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Sample records for high cancer rates

  1. High dose rate brachytherapy for oral cancer

    Science.gov (United States)

    YamazakI, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. PMID:23179377

  2. High mortality rates after non-elective colon cancer resection

    DEFF Research Database (Denmark)

    Bakker, I S; Snijders, H S; Grossmann, Irene

    2016-01-01

    AIM: Colon cancer resection in a non-elective setting is associated with high rates of morbidity and mortality. The aim of this retrospective study is to identify risk factors for overall mortality after colon cancer resection with a special focus on non-elective resection. METHOD: Data were...... obtained from the Dutch Surgical Colorectal Audit. Patients undergoing colon cancer resection in the Netherlands between January 2009 and December 2013 were included. Patient, treatment and tumour factors were analyzed in relation to the urgency of surgery. The primary outcome was the thirty day...... postoperative mortality. RESULTS: The study included 30,907 patients. In 5934 (19.2%) of patients, a non-elective colon cancer resection was performed. There was a 4.4% overall mortality rate, with significantly more deaths after non-elective surgery (8.5% vs 3.4%, P

  3. Interstitial high-dose-rate brachytherapy in eyelid cancer.

    Science.gov (United States)

    Mareco, Virgínia; Bujor, Laurentiu; Abrunhosa-Branquinho, André N; Ferreira, Miguel Reis; Ribeiro, Tiago; Vasconcelos, Ana Luisa; Ferreira, Cidalina Reis; Jorge, Marília

    2015-01-01

    To report the experience and the outcomes of interstitial high-dose-rate (HDR) brachytherapy (BT) of eyelid skin cancer at the Department of Radiotherapy of Hospital de Santa Maria in Lisbon. Seventeen patients (pts; mean age, 73.75 years) who underwent eyelid interstitial HDR BT with an (192)Ir source between January 2011 and February 2013 were analyzed. Lesions were basal (94%) and squamous (6%) cell carcinomas, on lower (88%) or upper (6%) eyelids, and on inner canthus (6%). T-stage was Tis (6%), T1 (46%), T2 (36%), and T3a (12%). The purpose of BT was radical (12%), adjuvant to surgery (71%), or salvage after surgery (18%). The BT implant and treatment planning were based on the Stepping Source Dosimetry System. The median total dose was 42.75 Gy (range, 32-50 Gy), with a median of 10 fractions (range, 9-11 fractions), twice daily, 6 h apart. The median V100 was 2.38 cm(3) (range, 0.83-5.59 cm(3)), and the median V150 was 1.05 cm(3) (range, 0.24-3.12 cm(3)). At a median followup of 40 months (range, 7-43 months), the local control was 94.1%. There was one local recurrence and one non-related death. The BT was well tolerated. Madarosis was the most common late effect (65% of pts) and was related with higher values of V100 (p = 0.027). Cosmetic outcomes were good and excellent in 70% of pts. Interstitial HDR BT is a feasible and safe technique for eyelid skin cancers, with good local control. Recurrent lesions and higher volumes receiving the prescribed dose were associated with worse outcomes. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  4. High mortality rates after nonelective colon cancer resection : results of a national audit

    NARCIS (Netherlands)

    Bakker, I. S.; Snijders, H. S.; Grossmann, I.; Karsten, T. M.; Havenga, K.; Wiggers, T.

    AimColon cancer resection in a nonelective setting is associated with high rates of morbidity and mortality. The aim of this retrospective study is to identify risk factors for overall mortality after colon cancer resection with a special focus on nonelective resection. MethodData were obtained from

  5. Brachytherapy guideline in prostate cancer (high and low dose rate)

    Energy Technology Data Exchange (ETDEWEB)

    Hanna, Samir Abdallah; Pimentel, Leonardo [Sociedade Brasileira de Radioterapia (SBR), Rio de Janeiro, RJ (Brazil)

    2017-04-15

    Through the elaboration of seven relevant clinical questions related to the proposed theme, we sought to present the main evidences regarding safety, toxicity and effectiveness of the presented radiotherapy (RT) techniques. The study population consisted of male patients of all ages with early primary prostate cancer and candidates for treatment with curative intent. For this, a systematic review of the literature was carried out in primary scientific databases (MEDLINE - PubMed; Embase - Elsevier; LILACS - BIREME; Cochrane Library -Record of Controlled Trials). All articles available through February 22, 2015 were considered. The search strategy used in MEDLINE searches is described in Appendix 1. The articles were selected based on critical evaluation, seeking the best evidence available. The recommendations were elaborated from discussions held with a drafting group composed of four members of the Brazilian Society of Radiotherapy. The guideline was reviewed by an independent group, which specializes in evidence-based clinical guidelines. After completion, the guideline was released for public consultation for 15 days; the suggestions obtained were forwarded to the authors for evaluation and possible insertion in the final text. (author)

  6. Learning curve of MRI-based planning for high-dose-rate brachytherapy for prostate cancer

    DEFF Research Database (Denmark)

    Buus, Simon; Rylander, Susanne; Hokland, Steffen

    2016-01-01

    Purpose To evaluate introduction of MRI-based high-dose-rate brachytherapy (HDRBT), including procedure times, dose-volume parameters, and perioperative morbidity. Methods and Materials Study included 42 high-risk prostate cancer patients enrolled in a clinical protocol, offering external beam...

  7. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, Antonio Cassio Assis, E-mail: acapellizzon@hcancer.org.br [A.C. Camargo Cancer Center, Sao Paulo, SP (Brazil). Departamento de Radioterapia

    2016-05-15

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. (author)

  8. Salvage high-dose-rate brachytherapy for local prostate cancer recurrence after radical radiotherapy

    Directory of Open Access Journals (Sweden)

    V. A. Solodkiy

    2016-01-01

    Full Text Available Studies salvage interstitial radiation therapy for recurrent prostate cancer, launched at the end of the XX century. In recent years, more and more attention is paid to high-dose-rate brachytherapy (HDR-BT as a method of treating local recurrence.The purpose of research – preliminary clinical results of salvage high-dose-rate brachytherapy applied in cases of suspected local recurrence or of residual tumour after radiotherapy.Preliminary findings indicate the possibility of using HDR-BT, achieving local tumor control with low genitourinary toxicity.

  9. Fractionated high-dose-rate brachytherapy in the management of uterine cervical cancer.

    Science.gov (United States)

    Park, Hee-Chul; Suh, Chang Ok; Kim, Gwi Eon

    2002-12-01

    It is well known that intracavitary radiotherapy (ICR), either alone or in combination with external-beam radiotherapy (EBRT) is an essential component of the radiation treatment of uterine cervical cancer. Although low-dose-rate (LDR) brachytherapy has been successfully applied to the management of such patients, several radiation oncologists have experience of using high-dose-rate (HDR) brachytherapy with promising clinical results over the past 4 decades. However, there has been a considerable reluctance by radiation oncologists and gynecologists in North America to employ the HDR remote afterloading technique instead of the more firmly established LDR treatment modality. In contrast, the HDR-ICR system is rapidly gaining acceptance in Korea since the introduction of the Ralstron, remotely controlled afterloading system using HDR Co-60 sources, at the Yonsei Cancer Center in 1979. According to brachytherapy statistics reported by the Korean Society of Therapeutic Radiology and Oncology, in 1997, brachytherapy was performed upon 1,758 Korean patients with uterine cervical cancer, of whom approximately 83% received HDR brachytherapy. In this review, we present our experiences of HDR-ICR for the treatment of uterine cervical cancer. In addition, we discuss the controversial points, which are raised by those considering the use of HDR-ICR for uterine cervical cancer; these issues include physical and radiobiological considerations, and the prospect of future technical improvements.

  10. Bladder wall recurrence of prostate cancer after high-dose-rate brachytherapy.

    Science.gov (United States)

    Raleigh, David R; Hsu, I-Chow; Braunstein, Steve; Chang, Albert J; Simko, Jeffry P; Roach, Mack

    2015-01-01

    Prostate cancer seeding after needle biopsy has been reported in the perineum, rectal wall, and periprostatic soft tissue. In this article, we report the results of a localized prostate cancer recurrence in the bladder following protrusion of a single high-dose-rate brachytherapy catheter through the bladder wall at the ultimate site of failure. A 62-year-old man with high-risk prostate adenocarcinoma was treated with long-term androgen deprivation therapy, intensity-modulated radiation, and high-dose-rate brachytherapy boost. He developed biochemical recurrence 4 years after treatment, and a CT scan of the pelvis revealed a nodule in the posterior, inferior bladder wall. Surgical pathology following transurethral resection of tumor within the bladder was consistent with high-grade prostate adenocarcinoma. The patient's prostate-specific antigen level fell to the range of normal postoperatively, and whole body imaging, including a multi-parametric MRI of the prostate with diffusion and spectroscopy, failed to reveal any other sites of disease. Review of the CT scan obtained for dosimetry at the time of brachytherapy demonstrated a lone catheter protruding through the bladder wall at the site of eventual recurrence. The tumor recurred in the bladder 12 months later, once more without evidence of disease within the prostate itself or distantly, and the patient was started on salvage androgen deprivation therapy. This case is the first report of prostate cancer recurrence in the bladder wall after brachytherapy and raises questions about prostate cancer biology, brachytherapy technique, and the timing of brachytherapy boost relative to whole pelvic radiotherapy for prostate cancer. Published by Elsevier Inc.

  11. Salvage high-dose-rate brachytherapy for esophageal cancer in previously irradiated patients: A retrospective analysis.

    Science.gov (United States)

    Wong Hee Kam, Stéphanie; Rivera, Sofia; Hennequin, Christophe; Lourenço, Nelson; Chirica, Mircea; Munoz-Bongrand, Nicolas; Gornet, Jean-Marc; Quéro, Laurent

    2015-01-01

    To evaluate outcomes after exclusive salvage high-dose-rate (HDR) intraluminal esophageal brachytherapy given to previously irradiated patients with recurrent esophageal cancer. We reviewed medical records of 30 patients who were treated by salvage HDR brachytherapy for local esophageal cancer. Brachytherapy delivered four to six fractions of 5-7 Gy at 5 mm from the applicator surface and 20 mm above and below the macroscopic tumor volume. Eighty percentage of patients received treatment as initially planned. Complete response rate, evaluated 1 month after brachytherapy by endoscopy and biopsy, was 53%. Squamous histology and complete endoscopic tumor response at 1 month were significantly associated with better local tumor control. Median local progression-free survival was 9.8 months. Overall survival was 31.5% and 17.5% at 1 and 2 years, respectively. On univariate analysis, preserved performance status and limited weight loss (brachytherapy were associated with better overall survival. Severe toxicity (Grade ≥3) occurred in 7 patients (23%). Although esophageal cancer in previously irradiated patients is associated with poor outcomes, HDR brachytherapy may be a valuable salvage treatment for inoperable patients with locally limited esophageal cancer, particularly in the subset of patients with preserved performance status and limited weight loss (≤10%) before salvage brachytherapy. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. Non-melanoma skin cancer treated with high-dose-rate brachytherapy: a review of literature.

    Science.gov (United States)

    Delishaj, Durim; Rembielak, Agata; Manfredi, Bruno; Ursino, Stefano; Pasqualetti, Francesco; Laliscia, Concetta; Orlandi, Francesca; Morganti, Riccardo; Fabrini, Maria Grazia; Paiar, Fabiola

    2016-12-01

    The incidence of non-melanoma skin cancer (NMSC) has been increasing over the past 30 years. There are different treatment options and surgical excision is the most frequent treatment due to its low rates of recurrence. Radiotherapy is an effective alternative of surgery, and brachytherapy (BT) might be a better therapeutic option due to high radiation dose concentration to the tumor with rapid dose fall-off resulting in normal tissues sparing. The aim of this review was to evaluate the local control, toxicity, and cosmetic outcomes in NMSC treated with high-dose-rate BT (HDR-BT). In May 2016, a systematic search of bibliographic database of PubMed, Web of Science, Scopus, and Cochrane Library with a combination of key words of "skin cancer", "high dose rate brachytherapy", "squamous cell carcinoma", "basal cell carcinoma", and "non melanoma skin cancer" was performed. In this systematic review, we included randomized trials, non-randomized trials, prospective and retrospective studies in patients affected by NMSC treated with HDR-BT. Our searches generated a total of 85 results, and through a process of screening, 10 publications were selected for the review. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 97%). Cosmetic outcome was reported in seven study and consisted in an excellent and good cosmetic results in 94.8% of cases. Based on the review data, we can conclude that the treatment of NMSC with HDR-BT is effective with excellent and good cosmetics results, even in elderly patients. The hypofractionated course appears effective with very good local disease control. More data with large-scale randomized controlled trials are needed to assess the efficacy and safety of brachytherapy.

  13. High-Dose-Rate Monotherapy: Safe and Effective Brachytherapy for Patients With Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Demanes, D. Jeffrey, E-mail: jdemanes@mednet.ucla.edu [California Endocurietherapy at UCLA, Department of Radiation Oncology, David Geffen School of Medicine of University of California at Los Angeles, Los Angeles, CA (United States); Martinez, Alvaro A.; Ghilezan, Michel [William Beaumont Hospital, Royal Oak, MI (United States); Hill, Dennis R.; Schour, Lionel; Brandt, David [California Endocurietherapy, Oakland, CA (United States); Gustafson, Gary [William Beaumont Hospital, Royal Oak, MI (United States)

    2011-12-01

    Purpose: High-dose-rate (HDR) brachytherapy used as the only treatment (monotherapy) for early prostate cancer is consistent with current concepts in prostate radiobiology, and the dose is reliably delivered in a prospectively defined anatomic distribution that meets all the requirements for safe and effective therapy. We report the disease control and toxicity of HDR monotherapy from California Endocurietherapy (CET) and William Beaumont Hospital (WBH) in low- and intermediate-risk prostate cancer patients. Methods and Materials: There were 298 patients with localized prostate cancer treated with HDR monotherapy between 1996 and 2005. Two biologically equivalent hypofractionation protocols were used. At CET the dose was 42 Gy in six fractions (two implantations 1 week apart) delivered to a computed tomography-defined planning treatment volume. At WBH the dose was 38 Gy in four fractions (one implantation) based on intraoperative transrectal ultrasound real-time treatment planning. The bladder, urethral, and rectal dose constraints were similar. Toxicity was scored with the National Cancer Institute Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 5.2 years. The median age of the patients was 63 years, and the median value of the pretreatment prostate-specific antigen was 6.0 ng/mL. The 8-year results were 99% local control, 97% biochemical control (nadir +2), 99% distant metastasis-free survival, 99% cause-specific survival, and 95% overall survival. Toxicity was scored per event, meaning that an individual patient with more than one symptom was represented repeatedly in the morbidity data table. Genitourinary toxicity consisted of 10% transient Grade 2 urinary frequency or urgency and 3% Grade 3 episode of urinary retention. Gastrointestinal toxicity was <1%. Conclusions: High disease control rates and low morbidity demonstrate that HDR monotherapy is safe and effective for patients with localized prostate cancer.

  14. Paediatric cancer survivors demonstrate a high rate of subclinical renal dysfunction.

    Science.gov (United States)

    Mudi, Abdullahi; Levy, Cecil Steven; Geel, Jennifer Ann; Poole, Janet Elizabeth

    2016-11-01

    Clinical manifestations of renal dysfunction in childhood cancer survivors include hypertension, proteinuria, tubulopathy (and its biochemical consequences) and renal insufficiency. This study aimed to determine the factors associated with renal dysfunction in paediatric cancer survivors at a single centre in Johannesburg. A descriptive cross-sectional study was performed on 130 cancer survivors between 2 and 18 years of age. Physical examination and screening urine dipstick were performed on all patients. Blood results of samples routinely drawn were analysed. After a median follow-up period of 2 years, the various manifestations of renal dysfunction included decreased estimated glomerular filtration rate (eGFR), hypomagnesaemia, hypophosphataemia, proteinuria, haematuria and hypertension. In total, 34 survivors (26.15%) had at least one manifestation of renal dysfunction after completing treatment. The most prevalent manifestation of renal dysfunction was decreased eGFR (17.7%) followed by hypomagnesaemia (6.2%) and hypophosphataemia (4.6%). Patients with pre-existing renal dysfunction were three times more likely to have renal dysfunction post-treatment (P = 0.020). Ifosfamide (P = 0.010) and nephrectomy (P = 0.003) had independent significant impact on reduction in eGFR. High cumulative ifosfamide doses were identified as a possible cause for hypophosphataemia (P = 0.021). While not clinically evident in the early follow-up period, the high rate of renal dysfunction is concerning. We suggest that patients with pre-existing renal dysfunction should be assessed by a nephrologist prior to initiation of cancer therapy, and nephro-protective measures should be employed stringently in all children with cancer. Patients with decreased eGFR should be followed up closely in a multidisciplinary late effects clinic. © 2016 Wiley Periodicals, Inc.

  15. Perioperative high-dose-rate interstitial brachytherapy boost for patients with early breast cancer.

    Science.gov (United States)

    Sharma, Daya Nand; Deo, S V S; Rath, Goura Kisor; Shukla, Nootan Kumar; Thulkar, Sanjay; Madan, Renu; Julka, Pramod Kumar

    2013-01-01

    To evaluate the clinical results of perioperative high-dose-rate interstitial brachytherapy boost treatment preceding whole breast external beam radiation therapy in patients with early breast cancer. From 2005-2010, 100 patients with early breast cancer who met the eligibility criteria were enrolled in the study. Brachytherapy implant was performed during the breast-conserving surgery procedure. The boost treatment was started on the 3rd postoperative day to deliver a dose of 15 Gy in 6 fractions over 3 days. Three weeks later, external beam radiation therapy to the whole breast was started for a prescription dose of 50 Gy. The study end points were local recurrence, acute toxicity and cosmetic outcome. Median age of the patients was 46 years, and median follow-up was 52 months. No patient developed a local recurrence but 5 patients developed distant metastases. The 5-year overall survival and disease-free survival were 86% and 77%, respectively. Eleven patients had acute toxicity; 4 wound complications and 7 grade III skin toxicity. Nine of the 11 patients had breast size of more than 1500 cc. Except for the breast volume (>1500 cc), there was no statistically significant correlation between any of the patient or dosimetry-related factors and acute toxicity. Good-excellent cosmesis was observed in 87% of patients. Perioperative high-dose-rate interstitial brachytherapy boost followed by whole breast external beam radiation therapy provides excellent local control, acceptable acute toxicity and good-excellent breast cosmesis in patients with early breast cancer.

  16. Nationwide, Multicenter, Retrospective Study on High-Dose-Rate Brachytherapy as Monotherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yasuo, E-mail: yoshioka@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Kotsuma, Tadayuki [Department of Radiation Oncology, Osaka National Hospital, Osaka (Japan); Komiya, Akira [Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama (Japan); Department of Urology, Chiba University Hospital, Chiba (Japan); Kariya, Shinji [Department of Radiology, Kochi Medical School, Kochi (Japan); Konishi, Koji [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Nonomura, Norio [Department of Urology, Osaka University Graduate School of Medicine, Osaka (Japan); Ogawa, Kazuhiko [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Tanaka, Eiichi [Department of Radiation Oncology, Osaka National Hospital, Osaka (Japan); Nishimura, Kensaku [Department of Urology, Osaka National Hospital, Osaka (Japan); Fujiuchi, Yasuyoshi; Kitamura, Hiroshi [Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama (Japan); Yamagami, Takuji [Department of Radiology, Kochi Medical School, Kochi (Japan); Yamasaki, Ichiro [Department of Urology, Kochi Medical School, Kochi (Japan); Nishimura, Kazuo [Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Teshima, Teruki [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Nakamura, Katsumasa [Department of Radiation Oncology, Hamamatsu University School of Medicine, Shizuoka (Japan); Itami, Jun [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)

    2017-04-01

    Purpose: To present, analyze, and discuss results of a nationwide, multicenter, retrospective study on high-dose-rate brachytherapy (HDR-BT) as monotherapy for low-, intermediate-, and high-risk prostate cancer. Methods and Materials: From 1995 through 2013, 524 patients, 73 (14%) with low-risk, 207 (40%) with intermediate-risk, and 244 (47%) with high-risk prostate cancer, were treated with HDR-BT as monotherapy at 5 institutions in Japan. Dose fractionations were 27 Gy/2 fractions for 69 patients (13%), 45.5 Gy/7 fractions for 168 (32%), 49 Gy/7 fractions for 149 (28%), 54 Gy/9 fractions for 130 (25%), and others for 8 (2%). Of these patients, 156 (30%) did not receive androgen deprivation therapy, and 202 patients (39%) did receive androgen deprivation therapy <1 year, 112 (21%) for 1-3 years, and 54 (10%) for >3 years. Median follow-up time was 5.9 years (range, 0.4-18.1 years), with a minimum of 2 years for surviving patients. Results: After 5 years, respective actuarial rates of no biochemical evidence of disease, overall survival, cause-specific survival, and metastasis-free survival for all patients were 92%, 97%, 99%, and 94%. For low/intermediate/high-risk patients, the 5-year no biochemical evidence of disease rates were 95%/94%/89%, the 5-year overall survival rates were 98%/98%/94%, the 5-year cause-specific survival rates were 98%/100%/98%, and the 5-year metastasis-free survival rates were 98%/95%/90%, respectively. The cumulative incidence of late grade 2 to 3 genitourinary toxicity at 5 years was 19%, and that of late grade 3 was 1%. The corresponding incidences of gastrointestinal toxicity were 3% and 0% (0.2%). No grade 4 or 5 of either type of toxicity was detected. Conclusions: The findings of this nationwide, multicenter, retrospective study demonstrate that HDR-BT as monotherapy was safe and effective for all patients with low-, intermediate-, and high-risk prostate cancer.

  17. Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

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    Lee, Sung Uk; Cho, Kwan Ho; Moon, Sung Ho; Choi, Sung Weon; Park, Joo Yong; Yun, Tak; Lee, Sang Hyun; Lim, Young Kyung; Jeong, Chi Young [National Cancer Center, Goyang (Korea, Republic of)

    2014-12-15

    To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

  18. Remote afterloading high dose-rate intracavity radiotherapy for advanced maxillary cancer. Treatment with individual appliances

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    Horimoto, Susumu; Kakei, Masaki; Saito, Tomokatsu [Yokohama City Univ. (Japan). School of Medicine] [and others

    1998-08-01

    Seven advanced maxillary cancers, 5 squamous cell carcinomas, and 2 adenoid cystic carcinomas were treated with remote afterloading high dose-rate intracavity radiotherapy. For treatment, we fabricated individual dental acrylic appliances for the postoperative area of the oral cavity. Because the appliance was specially matched to the remaining maxillary structures, radiation doses to the treated area were easily reproduced without distress to the patient. However, minor or major complications (moderate or severe mucositis and osteoradionecrosis) were observed in all patients. In this study, the number of patients was too small to assess the significance of this treatment. Nevertheless, with improvements, we think that remote afterloading high dose-rate intracavity radiotherapy with a dental acrylic appliance will soon be used to treat advanced maxillary carcinoma. (author)

  19. Post-colonoscopy colorectal cancer rate in the era of high-definition colonoscopy.

    Science.gov (United States)

    Iwatate, Mineo; Kitagawa, Tomoyuki; Katayama, Yasumi; Tokutomi, Naohiko; Ban, Shinichi; Hattori, Santa; Hasuike, Noriaki; Sano, Wataru; Sano, Yasushi; Tamano, Masaya

    2017-11-14

    To investigate the post-colonoscopy colorectal cancer (PCCRC) rate for high-definition (HD) colonoscopy compared with that for standard-definition colonoscopy reported previously. Using medical records at Sano Hospital (SH) and Dokkyo Medical University Koshigaya Hospital (DMUKH), we retrospectively obtained data on consecutive patients diagnosed as having CRC between January 2010 and December 2015. The definition of PCCRC was diagnosis of CRC between 7 and 36 mo after initial high-definition colonoscopy that had detected no cancer, and patients were divided into a PCCRC group and a non-PCCRC group. The primary outcome was the rate of PCCRC for HD colonoscopy. The secondary outcomes were factors associated with PCCRC and possible reason for occurrence of early and advanced PCCRC. Among 892 CRC patients, 11 were diagnosed as having PCCRC and 881 had non-PCCRC. The PCCRC rate was 1.7% (8/471) at SH and 0.7% (3/421) at DMUKH. In comparison with the non-PCCRC group, the PCCRC group had a significantly higher preponderance of smaller tumors (39 mm vs 19 mm, P = 0.002), a shallower invasion depth (T1 rate, 25.4% vs 63.6%, P = 0.01), a non-polypoid macroscopic appearance (39.0% vs 85.7%, P = 0.02) and an earlier stage (59.7% vs 90.9%, P = 0.03). Possible reasons for PCCRC were "missed or new" in 9 patients (82%), "incomplete resection" in 1 (9%), and "inadequate examination'" in 1 (9%). Among 9 "missed or new" PCCRC, the leading cause was non-polypoid shape for early PCCRC and blinded location for advanced PCCRC. The PCCRC rate for HD colonoscopy was 0.7%-1.7%, being lower than that for standard-definition colonoscopy (1.8%-9.0%) reported previously employing the same methodology.

  20. High rates of endometrial cancer among Pacific women in New Zealand: the role of diabetes, physical inactivity, and obesity.

    Science.gov (United States)

    Meredith, Ineke; Sarfati, Diana; Ikeda, Takayoshi; Atkinson, June; Blakely, Tony

    2012-06-01

    To determine the endometrial cancer rates, and the proportion attributable to diabetes mellitus (DM), physical inactivity, and overweight/obesity, by ethnicity with a focus on Pacific women in New Zealand. Linked census-cancer records (1981-2004) were used to determine incidence rates of endometrial cancer by ethnicity. Health survey data (2006-2007) were used to determine risk factor prevalence by ethnicity. Relative risks for the association between diabetes, obesity, physical inactivity and endometrial cancer were sourced from published studies. Population attributable risk (PAR) methods, with Monte Carlo simulation, were used to estimate the PAR% by ethnicity and applied to 2001-2004 cancer rates. Pacific women had 2.61 (95 % confidence interval 2.22-3.05) times the endometrial cancer rate of European/Other women pooled over time, and the most rapidly increasing rates over time with the rate ratio increasing from 1.96 (1.14-3.37) in 1981/1986 to 3.78 (3.03-4.71) in 2001/2004 (p for trend = 0.14). Pacific women had the highest PAR% for DM, physical inactivity, and overweight/obesity (63.1 %), followed by Māori (58.6 %) and European/Other (48.6 %). Applying these PAR% to 2001-2004 endometrial cancer rates, the rate ratio comparing Pacific to European/Other endometrial cancer reduced from 3.8 for total cancer (attributable plus non-attributable) to 2.3 for non-attributable cancer, and the rate difference reduced by 79 % from 51 to 11 per 100,000. Pacific women have high endometrial cancer rates in New Zealand. Some, but not all, of the ethnic inequalities were explained by measured differences in obesity/overweight, DM, and physical inactivity.

  1. Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl [Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Gruszczynska, Ewelina; Bijok, Michal [Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Jonska-Gmyrek, Joanna [Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Dabkowski, Mateusz [Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Staniaszek, Jagna [Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Michalski, Wojciech [Department of Clinical Trials and Biostatistics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Kowalczyk, Adam; Milanowska, Katarzyna [Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)

    2016-09-01

    Purpose: To evaluate the long-term results of computed tomography (CT)–planned high-dose-rate (HDR) brachytherapy (BT) for treating cervical cancer patients. Methods and Materials: CT-planned HDR BT was performed according to the adapted Group European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations in 216 consecutive patients with locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stage IB to IVA, who were treated with conformal external beam radiation therapy and concomitant chemotherapy. We analyzed outcomes and late side effects evaluated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Subjective, Objective, Management, Analysis evaluation scoring system and compared them with the results from a historical group. Results: The median age was 56 years (range, 32-83 years). The median follow-up time for living patients was 52 months (range 37-63 months). The 5-year cumulative incidence function for the local recurrence rate for patients with FIGO II and III was 5.5% and 20%, respectively (P=.001). The 5-year rates of overall survival (OS) and disease-free survival (DFS) were 66.4% and 58.5%, respectively. The relative risk of failure for OS and DFS for FIGO III in relation to FIGO II was 2.24 (P=.003) and 2.6 (P=.000) and for lymph node enlargement was 2.3 (P=.002) and 2 (P=.006), respectively. In 2 patients, rectovaginal fistula occurred, and in 1 patient, vesicovaginal fistula occurred without local progression. Comparison of late adverse effects in patients treated according to the GEC-ESTRO recommendations and in the historical group revealed a reduction in fistula formation of 59% and also a reduction in rectal grade 3 to 4 late toxicity of >59%. Conclusions: This is the largest report with mature data of CT-planned BT HDR for the treatment of cervical cancer with good local control and

  2. Non-melanoma skin cancer treated with high-dose-rate brachytherapy: a review of literature

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    Durim Delishaj

    2016-12-01

    Full Text Available Purpose: The incidence of non-melanoma skin cancer (NMSC has been increasing over the past 30 years. There are different treatment options and surgical excision is the most frequent treatment due to its low rates of recurrence. Radiotherapy is an effective alternative of surgery, and brachytherapy (BT might be a better therapeutic option due to high radiation dose concentration to the tumor with rapid dose fall-off resulting in normal tissues sparing. The aim of this review was to evaluate the local control, toxicity, and cosmetic outcomes in NMSC treated with high-dose-rate BT (HDR-BT. Material and methods: In May 2016, a systematic search of bibliographic database of PubMed, Web of Science, Scopus, and Cochrane Library with a combination of key words of “skin cancer”, “high dose rate brachytherapy”, “squamous cell carcinoma”, “basal cell carcinoma”, and “non melanoma skin cancer“ was performed. In this systematic review, we included randomized trials, non-randomized trials, prospective and retrospective studies in patients affected by NMSC treated with HDR-BT. Results: Our searches generated a total of 85 results, and through a process of screening, 10 publications were selected for the review. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 97%. Cosmetic outcome was reported in seven study and consisted in an excellent and good cosmetic results in 94.8% of cases. Conclusions : Based on the review data, we can conclude that the treatment of NMSC with HDR-BT is effective with excellent and good cosmetics results, even in elderly patients. The hypofractionated course appears effective with very good local disease control. More data with large-scale randomized controlled trials are needed to assess the efficacy and safety of brachytherapy.

  3. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

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    Tinkle, Christopher L.; Weinberg, Vivian [Department of Radiation Oncology, University of California, San Francisco, California (United States); Chen, Lee-May [Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California (United States); Littell, Ramey [Gynecologic Oncology, The Permanente Medical Group, San Francisco, California (United States); Cunha, J. Adam M.; Sethi, Rajni A. [Department of Radiation Oncology, University of California, San Francisco, California (United States); Chan, John K. [Gynecologic Oncology, California Pacific Medical Center, San Francisco, California (United States); Hsu, I-Chow, E-mail: ichow.hsu@ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, California (United States)

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  4. Hypofractionated high-dose-rate plesiotherapy in nonmelanoma skin cancer treatment.

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    Arenas, Meritxell; Arguís, Monica; Díez-Presa, Lorena; Henríquez, Ivan; Murcia-Mejía, Mauricio; Gascón, Marina; Gómez, David; Lafuerza, Anna; Mur, Encarna; Azón, Antoni; Rovirosa, Àngels; Sabater, Sebastià

    2015-01-01

    Nonmelanoma skin cancer (NMSC) is the commonest cancer in humans. NMSC treatment currently includes surgery, radiation therapy, and topical approaches. The objective was to analyze and compare the outcomes, toxicity, and cosmesis of NMSC treated by two hypofractionated high-dose-rate (HDR) plesiotherapy techniques. A retrospective institutional clinical study of 134 basal cell or squamous cell skin carcinomas treated at Radiation Oncology Department. Lesions were treated from November 2006 to December 2011 with a moderate hypofractionated HDR plesiotherapy using a fixed applicator or a customized mold. After a median follow-up of 33 months, overall disease-free survival at 3 and 5 years was 95.12% and 93.36%, respectively. For Leipzig applicator, disease-free survival at 3 years was 94.9% and 94.9% at 5 years, for customized mold was 93.1% at 3 years and 88% at 5 years. Complete regression was achieved in 98% of lesions. Two lesions persisted after treatment; both had been treated by a Leipzig applicator. Six lesions suffered local recurrence (five Leipzig applicators and three molds, p = 0.404). Grade skin toxicity. The cosmesis outcomes were excellent or good in 82% of patients, fair in 13%, and not available in 5%. Hypofractionated HDR plesiotherapy is an effective and well-tolerated treatment for NMSC with different toxicity levels depending on the plesiotherapy technique used. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

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    Metha Maenhout

    2017-04-01

    Full Text Available Purpose : Salvage treatments for localized radiorecurrent prostate cancer can be performed safely when a focal and image guided approach is used. Due to the low toxicity, the opportunity exists to investigate a second salvage treatment when a second locally recurrent prostate cancer occurs. Here, we describe a second salvage treatment procedure of 4 patients. Material and methods : Four patients with a pathologically proven second local recurrence were treated in an outpatient magnetic resonance imaging (MRI-guided setting with a single fraction of 19 Gy focal high-dose-rate brachytherapy (HDR-BT. Delineation was performed using choline-PET-CT or a 68Ga-PSMA PET in combination with multiparametric 3 Tesla MRI in all four patients. Toxicity was measured using common toxicity criteria for adverse events (CTCAE version 4.0. Results : With a median follow-up of 12 months (range, 6-15, there were 2 patients with biochemical recurrence as defined by the Phoenix-definition. There were no patients with grade 3 or more toxicity. In all second salvage HDR-BT treatments, the constraints for rectum, bladder, and urethra were met. Median treatment volume (GTV was 4.8 cc (range, 1.9-6.6 cc. A median of 8 catheters (range, 6-9 were used, and the median dose to the treatment volume (GTV was a D95: 19.3 Gy (SD 15.5-19.4 Gy. Conclusions : Second focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients.

  6. Biological effective doses in the intracavitary high dose rate brachytherapy of cervical cancer

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    Y. Sobita Devi

    2011-12-01

    Full Text Available Purpose: The aim of this study is to evaluate the decrease of biological equivalent dose and its correlation withlocal/loco-regional control of tumour in the treatment of cervical cancer when the strength of the Ir-192 high dose rate(HDR brachytherapy (BT source is reduced to single, double and triple half life in relation to original strength of10 Ci (~ 4.081 cGy x m2 x h–1. Material and methods: A retrospective study was carried out on 52 cervical cancer patients with stage II and IIItreated with fractionated HDR-BT following external beam radiation therapy (EBRT. International Commission onRadiation Units and Measurement (ICRU points were defined according to ICRU Report 38, using two orthogonal radiographimages taken by Simulator (Simulix HQ. Biologically effective dose (BED was calculated at point A for diffe -rent Ir-192 source strength and its possible correlation with local/loco-regional tumour control was discussed. Result: The increase of treatment time per fraction of dose due to the fall of dose rate especially in HDR-BT of cervicalcancer results in reduction in BED of 2.59%, 7.02% and 13.68% with single, double and triple half life reduction ofsource strength, respectively. The probabilities of disease recurrence (local/loco-regional within 26 months are expectedas 0.12, 0.12, 0.16, 0.39 and 0.80 for source strength of 4.081, 2.041, 1.020, 0.510 and 0.347 cGy x m2 x h–1, respectively.The percentages of dose increase required to maintain the same BED with respect to initial BED were estimated as1.71, 5.00, 11.00 and 15.86 for the dose rate of 24.7, 12.4, 6.2 and 4.2 Gy/hr at point A, respectively. Conclusions: This retrospective study of cervical cancer patients treated with HDR-BT at different Ir-192 sourcestrength shows reduction in disease free survival according to the increase in treatment time duration per fraction.The probable result could be associated with the decrease of biological equivalent dose to point A. Clinical

  7. Concomitant cervical and transperineal parametrial high-dose-rate brachytherapy boost for locally advanced cervical cancer

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    Caroline Bailleux

    2016-01-01

    Full Text Available Purpose: There is no consensus for parametrial boost technic while both transvaginal and transperineal approaches are discussed. A prototype was developed consisting of a perineal template, allowing transperineal needle insertion. This study analyzed acute toxicity of concomitant cervical and transperineal parametrial high-dose-rate brachytherapy (HDRB boost for locally advanced cervical cancer. Material and methods: From 01.2011 to 12.2014, 33 patients (pts presenting a locally advanced cervical cancer with parametrial invasion were treated. After the first course of external beam radiation therapy with cisplatinum, HDRB was performed combining endocavitary and interstitial technique for cervical and parametrial disease. Post-operative delineation (CTV, bladder, rectum, sigmoid and planification were based on CT-scan/MRI. HDRB was delivered in 3-5 fractions over 2-3 consecutive days. Acute toxicities occurring within 6 months after HDRB were retrospectively reviewed. Results: Median age was 56.4 years (27-79. Clinical stages were: T2b = 23 pts (69.7%, T3a = 1 pt (3%, T3b = 6 pts (18.2%, and T4a = 3 pts (9.1%. Median HDRB prescribed dose was 21 Gy (21-27. Median CTVCT (16 pts and HR-CTV MRI (17 pts were 52.6 cc (28.5-74.3, 31.9 cc (17.1-58, respectively. Median EQD2αβ10 for D90CTV and D90HR-CTV were 82.9 Gy (78.2-96.5, 84.8 Gy (80.6-91.4, respectively. Median EQD2αβ3 (CT/MRI for D2cc bladder, rectum and sigmoid were 75.5 Gy (66.6-90.9, 64.4 Gy (51.9-77.4, and 60.4 Gy (50.9-81.1, respectively. Median follow-up was 14 months (ranged 6-51. Among the 24 pts with MFU = 24 months, 2-year LRFS rate, RRFS, and OS were 86.8%, 88.8%, and 94.1%, respectively. The rates of acute genitourinary and gastrointestinal toxicities were 36% (G1 dysuria = 8 pts, G2 infection = 2 pt, G3 infection = 2 pts, and 27% (G1 diarrhea = 9 pts, respectively. One patient presented vaginal bleeding at the time of applicator withdrawal (G3-blood transfusion; no bleeding was

  8. High-dose-rate brachytherapy monotherapy without androgen deprivation therapy for intermediate-risk prostate cancer.

    Science.gov (United States)

    Patel, Shyamal; Demanes, D Jeffrey; Ragab, Omar; Zhang, Mingle; Veruttipong, Darlene; Nguyen, Kristine; Park, Sang-June; Marks, Leonard; Pantuck, Allan; Steinberg, Michael; Kamrava, Mitchell

    Outcomes using high-dose-rate (HDR) brachytherapy monotherapy (without androgen deprivation therapy or external beam radiation therapy) for National Comprehensive Cancer Network-defined intermediate-risk (IR) patients are limited. We report our long-term data using HDR monotherapy for this patient population. One-hundred ninety IR prostate cancer patients were treated 1996-2013 with HDR monotherapy. Biochemical prostate-specific antigen (PSA) failure was per the Phoenix definition. Acute and late genitourinary and gastrointestinal toxicities were graded according to Common Toxicity Criteria of Adverse Events, version 4. Kaplan-Meier (KM) biochemical progression-free survival (BPFS), cause-specific survival, and overall survival rates were calculated. Univariate analyses were performed to determine relationships with BPFS. The median patient age was 66 years (43-90), and the median initial PSA was 7.4 ng/mL. The Gleason score was ≤6 in 26%, 3 + 4 in 62%, and 4 + 3 in 12%. The median treatment BED1.5 was 254 Gy; 83% of patients were treated with a dose of 7.25 Gy × six fractions delivered in two separate implants. With a median follow-up of 6.2 years, KM BPFS at 5/8 years was 97%/90%, cause-specific survival at 8 years was 100%, and overall survival at 5/8 years was 93%/88%. Late genitourinary toxicities were 36.3% Grade 1, 18.9% Grade 2, and 3.7% Grade 3. Late gastrointestinal toxicities were 6.3% Grade 1, 1.1% Grade 2, and no Grade ≥3. Of the patients with no sexual dysfunction before treatment, 68% maintained potency. Age, initial PSA, T stage, Gleason score, prostate volume, and percent positive cores did not correlate with BPFS. Stratifying by favorable vs. unfavorable IR groups did not affect BPFS. HDR brachytherapy monotherapy represents a safe and highly effective treatment for IR prostate cancer patients with long-term follow-up. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  9. High-Dose-Rate Monotherapy for Localized Prostate Cancer: 10-Year Results

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    Hauswald, Henrik; Kamrava, Mitchell R.; Fallon, Julia M.; Wang, Pin-Chieh; Park, Sang-June; Van, Thanh; Borja, Lalaine; Steinberg, Michael L.; Demanes, D. Jeffrey, E-mail: JDemanes@mednet.ucla.edu

    2016-03-15

    Purpose: High-dose-rate (HDR) brachytherapy was originally used with external beam radiation therapy (EBRT) to increase the dose to the prostate without injuring the bladder or rectum. Numerous studies have reported HDR brachytherapy is safe and effective. We adapted it for use without EBRT for cases not requiring lymph node treatment. Patients and Methods: We entered the patient demographics, disease characteristics, and treatment parameters into a prospective registry and serially added follow-up data for 448 men with low-risk (n=288) and intermediate-risk (n=160) prostate cancer treated from 1996 to 2009. Their median age was 64 years (range 42-90). The median prostate-specific antigen (PSA) level was 6.0 ng/mL (range 0.2-18.2). The Gleason score was ≤6 in 76% and 7 in 24%. The median dose was 43.5 Gy in 6 fractions. The clinical and biochemical disease control and survival rates were calculated. Adverse events were graded according to the Common Toxicity Criteria of Adverse Events. Results: The median follow-up period was 6.5 years (range 0.3-15.3). The actuarial 6- and 10-year PSA progression-free survival was 98.6% (95% confidence interval [CI] 96.9%-99.4%) and 97.8% (95% CI 95.5%-98.9%). Overall survival at 10 years was 76.7% (95% CI 69.9%-82.2%). The local control, distant metastasis-free survival, and cause-specific survival were 99.7% (95% CI 97.9%-99.9%), 98.9% (95% CI 96.3%-99.7%), and 99.1% (95% CI 95.8%-99.8%). T stage, initial PSA level, Gleason score, National Comprehensive Cancer Network risk group, patient age, and androgen deprivation therapy did not significantly correlate with disease control or survival. No late grade 3 to 4 rectal toxicities developed. Late grade 3 to 4 genitourinary toxicity occurred in 4.9% (grade 3 in 4.7%). Conclusions: HDR monotherapy is a safe and highly effective treatment of low- and intermediate-risk prostate cancer.

