; Marr, Brian P.; Brodie, Scott E.; Gobin, Y. Pierre; Abramson, David H.

2014-01-01

206

Symbolically Modeling Concurrent MCAPI Executions  

NASA Technical Reports Server (NTRS)

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

Fischer, Topher; Mercer, Eric; Rungta, Neha

2011-01-01

207

HIV chemotherapy  

NASA Astrophysics Data System (ADS)

The use of chemotherapy to suppress replication of the human immunodeficiency virus (HIV) has transformed the face of AIDS in the developed world. Pronounced reductions in illness and death have been achieved and healthcare utilization has diminished. HIV therapy has also provided many new insights into the pathogenesis and the viral and cellular dynamics of HIV infection. But challenges remain. Treatment does not suppress HIV replication in all patients, and the emergence of drug-resistant virus hinders subsequent treatment. Chronic therapy can also result in toxicity. These challenges prompt the search for new drugs and new therapeutic strategies to control chronic viral replication.

Richman, Douglas D.

2001-04-01

208

A topological formal treatment for scenario-based software specification of concurrent real-time systems  

Microsoft Academic Search

Real-time systems are computing systems in which the meeting of their requirements is vital for their correctness. Consequently, if the real-time requirements of these systems are poorly understood and verified, the results can be disastrous and lead to irremediable project failures at the early phases of development. The present work addresses the problem of detecting deadlock situations early in the

Miriam C. Bergue Alves; Christine C. Dantas; Nanci Naomi Arai; Rovedy B. Da Silva

2008-01-01

209

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

PubMed Central

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

2010-01-01

210

Object-oriented concurrent programming  

SciTech Connect

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

Yonezawa, A.; Tokoro, M.

1986-01-01

211

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

NASA Technical Reports Server (NTRS)

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

Springer, P.

1993-01-01

212

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

Microsoft Academic Search

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

Benjamin Gamsa; Orran Krieger; Jonathan Appavoo; Michael Stumm

1999-01-01

213

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

SciTech Connect

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.

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

214

A probabilistic model for the evaluation of fault-tolerant multiprocessor systems using concurrent error detection  

NASA Technical Reports Server (NTRS)

A probabilistic model to evaluate fault-tolerant multiprocessor systems has been developed. The matrix-based model and the analysis algorihtms based on it are described. Various probabilities associated with an algorithm-based fault tolerance system are discussed and the fault coverage of a given check is derived analytically and illustrated with examples. The probability matrices that are formed by introducing the spatial probabilities into the matrix model are considered. Based on these matrices, a technique is developed to determine the combined coverage of multiple numbers of checks. Examples of the analysis of systems using the model are given.

Nair, V. S. S.; Abraham, J. A.

1990-01-01

215

RTOG 96-10: reirradiation with concurrent hydroxyurea and 5-fluorouracil in patients with squamous cell cancer of the head and neck  

Microsoft Academic Search

Purpose: Patients with recurrent squamous cell cancer of the head and neck (SCH&N) are generally treated with systemic chemotherapy. Improvement in survival has not occurred, despite an increased objective response rate. This study was undertaken to explore the feasibility and toxicity, and estimate the therapeutic impact of, reirradiation (RRT) with concurrent hydroxyurea and 5-fluorouracil.Methods and Materials: The eligibility requirements included

S. A Spencer; J Harris; R. H Wheeler; M Machtay; C Schultz; W Spanos; M Rotman; R Meredith

2001-01-01

216

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

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.

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

217

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

SciTech Connect

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.

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

1990-01-01

218

IL-27p28 inhibits central nervous system autoimmunity by concurrently antagonizing Th1 and Th17 responses.  

PubMed

Central nervous system (CNS) autoimmunity such as uveitis and multiple sclerosis is accompanied by Th1 and Th17 responses. In their corresponding animal models, experimental autoimmune uveitis (EAU) and experimental autoimmune encephalomyelitis (EAE), both responses are induced and can drive disease independently. Because immune responses have inherent plasticity, therapeutic targeting of only one pathway could promote the other, without reducing pathology. IL-27p28 antagonizes gp130, required for signaling by IL-27 and IL-6, which respectively promote Th1 and Th17 responses. We therefore examined its ability to protect the CNS by concurrently targeting both effector responses. Overexpression of IL-27p28 in vivo ameliorated EAU as well as EAE pathology and reduced tissue infiltration by Th1 and Th17 cells in a disease prevention, as well as in a disease reversal protocol. Mechanistic studies revealed inhibition of Th1 and Th17 commitment in vitro and decreased lineage stability of pre-formed effectors in vivo, with reduction in expression of gp130-dependent transcription factors and cytokines. Importantly, IL-27p28 inhibited polarization of human T cells to the Th1 and Th17 effector pathways. The ability of IL-27p28 to inhibit generation as well as function of pathogenic Th1 and Th17 effector cells has therapeutic implications for controlling immunologically complex autoimmune diseases. PMID:24021664

Chong, Wai Po; Horai, Reiko; Mattapallil, Mary J; Silver, Phyllis B; Chen, Jun; Zhou, Ru; Sergeev, Yuri; Villasmil, Rafael; Chan, Chi-Chao; Caspi, Rachel R

2014-05-01

219

Concurrent chemoradiotherapy for locally advanced breast cancer—time for a new paradigm?  

PubMed Central

Background In cases of locally advanced breast cancer (labc), preoperative (“neoadjuvant”) therapy was traditionally reserved to render the patient operable. More recently, neoadjuvant therapy, particularly chemotherapy, is being used in patients with operable disease to increase the opportunity for breast conservation. Despite the increasing use of preoperative chemotherapy, rates of pathologic complete response, a surrogate marker for disease-free survival, remain modest in patients with locally advanced disease and particularly so when the tumour is estrogen or progesterone receptor–positive and her2-negative. A new paradigm for labc patients is needed. In other solid tumours (for example, rectal, esophageal, and lung cancers), concurrent chemoradiotherapy (ccrt) is routinely used in neoadjuvant and adjuvant treatment protocols alike. Results The literature suggests that ccrt in labc patients with inoperable disease is associated with response rates higher than would be anticipated with systemic therapy alone. Conclusions Ongoing trials in this field are eagerly awaited to determine if ccrt should become the new paradigm.

Mandilaras, V.; Bouganim, N.; Spayne, J.; Dent, R.; Arnaout, A.; Boileau, J.F.; Brackstone, M.; Meterissian, S.; Clemons, M.

2015-01-01

220

Chemotherapy-induced peripheral neuropathy  

Microsoft Academic Search

Recent advances in the development and administration of chemotherapy for malignant diseases have led to prolonged survival\\u000a of patients and the promise of a return to normal lives. This progress comes with a price, however, and the nervous system\\u000a is frequently the target of therapy-induced toxicity. Unlike more immediate toxicities that affect the gastrointestinal tract\\u000a and bone marrow, chemotherapy-induced neurotoxicity

Bushra Malik; Mark Stillman

2008-01-01

221

An object-oriented constraints-based system for concurrent product development  

Microsoft Academic Search

This research work aims to develop an intelligent constraint-based system that enables designers to consider at the early stages of the design process all activities associated with product’s life cycle. One of the most important aspects of these activities is the evaluation and optimisation of manufacturing processes that require various type of information from the different aspects of product’s life

A. Gayretli; H. S. Abdalla

1999-01-01

222

Concurrent Computing  

NSDL National Science Digital Library

* 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.

Apon, Amy

223

[The new communication system about each patient's treatment from the ward to the chemotherapy center in our hospital].  

PubMed

Because the expert nurse of the chemotherapy center collected his profile from his chart and the hospital summary of nursing and we orientated about the induced chemotherapy regimen to the patient who got it after discharge from the ward former, we could not grasp neither his general condition nor mental status adequately. The merit of the outpatient chemotherapy is the improvement of the quality of life, but the patient feels the solitude and anxiety because of the lack of the medical and nursing staff around him. Then we changed that we have visited the patients to collect their profile and orientate about new regimen on his bedside for the smooth conversion to the outpatient chemotherapy. We visited a-total of 45 patients in 2007. Thirty-eight patients visited before their discharge answered, The orientation of the new chemotherapy before my discharge let me get with a security. The visit also enabled both staffs of the chemotherapy center and the ward to possess the common information of each patient and to do the common nursing. We thought that the visit before discharge was effective for the smooth conversion to the outpatient chemotherapy. We would like to reduce the anxiety of the patients who had chemotherapy and to support their struggle against diseases, cooperating to other department and standardizing our care program. PMID:20716901

Yamashita, Maki; Mitsuka, Mayumi; Nakamura, Yoshiko; Takeno, Atsuko; Tatsumi, Mitsutoshi; Nakamura, Takahito

2010-08-01

224

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

PubMed

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

An, Dami; Kim, Kwangmi; Kim, Jeongyun

2014-07-01

225

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

PubMed Central

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

An, Dami; Kim, Kwangmi; Kim, Jeongyun

2014-01-01

226

Concurrency Theory Alban Ponse  

E-print Network

University of Amsterdam http://www.science.uva.nl/~alban/ 2013 - 2014 Alban Ponse (TCS, UvA) Concurrency Slide material is also from the author (but slightly adapted) Alban Ponse (TCS, UvA) Concurrency Theory and associative: (a, b) = (b, a) ((a, b), c) = (a, (b, c)) Alban Ponse (TCS, UvA) Concurrency Theory - Lecture 7

Ponse, Alban

227

A concurrent track evolution algorithm for pattern recognition in the HERA-B main tracking system  

NASA Astrophysics Data System (ADS)

A strategy for pattern recognition in the main tracking system of a forward B spectrometer like HERA-B or LHC-B is presented. Intrinsically a local method, it combines the virtues of track following procedures with the necessary ability to optimize between many available paths in a high occupancy environment. A hit-locating procedure suitable for a multiplanar detector geometry has been developed. The performance of the method is tested on HERA-B Monte Carlo events with full detector simulation and a realistic spectrometer geometry.

Mankel, Rainer

1997-02-01

228

Performance study of optimistic concurrency control schemes for distributed database systems  

E-print Network

with Locking: Halici's Algorithm 2. 5. 6 Certification with Timestamp Ordering: Boksen- baum's Algorithm 19 21 5 5 6 8 10 13 16 17 18 23 2. 5. 7 Certification with Timestamp Ordering: Sinha's Algorithm 24 2. 5. 8 Certification with Timestamp... and requires too many mes- sages. 2. 5. 7 Certification with Timestamp Ordering: Sinha's Algorithm Sinha M. K, et al. proposed an algorithm in [23] for timestamp-based certification scheme in 1985. In this scheme, a transaction manager gets a system...

Kim Lee, Hyunsoon

1993-01-01

229

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

NASA Technical Reports Server (NTRS)

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

Gluck, R.

1988-01-01

230

Treating metastatic breast cancer with systemic chemotherapies: current trends and future perspectives.  

PubMed

Treatment selection for metastatic breast cancer (MBC) is guided by multiple factors, most importantly hormone receptor (HR) or HER2 expression, treatment history, and prognostic factors such as short disease-free interval, presence of visceral metastases, performance status, and degree of symptoms. Chemotherapy is indicated as initial therapy for patients with HR-negative disease and following failure of hormonal therapies in HR-positive disease. Patients treated with an anthracycline or a taxane in early-stage settings may no longer be candidates for those drugs in MBC, thus underscoring the need for alternative options. Sequential single-agent therapy or combination therapy are viable strategies. Trials have shown that ixabepilone plus capecitabine significantly improves progression-free survival compared with capecitabine alone in anthracycline- or taxane-pretreated or -resistant patients, and single-agent eribulin improves survival compared with the physician's choice of treatment in patients treated previously with at least two regimens for MBC. Regardless of the regimen, proactive management to detect treatment-related adverse events in a timely manner remains important for ensuring effective delivery of treatment. Many promising investigational agents are in development, including T-DM1 (trastuzumab emtansine) and pertuzumab for HER2-positive disease, as well as PARP-1 (poly[adenosine diphosphate ribose] polymerase-1) inhibitors and cetuximab for triple-negative disease. In addition, new options for the treatment of MBC following failure of an anthracycline and a taxane promise to improve patient outcomes. Nurses should remain vigilant for adverse events and remember that the goal of treatment remains control of the disease and palliation. PMID:22459535

Smith, Nancy Zeller

2012-04-01

231

Concurrent Use of an Audience Response System at a Multi-Campus College of Pharmacy  

PubMed Central

Objective. To assess the impact of an audience response system (ARS) on student engagement at a multi-campus college of pharmacy. Methods. An online questionnaire was designed and administered to measure the impact of an ARS on student engagement, distance education, projected use, and satisfaction among pharmacy students for a course delivered across 3 sites via synchronous video transmission. Results. Students reported that use of the ARS made it easier to participate (85.3%) and helped them to focus (75.7%) in classes when the lecturer was physically at a different site. They also valued that the ARS allowed them to respond anonymously (93.2%). A minority of students indicated that use of the ARS was distracting (11.8%). Conclusions. Implementation of an ARS was associated with positive student perceptions of engagement and may improve feelings of connectedness among students at schools with multiple sites. Use of ARSs could also represent a cognitive intercession strategy to help reduce communication apprehension. PMID:22412205

Alkhateeb, Fadi M.; Singh-Franco, Devada

2012-01-01

232

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

Microsoft Academic Search

Concurrent calorimetric and interferometric studies have been conducted to investigate the effect that reduction of the base-plate\\u000a dimensions has on the steady-state performance of the rate of natural convection heat transfer from miniaturized horizontal\\u000a single plate-fin systems and plate-fin arrays. The effect was studied through comparison of the present results with those\\u000a of earlier relevant calorimetric, interferometric, or numerical studies.

Filino Harahap; Herry Lesmana; Poetro Lebdo Sambegoro

2010-01-01

233

The effect of rice-seeding rate and fish stocking on the floodwater ecology of the trench of a concurrent, direct-seeded rice-fish system  

Microsoft Academic Search

Concurrent rice-fish systems in the Mekong Delta, Vietnam, are characterized by a rice field surrounded by a trench (on average 1000 m2, covering 15–20% of the field surface). Rice is direct seeded and fish are reared in polyculture. The most common species for polyculture are silver barb Barbodes gonionotus (Bleeker), common carp Cyprinus carpio L. and Nile tilapia Oreochromis niloticus

Nico Vromant; Nguyen T. H. Chau; Frans Ollevier

2001-01-01

234

Measuring and modelling concurrency  

PubMed Central

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

Sawers, Larry

2013-01-01

235

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

SciTech Connect

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.

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

236

36 CFR 14.56 - Concurrence by Federal Highway Administration.  

Code of Federal Regulations, 2010 CFR

...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...

2010-07-01

237

36 CFR 14.56 - Concurrence by Federal Highway Administration.  

Code of Federal Regulations, 2011 CFR

...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...

2011-07-01

238

36 CFR 14.56 - Concurrence by Federal Highway Administration.  

Code of Federal Regulations, 2013 CFR

...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...

2013-07-01

239

36 CFR 14.56 - Concurrence by Federal Highway Administration.  

Code of Federal Regulations, 2014 CFR

...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...

2014-07-01

240

36 CFR 14.56 - Concurrence by Federal Highway Administration.  

Code of Federal Regulations, 2012 CFR

...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...

2012-07-01

241

Multiversion concurrency control—theory and algorithms  

Microsoft Academic Search

Concurrency control is the activity of synchronizing operations issued by concurrently executing programs on a shared database. The goal is to produce an execution that has the same effect as a serial (noninterleaved) one. In a multiversion database system, each write on a data item produces a new copy (or version) of that data item. This paper presents a theory

Philip A. Bernstein; Nathan Goodman

1983-01-01

242

Supporting concurrent applications in wireless sensor networks  

Microsoft Academic Search

It is vital to support concurrent applications sharing a wire- less sensor network in order to reduce the deployment and ad- ministrative costs, thus increasing the usability and efficiency of the network. We describe Melete1, a system that supports concurrent applications with efficiency, reliability, flexibility, programmability, and scalability. Our work is based on the Mat´ e virtual machine (1) with

Yang Yu; Loren J. Rittle; Vartika Bhandari; Jason B. Lebrun

2006-01-01

243

Hierarchical Concurrent Finite State Machines in Ptolemy  

Microsoft Academic Search

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

Bilung Lee; Edward A. Lee

1998-01-01

244

Derivation and Evaluation of Concurrent Collectors  

Microsoft Academic Search

There are many algorithms for concurrent garbage collection, but they are complex to describe, verify, and implement. This has resulted in a poor under- standing of the relationships between the algorithms, and has precluded system- atic study and comparative evaluation. We present a single high-level, abstract concurrent garbage collection algorithm, and show how existing snapshot and incremental update collectors, can

Martin T. Vechev; David F. Bacon; Perry Cheng; David Grove

2005-01-01

245

STU attractors from vanishing concurrence  

SciTech Connect

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.