  10. Breast Cancer Rates by State

    Science.gov (United States)

    ... Associated Lung Ovarian Prostate Skin Uterine Cancer Home Breast Cancer Rates by State Language: English (US) Español (Spanish) ... from breast cancer each year. Rates of Getting Breast Cancer by State The number of people who get ...

  11. Salvage high-dose-rate brachytherapy for isolated vaginal recurrence of endometrial cancer.

    Science.gov (United States)

    Baek, Sungjae; Isohashi, Fumiaki; Yamaguchi, Hiroko; Mabuchi, Seiji; Yoshida, Ken; Kotsuma, Tadayuki; Yamazaki, Hideya; Tanaka, Eiichi; Sumida, Iori; Tamari, Keisuke; Otani, Keisuke; Seo, Yuji; Suzuki, Osamu; Yoshioka, Yasuo; Kimura, Tadashi; Ogawa, Kazuhiko

    We have retrospectively analyzed the outcomes of high-dose-rate (HDR) brachytherapy as a salvage therapy for vaginal recurrence of endometrial cancer. From 1997 to 2012, salvage HDR brachytherapy was performed in 43 patients. The median age was 64 years (range, 41-88 years). HDR brachytherapy was performed by interstitial brachytherapy in 34 patients (79%) and by intracavity brachytherapy in nine patients (21%). Seventeen (40%) of the 43 patients were treated with external beam radiotherapy. The median followup period was 58 months (range, 6-179 months). The 5-year overall survival (OS), progression-free survival (PFS), and local control rates (LC) were 84%, 52%, and 78%, respectively. Patients who received brachytherapy with external beam radiotherapy experienced no nodal recurrence (0 of 17 patients), whereas 23% of the patients (6 of 26 patients) who received brachytherapy alone experienced nodal recurrence (p = 0.047). The pathologic grade at the time of initial surgery (G1-2 vs. G3) was found to be a significant prognostic factor for both OS and PFS. The respective 5-year OS was 96% vs. 40% (p brachytherapy vs. intracavity brachytherapy) were significant prognostic factors for LC. The respective 5-year LC was 74% vs. 100% (p = 0.020) and 85% vs. 56% (p = 0.035). HDR brachytherapy is effective and feasible in patients with isolated vaginal recurrence of endometrial cancer. Pathologic grade, age, and modality were significant prognostic factors. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. High-dose-rate brachytherapy for uterine cervical cancer: the results of different fractionation regimen

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    Yoon, Won Sup; Kim, Tae Hyun; Yang, Dae Sik; Choi, Myung Sun; Kim, Chul Yong [College of Medicine, Korea University, Seoul (Korea, Republic of)

    2002-09-15

    Although high-dose-rate (HDR) brachytherapy regimens have been practiced with a variety of modalities and various degrees of success, few studies on the subject have been conducted. The purpose of this study was to compare the results of local control and late complication rate according to different HDR brachytherapy fractionation regimens in uterine cervical cancer patients. From November 1992 to March 1998, 224 patients with uterine cervical cancer were treated with external beam irradiation and HDR brachytherapy. In external pelvic radiation therapy, the radiation dose was 45 {approx} 54 Gy (median dose 54 Gy) with daily fraction size 1.8 Gy, five times per week. In HDR brachytherapy, 122 patients (Group A) were treated with three times weekly with 3 Gy to line-A (isodose line of 2 cm radius from source) and 102 patients (Group B) underwent the HDR brachytherapy twice weekly with 4 or 4.5 Gy to line-A after external beam irradiation. Iridium-192 was used as the source of HDR brachytherapy. Late complication was assessed from grade 1 to 5 using the RTOG morbidity grading system. The local control rate (LCR) at 5 years was 80% in group A and 84% in group B ({rho} = 0.4523). In the patients treated with radiation therapy alone, LCR at 5 years was 60.9% in group A and 76.9% in group B ({rho} = 0.2557). In post-operative radiation therapy patients, LCR at 5 years was 92.6% in group A and 91.6% in group B ({rho} 0.8867). The incidence of late complication was 18% (22 patients) and 29.4% (30 patients), of bladder complication was 9.8% (12 patients) and 14.7% (15 patients), and of rectal complication was 9.8% (12 patients) and 21.6% (22 patients), in group A and B, respectively. Lower fraction sized HDR brachytherapy was associated with decrease in late complication ({rho} =0.0405) (rectal complication, {rho} = 0.0147; bladder complication, {rho} =0.115). The same result was observed in postoperative radiation therapy patients ({rho} = 0.0860) and radiation only

  13. Clinical implementation of a novel applicator in high-dose-rate brachytherapy treatment of esophageal cancer

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    Ivan M. Buzurovic

    2016-08-01

    Full Text Available Purpose : In this study, we present the clinical implementation of a novel transoral balloon centering esophageal applicator (BCEA and the initial clinical experience in high-dose-rate (HDR brachytherapy treatment of esophageal cancer, using this applicator. Material and methods: Acceptance testing and commissioning of the BCEA were performed prior to clinical use. Full performance testing was conducted including measurements of the dimensions and the catheter diameter, evaluation of the inflatable balloon consistency, visibility of the radio-opaque markers, congruence of the markers, absolute and relative accuracy of the HDR source in the applicator using the radiochromic film and source position simulator, visibility and digitization of the applicator on the computed tomography (CT images under the clinical conditions, and reproducibility of the offset. Clinical placement of the applicator, treatment planning, treatment delivery, and patient’s response to the treatment were elaborated as well. Results : The experiments showed sub-millimeter accuracy in the source positioning with distal position at 1270 mm. The digitization (catheter reconstruction was uncomplicated due to the good visibility of markers. The treatment planning resulted in a favorable dose distribution. This finding was pronounced for the treatment of the curvy anatomy of the lesion due to the improved repeatability and consistency of the delivered fractional dose to the patient, since the radioactive source was placed centrally within the lumen with respect to the clinical target due to the five inflatable balloons. Conclusions : The consistency of the BCEA positioning resulted in the possibility to deliver optimized non-uniform dose along the catheter, which resulted in an increase of the dose to the cancerous tissue and lower doses to healthy tissue. A larger number of patients and long-term follow-up will be required to investigate if the delivered optimized treatment can

  14. Mortality and recurrence rates among systemically untreated high risk breast cancer patients included in the DBCG 77 trials

    DEFF Research Database (Denmark)

    Jensen, Maj Britt; Nielsen, Torsten O.; Knoop, Ann S.

    2018-01-01

    Background: Following loco-regional treatment for early breast cancer accurate prognostication is essential for communicating benefits of systemic treatment. The aim of this study was to determine time to recurrence and long-term mortality rates in high risk patients according to patient characte......Background: Following loco-regional treatment for early breast cancer accurate prognostication is essential for communicating benefits of systemic treatment. The aim of this study was to determine time to recurrence and long-term mortality rates in high risk patients according to patient...

  15. Direction-Modulated Brachytherapy for High-Dose-Rate Treatment of Cervical Cancer. I: Theoretical Design

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    Han, Dae Yup [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, California (United States); Webster, Matthew J. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Department of Physics, University of California San Diego, La Jolla, California (United States); Scanderbeg, Daniel J.; Yashar, Catheryn; Choi, Dongju; Song, Bongyong [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Devic, Slobodan [Medical Physics Unit, McGill University, Montréal, Québec (Canada); Department of Radiation Oncology, Jewish General Hospital, Montréal, Québec (Canada); Ravi, Ananth [Department of Medical Physics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Song, William Y., E-mail: wyjsong@gmail.com [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Department of Medical Physics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2014-07-01

    Purpose: To demonstrate that utilization of the direction-modulated brachytherapy (DMBT) concept can significantly improve treatment plan quality in the setting of high-dose-rate (HDR) brachytherapy for cervical cancer. Methods and Materials: The new, MRI-compatible, tandem design has 6 peripheral holes of 1.3-mm diameter, grooved along a nonmagnetic tungsten-alloy rod (ρ = 18.0 g/cm{sup 3}), enclosed in Delrin tubing (polyoxymethylene, ρ = 1.41 g/cm{sup 3}), with a total thickness of 6.4 mm. The Monte Carlo N-Particle code was used to calculate the anisotropic {sup 192}Ir dose distributions. An in-house-developed inverse planning platform, geared with simulated annealing and constrained-gradient optimization algorithms, was used to replan 15 patient cases (total 75 plans) treated with a conventional tandem and ovoids (T and O) applicator. Prescription dose was 6 Gy. For replanning, we replaced the conventional tandem with that of the new DMBT tandem for optimization but left the ovoids in place and kept the dwell positions as originally planned. All DMBT plans were normalized to match the high-risk clinical target volume V100 coverage of the T and O plans. Results: In general there were marked improvements in plan quality for the DMBT plans. On average, D2cc for the bladder, rectum, and sigmoid were reduced by 0.59 ± 0.87 Gy (8.5% ± 28.7%), 0.48 ± 0.55 Gy (21.1% ± 27.2%), and 0.10 ± 0.38 Gy (40.6% ± 214.9%) among the 75 plans, with best single-plan reductions of 3.20 Gy (40.8%), 2.38 Gy (40.07%), and 1.26 Gy (27.5%), respectively. The high-risk clinical target volume D90 was similar, with 6.55 ± 0.96 Gy and 6.59 ± 1.06 Gy for T and O and DMBT, respectively. Conclusions: Application of the DMBT concept to cervical cancer allowed for improved organ at risk sparing while achieving similar target coverage on a sizeable patient population, as intended, by maximally utilizing the anatomic information contained in 3-dimensional

  16. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Larissa J. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States)

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  17. Predictors of toxicity after image-guided high-dose-rate interstitial brachytherapy for gynecologic cancer.

    Science.gov (United States)

    Lee, Larissa J; Viswanathan, Akila N

    2012-12-01

    To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure adequate tumor coverage while minimizing the D2cc to the

  18. Current situation of high-dose-rate brachytherapy for cervical cancer in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Rogerio Matias Vidal da; Souza, Divanizia do Nascimento, E-mail: rmv.fisica@gmail.com [Universidade Federal de Sergipe (UFS), Sao Cristovao, SE (Brazil); Pinezi, Juliana Castro Dourado [Pontificia Universidade Catolica de Goias (PUC-Goias), Goiania, GO (Brazil); Macedo, Luiz Eduardo Andrade [Hospital Chama, Arapiraca, AL (Brazil)

    2014-05-15

    To assess the current situation of high-dose-rate (HDR) brachytherapy for cancer of the cervix in Brazil, regarding apparatuses, planning methods, prescription, fractionation schedule and evaluation of dose in organs at risk. Materials and methods: in the period between March/2012 and May/2013, a multiple choice questionnaire was developed and sent to 89 Brazilian hospitals which perform HDR brachytherapy. Results: sixty-one services answered the questionnaire. All regions of the country experienced a sharp increase in the number of HDR brachytherapy services in the period from 2001 to 2013. As regards planning, although a three-dimensional planning software was available in 91% of the centers, conventional radiography was mentioned by 92% of the respondents as their routine imaging method for such a purpose. Approximately 35% of respondents said that brachytherapy sessions are performed after teletherapy. The scheme of four 7 Gy intracavitary insertions was mentioned as the most frequently practiced. Conclusion: the authors observed that professionals have difficulty accessing adjuvant three-dimensional planning tools such as computed tomography and magnetic resonance imaging. (author)

  19. High-dose-rate interstitial brachytherapy for female peri-urethral cancer

    Directory of Open Access Journals (Sweden)

    Daya Nand Sharma

    2016-01-01

    Full Text Available Purpose: Peri-urethral cancer (PUC in females is a rare malignancy. Surgery is not usually contemplated due to associated morbidity. Radiation therapy (RT can be employed in the form of interstitial brachytherapy (IBT alone for early lesions, and external beam radiation therapy (EBRT with or without IBT for advanced lesions. We report our first experience in the literature to evaluate the role of high-dose-rate (HDR IBT in female PUC. Material and methods : Between 2008 and 2013, 10 female patients with PUC (5 primary and 5 recurrent were treated with HDR-IBT with or without EBRT at our center. Size of the lesion ranged from 1.5 cm to 5.0 cm. A 2-3 plane free-hand implant was performed using plastic catheters. The prescribed dose of HDR-IBT was 42 Gy in 14 fractions for brachytherapy alone (5 patients, and 18-21 Gy for the boost along with EBRT (5 patients. Patients were followed up regularly for assessment of disease control and toxicity. Results: At a median follow up of 25 months, six patients were disease free at their last follow up. Four patients developed recurrence: 2 at inguinal nodes, 1 at local site, and 1 at both local as well as inguinal nodes. Moist desquamation was the commonest acute toxicity observed in all 5 patients treated with IBT alone, which healed within 4 weeks’ time. Overall, grade II delayed complication rate was 30%. Conclusions : Though small sample size, the results of our study have shown that HDR-IBT provides good loco-regional control with acceptable toxicity for female PUC.

  20. Advantages of high-dose rate (HDR) brachytherapy in treatment of prostate cancer

    Science.gov (United States)

    Molokov, A. A.; Vanina, E. A.; Tseluyko, S. S.

    2017-09-01

    One of the modern methods of preserving organs radiation treatment is brachytherapy. This article analyzes the results of prostate brachytherapy. These studies of the advantages of high dose brachytherapy lead to the conclusion that this method of radiation treatment for prostate cancer has a favorable advantage in comparison with remote sensing methods, and is competitive, preserving organs in comparison to surgical methods of treatment. The use of the method of polyfocal transperineal biopsy during the brachytherapy session provides information on the volumetric spread of prostate cancer and adjust the dosimetry plan taking into account the obtained data.

  1. Learning curve of MRI-based planning for high-dose-rate brachytherapy for prostate cancer.

    Science.gov (United States)

    Buus, Simon; Rylander, Susanne; Hokland, Steffen; Søndergaard, Christian Skou; Pedersen, Erik Morre; Tanderup, Kari; Bentzen, Lise

    2016-01-01

    To evaluate introduction of MRI-based high-dose-rate brachytherapy (HDRBT), including procedure times, dose-volume parameters, and perioperative morbidity. Study included 42 high-risk prostate cancer patients enrolled in a clinical protocol, offering external beam radiotherapy + two HDRBT 8.5 Gy boosts. Time was recorded for initiation of anesthesia (A), fixation of needle implant (B), end of MR imaging (C), plan approval (D), and end of HDRBT delivery (E). We defined time A-E as total procedure time, A-B as operating room time, B-C as MRI procedure time, C-D as treatment planning time, and D to E as treatment delivery time. Dose-volume parameters were retrieved from the dose planning system. Results from the first 21 patients were compared with the last 21 patients. Total procedure time, operating room time, MRI procedure time, and treatment planning time decreased significantly from average 7.6 to 5.3 hours (p < 0.01), 3.6 to 2.4 hours (p < 0.01), 1.6 to 0.8 hours (p < 0.01), and 2.0 to 1.3 hours (p < 0.01), respectively. HDRBT delivery time remained unchanged at 0.5 hours. Clinical target volume prostate+3mmD90 fulfilled planning aim in 92% of procedures and increased significantly from average 8.3 to 9.0 Gy (p < 0.01). Urethral D0.1 cm(3) and rectal D2 cm(3) fulfilled planning aim in 78% and 95% of procedures, respectively, and did not change significantly. Hematuria occurred in (95%), hematoma (80%), moderate to strong pain (35%), and urinary retention (5%) of procedures. After introduction of MRI-based HDRBT, procedure times were significantly reduced. D90 Clinical target volumeprostate+3mm fulfilled constraints in most patients and improved over time, but not at expense of an increased urethral or rectal dose. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  2. Medically inoperable endometrial cancer in patients with a high body mass index (BMI): Patterns of failure after 3-D image-based high dose rate (HDR) brachytherapy

    DEFF Research Database (Denmark)

    Acharya, Sahaja; Esthappan, Jacqueline; Badiyan, Shahed

    2016-01-01

    BACKGROUND AND PURPOSE: High BMI is a reason for medical inoperability in patients with endometrial cancer in the United States. Definitive radiation is an alternative therapy for these patients; however, data on patterns of failure after definitive radiotherapy are lacking. We describe...... the patterns of failure after definitive treatment with 3-D image-based high dose rate (HDR) brachytherapy for medically inoperable endometrial cancer. MATERIALS AND METHODS: Forty-three consecutive patients with endometrial cancer FIGO stages I-III were treated definitively with HDR brachytherapy...

  3. A high response rate to liposomal doxorubicin is seen among women with BRCA mutations treated for recurrent epithelial ovarian cancer.

    Science.gov (United States)

    Adams, Sarah F; Marsh, Evelyn B; Elmasri, Wafic; Halberstadt, Steffanie; Vandecker, Stephanie; Sammel, Mary D; Bradbury, Angela R; Daly, Mary; Karlan, Beth; Rubin, Stephen C

    2011-12-01

    Ten percent of ovarian cancer is attributed to hereditary syndromes, most commonly to mutations in the BRCA1 or BRCA2 genes. These cancers are characterized by a prolonged sensitivity to platinum agents in spite of presentation at advanced stages. We hypothesized that women with BRCA-associated ovarian cancer would also show a high response rate to pegylated liposomal doxorubicin (Doxil). A retrospective cohort study was conducted to compare the response rate, progression-free, and overall survival among women with BRCA-associated or sporadic ovarian cancer who were treated with Doxil. A response to Doxil was seen in 13 of 23 patients with BRCA mutations (56.5%; 3 by RECIST criteria and 10 by CA125 levels) compared with only 8 of 41 women with non-hereditary cancers (19.5%; 2 by RECIST criteria and 6 by CA125 levels; p=0.004). This was associated with an improved progression-free and overall survival as measured from the time of Doxil administration. Notably, platinum sensitivity did not directly correlate with a response to Doxil. Women with BRCA-associated ovarian tumors demonstrate a greater sensitivity to cytotoxic therapy with Doxil than has previously been reported in unselected cases. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study

    Directory of Open Access Journals (Sweden)

    Umesh Mahantshetty

    2017-04-01

    Full Text Available Purpose: The aim of this study is to compare 3D dose volume histogram (DVH parameters of bladder and other organs at risk with different bladder filling protocol during high-dose-rate intracavitary brachytherapy (HDR-ICBT in cervical cancer, and to find optimized bladder volume. Material and methods : This dosimetric study was completed with 21 patients who underwent HDR-ICBT with computed tomography/magnetic resonance compatible applicator as a routine treatment. Computed tomography planning was done for each patient with bladder emptied (series 1, after 50 ml (series 2, and 100 ml (series 3 bladder filling with a saline infusion through the bladder catheter. Contouring was done on the Eclipse Planning System. 7 Gy to point A was prescribed with the standard loading patterns. Various 3D DVH parameters including 0.1 cc, 1 cc, 2 cc doses and mean doses to the OAR’s were noted. Paired t-test was performed. Results : The mean (± SD bladder volume was 64.5 (± 25 cc, 116.2 (± 28 cc, and 172.9 (± 29 cc, for series 1, 2, and 3, respectively. The 0.1 cm 3 ,1 cm 3 , 2 cm 3 mean bladder doses for series 1, series 2, and series 3 were 9.28 ± 2.27 Gy, 7.38 ± 1.72 Gy, 6.58 ± 1.58 Gy; 9.39 ± 2.28 Gy, 7.85 ± 1.85 Gy, 7.05 ± 1.59 Gy, and 10.09 ± 2.46 Gy, 8.33 ± 1.75 Gy, 7.6 ± 1.55 Gy, respectively. However, there was a trend towards higher bladder doses in series 3. Similarly, for small bowel dose 0.1 cm 3 , 1 cm 3 , and 2 cm 3 in series 1, 2, and 3 were 5.44 ± 2.2 Gy, 4.41 ± 1.84 Gy, 4 ± 1.69 Gy; 4.57 ± 2.89 Gy, 3.78 ± 2.21 Gy, 3.35 ± 2.02 Gy, and 4.09 ± 2.38 Gy, 3.26 ± 1.8 Gy, 3.05 ± 1.58 Gy. Significant increase in small bowel dose in empty bladder (series 1 compared to full bladder (series 3 (p = 0.03 was noted. However, the rectal and sigmoid doses were not significantly affected with either series. Conclusions : Bladder filling protocol with 50 ml and 100 ml was well tolerated and achieved a reasonably reproducible bladder volume

  5. Brachytherapy optimization using radiobiological-based planning for high dose rate and permanent implants for prostate cancer treatment

    Science.gov (United States)

    Seeley, Kaelyn; Cunha, J. Adam; Hong, Tae Min

    2017-01-01

    We discuss an improvement in brachytherapy--a prostate cancer treatment method that directly places radioactive seeds inside target cancerous regions--by optimizing the current standard for delivering dose. Currently, the seeds' spatiotemporal placement is determined by optimizing the dose based on a set of physical, user-defined constraints. One particular approach is the ``inverse planning'' algorithms that allow for tightly fit isodose lines around the target volumes in order to reduce dose to the patient's organs at risk. However, these dose distributions are typically computed assuming the same biological response to radiation for different types of tissues. In our work, we consider radiobiological parameters to account for the differences in the individual sensitivities and responses to radiation for tissues surrounding the target. Among the benefits are a more accurate toxicity rate and more coverage to target regions for planning high-dose-rate treatments as well as permanent implants.

  6. Assessment for effects and adverse effects of preoperative high-dose-rate intraluminal brachytherapy for lower rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Terauchi, Kazuo (Hyogo College of Medicine, Nishinomiya (Japan))

    1993-11-01

    Endoscopic and histological effects and perianal dermal side effects after high-dose-rate intraluminal brachytherapy (HDRIBT) using [sup 60]Co for preoperative irradiation were assessed in thirty-five patients with low-lying rectal cancers. In more than half of the patients irradiated with 30 Gy or more, marked effective change was observed under endoscopy. In the histological assessment, while the resected lesions irradiated with 16-20 Gy showed no effective change, 68.8%, 75.0%, and 76.9% respectively, of those in the groups given 30 Gy, 40-60 Gy, and 80 Gy showed marked destruction. While 23. 1% of the patients irradiated with 80 Gy developed severe perianal dermal lesions requiring surgical removal of the anus, 18.8% of the 30 Gy group and 25% of the 40-60 Gy group suffered from dermal side effects which were mild and reversible. Consequently, it has been concluded that the proper regimen for preoperative HDRIBT for rectal cancer was 30 Gy followed by surgery within two weeks. During the follow up period from 35 to 70 months, one patient (2.9%) who received 16 Gy HDRIBT developed local recurrence within 3 years after resection, and the other one developed hepatic metastasis. The 3-year local recurrence rate after resection for lower rectal cancer in the previous series at our department was 19.6%. We, therefore, concluded that HDRIBT was a promising adjuvant therapy for rectal cancer. (author).

  7. Lung Cancer Rates by State

    Science.gov (United States)

    ... Shareable Graphics Infographics “African-American Men and Lung Cancer” “Lung Cancer Is the Biggest Cancer Killer in Both ... Colorectal (Colon) HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by State Language: English (US) Español ( ...

  8. High-Intensity Focused Ultrasound for Prostate Cancer: Long-Term Followup and Complications Rate

    Directory of Open Access Journals (Sweden)

    Umberto Maestroni

    2012-01-01

    Full Text Available Introduction. As it is well known, High Intensity Focused Ultrasound (HIFU is a minimally invasive procedure for prostate cancer. Many investigators reported their series of patients, demonstrating the effectiveness of the treatment. The most majority of Authors, however, do not report the side effects and the complications of the procedure, which is the aim of our study. The diagnosis and management of complications is discussed, and the oncologic outcome is reported in terms of quality of life. Materials and Methods. We report our experience in 89 patients, low-, intermediate-, and high-risk patients according with D’Amico classification. All data collected along the study were analyzed, including side effects and complications of the procedure. Results. Our series demonstrates the effectiveness of the procedure, in line with larger series reported in literature by other investigators. The most important side effects are sexual function impairment and transient incontinence in a minority of cases. Minor complications are reported as well as rare cases of major complications, which can require surgical treatment.

  9. High-Dose-Rate Brachytherapy as a Monotherapy for Favorable-Risk Prostate Cancer: A Phase II Trial

    Energy Technology Data Exchange (ETDEWEB)

    Barkati, Maroie [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Williams, Scott G., E-mail: scott.williams@petermac.org [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Pathology, University of Melbourne, Melbourne (Australia); Foroudi, Farshad; Tai, Keen Hun; Chander, Sarat [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Pathology, University of Melbourne, Melbourne (Australia); Dyk, Sylvia van [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); See, Andrew [Ballarat Austin Radiation Oncology Centre, Ballarat (Australia); Duchesne, Gillian M. [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Pathology, University of Melbourne, Melbourne (Australia)

    2012-04-01

    Purpose: There are multiple treatment options for favorable-risk prostate cancer. High-dose-rate (HDR) brachytherapy as a monotherapy is appealing, but its use is still investigational. A Phase II trial was undertaken to explore the value of such treatment in low-to-intermediate risk prostate cancer. Methods and Materials: This was a single-institution, prospective study. Eligible patients had low-risk prostate cancer features but also Gleason scores of 7 (51% of patients) and stage T2b to T2c cancer. Treatment with HDR brachytherapy with a single implant was administered over 2 days. One of four fractionation schedules was used in a dose escalation study design: 3 fractions of 10, 10.5, 11, or 11.5 Gy. Patients were assessed with the Common Terminology Criteria for Adverse Events version 2.0 for urinary toxicity, the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scoring schema for rectal toxicity, and the Expanded Prostate Cancer Index Composite (EPIC) questionnaire to measure patient-reported health-related quality of life. Biochemical failure was defined as a prostate-specific antigen (PSA) nadir plus 2 ng/ml. Results: Between 2003 and 2008, 79 patients were enrolled. With a median follow-up of 39.5 months, biochemical relapse occurred in 7 patients. Three- and 5-year actuarial biochemical control rates were 88.4% (95% confidence interval [CI], 78.0-96.2%) and 85.1% (95% CI, 72.5-94.5%), respectively. Acute grade 3 urinary toxicity was seen in only 1 patient. There was no instance of acute grade 3 rectal toxicity. Rates of late grade 3 rectal toxicity, dysuria, hematuria, urinary retention, and urinary incontinence were 0%, 10.3%, 1.3%, 9.0%, and 0%, respectively. No grade 4 or greater toxicity was recorded. Among the four (urinary, bowel, sexual, and hormonal) domains assessed with the EPIC questionnaire, only the sexual domain did not recover with time. Conclusions: HDR brachytherapy as a monotherapy for favorable

  10. Two-piece customized mold technique for high-dose-rate brachytherapy on cancers of the buccal mucosa and lip.

    Science.gov (United States)

    Matsuzaki, Hidenobu; Takemoto, Mitsuhiro; Hara, Marina; Unetsubo, Teruhisa; Yanagi, Yoshinobu; Katsui, Kuniaki; Katayama, Norihisa; Yoshio, Kotaro; Takenobu, Toshihiko; Kuroda, Masahiro; Kanazawa, Susumu; Asaumi, Jun-Ichi

    2012-01-01

    High-dose-rate (HDR) brachytherapy using a customized mold is a minimally invasive treatment for oral cancer; however, it is difficult to use this technique for buccal and lip cancers involving the commissura labiorum, owing to its anatomic form. The purpose of this study was to introduce an improved customized mold consisting of 2 pieces to allow the fixation of molds to these sites. Five patients with buccal carcinoma and 1 patient with lip carcinoma were treated with this technique after external beam radiotherapy. One patient with neck metastasis underwent both neck dissection and partial tumor resection before HDR brachytherapy. At the end of the follow-up period, 5 patients had no tumor recurrence, and 1 patient had suffered local recurrence. Our technique is a viable therapeutic option for patients with buccal and lip carcinomas for whom the therapeutic modalities are limited by age, performance status, and other factors. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. High-dose-rate brachytherapy as salvage modality for locally recurrent prostate cancer after definitive radiotherapy. A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Chatzikonstantinou, Georgios; Zamboglou, Nikolaos; Roedel, Claus; Tselis, Nikolaos [J.W. Goethe University of Frankfurt, Department of Radiotherapy and Oncology, Frankfurt am Main (Germany); Zoga, Eleni [Sana Klinikum Offenbach, Department of Radiotherapy and Oncology, Offenbach am Main (Germany); Strouthos, Iosif [Medical Center - University of Freiburg, Department of Radiotherapy and Oncology, University of Freiburg, Freiburg (Germany); Butt, Saeed Ahmed [Sana Klinikum Offenbach, Department of Medical Physics and Engineering, Offenbach am Main (Germany)

    2017-09-15

    To review the current status of interstitial high-dose-rate brachytherapy as a salvage modality (sHDR BRT) for locally recurrent prostate cancer after definitive radiotherapy (RT). A literature search was performed in PubMed using ''high-dose-rate, brachytherapy, prostate cancer, salvage'' as search terms. In all, 51 search results published between 2000 and 2016 were identified. Data tables were generated and summary descriptions created. The main outcome parameters used were biochemical control (BC) and toxicity scores. Eleven publications reported clinical outcome and toxicity with follow-up ranging from 4-191 months. A variety of dose and fractionation schedules were described, including 19.0 Gy in 2 fractions up to 42.0 Gy in 6 fractions. The 5-year BC ranged from 18-77%. Late grade 3 genitourinary and gastrointestinal toxicity was 0-32% and 0-5.1%, respectively. sHDR BRT appears as safe and effective salvage modality for the reirradiation of locally recurrent prostate cancer after definitive RT. (orig.) [German] Zusammenfassende Darstellung relevanter Literatur zur interstitiellen High-Dose-Rate-Brachytherapie als Salvage-Modalitaet (sHDR-BRT) bei der Behandlung des lokal rezidivierten Prostatakarzinoms nach vorausgegangener definitiver Radiotherapie (RT). In der PubMed-Datenbank wurde eine Literaturrecherche mit den Suchbegriffen ''high-dose-rate, brachytherapy, prostate cancer, salvage'' durchgefuehrt. Zwischen den Jahren 2000 und 2016 wurden 51 Publikationen identifiziert. Die biochemische Kontrolle (BC) sowie das assoziierte Toxizitaetsprofil waren onkologische Hauptpunkte in der Analyse der beruecksichtigten Literatur. Von onkologischen Ergebnissen und Toxizitaeten berichteten 11 Publikationen bei einer medianen Nachbeobachtungszeit von 4-191 Monaten. Eine Variabilitaet von Dosis- und Fraktionierungsregimen wurde beschrieben mit totalen physikalischen Dosen von 19,0 Gy in 2 Fraktionen bis zu 42,0 Gy in 6 Fraktionen

  12. High 1-Year Complication Rate after Anterior Resection for Rectal Cancer

    NARCIS (Netherlands)

    Snijders, H. S.; Bakker, I. S.; Dekker, J. W. T.; Vermeer, T. A.; Consten, E. C. J.; Hoff, C.; Klaase, J. M.; Havenga, K.; Tollenaar, R. A. E. M.; Wiggers, T.

    Surgical options after anterior resection for rectal cancer include a primary anastomosis, anastomosis with a defunctioning stoma, and an end colostomy. This study describes short-term and 1-year outcomes of these different surgical strategies. Patients undergoing surgical resection for primary mid

  13. High rate of extra-haematological toxicity compromises dose-dense sequential adjuvant chemotherapy for breast cancer

    Science.gov (United States)

    Brain, E; Levy, C; Serin, D; Roché, H; Spielmann, M; Delva, R; Veyret, C; Mauriac, L; Rios, M; Martin, A L; Jimenez, M; Asselain, B; Gauthier, M; Bonnetain, F; Fumoleau, P

    2011-01-01

    Background: A dose-dense strategy has been considered to improve results of adjuvant chemotherapy for breast cancer. This randomised phase II trial investigated the feasibility of this approach with sequential anthracyclines and taxanes-based chemotherapy. Methods: Patients with high-risk node-positive breast cancer were treated with three cycles of fluorouracil 500 mg m−2, epirubicin 100 mg m−2, cyclophosphamide 500 mg m−2 (FEC 100) followed by three cycles of docetaxel 100 mg m−2 delivered at 2-weekly intervals supported by primary prophylaxis with filgrastim. All patients were randomised to either uninterrupted treatment (arm A) or to have a 2-week additional period of rest between the FEC and docetaxel (arm B). The primary endpoint was the rate of success of chemotherapy delivery. Using a two-stage Fleming design, 120 patients were required with one interim analysis. Results: In March 2005, enrolment was stopped into arm A after the observation of severe skin toxicities. Following the planned interim analysis, the study was closed because of the high rate of grade 3/4 skin toxicities in both arms (arm A: 32.4% and arm B: 18.9%). Conclusion: Sequential dose-dense FEC 100 followed by docetaxel 100 mg m−2 is not feasible. Feasibility still depends largely on several factors including the choice of drugs, dosage and sequence of administration. PMID:22009030

  14. Therapeutic analysis of high-dose-rate {sup 192}Ir vaginal cuff brachytherapy for endometrial cancer using a cylindrical target volume model and varied cancer cell distributions

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hualin, E-mail: hualin.zhang@northwestern.edu; Donnelly, Eric D.; Strauss, Jonathan B. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois 60611 (United States); Qi, Yujin [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia)

    2016-01-15

    Purpose: To evaluate high-dose-rate (HDR) vaginal cuff brachytherapy (VCBT) in the treatment of endometrial cancer in a cylindrical target volume with either a varied or a constant cancer cell distributions using the linear quadratic (LQ) model. Methods: A Monte Carlo (MC) technique was used to calculate the 3D dose distribution of HDR VCBT over a variety of cylinder diameters and treatment lengths. A treatment planning system (TPS) was used to make plans for the various cylinder diameters, treatment lengths, and prescriptions using the clinical protocol. The dwell times obtained from the TPS were fed into MC. The LQ model was used to evaluate the therapeutic outcome of two brachytherapy regimens prescribed either at 0.5 cm depth (5.5 Gy × 4 fractions) or at the vaginal mucosal surface (8.8 Gy × 4 fractions) for the treatment of endometrial cancer. An experimentally determined endometrial cancer cell distribution, which showed a varied and resembled a half-Gaussian distribution, was used in radiobiology modeling. The equivalent uniform dose (EUD) to cancer cells was calculated for each treatment scenario. The therapeutic ratio (TR) was defined by comparing VCBT with a uniform dose radiotherapy plan in term of normal cell survival at the same level of cancer cell killing. Calculations of clinical impact were run twice assuming two different types of cancer cell density distributions in the cylindrical target volume: (1) a half-Gaussian or (2) a uniform distribution. Results: EUDs were weakly dependent on cylinder size, treatment length, and the prescription depth, but strongly dependent on the cancer cell distribution. TRs were strongly dependent on the cylinder size, treatment length, types of the cancer cell distributions, and the sensitivity of normal tissue. With a half-Gaussian distribution of cancer cells which populated at the vaginal mucosa the most, the EUDs were between 6.9 Gy × 4 and 7.8 Gy × 4, the TRs were in the range from (5.0){sup 4} to (13

  15. Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, Niraj H., E-mail: nmehta@mednet.ucla.edu [University of California, Los Angeles, Los Angeles, California (United States); Kamrava, Mitchell; Wang, Pin-Chieh; Steinberg, Michael; Demanes, Jeffrey [University of California, Los Angeles, Los Angeles, California (United States)

    2013-07-15

    Purpose: To characterize the magnitude and kinetics of prostate-specific antigen (PSA) bounces after high-dose-rate (HDR) monotherapy and determine relationships between certain clinical factors and PSA bounce. Methods and Materials: Longitudinal PSA data and various clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy between 1996 and 2005. We used the following definition for PSA bounce: rise in PSA ≥threshold, after which it returns to the prior level or lower. Prostate-specific antigen failure was defined per the Phoenix definition (nadir +2 ng/mL). Results: A PSA bounce was noted in 67 patients (43%). The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0, and 5 in 1 (1%). The median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7, and its median duration was 0.75 years. Three patients (2%) were noted to have PSA failure. None of the 3 patients who experienced biochemical failure exhibited PSA bounce. In the fully adjusted model for predicting each bounce, patients aged <55 years had a statistically significant higher likelihood of experiencing a bounce (odds ratio 2.22, 95% confidence interval 1.38-3.57, P=.001). There was also a statistically significant higher probability of experiencing a bounce for every unit decrease in Gleason score (odds ratio 1.52, 95% confidence interval 1.01-2.04, P=.045). Conclusions: A PSA bounce occurs in a significant percentage of patients treated with HDR monotherapy, with magnitudes varying from <1 in 28% of cases to ≥1 in 15%. The median duration of bounce is <1 year. More bounces were identified in patients with lower Gleason score and age <55 years. Further investigation using a model to correlate magnitude and frequency of bounces with clinical variables are under way.

  16. Cancer radiotherapy based on femtosecond IR laser-beam filamentation yielding ultra-high dose rates and zero entrance dose.

    Science.gov (United States)

    Meesat, Ridthee; Belmouaddine, Hakim; Allard, Jean-François; Tanguay-Renaud, Catherine; Lemay, Rosalie; Brastaviceanu, Tiberius; Tremblay, Luc; Paquette, Benoit; Wagner, J Richard; Jay-Gerin, Jean-Paul; Lepage, Martin; Huels, Michael A; Houde, Daniel

    2012-09-18

    Since the invention of cancer radiotherapy, its primary goal has been to maximize lethal radiation doses to the tumor volume while keeping the dose to surrounding healthy tissues at zero. Sadly, conventional radiation sources (γ or X rays, electrons) used for decades, including multiple or modulated beams, inevitably deposit the majority of their dose in front or behind the tumor, thus damaging healthy tissue and causing secondary cancers years after treatment. Even the most recent pioneering advances in costly proton or carbon ion therapies can not completely avoid dose buildup in front of the tumor volume. Here we show that this ultimate goal of radiotherapy is yet within our reach: Using intense ultra-short infrared laser pulses we can now deposit a very large energy dose at unprecedented microscopic dose rates (up to 10(11) Gy/s) deep inside an adjustable, well-controlled macroscopic volume, without any dose deposit in front or behind the target volume. Our infrared laser pulses produce high density avalanches of low energy electrons via laser filamentation, a phenomenon that results in a spatial energy density and temporal dose rate that both exceed by orders of magnitude any values previously reported even for the most intense clinical radiotherapy systems. Moreover, we show that (i) the type of final damage and its mechanisms in aqueous media, at the molecular and biomolecular level, is comparable to that of conventional ionizing radiation, and (ii) at the tumor tissue level in an animal cancer model, the laser irradiation method shows clear therapeutic benefits.

  17. High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

    Energy Technology Data Exchange (ETDEWEB)

    Zamboglou, Nikolaos [Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany); Tselis, Nikolaos, E-mail: ntselis@hotmail.com [Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany); Baltas, Dimos [Department of Medical Physics and Engineering, Klinikum Offenbach, Offenbach (Germany); Buhleier, Thomas [Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany); Martin, Thomas [Department of Radiation Oncology, Klinikum Bremen-Mitte, Bremen (Germany); Milickovic, Natasa; Papaioannou, Sokratis [Department of Medical Physics and Engineering, Klinikum Offenbach, Offenbach (Germany); Ackermann, Hanns [Institute of Biostatistics, J.W. Goethe University of Frankfurt, Frankfurt (Germany); Tunn, Ulf W. [Department of Urology, Klinikum Offenbach, Offenbach (Germany)

    2013-03-01

    Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy, using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer.

  18. Needle migration and dosimetric impact in high-dose-rate brachytherapy for prostate cancer evaluated by repeated MRI

    DEFF Research Database (Denmark)

    Buus, Simon; Lizondo, Maria; Hokland, Steffen

    2017-01-01

    PURPOSE: To quantify needle migration and dosimetric impact in high-dose-rate brachytherapy for prostate cancer and propose a threshold for needle migration. METHODS AND MATERIALS: Twenty-four high-risk prostate cancer patients treated with an HDR boost of 2 × 8.5 Gy were included. Patients...... received an MRI for planning (MRI1), before (MRI2), and after treatment (MRI3). Time from needle insertion to MRI3 was ∼3 hours. Needle migration was evaluated from coregistered images: MRI1-MRI2 and MRI1-MRI3. Dose volume histogram parameters from the treatment plan based on MRI1 were related...... to parameters based on needle positions in MRI2 or MRI3. Regression was used to model the average needle migration per implant and change in D90 clinical target volume, CTVprostate+3mm. The model fit was used for estimating the dosimetric impact in equivalent dose in 2 Gy fractions for dose levels of 6, 8.5, 10...

  19. Recent trends in hormone therapy utilization and breast cancer incidence rates in the high incidence population of Marin County, California

    Directory of Open Access Journals (Sweden)

    Orenstein Fern

    2010-04-01

    Full Text Available Abstract Background Recent declines in invasive breast cancer have been reported in the US, with many studies linking these declines to reductions in the use of combination estrogen/progestin hormone therapy (EPHT. We evaluated the changing use of postmenopausal hormone therapy, mammography screening rates, and the decline in breast cancer incidence specifically for Marin County, California, a population with historically elevated breast cancer incidence rates. Methods The Marin Women's Study (MWS is a community-based, prospective cohort study launched in 2006 to monitor changes in breast cancer, breast density, and personal and biologic risk factors among women living in Marin County. The MWS enrolled 1,833 women following routine screening mammography between October 2006 and July 2007. Participants completed a self-administered questionnaire that included items regarding historical hormone therapy regimen (estrogen only, progesterone only, EPHT, age of first and last use, total years of use, and reason(s for stopping, as well as information regarding complementary hormone use. Questionnaire items were analyzed for 1,083 non-Hispanic white participants ages 50 and over. Breast cancer incidence rates were assessed overall and by tumor histology and estrogen receptor (ER status for the years 1990-2007 using data from the Northern California Surveillance, Epidemiology and End Results (SEER cancer registry. Results Prevalence of EPHT use among non-Hispanic white women ages 50 and over declined sharply from 21.2% in 1998 to 6.7% by 2006-07. Estrogen only use declined from 26.9% in 1998 to 22.4% by 2006-07. Invasive breast cancer incidence rates declined 33.4% between 2001 and 2004, with drops most pronounced for ER+ cancers. These rate reductions corresponded to declines of about 50 cases per year, consistent with population attributable fraction estimates for EPHT-related breast cancer. Self-reported screening mammography rates did not change

  20. High-dose-rate brachytherapy as a monotherapy for prostate cancer--Single-institution results of the extreme fractionation regimen.

    Science.gov (United States)

    Kukiełka, Andrzej Marek; Dąbrowski, Tomasz; Walasek, Tomasz; Olchawa, Agnieszka; Kudzia, Roksana; Dybek, Dorota

    2015-01-01

    We report a single-institution retrospective analysis of the outcomes, disease control, and toxicity of high-dose-rate (HDR) brachytherapy used as the only treatment modality (monotherapy) for localized prostate cancer. Between 2006 and 2012, 77 patients with diagnosed prostate cancer were treated with HDR brachytherapy as a monotherapy. The prescribed dose was 45 Gy in three separate implants 21 days apart, with single fraction per implant. Of the 77 patients, 67 (87%) received hormonal therapy. Prostate-specific antigen failure was defined according to Phoenix consensus, as nadir + 2 ng/mL. Toxicity was scored according to Common Terminology Criteria for Adverse Events, version 4.03. The median followup time was 57 months (4.75 years). The 5-year actuarial overall survival was 98.7%, biochemical control 96.7%, local control 96.9%, and metastasis-free survival 98.4%. Younger age at the beginning of brachytherapy predicted the onset of bounce phenomenon. There were no Grade 3 or higher acute toxicities detected, and Grade 2 genitourinary acute toxicity developed in 19 patients (24.6%). There were no Grade 2 gastrointestinal complications. No Grade 4 or 5 late toxicity was detected. There were also no Grade 3 gastrointestinal toxicities detected. One patient (1.3%) underwent transurethral resection of the prostate because of Grade 3 urethral stenosis and urinary retention. A total of 26 patients (33.8%) developed Grade 2 late toxicity. HDR brachytherapy as monotherapy for localized prostate cancer was feasible, effective, and had acceptable toxicity profile. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  1. Liver cancer mortality rate model in Thailand

    Science.gov (United States)

    Sriwattanapongse, Wattanavadee; Prasitwattanaseree, Sukon

    2013-09-01

    Liver Cancer has been a leading cause of death in Thailand. The purpose of this study was to model and forecast liver cancer mortality rate in Thailand using death certificate reports. A retrospective analysis of the liver cancer mortality rate was conducted. Numbering of 123,280 liver cancer causes of death cases were obtained from the national vital registration database for the 10-year period from 2000 to 2009, provided by the Ministry of Interior and coded as cause-of-death using ICD-10 by the Ministry of Public Health. Multivariate regression model was used for modeling and forecasting age-specific liver cancer mortality rates in Thailand. Liver cancer mortality increased with increasing age for each sex and was also higher in the North East provinces. The trends of liver cancer mortality remained stable in most age groups with increases during ten-year period (2000 to 2009) in the Northern and Southern. Liver cancer mortality was higher in males and increase with increasing age. There is need of liver cancer control measures to remain on a sustained and long-term basis for the high liver cancer burden rate of Thailand.

  2. Aflatoxin contamination of red chili pepper from Bolivia and Peru, countries with high gallbladder cancer incidence rates.

    Science.gov (United States)

    Asai, Takao; Tsuchiya, Yasuo; Okano, Kiyoshi; Piscoya, Alejandro; Nishi, Carlos Yoshito; Ikoma, Toshikazu; Oyama, Tomizo; Ikegami, Kikuo; Yamamoto, Masaharu

    2012-01-01

    Chilean red chili peppers contaminated with aflatoxins were reported in a previous study. If the development of gallbladder cancer (GBC) in Chile is associated with a high level of consumption of aflatoxin-contaminated red chili peppers, such peppers from other countries having a high GBC incidence rate may also be contaminated with aflatoxins. We aimed to determine whether this might be the case for red chili peppers from Bolivia and Peru. A total of 7 samples (3 from Bolivia, 4 from Peru) and 3 controls (2 from China, 1 from Japan) were evaluated. Aflatoxins were extracted with acetonitrile:water (9:1, v/v) and eluted through an immuno-affinity column. The concentrations of aflatoxins B1, B2, G1, and G2 were measured using high-performance liquid chromatography (HPLC), and then the detected aflatoxins were identified using HPLC-mass spectrometry. In some but not all of the samples from Bolivia and Peru, aflatoxin B1 or aflatoxins B1 and B2 were detected. In particular, aflatoxin B1 or total aflatoxin concentrations in a Bolivian samples were above the maximum levels for aflatoxins in spices proposed by the European Commission. Red chili peppers from Bolivia and Peru consumed by populations having high GBC incidence rates would appear to be contaminated with aflatoxins. These data suggest the possibility that a high level of consumption of aflatoxin-contaminated red chili peppers is related to the development of GBC, and the association between the two should be confirmed by a case-control study.

  3. High complication rate after low anterior resection for mid and high rectal cancer; results of a population-based study

    NARCIS (Netherlands)

    Bakker, I. S.; Snijders, H. S.; Wouters, M. W.; Havenga, K.; Tollenaar, R. A. E. M.; Wiggers, T.; Dekker, J. W. T.

    Background: Surgical resection is the cornerstone of treatment for rectal cancer patients. Treatment options consist of a primary anastomosis, anastomosis with defunctioning stoma or end-colostomy with closure of the distal rectal stump. This study aimed to compare postoperative outcome of these

  4. Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

    Science.gov (United States)

    Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

    Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Dosimetric and radiobiological comparison of volumetric modulated arc therapy, high-dose rate brachytherapy, and low-dose rate permanent seeds implant for localized prostate cancer.

    Science.gov (United States)

    Yang, Ruijie; Zhao, Nan; Liao, Anyan; Wang, Hao; Qu, Ang

    2016-01-01

    To investigate the dosimetric and radiobiological differences among volumetric modulated arc therapy (VMAT), high-dose rate (HDR) brachytherapy, and low-dose rate (LDR) permanent seeds implant for localized prostate cancer. A total of 10 patients with localized prostate cancer were selected for this study. VMAT, HDR brachytherapy, and LDR permanent seeds implant plans were created for each patient. For VMAT, planning target volume (PTV) was defined as the clinical target volume plus a margin of 5mm. Rectum, bladder, urethra, and femoral heads were considered as organs at risk. A 78Gy in 39 fractions were prescribed for PTV. For HDR and LDR plans, the dose prescription was D90 of 34Gy in 8.5Gy per fraction, and 145Gy to clinical target volume, respectively. The dose and dose volume parameters were evaluated for target, organs at risk, and normal tissue. Physical dose was converted to dose based on 2-Gy fractions (equivalent dose in 2Gy per fraction, EQD2) for comparison of 3 techniques. HDR and LDR significantly reduced the dose to rectum and bladder compared with VMAT. The Dmean (EQD2) of rectum decreased 22.36Gy in HDR and 17.01Gy in LDR from 30.24Gy in VMAT, respectively. The Dmean (EQD2) of bladder decreased 6.91Gy in HDR and 2.53Gy in LDR from 13.46Gy in VMAT. For the femoral heads and normal tissue, the mean doses were also significantly reduced in both HDR and LDR compared with VMAT. For the urethra, the mean dose (EQD2) was 80.26, 70.23, and 104.91Gy in VMAT, HDR, and LDR brachytherapy, respectively. For localized prostate cancer, both HDR and LDR brachytherapy were clearly superior in the sparing of rectum, bladder, femoral heads, and normal tissue compared with VMAT. HDR provided the advantage in sparing of urethra compared with VMAT and LDR. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  6. Chemotherapy and intensity-modulated radiation therapy for locally advanced pancreatic cancer achieves a high rate of R0 resection.

    Science.gov (United States)

    Huguet, Florence; Hajj, Carla; Winston, Corrine B; Shi, Weiji; Zhang, Zhigang; Wu, Abraham J; O'Reilly, Eileen M; Reidy, Diane L; Allen, Peter; Goodman, Karyn A

    2017-03-01

    To assess local control, survival and conversion to resectability among locally advanced pancreatic cancer (LAPC) patients treated with induction chemotherapy (ICT) followed by chemoradiotherapy treatment using intensity-modulated radiation therapy (IMRT). Between 2007 and 2012, 134 LAPC patients were treated with ICT followed by IMRT. After chemoradiotherapy, 40 patients received maintenance chemotherapy. With a median follow-up of 20 months, median overall survival (OS) was 23 months. One- and two-year OS was 85% and 47%, respectively. On multivariate analysis, progression of disease after IMRT was associated with worse OS. Cumulative incidence of local failure was 10% at one year and 36% at two years. Twenty-six patients (19%) underwent resection after chemoradiotherapy including 22 patients (85%) with negative margins. On multivariate analysis, response to IMRT was associated with surgery (p = .01). Acute grade 3-4 hematologic and non-hematologic toxicity rates were 26% and 4.5%, respectively. IMRT is safe in patients with LAPC. Patients with non-progressive LAPC after ICT and who received IMRT had high rates of local control and prolonged survival.

  7. Needle migration and dosimetric impact in high-dose-rate brachytherapy for prostate cancer evaluated by repeated MRI.

    Science.gov (United States)

    Buus, Simon; Lizondo, Maria; Hokland, Steffen; Rylander, Susanne; Pedersen, Erik M; Tanderup, Kari; Bentzen, Lise

    To quantify needle migration and dosimetric impact in high-dose-rate brachytherapy for prostate cancer and propose a threshold for needle migration. Twenty-four high-risk prostate cancer patients treated with an HDR boost of 2 × 8.5 Gy were included. Patients received an MRI for planning (MRI1), before (MRI2), and after treatment (MRI3). Time from needle insertion to MRI3 was ∼3 hours. Needle migration was evaluated from coregistered images: MRI1-MRI2 and MRI1-MRI3. Dose volume histogram parameters from the treatment plan based on MRI1 were related to parameters based on needle positions in MRI2 or MRI3. Regression was used to model the average needle migration per implant and change in D90 clinical target volume, CTV prostate+3mm . The model fit was used for estimating the dosimetric impact in equivalent dose in 2 Gy fractions for dose levels of 6, 8.5, 10, 15, and 19 Gy. Needle migration was on average 2.2 ± 1.8 mm SD from MRI1-MRI2 and 5.0 ± 3.0 mm SD from MRI1-MRI3. D90 CTV prostate+3mm was robust toward average needle migration ≤3 mm, whereas for migration >3 mm D90 decreased by 4.5% per mm. A 3 mm of needle migration resulted in a decrease of 0.9, 1.7, 2.3, 4.8, and 7.6 equivalent dose in 2 Gy fractions for dose levels of 6, 8.5, 10, 15, and 19 Gy, respectively. Substantial needle migration in high-dose-rate brachytherapy occurs frequently in 1-3 hours following needle insertion. A 3-mm threshold of needle migration is proposed, but 2 mm may be considered for dose levels ≥15 Gy. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. High-dose rate brachytherapy as monotherapy in prostate cancer: A systematic review of its safety and efficacy.

    Science.gov (United States)

    Sánchez-Gómez, L M; Polo-deSantos, M; Rodríguez-Melcón, J I; Angulo, J C; Luengo-Matos, S

    2017-03-01

    High-dose rate brachytherapy (HDR-BT) is an increasingly popular treatment for patients with localised prostate cancer (PC). To assess the safety and efficacy of HDR-BT as monotherapy in PC. A systematic literature review was conducted through searches on MEDLINE (PubMed), Cochrane Library, CDR, ClinicalTrials and EuroScan. We assessed safety and efficacy indicators. We selected 2 reviews and 12 uncontrolled studies, included in these 2 reviews. In terms of efficacy, local control in 6 studies was 97-100%. The biochemical progression-free survival varied as follows: 85-100% for low risk and 79-92% for high risk. Survival free of metastases was >95% at 8 years, except in one study where the survival rate was 87% at 5 years. The overall survival was ≥95% in 8 studies. In terms of safety, most of the studies recorded acute and long-term genitourinary and gastrointestinal complications, especially grade ≥2. Only 3 studies found grade 4 complications. All studies, except for one without complications, observed genitourinary complications that were more frequent and severe than the gastrointestinal complications. Two studies assessed the quality of life and showed an initial reduction in various domains and subsequent partial or total recovery, except in the sexual domain. HDR-BT is effective as monotherapy, especially in cases of low to intermediate risk. There is insufficient information on high-risk patients. The short to medium-term toxicity was acceptable. Further research needs to be funded to provide more information on the long-term safety and efficacy of this treatment. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Image guided radiation therapy boost in combination with high-dose-rate intracavitary brachytherapy for the treatment of cervical cancer

    Directory of Open Access Journals (Sweden)

    Xianliang Wang

    2016-04-01

    Full Text Available Purpose : The purpose of this study was to demonstrate the dosimetric and clinical feasibility of image guided radiation therapy (IGRT combined with high-dose-rate (HDR intracavitary brachytherapy (ICBT to improve dose distribution in cervical cancer treatment. Material and methods: For 42 cervical cancer patients, magnetic resonance imaging (MRI scans were acquired after completion of whole pelvic irradiation 45-46 Gy and 5 fractions of B + I (ICBT + IGRT treatment were subsequently received. The high risk clinical target volume (HRCTV, intermediate risk clinical target volume (IRCTV, bladder, rectum, and sigmoid were contoured on the computed tomography (CT scans. The total planning aim doses for HRCTV was D 90% > 85 Gy, whilst constraints for rectum and sigmoid were D 2cc < 75 Gy and D 2cc < 90 Gy for bladder in terms of an equivalent dose in 2 Gy (EQD2 for external beam radiotherapy (EBRT and brachytherapy boost. The IGRT plan was optimized on top of the ICBT dose distribution. A dosimetric comparison was made between B + I and optimized ICBT (O-ICBT only. Results: The mean D 90% of HRCTV was comparable for B + I and O-ICBT (p = 0.82. For B + I plan, HRCTV D100%, IRCTV D 100% , and IRCTV D 90% were significantly increased by a mean of 10.52 Gy, 5.61 Gy, and 2.70 Gy, respectively (p < 0.01. The D 2cc for bladder, rectum, and sigmoid were lower by a mean of 21.36, 6.78, and 10.65 Gy, respectively (p < 0.01. The mean rectum V60 Gy value over 42 patients was almost the same for both techniques but for bladder and sigmoid B + I had higher V60 Gy mean values as compared with the O-ICBT. Conclusions : B + I can improve dose distribution in cervical cancer treatment; it could be useful for tumors extended beyond the reach of intracavitary/interstitial brachytherapy (IC/ISBT or for centers that are inexperienced or ill-equipped with IC/ISBT techniques. Additional confirmatory prospective studies with larger numbers of patients and longer follow

  10. Medically inoperable endometrial cancer in patients with a high body mass index (BMI): Patterns of failure after 3-D image-based high dose rate (HDR) brachytherapy.

    Science.gov (United States)

    Acharya, Sahaja; Esthappan, Jacqueline; Badiyan, Shahed; DeWees, Todd A; Tanderup, Kari; Schwarz, Julie K; Grigsby, Perry W

    2016-01-01

    High BMI is a reason for medical inoperability in patients with endometrial cancer in the United States. Definitive radiation is an alternative therapy for these patients; however, data on patterns of failure after definitive radiotherapy are lacking. We describe the patterns of failure after definitive treatment with 3-D image-based high dose rate (HDR) brachytherapy for medically inoperable endometrial cancer. Forty-three consecutive patients with endometrial cancer FIGO stages I-III were treated definitively with HDR brachytherapy with or without external beam radiation therapy. Cumulative incidence of failures was estimated and prognostic variables were identified Mean follow up was 29.7 months. Median BMI was 50.2 kg/m(2) (range: 25.1-104 kg/m(2)). The two-year overall survival was 65.2%. The two-year cumulative incidence of pelvic and distant failures was 8.3% and 13.5%, respectively. Grade 3 disease was associated with a higher risk of all-failures (Hazard Ratio [HR]: 4.67, 95% CI: 1.04-20.9, p=0.044). The incidence of acute Grade 3 GI/GU toxicities was 4.6%. Pelvic failure at two years was less than 10%. Patients with grade 3 disease were more likely to experience disease failure and may warrant closer follow up. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Outcomes Associated With 3 Treatment Schedules of High-Dose-Rate Brachytherapy Monotherapy for Favorable-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jawad, Maha Saada; Dilworth, Joshua T.; Gustafson, Gary S.; Ye, Hong; Wallace, Michelle [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro [Michigan HealthCare Professionals/21" s" t Century Oncology, Farmington Hills, Michigan (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Krauss, Daniel J., E-mail: DKrauss@beaumont.edu [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2016-03-15

    Purpose: We report the outcomes associated with 3 high-dose-rate (HDR) brachytherapy regimens used as monotherapy for favorable-risk prostate cancer. Methods and Materials: Four hundred ninety-four patients with stage ≤T2b prostate cancer, Gleason score ≤7, and prostate-specific antigen levels ≤15 ng/mL underwent HDR brachytherapy as monotherapy. Of those, 319 received 38 Gy in 4 fractions, 79 received 24 Gy in 2 fractions, and 96 received 27 Gy in 2 fractions. Acute and chronic genitourinary (GU) and gastrointestinal (GI) toxicities were defined as side effects occurring ≤6 and >6 months, respectively, after radiation therapy (RT) and were graded according to the Common Terminology Criteria for Adverse Events version 3.0. The time to toxicity was calculated from the date of RT completion. Variables were analyzed with χ{sup 2} test. P values <.05 were considered significant. Results: The median overall follow-up time was 4 years (range, 5.5, 3.5, and 2.5 years for 38 Gy, 24 Gy, and 27 Gy, respectively, P<.001). Acute and chronic grade ≥2 GU and GI toxicity profiles were similar among groups. Acceptable rates of grade 2 GU toxicities were seen with overall acute/chronic frequency/urgency, dysuria, retention, incontinence, and hematuria rates of 14%/20%, 6%/7%, 7%/4%, 1.5%/2%, and 1.5%/7%, respectively. Minimal grade 3 and no grade 4 or 5 toxicities were seen. Grade 1, 2, and 3 chronic urethral stricture rates were 0.3%, 2%, and 1%, respectively. All GI toxicities were similar between groups, with overall rates of acute/chronic grade 2 diarrhea, rectal pain/tenesmus, rectal bleeding, and proctitis of 1%/1%, <1%/0.5%, 0%/2%, and <1%/1%, respectively. No grade 3, 4, or 5 toxicities were seen. All comparisons were similar for hormone-naïve patients. The median time to maximal GU/GI toxicity was similar between groups, ranging from 1 to 1.6 to 0.9 to 1.2 years, respectively. There were no differences in clinical outcomes between the 3 groups at 5

  12. Preoperative radiotherapy for advanced lower rectal cancer. Combination of external and high-dose-rate intraluminal irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Horikawa, Noriko; Yoshimura, Hitoshi; Tamamoto, Tetsuro; Tsuji, Yoshihiko; Uto, Fumiaki; Ohishi, Hajime; Uchida, Hideo; Fujii, Hisao; Nakano, Hiroshige [Nara Medical Univ., Kashihara (Japan)

    1999-01-01

    This paper reports the therapeutic results of preoperative irradiation using a combination of external irradiation and high dose rate intraluminal irradiation using {sup 60}Co aimed at enhancing postoperative local control of advanced rectal cancer. The subjects comprised 38 patients (RT group) in whom {>=} A{sub 1}` lower rectal cancer was suspected and who underwent preoperative irradiation at this hospital. A control group (N-RT group) consisted of 16 patients subjected to operation alone in whom clinical {>=} A{sub 1}` and postoperative histological study revealed {>=} a{sub 1}. Intraluminal irradiation was performed using a balloon applicator. The external irradiation was performed with a 10 MVX delivering 30-40 Gy/15-20 Fr to the entire pelvic cavity. Using the criteria of Ohboshi and Shimozato to judge the histopathological effect, no cases showed Grade I, while of Grade II, 15 cases showed IIA and 19 cases IIB, Grade III in 4 cases. Grade IIB or above was noted in 23 of 38 (61%). Five and 8-year survival rates were 82.5 and 82.5% in the RT group, and were 79.5 and 79.5% in the N-RT group. Although these differences were not significant, a trend to better survival was found in the RT group. The local recurrence rate was 8% (3/38 cases) in the RT group in contrast to 25% (4/16 cases) in the N-RT group. The following complications developed during radiation therapy: diarrhea 19 (50%), anal pain 18 (47%), and others. Postoperative complications consisted of perineal fluid collection 4 (10%), bowel obstruction 3 cases (8%), an anastomotic insufficiency 3 (8%), fistula formation of bladder 2 (5%), ureteral narrowing 1 (3%), and thrombosis of vein 1 cases (3%) of the RT group, while perineal fluid collection 1 (6%), bowel obstruction 1 (6%), an anastomotic insufficiency 4 (25%) of the N-RT group, only one case of RT group (3%) required surgical treatment for the fistula formation of bladder. (K.H.)

  13. High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

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    Guinot, Jose-Luis, E-mail: jguinot@fivo.org [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Baixauli-Perez, Cristobal [Health Services Research Unit, Center for Public Health Research, Valencia (Spain); Soler, Pablo; Tortajada, Maria Isabel; Moreno, Araceli; Santos, Miguel Angel; Mut, Alejandro [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Gozalbo, Francisco [Department of Pathology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Arribas, Leoncio [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain)

    2015-01-01

    Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

  14. American Brachytherapy Task Group Report: A pooled analysis of clinical outcomes for high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Mayadev, Jyoti; Viswanathan, Akila; Liu, Yu; Li, Chin-Shang; Albuquerque, Kevin; Damato, Antonio L; Beriwal, Sushil; Erickson, Beth

    Advanced imaging used in combination with brachytherapy (BT) has revolutionized the treatment of patients with cervical cancer. We present a comprehensive review of the literature for definitive radiation with high-dose-rate (HDR) BT. In addition, we investigate potential outcome improvement with image-based brachytherapy (IBBT) compared to studies using traditional Point A dosing. This review extensively investigates acute and late toxicities. This study reviews the literature from 2000 to 2015 with an emphasis on modern approaches including concurrent chemotherapy (chemoRT), radiation, and HDR BT and IBBT. Descriptive statistics and pelvic control (PC), disease-free survival (DFS), and overall survival (OS) outcomes were calculated using weighted means to report pooled analysis of outcomes. Literature search yielded 16 prospective, 51 retrospective studies that reported survival outcomes, and 13 retrospective studies that focused on acute and late toxicity outcomes regardless of applicator type. There are 57 studies that report Point A dose specification with 33 having chemoRT, and 10 studies that use IBBT, 8 with chemoRT. Patients receiving radiation and chemoRT with HDR BT in the prospective studies, with >24 months followup, rates of PC were: for RT: 73%, SD: 11; CRT: 82%, SD: 8; DFS-RT: 55%, SD: 10; CRT: 65%, SD: 7; OS-RT: 66%, SD: 7; CRT: 70%, SD: 11. In the retrospective studies, the PC rates (weighted means) for the radiation and chemoradiation outcomes are 75% vs. 80%, and for DFS, the values were 55% vs. 63%, respectively. Comparing patients receiving chemoRT and IBBT to traditional Point A dose specification, there is a significant improvement in PC (p Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Optimization for high-dose-rate brachytherapy of cervical cancer with adaptive simulated annealing and gradient descent.

    Science.gov (United States)

    Yao, Rui; Templeton, Alistair K; Liao, Yixiang; Turian, Julius V; Kiel, Krystyna D; Chu, James C H

    2014-01-01

    To validate an in-house optimization program that uses adaptive simulated annealing (ASA) and gradient descent (GD) algorithms and investigate features of physical dose and generalized equivalent uniform dose (gEUD)-based objective functions in high-dose-rate (HDR) brachytherapy for cervical cancer. Eight Syed/Neblett template-based cervical cancer HDR interstitial brachytherapy cases were used for this study. Brachytherapy treatment plans were first generated using inverse planning simulated annealing (IPSA). Using the same dwell positions designated in IPSA, plans were then optimized with both physical dose and gEUD-based objective functions, using both ASA and GD algorithms. Comparisons were made between plans both qualitatively and based on dose-volume parameters, evaluating each optimization method and objective function. A hybrid objective function was also designed and implemented in the in-house program. The ASA plans are higher on bladder V75% and D2cc (p=0.034) and lower on rectum V75% and D2cc (p=0.034) than the IPSA plans. The ASA and GD plans are not significantly different. The gEUD-based plans have higher homogeneity index (p=0.034), lower overdose index (p=0.005), and lower rectum gEUD and normal tissue complication probability (p=0.005) than the physical dose-based plans. The hybrid function can produce a plan with dosimetric parameters between the physical dose-based and gEUD-based plans. The optimized plans with the same objective value and dose-volume histogram could have different dose distributions. Our optimization program based on ASA and GD algorithms is flexible on objective functions, optimization parameters, and can generate optimized plans comparable with IPSA. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Clinical and cosmetic outcomes in patients treated with high-dose-rate electronic brachytherapy for nonmelanoma skin cancer.

    Science.gov (United States)

    Paravati, Anthony J; Hawkins, Peter G; Martin, Amanda N; Mansy, Gina; Rahn, Doug A; Advani, Sunil J; Hoisak, Jeremy; Dragojevic, Irena; Martin, Peter J; Miller, Charles J; Sanghvi, Parag

    2015-01-01

    To retrospectively analyze clinical and cosmetic outcomes in patients treated for nonmelanoma skin cancer (NMSC) with high-dose-rate (HDR) electronic brachytherapy (EBT) using surface applicators. We identified 127 patients who had 154 NMSC lesions, 149 of which were basal cell carcinoma, treated with HDR EBT at our institution between July 2012 and March 2014. Lesions were treated to 40 Gy in 8 fractions. Local control, acute toxicity, late toxicity, and cosmetic outcomes were analyzed retrospectively. Acute and late toxicities were graded using the Common Terminology Criteria for Adverse Events, version 4.0. Cosmetic outcomes were graded using a standard scale based on the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Schema. Median (range) follow-up from completion of treatment was 16.1 (3.4-34.8 months). The overall crude recurrence rate was 1.3% (n = 2). Grade 0 to 1 acute radiation dermatitis was observed in 52.6% of treated lesions (n = 81), grade 2 in 34.4% (n = 53), and grade 3 in 13.0% (n = 20). No acute toxicity greater than grade 3 was observed and all acute toxic events resolved after treatment. Grade 0 to 1 late toxicity was observed in 94.2% of cases (n = 145), and grade 2 in 5.8% (n = 9). No late toxicity greater than grade 2 was observed. Across the 152 controlled lesions, cosmetic results were excellent in 94.2% of treated lesions (n = 145), good in 3.3% (n = 5), fair in 0.7% (n = 1), and poor in 0.7% (n = 1). HDR EBT confers promising local control, minimal toxicity, and excellent cosmesis in our institutional experience. It should be considered ideal for NMSC of the head and neck, particularly for basal cell carcinoma involving central facial locations where surgical cosmesis may be inferior. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  17. Prostate-specific antigen nadir after high-dose-rate brachytherapy predicts long-term survival outcomes in high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Hideyasu Tsumura

    2016-04-01

    Full Text Available Purpose : To evaluate the prognostic value of prostate-specific antigen nadir (nPSA after high-dose-rate (HDR brachytherapy in clinically non-metastatic high-risk prostate cancer patients. Material and methods : Data from 216 patients with high-risk or locally advanced prostate cancer who underwent HDR brachytherapy and external beam radiation therapy with long-term androgen deprivation therapy (ADT between 2003 and 2008 were analyzed. The median prostate-specific antigen (PSA level at diagnosis was 24 ng/ml (range: 3-338 ng/ml. The clinical stage was T1c-2a in 55 cases (26%, T2b-2c in 48 (22%, T3a in 75 (35%, and T3b-4 in 38 (17%. The mean dose to 90% of the planning target volume was 6.3 Gy/fraction of HDR brachytherapy. After 5 fractions, external beam radiation therapy with 10 fractions of 3 Gy was administered. All patients initially underwent neoadjuvant ADT for at least 6 months, and adjuvant ADT was continued for 36 months. The median follow-up was 7 years from the start of radiotherapy. Results : The 7-year PSA relapse-free rate among patients with a post-radiotherapy nPSA level of ≤ 0.02 ng/ml was 94%, compared with 23% for patients with higher nPSA values (HR = 28.57; 95% CI: 12.04-66.66; p < 0.001. Multivariate analysis revealed that the nPSA value after radiotherapy was a significant independent predictor of biochemical failure, whereas pretreatment predictive values for worse biochemical control including higher level of initial PSA, Gleason score ≥ 8, positive biopsy core rate ≥ 67%, and T3b-T4, failed to reach independent predictor status. The 7-year cancer-specific survival rate among patients with a post-radiotherapy nPSA level of ≤ 0.02 ng/ml was 99%, compared with 82% for patients with higher nPSA values (HR = 32.25; 95% CI: 3.401-333.3; p = 0.002. Conclusions : A post-radiotherapy nPSA value of ≤ 0.02 ng/ml was associated with better long-term biochemical tumor control even if patients had pretreatment predictive

  18. High-dose-rate brachytherapy and external-beam radiotherapy for hormone-naïve low- and intermediate-risk prostate cancer: A 7-year experience

    NARCIS (Netherlands)

    S. Aluwini (Shafak); P.H. van Rooij (Peter); W.J. Kirkels (Wim); P.P. Jansen (Peter); J. Praag (John); C.H. Bangma (Chris); I.-K.K. Kolkman-Deurloo (Inger-Karina)

    2012-01-01

    textabstractPurpose: To report clinical outcomes and early and late complications in 264 hormone-naïve patients with low- and intermediate-risk prostate cancer treated with high-dose-rate brachytherapy (HDR-BT) in combination with external-beam radiotherapy (EBRT). Methods and Materials: Between

  19. Commissioning of a 3D image-based treatment planning system for high-dose-rate brachytherapy of cervical cancer.

    Science.gov (United States)

    Kim, Yongbok; Modrick, Joseph M; Pennington, Edward C; Kim, Yusung

    2016-03-08

    The objective of this work is to present commissioning procedures to clinically implement a three-dimensional (3D), image-based, treatment-planning system (TPS) for high-dose-rate (HDR) brachytherapy (BT) for gynecological (GYN) cancer. The physical dimensions of the GYN applicators and their values in the virtual applicator library were varied by 0.4 mm of their nominal values. Reconstruction uncertainties of the titanium tandem and ovoids (T&O) were less than 0.4 mm on CT phantom studies and on average between 0.8-1.0 mm on MRI when compared with X-rays. In-house software, HDRCalculator, was developed to check HDR plan parameters such as independently verifying active tandem or cylinder probe length and ovoid or cylinder size, source calibration and treatment date, and differences between average Point A dose and prescription dose. Dose-volume histograms were validated using another independent TPS. Comprehensive procedures to commission volume optimization algorithms and process in 3D image-based planning were presented. For the difference between line and volume optimizations, the average absolute differences as a percentage were 1.4% for total reference air KERMA (TRAK) and 1.1% for Point A dose. Volume optimization consistency tests between versions resulted in average absolute differences in 0.2% for TRAK and 0.9 s (0.2%) for total treatment time. The data revealed that the optimizer should run for at least 1 min in order to avoid more than 0.6% dwell time changes. For clinical GYN T&O cases, three different volume optimization techniques (graphical optimization, pure inverse planning, and hybrid inverse optimization) were investigated by comparing them against a conventional Point A technique. End-to-end testing was performed using a T&O phantom to ensure no errors or inconsistencies occurred from imaging through to planning and delivery. The proposed commissioning procedures provide a clinically safe implementation technique for 3D image-based TPS for HDR

  20. The usefulness of fleet rectal enemas on high-dose-rate intracavitary cervical cancer brachytherapy. A prospective trial

    Directory of Open Access Journals (Sweden)

    Ignacio Andres

    2017-05-01

    Full Text Available Purpose: To evaluate the effects of rectal enemas on rectal doses during radical high-dose-rate (HDR intracavitary cervical brachytherapy (BT. Material and methods : Twenty patients suffering from cervical cancer and treated with external beam radiotherapy and HDR-BT were included in a prospective trial. The first brachytherapy fraction was considered the basal status, and patients were instructed to self-administer two rectal cleansing enemas before the second fraction. Dose-volume histogram (DVH values were generated for the rectum and correlated with rectal volume variation. Brachytherapy was carried out with a Fletcher or Utrecht applicator. Results : No significant rectal volume differences were observed between fractions with or without rectal enemas (without, 52.64 ± 15.92 cc; with, 53.16 ± 19.28 cc. There was a significant correlation between both rectal volumes (r = 0.722, p = 0.001. No significant differences were observed in analyzed DVH parameters (median values: ΔD 0.1cc , 4.17 vs. 3.61 Gy; ΔD 1cc , 3.23 vs. 2.87 Gy; Δ D2cc , 2.9 vs. 2.54 Gy; ΔD 5cc , 2.35 vs. 2.05 Gy, for no enema and enema fraction, respectively. No significant rectal volume differences nor DVH parameter differences were observed according the applicator type. Conclusions : Our rectal enemas protocol prior to HDR-BT was ineffective in significantly modifying rectal DVH parameters. No differences were observed according to the type of applicator used.