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

2011-02-15

246

BertrandMeyer SYSTEMATIC CONCURRENT  

E-print Network

parties, the marriage between concurrent computa- tion and object-oriented programming-- a union much and operating systems--appears easy enough to arrange. This appearance, however, is deceptive: the problem marriage, this article raises a number of questions. Although crucial for both theoretical understanding

Meyer, Bertrand

247

Management of chemotherapy-induced peripheral neuropathy  

Microsoft Academic Search

Recent advances in the development and administration of chemotherapy for malignant diseases have been rewarded with prolonged\\u000a survival rates. The cost of progress has come at a price and the nervous system is frequently the target of chemotherapy-induced\\u000a neurotoxicity. Unlike more immediate toxicities that effect the gastrointestinal tract and bone marrow, chemotherapy-induced\\u000a neurotoxicity is frequently delayed in onset and may

Mark Stillman; Juan P. Cata

2006-01-01

248

TEACH - A concurrent robot control language  

NASA Technical Reports Server (NTRS)

This paper describes the TEACH robot control language and its supporting operating system. It addresses concurrency, device independence, and other issues related to manipulator control, task specification, and system operation.

Ruoff, C. F.

1979-01-01

249

Concurrent planning and execution for autonomous robots  

NASA Technical Reports Server (NTRS)

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.

Simmons, Reid G.

1992-01-01

250

The Compliance of Doctors with Viral Hepatitis B Screening and Antiviral Prophylaxis in Cancer Patients Receiving Cytotoxic Chemotherapy Using a Hospital-Based Screening Reminder System  

PubMed Central

Background and Aim Screenings for hepatitis B surface antigen (HBsAg) and antiviral prophylaxis are recommended for HBsAg-positive patients before the start of cytotoxic chemotherapy; however, compliance with these recommendations varies among doctors. We investigated the compliance of doctors with these recommendations using a reminder system and assessed the outcomes of HBsAg-positive patients receiving cytotoxic chemotherapy. Methods Using a computer-assisted reminder system, doctors were alerted of both HBsAg screening and antiviral prophylaxis prior to prescribing chemotherapy. The compliance between different doctors and outcomes of patients were investigated during the period of execution of this system. The rates of compliance with both recommendations were compared among various cancer types. Results A total of 1053 patients were enrolled, of which only 88 had previous data pertaining to HBsAg status. Using this reminder system, an overall screening rate of 85.5% (825/965) was achieved and did not significantly differ according to cancer type. However, the overall antiviral prophylactic rate was only 45.5% (61/134). The rates of antiviral prophylaxis were lower for doctors treating lung, breast and colorectal cancers than for those treating hematological malignancies (all p<0.05). Consequently, the rate of HBV reactivation was lower in patients who received antiviral prophylaxis than in those who did not (1.6% vs. 15.1%; p<0.01). Multivariate analysis revealed that male gender and antiviral prophylaxis were both related to reactivation of hepatitis B (p<0.05). Conclusions By using this reminder system, the overall screening rate for HBsAg was satisfactory, whereas the antiviral prophylaxis was inadequate in patients with solid tumors due to the varying compliance of the attending doctors. Further strategies to improve both screening and prophylaxis are needed to minimize HBV-related events during cytotoxic chemotherapy. PMID:25658926

Sun, Wei-Chih; Hsu, Ping-I; Yu, Hsien-Chung; Lin, Kung-Hung; Tsay, Feng-Woei; Wang, Huay-Min; Tsai, Tzung-Jiun; Chen, Wen-Chi; Lai, Kwok-Hung; Cheng, Jin-Shiung

2015-01-01

251

Ulceration of Striae distensae in high-grade glioma patients on concurrent systemic corticosteroid and bevacizumab therapy.  

PubMed

Striae distensae (stretch marks) are a common complication seen in patients on chronic corticosteroid therapy. Under certain circumstances, primary brain tumor patients require chronic corticosteroid therapy and can suffer from striae distensae. Bevacizumab, a humanized monoclonal antibody to vascular endothelial growth factor-A (VEGF-A) is now more widely used for the treatment of primary brain tumors. In this paper, we present four cases of ulcerated striae distensae in primary brain tumor patients on concurrent corticosteroid and bevacizumab therapy. Because of bevacizumab's effects on wound healing and its recent accelerated approval for recurrent glioblastoma multiforme (GBM), the most common malignant primary brain tumor in adults, this novel skin complication should be considered in patients on concurrent corticosteroid and bevacizumab therapy. PMID:20524043

Peters, Katherine B; Coyle, Thomas E; Vredenburgh, James J; Desjardins, Annick; Friedman, Henry S; Reardon, David A

2011-01-01

252

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

SciTech Connect

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.

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

253

Concurrent engineering research center  

NASA Technical Reports Server (NTRS)

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.

Callahan, John R.

1995-01-01

254

A phase II study evaluating the use of concurrent mitomycin C and capecitabine in patients with advanced unresectable pseudomyxoma peritonei  

PubMed Central

Pseudomyxoma peritonei (PMP) is a rare neoplastic process characterised by progressive intra-abdominal dissemination of mucinous tumour, and generally considered resistant to systemic chemotherapy. A phase II study in patients with advanced unresectable PMP was undertaken to evaluate the combination of systemic concurrent mitomycin C (7?mg?m?2 i.v. on day 1) and capecitabine (1250?mg?m?2 b.d. on days 1–14) in a 3-weekly cycle (MCap). Response was determined by semiquantitative assessment of disease volume on serial computed tomographic (CT) scans and serum tumour marker (CEA, CA125, CA19-9) changes at 12 weeks. Between 2003 and 2006, 40 patients were recruited through a national centre for the treatment of peritoneal surface tumours. At baseline, 23 patients had progressive disease and 17 had stable disease. Of 39 assessable patients, 15 (38%, 95% confidence intervals (CIs): 25, 54%) benefited from chemotherapy in the form of either reductions in mucinous deposition or stabilisation of progressive pretreatment disease determined on CT scan. Notably, two patients, originally considered unresectable, following MCap and re-staging underwent potentially curative cytoreductive surgery. Grade 3/4 toxicity rates were low (6%, 95% CIs: 4, 9%). Twenty out of 29 assessed patients (69%, 95% CIs: 51, 83%) felt that their Global Health Status improved during chemotherapy. This is the first trial to demonstrate an apparent benefit of systemic chemotherapy in patients with advanced unresectable PMP. PMID:18682713

Farquharson, A L; Pranesh, N; Witham, G; Swindell, R; Taylor, M B; Renehan, A G; Rout, S; Wilson, M S; O'Dwyer, S T; Saunders, M P

2008-01-01

255

A methodology for implementing highly concurrent data objects  

Microsoft Academic Search

A concurrent object is a data structure shared by concurrent processes. Conventional techniques for implementing concurrent objects typically rely on critical sections; ensuring that only one process at a time can operate on the object. Nevertheless, critical sections are poorly suited for asynchronous systems: if one process is halted or delayed in a critical section, other, nonfaulty processes will be

Maurice Herlihy

1993-01-01

256

Combined Treatment with High-Dose Methotrexate, Vincristine and Procarbazine, without Intrathecal Chemotherapy, Followed by Consolidation Radiotherapy for Primary Central Nervous System Lymphoma in Immunocompetent Patients  

Microsoft Academic Search

Objectives: To assess the feasibility and the activity, as well as the efficacy to treat meninges, of chemotherapy (CHT) containing high-dose methotrexate (HD-MTX) followed by radiation therapy (RT), without intrathecal CHT, in patients with primary central nervous system lymphoma. Methods: Eligibility criteria were histologically proven diagnosis, disease limited to the CNS, age ?70, ECOG performance status ?3, HIV-negative and no

Andrés J. M. Ferreri; Michele Reni; Stefania Dell’Oro; Fabio Ciceri; Massimo Bernardi; Lionello Camba; Maurilio Ponzoni; Maria Rosa Terreni; Maurizio Tomirotti; Michele Spina; Eugenio Villa; S. Ryozawa; T. Noguchi; Y. Iida; A. Oga; Y. Fukumoto; S. Kawauchi; K. Sasaki; S. Tanaka; M. Yoshihara; G. Kajiyama; M. Suzuki; M. Ohwada; T. Kohno; E. Ninci; T. Brandstetter; C. Ihling; R. Iggo; T. Bauknecht; P. Stura; F. Ferrando; P. Sismondi; M. Mesiti; F. Gomez; Z. Horváth; M. Bak; L. Kisbenedek; T. Takeda; Y. Sasaki; M. Sakon; T. Yamada; S. Ishiguro; S. Imaoka; M. Tsujimoto; G. Shiota; M. Meguro; M. Oshimura

2001-01-01

257

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

Microsoft Academic Search

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.

Andrés José María Ferreri; Chiara Verona; Letterio Salvatore Politi; Anna Chiara; Lucia Perna; Eugenio Villa; Michele Reni

2011-01-01

258

A Case of the Cauda Equina Syndrome Associated With the Intrathecal Chemotherapy in a Patient With Primary Central Nervous System Lymphoma  

PubMed Central

The intrathecal chemotherapy with methotrexate and cytarabine arabinoside is used for the treatment and prophylaxis of the primary central nervous system lymphoma. The therapy may induce neurotoxicity including the cauda equina syndrome. We report a case of a 58-year-old man with the diffuse large B-cell lymphoma, who developed the cauda equina syndrome after the administration of intrathecal methotrexate and cytarabine arabinoside, as diagnosed by the electrodiagnostic, urodynamic, and radiologic approaches. PMID:23869341

Park, Seunglee; Kang, Jung-Il; Bang, Hyun; Kim, Bo-Ram

2013-01-01

259

Axioms for concurrent objects  

Microsoft Academic Search

Specification and verification techniques for abstract data types that have been successful for sequential programs can be extended in a natural way to provide the same benefits for concurrent programs. We propose an approach to specifying and verifying concurrent objects based on a novel correctness condition, which we call “linearizability.” Linearizability provides the illusion that each operation takes effect instantaneously

Maurice P. Herlihy

1987-01-01

260

Concurrent Software Engineering Project  

ERIC Educational Resources Information Center

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

Stankovic, Nenad; Tillo, Tammam

2009-01-01

261

Concurrency Theory Alban Ponse  

E-print Network

University of Amsterdam http://www.science.uva.nl/~alban/ 2013 - 2014 Alban Ponse (TCS, UvA) Concurrency) at http://blackboard.ic.uva.nl/ (Mirror: http://staff.science.uva.nl/~alban/CT.html) Literature Handouts, not required for the exam. Alban Ponse (TCS, UvA) Concurrency Theory - Lecture 1 2013 - 2014 2 / 25 #12

Ponse, Alban

262

Long-term Remission of Primary Central Nervous System Lymphoma by Intensified Methotrexate Chemotherapy  

Microsoft Academic Search

High-dose (1–3.5?g\\/m2) methotrexate (MTX) followed by whole-brain radiation therapy (WBRT) has consistently improved length of survival in primary central nervous system lymphoma (PCNSL), but the prognosis remains dismal. To optimize and enhance the dose intensity of MTX, we applied MTX at 8?g\\/m2 to 20 patients with PCNSL. In an effort to lower the risk of neurotoxic treatment sequelae, the WBRT

Takao Watanabe; Yoichi Katayama; Atsuo Yoshino; Chiaki Komine; Takakazu Yokoyama; Takao Fukushima

2003-01-01

263

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

DOEpatents

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.

Gardner, Shea Nicole (San Leandro, CA)

2007-10-23

264

Asymptomatic Colorectal Cancer with Un-Resectable Liver Metastases: Immediate Colorectal Resection or Up-Front Systemic Chemotherapy?  

Microsoft Academic Search

Background  About 20% of patients with colorectal cancer have synchronous un-resectable liver metastases. Resection of colorectal cancer\\u000a in patients with moderate-severe symptoms is mandatory before starting chemotherapy. Surgical treatment of asymptomatic colorectal\\u000a cancers is still a matter of discussion.\\u000a \\u000a \\u000a \\u000a Methods  From January 2000 to December 2004, we prospectively collected data on 35 consecutive patients who were treated straightaway\\u000a by chemotherapy without primary

Andrea Muratore; Daria Zorzi; Hedayat Bouzari; Marco Amisano; Paolo Massucco; Elisa Sperti; Lorenzo Capussotti

2007-01-01

265

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

SciTech Connect

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.

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

266

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

SciTech Connect

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.

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

267

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

PubMed Central

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

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

268

Combination of Systemic Chemotherapy with Local Stem Cell Delivered S-TRAIL in Resected Brain Tumors.  

PubMed

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. Stem Cells 2015;33:101-110. PMID:25186100

Redjal, Navid; Zhu, Yanni; Shah, Khalid

2015-01-01

269

Chemotherapy Agents: A Primer for the Interventional Radiologist  

PubMed Central

In this article, the authors review the basic principles of cancer chemotherapy and provide an overview of each of the general classes of chemotherapeutic agents with a target audience of interventional radiologists in mind. Special attention is paid to agents used in regional chemotherapy as well as agents commonly included in systemic chemotherapeutic regimens for patients who also require regional chemotherapy. PMID:22550380

Mihlon, Frank; Ray, Charles E.; Messersmith, Wells

2010-01-01

270

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

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

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

2013-05-31

271

A 38-gene expression signature to predict metastasis risk in node-positive breast cancer after systemic adjuvant chemotherapy: a genomic substudy of PACS01 clinical trial  

Microsoft Academic Search

Currently, no prognostic gene-expression signature (GES) established from node-positive breast cancer cohorts, able to predict\\u000a evolution after systemic adjuvant chemotherapy, exists. Gene-expression profiles of 252 node-positive breast cancer patients\\u000a (median follow-up: 7.7 years), mostly included in a randomized clinical trial (PACS01), receiving systemic adjuvant regimen,\\u000a were determined by means of cDNA custom array. In the training cohort, we established a GES

Pascal Jézéquel; Mario Campone; Henri Roché; Wilfried Gouraud; Catherine Charbonnel; Gabriel Ricolleau; Florence Magrangeas; Stéphane Minvielle; Jean Genève; Anne-Laure Martin; Régis Bataille; Loïc Campion

2009-01-01

272

Concurrent Quantum Computation  

E-print Network

A quantum computer is a multi-particle interferometer that comprises beam splitters at both ends and arms, where the n two-level particles undergo the interactions among them. The arms are designed so that relevant functions required to produce a computational result is stored in the phase shifts of the 2^n arms. They can be detected by interferometry that allows us to utilize quantum parallelism. Quantum algorithms are accountable for what interferometers to be constructed to compute particular problems. A standard formalism for constructing the arms has been developed by the extension of classical reversible gate arrays. By its nature of sequential applications of logic operations, the required number of gates increases exponentially as the problem size grows. This may cause a crucial obstacle to perform a quantum computation within a limited decoherence time. We propose a direct and concurrent construction of the interferometer arms by one-time evolution of a physical system with arbitrary multi-particle interactions. It is inherently quantum mechanical and has no classical analogue. Encoding the functions used in Shor's algorithm for prime factoring, Grover's algorithm and Deutsch-Jozsa algorithm requires only one-time evolution of such a system regardless of the problem size n as opposed to its standard sequential counterpart that takes O(n^3), O(n) and O(n2^n).

F. Yamaguchi; C. P. Master; Y. Yamamoto

2000-05-31

273

Concurrent Parkinson tremors  

PubMed Central

Concurrent resting and postural tremors of patients with idiopathic Parkinson’s disease were monitored using transducers responding to angular velocity of rotation. Spectra and correlation functions were calculated for each pair of records. When concurrent tremor spectra share indistinguishable fundamental frequencies, have statistically significant peaks in their coherence spectra at those fundamental frequencies, and show significant peaks in their cross-correlation functions near zero delay, they are classified as linearly dependent. When such tremor records are superimposed, their phase-locked behaviour is evident. Pairs of correlated concurrent tremors, of varying duration, have been observed in both hands, both feet and in either hand and the contralateral or ipsilateral foot. Correlated tremors may be concurrent with other tremors that are independent. We hypothesize that correlated Parkinson tremors arise from one or more common (and possibly unilateral) central sources. PMID:11080268

Moore, G P; Ding, L; Bronte-Stewart, H M

2000-01-01

274

Concurrent cyclophosphamide and craniospinal radiotherapy for pediatric high-risk embryonal brain tumors.  