  1. Dosimetric evaluation of multilumen intracavitary balloon applicator rotation in high-dose-rate brachytherapy for breast cancer.

    Science.gov (United States)

    Kim, Yongbok; Trombetta, Mark G

    2014-01-06

    The objective of this work is to evaluate dosimetric impact of multilumen balloon applicator rotation in high-dose-rate (HDR) brachytherapy for breast cancer. Highly asymmetrical dose distribution was generated for patients A and B, depending upon applicator proximity to skin and rib. Both skin and rib spacing was ≤ 0.7 cm for A; only rib spacing was ≤ 0.7 cm for B. Thirty-five rotation scenarios were simulated for each patient by rotating outer lumens every 10° over ± 180° range with respect to central lumen using mathematically calculated rotational matrix. Thirty-five rotated plans were compared with three plans: 1) original multidwell multilumen (MDML) plan, 2) multidwell single-lumen (MDSL) plan, and 3) single-dwell single-lumen (SDSL) plan. For plan comparison, planning target volume for evaluation (PTV_EVAL) coverage (dose to 95% and 90% volume of PTV_EVAL) (D95 and D90), skin and rib maximal dose (Dmax), and normal breast tissue volume receiving 150% (V150) and 200% (V200) of prescribed dose (PD) were evaluated. Dose variation due to device rotation ranged from -5.6% to 0.8% (A) and -6.5% to 0.2% (B) for PTV_EVAL D95; -5.2% to 0.4% (A) and -4.1% to 0.7% (B) for PTV_EVAL D90; -2.0 to 18.4% (A) and -7.8 to 17.5% (B) for skin Dmax; -11.1 to 22.8% (A) and -4.7 to 55.1% (B) of PD for rib Dmax, respectively. Normal breast tissue V150 and V200 variation was < 1.0 cc, except for -0.1 to 2.5cc (B) of V200. Furthermore, 30° device rotation increased rib Dmax over 145% of PD: 152.9% (A) by clockwise 30° rotation and 152.5% (B) by counterclockwise 30° rotation. For a highly asymmetric dose distribution, device rotation can outweigh the potential benefit of improved dose shaping capability afforded by multilumen and make dosimetric data worse than single-lumen plans unless it is properly corrected.

  2. High dose rate brachytherapy using custom made superficial mould applicators and Leipzig applicators for non melanoma localized skin cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, A. Cassio A.; Miziara, Daniela; Lima, Flavia Pedroso de; Miziara, Miguel

    2014-07-01

    Purpose: advances in technology and the commercial production of Leipzig applicators allowed High Dose Rate after-load brachytherapy (HDR-BT) to address a number of the challenges associated with the delivery of superficial radiation to treat localized non melanoma skin cancer (NMSK). We reviewed our uni-institutional experience on the treatment of NMSK with HDR-BT. Methods: data were collected retrospectively from patients attending the Radiation Oncology Department at AV Carvalho Insitute, Sao Paulo, Brazil. HDR-BT was done using the stepping source HDR 192Ir Microselectron (Nucletron BV). The planning target volume consisted of the macroscopic lesion plus a 5mm to 10mm margin.The depth of treatment was 0.5 cm in smaller (< 2.0 cm) tumors and 10 to 15 mm for lesions bigger than that. Results: Thirteen patients were treated with HDR-BT from June, 2007 to June 2013. The median age and follow up time were 72 (38-90) years old and 36 (range, 7-73) months, respectively. There a predominance of males (61.5%) and of patients referred for adjuvant treatment due positive surgical margins or because they have had only a excision biopsy without safety margins (61.5%). Six (46.2%) patients presented with squamous cell carcinoma and 7 (53.8%) patients presented with basal cell carcinoma. The median tumor size was 20 (range, 5-42) mm. Patients were treated with a median total dose of 40 Gy (range, 20 -60), given in 10 (range, 2-15) fractions, given daily or twice a week. All patients responded very well to treatment and only one patient has failed locally so far, after 38 months of the end of the irradiation. The crude and actuarial 3-year local control rates were 100% and 80%, respectively. Moist desquamation, grade 2 RTOG, was observed in 4 (30.8%) patients. Severe late complication, radiation-induced dyspigmentation, occurred in 2 patients and 1 of the patients also showed telangiectasia in the irradiated area. The cosmetic result was considered good in 84% (11/13) patients

  3. Gallbladder Cancer Incidence and Death Rates

    Science.gov (United States)

    ... Cancer Conference Stay Informed Gallbladder Cancer Incidence and Death Rates Recommend on Facebook Tweet Share Compartir Quick ... a late stage with a poor outcome, often death. The journal Cancer Epidemiology, Biomarkers and Prevention published ...

  4. Salvage high-dose-rate brachytherapy for histologically confirmed macroscopic local relapsed prostate cancer after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    David Buchser

    2016-12-01

    Full Text Available Purpose: To evaluate the feasibility of the use of real-time magnetic resonance imaging (MRI-transrectal ultrasound (TRUS fusion guided high-dose-rate brachytherapy (HDR-BT +/– external beam radiation therapy (EBRT in patients with histologically-proven local relapse after radical prostatectomy. Material and methods : We retrospectively reviewed 13 patients treated with real-time MRI-TRUS fusion HDR-BT for a local relapse of prostate cancer after radical surgery. All patients underwent multiparametric magnetic resonance imaging (mpMRI to confirm the presence of macroscopic lesions in prostate bed, and choline positron emission tomography/computed tomography (PET/CT to rule out nodal or distant metastases. Local failure was confirmed by transrectal biopsy. Patients without previous EBRT received 1 fraction of 15 Gy with HDR-BT plus hypofractionated EBRT (37.5 Gy in 15 fractions. Two patients received 2 fractions of 12 Gy with HDR-BT without EBRT. Follow-up visits were at 1, 3, 6 months, and every 6 months thereafter. Results : After a median follow-up of 7 months, all patients showed an appropriate biochemical response. Median prostate-specific antigen (PSA levels before treatment, 1 month, and 6 months after HDR-BT were 2.62 ng/ml (range: 1.55-9.61, 0.97 ng/ml (range: 0.12-3.14, 0.23 ng/ml (range: 0.1-0.74, respectively. Five patients (42% experienced acute grade 1 GU toxicity and 1 patient (8% suffered from grade 2 GU toxicity. Regarding gastrointestinal (GI toxicity, 5 patients referred grade 1 acute toxicity and 1 grade 2 (proctitis. No late toxicity has been observed so far. Conclusions : MRI-TRUS fusion guided salvage HDR-BT +/– EBRT is a feasible procedure for patients with local macroscopic relapse in tumor bed after radical prostatectomy. Exquisite selection of patients through mpMRI and choline PET/CT is crucial to avoid overtreatment. A larger number of patients and longer follow-up are required in order to draw more solid

  5. High dose rate prostate brachytherapy: an overview of the rationale, experience and emerging applications in the treatment of prostate cancer

    Science.gov (United States)

    Challapalli, A; Jones, E; Harvey, C; Hellawell, G O; Mangar, S A

    2012-01-01

    The technological advances in real-time ultrasound image guidance for high dose rate (HDR) prostate brachytherapy places this treatment modality at the forefront of innovation in radiotherapy. This review article will explore the rationale for HDR brachytherapy as a highly conformal method of dose delivery and safe dose escalation to the prostate, in addition to the particular radiobiological advantages it has over low dose rate and external beam radiotherapy. The encouraging outcome data and favourable toxicity profile will be discussed before looking at emerging applications for the future and how this procedure will feature alongside stereotactic radiosurgery. PMID:23118099

  6. Comparison of (192) Ir, (169) Yb, and (60) Co high-dose rate brachytherapy sources for skin cancer treatment.

    Science.gov (United States)

    Safigholi, Habib; Meigooni, Ali S; Song, William Y

    2017-09-01

    To evaluate the possibility of utilizing the high-dose rate (HDR) (169) Yb and (60) Co sources, in addition to (192) Ir, for the treatment of skin malignancies with conical applicators. Monte Carlo (MC) simulations were used to benchmark the dosimetric parameters of single (169) Yb (4140), (60) Co (Co0.A86), and (192) Ir (mHDR-V2) brachytherapy sources in a water phantom and compared their results against published data. A standard conical tungsten alloy Leipzig-style applicator (Stand.Appl) was used for determination of the dose distributions at various depths with a single dwell position of the HDR sources. The HDR sources were modeled with its long axis parallel to the treatment plane within the opening section of the applicator. The source-to-surface distance (SSD) was 1.6 cm, which included a 0.1 cm thick removable plastic end-cap used for clinical applications. The prescription depth was considered to be 0.3 cm in a water phantom following the definitions in the literature for this treatment technique. Dose distributions generated with the Stand.Appl and the (169) Yb and (60) Co sources have been compared with those of the (192) Ir source, for the same geometry. Then, applicator wall thickness for the (60) Co source was increased (doubled) in MC simulations in order to minimize the leakage dose and penumbra to levels that were comparable to that from the (192) Ir source. For each source-applicator combination, the optimized plastic end-cap dimensions were determined in order to avoid over-dosage to the skin surface. The normalized dose profiles at the prescription depth for the (169) Yb-Stand.Appl and the (60) Co-double-wall applicator were found to be similar to that of the (192) Ir-Stand.Appl, with differences percentage depth doses (PDD) for the (192) Ir-, (169) Yb- and (60) Co-Stand.Appl were found to be comparable to the values with the (60) Co-double-walled applicator, with differences depth were also comparable at 0.309, 0.316, and 0.298 (cGy/hU) for

  7. High nodal positivity rates even in good clinical responders after chemoradiation of rectal cancer: is organ preservation feasible?

    Science.gov (United States)

    Vallam, K C; Engineer, R; Desouza, A; Patil, P; Saklani, A

    2016-10-01

    Local excision (LE) is emerging as a treatment option for rectal cancer responding well to chemoradiation. However, it does not address the mesorectal nodal burden. We aimed to identify the factors influencing nodal positivity and subsequently defined a low-risk group by including only patients at low risk. A single-centre, retrospective database analysis was carried out of patients with radically resected rectal cancer after neoadjuvant chemoradiation. This study included 524 patients with predominantly low rectal tumours. Nodal positivity among ypT0, T1 and T2 groups was 14.7%, 28% and 30%, respectively. Multivariate analysis with stepwise logistic regression identified the following low-risk features: age ≥ 40 years, nonsignet ring cell carcinoma (SRCC) histology and pathological complete response (pCR). Sixty-nine patients fulfilling all three criteria were analysed and the nodal positivity was found to be 10.1%, which implies that, if these patients had been selected for LE, one in 10 would have had positive mesorectal nodes. Even in patients with low-risk criteria (pCR, non-SRCC histology and age ≥ 40 years), the residual positive nodal disease burden is 10%. Whether this high incidence of residual nodal disease translates into a similar risk of locoregional recurrence if an organ-preservation strategy is adopted is unclear. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  8. Preventing Complications from High-Dose Rate Brachytherapy when Treating Mobile Tongue Cancer via the Application of a Modular Lead-Lined Spacer.

    Directory of Open Access Journals (Sweden)

    Shumei Murakami

    Full Text Available To point out the advantages and drawbacks of high-dose rate brachytherapy in the treatment of mobile tongue cancer and indicate the clinical importance of modular lead-lined spacers when applying this technique to patients.First, all basic steps to construct the modular spacer are shown. Second, we simulate and evaluate the dose rate reduction for a wide range of spacer configurations.With increasing distance to the source absorbed doses dropped considerably. Significantly more shielding was obtained when lead was added to the spacer and this effect was most pronounced on shorter (i.e. more clinically relevant distances to the source.The modular spacer represents an important addition to the planning and treatment stages of mobile tongue cancer using HDR-ISBT.

  9. Single particle aerosol mass spectrometry of coal combustion particles associated with high lung cancer rates in Xuanwei and Fuyuan, China.

    Science.gov (United States)

    Lu, Senlin; Tan, Zhengying; Liu, Pinwei; Zhao, Hui; Liu, Dingyu; Yu, Shang; Cheng, Ping; Win, Myat Sandar; Hu, Jiwen; Tian, Linwei; Wu, Minghong; Yonemochi, Shinich; Wang, Qingyue

    2017-11-01

    Coal combustion particles (CCPs) are linked to the high incidence of lung cancer in Xuanwei and in Fuyuan, China, but studies on the chemical composition of the CCPs are still limited. Single particle aerosol mass spectrometry (SPAMS) was recently developed to measure the chemical composition and size of single particles in real-time. In this study, SPAMS was used to measure individual combustion particles emitted from Xuanwei and Fuyuan coal samples and the results were compared with those by ICP-MS and transmission electron microscopy (TEM). The total of 38,372 particles mass-analyzed by SPAMS can be divided into 9 groups based on their chemical composition and their number percentages: carbonaceous, Na-rich, K-rich, Al-rich, Fe-rich, Si-rich, Ca-rich, heavy metal-bearing, and PAH-bearing particles. The carbonaceous and PAH-bearing particles are enriched in the size range below 0.56 μm, Fe-bearing particles range from 0.56 to 1.0 μm in size, and heavy metals such as Ti, V, Cr, Cu, Zn, and Pb have diameters below 1 μm. The TEM results show that the particles from Xuanwei and Fuyuan coal combustion can be classified into soot aggregates, Fe-rich particles, heavy metal containing particles, and mineral particles. Non-volatile particles detected by SPAMS could also be observed with TEM. The number percentages by SPAMS also correlate with the mass concentrations measured by ICP-MS. Our results could provide valuable insight for understanding high lung cancer incidence in the area. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. A High-Fat Diet Containing Lard Accelerates Prostate Cancer Progression and Reduces Survival Rate in Mice: Possible Contribution of Adipose Tissue-Derived Cytokines

    Directory of Open Access Journals (Sweden)

    Han Jin Cho

    2015-04-01

    Full Text Available To examine the effects of high-fat diet (HFD containing lard on prostate cancer development and progression and its underlying mechanisms, transgenic adenocarcinoma mouse prostate (TRAMP and TRAMP-C2 allograft models, as well as in vitro culture models, were employed. In TRAMP mice, HFD feeding increased the incidence of poorly differentiated carcinoma and decreased that of prostatic intraepithelial neoplasia in the dorsolateral lobes of the prostate, which was accompanied by increased expression of proteins associated with proliferation and angiogenesis. HFD feeding also led to increased metastasis and decreased survival rate in TRAMP mice. In the allograft model, HFD increased solid tumor growth, the expression of proteins related to proliferation/angiogenesis, the number of lipid vacuoles in tumor tissues, and levels of several cytokines in serum and adipose tissue. In vitro results revealed that adipose tissue-conditioned media from HFD-fed mice stimulated the proliferation and migration of prostate cancer cells and angiogenesis compared to those from control-diet-fed mice. These results indicate that the increase of adipose tissue-derived soluble factors by HFD feeding plays a role in the growth and metastasis of prostate cancer via endocrine and paracrine mechanisms. These results provide evidence that a HFD containing lard increases prostate cancer development and progression, thereby reducing the survival rate.

  11. Lung Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Shareable Graphics Infographics “African-American Men and Lung Cancer” “Lung Cancer Is the Biggest Cancer Killer in Both ... Colorectal (Colon) HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by Race and Ethnicity Language: English ( ...

  12. Does cancer affect the divorce rate?

    Directory of Open Access Journals (Sweden)

    Øystein Kravdal

    2007-06-01

    Full Text Available Discrete-time hazard regression models were employed to register and census data on 1.4 million Norwegian married couples from 1974-2001 to explore the probability of divorce following cancer illness. Divorce rates for around 215 000 persons diagnosed with cancer were compared to divorce rates for persons for whom all the other observed variables were the same. No overall harmful influence of a cancer diagnosis was observed. Most cancer forms resulted in small, immediate declines in divorce rates the first years following diagnosis. Exceptions were significant increases in the divorce rates for persons diagnosed with cervical and testicular cancer.

  13. Skin Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Controlled Tanning Is Not Safe Tanning Guidelines for School Programs to Prevent Skin Cancer Research Related Links Buttons and Badges Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All ...

  14. Prostate Specific Antigen (PSA as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT in Combination with Additional External Beam Radiation Therapy (EBRT for High Risk Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Thorsten H. Ecke

    2016-11-01

    Full Text Available High-dose-rate brachytherapy (HDR-BT with external beam radiation therapy (EBRT is a common treatment option for locally advanced prostate cancer (PCa. Seventy-nine male patients (median age 71 years, range 50 to 79 with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index, Gleason score, D’Amico risk classification for PCa, digital rectal examination (DRE, PSA value after one/three/five year(s follow-up (FU, time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis (p = 0.009, PSA on date of first HDR-BT (p = 0.033, and PSA on date of first follow-up after one year (p = 0.025 have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  15. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

    Science.gov (United States)

    Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-11-10

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis (p = 0.009), PSA on date of first HDR-BT (p = 0.033), and PSA on date of first follow-up after one year (p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  16. Sexual Functioning Among Endometrial Cancer Patients Treated With Adjuvant High-Dose-Rate Intra-Vaginal Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Damast, Shari, E-mail: shari.damast@yale.edu [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Alektiar, Kaled M. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Goldfarb, Shari [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Eaton, Anne; Patil, Sujata [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mosenkis, Jeffrey [Department of Comparative Human Development, University of Chicago, Chicago, Illinois (United States); Bennett, Antonia [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Atkinson, Thomas [Department of Psychiatry, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Jewell, Elizabeth; Leitao, Mario; Barakat, Richard; Carter, Jeanne [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Basch, Ethan [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2012-10-01

    Purpose: We used the Female Sexual Function Index (FSFI) to investigate the prevalence of sexual dysfunction (SD) and factors associated with diminished sexual functioning in early stage endometrial cancer (EC) patients treated with simple hysterectomy and adjuvant brachytherapy. Methods and Materials: A cohort of 104 patients followed in a radiation oncology clinic completed questionnaires to quantify current levels of sexual functioning. The time interval between hysterectomy and questionnaire completion ranged from <6 months to >5 years. Multivariate regression was performed using the FSFI as a continuous variable (score range, 1.2-35.4). SD was defined as an FSFI score of <26, based on the published validation study. Results: SD was reported by 81% of respondents. The mean ({+-} standard deviation) domain scores in order of highest-to-lowest functioning were: satisfaction, 2.9 ({+-}2.0); orgasm, 2.5 ({+-}2.4); desire, 2.4 ({+-}1.3); arousal, 2.2 ({+-}2.0); dryness, 2.1 ({+-}2.1); and pain, 1.9 ({+-}2.3). Compared to the index population in which the FSFI cut-score was validated (healthy women ages 18-74), all scores were low. Compared to published scores of a postmenopausal population, scores were not statistically different. Multivariate analysis isolated factors associated with lower FSFI scores, including having laparotomy as opposed to minimally invasive surgery (effect size, -7.1 points; 95% CI, -11.2 to -3.1; P<.001), lack of vaginal lubricant use (effect size, -4.4 points; 95% CI, -8.7 to -0.2, P=.040), and short time interval (<6 months) from hysterectomy to questionnaire completion (effect size, -4.6 points; 95% CI, -9.3-0.2; P=.059). Conclusions: The rate of SD, as defined by an FSFI score <26, was prevalent. The postmenopausal status of EC patients alone is a known risk factor for SD. Additional factors associated with poor sexual functioning following treatment for EC included receipt of laparotomy and lack of vaginal lubricant use.

  17. Long-Term Efficacy and Toxicity of Low-Dose-Rate {sup 125}I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kittel, Jeffrey A.; Reddy, Chandana A.; Smith, Kristin L.; Stephans, Kevin L.; Tendulkar, Rahul D. [Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio (United States); Ulchaker, James; Angermeier, Kenneth; Campbell, Steven; Stephenson, Andrew; Klein, Eric A. [Department of Urology, Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio (United States); Wilkinson, D. Allan [Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio (United States); Ciezki, Jay P., E-mail: ciezkij@ccf.org [Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio (United States)

    2015-07-15

    Purpose/Objectives: To report long-term efficacy and toxicity for a single-institution cohort of patients treated with low-dose-rate prostate brachytherapy permanent implant (PI) monotherapy. Methods and Materials: From 1996 to 2007, 1989 patients with low-risk (61.3%), intermediate-risk (29.8%), high-intermediate-risk (4.5%), and high-risk prostate cancer (4.4%) were treated with PI and followed up prospectively in a registry. All patients were treated with {sup 125}I monotherapy to 144 Gy. Late toxicity was coded retrospectively according to a modified Common Terminology Criteria for Adverse Events 4.0 scale. The rates of biochemical relapse-free survival (bRFS), distant metastasis-free survival (DMFS), overall survival (OS), and prostate cancer–specific mortality (PCSM) were calculated. We identified factors associated with late grade ≥3 genitourinary (GU) and gastrointestinal (GI) toxicity, bRFS, DMFS, OS, PCSM, and incontinence. Results: The median age of the patients was 67 years, and the median overall and prostate-specific antigen follow-up times were 6.8 years and 5.8 years, respectively. The overall 5-year rates for bRFS, DMFS, OS, and PCSM were 91.9%, 97.8%, 93.7%, and 0.71%, respectively. The 10-year rates were 81.5%, 91.5%, 76.1%, and 2.5%, respectively. The overall rates of late grade ≥3 GU and GI toxicity were 7.6% and 0.8%, respectively. On multivariable analysis, age and prostate length were significantly associated with increased risk of late grade ≥3 GU toxicity. The risk of incontinence was highly correlated with both pre-PI and post-PI transurethral resection of the prostate. Conclusions: Prostate brachytherapy as monotherapy is an effective treatment for low-risk and low-intermediate-risk prostate cancer and appears promising as a treatment for high-intermediate-risk and high-risk prostate cancer. Significant long-term toxicities are rare when brachytherapy is performed as monotherapy.

  18. Template guided transperineal saturation biopsy of the prostate: lessons for focal and urethra-sparing high-dose-rate brachytherapy for localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Sergey Nikolaevich Novikov

    2016-04-01

    Full Text Available Purpose : The aim of this work is to evaluate results of prostate transperineal saturation biopsy as a guide for focal high-dose-rate brachytherapy in patients with prostate cancer (PCa. Material and methods: Template guided saturation biopsy was performed in 67 primary patients with suspicion for prostate cancer. Biopsy was performed under ultrasonography (US control with the help of brachytherapy grid and 5 mm distance between samples. We put special attention for accurate sampling of prostate in periurethral region. The number of cores varied from 17 to 81 (average 36 cores. Finally, in 40 patients with confirmed prostate cancer results of biopsy were used for brachytherapy planning. Results : Saturation biopsy revealed prostate cancer in 40 of 67 evaluated patients. The extent of biopsy core involvement varied from 5% to 100% (average: 57%. Focal nature of PCa (single unilateral tumor nodule was diagnosed in 10 (25%, multifocal – in another 30 (75% patients. Hemigland invasion was mentioned in 12 (30% cases. Saturation biopsy detected PCa in periurethral cores in 27 (67.5% of 40 evaluated patients. In 10 patients, the extent of involvement in periurethral cores varied between 10% and 50%; in another, 17 observations exceeded 50%. According to results obtained on saturation biopsy, we performed HDR brachytherapy with “urethra low dose tunnel” (D10ur ≤ 80-90% in 13 patients with noninvolved periurethral cores. Theoretically, hemigland brachytherapy was possible in 12 of 40 evaluated patients with PCa. Conclusions : In low risk patients with PCa results of template guided saturation biopsy indicates high frequency (75% of multifocal disease and high probability (67.5% of periurethral invasion. Suitable candidates for focal HDR brachytherapy or irradiation with additional sparing of urethra can be effectively determined with the help of saturation biopsy.

  19. Concomitant chemoradiotherapy with high dose rate brachytherapy ...

    African Journals Online (AJOL)

    Purpose: This study aims to report the incidence of treatment-induced acute toxicities, local control and survival of patients with cervix cancer treated by external beam radiotherapy (EBR) and high-dose-rate (HDR) brachytherapy concomitant with weekly Cisplatin chemotherapy. Methods: Forty patients with FIGO Stages IB2 ...

  20. Cancer rates after kidney transplantation

    DEFF Research Database (Denmark)

    Sodemann, Ulrik; Bistrup, Claus; Marckmann, Peter

    2011-01-01

    Previous studies demonstrated a 3-5-fold increased cancer risk in kidney allograft recipients compared with the general population. Our aim was to estimate cancer frequencies among kidney allograft recipients who were transplanted in 1997-2000 and who were immunosuppressed according to a more...

  1. Electron and high-dose-rate brachytherapy boost in the conservative treatment of stage I-II breast cancer. First results of the randomized Budapest boost trial

    Energy Technology Data Exchange (ETDEWEB)

    Polgar, C.; Fodor, J. [National Institute of Oncology, Department of Radiotherapy, Budapest (Hungary); Orosz, Z. [National Institute of Oncology, Center of Experimental and Human Tumor Pathology Budapest (HU)] [and others

    2002-11-01

    Background and Aims: To evaluate the effect of electron and high-dose-rate brachytherapy (HDR BT) boost on local tumor control (LTC), side effects and cosmesis after breast-conserving surgery (BCS) in a prospective randomized study. Patients and Methods: 207 women with stage I-II breast cancer who underwent BCS were treated by 50 Gy irradiation to the whole breast and then randomly assigned to receive either a boost to the tumor bed (n=104) or no further radiotherapy (n=103). Boost treatments consisted of either 16 Gy electron irradiation (n=52) or 12-14.25 Gy HDR BT (n=52). Breast cancer-related events, side effects, and cosmetic results were assessed. Results: At a median follow-up of 5.3 years, the crude rate of local recurrence was 6.7% (7/104) with and 15.5% (16/103) without boost. The 5-year probability of LTC, relapse-free survival (RFS), and cancer-specific survival (CSS) was 92.7% vs 84.9% (p=0.049), 76.6% vs 66.2% (p=0.044), and 90.4% vs. 82.1% (p=0.053), respectively. There was no significant difference in LTC between patients treated with electron or HDR BT boost (94.2% vs 91.4%; p=0.74). On multivariate analysis, patient age <40 years (RR: 4.53), positive margin status (RR: 4.17), and high mitotic activity index (RR: 3.60) were found to be significant risk factors for local recurrence. The incidence of grade 2-3 side effects was higher in the boost arm (17.3% vs 7.8%; p=0.03). However, the rate of excellent/good cosmetic results was similar for the two arms (85.6% vs 91.3%; p=0.14). Cosmesis was rated as excellent/good in 88.5% of patients treated with HDR BT and 82.7% of patients with electron boost (p=0.29). Conclusions: Boost dose significantly improves LTC and RFS in patients treated with BCS and radiotherapy. In spite of the higher incidence of late side effects in the boost arm, boost dose is strongly recommended for patients at high risk for local recurrence. Positive or close margin status, high mitotic activity index, and young patient age

  2. Colorectal Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir The rate of people getting colorectal cancer or dying from colorectal cancer varies by race and ethnicity. Incidence Rates by Race/Ethnicity and Sex “Incidence rate” means how many people out of a given number ...

  3. Breast Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir The rate of women getting breast cancer or dying from breast cancer varies by race and ethnicity. Incidence Rates by Race/Ethnicity “Incidence rate” means how many women out of a given number ...

  4. Prostate Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir The rate of men getting prostate cancer or dying from prostate cancer varies by race and ethnicity. Incidence Rates by Race/Ethnicity “Incidence rate” means how many men out of a given number ...

  5. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-03-15

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.

  6. Single-fraction high-dose-rate brachytherapy and hypofractionated external beam radiation therapy in the treatment of intermediate-risk prostate cancer - long term results.

    Science.gov (United States)

    Cury, Fabio L; Duclos, Marie; Aprikian, Armen; Patrocinio, Horacio; Kassouf, Wassim; Shenouda, George; Faria, Sergio; David, Marc; Souhami, Luis

    2012-03-15

    We present the long-term results of a cohort of patients with intermediate-risk prostate cancer (PC) treated with single-fraction high-dose-rate brachytherapy (HDRB) combined with hypofractionated external beam radiation therapy (HypoRT). Patients were treated exclusively with HDRB and HypoRT. HDRB delivered a dose of 10 Gy to the prostate surface and HypoRT consisted of 50 Gy delivered in 20 daily fractions. The first 121 consecutive patients with a minimum of 2 years posttreatment follow-up were assessed for toxicity and disease control. The median follow-up was 65.2 months. No acute Grade III or higher toxicity was seen. Late Grade II gastrointestinal toxicity was seen in 9 patients (7.4%) and Grade III in 2 (1.6%). Late Grade III genitourinary toxicity was seen in 2 patients (1.6%). After a 24-month follow-up, a rebiopsy was offered to the first 58 consecutively treated patients, and 44 patients agreed with the procedure. Negative biopsies were found in 40 patients (91%). The 5-year biochemical relapse-free survival rate was 90.7% (95% CI, 84.5-96.9%), with 13 patients presenting biochemical failure. Among them, 9 were diagnosed with distant metastasis. Prostate cancer-specific and overall survival rates at 5 years were 100% and 98.8% (95% CI, 96.4-100%), respectively. The combination of HDRB and HypoRT is well tolerated, with acceptable toxicity rates. Furthermore, results from rebiopsies revealed an encouraging rate of local control. These results confirm that the use of conformal RT techniques, adapted to specific biological tumor characteristics, have the potential to improve the therapeutic ratio in intermediate-risk PC patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. A prospective cohort study to compare treatment results between 2 fractionation schedules of high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer.

    Science.gov (United States)

    Huang, Eng-Yen; Sun, Li-Min; Lin, Hao; Lan, Jen-Hong; Chanchien, Chan-Chao; Huang, Yu-Jie; Wang, Chang-Yu; Wang, Chong-Jong

    2013-01-01

    To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy×4 (HDR-4) (n=144) or 4.5 Gy×6 (HDR-6) (n=123) to point A of ICBT using 192Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis, and enterocolitis were compared between HDR-4 and HDR-6. There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged≥62 years old (P=.012) but not in patients agedschedules. The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Role of vaginal pallor reaction in predicting late vaginal stenosis after high-dose-rate brachytherapy in treatment-naive patients with cervical cancer.

    Science.gov (United States)

    Yoshida, Ken; Yamazaki, Hideya; Nakamura, Satoaki; Masui, Koji; Kotsuma, Tadayuki; Akiyama, Hironori; Tanaka, Eiichi; Yoshikawa, Nobuhiko; Uesugi, Yasuo; Shimbo, Taiju; Narumi, Yoshifumi; Yoshioka, Yasuo

    2015-07-01

    To assess actual rates of late vaginal stenosis and identify predisposing factors for complications among patients with previously untreated cervical cancer following high-dose-rate brachytherapy. We performed longitudinal analyses of 57 patients using the modified Dische score at 6, 12, 18, 24, 36, and 60 months after treatment, which consisted of 15 interstitial brachytherapys and 42 conventional intracavitary brachytherapys, with a median follow-up time of 36 months (range, 6 to 144 months). More than half of the patients developed grade 1 (mild) vaginal stenosis within the first year of follow-up, and grade 2 (97.5%, moderate) to grade 3 (severe) stenosis gradually increased with time. Actual stenosis rates for grade 1, 2, and 3 were 97.5% (95% confidence interval [CI], 92.7 to 97.5), 60.7% (95% CI, 42.2 to 79.3), and 7.4% (95% CI, 0 to 18.4) at 3 years after treatment. Pallor reaction grade 2-3 at 6 months was only a statistically significant predisposing factor for grade 2-3 late vaginal stenosis 3 years or later with a hazard ratio of 3.48 (95% CI, 1.32 to 9.19; p=0.018) by a multivariate Cox proportional hazard model. Patients with grade 0-1 pallor reaction at 6 months showed a grade ≥2 vaginal stenosis rate of 53%, whereas the grade 2-3 pallor reaction group achieved a grade ≥2 vaginal stenosis rate at 3 years at 100% (p=0.001). High-dose-rate brachytherapy was associated with high incidence of late vaginal stenosis. Pallor reaction grade 2-3 at 6 months was predictive of late grade 2-3 vaginal stenosis at 3 years after treatment. These findings should prove helpful for patient counseling and preventive intervention.

  9. Low cancer incidence rates in Ohio Amish.

    Science.gov (United States)

    Westman, Judith A; Ferketich, Amy K; Kauffman, Ross M; MacEachern, Steven N; Wilkins, J R; Wilcox, Patricia P; Pilarski, Robert T; Nagy, Rebecca; Lemeshow, Stanley; de la Chapelle, Albert; Bloomfield, Clara D

    2010-01-01

    The Amish have not been previously studied for cancer incidence, yet they have the potential to help in the understanding of its environmental and genetic contributions. The purpose of this study was to estimate the incidence of cancer among the largest Amish population. Adults from randomly selected households were interviewed and a detailed cancer family history was taken. Using both the household interview data and a search of the Ohio cancer registry data, a total of 191 cancer cases were identified between the years 1996 and 2003. The age-adjusted cancer incidence rate for all cancers among the Amish adults was 60% of the age-adjusted adult rate in Ohio (389.5/10(5) vs. 646.9/10(5); p Amish was 37% of the rate for Ohio adults (p Amish was 72% of the age-adjusted adult rate in Ohio (p = 0.0001). Cancer incidence is low in the Ohio Amish. These data strongly support reduction of cancer incidence by tobacco abstinence but cannot be explained solely on this basis. Understanding these contributions may help to identify additional important factors to target to reduce cancer among the non-Amish.

  10. A dosimetric study of polyethylene glycol hydrogel in 200 prostate cancer patients treated with high-dose rate brachytherapy±intensity modulated radiation therapy.

    Science.gov (United States)

    Strom, Tobin J; Wilder, Richard B; Fernandez, Daniel C; Mellon, Eric A; Saini, Amarjit S; Hunt, Dylan C; Pow-Sang, Julio M; Spiess, Phillipe E; Sexton, Wade J; Poch, Michael A; Biagioli, Matthew C

    2014-04-01

    We sought to analyze the effect of polyethylene glycol (PEG) hydrogel on rectal doses in prostate cancer patients undergoing radiotherapy. Between July 2009 and April 2013, we treated 200 clinically localized prostate cancer patients with high-dose rate (HDR) brachytherapy±intensity modulated radiation therapy. Half of the patients received a transrectal ultrasound (TRUS)-guided transperineal injection of 10mL PEG hydrogel (DuraSeal™ Spinal Sealant System; Covidien, Mansfield, MA) in their anterior perirectal fat immediately prior to the first HDR brachytherapy treatment and 5mL PEG hydrogel prior to the second HDR brachytherapy treatment. Prostate, rectal, and bladder doses and prostate-rectal distances were calculated based upon treatment planning CT scans. There was a success rate of 100% (100/100) with PEG hydrogel implantation. PEG hydrogel significantly increased the prostate-rectal separation (mean±SD, 12±4mm with gel vs. 4±2mm without gel, phydrogel temporarily displaced the rectum away from the prostate by an average of 12mm and led to a significant reduction in rectal radiation doses, regardless of BMI. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Mineralogical and compositional characteristics of Late Permian coals from an area of high lung cancer rate in Xuan Wei, Yunnan, China: Occurrence and origin of quartz and chamosite

    Science.gov (United States)

    Dai, S.; Tian, L.; Chou, C.-L.; Zhou, Y.; Zhang, M.; Zhao, L.; Wang, Jingyuan; Yang, Z.; Cao, H.; Ren, D.