PubMed

Embryonal tumors are an aggressive subtype of high-grade, pediatric central nervous system (CNS) tumors often with dismal survival rates. The 5-year survival for highest-risk embryonal tumors may be as low as 10 %. We report feasibility and efficacy from our experience using intravenous (IV) cyclophosphamide concurrently with craniospinal radiation (CSI) in high-risk embryonal CNS tumors of childhood. Ten consecutive children (aged: 3.5-15.5 years, median: 10.2 years, six male) with high-risk embryonal tumors, including: large cell/anaplastic medulloblastoma (6), atypical teratoid rhabdoid tumor (1), and leptomeningeal primitive neuroectodermal tumor (3), were treated with IV cyclophosphamide 1 g/M(2) on days 1 and 2 of CSI. Following a median of 36 Gy CSI plus tumor boosts, adjuvant treatment consisted of 21 doses of oral etoposide (7) and alkylator based chemotherapy from five to eight cycles in all. Of the ten patients thus treated, six remain alive with no evidence of disease and four are deceased. Median survival was 3.3 years, with a 3-year progression-free survival of 50 % (5/10). Median follow-up was: 3.3 years (range: 5 months-12.9 years) in the five patients with progression, median time-to-progression was: 1.3 years (range: 1 month-3 years). Median follow-up in the patients without progression is 8.8 years (range: 3-12.9 years). Complications due to adjuvant chemotherapy were typical and included myelosupression (10), necessitating shortened duration of chemotherapy in three, and hemorrhagic cystitis (1). In high-risk embryonal CNS tumors, cyclophosphamide given concurrently with CSI is well tolerated. Early results suggest that a phase II trial is warranted. PMID:22941430

Campen, Cynthia J; Dearlove, Joanna; Partap, Sonia; Murphy, Patricia; Gibbs, Iris C; Dahl, Gary V; Fisher, Paul Graham

2012-11-01

275

Whole-body hyperthermia in the scope of von Ardenne's systemic cancer multistep therapy (sCMT) combined with chemotherapy in patients with metastatic colorectal cancer: a phase I/II study.  

PubMed

This phase I/II study evaluated the feasibility, toxicity and response rates of von Ardenne's systemic cancer multistep therapy (sCMT) when applied as an adjunct to cytostatic therapy in patients with metastatic colorectal cancer. sCMT consists of whole-body hyperthermia (WBH) at 41.8-42.1 degrees C, hyperglycaemia and hyperoxaemia. All patients who entered the trial first received three monthly courses of chemotherapy (folinic acid, 50 mg, days 1-5; 5-fluorouracil, 425 mg/m2, days 1-5; mitomycin 8 mg/m2, day 1), followed by response evaluation according World Health Organization (WHO) criteria. Responders (partial/complete remission) were assigned to three further courses of chemotherapy, whereas non-responders (stable/progressive disease) were allocated to additional sCMT on day 1 of every subsequent chemotherapy course. The WBH procedure was administered under general anaesthesia employing the Iratherm-2000 radiant heat device. Of 28 patients enrolled, 19 received more than three treatment courses. Eight of these 19 patients had responded to chemotherapy (PR) and thus obtained three further courses of chemotherapy alone. In 10 of 19 patients who had not responded (SD, PD), three additional courses of chemotherapy were combined with sCMT (with 25 sCMT applications). One patient who did not respond to initial treatment declined sCMT and was continued with chemotherapy alone. It was found that sCMT was feasible, but associated with a specific spectrum of grade III/IV toxicity (skin 20%, pain 16%, peripheral nerves 8% of treatment courses). The fact that three patients who did not respond to initial chemotherapy achieved a PR after additional sCMT suggests that sCMT may enhance the effect of chemotherapy in patients with colorectal cancer. PMID:15204528

Hildebrandt, B; Dräger, J; Kerner, T; Deja, M; Löffel, J; Stroszczynski, C; Ahlers, O; Felix, R; Riess, H; Wust, P

2004-05-01

276

C formal verification with unix communication and concurrency  

NASA Technical Reports Server (NTRS)

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.

Hoover, Doug N.

1990-01-01

277

Chemotherapy induced Takotsubo cardiomyopathy  

PubMed Central

Chemotherapy has been linked with Takotsubo cardiomyopathy. Most of the literature on chemotherapy associated Takotsubo cardiomyopathy is on the drug 5-fluorouracil. In this report, we describe the case of a 55-year-old Asian male who developed Takotsubo cardiomyopathy while receiving dual chemotherapy with cytarabine and daunorubicin for acute myeloid leukemia. To our knowledge, it is the first case of Takotsubo cardiomyopathy associated with daunorubicin and/or cytarabine. PMID:25325068

Goel, Sunny; Sharma, Abhishek; Garg, Aakash; Chandra, Abhinav; Shetty, Vijay

2014-01-01

278

Chemotherapy-Induced Neurotoxicity  

Microsoft Academic Search

\\u000a Chemotherapy-induced neurotoxicity is a common and dose-limiting side effect of many cancer treatments. While other dose-limiting\\u000a toxicities such as myelosupression and hypersensitivity reactions are largely amenable to treatment, chemotherapy-induced\\u000a neurotoxicity remains a significant problem, with limited treatment options and no standardized diagnostic or management criteria.\\u000a Receiving a full course of chemotherapy on schedule is a critical factor that determines patient

Susanna B. Park; Matthew C. Kiernan

279

Photoswitchable nanoparticles for in vivo cancer chemotherapy  

E-print Network

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

Tong, Rong

280

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

SciTech Connect

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.

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

281

A short introduction to Concurrent Euclid  

Microsoft Academic Search

This is an introduction to Concurrent Euclid (CE), a language designed for high performance, highly reliable system software, such as operating systems, compilers and embedded microprocessor systems. CE is a Pascal-based language with processes and monitors (as specified by C. A. R. Hoare). It has language constructs needed for systems programming including separate compilation, variables at absolute addresses, type converters,

Richard C. Holt

1982-01-01

282

P. Sandborn and P. Singh, "Forecasting Technology Insertion Concurrent with Design Refresh Planning for COTS-Based Electronics Systems," Logistics Spectrum, Vol. 38, No. 2, pp. 25-28, April-June 2004.  

E-print Network

for COTS-Based Electronics Systems," Logistics Spectrum, Vol. 38, No. 2, pp. 25-28, April-June 2004. Forecasting Technology Insertion Concurrent with Design Refresh Planning for COTS-Based Electronic Systems their constituent parts (specifically Commercial Off The Shelf ­ COTS electronic parts). These life cycle mismatches

Sandborn, Peter

283

Comparison of Fusion Imaging Using a Combined SPECT/CT System and Intra-arterial CT: Assessment of Drug Distribution by an Implantable Port System in Patients Undergoing Hepatic Arterial Infusion Chemotherapy  

SciTech Connect

Hepatic arterial infusion (HAI) chemotherapy is effective for treating primary and metastatic carcinoma of the liver. We compared the perfusion patterns of HAI chemotherapy on intra-arterial port-catheter computed tomography (iapc-CT) and fused images obtained with a combined single-photon emission computed tomography/computed tomography (SPECT/CT) system. We studied 28 patients with primary or metastatic carcinoma of the liver who bore an implantable HAI port system. All underwent abdominal SPECT using Tc-99m-MAA (185 Mbq); the injection rate was 1 mL/min, identical to the chemotherapy infusion rate, and 0.5 mL/sec for iapc-CT. Delivery was through an implantable port. We compared the intrahepatic perfusion (IHP) and extrahepatic perfusion (EHP) patterns of HAI chemotherapy on iapc-CT images and fused images obtained with a combined SPECT/CT system. In 23 of 28 patients (82%), IHP patterns on iapc-CT images and fused images were identical. In 5 of the 28 patients (18%), IHP on fusion images was different from IHP on iapc-CT images. EHP was seen on fused images in 12 of the 28 patients (43%) and on iapc-CT images in 8 patients (29%). In 17 patients (61%), upper gastrointestinal endoscopy revealed gastroduodenal mucosal lesions. EHP was revealed on fused images in 10 of these patients; 9 of them manifested gastroduodenal toxicity at the time of subsequent HAI chemotherapy. Fusion imaging using the combined SPECT/CT system reflects the actual distribution of the infused anticancer agent. This information is valuable not only for monitoring adequate drug distribution but also for avoiding potential extrahepatic complications.

Ikeda, Osamu, E-mail: osamu-3643ik@do9.enjoy.ne.jp; Kusunoki, Shinichiroh; Nakaura, Takeshi; Shiraishi, Shinya; Kawanaka, Kouichi; Tomiguchi, Seiji; Yamashita, Yasuyuki [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan); Takamori, Hiroshi; Chikamoto, Akira; Kanemitsu, Keiichiro [Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Gastroenterological Surgery (Japan)

2006-06-15

284

A patient with cholangiocarcinoma demonstrating pathologic complete response to chemotherapy: exploring the role of neoadjuvant therapy in biliary tract cancer.  

PubMed

The role of neoadjuvant chemotherapy and/or radiation for localized or potentially resectable cholangiocarcinoma (CCA) has not been well established. We present here the case of a patient with an extrahepatic CCA who achieved a pathologic complete response after undergoing preoperative gemcitabine-based chemotherapy, without sequential or concurrent use of radiation. Further evaluation of neoadjuvant strategies in CCA, including not only combined-modality therapy but also the use of chemotherapy exclusively, is warranted in prospective study design. PMID:25436138

Walker, Evan J; Simko, Jeffry P; Nakakura, Eric K; Ko, Andrew H

2014-12-01

285

A patient with cholangiocarcinoma demonstrating pathologic complete response to chemotherapy: exploring the role of neoadjuvant therapy in biliary tract cancer  

PubMed Central

The role of neoadjuvant chemotherapy and/or radiation for localized or potentially resectable cholangiocarcinoma (CCA) has not been well established. We present here the case of a patient with an extrahepatic CCA who achieved a pathologic complete response after undergoing preoperative gemcitabine-based chemotherapy, without sequential or concurrent use of radiation. Further evaluation of neoadjuvant strategies in CCA, including not only combined-modality therapy but also the use of chemotherapy exclusively, is warranted in prospective study design. PMID:25436138

Walker, Evan J.; Simko, Jeffry P.; Nakakura, Eric K.

2014-01-01

286

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

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 naïve 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

Eng, Cathy; Chang, George J; You, Y Nancy; 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

2014-11-30

287

Interventionally implanted port catheter systems for hepatic arterial infusion of chemotherapy in patients with primary liver cancer: A phase II-study (NCT00356161)  

PubMed Central

Background Hepatic arterial infusion (HAI) of chemotherapy requires the implantation of a transcatheter application system which is traditionally performed by surgery. This procedure, but particularly the adjacent drug application via pump or port is often hampered by specific complications and device failure. Interventionally implanted port catheter systems (IIPCS) facilitate the commencement of HAI without need for laparatomy, and are associated with favorable complication rates. We here present an evaluation of the most important technical endpoints associated with the use of IIPCS for HAI in patients with primary liver cancers. Methods 70 patients (pts) with hepatocellular (HCC, n=33) and biliary tract cancer (BTC, n=37) were enrolled into a phase II –study. Of those, n=43 had recurrent disease and n=31 suffered from liver-predominant UICC-stage IVb. All pts were provided with IIPCSs before being treated with biweekly, intraarterial chemotherapy (oxaliplatin, 5-Flourouracil, folinic acid). The primary objective of the trial was defined as evaluation of device-related complications and port duration. Results Implantation of port catheters was successful in all patients. Mean treatment duration was 5.8 months, and median duration of port patency was not reached. Disease-progression was the most common reason for treatment discontinuation (44 pts., 63%), followed by chemotherapy-related toxicity (12 pts., 17%), and irreversible device failure (5 pts., 7%). A total of 28 port complications occurred in 21 pts (30%). No unexpected complications were observed. Conclusions HAI via interventionally implanted port catheters can be safely applied to patients with primary liver tumors far advanced or/and pretreated. PMID:23927554

2013-01-01

288

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

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 naïve 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

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

289

Chemotherapy for Soft Tissue Sarcomas  

MedlinePLUS

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

290

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

NASA Technical Reports Server (NTRS)

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

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

1995-01-01

291

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

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.

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

292

Chemotherapy-related changes in central nervous system phospholipids and neurocognitive function in childhood acute lymphoblastic leukemia.  

PubMed

Long-term survivors of childhood leukemia are at risk for neurocognitive impairment, although the neurophysiological basis is not well understood. The purpose of this study was to explore associations between changes in cerebrospinal fluid (CSF) phospholipids and neurocognitive function in children undergoing chemotherapy for acute lymphoblastic leukemia. Seventy-six children were followed prospectively from diagnosis. CSF samples were collected during scheduled lumbar punctures and phospholipids were extracted. Neurocognitive evaluations were conducted annually beginning shortly after diagnosis. Concentrations of sphingomyelin (SM) increased following induction (p = 0.03) and consolidation (p = 0.04), while lysophosphatidylcholine (LPC) increased following induction (p = 0.003). Multivariable analyses demonstrated associations between post-induction SM and motor speed at 1 year (p < 0.001), 2 years (p = 0.001) and 3 years (p = 0.02) following diagnosis. Post-induction LPC was associated with verbal working memory (p = 0.007). Results indicate that early changes in phospholipids are related to neurocognitive decline and suggest a chemotherapy impact on white matter integrity. PMID:22856670

Krull, Kevin R; Hockenberry, Marilyn J; Miketova, Petra; Carey, Marissa; Moore, Ida M

2013-03-01

293

Chemotherapy-related Changes in Central Nervous System Phospholipids and Neurocognitive Function in Childhood Acute Lymphoblastic Leukemia  

PubMed Central

Long-term survivors of childhood leukemia are at risk for neurocognitive impairment, though the neurophysiological basis is not well understood. The purpose of this study was to explore associations between changes in cerebrospinal fluid (CSF) phospholipids and neurocognitive function in children undergoing chemotherapy for acute lymphoblastic leukemia. 76 children were followed prospectively from diagnosis. CSF samples were collected during scheduled lumbar punctures and phospholipids were extracted. Neurocognitive evaluations were conducted annually beginning shortly after diagnosis. Concentrations of sphingomyelin (SM) increased following induction (p=0.03) and consolidation (p=0.04), while lysophosphatidylcholine (LPC) increased following induction (p=0.003). Multivariable analyses demonstrated associations between post-induction SM and motor speed at one (p<0.001), two (p=0.001), and three (p=0.02) years following diagnosis. Post-induction LPC was associated with verbal working memory (p=0.007). Results indicate early changes in phospholipids are related to neurocognitive decline and suggest a chemotherapy impact on white matter integrity. PMID:22856670

Krull, Kevin R.; Hockenberry, Marilyn J.; Miketova, Petra; Carey, Marissa; Moore, Ida M.