    2008-01-01

    Some townships in Xuan Wei County, Yunnan Province, have one of the highest lung cancer mortality rates in China and the epidemic disease in the area has generally been attributed to the polycyclic aromatic hydrocarbons (PAHs) released from domestic coal burning. However, the cancer-causing culprit is not settled as Tian [Tian, L., 2005. Coal Combustion Emissions and Lung Cancer in Xuan Wei, China. Ph.D. thesis, University of California, Berkeley.] found nanometer quartz in these coals, soot emissions, and lung cancer tissues. We have conducted mineralogical and geochemical studies of the coals from Xuan Wei for the purpose of shedding light on the minerals which may be related to the epidemic lung cancer. In this paper, abundances, modes of occurrence, and origins of minerals and elements in the coals from two mines in Xuan Wei have been studied using optical microscope, low-temperature ashing, X-ray diffraction analysis, scanning electron microscope equipped with energy-dispersive X-ray spectrometer, and inductively-coupled plasma mass spectrometry. The minerals in the coals are mainly composed of quartz, chamosite, kaolinite, and calcite. The particle size of quartz is rather small, mostly less than 20????m and it is of authigenic origin. Chamosite occurs mainly as cell-fillings. The occurrence of quartz and chamosite indicates that they were derived from the hydrothermal fluids. Epigenetic calcite is derived from calcic fluids. Kaolinite is derived mainly from sediment source region of Kangdian Oldland to the west of coal basin. The composition of Xuan Wei coal is high in SiO2, Fe2O3, TiO2, CaO, MnO, V, Co, Ni, Cu, and Zn. The high SiO2 content is attributed to quartz, and the Fe2O3 content to chamosite. The high Mn and low Mg contents in the coal indicate the inputs of hydrothermal fluids. CaO occurs mainly in epigenetic calcite. Elements Ti, Co, Ni, Cu, Zn, and rare earth elements were derived from the basaltic rocks at sediment source region. ?? 2008

  12. Posttraumatic Stress Disorder After High-Dose-Rate Brachytherapy for Cervical Cancer With 2 Fractions in 1 Application Under Spinal/Epidural Anesthesia: Incidence and Risk Factors

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    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Czajka-Pepl, Agnieszka [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Ponocny-Seliger, Elisabeth [Department of Psychology, Sigmund Freud Private University Vienna, Vienna (Austria); Scharbert, Gisela; Wetzel, Léonore [Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Sturdza, Alina [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Dimopoulos, Johannes C. [Metropolitan Hospital, Athens (Greece); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)

    2014-06-01

    Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful

  13. High-dose-rate interstitial brachytherapy in early stage oral tongue cancer – 15 year experience from a tertiary care institute

    Directory of Open Access Journals (Sweden)

    Anshuma Bansal

    2016-02-01

    Full Text Available Purpose: To determine outcomes of interstitial high-dose-rate brachytherapy (HDR-BT in patients with early stage oral tongue cancer. Material and methods : Ninety-two patients with stage I and II oral tongue cancer were treated with HDR-BT between 1999 and 2014: brachytherapy alone = 62 (67.4%, and combination of external beam radiotherapy (EBRT and brachytherapy = 30 (32.6%. Median follow-up was 53.5 months. Patterns of failure, overall survival (OS, disease-free survival (DFS, local control rates (LCR, and nodal control rates (NCR were determined. Results : 5-year OS, DFS, LCR, and NCR were 73.2%, 58.2%, 64.2%, and 83.8%, respectively. In total, 43 patients (46.7% failed treatment: isolated local failures = 28 (30.4%, isolated nodal failures = 8 (8.7%, both local and regional failures = 7 (7.6%. While in T1 stage, 5 year LCR were significantly higher in brachytherapy alone group compared to combined EBRT and brachytherapy group (81.7% vs. 62.5%, p = 0.04, the isolated nodal failure rates were not significantly different among the two groups. For T2 stage, NCR were higher in combined EBRT and brachytherapy group compared to brachytherapy alone (92.9% vs. 74.3%. Acute mucositis (grade ≥ 2 was seen more in brachytherapy alone group compared to the combined modality group (87% vs. 66%, and this correlated significantly with the higher biological equivalent dose (BED in the brachytherapy alone group. Conclusions : Our study recommends treating patients with brachytherapy alone in T1 stage, and demonstrates the need for addressing nodal region either by neck dissection or nodal irradiation in T2 stage patients. Also, the study highlights the need for dose escalation (from the doses used in the study in both T1 and T2 stage tumors when using interstitial brachytherapy either as sole modality or as a boost.

  14. Clinicopathologic Comparison of High-Dose-Rate Endorectal Brachytherapy versus Conventional Chemoradiotherapy in the Neoadjuvant Setting for Resectable Stages II and III Low Rectal Cancer

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    Jessica A. Smith

    2012-01-01

    Full Text Available Purpose. To assess for differences in clinical, radiologic, and pathologic outcomes between patients with stage II-III rectal adenocarcinoma treated neoadjuvantly with conventional external beam radiotherapy (3D conformal radiotherapy (3DRT or intensity-modulated radiotherapy (IMRT versus high-dose-rate endorectal brachytherapy (EBT. Methods. Patients undergoing neoadjuvant EBT received 4 consecutive daily 6.5 Gy fractions without chemotherapy, while those undergoing 3DRT or IMRT received 28 daily 1.8 Gy fractions with concurrent 5-fluorouracil. Data was collected prospectively for 7 EBT patients and retrospectively for 25 historical 3DRT/IMRT controls. Results. Time to surgery was less for EBT compared to 3DRT and IMRT (P<0.001. There was a trend towards higher rate of pathologic CR for EBT (P=0.06. Rates of margin and lymph node positivity at resection were similar for all groups. Acute toxicity was less for EBT compared to 3DRT and IMRT (P=0.025. Overall and progression-free survival were noninferior for EBT. On MRI, EBT achieved similar complete response rate and reduction in tumor volume as 3DRT and IMRT. Histopathologic comparison showed that EBT resulted in more localized treatment effects and fewer serosal adhesions. Conclusions. EBT offers several practical benefits over conventional radiotherapy techniques and appears to be at least as effective against low rectal cancer as measured by short-term outcomes.

  15. Outcomes of salvage high-dose-rate brachytherapy with or without external beam radiotherapy for isolated vaginal recurrence of endometrial cancer

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    Shuhei Sekii

    2017-05-01

    Full Text Available Purpose: This study was designed to retrospectively analyze outcomes of high-dose-rate (HDR brachytherapy, with or without external beam radiotherapy (EBRT, in patients with vaginal recurrence of endometrial carcinoma, and to identify factors prognostic of patient outcomes. Material and methods : The medical records of all patients who underwent HDR brachytherapy for initial recurrence in the vagina of endometrial cancer after definitive surgery between 1992 and 2014 were retrospectively reviewed. All patients underwent either intracavitary brachytherapy (ICBT or interstitial brachytherapy (ISBT with or without EBRT. Late toxicity was graded using the EORTC (LENT/SOMA scale, revised in 1995. Results : Thirty-seven patients were identified. The median follow-up time was 48 months (range: 6-225 months. Of these 37 patients, 23 underwent ICBT, 14 underwent ISBT, and 26 underwent EBRT. Tumor size at first examination of initial relapse was significantly larger in the ISBT than in the ICBT group. The 4-year respective overall survival (OS, local control (LC, and progression-free survival (PFS rates in the entire cohort were 81.0%, 77.9%, and 56.8%, respectively. The interval between diagnosis of first recurrence and radiotherapy (< 3 months, ≥ 3 months was a significant predictor of LC and PFS. OS and LC rates did not differ significantly in the ICBT and ISBT groups. Two patients experienced grade 2 rectal bleeding, and four experienced grade 2 hematuria. No grade 3 or higher late complications were observed. Conclusions : Salvage HDR brachytherapy is an optimal for treating vaginal recurrence of endometrial carcinoma with acceptable morbidity. Early radiotherapy, including brachytherapy, should be considered for women who experience vaginal recurrence of endometrial cancer.

  16. Clinical outcome of interstitial pulsed dose rate brachytherapy in multimodality treatment of locally advanced primary or recurrent rectal and sigmoid cancer with high risk of incomplete microscopic resection.

    Science.gov (United States)

    Nielsen, Mette Bak; Rasmussen, Peter Christian; Tanderup, Kari; Nielsen, Søren Kynde; Fokdal, Lars; Laurberg, Søren; Lindegaard, Jacob Christian

    2016-12-01

    To evaluate the role of interstitial pulsed dose rate brachytherapy (PDR-BT) in multimodality treatment of locally advanced primary or recurrent rectal and sigmoid cancer with high risk of microscopic incomplete resection (R1). A total of 73 consecutive patients (recurrent/primary: 40/33) were treated with PDR-BT between 2001 and 2010. Patients received preoperative external beam radiotherapy (EBRT) and concomitant chemotherapy. Following resection of the tumor and the involved pelvic organs, a median of four (3-8) catheters were sutured to the tumor bed with a distance of approximately 1 cm between the catheters. A target respecting the catheters with a margin of 5 mm was contoured on computed tomography (CT) and three-dimensional (3D) dose planning with a planning aim for BT of D90 > 30 Gy, (0.6 Gy/pulse, 1 pulse/h) was performed. Previously irradiated patients (27%) underwent surgery that was directly followed by PDR-BT. Postoperative EBRT was then applied to the tumor bed 3-5 weeks after PDR-BT. A total of 23 patients (31%) received a radical resection (R0) and 45 patients (62%) received an R1 resection. Five patients (7%) received a macroscopic incomplete resection (R2). The five-year overall survival was 33%. Local control at five years was 67% for patients who received a R0 resection and 32% for patients who received an R1 resection. The five-year actuarial risk of a grade 3-4 BT-related complication was 5%. Meaningful disease control and survival can be obtained at an acceptable rate of late morbidity in selected patients with locally advanced primary and recurrent rectal or sigmoid cancer using (chemo) RT, extensive surgery and PDR-BT when a high risk of an R1 resection is expected.

  17. Updated results of high-dose rate brachytherapy and external beam radiotherapy for locally and locally advanced prostate cancer using the RTOG-ASTRO phoenix definition

    Directory of Open Access Journals (Sweden)

    Antonio C. Pellizzon

    2008-06-01

    Full Text Available PURPOSE: To evaluate the prognostic factors for patients with local or locally advanced prostate cancer treated with external beam radiotherapy (RT and high dose rate brachytherapy (HDR according to the RTOG-ASTRO Phoenix Consensus Conference. MATERIALS AND METHODS: The charts of 209 patients treated between 1997 and 2005 with localized RT and HDR as a boost at the Department of Radiation Oncology, AC Camargo Hospital, Sao Paulo, Brazil were reviewed. Clinical and treatment parameters i.e.: patient's age, Gleason score, clinical stage, initial PSA (iPSA, risk group (RG for biochemical failure, doses of RT and HDR were evaluated. Median age and median follow-up time were 68 and 5.3 years, respectively. Median RT and HDR doses were 45 Gy and 20 Gy. RESULTS: Disease specific survival (DSS at 3.3 year was 94.2%. Regarding RG, for the LR (low risk, IR (intermediate risk and HR (high risk, the DSS rates at 3.3 years were 91.5%, 90.2% and 88.5%, respectively. On univariate analysis prognostic factors related to DSS were RG (p = 0.040, Gleason score ≤ 6 ng/mL (p = 0.002, total dose of HDR ≥ 20 Gy (p < 0.001 On multivariate analysis the only statistical significant predictive factor for biochemical control (bNED was the RG, p < 0.001 (CI - 1.147-3.561. CONCLUSIONS: Although the radiation dose administered to the prostate is an important factor related to bNED, this could not be established with statistical significance in this group of patients. To date , in our own experience, HDR associated to RT could be considered a successful approach in the treatment of prostate cancer.

  18. Workflow efficiency for the treatment planning process in CT-guided high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Michaud, Anthony L; Benedict, Stanley; Montemayor, Eliseo; Hunt, Jon Paul; Wright, Cari; Mathai, Mathew; Mayadev, Jyoti S

    2016-01-01

    To investigate process efficiency, we present a prospective investigation of the treatment planning phase of image-guided brachytherapy (BT) for cervical cancer using a specific checklist. From October 2012 to January 2014, 76 BT procedures were consecutively performed. Prospective data on the CT-based treatment planning process was collected using a specific checklist which details the following steps: (1) dosimetry planning, (2) physician review start, (3) physician review time, (4) dosimetry processing, (5) physics review start, (6) physics review, and (7) procedural pause. Variables examined included the use of a pre-BT MRI, clinic duty conflicts, resident teaching, and the use of specific BT planners. Analysis was performed using descriptive statistics, t-test, and analysis of variance. Seventy-five prospectively gathered checklists comprised this analysis. The mean time for treatment planning was 95 minutes (med 94, std 18). The mean intervals in the above steps were (1) = 42, (2) = 5, (3) = 19, (4) = 10, (5) = 6, (6) = 13, and (7) = 26 minutes. There was no statistical difference in patients who had a pre-BT MRI. Resident teaching did not influence time, p = 0.17. Treatment planning time was decreased with a specific planner, p = 0.0015. A skillful team approach is required for treatment planning efficiency in image-guided BT. We have found that the specific BT planners can have a significant effect on the overall planning efficiency. We continue to examine clinical and workflow-related factors that will enhance our safety and workflow process with BT. Published by Elsevier Inc.

  19. Ecological integrity of streams related to human cancer mortality rates.

    Science.gov (United States)

    Hitt, Nathaniel P; Hendryx, Michael

    2010-08-01

    Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate community structure (West Virginia Stream Condition Index, SCI) and quantified human cancer mortality rates using county-level data from the Centers for Disease Control and Prevention. Regression and spatial analyses revealed significant associations between ecological integrity and public health. SCI was negatively related to age-adjusted total cancer mortality per 100,000 people. Respiratory, digestive, urinary, and breast cancer rates increased with ecological disintegrity, but genital and oral cancer rates did not. Smoking, poverty, and urbanization were significantly related to total cancer mortality, but did not explain the observed relationships between ecological integrity and cancer. Coal mining was significantly associated with ecological disintegrity and higher cancer mortality. Spatial analyses also revealed cancer clusters that corresponded to areas of high coal mining intensity. Our results demonstrated significant relationships between ecological integrity and human cancer mortality in West Virginia, and suggested important effects of coal mining on ecological communities and public health. Assessments of ecological integrity therefore may contribute not only to monitoring goals for aquatic life, but also may provide valuable insights for human health and safety.

  20. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

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    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Deshields, Teresa L. [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A.; Cyr, Amy E. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A.; Ochoa, Laura L. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-12-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.

  1. High-dose-rate brachytherapy with or without intensity modulated radiation therapy as salvage treatment for an isolated, gross local recurrence of prostate cancer post-prostatectomy.

    Science.gov (United States)

    Strom, Tobin J; Wilder, Richard B; Fernandez, Daniel C; Mellon, Eric A; Saini, Amarjit S; Hunt, Dylan C; Biagioli, Matthew C

    2014-01-01

    To evaluate the use of high-dose-rate (HDR) brachytherapy ± intensity modulated radiation therapy (IMRT) as salvage therapy for patients with an isolated, gross local recurrence of prostate cancer after radical prostatectomy. Between October 2009 and May 2013, the authors treated six patients with salvage iridium-192 HDR brachytherapy ± IMRT for biopsy-proven, recurrent prostate cancer post-prostatectomy. In each patient, a pelvic MRI scan or CT scan demonstrated a nodule (range 1.6, 4.7 cm) in the prostate bed. Although prostate-specific antigen values were 0.2-9.5 ng/mL at the time of salvage brachytherapy, there was no pelvic adenopathy on CT or MRI scan, and a bone scan was negative in all cases. Five patients were treated with IMRT to 4500-5040 cGy in 25-28 fractions to the prostate bed followed by two 950 cGy HDR brachytherapy fractions separated by 1-2 weeks. A sixth patient underwent HDR brachytherapy monotherapy consisting of 3800 cGy in four fractions over 3 days. Toxicities were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. Median followup was 9 months (range 3, 40 months). All six patients have been free of androgen deprivation therapy and have an undetectable prostate-specific antigen. One patient developed late Grade 2 urinary incontinence. There was no late grade ≥2 gastrointestinal toxicity. HDR brachytherapy ± IMRT is a safe and effective salvage therapy option for an isolated, gross local recurrence of prostate cancer after radical prostatectomy and merits further study. Copyright © 2014. Published by Elsevier Inc.

  2. International Variation in Female Breast Cancer Incidence and Mortality Rates.

    Science.gov (United States)

    DeSantis, Carol E; Bray, Freddie; Ferlay, Jacques; Lortet-Tieulent, Joannie; Anderson, Benjamin O; Jemal, Ahmedin

    2015-10-01

    Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death among women worldwide. Herein, we examine global trends in female breast cancer rates using the most up-to-date data available. Breast cancer incidence and mortality estimates were obtained from GLOBOCAN 2012 (globocan.iarc.fr). We analyzed trends from 1993 onward using incidence data from 39 countries from the International Agency for Research on Cancer and mortality data from 57 countries from the World Health Organization. Of 32 countries with incidence and mortality data, rates in the recent period diverged-with incidence increasing and mortality decreasing-in nine countries mainly in Northern/Western Europe. Both incidence and mortality decreased in France, Israel, Italy, Norway, and Spain. In contrast, incidence and death rates both increased in Colombia, Ecuador, and Japan. Death rates also increased in Brazil, Egypt, Guatemala, Kuwait, Mauritius, Mexico, and Moldova. Breast cancer mortality rates are decreasing in most high-income countries, despite increasing or stable incidence rates. In contrast and of concern are the increasing incidence and mortality rates in a number of countries, particularly those undergoing rapid changes in human development. Wide variations in breast cancer rates and trends reflect differences in patterns of risk factors and access to and availability of early detection and timely treatment. Increased awareness about breast cancer and the benefits of early detection and improved access to treatment must be prioritized to successfully implement breast cancer control programs, particularly in transitioning countries. ©2015 American Association for Cancer Research.

  3. High-dose-rate Three-dimensional Conformal Radiotherapy Combined with Active Breathing Control for Stereotactic Body Radiotherapy of Early-stage Non-small-cell Lung Cancer.

    Science.gov (United States)

    Wang, Ruozheng; Yin, Yong; Qin, Yonghui; Yu, Jinming

    2015-12-01

    The purpose of this study was to evaluate the feasibility and benefits of using high-dose-rate three-dimensional conformal radiotherapy (3D-CRT) combined with active breathing control (ABC) for stereotactic body radiotherapy (SBRT) of patients with early-stage non-small-cell lung cancer (NSCLC). Eight patients with early-stage NSCLC underwent CT scans under standard free-breathing (FB) and moderately deep inspiration breath-hold (mDIBH) with ABC. Two high-dose-rate 3D-CRT plans (1000 Mu/min) were designed based on the CT scans with FB and mDIBH. The maximal dose (D1%), minimal dose (D99%), conformity index (CI), and homogeneity index (HI) of the planning target volume (PTV), and dose-volume indices of the organs at risk between each plan were compared. The mean PTV volume decreased from 158.04 cm(3) with FB to 76.90 cm(3) with mDIBH (p < 0.05). When mDIBH was used, increases in the affected lung volume (by 47%), contralateral lung volume (by 55%), and total lung volume (by 50%) were observed compared to FB (p < 0.05). The V5-V40 of the affected lung (Vx represented the percentage volume of organs receiving at least the x Gy), V5-V40 and the mean dose for the total lung, V5-V40 and mean dose of the chest wall, and the maximum dose of the spinal cord were less for mDIBH than FB (p < 0.05). There were no significant differences in CI, HI, D1%, or D99% for the PTV between the plans. In conclusion, high-dose-rate 3D-CRT combined with ABC reduced the radiation dose to the lungs and chest wall without affecting the dose distribution in SBRT of early-stage NSCLC patients. © The Author(s) 2014.

  4. Chemoradiation in cervical cancer with cisplatin and high-dose rate brachytherapy combined with external beam radiotherapy. Results of a phase-II study

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    Strauss, H.G.; Laban, C.; Puschmann, D.; Koelbl, H. [Dept. of Gynecology, Martin-Luther Univ. Halle-Wittenberg (Germany); Kuhnt, T.; Pigorsch, S.; Dunst, J.; Haensgen, G. [Dept. of Radiotherapy, Martin-Luther Univ. Halle-Wittenberg (Germany)

    2002-07-01

    Background: In 1999, five randomized studies demonstrated that chemoradiation with cisplatin and low-dose rate (LDR) brachytherapy has a benefit in locally advanced cervical cancer and for surgically treated patients in high-risk situations. We evaluated the safety and efficacy of concomitant chemoradiation with cisplatin and high-dose rate (HDR) brachytherapy in patients with cervical cancer. Patients and Method: 27 patients were included in our phase-II trial: 13 locally advanced cases (group A) and 14 adjuvant-therapy patients in high-risk situations (group B). A definitive radiotherapy was performed with 25 fractions of external beam therapy (1.8 Gy per fraction/middle shielded after eleven fractions). Brachytherapy was delivered at HDR schedules with 7 Gy in point A per fraction (total dose 35 Gy) in FIGO Stages IIB-IIIB. The total dose of external and brachytherapy was 70 Gy in point A and 52-54 Gy in point B. All patients in stage IVA were treated without brachytherapy. Adjuvant radiotherapy was performed with external beam radiotherapy of the pelvis with 1.8 Gy single-dose up to 50.4 Gy. Brachytherapy was delivered at HDR schedules with two fractions of 5 Gy only in patients with tumor-positive margins or tumor involvement of the upper vagina. The chemotherapeutic treatment schedule provided six courses of cisplatin 40 mg/m{sup 2} weekly recommended in the randomized studies GOG-120 and -123. Results: A total of 18/27 patients (66.7%) completed all six courses of chemotherapy. Discontinuation of radiotherapy due to therapy-related morbidity was not necessary in the whole study group. G3 leukopenia (29.6%) was the only relevant acute toxicity. There were no differences in toxicity between group A and B. Serious late morbidity occurred in 2/27 patients (7.4%). 12/13 patients (92.3%) with IIB-IVA cervical cancer showed a complete response (CR). 13/14 adjuvant cases (92.8%) are free of recurrence (median follow up: 19.1 months). Conclusion: Concomitant

  5. External-Beam Radiation Therapy and High-Dose Rate Brachytherapy Combined With Long-Term Androgen Deprivation Therapy in High and Very High Prostate Cancer: Preliminary Data on Clinical Outcome

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    Martinez-Monge, Rafael, E-mail: rmartinezm@unav.es [Department of Radiation Oncology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarre (Spain); Moreno, Marta; Ciervide, Raquel; Cambeiro, Mauricio [Department of Radiation Oncology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarre (Spain); Perez-Gracia, Jose Luis; Gil-Bazo, Ignacio [Department of Medical Oncology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarre (Spain); Gaztanaga, Miren; Arbea, Leire [Department of Radiation Oncology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarre (Spain); Pascual, Ignacio [Department of Urology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarre (Spain); Aristu, Javier [Department of Radiation Oncology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarre (Spain)

    2012-03-01

    Purpose: To determine the feasibility of combined long-term androgen deprivation therapy (ADT) and dose escalation with high-dose-rate (HDR) brachytherapy. Methods and Materials: Between 2001 and 2007, 200 patients with high-risk prostate cancer (32.5%) or very high-risk prostate cancer (67.5%) were prospectively enrolled in this Phase II trial. Tumor characteristics included a median pretreatment prostate-specific antigen of 15.2 ng/mL, a clinical stage of T2c, and a Gleason score of 7. Treatment consisted of 54 Gy of external irradiation (three-dimensional conformal radiotherapy [3DCRT]) followed by 19 Gy of HDR brachytherapy in four twice-daily treatments. ADT started 0-3 months before 3DCRT and continued for 2 years. Results: One hundred and ninety patients (95%) received 2 years of ADT. After a median follow-up of 3.7 years (range, 2-9), late Grade {>=}2 urinary toxicity was observed in 18% of the patients and Grade {>=}3 was observed in 5%. Prior transurethral resection of the prostate (p = 0.013) and bladder D{sub 50} {>=}1.19 Gy (p = 0.014) were associated with increased Grade {>=}2 urinary complications; age {>=}70 (p = 0.05) was associated with Grade {>=}3 urinary complications. Late Grade {>=}2 gastrointestinal toxicity was observed in 9% of the patients and Grade {>=}3 in 1.5%. CTV size {>=}35.8 cc (p = 0.007) and D{sub 100} {>=}3.05 Gy (p = 0.01) were significant for increased Grade {>=}2 complications. The 5-year and 9-year biochemical relapse-free survival (nadir + 2) rates were 85.1% and 75.7%, respectively. Patients with Gleason score of 7-10 had a decreased biochemical relapse-free survival (p = 0.007). Conclusions: Intermediate-term results at the 5-year time point indicate a favorable outcome without an increase in the rate of late complications.

  6. TLD skin dose measurements and acute and late effects after lumpectomy and high-dose-rate brachytherapy only for early breast cancer.

    Science.gov (United States)

    Perera, Francisco; Chisela, Frank; Stitt, Larry; Engel, Jay; Venkatesan, Varagur

    2005-08-01

    This report examines the relationships between measured skin doses and the acute and late skin and soft tissue changes in a pilot study of lumpectomy and high-dose-rate brachytherapy only for breast cancer. Thirty-seven of 39 women enrolled in this pilot study of high-dose-rate brachytherapy (37.2 Gy in 10 fractions b.i.d.) each had thermoluminescent dosimetry (TLD) at 5 points on the skin of the breast overlying the implant volume. Skin changes at TLD dose points and fibrosis at the lumpectomy site were documented every 6 to 12 months posttreatment using a standardized physician-rated cosmesis questionnaire. The relationships between TLD dose and acute skin reaction, pigmentation, or telangiectasia at 5 years were analyzed using the GEE algorithm and the GENMOD procedure in the SAS statistical package. Fisher's exact test was used to determine whether there were any significant associations between acute skin reaction and late pigmentation or telangiectasia or between the volumes encompassed by various isodoses and fibrosis or fat necrosis. The median TLD dose per fraction (185 dose points) multiplied by 10 was 9.2 Gy. In all 37 patients, acute skin reaction Grade 1 or higher was observed at 5.9% (6 of 102) of dose points receiving 10 Gy or less vs. 44.6% (37 of 83) of dose points receiving more than 10 Gy (p skin reaction was also significantly associated with development of Grade 1 or more pigmentation or telangiectasia at 60 months. This association was most significant for acute reaction and telangiectasia directly over the lumpectomy site (p brachytherapy to the lumpectomy site, TLD skin dose was significantly related to acute skin reaction and to pigmentation and telangiectasia at 60 months. An acute skin reaction was also significantly associated with the development of telangiectasia at 60 months. TLD skin dose measurement may allow modification of the brachytherapy implant geometry (dwell times and position) to minimize late skin toxicity.

  7. Nodal Clearance Rate and Long-Term Efficacy of Individualized Sentinel Node–Based Pelvic Intensity Modulated Radiation Therapy for High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Müller, Arndt-Christian, E-mail: arndt-christian.mueller@med.uni-tuebingen.de [Department of Radiation Oncology, Eberhard Karls University, Tübingen (Germany); Eckert, Franziska; Paulsen, Frank; Zips, Daniel [Department of Radiation Oncology, Eberhard Karls University, Tübingen (Germany); Stenzl, Arnulf; Schilling, David [Department of Urology, Eberhard Karls University, Tübingen (Germany); Alber, Markus [Department of Oncology, Aarhus University, Aarhus (Denmark); Bares, Roland [Department of Nuclear Medicine and Clinical Molecular Imaging, Eberhard Karls University, Tübingen (Germany); Martus, Peter [Institute for Clinical Epidemiology and Applied Biometry, Eberhard Karls University, Tübingen (Germany); Weckermann, Dorothea [Department of Urology, Klinikum Augsburg, Augsburg (Germany); Belka, Claus; Ganswindt, Ute [Department of Radiation Oncology, Ludwig-Maximilians-University, Munich (Germany)

    2016-02-01

    Purpose: To assess the efficacy of individual sentinel node (SN)-guided pelvic intensity modulated radiation therapy (IMRT) by determining nodal clearance rate [(n expected nodal involvement − n observed regional recurrences)/n expected nodal involvement] in comparison with surgically staged patients. Methods and Materials: Data on 475 high-risk prostate cancer patients were examined. Sixty-one consecutive patients received pelvic SN-based IMRT (5 × 1.8 Gy/wk to 50.4 Gy [pelvic nodes + individual SN] and an integrated boost with 5 × 2.0 Gy/wk to 70.0 Gy to prostate + [base of] seminal vesicles) and neo-/adjuvant long-term androgen deprivation therapy; 414 patients after SN–pelvic lymph node dissection were used to calculate the expected nodal involvement rate for the radiation therapy sample. Biochemical control and overall survival were estimated for the SN-IMRT patients using the Kaplan-Meier method. The expected frequency of nodal involvement in the radiation therapy group was estimated by imputing frequencies of node-positive patients in the surgical sample to the pattern of Gleason, prostate-specific antigen, and T category in the radiation therapy sample. Results: After a median follow-up of 61 months, 5-year OS after SN-guided IMRT reached 84.4%. Biochemical control according to the Phoenix definition was 73.8%. The nodal clearance rate of SN-IMRT reached 94%. Retrospective follow-up evaluation is the main limitation. Conclusions: Radiation treatment of pelvic nodes individualized by inclusion of SNs is an effective regional treatment modality in high-risk prostate cancer patients. The pattern of relapse indicates that the SN-based target volume concept correctly covers individual pelvic nodes. Thus, this SN-based approach justifies further evaluation, including current dose-escalation strategies to the prostate in a larger prospective series.

  8. A novel conformal superficial high-dose-rate brachytherapy device for the treatment of nonmelanoma skin cancer and keloids.

    Science.gov (United States)

    Ferreira, Clara; Johnson, Daniel; Rasmussen, Karl; Leinweber, Clinton; Ahmad, Salahuddin; Jung, Jae Won

    To develop a novel conformal superficial brachytherapy (CSBT) device as a treatment option for the patient-specific radiation therapy of conditions including superficial lesions, postsurgical positive margins, Dupuytren's contractures, keloid scars, and complex anatomic sites (eyelids, nose, ears, etc.). A preliminary CSBT device prototype was designed, built, and tested using readily available radioactive seeds. Iodine-125 ((125)I) seeds were independently guided to the treatment surface to conform to the target. Treatment planning was performed via BrachyVision Planning System (BPS) and dose distributions measured with Gafchromic EBT3 film. Percent depth dose curves and profiles for Praseodymium-142 ((142)Pr), and Strontium-90/Yttrium-90 ((90)Sr-(90)Y) were also investigated as potential sources. Results achieved with (90)Sr-(90)Y and electron external beam radiation therapy were compared and Monte Carlo N-Particle eXtended 2.6 simulations of (142)Pr seeds were validated. BPS was able to predict clinical dose distributions for a multiple seeds matrix. Calculated and measured doses for the (125)I seed matrix were 500 cGy and 473.5 cGy at 5 mm depth, and 171.0 cGy and 201.0 cGy at 10 mm depth, respectively. Results of (90)Sr-(90)Y tests demonstrate a more conformal dose than electron EBRT (1.6 mm compared to 4.3 mm penumbra). Measured (142)Pr doses were 500 cGy at surface and 17.4 cGy at 5 mm depth. The CSBT device provides a highly conformal dose to small surface areas. Commercially available BPS can be used for treatment planning, and Monte Carlo simulation can be used for plans using beta-emitting sources and complex anatomies. Various radionuclides may be used in this device to suit prescription depths and treatment areas. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  9. Lung cancer death rates fall, helping drive decrease in overall cancer death rates

    Science.gov (United States)

    The Annual Report to the Nation on the Status of Cancer, covering the period 1975–2010, showed death rates for lung cancer, which accounts for more than one in four cancer deaths, dropping at a faster pace than in previous years.

  10. Magnetic Resonance Imaging (MRI) Markers for MRI-Guided High-Dose-Rate Brachytherapy: Novel Marker-Flange for Cervical Cancer and Marker Catheters for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schindel, Joshua; Muruganandham, Manickam [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Pigge, F. Christopher [Department of Chemistry, University of Iowa, Iowa City, Iowa (United States); Anderson, James [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Kim, Yusung, E-mail: yusung-kim@uiowa.edu [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States)

    2013-06-01

    Purpose: To present a novel marker-flange, addressing source-reconstruction uncertainties due to the artifacts of a titanium intracavitary applicator used for magnetic resonance imaging (MRI)-guided high-dose-rate (HDR) brachytherapy (BT); and to evaluate 7 different MRI marker agents used for interstitial prostate BT and intracavitary gynecologic HDR BT when treatment plans are guided by MRI. Methods and Materials: Seven MRI marker agents were analyzed: saline solution, Conray-60, copper sulfate (CuSO{sub 4}) (1.5 g/L), liquid vitamin E, fish oil, 1% agarose gel (1 g agarose powder per 100 mL distilled water), and a cobalt–chloride complex contrast (C4) (CoCl{sub 2}/glycine = 4:1). A plastic, ring-shaped marker-flange was designed and tested on both titanium and plastic applicators. Three separate phantoms were designed to test the marker-flange, interstitial catheters for prostate BT, and intracavitary catheters for gynecologic HDR BT. T1- and T2-weighted MRI were analyzed for all markers in each phantom and quantified as percentages compared with a 3% agarose gel background. The geometric accuracy of the MR signal for the marker-flange was measured using an MRI-CT fusion. Results: The CuSO{sub 4} and C4 markers on T1-weighted MRI and saline on T2-weighted MRI showed the highest signals. The marker-flange showed hyper-signals of >500% with CuSO{sub 4} and C4 on T1-weighted MRI and of >400% with saline on T2-weighted MRI on titanium applicators. On T1-weighted MRI, the MRI signal inaccuracies of marker-flanges were measured <2 mm, regardless of marker agents, and that of CuSO{sub 4} was 0.42 ± 0.14 mm. Conclusion: The use of interstitial/intracavitary markers for MRI-guided prostate/gynecologic BT was observed to be feasible, providing accurate source pathway reconstruction. The novel marker-flange can produce extremely intense, accurate signals, demonstrating its feasibility for gynecologic HDR BT.

  11. Cervical cancer screening cotesting with cytology and MRNA HPV E6/E7 yields high rates of CIN2+ lesions in young women.

    Science.gov (United States)

    Granados, Rosario; Tellez-Safina, Hilda; Solis, Isabel; Mateos, Francisco; Rodriguez-Barbero, Jose Maria; Aramburu, Jose Antonio; Huertas, Miguel Angel; Bajo, Paloma; Camarmo, Encarnacion; Corrales, Teresa; Medina, Pedro; Calvo, Beatriz; Martin, Esther; Anta, Laura; Zamora, Manuel; Alcaide, Teresa

    2017-12-01

    European guidelines recommend primary HPV testing for cervical cancer screening. However, the starting age remains to be defined, with an undecided window between 30 and 35 years. This pilot study compares the effectiveness of primary HPV testing to that of cytology for the detection of high-grade (CIN2+) lesions stratified by age. Cotesting with LBC cytology and APTIMA® HPV (AHPV) was performed in 5053 women aged 25-65 in an opportunistic screening program in Madrid. AHPV-positive cases were referred to colposcopy and genotyped for HPV16 and 18/45 (AHPV-GT). Results were analyzed stratified in four age groups. 454 cases (9.0%) were AHPV-positive. Women under 35 had a 30.2% CIN2+ rate, compared to 21.9% and 20.4% for women aged 35-44 or 45-54. There was a significant increase (P < .05) in the rate of CIN2+ in AHPV-GT-positive women when compared to that for other HPV types (AHPV-other), being 43.3% versus 15.7%. AHPV-GT-positive women under 35 had significantly higher rates of CIN2+ lesions than any other age-group. The sensitivity of cytology for cervical CIN2+ in APHV-positive women was 60.6%. All 4 carcinomas, including one AHPV-negative endometrial adenocarcinoma, had abnormal cytology. All cervical CIN2+ lesions biopsied were AHPV-positive. Aptima HPV shows a significantly higher sensitivity for cervical CIN2+ lesions than cytology alone. Unexpectedly, AHPV-positive women under 35 had the highest incidence of CIN2+ lesions, particularly when they are HPV16/18/45-positive. Reconsidering HPV primary screening before the recommended age of 35 is warranted. © 2017 Wiley Periodicals, Inc.

  12. The impact of body mass index on rectal dose in locally advanced cervical cancer treated with high-dose-rate brachytherapy.

    Science.gov (United States)

    Lim, Jihoon; Durbin-Johnson, Blythe; Valicenti, Richard; Mathai, Matthew; Stern, Robin L; Mayadev, Jyoti

    2013-01-01

    The impact of body mass index (BMI) on rectal dose in brachytherapy for cervical cancer is unknown. We assessed the association of BMI on rectal dose and lower gastrointestinal (GI) toxicity. Between 2007 and 2010, 51 patients with 97 brachytherapy planning images were reviewed. Volumetric measurements of the maximum percentage, mean percentage, dose to 2cc (D2cc), and dose to 1cc (D1cc) of the rectum, and the Internal Commission on Radiation Units and Measurement (ICRU) rectal point were recorded. Linear mixed effect models, analysis of variance, and regression analyses were used to determine the correlation between multiple observations or to detect a difference in the mean. The GI acute and late toxicity were prospectively recorded and retrospectively analyzed. The average BMI (kg/m(2)) was 27.7 with a range of 17.4-46.6. Among the patients, 8% were morbidly obese, 25% obese, 25% overweight, 40% normal weight, and 2% underweight. The mean D1cc, D2cc, mean rectal dose (%), maximum rectal dose (%), and ICRU rectum was 3.03 Gy, 2.78 Gy, 20%, 60%, and 2.99 Gy, respectively. On multivariate analysis, there was a significant decrease in the D1cc and D2cc rectal dose (p=0.016), ICRU rectal point dose (p=0.022), and mean rectal dose percentage (p=0.021) with an increase in BMI. There was, however, no statistically significant relationship between BMI and GI toxicity. Obesity decreases the rectal dose given in high-dose-rate brachytherapy for locally advanced cervical cancer because of an increase in fatty tissue in the recto-uterine space. There is no significant correlation between BMI and acute or late GI toxicity. Published by Elsevier Inc.

  13. Determination of Prognostic Factors for Vaginal Mucosal Toxicity Associated With Intravaginal High-Dose Rate Brachytherapy in Patients With Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bahng, Agnes Y.; Dagan, Avner [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Bruner, Deborah W. [University of Pennsylvania School of Nursing, Philadelphia, PA (United States); Lin, Lilie L., E-mail: lin@xrt.upenn.edu [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States)

    2012-02-01

    Purpose: The objective of this study was to determine the patient- and treatment-related prognostic factors associated with vaginal toxicity in patients who received intravaginal high dose rate (HDR) brachytherapy alone as adjuvant treatment for endometrial cancer. Secondary goals of this study included a quantitative assessment of optimal dilator use frequency and a crude assessment of clinical predictors for compliant dilator use. Methods and Materials: We retrospectively reviewed the charts of 100 patients with histologically confirmed endometrial cancer who underwent total hysterectomy and bilateral salpingo-oophorectomy with or without lymph node dissection and adjuvant intravaginal brachytherapy between 1995 and 2009 at the Hospital of University of Pennsylvania. The most common treatment regimen used was 21 Gy in three fractions (71 patients). Symptoms of vaginal mucosal toxicity were taken from the history and physical exams noted in the patients' charts and were graded according to the Common Toxicity Criteria for Adverse Events v. 4.02. Results: The incidence of Grade 1 or asymptomatic vaginal toxicity was 33% and Grade 2-3 or symptomatic vaginal toxicity was 14%. Multivariate analysis of age, active length, and dilator use two to three times a week revealed odds ratios of 0.93 (p = 0.013), 3.96 (p = 0.008), and 0.17 (p = 0.032) respectively. Conclusion: Increasing age, vaginal dilator use of at least two to three times a week, and shorter active length were found to be significantly associated with a decreased risk of vaginal stenosis. Future prospective studies are necessary to validate our findings.