2013-01-01

294

Central Venous Access for Chemotherapy  

Microsoft Academic Search

\\u000a Systemic chemotherapy is the cornerstone of modern day cancer treatment. Chemotherapeutic agents are often caustic solutions\\u000a that require large high flow venous channels for safe delivery; hence the need for central venous access. Chemotherapeutic\\u000a protocols vary greatly with respect to frequency, intensity, and duration. The concept of dose intensity is being scrutinized\\u000a with current trends favoring more frequent administration of

M. Andreas Mauro

295

Chemotherapy-induced peripheral neuropathy  

Microsoft Academic Search

Recent advances in the development and administration of chemotherapy for malignant diseases have led to prolonged survival\\u000a of patients and the promise of a return to normal lives. The cost of progress comes with a price, however, and the nervous\\u000a system is frequently the target of therapy-induced toxicity. Unlike more immediate toxicities that affect the gastrointestinal\\u000a tract and bone marrow,

Bushra Malik; Mark Stillman

2008-01-01

296

Acute reversible neurological deficit following intrathecal chemotherapy  

Microsoft Academic Search

We report on two patients with non-Hodgkin's lymphoma (NHL) who developed reversible, short-lived neurological deficit following intrathecal (i.t.) chemotherapy. One patient received i.t. methotrexate for treatment of meningeal disease, and the other received i.t. methotrexate with cytosine arabinoside (ara-C) and hydrocortisone as central nervous system (CNS) prophylaxis. Although transient paresis following i.t. chemotherapy has previously been reported, it has been

H. DunkelmanL; H. M. Earl; C. Twelves

1991-01-01

297

-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

298

-PTOLEMY II -HETEROGENEOUS CONCURRENT  

E-print Network

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

299

Concurrent Kripke Structures  

Microsoft Academic Search

We consider a class of Kripke Structures in which the atomic propo- sitions are events. This enables us to represent worlds as sets of events and the transition and satisfaction relations of Kripke structures as the subset and membership relations on sets. We use this class, called event Kripke structures, to model concurrency. The obvious semantics for these structures is

Vineet Gupta

300

Specifying Concurrent Program Modules  

Microsoft Academic Search

A method for specifying program modules in a concurrent program is described. It is based upon temporal logic, but uses new kinds of temporal assertions to make the specifications simpler and easier to understand. The semantics of the specifications is described informally, and a sequence of examples are given culminating in a specification of three modules comprising the alternating-bit communication

Leslie Lamport

1983-01-01

301

Intrathecal chemotherapy for hematologic malignancies: drugs and toxicities  

Microsoft Academic Search

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

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

2009-01-01

302

Should Patients Undergoing Chemotherapy and Radiotherapy Be Prescribed Antioxidants?  

Microsoft Academic Search

In September 2005, CA: A Cancer Journal for Clinicians published a warning by Gabriella D’Andrea, MD, against the concurrent use of antioxidants with radiotherapy and chemotherapy. However, several deficiencies of the CA article soon became apparent, not least the selective omission of prominent studies that contradicted the author’s conclusions. While acknowledging that only large-scale, randomized trials could provide a valid

Ralph W. Moss

2006-01-01

303

Chemotherapy induced peripheral neuropathic pain  

PubMed Central

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

2014-01-01

304

Data-dependent Concurrency Control and Recovery  

E-print Network

is a difficult task, particularly in a distributed system. A variety of researchers have suggested atomicity as a fundamental organizational concept for such systems. In this paper we present a formal treatment of atomicity.specified semantic information to achieve greater concurrency. Third, we focus on local properties of components

Gummadi, Ramakrishna

305

Advances in chemotherapy for head and neck cancer.  

PubMed

Systemic chemotherapy is increasingly being used with radiotherapy for the radical treatment of advanced head and neck cancers. Chemotherapy offers modest benefits in the metastatic setting. Platinum containing agents are the most active drugs and form the mainstay of most chemotherapy schedules. In recent years taxanes have been shown activity in head and neck cancers and are being incorporated into neo-adjuvant and concomitant chemotherapy regimens. Targeted agents EGFR inhibitors like cetuximab, in particular have shown benefit in the metastatic and the concomitant setting. EGFR inhibitors and other targeted agents form the thrust of pre-clinical and clinical research into systemic treatment of head and neck cancer. PMID:20400360

Bhide, S A; Nutting, C M

2010-06-01

306

Inhaled chemotherapy in lung cancer: future concept of nanomedicine  

PubMed Central

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

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

2012-01-01

307

Multidisciplinary Concurrent Design Optimization via the Internet  

NASA Technical Reports Server (NTRS)

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

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

2001-01-01

308

[Hepatotoxicity of chemotherapy].  

PubMed

Patients who will receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs are not appropriate, and which drugs need dose modification. However, if the hepatic parenchymal abnormalities are caused by an underlying neoplasm and the neoplasm is sensitive to the drugs, it may not be necessary to reduce the dose. Clearly, this is an area where clinical judgment must be used to assess the risk/benefit ratio. Treatment of chronic hepatitis B virus (HBV) involves either the nucleoside analogue lamivudine or interferon alpha. The advantage of lamivudine includes limited adverse effects and the fact that histological improvement has been documented in the majority of patients. Primary prophylaxis with lamivudine may be a well tolerated and effective method to reduce the frequency of chemotherapy-induced HBV reactivation in chronic HbsAg carriers. HbsAg screening is necessary before beginning chemotherapy for non Hodgkin's lymphoma patients. However, the main problem with long-term lamivudine therapy is the emergence of genotypic resistance because of base pair substitution at specific sites within the YMDD locus of the DNA polymerase gene. Significant hepatic dysfunction is uncommon among hepatitis C virus (HCV) infected patients treated with chemotherapy for hematological malignancies. However, infection with elevated AST levels is a significant risk factor for veno-occlusive disease after hematopoietic stem cell transplantation. Clinical judgment and a high index of suspicion remain critical tools in preventing and treating hepatic manifestations of cancer chemotherapy. PMID:12852343

Okamoto, Rumiko; Maeda, Yoshiharu; Sasaki, Tsuneo

2003-06-01

309

Concurrency Control Theory for Deferred Materialized Views  

Microsoft Academic Search

. We consider concurrency control problems that arise in thepresence of materialized views. Consider a database system supportingmaterialized views to speed up queries. For a range of important applications (e.g. banking, billing, network management), transactions that accessmaterialized views would like to get some consistency guarantees---ifa transaction reads a base relation after an update, and then reads a materializedview derived from

Akira Kawaguchi; Daniel F. Lieuwen; Inderpal Singh Mumick; Dallan Quass; Kenneth A. Ross

1997-01-01

310

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

NASA Technical Reports Server (NTRS)

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.

1974-01-01

311

The engineering of concurrent simulations of complex systems Fiona A. C. Polack Paul S. Andrews Adam T. Sampson  

E-print Network

evaluators (as, for instance, in the UK Civil Aviation Authority air-safety certification processes standard 00-56 on safety requirements management). In Fiona Polack and Paul Andrews: Department of Computer- language. general, the safety (or security, reliability etc) of a system is evaluated via a case

Kent, University of

312

Clinicopathological analysis of primary adrenal diffuse large B-cell lymphoma: effectiveness of rituximab-containing chemotherapy including central nervous system prophylaxis  

PubMed Central

Background Primary adrenal lymphoma (PAL) is an extremely rare subtype of extranodal non-Hodgkin’s lymphoma. Some researchers have reported some of the characteristics of PAL and its association with poor prognosis; however, the clinicopathological features of PAL remain to be elucidated. Methods From 2008 to 2011 we experienced seven cases of PAL in our institutions. We retrospectively analyzed the clinical and pathological features of these patients. Results The patients ranged in age from 50 to 85 years, with a median of 71 years. The overall male:female ratio was 6:1. All seven patients were diagnosed with diffuse large B-cell lymphoma (DLBCL) pathologically. Bilateral adrenal involvement was confirmed in five patients. The median largest tumor diameter at diagnosis was 58 mm. The Ki-67 index was generally high (>70%). All patients were treated with rituximab-containing chemotherapy, and central nervous system (CNS) prophylaxis was conducted for three patients. One patient with CNS involvement at the time of the diagnosis also received whole-brain radiation. The overall survival rate at two years was 57% (median follow-up; 24.8 months). It is noteworthy that the three patients who received a full course of the rituximab-containing regimen and CNS prophylaxis are currently alive without disease relapse, and that none of the seven patients died due to progression of lymphoma. Conclusions Primary adrenal DLBCL can be a clinically aggressive disease entity. Rituximab-containing chemotherapy combined with CNS prophylaxis could be a reasonable option for the treatment of PAL; however, analyses of more PAL cases are needed for the establishment of this strategy. PMID:23915571

2013-01-01

313

Chemotherapy and signaling  

PubMed Central

In recent years, oncologists have begun to conclude that chemotherapy has reached a plateau of efficacy as a primary treatment modality, even if toxicity can be effectively controlled. Emerging specific inhibitors of signaling and metabolic pathways (i.e., targeted agents) contrast with traditional chemotherapy drugs in that the latter primarily interfere with the DNA biosynthesis and the cell replication machinery. In an attempt to improve on the efficacy, combination of targeted drugs with conventional chemotherapeutics has become a routine way of testing multiple new agents in early phase clinical trials. This review discusses the recent advances including integrative systematic biology and RNAi approaches to counteract the chemotherapy resistance and to buttress the selectivity, efficacy and personalization of anticancer drug therapy. PMID:20935499

Bagnyukova, Tetyana; Serebriiskii, Ilya G; Zhou, Yan; Hopper-Borge, Elizabeth A; Golemis, Erica A

2010-01-01

314

[Hepatotoxicity of chemotherapy].  

PubMed

Patients who will receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs are not appropriate, and which drug need dose modification. Many medications, alcohol has their more or less hepatotoxic effect, so because of their immunocompromise state, some body are prone to liver infection, including viral hepatitis. Lamivudine is effective in treating hepatitis B reactivation during chemotherapy. Now, the increased use of high-dose regimens with bone marrow or stem-cell support has been shown the drugs toxicities complication more, which does not observed in with conventional doses. Clinical judgment and a high index of suspicion remain critical tool in preventing and treating hepatic manifestations of cancer chemotherapy. PMID:12806946

Okamoto, Rumiko; Maeda, Yoshiharu; Sasaki, Tsuneo

2003-06-01

315

Update on Adjuvant Chemotherapy for Early Breast Cancer  

PubMed Central

Breast cancer is the second most common cancer in women worldwide. Although most women are diagnosed with early breast cancer, a substantial number recur due to persistent micro-metastatic disease. Systemic adjuvant chemotherapy improves outcomes and has advanced from first-generation regimens to modern dose-dense combinations. Although chemotherapy is the cornerstone of adjuvant therapy, new biomarkers are identifying patients who can forego such treatment. Neo-adjuvant therapy is a promising platform for drug development, but investigators should recognize the limitations of surrogate endpoints and clinical trials. Previous decades have focused on discovering, developing, and intensifying adjuvant chemotherapy. Future efforts should focus on customizing therapy and reducing chemotherapy for patients unlikely to benefit. In some cases, it may be possible to replace chemotherapy with treatments directed at specific genetic or molecular breast cancer subtypes. Yet, we anticipate that chemotherapy will remain a critical component of adjuvant therapy for years to come. PMID:25336961

Rampurwala, Murtuza M; Rocque, Gabrielle B; Burkard, Mark E

2014-01-01

316

The performance of PC solid-state disks (SSDs) as a function of bandwidth, concurrency, device architecture, and system organization  

Microsoft Academic Search

As their prices decline, their storage capacities increase, and their endurance improves, NAND Flash Solid State Disks (SSD) provide an increasingly attractive alternative to Hard Disk Drives (HDD) for portable computing systems and PCs. This paper presents a study of NAND Flash SSD architectures and their management techniques, quantifying SSD performance under user-driven\\/PC applications in a multi-tasked environment; user activity

Cagdas Dirik; Bruce Jacob

2009-01-01

317

Locally Advanced and Unresectable Cutaneous Squamous Cell Carcinoma: Outcomes of Concurrent Cetuximab and Radiotherapy  

PubMed Central

Background. Advanced age and immune dysfunction are risk factors for cutaneous squamous cell carcinoma (cSCC) and often render patients with locally-advanced disease medically inoperable or surgically unresectable, but potentially curable with radiotherapy. Concurrent chemotherapy and radiotherapy may not be well tolerated in this population, but another systemic therapy may improve disease control. Objective. Determine the tolerance and efficacy of concurrent cetuximab and radiotherapy (CRT) for patients with locally advanced and unresectable cSCC. Methods. Retrospective analysis of 12 patients treated with CRT for locally advanced and unresectable cSCC. Results. Patients were elderly and 75% had moderate-to-severe comorbidities, while 42% had immune dysfunction. Grades 3-4 adverse events were noted in 83% of patients; 67% required hospital admission for adverse events. Complete and partial response was noted in 36% and 27% (response rate, 64%). Stable and progressive disease was noted in 3 and 1 patients, respectively (disease control rate, 91%). Median progression-free and overall survival were 6.4 and 8.0 months, respectively. Limitations. Retrospective small-cohort, single-institution analysis. Conclusion. Patients selected for CRT were elderly, with comorbidities and immune dysfunction, but treatment responses were observed. Patients selected for this treatment approach have a poor prognosis with limited capacity for therapy; more effective treatment is needed. PMID:25136458

Samstein, Robert M.; Ho, Alan L.; Lee, Nancy Y.; Barker, Christopher A.

2014-01-01

318

Alternating Chemotherapy and Radiotherapy in Locally Advanced Head and Neck Cancer: An Alternative?  

Microsoft Academic Search

Rapidly alternating chemotherapy and radiotherapy (ACR) is a minor variation of concurrent chemoradia- tion (CCR). This scheduling has been tested in advanced head and neck cancer and has shown superiority over standard radiation in some randomized trials with only marginally greater toxicity. This paper reviews ACR in advanced head and neck cancer. The hypothesis that this approach could have a

Marco Merlano

319

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

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.

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

320

Concurrent C++: Concurrent Programming with Class(es)  

Microsoft Academic Search

ion and Concurrent ProgrammingAll the advantages of using data abstraction facilities for sequential programming also apply to concurrentprogramming. Specifically, with regard to concurrent programming, data abstraction facilities can providea better, higher-level and more robust interface for the services provided by one or more processes. Classescan be used to ensure that the protocol for interacting with a process is properly observed

Narain H. Gehani; William D. Roome

1988-01-01

321

Hyperthermia adds to chemotherapy  

Microsoft Academic Search

The hallmarks of hyperthermia and its pleotropic effects are in favour of its combined use with chemotherapy. Preclinical research reveals that for heat killing and synergistic effects the thermal dose is most critical. Thermal enhancement of drug cytotoxicity is accompanied by cellular death and necrosis without increasing its oncogenic potential. The induction of genetically defined stress responses can deliver danger

Rolf D. Issels

2008-01-01

322

Problems in Antifungal Chemotherapy  

Microsoft Academic Search

Summary The field of antifungal chemotherapy is undergoing rapid change at present, with an accelerating pace of introduction of new agents. The problems at present include the need for more effective agents, particularly with novel modes of action. Fungal infection must be considered more frequently in differential diagnosis, and methods developed for early diagnosis. The literature must be improved, with

D. A. Stevens

1987-01-01

323

Exposure, infection, systemic cytokine levels and antibody responses in young children concurrently exposed to schistosomiasis and malaria  

PubMed Central

SUMMARY Despite the overlapping distribution of Schistosoma haematobium and Plasmodium falciparum infections, few studies have investigated early immune responses to both parasites in young children resident in areas co-endemic for the parasites. This study measures infection levels of both parasites and relates them to exposure and immune responses in young children. Levels of IgM, IgE, IgG4 directed against schistosome cercariae, egg and adult worm and IgM, IgG directed against P. falciparum schizonts and the merozoite surface proteins 1 and 2 together with the cytokines IFN-?, IL-4, IL-5, IL-10 and TNF-? were measured by ELISA in 95 Zimbabwean children aged 1–5 years. Schistosome infection prevalence was 14·7% and that of Plasmodium infection was 0% in the children. 43. 4% of the children showed immunological evidence of exposure to schistosome parasites and 13% showed immunological evidence of exposure to Plasmodium parasites. Schistosome–specific responses, indicative of exposure to parasite antigens, were positively associated with cercariae-specific IgE responses, while Plasmodium-specific responses, indicative of exposure to parasite antigens, were negatively associated with responses associated with protective immunity against Plasmodium. There was no significant association between schistosome-specific and Plasmodium-specific responses. Systemic cytokine levels rose with age as well as with schistosome infection and exposure. Overall the results show that (1) significantly more children are exposed to schistosome and Plasmodium infection than those currently infected and; (2) the development of protective acquired immunity commences in early childhood, although its effects on infection levels and pathology may take many years to become apparent. PMID:21813042

IMAI, NATSUKO; RUJENI, NADINE; NAUSCH, NORMAN; BOURKE, CLAIRE D.; APPLEBY, LAURA J.; COWAN, GRAEME; GWISAI, REGGIS; MIDZI, NICHOLAS; CAVANAGH, DAVID; MDULUZA, TAKAFIRA; TAYLOR, DAVID; MUTAPI, FRANCISCA

2011-01-01

324

Rapid and sustained response of an intra- and extracranial large cell lymphoma mass to liposomal intrathecal Ara-C and R-MegaCEOP systemic chemotherapy.  

PubMed

Prognosis of patients suffering from secondary central nervous system (CNS) lymphoma is dismal. Intracranial spread of a lymphoma arising in adjacent extranodal tissues is a rare event. A 32-year-old patient was diagnosed with progressive diffuse large B-cell lymphoma (DLBCL) with extra- and intracranial localization. He complained of headache, left diplopia, marked rigidity of the neck muscles, and difficulty in swallowing and articulating words, caused by bilateral palsy of the XII cranial nerve. Computed tomography (CT) and positron emission tomography (PET) scans showed disease localizations in the occipital-cervical soft tissue, and cerebellar parenchyma. Due to the severity of the clinical picture, high-dose dexamethasone was immediately administered. Mild improvement was observed during the first 2 days of treatment, but dramatic reduction of symptoms and nerve palsy was documented only in the 48 h after the first intrathecal administration of liposomal Ara-C. Systemic R-MegaCEOP chemotherapy was started 7 days later. Concomitant intrathecal liposomal Ara-C injections were continued for a total of nine administrations during the eight cycles of immunochemotherapy without any toxicity observed. Interim and post-therapy PET showed complete resolution of radionuclide accumulation in the involved sites. Consolidation radiotherapy (36 Gy) was administered in involved areas after the completion of the immunochemotherapy program. At the time of writing, no cumulative neurotoxicity is evident at follow-up of 17 months from diagnosis and 9 months after the overall therapeutic program has been accomplished. PMID:19696967

Falchi, Lorenzo; Gunnellini, Marco; Franco, Laura; Ferrazza, Patrizia; Ascani, Stefano; Liberati, Anna Marina

2010-03-01

325

Estimating concurrence via entanglement witnesses  

SciTech Connect

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.

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

2010-05-15

326

Finding Concurrency Bugs In Java  

Microsoft Academic Search

Because threads are a core feature of the Java language, the widespread adoption of Java has exposed a much wider audi- ence to concurrency than previous languages have. Concur- rent programs are notoriously dicult to write correctly, and many subtle bugs can result from incorrect use of threads and synchronization. Therefore, finding techniques to find concurrency bugs is an important

David Hovemeyer; William Pugh

2004-01-01

327

Neoadjuvant Concurrent Chemoradiation for Curative Treatment of Penile Squamous Cell Carcinoma  

PubMed Central

Introduction. Penile cancer is a rare malignancy often treated with neoadjuvant chemotherapy followed by surgery. However, the utility of neoadjuvant chemoradiation, particularly when the tumor is resistant to chemotherapy alone, has not been established. In this study, we report a case of pT3cN3M0 penile squamous cell carcinoma with progression of nodal disease on chemotherapy, which was cured with use of neoadjuvant concurrent chemoradiation. Case Report. A 65-year-old male presented with a fixed left inguinal lymph node with associated firmness of the penile glans. Biopsies of both sites revealed evidence of squamous cell carcinoma. The patient underwent partial penectomy for the primary lesion and began neoadjuvant chemotherapy to reduce the size of the unresectable left inguinal node. However, he displayed disease progression in the left inguinal node. As such, we attempted concurrent chemoradiation therapy with regression of his nodal disease. The patient was able to undergo left inguinal node dissection and has no evidence of disease 18 months since his initial surgery. Conclusion. The use of neoadjuvant chemoradiation for bulky cN2-3 disease seems appropriate in the setting of progressive disease. Further studies are necessary to assess the utility of concurrent chemoradiation both in the neoadjuvant and salvage setting. PMID:25400960

Schwartz, David; Leaf, Andrea; Karanikolas, Nikolaos; Weiss, Jeffrey P.; Schreiber, David

2014-01-01

328

Clinical concepts derived from animal chemotherapy studies  

SciTech Connect

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

Goldin, A.; Schabel, F.M.

1981-01-01

329

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

PubMed Central

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

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

330

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

PubMed

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

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

2014-01-01

331

Chemotherapy with cisplatin or carboplatin in combination with etoposide for small-cell esophageal cancer: a systemic analysis of case series.  

PubMed

Chemotherapy has been the first-choice treatment for small-cell esophageal cancer (SCEC), etoposide plus cisplatin or carboplatin (EP/CP) is the most commonly recommended chemotherapeutical strategy. However, the choice of chemotherapy in treating SCEC has not been validated by studies of large cohorts of cases because of the rarity of the malignancy, and the efficacy superiority of EP/CP over other chemotherapy combinations has not been confirmed. The present case series analysis was conducted to address the above issues. Reported studies of SCEC patients were retrieved. Case series with more than five patients were enrolled. Eight patients treated in our institute were also included as another case series. Data pertaining to clinical stages, treatment regimens, and survival time were collected and analyzed. Altogether, 19 SCEC case series were enrolled, including 164 male and 61 female patients with a median age of 63.5?years. The follow-up time ranged from 0.1 to 221 months (median 12.3 months). The median survival time (MST) was 19 months for limited disease (LD) patients (124 cases) and 9 months for extensive disease (ED) patients (88 cases) (P<0.001). For LD patients, MST was obviously prolonged by chemotherapeutical regimens (20 vs. 10 months, P<0.01), whereas this superiority was not proved in ED patients (10 vs. 10 months, P>0.05). EP/CP did not result in significantly longer MST, compared with that of the cases treated by other chemotherapy combinations (P>0.05, for either LD or ED cases). Chemotherapy prolongs the survival time of the LD SCEC patients, which indicates that chemotherapeutical treatment is effective for SCEC. EP/CP, as commonly recommended multidrug chemotherapy regimen, is not superior to other chemotherapy combinations. PMID:24118373

Gao, R; Zhang, Y; Wen, X P; Fu, J; Zhang, G J

2014-01-01

332

Primary Vaginal Cancer Treated With Concurrent Chemoradiation Using Cis-Platinum  

SciTech Connect

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.

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

333

Concurrent adaptation to four different visual rotations.  

PubMed

The human sensorimotor system can concurrently adapt to two different distortions without interference when the distortions are cued by different contexts. We investigated whether this holds with four distortions as well. Subjects were exposed to an interlaced sequence of +30°, -30°, +60°, and -60° visuomotor rotations as the adaptation phase, cued by combinations of workspace location and by the arm used. Adaptation phase was followed by two episodes in each condition without any distortion testing the aftereffects. Results showed that the error at the onset of adaptation gradually decreased during adaptation to all four distortions without any sign of interference between the conditions. Furthermore, aftereffects of adaptation to ±30° rotation were significantly greater than of adaptation to ±60° rotation. We conclude that the human sensorimotor system is able to concurrently adapt to four different visual distortions when they are cued by different contexts. However, the results of aftereffects are ambiguous: Recalibration could be based on at least four parallel modules. PMID:22777101

Thomas, Monika; Bock, Otmar

2012-08-01

334

Successfull high-dose chemotherapy of secondary central nervous system anaplastic T-cell Non Hodgkin!s lymphoma in a patient with a 50-year history of relapsing malignant lymphomas  

Microsoft Academic Search

Summary We describe the successfull chemotherapy of a patient with secondary central nervous system lymphoma occurring after a fifty-year history of relapsing malignant lymphomas with three distinct histological entities. The lymphoma cells documented in the orbital and cerebrospinal fluid of this patient were characterized as a central manifestation of an anaplastic large cell T-cell Non-Hodgkins lymphoma, and interpreted as a

Sebastian Fetscher; Jan Schmielau; Osnat Bairey

335

Software For Drawing Design Details Concurrently  

NASA Technical Reports Server (NTRS)

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

Crosby, Dewey C., III

1990-01-01

336

99mTc-Sestamibi Using a Direct Conversion Molecular Breast Imaging System to Assess Tumor Response to Neoadjuvant Chemotherapy in Women With Locally Advanced Breast Cancer  

PubMed Central

Purpose The objective of this study was to determine the ability of breast imaging with 99mTc-sestamibi and a direct conversion–molecular breast imaging (MBI) system to predict early response to neoadjuvant chemotherapy (NAC). Methods Patients undergoing NAC for breast cancer were imaged with a direct conversion–MBI system before (baseline), at 3 to 5 weeks after onset, and after completion of NAC. Tumor size and tumor-to-background (T/B) uptake ratio measured from MBI images were compared with extent of residual disease at surgery using the residual cancer burden. Results Nineteen patients completed imaging and proceeded to surgical resection after NAC. Mean reduction in T/B ratio from baseline to 3 to 5 weeks for patients classified as RCB-0 (no residual disease), RCB-1 and RCB-2 combined, and RCB-3 (extensive residual disease) was 56% (SD, 0.20), 28% (SD, 0.20), and 4% (SD, 0.15), respectively. The reduction in the RCB-0 group was significantly greater than in RCB-1/2 (P = 0.036) and RCB-3 (P = 0.001) groups. The area under the receiver operator characteristic curve for determining the presence or absence of residual disease was 0.88. Using a threshold of 50% reduction in T/B ratio at 3 to 5 weeks, MBI predicted presence of residual disease at surgery with a diagnostic accuracy of 89.5% (95% confidence interval [CI], 0.64%–0.99%), sensitivity of 92.3% (95% CI, 0.74%–0.99%), and specificity of 83.3% (95% CI, 0.44%–0.99%). The reduction in tumor size at 3 to 5 weeks was not statistically different between RCB groups. Conclusions Changes in T/B ratio on MBI images performed at 3 to 5 weeks following initiation of NAC were accurate at predicting the presence or absence of residual disease at NAC completion. PMID:24152645

Mitchell, David; Hruska, Carrie B.; Boughey, Judy C.; Wahner-Roedler, Dietlind L.; Jones, Katie N.; Tortorelli, Cindy; Conners, Amy Lynn; O’Connor, Michael K.

2014-01-01

337

Electronic Chemotherapy Order Entry: A Major Cancer Center's Implementation  

PubMed Central

Implementation of a computerized provider order entry system for complex chemotherapy regimens at a large cancer center required intense effort from a multidisciplinary team of clinical and systems experts with experience in all facets of the chemotherapy process. The online tools had to resemble the paper forms used at the time and parallel the successful established process as well as add new functionality. Close collaboration between the institution and the vendor was necessary. This article summarizes the institutional efforts, challenges, and collaborative processes that facilitated universal chemotherapy computerized electronic order entry across multiple sites during a period of several years. PMID:22043182

Sklarin, Nancy T.; Granovsky, Svetlana; O'Reilly, Eileen M.; Zelenetz, Andrew D.

2011-01-01

338

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

PubMed Central

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

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

339

Learning from Mistakes --- A Comprehensive Study on Real World Concurrency Bug Characteristics. In the proceedings of the 13th International Conference on Architecture Support for Programming Languages and Operating Systems (ASPLOS'08), March 2008  

SciTech Connect

The reality of multi-core hardware has made concurrent programs pervasive. Unfortunately, writing correct concurrent programs is dif#2;cult. Addressing this challenge requires advances in multiple directions, including concurrency bug detection, concurrent program testing, concurrent programming model design, etc. Designing effective techniques in all these directions will signi#2;cantly bene#2;t from a deep understanding of real world concurrency bug characteristics. This paper provides the #2;rst (to the best of our knowledge) comprehensive real world concurrency bug characteristic study. Specifically, we have carefully examined concurrency bug patterns, manifestation, and #2;x strategies of 105 randomly selected real world concurrency bugs from 4 representative server and client opensource applications (MySQL, Apache, Mozilla and OpenOf#2;ce). Our study reveals several interesting #2;ndings and provides useful guidance for concurrency bug detection, testing, and concurrent programming language design. Some of our #2;ndings are as follows: (1) Around one third of the examined non-deadlock concurrency bugs are caused by violation to programmers' order intentions, which may not be easily expressed via synchronization primitives like locks and transactional memories; (2) Around 34% of the examined non-deadlock concurrency bugs involve multiple variables, which are not well addressed by existing bug detection tools; (3) About 92% of the examined concurrency bugs can be reliably triggered by enforcing certain orders among no more than 4 memory accesses. This indicates that testing concurrent programs can target at exploring possible orders among every small groups of memory accesses, instead of among all memory accesses; (4) About 73% of the examined non-deadlock concurrency bugs were not #2;xed by simply adding or changing locks, and many of the #2;xes were not correct at the #2;rst try, indicating the dif#2;culty of reasoning concurrent execution by programmers.

Yuanyuan Zhou

2008-03-01

340

Advances in concurrent computers for autonomous robots  

SciTech Connect

Some of the most challenging computational requirements facing scientists and engineers today arise within the framework of intelligent autonomous systems. To enable robots to work effectively in real time in an unstructured environment, one needs to solve repeatedly a variety of highly complex mathematical problems such as on-line planning, vision, sensor fusion, navigation, manipulator dynamics and control. The computational requirements of most of these problems fall into the ''supercomputer'' class, but ultimately one needs to process them ''onboard'' the autonomous machine. Currently, the only realistic option is VLSI-based concurrent computation. This paper builds on the recent development of a VLSI hypercube supercomputer, to address the fundamental issue of implementing robotic algorithms on actual concurrent hardware. 26 refs.

Barhen, J.; Halbert, E.C.; Einstein, J.R.

1986-01-01

341

Dynamics of the bounds of squared concurrence  

NASA Astrophysics Data System (ADS)

The dynamics of the quantum entanglement is a fundamental characteristic for various quantum systems. Since the computable entanglement measure for higher dimensional quantum states itself is absent, the dynamics of the entanglement expressed in an operational method will be of interest. We study the dynamics of ? , an analytical lower bound of squared concurrence, of a bipartite d?d quantum state when one party goes through an arbitrary noisy channel. For a pure input state, the range of ? is obtained explicitly. For a mixed input state, an upper bound of ? is found. Interestingly, the tangle ?' , as an upper bound of squared concurrence, also has a similar dynamical property. Our results are similar to that of Konrad and can help the estimation of high-dimension bipartite entanglement in experiments.

Liu, Zhao; Fan, Heng

2009-03-01

342

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

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.

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

343

Symbolic Analysis of Concurrent Programs with Polymorphism  

NASA Technical Reports Server (NTRS)

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.

Rungta, Neha Shyam

2010-01-01

344

Cytotoxic chemotherapy tooth ache following chemotherapy: a rare case report.  

PubMed

Currently, localized pulpalgia is listed as a rare manifestation of chemotherapy treatments in patients with malignant tumors. The neuropathy originated from neurotoxicity of anticancer drugs is usually described as a diffuse jaw pain or numbness in orofacial structures. This article reports localized tooth pain as a possible outcome of administrating high dosage chemotherapy drugs particularly in the last cycles of application. PMID:25628837

Kuzekanani, Maryam; Haghani, Jahangir

2012-01-01

345

Cytotoxic Chemotherapy Tooth Ache Following Chemotherapy: a Rare Case Report  

PubMed Central

Currently, localized pulpalgia is listed as a rare manifestation of chemotherapy treatments in patients with malignant tumors. The neuropathy originated from neurotoxicity of anticancer drugs is usually described as a diffuse jaw pain or numbness in orofacial structures. This article reports localized tooth pain as a possible outcome of administrating high dosage chemotherapy drugs particularly in the last cycles of application. PMID:25628837

Kuzekanani, Maryam; Haghani, Jahangir

2012-01-01

346

Concurrent Chemoradiotherapy without Brachytherapy in Locally Advanced Cervical Cancer  

PubMed Central

Background Concurrent chemoradiotherapy (EBRT + cisplatin) plus intracavitary brachytherapy is the standard of care in patients with advanced cervical cancer. However, a number of patients could not undergone brachytherapy due to massive residual tumor or anatomical distortion. In this study, we have evaluated the treatment outcome in patients with locally advanced cervical cancer, undergone conventional EBRT plus cisplatin based chemotherapy. Methods In this study, we have selected patients with locally advanced cervical carcinoma (stage: IIB to IIIB) undergone external beam radiotherapy and chemotherapy without brachytherapy at our institute between October of 2007 and October of 2009. The patients have received 50 Gy within 5 weeks to whole pelvic that has followed by a localized boost dose on tumor to 70 Gy concurrently with cisplatin 35 mg/m2 weekly. The treatment has related toxicities, and survival (overall and disease free) have evaluated. Results 30 cases with a median age of 55 (range; 40 to 73) have been studied. According to FIGO classification, the clinical stages were as follows: stage: IIB 23, IIIA 4, and IIIB 3 cases. Three months after treatment, 19 patients (63.3%) have achieved complete response. With a median follow up time of 18 months (range; 10-33 months), 8/23 cases (34.7%) with stage IIB and 2/7 (28.5%) among stage IIIA-IIIB remained disease free at the end of follow up. Data have shown a 2-year overall survival rate of 58.7% ± 9% and 2- year disease free survival of 37.7% ± 9% . Most toxicities were grade I and II. 2 (6.6%) grade III diarrhea and 4 (13.3%) grade III neutropenia have recorded. Conclusion Although a considerable number of patients have achieved complete response using concurrent chemoradiotherapy without brachytherapy, the overall treatment outcomes especially for stage IIIA-IIIB were unsatisfactory. Using modern radiation therapy techniques with increased delivered boost dose could improve treatment results. PMID:25250134

Kadkhodayan, Sima; Homaei Shandiz, Fatemeh; Seilanian Toussi, Mehdi; Afzal Aghaee, Monavar; Farshidi, Farnoosh; Dehghan, Parvane

2013-01-01

347

A prospective evaluation of the combined helical tomotherapy and chemotherapy in pediatric patients with unresectable rhabdomyosarcoma of the temporal bone.  