  14. High-Dose-Rate Brachytherapy and External-Beam Radiotherapy for Hormone-Naieve Low- and Intermediate-Risk Prostate Cancer: A 7-Year Experience

    Energy Technology Data Exchange (ETDEWEB)

    Aluwini, Shafak, E-mail: s.aluwini@erasmusmc.nl [Department of Radiation Oncology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Rooij, Peter H. van [Department of Radiation Oncology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Kirkels, Wim J. [Department of Urology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Jansen, Peter P.; Praag, John O. [Department of Radiation Oncology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Bangma, Chris H. [Department of Urology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Kolkman-Deurloo, Inger-Karine K. [Department of Radiation Oncology, Erasmus MC, Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-08-01

    Purpose: To report clinical outcomes and early and late complications in 264 hormone-naieve patients with low- and intermediate-risk prostate cancer treated with high-dose-rate brachytherapy (HDR-BT) in combination with external-beam radiotherapy (EBRT). Methods and Materials: Between February 2000 and July 2007, 264 patients underwent HDR-BT in combination with EBRT as a treatment for their low- to intermediate-risk prostate cancer. The HDR-BT was performed using ultrasound-based implantation. The total HDR-BT dose was 18 Gy in 3 fractions within 24 h, with a 6-h minimum interval. The EBRT started 2 weeks after HDR-BT and was delivered in 25 fractions of 1.8 Gy to 45 Gy within 5 weeks. Results: After a mean follow-up of 74.5 months, 4 patients (1.5%) showed prostate-specific antigen progression according to the American Society for Radiation Oncology definition and 8 patients (3%) according to the Phoenix definition. A biopsy-proven local recurrence was registered in 1 patient (0.4%), and clinical progression (bone metastases) was documented in 2 patients (0.7%). Seven-year actuarial freedom from biochemical failure was 97%, and 7-year disease-specific survival and overall survival were 100% and 91%, respectively. Toxicities were comparable to other series. Conclusions: Treatment with interstitial HDR-BT plus EBRT shows a low incidence of late complications and a favorable oncologic outcome after 7 years follow-up.

  15. High-dose-rate brachytherapy and external-beam radiotherapy for hormone-naïve low- and intermediate-risk prostate cancer: a 7-year experience.

    Science.gov (United States)

    Aluwini, Shafak; van Rooij, Peter H; Kirkels, Wim J; Jansen, Peter P; Praag, John O; Bangma, Chris H; Kolkman-Deurloo, Inger-Karine K

    2012-08-01

    To report clinical outcomes and early and late complications in 264 hormone-naïve patients with low- and intermediate-risk prostate cancer treated with high-dose-rate brachytherapy (HDR-BT) in combination with external-beam radiotherapy (EBRT). Between February 2000 and July 2007, 264 patients underwent HDR-BT in combination with EBRT as a treatment for their low- to intermediate-risk prostate cancer. The HDR-BT was performed using ultrasound-based implantation. The total HDR-BT dose was 18 Gy in 3 fractions within 24 h, with a 6-h minimum interval. The EBRT started 2 weeks after HDR-BT and was delivered in 25 fractions of 1.8 Gy to 45 Gy within 5 weeks. After a mean follow-up of 74.5 months, 4 patients (1.5%) showed prostate-specific antigen progression according to the American Society for Radiation Oncology definition and 8 patients (3%) according to the Phoenix definition. A biopsy-proven local recurrence was registered in 1 patient (0.4%), and clinical progression (bone metastases) was documented in 2 patients (0.7%). Seven-year actuarial freedom from biochemical failure was 97%, and 7-year disease-specific survival and overall survival were 100% and 91%, respectively. Toxicities were comparable to other series. Treatment with interstitial HDR-BT plus EBRT shows a low incidence of late complications and a favorable oncologic outcome after 7 years follow-up. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Outcomes of Gleason Score ≤ 8 among high risk prostate cancer treated with 125I low dose rate brachytherapy based multimodal therapy.

    Science.gov (United States)

    Park, Dong Soo; Gong, In Hyuck; Choi, Don Kyung; Hwang, Jin Ho; Shin, Hyun Soo; Oh, Jong Jin

    2013-09-01

    To investigate the role of low dose rate (LDR) brachytherapy-based multimodal therapy in high-risk prostate cancer (PCa) and analyze its optimal indications. We reviewed the records of 50 high-risk PCa patients [clinical stage ≥ T2c, prostate-specific antigen (PSA) >20 ng/mL, or biopsy Gleason score ≥ 8] who had undergone 125I LDR brachytherapy since April 2007. We excluded those with a follow-up period Gleason score ≥ 9 and Gleason score ≤ 8. The mean initial PSA was 22.1 ng/mL, and mean D90 was 244.3 Gy. During a median follow- up of 39.2 months, biochemical control was obtained in 72% (36/50) of the total patients; The estimated 3-year BCR-free survival was 92% for the patients with biopsy Gleason scores ≤ 8, and 40% for those with Gleason scores ≥ 9 (pGleason score ≥ 9 was observed to be significantly associated with BCR (p=0.021). Acute and late grade ≥ 3 toxicities were observed in 20% (10/50) and 36% (18/50) patients, respectively. Our results showed that 125I LDR brachytherapy-based multimodal therapy in high-risk PCa produced encouraging relatively long-term results among the Asian population, especially in patients with Gleason score ≤ 8. Despite small number of subjects, biopsy Gleason score ≥ 9 was a significant predictor of BCR among high risk PCa patients after brachytherapy.

  17. High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

    Energy Technology Data Exchange (ETDEWEB)

    Ghilezan, Michel, E-mail: mghilezan@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States); Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States)

    2012-07-01

    Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy Multiplication-Sign 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy Multiplication-Sign 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of {<=}12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable

  18. Rectal Bleeding After High-Dose-Rate Brachytherapy Combined With Hypofractionated External-Beam Radiotherapy for Localized Prostate Cancer: The Relationship Between Dose-Volume Histogram Parameters and the Occurrence Rate

    Energy Technology Data Exchange (ETDEWEB)

    Okamoto, Masahiko, E-mail: masaoka@showa.gunma-u.ac.jp [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan); Ishikawa, Hitoshi; Ebara, Takeshi; Kato, Hiroyuki; Tamaki, Tomoaki [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan); Akimoto, Tetsuo [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Ito, Kazuto; Miyakubo, Mai; Yamamoto, Takumi; Suzuki, Kazuhiro [Department of Urology, Gunma University Graduate School of Medicine, Gunma (Japan); Takahashi, Takeo; Nakano, Takashi [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan)

    2012-02-01

    Purpose: To determine the predictive risk factors for Grade 2 or worse rectal bleeding after high-dose-rate brachytherapy (HDR-BT) combined with hypofractionated external-beam radiotherapy (EBRT) for prostate cancer using dose-volume histogram analysis. Methods and Materials: The records of 216 patients treated with HDR-BT combined with EBRT were analyzed. The treatment protocols for HDR-BT were 5 Gy Multiplication-Sign five times in 3 days or 7 Gy Multiplication-Sign three, 10.5 Gy Multiplication-Sign two, or 9 Gy Multiplication-Sign two in 2 days. The EBRT doses ranged from 45 to 51 Gy with a fractional dose of 3 Gy. Results: In 20 patients Grade 2 or worse rectal bleeding developed, and the cumulative incidence rate was 9% at 5 years. By converting the HDR-BT and EBRT radiation doses into biologic effective doses (BED), the BED{sub 3} at rectal volumes of 5% and 10% in the patients who experienced bleeding were significantly higher than those in the remaining 196 patients. Univariate analysis showed that a higher rectal BED{sub 3-5%} and the use of fewer needles in brachytherapy were correlated with the incidence of bleeding, but BED{sub 3-5%} was found to be the only significant factor on multivariate analysis. Conclusions: The radiation dose delivered to small rectal lesions as 5% is important for predicting Grade 2 or worse rectal bleeding after HDR-BT combined with EBRT for prostate cancer.

  19. 3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: A cross-sectional quality-of-life survey

    Energy Technology Data Exchange (ETDEWEB)

    Vordermark, Dirk [Univ. of Wuerzburg (DE). Dept. of Radiation Oncology] (and others)

    2006-09-15

    The effects of two modalities of dose-escalated radiotherapy on health-related quality of life (HRQOL) were compared. Forty-one consecutive patients were treated with a 3-D conformal (3-DC) boost to 74 Gy, and 43 with high-dose rate (HDR) brachytherapy boost (2x9 Gy), following 3-D conformal treatment to 46 Gy. Median age was 70 years in both groups, median initial PSA was 7.9 {mu}g/l in 3-DC boost patients and 8.1 {mu}g/l in HDR boost patients. Stage was 7 in 52% and 47%, respectively. HRQOL was assessed cross-sectionally using EORTC QLQ-C30 and organ-specific PR25 modules 3-32 (median 19) and 4-25 (median 14) months after treatment, respectively. Questionnaires were completed by 93% and 97% of patients, respectively. Diarrhea and insomnia scores were significantly increased in both groups. In the PR25 module, scores of 3-DC boost and HDR boost patients for urinary, bowel and treatment-related symptoms were similar. Among responders, 34% of 3-DC boost patients and 86% of HDR boost patients had severe erectile problems. Dose escalation in prostate cancer by either 3-DC boost to 74 Gy or HDR brachytherapy boost appears to result in similar HRQOL profiles.

  20. Image-guided high-dose-rate interstitial brachytherapy – a valuable salvage treatment approach for loco-regional recurrence of papillary thyroid cancer

    Directory of Open Access Journals (Sweden)

    Ning Wu

    2016-04-01

    Full Text Available Purpose : To report the treatment effect of image-guided high-dose-rate (HDR interstitial brachytherapy for refractory recurrence of papillary thyroid cancer (PTC. Case report: This 66-year-old female presented with recurrence 5 years after thyroidectomy for PTC. Despite external irradiation and radioactive 131I, the lesion expanded as 3.7 × 3.0 × 2.3 cm3 and 2.0 × 1.5 × 1.5 cm3. The locoregional recurrent tumor was treated with image-guided HDR interstitial brachytherapy. The total dose of 30 Gy in 6 fractions were delivered on the whole recurrent tumor. Results: Removal of the recurrent tumor was securely achieved by HDR interstitial brachytherapy guided with ultrasound, computed tomography (CT, and magnetic resonance imaging (MRI scanning. The refractory tumor in the patients healed uneventfully after HDR interstitial brachytherapy without recurrence during the 14 months of follow-up. Conclusions : The image-guided HDR interstitial brachytherapy may be a valuable salvage treatment approach for refractory recurrence of PTC.

  1. HPV-Associated Oropharyngeal Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Related Links Stay Informed Rates by Race and Ethnicity for Other Kinds of Cancer All Cancers Combined ... HPV-Associated Oropharyngeal Cancer Rates by Race and Ethnicity Language: English (US) Español (Spanish) Recommend on ...

  2. Favorable Preliminary Outcomes for Men With Low- and Intermediate-risk Prostate Cancer Treated With 19-Gy Single-fraction High-dose-rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Krauss, Daniel J., E-mail: dkrauss@beaumont.edu [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Ye, Hong [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro A. [21st Century Oncology, Farmington Hills, Michigan (United States); Mitchell, Beth; Sebastian, Evelyn; Limbacher, Amy; Gustafson, Gary S. [Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2017-01-01

    Purpose: To report the toxicity and preliminary clinical outcomes of a prospective trial evaluating 19-Gy, single-fraction high-dose-rate (HDR) brachytherapy for men with low- and intermediate-risk prostate cancer. Methods and Materials: A total of 63 patients were treated according to an institutional review board-approved prospective study of single-fraction HDR brachytherapy. Eligible patients had tumor stage ≤T2a, prostate-specific antigen level ≤15 ng/mL, and Gleason score ≤7. Patients with a prostate gland volume >50 cm{sup 3} and baseline American Urologic Association symptom score >12 were ineligible. Patients underwent transrectal ultrasound-guided transperineal implantation of the prostate, followed by single-fraction HDR brachytherapy. Treatment was delivered using {sup 192}Ir to a dose of 19 Gy prescribed to the prostate, with no additional margin applied. Results: Of the 63 patients, 58 had data available for analysis. Five patients had withdrawn consent during the follow-up period. The median follow-up period was 2.9 years (range 0.3-5.2). The median age was 61.4 years. The median gland volume at treatment was 34.8 cm{sup 3}. Of the 58 patients, 91% had T1 disease, 71% had Gleason score ≤6 (29% with Gleason score 7), and the median pretreatment prostate-specific antigen level was 5.1 ng/mL. The acute and chronic grade 2 genitourinary toxicity incidence was 12.1% and 10.3%, respectively. No grade 3 urinary toxicity occurred. No patients experienced acute rectal toxicity grade ≥2, and 2 experienced grade ≥2 chronic gastrointestinal toxicity. Three patients experienced biochemical failure, yielding a 3-year cumulative incidence estimate of 6.8%. Conclusions: Single-fraction HDR brachytherapy is well-tolerated, with favorable preliminary biochemical and clinical disease control rates.

  3. Postoperative radiotherapy appeared to improve the disease free survival rate of patients with extrahepatic bile duct cancer at high risk of loco-regional recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Kim, Jin Hee; Kim, Yong Hoon [Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Byun, Sang Jun [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    To investigate the outcomes of postoperative radiotherapy (RT), in patients with extrahepatic bile duct (EHBD) cancer by comparing the survival rate between patients undergoing surgery alone or surgery plus postoperative RT, and to identify the prognostic factors affecting survival. Between 2000 and 2013, 52 patients with EHBD cancer underwent surgical resection. Of these, 33 patients did not receive postoperative RT (group I), and 19 patients did (group II). R1 resection was significantly more frequent in group II. The median radiation dose was 5,040 cGy. The 3-year overall survival (OS) rate for group I and group II was 38% and 56%, respectively (p = 0.274). The 3-year disease free survival (DFS) rate for group I and group II was 20% and 31%, respectively (p = 0.049), and the 3-year loco-regional recurrence free survival (LRFS) rates were 19% and 58%, respectively (p = 0.002). Multivariate analyses showed that postoperative RT and lymphovascular invasion were independent prognostic factors for DFS and LRFS. Overall, 42 patients (80%) experienced treatment failure. Distant metastasis was the predominant pattern of failure in group II. Postoperative RT after surgical resection appeared to improve the loco-regional control and DFS rate. More effort is needed to reduce distant metastasis, the major pattern of failure, in patients who receive postoperative RT.

  4. Postoperative radiotherapy appeared to improve the disease free survival rate of patients with extrahepatic bile duct cancer at high risk of loco-regional recurrence.

    Science.gov (United States)

    Kim, Mi Young; Kim, Jin Hee; Kim, Yonghoon; Byun, Sang Jun

    2016-12-01

    To investigate the outcomes of postoperative radiotherapy (RT), in patients with extrahepatic bile duct (EHBD) cancer by comparing the survival rate between patients undergoing surgery alone or surgery plus postoperative RT, and to identify the prognostic factors affecting survival. Between 2000 and 2013, 52 patients with EHBD cancer underwent surgical resection. Of these, 33 patients did not receive postoperative RT (group I), and 19 patients did (group II). R1 resection was significantly more frequent in group II. The median radiation dose was 5,040 cGy. The 3-year overall survival (OS) rate for group I and group II was 38% and 56%, respectively (p = 0.274). The 3-year disease free survival (DFS) rate for group I and group II was 20% and 31%, respectively (p = 0.049), and the 3-year loco-regional recurrence free survival (LRFS) rates were 19% and 58%, respectively (p = 0.002). Multivariate analyses showed that postoperative RT and lymphovascular invasion were independent prognostic factors for DFS and LRFS. Overall, 42 patients (80%) experienced treatment failure. Distant metastasis was the predominant pattern of failure in group II. Postoperative RT after surgical resection appeared to improve the loco-regional control and DFS rate. More effort is needed to reduce distant metastasis, the major pattern of failure, in patients who receive postoperative RT.

  5. Commissioning of applicator-guided stereotactic body radiation therapy boost with high-dose-rate brachytherapy for advanced cervical cancer using radiochromic film dosimetry.

    Science.gov (United States)

    Aldelaijan, Saad; Wadi-Ramahi, Shada; Nobah, Ahmad; Moftah, Belal; Devic, Slobodan; Jastaniyah, Noha

    To describe an EBT3 GAFCHROMIC film-based dosimetry method to be used in commissioning of a combined HDR brachytherapy (HDRB) and stereotactic body radiation therapy (SBRT) boost for treatment of advanced cervical cancer involving extensive residual disease after external beam treatment. A cube phantom was designed to firmly fit an intrauterine tandem applicator and EBT3 radiochromic film pieces. A high-risk clinical target volume (CTVHR, Total) was contoured with an extended arm at one side. The HDRB treatment was planned to cover the proximal CTVHR, Total with 7 Gy and the distal volume, referred to as CTVHR, Distal, was planned by SBRT for dose augmentation. After HDRB treatment delivery, SBRT treatment was delivered within 1 hour by image guidance using the applicator geometry. Intentional 1D and 2D misalignments were introduced to evaluate the effect on target volumes. In addition, effect of film reirradiation at different time gaps and dose levels was evaluated. Film dosimetric accuracy, with up to 2 hours gap between irradiations, was shown to be unaffected. A 2%/2 mm gamma analysis between measured and planned doses showed agreement of >99%. Misalignments of more than 2 mm between applicator and SBRT isocenter resulted in suboptimal dose-volume histogram affecting mostly D98% and D90% of CTVHR, Distal. Visualizing how target dose-volume metrics are affected by minor misalignments between SBRT and HDRB dose gradients, in light of achievable phantom-based experimental quality assurance level, encourages the clinical applicability of this technique. Radiochromic film was shown to be a valuable tool to commission procedures combining two different treatment planning systems and modalities with varying dose rates and energy ranges. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  6. Tandem-ring dwell time ratio in Nigeria: dose comparisons of two loading patterns in standard high-dose-rate brachytherapy planning for cervical cancer.

    Science.gov (United States)

    Ibhade, Obed Rachel; Oyeyemi, Oyekunle Emmanuel; Idayat, Akinlade Bidemi; Atara I, Ntekim

    2015-04-01

    In high-dose-rate (HDR) brachytherapy (BT), the source dwell times and dwell positions are essential treatment planning parameters. An optimal choice of these factors is fundamental to obtain the desired target coverage with the lowest achievable dose to the organs at risk (OARs). This study evaluates relevant dose parameters in cervix brachytherapy in order to assess existing tandem-ring dwell time ratio used at the first HDR BT center in Nigeria, and compare it with an alternative source loading pattern. At the Radiotherapy Department, University College Hospital (UCH), Ibadan, Nigeria, a total of 370 standard treatment plans in two alternative sets were generated with HDR basic 2.6 software for one hundred and eighty five cervical cancer patients. The initial 185 individual plans were created for clinical treatment using the tandem-ring dwell time ratio of 1 : 1. Modifying the initial applicator loading ratio, the second set of plans with related dose data were also obtained for study purposes only. Total reference air kerma (TRAK), total time index (TTI), ICRU volume, treatment time, point B dose, ICRU bladder dose, and rectal points dose were evaluated for both sets of plans. The means of all evaluated dose parameters decreased when the existing tandem-ring dwell time ratio (1 : 1) was modified to other dwell weightings (1 : 1 - 3 : 1). These reductions were 13.43% (ICRU volume), 9.83% (rectal dose), 6.68% (point B dose), 6.08% (treatment time), 5.90% (TRAK), 5.88% (TTI), and 1.08% (bladder dose). Correspondingly, coefficients of variation changed by -7.98%, -5.02%, -5.23%, -4.20%, -3.93%, 8.65%, and 3.96% from the existing pattern to the alternative one. Tandem-ring dwell time ratio has significant influence on dosimetric parameters. This study has indicated the need to modify the existing planning approach at UCH.

  7. Reirradiation of head and neck cancer with high-dose-rate brachytherapy: a customizable intraluminal solution for postoperative treatment of tracheal mucosa recurrence.

    Science.gov (United States)

    Doyle, Laura A; Harrison, Amy S; Cognetti, David; Xiao, Ying; Yu, Yan; Liu, Haisong; Ahn, Peter H; Anné, P Rani; Showalter, Timothy N

    2011-01-01

    Delivering adequate dose to tracheal mucosa recurrence after multiple prior courses of surgery and radiation presented a challenge for radiation delivery. Tumor bed location and size, combined with previous doses to surrounding areas, complicated the use of external beam therapy with either photons or electrons. High-dose-rate (HDR) brachytherapy was explored to provide sufficient dose coverage. A 45-year-old gentleman presented with recurrent head and neck cancer. After undergoing additional excision of gross tumor in the tracheal region, radiation was recommended to improve local control. The region of residual tumor was confined to a small superficial lesion at the posterior-superior aspect of the trachea, involving mucosa located along the bend of the trachea, immediately deep to the stoma. External beam treatment was discussed but was not recommended based on recurrence location in the prior radiation field and patient's flexed chin position. HDR technique with a custom applicator was preferred. A three-dimensional HDR plan based on computed tomography used a single catheter optimized to cover gross tumor volume as delineated by physician. Prescribed dose was 5 Gy/fraction for six fractions (two fractions/wk). The applicator position was verified daily with computed tomography and physician setup approval before treatment. The patient was positioned on a wing board to allow access to the stoma. HDR brachytherapy was well tolerated. Intraluminal HDR brachytherapy is a viable option for providing dose to region inside tracheal stoma. Advantages over photon and electron beam therapy include reduced dose to surrounding tissues previously irradiated, skin dose, and reproducibility of treatment delivery. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. High Resolution, High Frame Rate Video Technology

    Science.gov (United States)

    1990-01-01

    Papers and working group summaries presented at the High Resolution, High Frame Rate Video (HHV) Workshop are compiled. HHV system is intended for future use on the Space Shuttle and Space Station Freedom. The Workshop was held for the dual purpose of: (1) allowing potential scientific users to assess the utility of the proposed system for monitoring microgravity science experiments; and (2) letting technical experts from industry recommend improvements to the proposed near-term HHV system. The following topics are covered: (1) State of the art in the video system performance; (2) Development plan for the HHV system; (3) Advanced technology for image gathering, coding, and processing; (4) Data compression applied to HHV; (5) Data transmission networks; and (6) Results of the users' requirements survey conducted by NASA.

  9. High rate of mutations in the BRCA1, BRCA2, CHEK2, NBN, and BLM genes in Russian ovarian cancer patients

    Directory of Open Access Journals (Sweden)

    Ye. I. Bateneva

    2014-01-01

    Full Text Available Background. The early diagnosis of ovarian cancer (OC is an important problem in modern gynecological oncology due to significant detection rates for late-stage tumors. Intensive screening of patients from high-risk groups that include OC predisposition gene mutation carriers is indicated.Subjects and methods. An unselected group of 202 patients with OC and two control groups of blood donors: 591 healthy females; 1197 persons (including 591 females, 606 males were examined. Patients and healthy individuals who identified themselves as ethnic Russians and residents of the Russian Federation participated in the study. Whole peripheral blood samples were collected at the Clinical Subdivisions of the N.N. Blokhin Russian Cancer Research Center and at the Department of Transfusiology of the Acad. B.V. Petrovsky Russian Research Center of Surgery in 2012–2013. Informed consent was obtained from all the participants. DNA was extracted using a Prep-GS-Genetics reagent kit. Real-time polymerase chain reaction genotyping assay was carried out by melting-curve analysis employing an BRCA SNP genotyping kit(BRCA1 and BRCA2 gene mutations and original oligonucleotides (CHEK2, NBN, and BLM gene mutations. Thirteen population-specific mutations, including 7 (185delAG, 4153delA, 5382insC, 3819delGTAAA, 3875delGTCT, 300T>G, and 2080delA in the BRCA1 gene, 1 (6174delT in the BRCA2 gene, 3 (1100delC, IVS2+1G>A, and 470T>C in the CHEK2 gene, 1 (657delACAAA in the NBN gene, and 1 (1642C>T in the BLM gene, were genotyped. Polymerase chain reaction was performed using a DTprime real-time detection thermal cycler.Results and discussion. BRCA1 and BRCA2 gene mutations were detected in 46 (22.8 % patients with OC; the prevailing mutation in the BRCA1 gene was 5382insC (58.7 %. OC was diagnosed in 32.6 % of the patients aged 51 years or older. The rate of moderate-penetrance mutations (1100delC and IVS2+1G>A in the CHEK2 gene, 657del5 in the NBN gene, and 1642

  10. Comparison of 2D and 3D Imaging and Treatment Planning for Postoperative Vaginal Apex High-Dose Rate Brachytherapy for Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Russo, James K. [Department of Radiation Oncology, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Armeson, Kent E. [Division of Biostatistics and Epidemiology, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina (United States); Richardson, Susan, E-mail: srichardson@radonc.wustl.edu [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2012-05-01

    Purpose: To evaluate bladder and rectal doses using two-dimensional (2D) and 3D treatment planning for vaginal cuff high-dose rate (HDR) in endometrial cancer. Methods and Materials: Ninety-one consecutive patients treated between 2000 and 2007 were evaluated. Seventy-one and 20 patients underwent 2D and 3D planning, respectively. Each patient received six fractions prescribed at 0.5 cm to the superior 3 cm of the vagina. International Commission on Radiation Units and Measurements (ICRU) doses were calculated for 2D patients. Maximum and 2-cc doses were calculated for 3D patients. Organ doses were normalized to prescription dose. Results: Bladder maximum doses were 178% of ICRU doses (p < 0.0001). Two-cubic centimeter doses were no different than ICRU doses (p = 0.22). Two-cubic centimeter doses were 59% of maximum doses (p < 0.0001). Rectal maximum doses were 137% of ICRU doses (p < 0.0001). Two-cubic centimeter doses were 87% of ICRU doses (p < 0.0001). Two-cubic centimeter doses were 64% of maximum doses (p < 0.0001). Using the first 1, 2, 3, 4 or 5 fractions, we predicted the final bladder dose to within 10% for 44%, 59%, 83%, 82%, and 89% of patients by using the ICRU dose, and for 45%, 55%, 80%, 85%, and 85% of patients by using the maximum dose, and for 37%, 68%, 79%, 79%, and 84% of patients by using the 2-cc dose. Using the first 1, 2, 3, 4 or 5 fractions, we predicted the final rectal dose to within 10% for 100%, 100%, 100%, 100%, and 100% of patients by using the ICRU dose, and for 60%, 65%, 70%, 75%, and 75% of patients by using the maximum dose, and for 68%, 95%, 84%, 84%, and 84% of patients by using the 2-cc dose. Conclusions: Doses to organs at risk vary depending on the calculation method. In some cases, final dose accuracy appears to plateau after the third fraction, indicating that simulation and planning may not be necessary in all fractions. A clinically relevant level of accuracy should be determined and further research conducted to address

  11. SU-E-T-579: Impact of Cylinder Size in High-Dose Rate Brachytherapy (HDRBT) for Primary Cancer in the Vagina

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, H; Gopalakrishnan, M; Lee, P; Sathiaseelan, V [Department of Radiation Oncology, Northwestern Memorial Hospital, Chicago, IL (United States)

    2014-06-01

    Purpose: To evaluate the dosimetric impact of cylinder size in high dose rate Brachytherapy for primary vaginal cancers. Methods: Patients treated with HDR vaginal vault radiation in a list of cylinders ranging from 2.5 to 4 cm in diameter at 0.5 cm increment were analyzed. All patients’ doses were prescribed at the 0.5 cm from the vaginal surface with different treatment lengths. A series of reference points were created to optimize the dose distribution. The fraction dose was 5.5 Gy, the treatment was repeated for 4 times in two weeks. A cylinder volume was contoured in each case according to the prescribed treatment length, and then expanded to 5 mm to get a volume Cylinder-5mm-exp. A volume of PTV-Eval was obtained by subtracting the cylinder volume from the Cylinder-5mm-exp. The shell volume, PTV-Eval serves as the target volume for dosimetric evaluation. Results: DVH curves and average doses of PTV-Eval were obtained. Our results indicated that the DVH curves shifted toward higher dose side when larger cylinder was used instead of smaller ones. When 3.0 cm cylinder was used instead of 2.5 cm, for 3.0 cm treatment length, the average dose only increased 1%, from 790 to 799 cGy. However, the average doses for 3.5 and 4 cm cylinders respectively are 932 and 1137 cGy at the same treatment length. For 5.0 cm treatment length, the average dose is 741 cGy for 2.5 cm cylinder, and 859 cGy for 3 cm cylinder. Conclusion: Our data analysis suggests that for the vaginal intracavitary HDRBT, the average dose is at least 35% larger than the prescribed dose in the studied cases; the size of the cylinder will impact the dose delivered to the target volume. The cylinder with bigger diameter tends to deliver larger average dose to the PTV-Eval.

  12. A comparison of the biological effects of 125I seeds continuous low-dose-rate radiation and 60Co high-dose-rate gamma radiation on non-small cell lung cancer cells.

    Directory of Open Access Journals (Sweden)

    Zhongmin Wang

    Full Text Available To compare the biological effects of 125I seeds continuous low-dose-rate (CLDR radiation and 60Co γ-ray high-dose-rate (HDR radiation on non-small cell lung cancer (NSCLC cells.A549, H1299 and BEAS-2B cells were exposed to 125I seeds CLDR radiation or 60Co γ-ray HDR radiation. The survival fraction was determined using a colony-forming assay. The cell cycle progression and apoptosis were detected by flow cytometry (FCM. The expression of the apoptosis-related proteins caspase-3, cleaved-caspase-3, PARP, cleaved-PARP, BAX and Bcl-2 were detected by western blot assay.After irradiation with 125I seeds CLDR radiation, there was a lower survival fraction, more pronounced cell cycle arrest (G1 arrest and G2/M arrest in A549 and H1299 cells, respectively and a higher apoptotic ratio for A549 and H1299 cells than after 60Co γ-ray HDR radiation. Moreover, western blot assays revealed that 125I seeds CLDR radiation remarkably up-regulated the expression of Bax, cleaved-caspase-3 and cleaved-PARP proteins and down-regulated the expression of Bcl-2 proteins in A549 and H1299 cells compared with 60Co γ-ray HDR radiation. However, there was little change in the apoptotic ratio and expression of apoptosis-related proteins in normal BEAS-2B cells receiving the same treatment.125I seeds CLDR radiation led to remarkable growth inhibition of A549 and H1299 cells compared with 60Co HDR γ-ray radiation; A549 cells were the most sensitive to radiation, followed by H1299 cells. In contrast, normal BEAS-2B cells were relatively radio-resistant. The imbalance of the Bcl-2/Bax ratio and the activation of caspase-3 and PARP proteins might play a key role in the anti-proliferative effects induced by 125I seeds CLDR radiation, although other possibilities have not been excluded and will be investigated in future studies.

  13. Methodological choices affect cancer incidence rates: a cohort study

    OpenAIRE

    Brooke, Hannah L.; Talb?ck, Mats; Feychting, Maria; Ljung, Rickard

    2017-01-01

    Background Incidence rates are fundamental to epidemiology, but their magnitude and interpretation depend on methodological choices. We aimed to examine the extent to which the definition of the study population affects cancer incidence rates. Methods All primary cancer diagnoses in Sweden between 1958 and 2010 were identified from the national Cancer Register. Age-standardized and age-specific incidence rates of 29 cancer subtypes between 2000 and 2010 were calculated using four definitions ...

  14. PRESSING MORTALITY RATE THROUGH SCREENING oral cancer

    Directory of Open Access Journals (Sweden)

    L. K. Widnyani Wulan Laksmi

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Based on World Health Organization (WHO data, oral cancer is one of malignancy with the highest mortality. In USA, there are more than 30.000 new cases every year. We can find many risk factors of oral cancer in our daily living. Moreover, it’s easy to find the main risk factors in our society, they are smoking, alcohol consumption, tobacco consumtion, viral infection, and bad oral hygiene. For the early stadium, Five-years survival rate is about 82% and 61% for all stadium. But, more than 50% of oral cancer has been distributed (metastatic regionally and also into the other organ far away from the oral itself when it’s detected. It will decrease 5-years survival rate to be less than 50%. So that, it’s really important to detect the oral cancer at the earlier stadium. Screening is the way to find the earlier stadium. Screening is done by some methods, start from the anamnesis, physical examination, toluidine blue staining, endoscopy, cytology, telomerase examination, and also PET-scan if it’s possible (because of the financial reasons. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  15. Autism's 'Worryingly' High Suicide Rates Spur Conference

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_165946.html Autism's 'Worryingly' High Suicide Rates Spur Conference Signs of ... News) -- High rates of suicide among people with autism are drawing specialists to a conference this week ...

  16. Methodological choices affect cancer incidence rates: a cohort study.

    Science.gov (United States)

    Brooke, Hannah L; Talbäck, Mats; Feychting, Maria; Ljung, Rickard

    2017-01-19

    Incidence rates are fundamental to epidemiology, but their magnitude and interpretation depend on methodological choices. We aimed to examine the extent to which the definition of the study population affects cancer incidence rates. All primary cancer diagnoses in Sweden between 1958 and 2010 were identified from the national Cancer Register. Age-standardized and age-specific incidence rates of 29 cancer subtypes between 2000 and 2010 were calculated using four definitions of the study population: persons resident in Sweden 1) based on general population statistics; 2) with no previous subtype-specific cancer diagnosis; 3) with no previous cancer diagnosis except non-melanoma skin cancer; and 4) with no previous cancer diagnosis of any type. We calculated absolute and relative differences between methods. Age-standardized incidence rates calculated using general population statistics ranged from 6% lower (prostate cancer, incidence rate difference: -13.5/100,000 person-years) to 8% higher (breast cancer in women, incidence rate difference: 10.5/100,000 person-years) than incidence rates based on individuals with no previous subtype-specific cancer diagnosis. Age-standardized incidence rates in persons with no previous cancer of any type were up to 10% lower (bladder cancer in women) than rates in those with no previous subtype-specific cancer diagnosis; however, absolute differences were cancer subtypes. For some cancer subtypes incidence rates vary depending on the definition of the study population. For these subtypes, standardized incidence ratios calculated using general population statistics could be misleading. Moreover, etiological arguments should be used to inform methodological choices during study design.

  17. High bit rate BPSK receiver

    Science.gov (United States)

    Osorio-Marti, J. A.; Sieiro, J. J.; Lopez-Villegas, J. M.

    2005-06-01

    This work presents a simple differentially BPSK receiver front-end using a novel schema without the need of an explicit carrier recovery system. The main principle of operation is the conversion of the incoming BPSK signal into an ASK signal having the same modulation pattern. Two versions of the system have been designed. One is intended to work at the 433.92 MHz ISM band and the other at 2 GHz frequency band. Accordingly, two prototypes of the system core, the BPSK to ASK converter circuit, have been implemented and tested. First a hybrid version for the low frequency operation and, second a multi chip module (MCM) for the 2 GHz frequency band. The system performance has been evaluated using Agilent Technologies Advanced Design System (ADS) platform. The ability to jointly perform system, circuit and EM simulations and co-simulations is the main advantage of this design tool. Obtained results indicate that modulation rates up to 20 Mbits/s for the hybrid version and up to 80 Mbits/s for the MCM version can be reached.

  18. Self-rated health and cancer risk

    DEFF Research Database (Denmark)

    Roelsgaard, Ida Kristiane; Olesen, Anne Marie; Simonsen, Mette Kildevæld

    2016-01-01

    . MATERIALS AND METHODS: SRH and information on lifestyle and other risk factors were obtained for 13-636 women in the Danish Nurse Cohort. Cancers that developed during 12 years of follow-up were identified in the National Patient Registry. An association between SRH and cancer was examined in a Cox...... is not significantly associated with the incidence of all cancers or breast, lung or colon cancer among Danish female nurses. Women who reported a decrease in SRH between 1993 and 1999 had the same risk for cancer as those who reported unchanged or improved SRH....

  19. Bladder accumulated dose in image-guided high-dose-rate brachytherapy for locally advanced cervical cancer and its relation to urinary toxicity

    Science.gov (United States)

    Zakariaee, Roja; Hamarneh, Ghassan; Brown, Colin J.; Gaudet, Marc; Aquino-Parsons, Christina; Spadinger, Ingrid

    2016-12-01

    The purpose of this study was to estimate locally accumulated dose to the bladder in multi-fraction high-dose-date (HDR) image-guided intracavitary brachytherapy (IG-ICBT) for cervical cancer, and study the locally-accumulated dose parameters as predictors of late urinary toxicity. A retrospective study of 60 cervical cancer patients who received five HDR IG-ICBT sessions was performed. The bladder outer and inner surfaces were segmented for all sessions and a bladder-wall contour point-set was created in MATLAB. The bladder-wall point-sets for each patient were registered using a deformable point-set registration toolbox called coherent point drift (CPD), and the fraction doses were accumulated. Various dosimetric and volumetric parameters were calculated using the registered doses, including r{{\\text{D}}n \\text{c{{\\text{m}}\\text{3}}}} (minimum dose to the most exposed n-cm3 volume of bladder wall), r V n Gy (wall volume receiving at least m Gy), and r\\text{EQD}{{2}n \\text{c{{\\text{m}}\\text{3}}}} (minimum equivalent biologically weighted dose to the most exposed n-cm3 of bladder wall), where n  =  1/2/5/10 and m  =  3/5/10. Minimum dose to contiguous 1 and 2 cm3 hot-spot volumes was also calculated. The unregistered dose volume histogram (DVH)-summed equivalent of r{{\\text{D}}n \\text{c{{\\text{m}}3}}} and r\\text{EQD}{{2}n \\text{c{{\\text{m}}3}}} parameters (i.e. s{{\\text{D}}n \\text{c{{\\text{m}}\\text{3}}}} and s\\text{EQD}{{2}n \\text{c{{\\text{m}}3}}} ) were determined for comparison. Late urinary toxicity was assessed using the LENT-SOMA scale, with toxicity Grade 0-1 categorized as Controls and Grade 2-4 as Cases. A two-sample t-test was used to identify the differences between the means of Control and Case groups for all parameters. A binomial logistic regression was also performed between the registered dose parameters and toxicity grouping. Seventeen patients were in the Case and 43 patients in the Control group. Contiguous

  20. 3D image-based adapted high-dose-rate brachytherapy in cervical cancer with and without interstitial needles: measurement of applicator shift between imaging and dose delivery

    Directory of Open Access Journals (Sweden)

    Leif Karlsson

    2017-02-01

    Full Text Available Purpose: Using 3D image-guided adaptive brachytherapy for cervical cancer treatment, it often means that patients are transported and moved during the treatment procedure. The purpose of this study was to determine the intra-fractional longitudinal applicator shift in relation to the high risk clinical target volume (HR-CTV by comparing geometries at imaging and dose delivery for patients with and without needles. Material and methods : Measurements were performed in 33 patients (71 fractions, where 25 fractions were without and 46 were with interstitial needles. Gold markers were placed in the lower part of the cervix as a surrogate for HR-CTV, enabling distance measurements between HR-CTV and the ring applicator. Shifts of the applicator relative to the markers were determined using planning computed tomography (CT images used for planning, and the radiographs obtained at dose delivery. Differences in the physical D90 for HR-CTV due to applicator shifts were simulated individually in the treatment planning system to provide the relative dose variation. Results : The maximum distances of the applicator shifts, in relation to the markers, were 3.6 mm (caudal, and –2.5 mm (cranial. There was a significant displacement of –0.7 mm (SD = 0.9 mm without needles, while with needles there was no significant shift. The relative dose variation showed a significant increase in D90 HR-CTV of 1.6% (SD = 2.6% when not using needles, and no significant dose variation was found when using needles. Conclusions : The results from this study showed that there was a small longitudinal displacement of the ring applicator and a significant difference in displacement between using interstitial needles or not.