PubMed

We determined the efficacy of combined helical tomotherapy (HT) and chemotherapy in primary/recurrent unresectable rhabdomyosarcoma (RMS) of temporal bone. For this purpose, 9 patients (7 males/2 females), aged 4-9 (average: 6.89) years, with unresectable embryonal RMS of the temporal bone were treated at our hospital. The tumors had either invaded the carotid artery in the cavernous sinus (7/9) or both the cavernous sinus and the skull base foramen (2/9); 7 patients had primary and 2 had recurrent RMS. All patients underwent 2 cycles of induction chemotherapy with VIE (vincristine, ifosfamide, and etoposide), followed by concurrent HT (50-70 Gy) and chemotherapy with VE (vincristine and etoposide for 2 cycles), and 11 cycles of adjuvant chemotherapy with VIE. As a result, all patients achieved complete response, and the 2-year tumor-free survival rate was 100 %. During a follow-up of 3-51 months, all 9 patients were alive. We, therefore, conclude that the induction chemotherapy, adjuvant chemotherapy with VIE and concurrent HT and chemotherapy with VE regimen is effective in treating unresectable embryonal RMS of the temporal bone. The combined modality treatment may achieve the best chance of cure for these patients, thereby changing the therapeutic strategy from palliative to possibly curative. PMID:24619819

Zhang, Xinxin; Ma, Kun; Wang, Jaling; Wu, Wenming; Ma, Lin; Huang, Deliang

2014-09-01

348

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

PubMed Central

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

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

349

Lung cancer and concurrent or sequential lymphoma: Two case reports with hypersensitivity to bevacizumab and a review of the literature  

PubMed Central

Non-small cell lung cancer (NSCLC) accounts for ~80% of all cases of lung cancer, and is the leading cause of cancer-related mortality worldwide. The majority of NSCLC cases of are diagnosed at an advanced stage. The outcome of patients with advanced NSCLC is poor with a median survival time of ~12 months in European and American populations. Lymphoproliferative disorders (LPDs) represent a heterogeneous group of expanding lymphoid cells, which occurs as a result of immune dysfunction. LPDs are often associated with primary solid cancers. We report two cases of LPD diagnosed concurrently and successively to NSCLC. The first case presents a 65-year-old female patient with advanced IV stage lung cancer, according to the International Association for the Study of Lung Cancer TNM staging system. The patient developed a concurrent lymphoma and was treated with first-line therapy including six cycles of gemcitabine and cisplatin, however, the patient experienced an adverse drug reaction to bevacizumab, which was administered after gemcitabine and prior to cisplatin. The second case presented a 74-year-old male patient diagnosed with large B cell lymphoma. The patient acheived remission of the illness, however, after one year the patient was diagnosed with squamous cell lung cancer. After three years, the patient underwent surgery, however disease recurrence was identified. Subsequently, the patient was treated with sterotactic radiotherapy and oral chemotherapy. A review of the associated literature was also conducted.

PEZZUTO, ALDO; PIRAINO, ALESSIO; MARIOTTA, SALVATORE

2015-01-01

350

Basaloid squamous cell carcinoma in the nasal cavity treated with proton beam therapy concurrent with cisplatin: a case report  

PubMed Central

Introduction Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma. Basaloid squamous cell carcinoma is mostly seen in the upper aerodigestive tract and has a propensity for lymph node spread and systemic metastases. Various treatment modalities have been reported, including surgical excision supplemented with radiotherapy/adjuvant chemotherapy. To the best of our knowledge, treatment of nasal basaloid squamous cell carcinoma with proton beam therapy and cisplatin has not been described in the literature. Case presentation We report the case of a 56-year-old Japanese man with locally invasive basaloid squamous cell carcinoma in his right nasal cavity with invasion of the orbit, paranasal sinus, and buccal subcutaneous tissue. He underwent proton beam therapy concurrent with cisplatin. Acute and late side effects did not exceed grade 3. At 24-month follow up, he remains in complete remission. Conclusion Proton beam therapy concurrent with cisplatin may be one choice for locally invasive basaloid squamous cell carcinoma. PMID:24716457

2014-01-01

351

Chemotherapy-associated renal dysfunction  

Microsoft Academic Search

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

Vaibhav Sahni; Devasmita Choudhury; Ziauddin Ahmed

2009-01-01

352

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

SciTech Connect

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

Haffty, Bruce G. [Department of Radiation Oncology, Cancer Institute of New Jersey, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ (United States)], E-mail: hafftybg@umdnj.edu; Vicini, Frank A. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beitsch, Peter [Department of Surgery, Dallas Breast Center, Dallas, TX (United States); Quiet, Coral [Department of Radiation Oncology, Arizona Oncology Services, Scottsdale, AZ (United States); Keleher, Angela [Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA (United States); Garcia, Delia [Department of Radiation Oncology, St. Louis Cancer and Breast Center, St. Louis, MO (United States); Snider, Howard [Department of Surgery, Alabama Breast Center, Montgomery, AL (United States); Gittleman, Mark [Department of Surgery, Sacred Heart Hospital, Allentown, PA (United States); Zannis, Victor [Department of Surgery, Breast Care Center of the Southwest, Phoenix, AZ (United States); Kuerer, Henry [Department of Surgery, M. D. Anderson Cancer Center, Houston, TX (United States); Whitacre, Eric [Department of Surgery, Breast Center of Southern Arizona, Tucson, AZ (United States); Whitworth, Pat [Department of Surgery, Vassar Brothers Medical Center, Poughkeepsie, NY (United States); Fine, Richard [Department of Surgery, Advanced Breast Care, Marietta, GA (United States); Keisch, Martin [Department of Radiation Oncology, Cedars Medical Center, Miami, FL (United States)

2008-12-01

353

The effect of cytotoxic chemotherapy on female fertility.  

PubMed

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

Chasle, Sharon; How, Christine C

2003-06-01

354

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

Microsoft Academic Search

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

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

355

Architectural support for concurrent logic programming languages  

SciTech Connect

The authors propose a special-purpose processor and shared-memory multiprocessor architecture for the efficient execution of flat concurrent prolog (FCP). Their design method is based on the analysis of the following suspected implementation bottlenecks: the overhead of redundant clause-tries, goal suspension, activation, argument dereferencing, and clause-trailing. The analysis consists of a set of performance models that are part of a general goal reduction model. The authors evaluate the models using program parameters obtained empirically by executing the System's Development Workload, which includes programs like the logix operating system, FCP compiler, FCP processor simulator, program analyzer and debugger. Measurements are obtained using the Statistics Logix (Slogix) emulator.

Alkalaj, L.

1989-01-01

356

Chemotherapy-induced immunosuppression.  

PubMed Central

Chemotherapeutic agents are used widely in clinical medicine for the treatment of conditions where diminution of the host immune response is a goal. The clinical use of immunosuppression is indicated for immunologically mediated disease, lymphoproliferative diseases, and prevention of graft rejection. Five categories of agents are useful for these purposes; they are ionizing irradiation, corticosteroids, biological alkylating agents, antilymphocyte sera and antimetabolites. While the specific molecular action of many of these drugs is known, how they affect cellular events in immune responses is less clear. One of the unfortunate sequelae of chemotherapy induced immunosuppression is an increased susceptibility of the host to opportunistic pathogens or malignancies. Specific methods are described for monitoring the various parameters of both humoral and cellular immunity. Studies of immunologic function in lymphoma patients and cardiac transplant patients treated with immunosuppressive drugs have shown specific defects in cell mediated immunity to herpes viruses which may relate to their increased susceptibility to infection by these agents. PMID:7037385

Rasmussen, L; Arvin, A

1982-01-01

357

Chemotherapy-induced Cardiotoxicity  

PubMed Central

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

FLORESCU, Maria; CINTEZA, Mircea; VINEREANU, Dragos

2013-01-01

358

Chromonychia Secondary to Chemotherapy  

PubMed Central

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

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

2013-01-01

359

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: where are we?  

PubMed

Peritoneal surface malignancies are generally associated with poor prognosis. In daily clinical routine, systemic chemotherapy is still considered the only reasonable therapy despite of encouraging results of cytoreductive surgery (CRS) along with intraperitoneal hyperthermic chemotherapy (HIPEC). The Achilles heel of CRS and HIPEC is appropriate patient selection and precise surgical technique preventing patients from excessive morbidity and mortality. Given these findings, new concepts of second look surgery for high risk patients allow detection of peritoneal spread ahead of clinical symptoms or presence of peritoneal masses reducing perioperative morbidity. In addition, personalized intraperitoneal chemotherapy might further improve outcome by appreciating individual tumor biology. These days, every physician should be aware of CRS and HIPEC for treatment of peritoneal surface malignancies. Since there is now sufficient data for the superiority of CRS and HIPEC to systemic chemotherapy in selected patients, our next goal should be providing this strategy with minimal morbidity and mortality even in the presence of higher tumor load. PMID:23082046

Königsrainer, Ingmar; Beckert, Stefan

2012-10-14

360

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Where are we?  

PubMed Central

Peritoneal surface malignancies are generally associated with poor prognosis. In daily clinical routine, systemic chemotherapy is still considered the only reasonable therapy despite of encouraging results of cytoreductive surgery (CRS) along with intraperitoneal hyperthermic chemotherapy (HIPEC). The Achilles heel of CRS and HIPEC is appropriate patient selection and precise surgical technique preventing patients from excessive morbidity and mortality. Given these findings, new concepts of second look surgery for high risk patients allow detection of peritoneal spread ahead of clinical symptoms or presence of peritoneal masses reducing perioperative morbidity. In addition, personalized intraperitoneal chemotherapy might further improve outcome by appreciating individual tumor biology. These days, every physician should be aware of CRS and HIPEC for treatment of peritoneal surface malignancies. Since there is now sufficient data for the superiority of CRS and HIPEC to systemic chemotherapy in selected patients, our next goal should be providing this strategy with minimal morbidity and mortality even in the presence of higher tumor load. PMID:23082046

Königsrainer, Ingmar; Beckert, Stefan

2012-01-01

361

Do I use the wrong definition?: DeFuse: definition-use invariants for detecting concurrency and sequential bugs  

Microsoft Academic Search

Software bugs, such as concurrency, memory and semantic bugs, can significantly affect system reliability. Although much effort has been made to address this problem, there are still many bugs that cannot be detected, especially concurrency bugs due to the complexity of concurrent programs. Effective approaches for detecting these common bugs are therefore highly desired. This paper presents an invariant-based bug

Yao Shi; Soyeon Park; Zuoning Yin; Shan Lu; Yuanyuan Zhou; Wenguang Chen; Weimin Zheng

2010-01-01

362

Chemotherapy or radiation-induced oral mucositis.  

PubMed

Oral mucositis is a significant toxicity of systemic chemotherapy and of radiation therapy to the head and neck region. The morbidity of oral mucositis can include pain, nutritional compromise, impact on quality of life, alteration in cancer therapy, risk for infection, and economic costs. Management includes general symptomatic support and targeted therapeutic interventions for the prevention or treatment of oral mucositis. Evidence-based clinical practice guidelines are available to guide clinicians in the selection of effective management strategies. PMID:24655526

Lalla, Rajesh V; Saunders, Deborah P; Peterson, Douglas E

2014-04-01

363

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

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.

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

364

BOISE STATE UNIVERSITY CONCURRENT ENROLLMENT  

E-print Network

in concurrent enrollment opportunities. For the past 16 years Boise State has been working to build the premier, with the opportunity to access the Writing Center, free tutorial services, the Albertsons Library, a student ID card university course work, while at the same time gaining an early start on your college career. Credits

Barrash, Warren

365

BOISE STATE UNIVERSITY CONCURRENT ENROLLMENT  

E-print Network

in concurrent enrollment opportunities. For the past 15 years Boise State has been working to build the premier, with the opportunity to access the Writing Center, free tutorial services, the Albertsons Library, a student ID card university course work, while at the same time gaining an early start on your college career. Credits

Barrash, Warren

366

Structured Concurrent Programming William Cook  

E-print Network

Structured Concurrent Programming William Cook Jayadev Misra David Kitchin John Thywissen Arthur if the quote is at most $300. · Buy the cheapest ticket if both quotes are above $300. · Buy a ticket · Adaptive Workflow (Business process management): Workflow lasting over months or years Security, Failure

Misra, Jayadev

367

Multipartite concurrence for states under decoherence  

NASA Astrophysics Data System (ADS)

In this paper, the dynamics evolution of multipartite entanglement for each qubit interacting with a local decoherence channel, such as phase damping, phase flip, bit flip and bit-phase flip channel, is investigated. It is shown that the initial concurrence monotonously decreases much faster with the number of qubit increases and there exists entanglement sudden death (ESD) only for the bit flip channel and bit-phase flip channels. Meanwhile, the time of ESD decreases with the increases of the number of qubit in the multipartite system.

Shi, Jia-dong; Wu, Tao; Song, Xue-ke; Ye, Liu

2014-04-01

368

Chemotherapy for lung cancers: here to stay.  

PubMed

Four decades of clinical research document the effectiveness of chemotherapy in patients with lung cancers. Chemotherapeutic agents can improve lung cancer symptoms, lengthen life in most patients with lung cancers, and enhance curability in individuals with locoregional disease when combined with surgery or irradiation. Chemotherapy's effectiveness is enhanced in patients with EGFR-mutant and ALK-positive lung cancers and can "rescue" individuals whose oncogene-driven cancers have become resistant to targeted agents. As immunotherapies become part of the therapeutic armamentarium for lung cancers, chemotherapeutic drugs have the potential to modulate the immune system to enhance the effectiveness of immune check point inhibitors. Even in this era of personalized medicine and targeted therapies, chemotherapeutic agents remain essential components in cancer care. PMID:24857127

Kris, Mark G; Hellmann, Matthew D; Chaft, Jamie E

2014-01-01

369

Design and evaluation of executable assertions for concurrent error detection  

NASA Technical Reports Server (NTRS)

System level concurrent detection of errors due to hardware faults can be accomplished by introducing software redundancy in the form of executable assertions into a program to monitor the correct operation of the system during its execution. This paper attempts to formalize the use of executable assertions for the purpose of concurrent error detection, and discusses a transformation approach to the design of assertion statements. The second part deals with the effectiveness of the error detection technique. A fault simulation method for the evaluation of the reliability of the assertion statements is described. This scheme was used to study the effectiveness of a nontrivial program in providing protection against faults in the underlying system. The experimental results shows that the use of executable assertions provides an effective approach to achieve concurrent error detection.

Hua, Kien A.; Abraham, Jacob A.

1987-01-01

370

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 ...

371

Combination Chemotherapy for Liver Cancer  

Cancer.gov

In this clinical trial, researchers are adding a new drug called bortezomib to chemotherapy with doxorubicin to see if it can cause liver tumors to shrink or stop growing better than doxorubicin alone.

372

Understanding resistance to combination chemotherapy  

E-print Network

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

Pritchard, Justin R.

373

Cyclocreatine in cancer chemotherapy.  