  1. Distribution of cancer mortality rates by province in South Africa.

    Science.gov (United States)

    Made, Felix; Wilson, Kerry; Jina, Ruxana; Tlotleng, Nonhlanhla; Jack, Samantha; Ntlebi, Vusi; Kootbodien, Tahira

    2017-12-01

    Cancer mortality rates are expected to increase in developing countries. Cancer mortality rates by province remain largely unreported in South Africa. This study described the 2014 age standardised cancer mortality rates by province in South Africa, to provide insight for strategic interventions and advocacy. 2014 deaths data were retrieved from Statistics South Africa. Deaths from cancer were extracted using 10th International Classification of Diseases (ICD) codes for cancer (C00-C97). Adjusted 2013 mid-year population estimates were used as a standard population. All rates were calculated per 100 000 individuals. Nearly 38 000 (8%) of the total deaths in South Africa in 2014 were attributed to cancer. Western Cape Province had the highest age standardised cancer mortality rate in South Africa (118, 95% CI: 115-121 deaths per 100 000 individuals), followed by the Northern Cape (113, 95% CI: 107-119 per 100 000 individuals), with the lowest rate in Limpopo Province (47, 95% CI: 45-49 per 100 000). The age standardised cancer mortality rate for men (71, 95% CI: 70-72 per 100 000 individuals) was similar to women (69, 95% CI: 68-70 per 100 000). Lung cancer was a major driver of cancer death in men (13, 95% CI: 12.6-13.4 per 100 000). In women, cervical cancer was the leading cause of cancer death (13, 95% CI: 12.6-13.4 per 100 000 individuals). There is a need to further investigate the factors related to the differences in cancer mortality by province in South Africa. Raising awareness of risk factors and screening for cancer in the population along with improved access and quality of health care are also important. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Human Papillomavirus Vaccination Rates in Young Cancer Survivors.

    Science.gov (United States)

    Klosky, James L; Hudson, Melissa M; Chen, Yanjun; Connelly, James A; Wasilewski-Masker, Karen; Sun, Can-Lan; Francisco, Liton; Gustafson, Laura; Russell, Kathryn M; Sabbatini, Gina; Flynn, Jessica S; York, Jocelyn M; Giuliano, Anna R; Robison, Leslie L; Wong, F Lennie; Bhatia, Smita; Landier, Wendy

    2017-11-01

    Purpose Cancer survivors are at high risk for human papillomavirus (HPV)-related morbidities; we estimated the prevalence of HPV vaccine initiation in cancer survivors versus the US population and examined predictors of noninitiation. Methods Participants included 982 cancer survivors (9 to 26 years of age; 1 to 5 years postcompletion of therapy); we assessed HPV vaccine initiation, sociodemographic and clinical characteristics, and vaccine-specific health beliefs; age-, sex-, and year-matched US population comparisons were from the National Immunization Survey-Teen and the National Health Interview Survey (2012-2015). Results The mean age at the time of the study was 16.3 ± 4.7 years; the mean time off therapy was 2.7 ± 1.2 years; participants were 55% male and 66% non-Hispanic white; 59% had leukemia/lymphoma. Vaccine initiation rates were significantly lower in cancer survivors versus the general population (23.8%; 95% CI, 20.6% to 27.0% v 40.5%; 95% CI, 40.2% to 40.7%; P P P young adult survivors and peers (ages 18 to 26 years) was comparably low (25.3%; 95% CI, 20.9% to 29.7% v 24.2%; 95% CI, 23.6% to 24.9%). Predictors of noninitiation included lack of provider recommendation (OR, 10.8; 95% CI, 6.5 to 18.0; P P P P P < .001; comparison, 13 to 17 years). Conclusion HPV vaccine initiation rates in cancer survivors are low. Lack of provider recommendation and barriers to vaccine receipt should be targeted in vaccine promotion efforts.

  3. The relationship between the biochemical control outcomes and the quality of planning of high-dose rate brachytherapy as a boost to external beam radiotherapy for locally and locally advanced prostate cancer using the RTOG-ASTRO Phoenix definition.

    Science.gov (United States)

    Pellizzon, Antonio Cassio Assis; Salvajoli, João; Novaes, Paulo; Maia, Maria; Fogaroli, Ricardo; Gides, Doglas; Horriot, Rodrigues

    2008-06-04

    To evaluated prognostic factors and impact of the quality of planning of high dose rate brachytherapy (HDR-BT) for patients with local or locally advanced prostate cancer treated with external beam radiotherapy (EBRT) and HDR-BT. Between 1997 and 2005, 209 patients with biopsy proven prostate adenocarcinoma were treated with localized EBRT and HDR-BT at the Department of Radiation-Oncology, Hospital A. C. Camargo, Sao Paulo, Brazil. Patient's age, Gleason score (GS), clinical stage (CS), initial PSA (iPSA), risk group for biochemical failure (GR), doses of EBRT and HDR-BT, use of three-dimensional planning for HDR-BT (3DHDR) and the Biological Effective Dose (BED) were evaluated as prognostic factors for biochemical control (bC). Median age and median follow-up time were 68 and 5.3 years, respectively. Median EBRT and HDR-BT doses were 45 Gy and 20 Gy. The crude bC at 3.3 year was 94.2%. For the Low, intermediate and high risk patients the bC rates at 3.3 years were 91.5%, 90.2% and 88.5%, respectively. Overall survival (OS) and disease specific survival rates at 3.3 years were 97.8% and 98.4%, respectively. On univariate analysis the prognostic factors related bC were GR (p= 0.040), GS or = 20 Gy (p or = 99 Gy(1.5) (p or = 185 (p or = 20 Gy (p=0.008) and 3DHDR (p<0.001). we observed that the bC rates correlates with the generally accepted risk factors described in the literature. Dose escalation, evaluated through the BED, and the quality of planning of HDR-BT are also important predictive factors when treating prostate cancer.

  4. How will transitioning from cytology to HPV testing change the balance between the benefits and harms of cervical cancer screening? Estimates of the impact on cervical cancer, treatment rates and adverse obstetric outcomes in Australia, a high vaccination coverage country.

    Science.gov (United States)

    Velentzis, Louiza S; Caruana, Michael; Simms, Kate T; Lew, Jie-Bin; Shi, Ju-Fang; Saville, Marion; Smith, Megan A; Lord, Sarah J; Tan, Jeffrey; Bateson, Deborah; Quinn, Michael; Canfell, Karen

    2017-12-15

    high vaccination coverage, is therefore expected to both improve the benefits (further decrease risk of cervical cancer) and reduce the harms (reduce treatments and possible obstetric complications) associated with cervical cancer screening. © 2017 UICC.

  5. eHealth in Modern Patient-Caregiver Communication: High Rate of Acceptance Among Physicians for Additional Support of Breast Cancer Patients During Long-Term Therapy.

    Science.gov (United States)

    Kirkovits, Thomas; Schinkoethe, Timo; Drewes, Caroline; Gehring, Caroline; Bauerfeind, Ingo; Harbeck, Nadia; Wuerstlein, Rachel

    2016-09-19

    Lack of adherence and compliance with drug regimens among breast cancer patients represent substantial problems in oral therapies, leading to significant impacts on mortality. Where other systems have failed, electronic health (eHealth) could be a possible solution to improve medication intake, along with the doctor-patient relationship. Initial results from studies concerning new interventions for therapy support are promising, but reports suggest that general acceptance of new treatment support tools is needed among patients and physicians alike. The aim of this study was to investigate the actual use of the Internet and other modern media among physicians involved in breast cancer treatment. Using a standardized questionnaire, actual utilization of new media among physicians was analyzed. Internet-related behaviors in private, as well as in business life, were investigated. Attention was focused on physicians' opinions regarding modern eHealth tools and how patients could be best supported to enhance adherence. A total of 120 physicians, all participating in breast cancer care, completed the questionnaire (median age 41 years). Almost all participants (99.2%, 119/120) used the Internet for general purposes and 98.3% (118/120) used it for medical issues as well. Virtually all medical professionals (99.2%, 119/120) reported that they owned a computer, while more recently invented technologies such as tablets and smartphones were owned by 31.9% (38/119) and 73.1% (87/119), respectively. The Internet was favored by 66.4% (79/119) of the physicians in our survey as a source for patient support; 71.2% (84/118) would also favor modern media for side effect registration. Based on our analysis, the most frequent Internet-utilizing physicians were characterized by age Internet-related technologies among physicians, indicating that the use of eHealth for advanced and individualized support in breast cancer care is a promising addition to treatment management. Such

  6. Interval cancer rates in the Irish national breast screening programme.

    Science.gov (United States)

    O'Brien, Katie M; Dwane, Fiona; Kelleher, Tracy; Sharp, Linda; Comber, Harry

    2015-09-01

    To compare interval cancer rates from the Irish breast screening programme, BreastCheck, for the period 2000-2007 with those from other European countries. Data from BreastCheck was linked to National Cancer Registry breast cancer registrations, to calculate numbers of women screened, screen-detected cancers, and interval cancers, by year of screening, in the first and second years after screening, and by initial or subsequent screen. Estimated underlying cancer incidence from the period 1996-1999 inclusive was used to calculate proportionate incidence. We calculated the interval cancer ratio as an alternative measure of the burden of interval cancers. There were 372,658 screening records for 178,147 women in the period 2000-2007. The overall interval rate was 9.6 per 10,000 screens. In the first year after screening, the interval cancer rate was 5.8 per 10,000 screens and this increased to 13.4 in the second year after screening. The screen detection rate for the period was 53.6 per 10,000 screened for all screens combined. Initial screens produced a higher detection rate at 66.9 per 10,000 screened compared with subsequent screens with a screen-detected rate of 41.4 per 10,000 screens. Interval breast cancer rates for the first years of the programme are within acceptable limits and are comparable with those in other European programmes. Nationwide roll-out together with the adoption of digital mammography may have an impact on interval cancer rates in future years. © The Author(s) 2015.

  7. A quantitative analysis of two-dimensional manually segmented transrectal ultrasound axial images in planning high dose rate brachytherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Dabić-Stanković Kata

    2017-01-01

    Full Text Available Background/Aim. Prostate delineation, pre-planning and catheter implantation procedures, in high-dose rate brachytherapy (HDR-BT, are commonly based on the prostate manually segmented transrectal ultrasound (TRUS images. The aim of this study was to quantitatively analyze the consistency of prostate capsule delineation, done by a single therapist, prior to each HDR-BT fraction and the changes in the shape of the prostate capsule during HDR-BT, using two dimensional (2D TRUS axial image. Methods. A group of 16 patients were treated at the Medical System Belgrade Brachytherapy Department with definitive HDRBT. The total applied median dose of 52 Gy was divided into four individual fractions, each fraction being delivered 2– 3 weeks apart. Real time prostate axial visualization and the manual segmentation prior to each fraction were performed using B-K Medical ultrasound. Quantitative analyses, analysis of an area and shape were applied on 2D-TRUS axial images of the prostate. Area analyses were used to calculate the average value of the cross-sectional area of the prostate image. The parameters of the prostate shape, the fractal dimension and the circularity ratio of the prostate capsule contour were estimated at the maximum axial cross section of the prostate image. Results. The sample group consisted of four phases, each phase being performed prior to the first, second, third and fourth HDR-BT fraction, respectively. Statistical analysis showed that during HDR-BT fractions there were no significant differences in the average value of area, as well as in the maximum shape of prostate capsule. Conclusions. Quantitative analysis of TRUS axial prostate segmented images shows a successful capsule delineation in the series of manually segmented TRUS images, and the prostate maximum shape remaining unchanged during HDR-BT fractions.

  8. Objective method to report planner-independent skin/rib maximal dose in balloon-based high dose rate (HDR) brachytherapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yongbok; Trombetta, Mark G. [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States) and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, Pennsylvania 15212 (United States)

    2011-04-15

    Purpose: An objective method was proposed and compared with a manual selection method to determine planner-independent skin and rib maximal dose in balloon-based high dose rate (HDR) brachytherapy planning. Methods: The maximal dose to skin and rib was objectively extracted from a dose volume histogram (DVH) of skin and rib volumes. A virtual skin volume was produced by expanding the skin surface in three dimensions (3D) external to the breast with a certain thickness in the planning computed tomography (CT) images. Therefore, the maximal dose to this volume occurs on the skin surface the same with a conventional manual selection method. The rib was also delineated in the planning CT images and its maximal dose was extracted from its DVH. The absolute (Abdiff=|D{sub max}{sup Man}-D{sub max}{sup DVH}|) and relative (Rediff[%]=100x(|D{sub max}{sup Man}-D{sub max}{sup DVH}|)/D{sub max}{sup DVH}) maximal skin and rib dose differences between the manual selection method (D{sub max}{sup Man}) and the objective method (D{sub max}{sup DVH}) were measured for 50 balloon-based HDR (25 MammoSite and 25 Contura) patients. Results: The average{+-}standard deviation of maximal dose difference was 1.67%{+-}1.69% of the prescribed dose (PD). No statistical difference was observed between MammoSite and Contura patients for both Abdiff and Rediff[%] values. However, a statistically significant difference (p value <0.0001) was observed in maximal rib dose difference compared with maximal skin dose difference for both Abdiff (2.30%{+-}1.71% vs 1.05%{+-}1.43%) and Rediff[%] (2.32%{+-}1.79% vs 1.21%{+-}1.41%). In general, rib has a more irregular contour and it is more proximally located to the balloon for 50 HDR patients. Due to the inverse square law factor, more dose difference was observed in higher dose range (D{sub max}>90%) compared with lower dose range (D{sub max}<90%): 2.16%{+-}1.93% vs 1.19%{+-}1.25% with p value of 0.0049. However, the Rediff[%] analysis eliminated the

  9. High-Rate Receiver Design Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose an initial architectural and preliminary hardware design study for a high-rate receiver capable of decoding modulation suites specified by CCSDS 413.0-G-1...

  10. Objective method to report planner-independent skin/rib maximal dose in balloon-based high dose rate (HDR) brachytherapy for breast cancer.

    Science.gov (United States)

    Kim, Yongbok; Trombetta, Mark G

    2011-04-01

    An objective method was proposed and compared with a manual selection method to determine planner-independent skin and rib maximal dose in balloon-based high dose rate (HDR) brachytherapy planning. The maximal dose to skin and rib was objectively extracted from a dose volume histogram (DVH) of skin and rib volumes. A virtual skin volume was produced by expanding the skin surface in three dimensions (3D) external to the breast with a certain thickness in the planning computed tomography (CT) images. Therefore, the maximal dose to this volume occurs on the skin surface the same with a conventional manual selection method. The rib was also delineated in the planning CT images and its maximal dose was extracted from its DVH. The absolute (Abdiff = [D(max) Man - D (max)DVH]) and relative (Rediff[%] = 100 x ([D(max)Man-D(max)DVH])/D(max)DVH) maximal skin and rib dose differences between the manual selection method (D(max)Man) and the objective method (D(max)DVH) were measured for 50 balloon-based HDR (25 MammoSite and 25 Contura) patients. The average +/- standard deviation of maximal dose difference was 1.67% +/- 1.69% of the prescribed dose (PD). No statistical difference was observed between MammoSite and Contura patients for both Abdiff and Rediff[%] values. However, a statistically significant difference (p value skin dose difference for both Abdiff (2.30% +/- 1.71% vs 1.05% +/- 1.43%) and Rediff[%] (2.32% +/- 1.79% vs 1.21% +/- 1.41%). In general, rib has a more irregular contour and it is more proximally located to the balloon for 50 HDR patients. Due to the inverse square law factor, more dose difference was observed in higher dose range (D(max) > 90%) compared with lower dose range (D(max) skin and rib can determine the planner-independent maximal dose compared with the manual selection method. However, the difference was < 2% of PD, on average, if appropriate attention is paid to selecting a manual dose point in 3D planning CT images.

  11. Dose-volume analysis of target volume and critical structures in computed tomography image-based multicatheter high-dose-rate interstitial brachytherapy for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Hironori Akiyama

    2017-12-01

    Full Text Available Purpose : To evaluate dose-volume relationships of target volume and critical structures in computed tomography (CT image-based brachytherapy for head and neck cancer. Material and methods : Thirty-seven patients with mobile tongue, floor of mouth, and base of tongue cancer treated with brachytherapy (post-operative alone and as a boost after external beam radiotherapy [EBRT], or definitive alone or as a boost after EBRT were selected. Treatment plans were made using post-implant CT images. The fractionation schedule was 7-15 × 3-5 Gy for post-operative (with or without EBRT, 14-15 × 3 Gy for definitive alone, and 5-10 × 3 Gy for boost treatments. For the target volume, V 100 , D 90 , and dose non-uniformity ratio (DNR were calculated. For the mandible, spinal cord and salivary glands doses to specified volumes were reported. Results : The median values of V 100 and D 90 were 89.9% and 99.9%, respectively; the median values of DNR was 0.46. The median D 2cm 3 of the mandible and spinal cord were 48.3% and 5.8%, respectively. The ipsilateral median D 2cm 3 of parotid and submandibular glands were 6.4% and 12.5%, whereas on the contralateral side, the corresponding values were 5.3% and 7.0%, respectively. Conclusions : Using conformal treatment planning, it was desirable to keep the dose to the mandible, spinal cord, and salivary glands at an acceptable level. The quantitative plan evaluation may help us find correlations between dosimetric parameters and clinical outcome, which may lead to improve the quality of the treatment, but it requires longer follow-up and results from other studies.

  12. Trends in lung cancer incidence rates, Oklahoma 2005-2010.

    Directory of Open Access Journals (Sweden)

    Dana S Mowls

    Full Text Available Lung cancer is the second most frequently diagnosed cancer among men and women in the United States. With cigarette smoking causing the majority of cases, patterns in lung cancer are often monitored to understand the impact of anti-tobacco efforts. The purpose of this research was to investigate trends in lung cancer incidence rates for the period 2005-2010 in Oklahoma.Data on Oklahoma's incident cases of lung cancer (2005-2010 were obtained from the Centers for Disease Control and Prevention WONDER system. Annual percent change (APC was calculated by linear regression to characterize trends in lung cancer incidence rates over time for the overall population, by gender, by age group, and by age group within gender. Rates were considered to increase or decrease if the p-value for trend was <0.05.From 2005 through 2010, lung cancer incidence rates declined from 81.96 to 68.19 per 100,000 population, with an APC of -3.58% (p-value: 0.0220. When subgroups were examined, declines were observed among all males (APC: -4.25%; p-value: 0.0270, males <65 years (APC: -5.32%; p-value: 0.0008, females <65 years (APC: -4.85%; p-value: 0.0044, and persons aged 55-64 years (APC: -6.38%; p-value: 0.0017.Declines in lung cancer incidence rates occurred during 2005-2010 among the overall population and within select demographic groups in Oklahoma. Although trends were stable for several demographic groups, rates of lung cancer incidence were lower in 2010 compared to 2005. Continued evidence-based tobacco control efforts are needed to ensure further reductions in lung cancer incidence rates in the state of Oklahoma.

  13. Cancer incidence rates in Turkey in 2006: a detailed registry based estimation.

    Science.gov (United States)

    Eser, Sultan; Yakut, Cankut; Özdemir, Raziye; Karakilinç, Hülya; Özalan, Saniye; Marshall, Sarah F; Karaoğlanoğlu, Okan; Anbarcioğlu, Zehra; Üçüncü, Nurşen; Akin, Ümit; Özen, Emire; Özgül, Nejat; Anton-Culver, Hoda; Tuncer, Murat

    2010-01-01

    The purpose of this study is to provide a detailed report on cancer incidence in Turkey, a relatively large country with a population of 72 million. We present the estimates of the cancer burden in Turkey for 2006, calculated using data from the eight population based cancer registries which have been set up in selected provinces representative of sociodemographic patterns in their regions. We calculated age specific and age adjusted incidence rates (AAIR-world standard population) for each of registries separately. We assigned a weighting coefficient for each registry proportional to the population size of the region which the registry represents. We pooled a total of 24,428 cancers (14,581 males, 9,847 females). AAIRs per 100 000 were: 210.1 in men and 129.4 in women for all cancer sites excluding non-melanoma skin cancer. The AAIR per 100 000 men was highest for lung cancer (60.3) followed by prostate (22.8), bladder (19.6), stomach (16.3) and colo-rectal (15.4) cancers. Among women the rate per 100 000 was highest for breast cancer (33.7) followed by colorectal (11.5), stomach (8.8), thyroid (8.8) and lung (7.7). The most striking findings about the cancer incidence in the provinces were the high incidence rates for stomach and esophageal cancers in Erzurum and high stomach cancer incidence rates in Trabzon for both sexes. We are thus able to present the most accurate and realistic estimations for cancer incidence in Turkey so far. Lung, prostate, bladder, stomach, colorectal, larynx cancers in men and breast, colorectal, stomach, thyroid, lung, corpus uteri cancers in women are the leading cancers respectively. This figure shows us tobacco related cancers, lung, bladder and larynx, predominate in men. Concurrently, we analyzed the data for each province separately, giving us the opportunity to present the differences in cancer patterns among provinces. The high incidences of stomach and esophageal cancers in East and high incidence of stomach cancer in

  14. Does childhood cancer affect parental divorce rates? A population-based study.

    Science.gov (United States)

    Syse, Astri; Loge, Jon H; Lyngstad, Torkild H

    2010-02-10

    PURPOSE Cancer in children may profoundly affect parents' personal relationships in terms of psychological stress and an increased care burden. This could hypothetically elevate divorce rates. Few studies on divorce occurrence exist, so the effect of childhood cancers on parental divorce rates was explored. PATIENTS AND METHODS Data on the entire Norwegian married population, age 17 to 69 years, with children age 0 to 20 years in 1974 to 2001 (N = 977,928 couples) were retrieved from the Cancer Registry, the Central Population Register, the Directorate of Taxes, and population censuses. Divorce rates for 4,590 couples who were parenting a child with cancer were compared with those of otherwise similar couples by discrete-time hazard regression models. Results Cancer in a child was not associated with an increased risk of parental divorce overall. An increased divorce rate was observed with Wilms tumor (odds ratio [OR], 1.52) but not with any of the other common childhood cancers. The child's age at diagnosis, time elapsed from diagnosis, and death from cancer did not influence divorce rates significantly. Increased divorce rates were observed for couples in whom the mothers had an education greater than high school level (OR, 1.16); the risk was particularly high shortly after diagnosis, for CNS cancers and Wilms tumors, for couples with children 0 to 9 years of age at diagnosis, and after a child's death. CONCLUSION This large, registry-based study shows that cancer in children is not associated with an increased parental divorce rate, except with Wilms tumors. Couples in whom the wife is highly educated appear to face increased divorce rates after a child's cancer, and this may warrant additional study.

  15. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    alleles was associated with a 3 % higher BMI (P cancer. In instrumental variable analysis for a 10 kg/m(2) higher genetically determined BMI the odds ratio for any non-skin cancer was 1.16 (0.64-2.09), with a corresponding observational estimate of 0.94 (0.88-1.01). Using......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...... of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...

  16. Onion: Anti Cancer Sulfur Compounds with High Cancer Chemo ...

    African Journals Online (AJOL)

    Onions are chock full of anti cancer sulfur compounds which are highly beneficial for cancer chemoprevention. Advanced studies have shown that onion may be inhibit liver, colon, prostate, lung cancer etc. with high antioxidant properties which also reduce not only oxidative stress, free radicals but also xenobiotics.

  17. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

    DEFF Research Database (Denmark)

    Hammer, Anne; Rositch, Anne; Kahlert, Johnny Abildgaard

    2015-01-01

    of gynecological cancer incidence rates, performed via removing the proportion of hysterectomized or oophorectomized women from the population-at-risk-denominator, the impact of prevention strategies may be masked or misinterpreted. Furthermore, since national cervical cancer screening guidelines are at least...

  18. Incidence and frequency rates of childhood cancer in Namibia

    African Journals Online (AJOL)

    incidence of childhood cancer recorded in Namibia was lower than ... relative frequency rates to estimate cancer frequency, and ..... No reason was found for this possible selective underdiagnosis. Pre-emptive deaths in the leukaemic age group and similarity of symptoms in leukaemias, lymphomas and infectious diseases.

  19. Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009.

    LENUS (Irish Health Repository)

    Ali, Hala

    2016-12-20

    Oral cancer is a significant public health problem world-wide and exerts high economic, social, psychological, and physical burdens on patients, their families, and on their primary care providers. We set out to describe the changing trends in incidence and survival rates of oral cancer in Ireland between 1994 and 2009.

  20. Thrombus Formation at High Shear Rates.

    Science.gov (United States)

    Casa, Lauren D C; Ku, David N

    2017-06-21

    The final common pathway in myocardial infarction and ischemic stroke is occlusion of blood flow from a thrombus forming under high shear rates in arteries. A high-shear thrombus forms rapidly and is distinct from the slow formation of coagulation that occurs in stagnant blood. Thrombosis at high shear rates depends primarily on the long protein von Willebrand factor (vWF) and platelets, with hemodynamics playing an important role in each stage of thrombus formation, including vWF binding, platelet adhesion, platelet activation, and rapid thrombus growth. The prediction of high-shear thrombosis is a major area of biofluid mechanics in which point-of-care testing and computational modeling are promising future directions for clinically relevant research. Further research in this area will enable identification of patients at high risk for arterial thrombosis, improve prevention and treatment based on shear-dependent biological mechanisms, and improve blood-contacting device design to reduce thrombosis risk.

  1. Bone Cancer Rates in Dinosaurs Compared with Modern Vertebrates

    CERN Document Server

    Natarajan, L C; Rothschild, B M; Martin, L D

    2007-01-01

    Data on the prevalence of bone cancer in dinosaurs is available from past radiological examination of preserved bones. We statistically test this data for consistency with rates extrapolated from information on bone cancer in modern vertebrates, and find that there is no evidence of a different rate. Thus, this test provides no support for a possible role of ionizing radiation in the K-T extinction event.

  2. Colorectal Cancer in Jordan: Survival Rate and Its Related Factors.

    Science.gov (United States)

    Sharkas, Ghazi Faisal; Arqoub, Kamal H; Khader, Yousef S; Tarawneh, Mohammad R; Nimri, Omar F; Al-Zaghal, Marwan J; Subih, Hadil S

    2017-01-01

    Objectives. To estimate the survival rate of colorectal cancer (CRC) and determine its predictors among Jordanian patients who were diagnosed in the period of 2005-2010. Methods. This study was based on Jordan cancer registry. All CRC cases that were registered in cancer registry during 2005-2010 were analyzed using the survival analysis. The last date for follow-up was 1st Oct 2016. Results. A total of 3005 patients with CRC were registered during 2005-2010. The overall 5-year and 10-year survival rates for patients with CRC were 58.2% and 51.8%, respectively. The 5-year survival rate decreased significantly from 60.4% for the age <50 years to 49.3% for the age ≥70 years (p < 0.005). The 5-year survival rate was 72.1% for the localized stage, 53.8% for the regional stage, and 22.6% for the distant metastasis. In the multivariate analysis, the only factors that were significantly associated with survival were age, grade, stage, and location of tumor. Conclusions. The overall 5-year and ten-year survival rates for CRC were 58.2% and 51.8%, respectively. Increased age, poor differentiation, advanced cancer stage, and right-sided cancers were associated with lower survival rates. Screening strategies are needed for early detection of colon adenomas and colorectal cancer in Jordan.

  3. Colorectal Cancer in Jordan: Survival Rate and Its Related Factors

    Directory of Open Access Journals (Sweden)

    Ghazi Faisal Sharkas

    2017-01-01

    Full Text Available Objectives. To estimate the survival rate of colorectal cancer (CRC and determine its predictors among Jordanian patients who were diagnosed in the period of 2005–2010. Methods. This study was based on Jordan cancer registry. All CRC cases that were registered in cancer registry during 2005–2010 were analyzed using the survival analysis. The last date for follow-up was 1st Oct 2016. Results. A total of 3005 patients with CRC were registered during 2005–2010. The overall 5-year and 10-year survival rates for patients with CRC were 58.2% and 51.8%, respectively. The 5-year survival rate decreased significantly from 60.4% for the age <50 years to 49.3% for the age ≥70 years (p<0.005. The 5-year survival rate was 72.1% for the localized stage, 53.8% for the regional stage, and 22.6% for the distant metastasis. In the multivariate analysis, the only factors that were significantly associated with survival were age, grade, stage, and location of tumor. Conclusions. The overall 5-year and ten-year survival rates for CRC were 58.2% and 51.8%, respectively. Increased age, poor differentiation, advanced cancer stage, and right-sided cancers were associated with lower survival rates. Screening strategies are needed for early detection of colon adenomas and colorectal cancer in Jordan.

  4. Triple-tandem high-dose-rate brachytherapy for early-stage medically inoperable endometrial cancer: Initial report on acute toxicity and dosimetric comparison to stereotactic body radiation therapy.

    Science.gov (United States)

    Kauffmann, Greg; Wu, Tianming; Al-Hallaq, Hania; Hasan, Yasmin

    Stereotactic body radiotherapy (SBRT) may be appealing in medically inoperable endometrial cancer to avoid procedural risks. We performed a dosimetric comparison to triple-tandem, high-dose-rate (HDR) brachytherapy. Six consecutive clinical stage I, grade 1-2, medically inoperable endometrial cancer patients were treated with triple-tandem HDR brachytherapy. We report patient factors and acute toxicity. Also, we performed dosimetric comparison to SBRT using both 3D conformal arc (3DArc) and volumetric-modulated arc therapy. D2cc values for normal tissues were calculated and compared to the HDR plans. Median age was 57 years. Patient comorbidities included morbid obesity, congestive heart failure, diabetes, and pulmonary emboli. In three patients who received prior external beam radiation (EBRT), median EBRT and HDR doses were 46 Gy and 20 Gy, respectively. The median dose with HDR brachytherapy monotherapy was 35 Gy. Acute toxicities during EBRT included gastrointestinal (3/3 with grade 1-2) and genitourinary (3/3 with grade 1-2). Acute toxicities during HDR brachytherapy were gastrointestinal (2/6 total with grade 1-2) and genitourinary (2/6 total with grade 1). The mean D2cc/Gy of prescription dose for rectum, sigmoid, and bladder were 0.58, 0.40, and 0.47 respectively. Overall, doses to normal tissues were higher for SBRT plans as compared to HDR. Also, the R50 (ratio of the 50% prescription isodose volume to the PTV) was lowest with HDR brachytherapy. In medically inoperable, clinical stage I endometrial cancer patients with multiple comorbidities, definitive triple-tandem, HDR brachytherapy results in mild acute toxicity. In addition, HDR brachytherapy achieves relatively lower doses to surrounding normal tissues as compared to SBRT. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

    Science.gov (United States)

    Melchert, Corinna; Kovács, György

    2016-01-01

    Purpose This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. PMID:27648082

  6. External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

    Directory of Open Access Journals (Sweden)

    Martje Marie Terheyden

    2016-08-01

    Full Text Available Purpose : This study aims to compare the dosimetric data of local tumor’s bed dose escalation (boost with photon beams (external beam radiation therapy – EBRT versus high-dose-rate interstitial brachytherapy (HDR-BT after breast-conserving treatment in women with early-stage breast cancer. Material and methods : We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]. Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH. A non-parametric test was performed to compare the two different boost forms. Results : There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34. The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01. Conclusions : Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer.

  7. High risk bladder cancer : current management and survival

    NARCIS (Netherlands)

    Leliveld-Kors, Anna; Bastiaannet, Esther; Doornweerd, Benjamin H J; Schaapveld, Michael; de Jong, Igle J

    2011-01-01

    Purpose: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC) in the Comprehensive Cancer Center North-Netherlands (CCCN) and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. Materials and

  8. High Strain Rate Characterisation of Composite Materials

    DEFF Research Database (Denmark)

    Eriksen, Rasmus Normann Wilken

    -reinforced polymers, were considered, and it was first shown that the loading history controls equilibrium process. Then the High-speed servo-hydraulic test machine was analysed in terms its ability to create a state of constant strain rate in the specimen. The invertible inertial forces in the load train prevented...... a linear elastic specimen to reach a state of constant strain rate before fracture. This was in contrast to ductile materials, which are widely tested with for the High-speed servohydraulic test machine. The development of the analysis and the interpretation of the results, were based on the experience...... from designing and constructing a high-speed servo-hydraulic test machine and by performing a comprehensive test series. The difficulties encountered in the test work could be addressed with the developed analysis. The conclusion was that the High-speed servo-hydraulic test machine is less suited...

  9. High resolution measurement of the glycolytic rate

    Directory of Open Access Journals (Sweden)

    Carla X Bittner

    2010-09-01

    Full Text Available The glycolytic rate is sensitive to physiological activity, hormones, stress, aging and malignant transformation. Standard techniques to measure the glycolytic rate are based on radioactive isotopes, are not able to resolve single cells and have poor temporal resolution, limitations that hamper the study of energy metabolism in the brain and other organs. A new method is described in this article, which makes use of a recently-developed FRET glucose nanosensor to measure the rate of glycolysis in single cells with high temporal resolution. Used in cultured astrocytes, the method showed for the first time that glycolysis can be activated within seconds by a combination of glutamate and K+, supporting a role for astrocytes in neurometabolic and neurovascular coupling in the brain. It was also possible to make a direct comparison of metabolism in neurons and astrocytes lying in close proximity, paving the way to a high-resolution characterization of brain energy metabolism. Single-cell glycolytic rates were also measured in fibroblasts, adipocytes, myoblasts and tumor cells, showing higher rates for undifferentiated cells and significant metabolic heterogeneity within cell types. This method should facilitate the investigation of tissue metabolism at the single-cell level and is readily adaptable for high-throughput analysis.

  10. High Rate Performing Li-ion Battery

    Science.gov (United States)

    2015-02-09

    permeable to lithium ions and efficient in transferring the electrons into/from the LVP surface to the corresponding current collector. a) b) c) d) e...PO4)3/C for High Rate Lithium-ion Battery Applications”, Lee Hwang Sheng, Nail Suleimanov, Vishwanathan Ramar, Mangayarkarasi Murugan, Kuppan

  11. High dose rate brachytherapy in the treatment of endometrium carcinoma; Tratamento de cancer do endometrio com braquiterapia de alta taxa de dose

    Energy Technology Data Exchange (ETDEWEB)

    Aisen, Salim; Carvalho, Heloisa A.; Nadalin, Wladimir [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Servico de Radioterapia

    1995-11-01

    One hundred and four patients with histologic proven carcinoma of the endometrium were referred to our department for treatment. The median age was 65.5 years and the median follow-up was 38 months. Ninety-five was pos-menopaused, 7 peri and 2 were pre-menopaused. Sixteen patients were staged (pos-surgery) IA, 5 GI, 8 G2 and 3 G3. Thirty and four stage IB, 10 G1, 18 G2 and 1 G3. Twenty-five were stage IC, 9 G1, 9 G2 and 7 G3. Six were stage IIA, 2 GI, 3 G2 and 1 G3. Eight were stages IIB, 1 G1,3 G2 and 4 G3. Nine were stage IIA, 2 GI, 5 G2, 2 G3. Three were stage IIIB, 2 GI and 1 G2. One was stage III C G3, and two were IVA G3. Depending of the extension of the disease, patients underwent total hysterectomy and bilateral salpino-ooforectomy, or total hysterectomy and bilateral salpino-ooforectomy plus omentectomy or Werthein-Megs technique. All the patients IA and IB have no evidence of disease (NED). Twenty-four patients IC are NED and one presented distant metastasis. From the IIB patients, 6 are NED, one shown progressive local disease (PLD) and one died from disease. From the patients IIIA, 7 are NED, one DM and one PLD. From the IIIB patients one is NED and TWO are PLD. From the IIIC patient is NED two months after treatment and the IVA patients are NED three and four month after treatment. Eight patients have shown mild complications of treatment. The results of survival and complications are similar to the therapeutic with low dose rate brachytherapy, with the advantage of an outpatient treatment, without the inconvenience of impatient regime. (author). 22 refs., 1 tab.

  12. An investigation of cancer rates in the Argentia region, Newfoundland and Labrador: an ecological study.

    Science.gov (United States)

    Duke, Pauline; Godwin, Marshall; Peach, Mandy; Fortier, Jacqueline; Bornstein, Stephen; Buehler, Sharon; McCrate, Farah; Pike, Andrea; Wang, Peizhong Peter; Cullen, Richard M

    2015-01-01

    The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region. Cases of cancer diagnosed between 1985 and 2011 were obtained for the Argentia region, two comparison communities, and the province of Newfoundland and Labrador. Crude and age-standardized incidence rates of cancer diagnosis were calculated and compared. The crude incidence rate was adjusted for differences in age demographics using census data, and age-standardized incidence rates were compared. Although the Argentia region had a higher crude rate of cancer diagnosis, the age-standardized incidence rate did not differ significantly from the comparison communities or the provincial average. Argentia has an aging population, which may have influenced the perception of increased cancer diagnosis in the community. We did not detect an increased burden of cancer in the Argentia region.

  13. An Investigation of Cancer Rates in the Argentia Region, Newfoundland and Labrador: An Ecological Study

    Directory of Open Access Journals (Sweden)

    Pauline Duke

    2015-01-01

    Full Text Available Background. The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region. Methods. Cases of cancer diagnosed between 1985 and 2011 were obtained for the Argentia region, two comparison communities, and the province of Newfoundland and Labrador. Crude and age-standardized incidence rates of cancer diagnosis were calculated and compared. The crude incidence rate was adjusted for differences in age demographics using census data, and age-standardized incidence rates were compared. Results. Although the Argentia region had a higher crude rate of cancer diagnosis, the age-standardized incidence rate did not differ significantly from the comparison communities or the provincial average. Argentia has an aging population, which may have influenced the perception of increased cancer diagnosis in the community. Conclusions. We did not detect an increased burden of cancer in the Argentia region.

  14. Incidence trends and mortality rates of gastric cancer in Israel.

    Science.gov (United States)

    Lavy, Ron; Kapiev, Andronik; Poluksht, Natan; Halevy, Ariel; Keinan-Boker, Lital

    2013-04-01

    Gastric cancer is the fourth most common malignancy worldwide. The incidence trends and mortality rates of gastric cancer in Israel have not been studied in depth. The aim of our study was to try and investigate the aforementioned issues in Israel in different ethnic groups. This retrospective study is based on the data of The Israel National Cancer Registry and The Central Bureau of Statistics. Published data from these two institutes were collected, summarized, and analyzed in this study. Around 650 new cases of gastric cancer are diagnosed yearly in Israel. While we noticed a decline during the period 1990-2007 in the incidence in the Jewish population (13.6-8.9 and 6.75-5.42 cases per 100,000 in Jewish men and women, respectively), an increase in the Arab population was noticed (7.7-10.2 and 3.7-4.2 cases per 100,000 in men and women, respectively). Age-adjusted mortality rates per 10,000 cases of gastric cancer decreased significantly, from 7.21 in 1990 to 5.46 in 2007, in the total population. The 5-year relative survival showed a slight increase for both men and women. There is a difference in the incidence and outcome of gastric cancer between the Jewish and Arab populations in Israel. The grim prognosis of gastric cancer patients in Israel is probably due to the advanced stage at which gastric cancer is diagnosed in Israel.