PubMed

Cyclocreatine, an analog of creatine, is an efficient substrate for creatine kinase, but its phosphorylated form is a poor phosphate donor in comparison with creatine phosphate. Cyclocreatine was not very cytotoxic upon 24 h of exposure of human SW2 small-cell lung cancer cells to concentrations of up to 5 mM. However, combinations of cyclocreatine (0.5 mM, 24 h) with each of four antitumor alkylating agents, cis-diamminedichloroplatinum(II), melphalan, 4-hydroperoxycyclophosphamide, and carmustine, resulted in additive to greater-than-additive cytotoxicity toward exponentially growing SW2 cells. The greatest levels of synergy were seen at higher concentrations of 4-hydroperoxycyclophosphamide and carmustine as determined by isobologram analysis. In vivo cyclocreatine (0.5 or 1 g/kg) was more effective if given i.v. rather than i.p. The longest tumor-growth delays, up to 10 days, were produced by extended regimens of cyclocreatine. Cyclocreatine was an effective addition to therapy with standard anticancer agents including cis-diamminedichloroplatinum(II), cyclophosphamide, Adriamycin, or 5-fluorouracil. No additional toxicity was observed when 10 days of cyclocreatine treatment was given with full standard-dose regimens of each drug. The resultant increases in tumor-growth delay were 1.7- to 2.4-fold as compared with those obtained for each of the drugs alone. These results indicate that cyclocreatine may be an effective single agent and an effective addition to combination chemotherapy regimens. PMID:7850923

Teicher, B A; Menon, K; Northey, D; Liu, J; Kufe, D W; Kaddurah-Daouk, R

1995-01-01

374

Response of hemorrhagic bullous skin lesions of the breast secondary to primary systemic amyloidosis to a five-drug combination chemotherapy: a case report and review of the literature  

PubMed Central

Two major types of amyloidosis are primary amyloidosis or amyloid light chain amyloidosis and secondary amyloidosis. Although amyloidosis involves a variety of organ systems including skin, the occurrence of bullous skin lesions is rare. Little is known about the mechanism of blister formation. These blisters are often hemorrhagic and typically occur in the oral mucosa. Only a few case reports have described skin involvement in systemic amyloidosis. The manifestation of bullous lesions on the breast in association with primary amyloidosis has not been previously reported. Therefore, we report a case of cutaneous hemorrhagic bullous of the breast secondary to primary systemic amyloidosis, which may be important for medical oncologists to be aware of this uncommon presentation of plasma cell dysrasias. Furthermore, this case only partially responded to the commonly used multiple myeloma-type regimen, the skin lesions responded completely to a five-drug combination chemotherapy regimen, utilizing immunomodulators, liposomal doxorubicin, cyclophosphamide, bortezomib, and dexamethasone, suggesting that a more aggressive modality of chemotherapy may be necessary to treat such cases. PMID:23210921

2012-01-01

375

Concurrent initialization for Bearing-Only SLAM.  

PubMed

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

Munguía, Rodrigo; Grau, Antoni

2010-01-01

376

Object-Oriented Analysis and Design of Concurrent,  

E-print Network

Object-Oriented Analysis and Design of Concurrent, Real-Time SystemsKEVIN L. MILLS INFT 860 SPRING 1993 DESIGN METHODS FOR REAL-TIME SYSTEMS GEORGE MASON UNIVERSITY #12;I. Introduction of these real-time, automated applications grow, our ability to analyze requirements and to design solutions

Mills, Kevin

377

Magnetic nanoparticle-based therapeutic agents for thermo-chemotherapy treatment of cancer  

NASA Astrophysics Data System (ADS)

Magnetic nanoparticles have been widely investigated for their great potential as mediators of heat for localised hyperthermia therapy. Nanocarriers have also attracted increasing attention due to the possibility of delivering drugs at specific locations, therefore limiting systematic effects. The enhancement of the anti-cancer effect of chemotherapy with application of concurrent hyperthermia was noticed more than thirty years ago. However, combining magnetic nanoparticles with molecules of drugs in the same nanoformulation has only recently emerged as a promising tool for the application of hyperthermia with combined chemotherapy in the treatment of cancer. The main feature of this review is to present the recent advances in the development of multifunctional therapeutic nanosystems incorporating both magnetic nanoparticles and drugs, and their superior efficacy in treating cancer compared to either hyperthermia or chemotherapy as standalone therapies. The principle of magnetic fluid hyperthermia is also presented.

Hervault, Aziliz; Thanh, Nguyêl; N. Thé, Kim

2014-09-01

378

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

PubMed Central

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

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

2014-01-01

379

Concurrent Prime Number Test Model  

NSDL National Science Digital Library

The Concurrent Prime Number Test Model uses the trial division algorithm to decide if a number is prime.  The prime division algorithm is inefficient and we use it here only to test the EJS implementation of the Parallel Region Element in EJS.  A parallel region executes independent code in threads that execute simultaneously on a multi-core processor.  The screen capture shows that the total execution time for four computations on a quad-core processor is only one millisecond longer than the execution time for the longest single computation.  This linear speedup is close to the theoretical maximum. The Concurrent Prime Number Test Model was created using the Easy Java Simulations (EJS) modeling tool. It is distributed as a ready-to-run (compiled) Java archive. Double clicking the model's jar file will run the simulation if Java is installed.

Christian, Wolfgang

2012-01-19

380

Oral toxicity produced by chemotherapy: A systematic review  

PubMed Central

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

2014-01-01

381

Imaging enhancement of malignancy by cyclophosphamide: surprising chemotherapy opposite effects  

NASA Astrophysics Data System (ADS)

Although side effects of cancer chemotherapy are well known, "opposite effects" of chemotherapy which enhance the malignancy of the treated cancer are not well understood. We have observed a number of steps of malignancy that are enhanced by chemotherapy pre-treatment of mice before transplantation of human tumor cells. The induction of intravascular proliferation, extravasation, and colony formation by cancer cells, critical steps of metastasis was enhanced by pretreatment of host mice with the commonly-used chemotherapy drug cyclophosphamide. Cyclophosphamide appears to interfere with a host process that inhibits intravascular proliferation, extravasation, and extravascular colony formation by at least some tumor cells. Cyclophosphamide does not directly affect the cancer cells since cyclophosphamide has been cleared by the time the cancer cells were injected. Without cyclophosphamide pretreatment, human colon cancer cells died quickly after injection in the portal vein of nude mice. Extensive clasmocytosis (destruction of the cytoplasm) of the cancer cells occurred within 6 hours. The number of apoptotic cells rapidly increased within the portal vein within 12 hours of injection. However, when the host mice were pretreated with cyclophosphamide, the cancer cells survived and formed colonies in the liver after portal vein injection. These results suggest that a cyclophosphamide-sensitive host cellular system attacked the cancer cells. This review describes an important unexpected "opposite effects" of chemotherapy that enhances critical steps in malignancy rather than inhibiting them, suggesting that certain current approaches to cancer chemotherapy should be modified.

Yamauchi, Kensuke; Yang, Meng; Hayashi, Katsuhiro; Jiang, Ping; Xu, Mingxu; Yamamoto, Norio; Tsuchiya, Hiroyuki; Tomita, Katsuro; Moossa, A. R.; Bouvet, Michael; Hoffman, Robert M.

2008-02-01

382

Spontaneous Pneumomediastinum with Concurrent Pneumorrhachis  

PubMed Central

Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.

Jung, Hanna; Lee, Sang Cjeol; Lee, Deok Heon; Kim, Gun-Jik

2014-01-01

383

Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature  

PubMed Central

Introduction. Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved. Materials and Methods. The management and outcomes of 20 patients with ATC were reviewed. Results. Median age at diagnosis was 69.5 years. 19 patients died due to ATC, 40% of whom died from asphyxiation. Median survival for all cases was 59 days. Patients who had previous surgery prior to other treatment modalities had a longer median survival overall compared to those who had not had previous surgery (142 days compared to 59 days) and produced the one long-term survivor. Chemotherapy followed by radiotherapy (without previous surgery) was associated with longer median survival (220 days). Palliative radiotherapy alone did not decrease the rate of death by asphyxiation when compared to other single modality treatments. Conclusion. Multimodality treatment including surgery when feasible remains the best strategy to improve survival and prevent death from asphyxiation in the management of ATC. The addition of chemotherapy to our institutional protocol led to improved survival but prognosis remains very poor. PMID:25184150

Lowe, Natalie M.; Loughran, Sean; Slevin, Nicholas J.; Yap, Beng K.

2014-01-01

384

Neoadjuvant Combined Microwave Induced Local Hyperthermia and Topical Chemotherapy Versus Chemotherapy Alone for Superficial Bladder Cancer  

Microsoft Academic Search

PurposeWe evaluated the effectiveness of local bladder hyperthermia and intravesical chemotherapy compared to intravesical chemotherapy alone in the treatment of superficial transitional cell carcinoma.

Renzo Colombo; Luigi F. Da Pozzo; Avigdor Lev; Massimo Freschi; Giuseppe Gallus; Patrizio Rigatti

1996-01-01

385

Practical considerations in ovarian cancer chemotherapy  

PubMed Central

Epithelial ovarian cancer remains the most lethal gynecologic malignancy despite advances in treatment. The standard management generally involves a combination of surgical tumor debulking and chemotherapy. Over the decades, chemotherapy for ovarian cancer has evolved and currently involves a combination of intravenous platinum and taxane chemotherapy. Over the past decade, three randomized phase III trials have been reported, and all have demonstrated a significant survival advantage for intraperitoneal compared with intravenous chemotherapy. However, there are potential barriers and controversies related to the administration of intraperitoneal chemotherapy in ovarian cancer patients. In this review, we discuss the evolution and current management considerations of chemotherapy for the treatment of epithelial ovarian cancer. PMID:21789133

Cristea, Mihaela; Han, Ernest; Salmon, Lennie; Morgan, Robert J.

2010-01-01

386

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

E-print Network

A Ã?MINIUM: 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

Aldrich, Jonathan

387

Concurrent multifrontal methods: Shared memory, cache, and frontwidth issues  

SciTech Connect

Frontal methods are an efficient and popular means of Gauss elimination of matrix equations that arise in finite element analysis. Nested dissection of a computational domain makes possible high-level parallelism in a widely used frontal algorithm for unsymmetric systems. A concurrent, highly vectorized, multifrontal, finite element analysis of axisymmetric liquid drop oscillations with 2,210 equations runs on the CRAY X-MP/48 with factors of 1.9 and 2.9 reduction in elapsed time on two and four processors, respectively. On an ELXSI 6400 (which has an additional memory level, local processor cache, ignored in the algorithm's design for the CRAY), implementation of the same problem initially achieved a speedup of only 1.4 on four processors. Modification of the concurrent algorithm, to take advantage of the cache and frontwidth reduction by element reordering, doubled the concurrent speedup on the ELXSI to 2.8 on four processors.

Benner, R.E.; Montry, G.R.; Weigand, G.G.; Duff, I.

1987-01-01

388

Hardware Emulation Strategies for Concurrent Microsatellite Hardware and Software  

E-print Network

Hardware Emulation Strategies for Concurrent Microsatellite Hardware and Software Development G. If the functionality of the hardware can be efficiently emulated using software, then it would be possible to use software emulation. The simulation system can then be used to test the interaction between flight code

Damaren, Christopher J.

389

Designing application specific circuits with concurrent C# programs  

Microsoft Academic Search

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

David J. Greaves; Satnam Singh

2010-01-01

390

E ective Optimistic Concurrency Control in Multiversion Object Bases  

E-print Network

framework. This protocol avoids the high roll back costs associated with optimistic protocols in two ways concurrent executions are invalid. Fewer con- icts means fewer roll backs are necessary. Second rather than roll back. 1 Introduction Object base systems have been of particular interest

Graham, Peter

391

A C++ Thread Package for Concurrent and Parallel Programming  

SciTech Connect

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.

Jie Chen; William Watson

1999-11-01

392

Factorization law for two lower bounds of concurrence  

NASA Astrophysics Data System (ADS)

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 , Nat. Phys.1745-247310.1038/nphys885 4, 99 (2008)]. We also discuss the application of this property in an example.

Mirafzali, Sayyed Yahya; Sargolzahi, Iman; Ahanj, Ali; Javidan, Kurosh; Sarbishaei, Mohsen

2010-09-01

393

Concurrent and sequential administration of sunitinib malate and docetaxel in human non-small cell lung cancer cells and xenografts  

Microsoft Academic Search

Optimal scheduling of chemotherapy with molecular-targeted agents is important to maximize clinical benefit. We compared the\\u000a effects of concurrent and sequential administration of docetaxel and multi-target inhibitor sunitinib malate on tumor cells\\u000a and xenografts and studied several mechanisms involved in drug interaction to provide experimental data in support of their\\u000a clinical use in non-small cell lung cancer (NSCLC). Human umbilical

Dongchun Wang; Zhenzhou Jiang; Luyong Zhang

394

[Safety management of intravenous cancer chemotherapy and oral premedication drugs].  

PubMed

The administration of oral premedication drugs(OPDs)is increased before intravenous cancer chemotherapy to prevent adverse events such as hypersensitivity or nausea and vomiting. As intravenous chemotherapy regimens and OPDs are ordered separately in the electronic medical record system, the prescription or administration of OPDs may be missed. To overcome this problem, we developed a combination regimen ordering(CRO)system, in which OPDs were included in the intravenous chemotherapy regimen enabling simultaneous ordering. This system used the electronic medical record system HAPPY ACTIS by TOSHIBA Medical Information Systems Co. in our hospital. OPDs were prepared in an envelope labeled with a bar code to identify the patient, which was then used by the nursing staff to administer the medication. Between August 2011 and January 2014, CRO systems were used in 66 regimens for the treatment of the following cancers: 21 lung cancers, 14 breast cancers, 9 hematologic malignancies, 7 genitourinary cancers, 6 gastrointestinal cancers, 5 gynecological cancers, 3 head and neck cancers, and 1 dermatological malignancy. The OPDs administered were diphenhydramine, loxoprofen, chlorpheniramine, aprepitant, and ramosetron. Although we were unable to check OPDs in the oral drug administration histories, no errors in the administration of OPDs have been reported after the adoption of the CRO system. Therefore, our CRO system improved the safety and quality of patient care for cancer chemotherapy. PMID:25596683

Hikino, Hajime; Nanme, Yuki

2015-01-01

395

Managing Chemotherapy Side Effects: Nerve Changes  

MedlinePLUS

... institutes of health Managing Chemotherapy Side Effects Nerve Changes “My fingers and toes felt numb and tingly. ... getting cuts, I always wore shoes.” About nerve changes Some chemotherapy can cause nerve problems. You may ...

396

Hepatic arterial infusion pump chemotherapy in the management of colorectal liver metastases: expert consensus statement.  

PubMed

Despite significant improvements in systemic therapy for patients with colorectal liver metastases (crlms), response rates in the first-line setting are not optimal, and response rates in the second-line setting remain disappointing. Hepatic arterial infusion pump (haip) chemotherapy has been extensively studied in patients with crlms, but it remains infrequently used. We convened an expert panel to discuss the role of haip in the contemporary management of patients with crlm. Using a consensus process, we developed these statements: haip chemotherapy should be given in combination with systemic chemotherapy.haip chemotherapy should be offered in the context of a multidisciplinary program that includes expertise in hepatobiliary surgery, medical oncology, interventional radiology, nursing, and nuclear medicine.haip chemotherapy in combination with systemic therapy should be considered in patients with unresectable crlms who have progressed on first-line systemic treatment. In addition, haip chemotherapy is acceptable as first-line treatment in patients with unresectable colorectal liver metastases.haip chemotherapy is not recommended in the setting of extrahepatic disease outside the context of a clinical trial.haip chemotherapy in combination with systemic therapy is an option for select patients with resected colorectal liver metastases. These consensus statements provide a framework that clinicians who treat patients with crlm can use when considering treatment with haip. PMID:24523610

Karanicolas, P J; Metrakos, P; Chan, K; Asmis, T; Chen, E; Kingham, T P; Kemeny, N; Porter, G; Fields, R C; Pingpank, J; Dixon, E; Wei, A; Cleary, S; Zogopoulos, G; Dey, C; D'Angelica, M; Fong, Y; Dowden, S; Ko, Y J

2014-02-01

397

Hepatic arterial infusion pump chemotherapy in the management of colorectal liver metastases: expert consensus statement  

PubMed Central

Despite significant improvements in systemic therapy for patients with colorectal liver metastases (crlms), response rates in the first-line setting are not optimal, and response rates in the second-line setting remain disappointing. Hepatic arterial infusion pump (haip) chemotherapy has been extensively studied in patients with crlms, but it remains infrequently used. We convened an expert panel to discuss the role of haip in the contemporary management of patients with crlm. Using a consensus process, we developed these statements: haip chemotherapy should be given in combination with systemic chemotherapy.haip chemotherapy should be offered in the context of a multidisciplinary program that includes expertise in hepatobiliary surgery, medical oncology, interventional radiology, nursing, and nuclear medicine.haip chemotherapy in combination with systemic therapy should be considered in patients with unresectable crlms who have progressed on first-line systemic treatment. In addition, haip chemotherapy is acceptable as first-line treatment in patients with unresectable colorectal liver metastases.haip chemotherapy is not recommended in the setting of extrahepatic disease outside the context of a clinical trial.haip chemotherapy in combination with systemic therapy is an option for select patients with resected colorectal liver metastases. These consensus statements provide a framework that clinicians who treat patients with crlm can use when considering treatment with haip PMID:24523610

Karanicolas, P.J.; Metrakos, P.; Chan, K.; Asmis, T.; Chen, E.; Kingham, T.P.; Kemeny, N.; Porter, G.; Fields, R.C.; Pingpank, J.; Dixon, E.; Wei, A.; Cleary, S.; Zogopoulos, G.; Dey, C.; D’Angelica, M.; Fong, Y.; Dowden, S.; Ko, Y.J.

2014-01-01

398

Nutritional strategies to support concurrent training.  

PubMed

Abstract Concurrent training (the combination of endurance exercise to resistance training) is a common practice for athletes looking to maximise strength and endurance. Over 20 years ago, it was first observed that performing endurance exercise after resistance exercise could have detrimental effects on strength gains. At the cellular level, specific protein candidates have been suggested to mediate this training interference; however, at present, the physiological reason(s) behind the concurrent training effect remain largely unknown. Even less is known regarding the optimal nutritional strategies to support concurrent training and whether unique nutritional approaches are needed to support endurance and resistance exercise during concurrent training approaches. In this review, we will discuss the importance of protein supplementation for both endurance and resistance training adaptation and highlight additional nutritional strategies that may support concurrent training. Finally, we will attempt to synergise current understanding of the interaction between physiological responses and nutritional approaches into practical recommendations for concurrent training. PMID:25159707

Perez-Schindler, Joaquin; Hamilton, D Lee; Moore, Daniel R; Baar, Keith; Philp, Andrew

2015-02-01

399

Neoadjuvant chemotherapy for ovarian cancer.  

PubMed

Primary debulking surgery by a gynecologic oncologist remains the standard of care in advanced ovarian cancer. Optimal debulking surgery should be defined as no residual tumor load. In retrospective analyses, neoadjuvant chemotherapy followed by interval debulking surgery does not seem to worsen prognosis compared to primary debulking surgery followed by chemotherapy. However, we will have to wait for the results of future randomized trials to know whether neoadjuvant chemotherapy followed by interval debulking surgery is as good as primary debulking surgery in stage IIIC and IV patients. Interval debulking is defined as an operation performed after a short course of induction chemotherapy. Based on the randomized European Organization for Research and Treatment of Cancer-Gynecological Cancer Group (EORTC-GCG) trial, interval debulking by an experienced surgeon improves survival in some patients who did not undergo optimal primary debulking surgery. Based on Gynecologic Oncology Group (GOG) 152 data, interval debulking surgery does not seem to be indicated in patients who underwent primarily a maximal surgical effort by a gynecologic oncologist. Open laparoscopy is probably the most valuable tool for evaluating the operability primarily or at the time of interval debulking surgery. PMID:16396153

Vergote, Ignace; van Gorp, Toon; Amant, Frederic; Neven, Patrick; Berteloot, Patrick

2005-11-01

400

Review Photodynamic antimicrobial chemotherapy (PACT)  

Microsoft Academic Search

Whereas the photodynamic therapy (PDT) of cancer has recently shown rapid clinical accept- ance, photodynamic antimicrobial chemotherapy (PACT)—which predates the related cancer regimen—is not widely appreciated. Like PDT, PACT utilizes photosensitizers and visible or ultraviolet light in order to give a phototoxic response, normally via oxidative damage. Currently, the major use of PACT is in the disinfection of blood products,

Mark Wainwright

1998-01-01

401

Axioms for concurrent objects. Interim report  

SciTech Connect

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

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

1987-12-01

402

Towards a Framework for Characterising Concurrent Comprehension  

NASA Astrophysics Data System (ADS)

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 students' knowledge. In particular, the proposed framework attempts to categorize the types of information students seek and the types of information they obtain, as they learn about concurrent software. Thus the framework could be used to guide teaching methods in this area, to hone the representations used to portray concurrent software to students and subsequently, to assess students' performance.

Hughes, Connor; Buckley, Jim; Exton, Chris; O'Carroll, Des; SVCR Group

2005-03-01

403

Outcomes after HLA-matched sibling transplantation or chemotherapy in children with acute lymphoblastic leukemia in a second remission after an isolated central nervous system relapse: a collaborative study of the Children's Oncology Group and the Center for International Blood and Marrow Transplant Research.  

PubMed

In children with acute lymphoblastic leukemia (ALL) with isolated central nervous system (CNS) relapse and a human leucocyte antigen (HLA)-matched sibling, the optimal treatment after attaining second remission is unknown. We compared outcomes in 149 patients enrolled on chemotherapy trials and 60 HLA-matched sibling transplants, treated in 1990-2000. All patients achieved a second complete remission. Groups were similar, except the chemotherapy recipients were younger at diagnosis, less likely to have T-cell ALL and had longer duration (> or = 18 months) first remission. To adjust for time-to-transplant bias, left-truncated Cox's regression models were constructed. Relapse rates were similar after chemotherapy and transplantation. In both treatment groups, relapse rates were higher in older children (11-17 years; RR 2.81, P=0.002) and shorter first remission (< 18 months; RR 3.89, P<0.001). Treatment-related mortality rates were higher after transplantation (RR 4.28, P=0.001). The 8-year probabilities of leukemia-free survival adjusted for age and duration of first remission were similar after chemotherapy with irradiation and transplantation (66 and 58%, respectively). In the absence of an advantage for one treatment option over another, the data support use of either intensive chemotherapy with irradiation or HLA-matched sibling transplantation with total body irradiation containing conditioning regimen for children with ALL in second remission after an isolated CNS relapse. PMID:18033318

Eapen, M; Zhang, M-J; Devidas, M; Raetz, E; Barredo, J C; Ritchey, A K; Godder, K; Grupp, S; Lewis, V A; Malloy, K; Carroll, W L; Davies, S M; Camitta, B M

2008-02-01

404

Long-term intraarterial chemotherapy infusion of ambulatory head and neck cancer patients.  

PubMed

The complications of percutaneous intraarterial infusion chemotherapy of the head-and-neck-cancer patient has dampened enthusiasm for this approach. A totally implantable infusion pump system circumvents many of these complications and will in the long term enhance the opportunity to expand upon the advantages of infusion chemotherapy for the benefit of all cancer patients. PMID:6290790

Baker, S R; Wheeler, R H

1982-10-01

405

Durable Long-Term Remission With Chemotherapy Alone for Stage II to IV Laryngeal Cancer  

PubMed Central

Purpose For patients with stage II to IV laryngeal cancer, radiation therapy (RT) either alone or with concurrent chemotherapy provides the highest rate of organ preservation but can be associated with functional impairment. Thus, we studied the use of induction chemotherapy with or without conservation laryngeal surgery (CLS). Our objectives were to study the sensitivity of laryngeal cancer to platinum-based chemotherapy alone and to highlight the efficacy of CLS in this setting. Patients and Methods Thirty-one previously untreated patients with laryngeal cancer (T2-4, N0-1, M0), who were resectable with CLS, were enrolled. Patients received three to four cycles of paclitaxel, ifosfamide, and cisplatin (TIP) chemotherapy, and response was assessed histologically. Patients with partial response (PR) proceeded to CLS. Patients achieving pathologic complete response (pCR) received an additional three cycles of TIP and no other treatment. Results Thirty patients were assessable for response. With TIP chemotherapy alone, 11 patients (37%) achieved pCR, 10 of whom (33%) remain alive with durable disease remission and no evidence of recurrence over a median follow-up time of 5 years. Nineteen patients (63%) treated with TIP alone achieved PR. The overall laryngeal preservation (LP) rate was 83%, and only five patients (16%) required postoperative RT. No patient required a gastrostomy tube or tracheotomy. Conclusion Chemotherapy alone in selected patients with T2-4, N0-1 laryngeal cancer can provide durable disease remission at 5 years. For patients with PR, CLS provides a high rate of LP. This prospective study suggests that chemotherapy alone may cure selected patients with laryngeal cancer, warranting further prospective investigation. PMID:19289628

Holsinger, F. Christopher; Kies, Merrill S.; Diaz, Eduardo M.; Gillenwater, Ann M.; Lewin, Jan S.; Ginsberg, Lawrence E.; Glisson, Bonnie S.; Garden, Adam S.; Ark, Nebil; Lin, Heather Y.; Lee, J. Jack; El-Naggar, Adel K.; Ki Hong, Waun; Shin, Dong M.; Khuri, Fadlo R.

2009-01-01

406

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

SciTech Connect

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.

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

407

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

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

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

408

Cryoablation plus chemotherapy in colorectal cancer patients with liver metastases.  

PubMed

Cryoablation and surgery achieve similar removal rates for some colorectal cancer (CRC) liver metastasis removal, and systemic chemotherapy is accepted as the most important approach to improving overall survival (OS) in CRC patients with liver metastases. We aimed to evaluate the potential benefit of cryoablation plus chemotherapy in CRC patients with liver metastases. We retrospectively analyze 63 patients of CRC liver metastasis. There were 32 patients in group A, who have received cryoablation plus chemotherapy, and there were 31 patients in group B, who have received chemotherapy alone. We mainly observe the 2-year survival, the quality of life (QOL), and adverse effects. Patients in group A had a higher 2-year survival rate, better OS, better QOL, and better treatment response than patients in group B. Two-year survival rates were 71.9 and 51.6 %,respectively, in group A and group B. The negative conversion rates of carcinoembryonic antigen and carbohydrate antigen 19-9 (CA199) were 57.1 and 61.5 %, respectively, in group A, and 22.2 and 30 %, respectively, in group B. The tumor shrinkage (a tumor volume reduction of ?30 %) rates were 62.5 and 22.6 %, respectively, in groups A and B. Performance status remained stable or improved in 16 patients (50 %) in group A and eight patients (25.81 %) in group B. Cryoablation in combination with chemotherapy may increase the 2-year survival rate and improve QOL in CRC patients with liver metastasis. PMID:25081377

Li, Zhiwei; Fu, Yujiao; Li, Qingwei; Yan, Feihu; Zhao, Juan; Dong, Xiaoqun; Zhang, Yanqiao

2014-11-01

409

Dietetic management in gastrointestinal complications from antimalignant chemotherapy.  

PubMed

Antineoplastic chemotherapy (CT) represents the systemic treatment of malignant tumors. It can be used alone or combined with surgery and / or radiotherapy. The cytotoxic agents used in chemotherapy work on both cancerous cells and noncancerous cells of the body, generally resulting in high toxicity. The biological aggressiveness of chemotherapy particularly affects rapidly replicating cells, such as those of the digestive tract, resulting in adverse effects that impair food intake, leading to compromised nutritional status and which may lead to cachexia. The main toxic effects of chemotherapy in the gastrointestinal tract include nausea, vomiting -these are the most frequent- constipation, diarrhea, xerostomia, mucositis, dysphagia and anorexia. Given the high frequency of such effects, nutritional intervention should be an integral part of cancer treatment, to maintain and/or improve the patient's nutritional status and reduce or minimize the side effects caused by treatment. Accordingly, the goal of this study is to review dietetic conduct in the process of caring for patients undergoing cancer chemotherapy. PMID:22566305

Calixto-Lima, L; Martins de Andrade, E; Gomes, A P; Geller, M; Siqueira-Batista, R

2012-01-01

410

Concurrent administration of chemo-endocrine therapy for postmenopausal breast cancer patients  

Microsoft Academic Search

Background  We have been treating hormone receptor-positive, postmenopausal women with breast cancer with a regimen of neoadjuvant chemotherapy\\u000a (NAC), FEC (fluorouracil, epirubicin, and cyclophosphamide), followed by weekly doses of paclitaxel combined with the concurrent\\u000a administration of anastrozole. In this article, we compared our results retrospectively with those of past trials.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Twenty-six patients that were postmenopausal and were younger than 70 years of

Naoki Watanabe; Yasuyuki Ootawa; Kikue Kodama; Akemi Kaide; Nobutoshi Ootsuka; Jyunji Matsuoka

2010-01-01

411

Health Promoting Life-Style Behaviors and Systemic Inflamma­tion in African American and Caucasian Women Prior to Chemo­therapy for Breast Cancer  

PubMed Central

Background: Racial disparities in breast cancer outcomes persist, with differential adverse outcomes in African American women. Although research has ex­amined possible genetic differences, there has been little research on potentially modifiable characteristics such as health promoting behaviors. The purpose of this article is to describe the characteristics and to compare the differences by race in lifestyle factors and inflammatory biomarkers in African American and Caucasian women with breast cancer. Methods: This is a baseline descriptive analysis from an ongoing randomized controlled trial that includes 124 women diagnosed with early stage breast cancer prior to chemotherapy. Data sources included medical records, self-re­port questionnaires and a blood sample for measures of inflammation. The sta­tistical analysis included descriptive statistics and ANOVA models to determine differences between the two groups. Results: Overall, both groups had low levels of health promoting behaviors. African Americans had a significantly higher body mass index. Caucasian women consumed more alcohol. Levels of C-reactive protein and MIP-1? were significantly higher in African Americans. Conclusion: Potentially modifiable factors such as nutrition, physical activity and levels of inflammation warrant further attention. PMID:25097833

E Lyon, Debra; Mohanraj, Lathika; Kelly, Debra Lynch; Elswick Jr, RK

2014-01-01

412

Reducing Concurrency Bottlenecks in Parallel I/O Workloads  

SciTech Connect

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.

Manzanares, Adam C. [Los Alamos National Laboratory; Bent, John M. [Los Alamos National Laboratory; Wingate, Meghan [Los Alamos National Laboratory

2011-01-01

413

[Failure mode and effect analysis: application in chemotherapy].  

PubMed

Medical institutions are increasingly concerned about ensuring the safety of patients under their care. Failure mode and effect analysis (FMEA) is a qualitative approach based on a proactive process. Strongly promoted by the Joint Commission Accredited of Health Organization (JCAHO) since 2002, FMEA has since been adopted and widely practiced in healthcare organizations to assess and analyze clinical error events. FMEA has proven to be an effective method of minimizing errors in both manufacturing and healthcare industries. It predicts failure points in systems and allows an organization to address proactively the causes of problems and prioritize improvement strategies. The application of FMEA in chemotherapy at our department identified three main failure points: (1) inappropriate chemotherapy standard operating procedures (SOPs), (2) communication barriers, and (3) insufficient training of nurses. The application of FMEA in chemotherapy is expected to enhance the sensitivity and proactive abilities of healthcare practitioners during potentially risky situations as well as to improve levels of patient care safety. PMID:19634100

Chuang, Ching-Hui; Chuang, Sheu-Wen

2009-08-01

414

Metastatic melanoma: Chemotherapy  

Microsoft Academic Search

The incidence of cutaneous melanoma has been rapidly increasing, with an estimate of 47,700 new cases diagnosed in 2000 in the United States. In the early phase of its natural history, melanoma is cured in most cases by surgery, but once the metastatic phase develops, it is almost always fatal. The treatment of metastatic melanoma remains unsatisfactory. Systemic therapy has

Emilio Bajetta; Michele Del Vecchio; Chantal Bernard-Marty; Milena Vitali; Roberto Buzzoni; Olivier Rixe; Paola Nova; Stefania Aglione; Sophie Taillibert; David Khayat

2002-01-01

415

Practical Considerations for NonBlocking Concurrent Objects A version of this paper appears in the May 1993 Distributed Computing Systems Conference (DCS).  

E-print Network

memory multiprocessors. We first describe an oper­ ating system­based solution that permits the construc there is contention. This research was sponsored in part by a National Science Foundation Presidential Young

416

Concurrent Engineering: A Partnership Approach  

NSDL National Science Digital Library

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.

Barton, Russell R.; Nowack, Craig A.; Smith, Robert P.; Zayas-Castro, Jose L.

2011-03-10