  15. High strain rate behaviour of polypropylene microfoams

    Directory of Open Access Journals (Sweden)

    Martínez A.B.

    2012-08-01

    Full Text Available Microcellular materials such as polypropylene foams are often used in protective applications and passive safety for packaging (electronic components, aeronautical structures, food, etc. or personal safety (helmets, knee-pads, etc.. In such applications the foams which are used are often designed to absorb the maximum energy and are generally subjected to severe loadings involving high strain rates. The manufacture process to obtain polymeric microcellular foams is based on the polymer saturation with a supercritical gas, at high temperature and pressure. This method presents several advantages over the conventional injection moulding techniques which make it industrially feasible. However, the effect of processing conditions such as blowing agent, concentration and microfoaming time and/or temperature on the microstructure of the resulting microcellular polymer (density, cell size and geometry is not yet set up. The compressive mechanical behaviour of several microcellular polypropylene foams has been investigated over a wide range of strain rates (0.001 to 3000 s−1 in order to show the effects of the processing parameters and strain rate on the mechanical properties. High strain rate tests were performed using a Split Hopkinson Pressure Bar apparatus (SHPB. Polypropylene and polyethylene-ethylene block copolymer foams of various densities were considered.

  16. High strain rate behaviour of polypropylene microfoams

    Science.gov (United States)

    Gómez-del Río, T.; Garrido, M. A.; Rodríguez, J.; Arencón, D.; Martínez, A. B.

    2012-08-01

    Microcellular materials such as polypropylene foams are often used in protective applications and passive safety for packaging (electronic components, aeronautical structures, food, etc.) or personal safety (helmets, knee-pads, etc.). In such applications the foams which are used are often designed to absorb the maximum energy and are generally subjected to severe loadings involving high strain rates. The manufacture process to obtain polymeric microcellular foams is based on the polymer saturation with a supercritical gas, at high temperature and pressure. This method presents several advantages over the conventional injection moulding techniques which make it industrially feasible. However, the effect of processing conditions such as blowing agent, concentration and microfoaming time and/or temperature on the microstructure of the resulting microcellular polymer (density, cell size and geometry) is not yet set up. The compressive mechanical behaviour of several microcellular polypropylene foams has been investigated over a wide range of strain rates (0.001 to 3000 s-1) in order to show the effects of the processing parameters and strain rate on the mechanical properties. High strain rate tests were performed using a Split Hopkinson Pressure Bar apparatus (SHPB). Polypropylene and polyethylene-ethylene block copolymer foams of various densities were considered.

  17. Childhood cancer survival rates in two South African units | Stones ...

    African Journals Online (AJOL)

    The most common cancers were leukaemia (25.0%), brain tumours (19.5%), lymphoma (13.0%) and nephroblastoma (10.0%). ... A comparison between ethnic groups showed white children to have the highest survival rate (62.8%); the rate for children of mixed racial origin was 53.8% and that for black children 48.5%.

  18. Cancer Rates by Race/Ethnicity and Sex

    Science.gov (United States)

    ... Skin Uterine Cancer Rates by Race/Ethnicity and Sex Language: English (US) Español (Spanish) Recommend on Facebook ... and ethnicity. Incidence Rates by Race/Ethnicity and Sex “Incidence rate” means how many people out of ...

  19. Men and women show similar survival rates after breast cancer.

    Science.gov (United States)

    Bender, Paulo Franscisco Mascarenhas; de Oliveira, Letícia Lima; Costa, Célia Regina; de Aguiar, Suzana Sales; Bergmann, Anke; Thuler, Luiz Claudio Santos

    2017-04-01

    To compare the disease-free survival (DFS) and overall survival (OS) rates of men and women undergoing treatment for breast cancer. A retrospective cohort study of patients with breast cancer diagnosed and treated at the Cancer Hospital III of the National Cancer Institute of Brazil, Rio de Janeiro, Brazil, between 1999 and 2013. Male breast cancer cases were matched for age, year of diagnosis, and clinical staging to three female cases (1:3). Patient characteristics were abstracted from hospital records and medical charts. Cases were analyzed using descriptive statistics, and comparisons between the genders were performed using Kaplan-Meier curves and Cox regression analysis with 95% confidence intervals. The study population comprised 98 men and 294 women. There were significant differences (p breast surgery, neoadjuvant chemotherapy, adjuvant radiotherapy, and use of palliative bisphosphonate therapy. Five- and 10-year DFS rates were, respectively, 80.0 and 51.4% for men and 71.4 and 63.5% for women (p = 0.245), and 5- and 10-year OS rates were, respectively, 65.0 and 47.5% for men and 56.5 and 41.4% for women (p = 0.221). There was no significant difference in prognosis (DFS and OS rates) between the genders, but significant differences in sociodemographic and clinical characteristics were detected between male and female breast cancer cases.

  20. High-Rate Capable Floating Strip Micromegas

    Science.gov (United States)

    Bortfeldt, Jonathan; Bender, Michael; Biebel, Otmar; Danger, Helge; Flierl, Bernhard; Hertenberger, Ralf; Lösel, Philipp; Moll, Samuel; Parodi, Katia; Rinaldi, Ilaria; Ruschke, Alexander; Zibell, André

    2016-04-01

    We report on the optimization of discharge insensitive floating strip Micromegas (MICRO-MEsh GASeous) detectors, fit for use in high-energy muon spectrometers. The suitability of these detectors for particle tracking is shown in high-background environments and at very high particle fluxes up to 60 MHz/cm2. Measurement and simulation of the microscopic discharge behavior have demonstrated the excellent discharge tolerance. A floating strip Micromegas with an active area of 48 cm × 50 cm with 1920 copper anode strips exhibits in 120 GeV pion beams a spatial resolution of 50 μm at detection efficiencies above 95%. Pulse height, spatial resolution and detection efficiency are homogeneous over the detector. Reconstruction of particle track inclination in a single detector plane is discussed, optimum angular resolutions below 5° are observed. Systematic deviations of this μTPC-method are fully understood. The reconstruction capabilities for minimum ionizing muons are investigated in a 6.4 cm × 6.4 cm floating strip Micromegas under intense background irradiation of the whole active area with 20 MeV protons at a rate of 550 kHz. The spatial resolution for muons is not distorted by space charge effects. A 6.4 cm × 6.4 cm floating strip Micromegas doublet with low material budget is investigated in highly ionizing proton and carbon ion beams at particle rates between 2 MHz and 2 GHz. Stable operation up to the highest rates is observed, spatial resolution, detection efficiencies, the multi-hit and high-rate capability are discussed.

  1. Birth rates among male cancer survivors and mortality rates among their offspring : a population-based study from Sweden

    NARCIS (Netherlands)

    Tang, Siau-Wei; Liu, Jenny; Juay, Lester; Czene, Kamila; Miao, Hui; Salim, Agus; Verkooijen, Helena M; Hartman, Mikael

    2016-01-01

    BACKGROUND: With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring. METHODS: From the Swedish Multi-generation Register and Cancer Register, we identified

  2. What implementation interventions increase cancer screening rates? a systematic review

    Directory of Open Access Journals (Sweden)

    Lent Barbara

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic

  3. What implementation interventions increase cancer screening rates? a systematic review.

    Science.gov (United States)

    Brouwers, Melissa C; De Vito, Carol; Bahirathan, Lavannya; Carol, Angela; Carroll, June C; Cotterchio, Michelle; Dobbins, Maureen; Lent, Barbara; Levitt, Cheryl; Lewis, Nancy; McGregor, S Elizabeth; Paszat, Lawrence; Rand, Carol; Wathen, Nadine

    2011-09-29

    Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as the evidentiary foundation for an

  4. Effect of a chemical manufacturing plant on community cancer rates

    Directory of Open Access Journals (Sweden)

    Churches Tim

    2005-04-01

    Full Text Available Abstract Background We conducted a retrospective study to determine if potential past exposure to dioxin had resulted in increased incidence of cancer in people living near a former manufacturing plant in New South Wales, Australia. During operation, from 1928 to 1970, by-products of the manufacturing process, including dioxin and other chemical waste, were dumped into wetlands and mangroves, discharged into a nearby bay and used to reclaim land along the foreshore, leaving a legacy of significant dioxin contamination. Methods We selected 20 Census Collector Districts within 1.5 kilometres of the former manufacturing plant as the study area. We obtained data on all cases of cancer and deaths from cancer in New South Wales from 1972 to 2001. We also compared rates for some cancer types that have been associated with dioxin exposure. Based on a person's residential address at time of cancer diagnosis, or at time of death due to cancer, various geo-coding software and processes were used to determine which collector district the case or death should be attributed to. Age and sex specific population data were used to calculate standardised incidence ratios and standardised mortality ratios, to compare the study area to two comparison areas, using indirect standardisation. Results During the 30-year study period 1,106 cases of cancer and 524 deaths due to cancer were identified in the study area. This corresponds to an age-sex standardised rate of 3.2 cases per 1,000 person-years exposed and 1.6 deaths per 1,000 person-years exposed. The study area had a lower rate of cancer and deaths from cancer than the comparison areas. The case incidence and mortality due to lung and bronchus carcinomas and haematopoietic cancers did not differ significantly from the comparison areas for the study period. There was no obvious geographical trend in ratios when comparing individual collector districts to New South Wales according to distance from the potential

  5. Computed Tomography–Guided Interstitial High-Dose-Rate Brachytherapy in Combination With Regional Positive Lymph Node Intensity-Modulated Radiation Therapy in Locally Advanced Peripheral Non–Small Cell Lung Cancer: A Phase 1 Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Xiang, Li; Zhang, Jian-wen; Lin, Sheng; Luo, Hui-Qun; Wen, Qing-Lian; He, Li-Jia; Shang, Chang-Ling; Ren, Pei-Rong; Yang, Hong-Ru; Pang, Hao-Wen; Yang, Bo; He, Huai-Lin [Department of Oncology, Affiliated Hospital of Luzhou Medical College, Luzhou (China); Chen, Yue, E-mail: chenyue5523@126.com [Department of Nuclear Medicine, Affiliated Hospital of Luzhou Medical College, Luzhou (China); Wu, Jing-Bo, E-mail: wjb6147@163.com [Department of Oncology, Affiliated Hospital of Luzhou Medical College, Luzhou (China)

    2015-08-01

    Purpose: To assess the technical safety, adverse events, and efficacy of computed tomography (CT)-guided interstitial high-dose-rate (HDR) brachytherapy in combination with regional positive lymph node intensity modulated radiation therapy in patients with locally advanced peripheral non–small cell lung cancer (NSCLC). Methods and Materials: Twenty-six patients with histologically confirmed NSCLC were enrolled in a prospective, officially approved phase 1 trial. Primary tumors were treated with HDR brachytherapy. A single 30-Gy dose was delivered to the 90% isodose line of the gross lung tumor volume. A total dose of at least 70 Gy was administered to the 95% isodose line of the planning target volume of malignant lymph nodes using 6-MV X-rays. The patients received concurrent or sequential chemotherapy. We assessed treatment efficacy, adverse events, and radiation toxicity. Results: The median follow-up time was 28 months (range, 7-44 months). There were 3 cases of mild pneumothorax but no cases of hemothorax, dyspnea, or pyothorax after the procedure. Grade 3 or 4 acute hematologic toxicity was observed in 5 patients. During follow-up, mild fibrosis around the puncture point was observed on the CT scans of 2 patients, but both patients were asymptomatic. The overall response rates (complete and partial) for the primary mass and positive lymph nodes were 100% and 92.3%, respectively. The 1-year and 2-year overall survival (OS) rates were 90.9% and 67%, respectively, with a median OS of 22.5 months. Conclusion: Our findings suggest that HDR brachytherapy is safe and feasible for peripheral locally advanced NSCLC, justifying a phase 2 clinical trial.

  6. Acute and late vaginal toxicity after adjuvant high-dose-rate vaginal brachytherapy in patients with intermediate risk endometrial cancer: is local therapy with hyaluronic acid of clinical benefit?

    Directory of Open Access Journals (Sweden)

    Concetta Laliscia

    2016-12-01

    Full Text Available Purpose : The aim of the present study was to evaluate the effectiveness of hyaluronic acid (HA in the prevention of acute and late vaginal toxicities after high-dose-rate (HDR vaginal brachytherapy (BT. Material and methods : Between January 2011 and January 2015, we retrospectively analyzed 126 patients with endometrial cancer who underwent extrafascial hysterectomy with or without lymphadenectomy and adjuvant HDR-vaginal BT +/– adjuvant chemotherapy. The total dose prescription was 21 Gy in 3 fractions (one fraction for week. Vaginal ovules containing 5 mg of HA were given for whole duration of vaginal BT and for the two following weeks. Acute and late toxicities were evaluated according to CTCAE vs 4.02. Results : According to the revised FIGO 2009 classification, most tumors were in stage IA (30.9% and in stage IB (57.9%. Thirty-three patients (26.2% received adjuvant chemotherapy before vaginal BT. Five-year disease-free survival (DFS and five-year overall survival (OS were 88% and 93%, respectively. The most common grade 1-2 acute toxicities were vaginal inflammation (18 patients, 14.3% and dyspareunia (7 patients, 5.5%. Two patients (1.6% had more than one toxicity. Late toxicity occurred in 20 patients (15.9%. Grade 1-2 late toxicities were fibrosis (14 patients, 11.1% and telangiectasias (7 patients, 5.5%. Six patients (4.8% had more than one late toxicity. No grade 3 or higher acute or late toxicities were observed. Conclusions : These results appear to suggest that the local therapy with HA is of clinical benefit for intermediate risk endometrial cancer patients who receive adjuvant HDR-vaginal BT after surgery. A randomized trial comparing HA treatment vs. no local treatment in this clinical setting is warranted to further evaluate the efficacy of HA in preventing vaginal BT-related vaginal toxicity.

  7. High strain rate deformation of layered nanocomposites

    Science.gov (United States)

    Lee, Jae-Hwang; Veysset, David; Singer, Jonathan P.; Retsch, Markus; Saini, Gagan; Pezeril, Thomas; Nelson, Keith A.; Thomas, Edwin L.

    2012-11-01

    Insight into the mechanical behaviour of nanomaterials under the extreme condition of very high deformation rates and to very large strains is needed to provide improved understanding for the development of new protective materials. Applications include protection against bullets for body armour, micrometeorites for satellites, and high-speed particle impact for jet engine turbine blades. Here we use a microscopic ballistic test to report the responses of periodic glassy-rubbery layered block-copolymer nanostructures to impact from hypervelocity micron-sized silica spheres. Entire deformation fields are experimentally visualized at an exceptionally high resolution (below 10 nm) and we discover how the microstructure dissipates the impact energy via layer kinking, layer compression, extreme chain conformational flattening, domain fragmentation and segmental mixing to form a liquid phase. Orientation-dependent experiments show that the dissipation can be enhanced by 30% by proper orientation of the layers.

  8. A simple algebraic cancer equation: calculating how cancers may arise with normal mutation rates

    Directory of Open Access Journals (Sweden)

    Shibata Darryl

    2010-01-01

    Full Text Available Abstract Background The purpose of this article is to present a relatively easy to understand cancer model where transformation occurs when the first cell, among many at risk within a colon, accumulates a set of driver mutations. The analysis of this model yields a simple algebraic equation, which takes as inputs the number of stem cells, mutation and division rates, and the number of driver mutations, and makes predictions about cancer epidemiology. Methods The equation [p = 1 - (1 - (1 - (1 - udkNm ] calculates the probability of cancer (p and contains five parameters: the number of divisions (d, the number of stem cells (N × m, the number of critical rate-limiting pathway driver mutations (k, and the mutation rate (u. In this model progression to cancer "starts" at conception and mutations accumulate with cell division. Transformation occurs when a critical number of rate-limiting pathway mutations first accumulates within a single stem cell. Results When applied to several colorectal cancer data sets, parameter values consistent with crypt stem cell biology and normal mutation rates were able to match the increase in cancer with aging, and the mutation frequencies found in cancer genomes. The equation can help explain how cancer risks may vary with age, height, germline mutations, and aspirin use. APC mutations may shorten pathways to cancer by effectively increasing the numbers of stem cells at risk. Conclusions The equation illustrates that age-related increases in cancer frequencies may result from relatively normal division and mutation rates. Although this equation does not encompass all of the known complexity of cancer, it may be useful, especially in a teaching setting, to help illustrate relationships between small and large cancer features.

  9. Braquiterapia intersticial de alta tasa de rescate en cáncer cabeza cuello previamente radiado High-dose-rate (HDR brachytherapy in previously irradiated recurrent head and neck cancer

    Directory of Open Access Journals (Sweden)

    Lucía Gutiérrez-Bayard

    2011-09-01

    Full Text Available A pesar de los avances en el tratamiento de cáncer de cabeza y cuello (CCC, el 15-50% de los pacientes presentan recurrencia locorregional. Para los pacientes que presentan enfermedad localmente recurrente o un segundo tumor primario en un campo previamente irradiado, las opciones terapéuticas de rescate son limitadas, siendo la resección quirúrgica con intención curativa la opción de elección para los pacientes con enfermedad limitada. Reirradiación con o sin la adición de quimioterapia puede ser una buena opción, obteniendo en pacientes seleccionados supervivencia a largo plazo. La braquiterapia de alta tasa de dosis (HDRBT puede jugar un papel importante en el tratamiento de rescate en tumores de cabeza y cuello recurrentes. Presentamos un paciente de 56 años diagnosticado de cáncer de lengua sometido a cirugía y radioterapia externa adyuvante, y recurrencia metastásica ganglionar cervical contralateral a los 18 meses. Recibió tratamiento multidisciplinar con quimioterapia, cirugía y braquiterapia intersticial.Despite advances in the treatment of head and neck cancer (HNC, 15-50% of patients present locoregional disease recurrence. The therapeutic options are limited for patients who present locally recurrent disease or a second primary tumor in a previously irradiated field. Surgical salvage with curative intent is the preferred option for patients with limited-volume disease. Re-irradiation with or without the addition of chemotherapy may hold promise for long-term survival for selected patients. High-dose-rate (HDR brachytherapy can play an important role in the salvage treatment of previously irradiated recurrent head and neck cancer. The case reported was a 56-year old man diagnosed of tongue cancer who presented recurrent metastatic contralateral cervical node 1.5 years after radical treatment with surgery and adjuvant external radiotherapy. He received multidisciplinary treatment with chemotherapy, surgery and HDR

  10. Estimation of an optimal chemotherapy utilisation rate for cancer: setting an evidence-based benchmark for quality cancer care.

    Science.gov (United States)

    Jacob, S A; Ng, W L; Do, V

    2015-02-01

    There is wide variation in the proportion of newly diagnosed cancer patients who receive chemotherapy, indicating the need for a benchmark rate of chemotherapy utilisation. This study describes an evidence-based model that estimates the proportion of new cancer patients in whom chemotherapy is indicated at least once (defined as the optimal chemotherapy utilisation rate). The optimal chemotherapy utilisation rate can act as a benchmark for measuring and improving the quality of care. Models of optimal chemotherapy utilisation were constructed for each cancer site based on indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient- and tumour-related attributes for which chemotherapy was indicated were obtained, using population-based data where possible. Treatment indications and epidemiological data were merged to calculate the optimal chemotherapy utilisation rate. Monte Carlo simulations and sensitivity analyses were used to assess the effect of controversial chemotherapy indications and variations in epidemiological data on our model. Chemotherapy is indicated at least once in 49.1% (95% confidence interval 48.8-49.6%) of all new cancer patients in Australia. The optimal chemotherapy utilisation rates for individual tumour sites ranged from a low of 13% in thyroid cancers to a high of 94% in myeloma. The optimal chemotherapy utilisation rate can serve as a benchmark for planning chemotherapy services on a population basis. The model can be used to evaluate service delivery by comparing the benchmark rate with patterns of care data. The overall estimate for other countries can be obtained by substituting the relevant distribution of cancer types. It can also be used to predict future chemotherapy workload and can be easily modified to take into account future changes in cancer incidence, presentation stage or chemotherapy indications. Copyright © 2014 The Royal College of Radiologists. Published by

  11. [New Combination Therapy to Improve the Functional Preservation Rate of the Larynx in Laryngeal, Oropharyngeal, and Hypopharyngeal Cancers].

    Science.gov (United States)

    Furusaka, Tohru

    2015-10-01

    A new combination therapy has been developed to achieve high overall survival and functional laryngeal preservation rates in head and neck cancers, which require laryngectomy. In order to treat the primary site without resection, superselective intra-arterial infusions with DCF anterogradely and 60 mg/m2 of DOC and 60 mg/m2 of CDDP via the femoral artery on day 1 were administered, followed by continuous intravenous instillation of 750 mg/m2/day of 5-FU for 5 days from day 2. The 5- year survival rate was 70.4% in laryngeal cancer, 72.8% in oropharyngeal cancer, and 68.5% in hypopharyngeal cancer. The 5-year functional laryngeal preservation rate was 71.0% in laryngeal cancer, 63.4% in oropharyngeal cancer, and 65.2% in hypopharyngeal cancer. In addition to regional lymph node control, a thorough neck dissection was performed. Good overall survival and functional laryngeal preservation rates were achieved.

  12. High-energy, high-rate materials processing

    Science.gov (United States)

    Marcus, H. L.; Bourell, D. L.; Eliezer, Z.; Persad, C.; Weldon, W.

    1987-12-01

    The increasingly available range of pulsed-power, high energy kinetic storage devices, such as low-inductance pulse-forming networks, compulsators, and homopolar generators, is presently considered as a basis for industrial high energy/high rate (HEHR) processing to accomplish shock hardening, drilling, rapid surface alloying and melting, welding and cutting, transformation hardening, and cladding and surface melting in metallic materials. Time-temperature-transformation concepts furnish the basis for a fundamental understanding of the potential advantages of this direct pulsed power processing. Attention is given to the HEHR processing of a refractory molybdenum alloy, a nickel-base metallic glass, tungsten, titanium aluminides, and metal-matrix composites.

  13. Single-fraction high-dose-rate brachytherapy using real-time transrectal ultrasound based planning in combination with external beam radiotherapy for prostate cancer: dosimetrics and early clinical results

    Directory of Open Access Journals (Sweden)

    Olivier Lauche

    2016-04-01

    Full Text Available Purpose : To validate the feasibility of a single-fraction high-dose-rate brachytherapy (HDRBT boost for prostate cancer using real-time transrectal ultrasound (TRUS based planning. Material and methods : From August 2012 to September 2015, 126 patients underwent a single-fraction HDRBT boost of 15 Gy using real-time TRUS based planning. External beam radiation therapy (EBRT (37.5 Gy/15 fractions, 44 Gy/22 fractions, or 45 Gy/25 fractions was performed before (31% or after (69% HDRBT boost. Genito-urinary (GU and gastro-intestinal (GI toxicity were assessed 4 and 12 months after the end of combined treatment using the international prostate symptom score scale (IPSS and the common terminology criteria for adverse events (CTCAE v3.0. Results : All dose-planning objectives were achieved in 90% of patients. Prostate D 90 ≥ 105% and ≤ 115% was achieved in 99% of patients, prostate V 150 ≤ 40% in 99%, prostate V 200 < 11% in 96%, urethra D 10 < 120% for 99%, urethra V 125 = 0% in 100%, and rectal V 75 < 1 cc in 93% of patients. Median IPSS score was 4 at baseline and did not change at 4 and 12 months after combined treatment. No patients developed ≥ grade 2 GI toxicity. With a median follow-up of 10 months, only two patients experienced biochemical failure. Among patients who didn’t receive ADT, cumulative percentage of patients with PSA ≤ 1 ng/ml at 4 and 18 months was respectively 23% and 66%. Conclusions : Single-fraction HDRBT boost of 15 Gy using real-time TRUS based planning achieves consistently high dosimetry quality. In combination with EBRT, toxicity outcomes appear promising. A longer follow-up is needed to assess long-term outcome and toxicities.

  14. Operation of high rate microstrip gas chambers

    CERN Document Server

    Barr, A J; Bouclier, Roger; Capéans-Garrido, M; Dominik, Wojciech; Manzin, G; Million, Gilbert; Hoch, M; Ropelewski, Leszek; Sauli, Fabio; Sharma, A

    1996-01-01

    We describe recent measurements carried out in well controlled and reproducible conditions to help understanding the factors affecting the short and long term behaviour of Microstrip Gas Chambers. Special care has been taken concerning the gas purity and choice of materials used in the system and for the detectors construction. Detectors built on glasses with surface resistivity in the range $10^{13}-10^{15} \\Omega/\\Box$ have shown satisfactory performance as they do not show charging-up process at high rate and stand the large doses required for the future high luminosity experiments (~10 mC·cm-1·yr-1). Concerning the lifetime measurements, it has been observed that chambers manufactured on high-resistivity glass are far more susceptible of suffering ageing than detectors made on low resistivity, electron-conducting supports, independently of the metal used for the artwork (chromium or gold) at least in clean gas conditions. The successfully operation in the laboratory of detectors manufactured on diamond-...

  15. Implant survival rate after oral cancer therapy: a review.

    Science.gov (United States)

    Javed, Fawad; Al-Hezaimi, Khalid; Al-Rasheed, Abdulaziz; Almas, Khalid; Romanos, George E

    2010-12-01

    The overall impression regarding the success of dental implants (DI) in patients having undergone oral cancer therapy remains unclear. The aim of the present review study was to assess the implant survival rate after oral cancer therapy. Databases were explored from 1986 up to and including September 2010 using the following keywords in various combinations: "cancer", "chemotherapy", "dental implant", "oral", "osseointegration", "radiotherapy", "surgery" and "treatment". The eligibility criteria were: (1) original research articles; (2) clinical studies; (3) reference list of pertinent original and review studies; (4) intervention: patients having undergone radio- and chemotherapy following oral cancer surgery; and (5) articles published only in English. Twenty-one clinical studies were included. Results from 16 studies reported that DI can osseointegrate and remain functionally stable in patients having undergone radiotherapy following oral cancer surgery; whereas three studies showed irradiation to have negative effects on the survival of DI. Two studies reported that DI can osseointegrate and remain functionally stable in patients having undergone chemotherapy. It is concluded that DI can osseointegrate and remain functionally stable in patients having undergone oral cancer treatment. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  16. The combined effect of individual and neighborhood socioeconomic status on cancer survival rates.

    Directory of Open Access Journals (Sweden)

    Chun-Ming Chang

    Full Text Available BACKGROUND: This population-based study investigated the relationship between individual and neighborhood socioeconomic status (SES and mortality rates for major cancers in Taiwan. METHODS: A population-based follow-up study was conducted with 20,488 cancer patients diagnosed in 2002. Each patient was traced to death or for 5 years. The individual income-related insurance payment amount was used as a proxy measure of individual SES for patients. Neighborhood SES was defined by income, and neighborhoods were grouped as living in advantaged or disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding and risk factors. RESULTS: After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence, tumor extent, treatment modalities (operation and adjuvant therapy, and hospital characteristics (ownership and teaching level, colorectal cancer, and head and neck cancer patients under 65 years old with low individual SES in disadvantaged neighborhoods conferred a 1.5 to 2-fold higher risk of mortality, compared with patients with high individual SES in advantaged neighborhoods. A cross-level interaction effect was found in lung cancer and breast cancer. Lung cancer and breast cancer patients less than 65 years old with low SES in advantaged neighborhoods carried the highest risk of mortality. Prostate cancer patients aged 65 and above with low SES in disadvantaged neighborhoods incurred the highest risk of mortality. There was no association between SES and mortality for cervical cancer and pancreatic cancer. CONCLUSIONS: Our findings indicate that cancer patients with low individual SES have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.

  17. Quality control for thermoluminescent dosemeters TLD-100 de Li F: Mg, Ti for high dose rate treatments using Ir-192 sources in breast, esophagus and bronchus; Control de calidad con dosimetros thermoluminiscentes TLD-100 de Li F: Mg, Ti para tratamientos de alta tasa de dosis com fuentes de Ir-192 en canceres de seno, esofago y bronchio

    Energy Technology Data Exchange (ETDEWEB)

    Torres, F. [Universidad Nacional de Colombia, Bogota (Colombia)]. E-mail: franciscotorreshoyos@yahoo.com; Plazas, M.C. [Instituto Nacional de Cancerologia, Bogota (Colombia); Cavadia, W. [Universidad de Cordoba (Colombia)

    2004-07-01

    Rods - shaped, TLD - 100, LiF: Mg,Ti thermoluminescence dosimeters are used to check duality control during breast, esophagus and bronchus cancer treatments with high rate dose and Ir -192 source. We conclude that the specificity dose in prescription points is in agreement with parameters given in international protocols. (author)

  18. A Comparison Between Low-Dose-Rate Brachytherapy With or Without Androgen Deprivation, External Beam Radiation Therapy With or Without Androgen Deprivation, and Radical Prostatectomy With or Without Adjuvant or Salvage Radiation Therapy for High-Risk Prostate Cancer.

    Science.gov (United States)

    Ciezki, Jay P; Weller, Michael; Reddy, Chandana A; Kittel, Jeffrey; Singh, Harguneet; Tendulkar, Rahul; Stephans, Kevin L; Ulchaker, James; Angermeier, Kenneth; Stephenson, Andrew; Campbell, Steven; Haber, Georges-Pascal; Klein, Eric A

    2017-04-01

    We compare the efficacy and toxicity among the 3 major modalities available used to treat high-risk prostate cancer (HRCaP). From 1996 to 2012, 2557 HRCaP patients were treated: 734 received external beam radiation therapy (EBRT) with or without androgen deprivation therapy (ADT), 515 received low-dose-rate prostate brachytherapy (LDR) with or without ADT, and 1308 received radical prostatectomy (RP) with or without EBRT. Biochemical relapse-free survival (bRFS), clinical relapse-free survival (cRFS), and prostate cancer-specific mortality (PCSM) were assessed. Toxicity was assessed using the Common Terminology Criteria for Adverse Events, version 4.03. The log-rank test compared bRFS and cRFS among the modalities, and Cox regression identified factors associated with bRFS and cRFS. Gray's test compared differences in late toxicity and PSCM among the modalities. Competing risk regression identified factors associated with PCSM. The median follow-up time and age were 63.5 months and 65 years, respectively. The bRFS at 5 and 10 years, respectively, was 74% and 53% for EBRT, 74% and 52% for LDR, and 65% and 47% for RP (P=.0001). The cRFS at 5 and 10 years, respectively, was 85% and 73% for EBRT, 90% and 76% for LDR, and 89% and 75% for RP (P=.121). The PCSM at 5 and 10 years, respectively, was 5.3% and 11.2% for EBRT, 3.2% and 3.6% for LDR, and 2.8% and 6.8% for RP (P=.0004). The 10-year cumulative incidence of ≥grade 3 genitourinary toxicity was 8.1% for EBRT, 7.2% for LDR, and 16.4% for RP (P<.0001). The 10-year cumulative incidence of ≥grade 3 gastrointestinal toxicity was 4.6% for EBRT, 1.1% for LDR, and 1.0% for RP (P<.0001). HRCaP treated with EBRT, LDR, or RP yields efficacy showing better bRFS for LDR and EBRT relative to RP, equivalence for cRFS, and a PCSM advantage of LDR and RP over EBRT. The toxicity is lowest for LDR. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Upgrade Strategy for ALICE at High Rate

    CERN Document Server

    Musa, L

    2012-01-01

    The longterm goal of the ALICE experiment is to provide a precise characterization of the Quark-Gluon Plasma (QGP) state. Such a determination of its properties including initial temperature, degrees of freedom, speed of sound, and in general, transport coefficients would be a major achievement. This would go a long way towards a better understanding of QCD as a genuine multi-particle theory. To achieve this goal, high statistics measurements are required, which will give access also to the very rare physics channels needed to understand the dynamics of this condensed phase of QCD. The general upgrade strategy for the ALICE central barrel is conceived to deal with this challenge with expected Pb-Pb interaction rates of up to 50 kHz, that would provide an accumulated sample of the order of 10 nb^-1 in the period 2019-2023. In this document we sketch the modifications/replacements needed in all ALICE central barrel detectors and online systems (Trigger, DAQ and HLT) for high luminosity running. As the ALICE for...

  20. High Data Rate Architecture (HiDRA)

    Science.gov (United States)

    Hylton, Alan; Raible, Daniel

    2016-01-01

    high-rate laser terminals. These must interface with the existing, aging data infrastructure. The High Data Rate Architecture (HiDRA) project is designed to provide networked store, carry, and forward capability to optimize data flow through both the existing radio frequency (RF) and new laser communications terminal. The networking capability is realized through the Delay Tolerant Networking (DTN) protocol, and is used for scheduling data movement as well as optimizing the performance of existing RF channels. HiDRA is realized as a distributed FPGA memory and interface controller that is itself controlled by a local computer running DTN software. Thus HiDRA is applicable to other arenas seeking to employ next-generation communications technologies, e.g. deep space. In this paper, we describe HiDRA and its far-reaching research implications.

  1. Regional geographic variations in kidney cancer incidence rates in European countries.

    Science.gov (United States)

    Li, Peng; Znaor, Ariana; Holcatova, Ivana; Fabianova, Eleonora; Mates, Dana; Wozniak, Magdalena B; Ferlay, Jacques; Scelo, Ghislaine

    2015-06-01

    Marked unexplained national variations in incidence rates of kidney cancer have been observed for decades in Europe. To investigate geographic variations at the regional level and identify European regions with high incidence rates of kidney cancer. Regional- and national-level incidence data were extracted from the Cancer Incidence in Five Continents databases, local cancer registry databases, and local published reports. World population age-standardised rates (ASRs) were calculated for the periods 2003-2007 and 1988-1992. Rates by period and sex were compared using map visualisation. During 2003-2007, the highest ASR was found in the Plzen region, Czech Republic (31.4/100,000 person-years in men). Other regions of the Czech Republic had ASRs of 18.6-27.5/100,000 in men, with a tendency for higher rates in regions south of Prague. Surrounding regions, including eastern Germany and regions of Slovakia and Austria, had medium-to-high incidence rates (13.0-16.8/100,000 in men). Three other areas in Europe showed higher incidence rates in men compared with the rest of the continent: Lithuania, Estonia, Latvia, and Belarus (15.0-17.6/100,000); Iceland (13.5/100,000), and northern Italy (up to 16.0/100,000). Similar regional differences were observed among women, with rates approximately half of those observed in men in the same region. In general, these regional geographic variations remained stable over the periods 1988-1992 and 2003-2007, although higher incidence rates were detected in the Baltic countries in 2003-2007. Several European regions show particularly high rates of kidney cancer incidence. Large variations were observed within countries covered by national health-care systems, implying that overdetection is not the major factor. We present regional geographic variations in kidney cancer incidence rates in Europe. We highlight several regions with high incidence rates where further studies should be conducted for cancer control and prevention. Copyright

  2. Incidence rate of female breast cancer in urban Shijiazhuang in 2012 and modifiable risk factors.

    Science.gov (United States)

    Wen, Denggui; He, Yutong; Wei, Lizhen; Zhang, Nan; Li, Shumei; Wen, Xiaoduo; Yang, Yi; Wang, Guiying; Wang, Shijie; Geng, Cuizhi; Liu, Yunjiang; Shan, Baoen

    2016-09-01

    Breast cancer is diagnosed more frequently among urban than rural women in China; however, the incidence among women in Shijiazhuang is unknown. As registered Chinese citizens are entitled to complete public medical insurance coverage, the incidence rate was estimated using reimbursement records of first hospitalization. Breast cancer is the most common cancer among women in Shijiazhuang. The crude rate and age-standardized incidence rates by China (ASRC) and world (ASRW) standards were 59.6, 48.5 and 45.5/100 000 in 2012. Mean age at diagnosis was 55.1 years. Incidence increased with age, peaking at 165.1 at 70-74. In comparison with urban women in other Chinese cities, incidence in Shijiazhuang was similar to Shanghai (ASRC 46.6) and Suzhou (ASRW 45). When compared with 31 other Chinese cities, Shijiazhuang ranked second highest behind Guangzhou (ASRW 46.6), and the ASRW correlated significantly with gross domestic product per capita among the 32 cities. The breast cancer ASRW in Shijiazhuang was 2.7 times the rate of 41 rural Chinese counties (17). When compared with GLOBOCAN 2012 data according to the Human Development Index, breast cancer incidence in Shijiazhuang matched countries with a high human development index (ASRW 45.2). Breast cancer incidence in Shijiazhuang in 2012 was the highest in China, matching the rate in countries with high social economic development. This rate may continue to rise, parallel with urbanization, and may be associated with changing reproductive patterns and Westernization. Prevention methods need to be incorporated. © 2016 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

  3. ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer.

    Science.gov (United States)

    Rodda, Sree; Tyldesley, Scott; Morris, W James; Keyes, Mira; Halperin, Ross; Pai, Howard; McKenzie, Michael; Duncan, Graeme; Morton, Gerard; Hamm, Jeremy; Murray, Nevin

    2017-06-01

    To report the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68 years, who were then randomized to either a standard arm that included 12 months of androgen deprivation therapy and pelvic irradiation to 46 Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5 years. The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5 years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (Pversus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5 years, versus 37% after DE-EBRT (P=.30). The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of erectile dysfunction were observed. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Photocathodes for High Repetition Rate Light Sources

    Energy Technology Data Exchange (ETDEWEB)

    Ben-Zvi, Ilan [Stony Brook Univ., NY (United States). Dept. of Physics and Astronomy. Center for Accelerator Science and Education

    2014-04-20

    This proposal brought together teams at Brookhaven National Laboratory (BNL), Lawrence Berkeley National Laboratory (LBNL) and Stony Brook University (SBU) to study photocathodes for high repetition rate light sources such as Free Electron Lasers (FEL) and Energy Recovery Linacs (ERL). Below details the Principal Investigators and contact information. Each PI submits separately for a budget through his corresponding institute. The work done under this grant comprises a comprehensive program on critical aspects of the production of the electron beams needed for future user facilities. Our program pioneered in situ and in operando diagnostics for alkali antimonide growth. The focus is on development of photocathodes for high repetition rate Free Electron Lasers (FELs) and Energy Recovery Linacs (ERLs), including testing SRF photoguns, both normal-­conducting and superconducting. Teams from BNL, LBNL and Stony Brook University (SBU) led this research, and coordinated their work over a range of topics. The work leveraged a robust infrastructure of existing facilities and the support was used for carrying out the research at these facilities. The program concentrated in three areas: a) Physics and chemistry of alkali-­antimonide cathodes (BNL – LBNL) b) Development and testing of a diamond amplifier for photocathodes (SBU -­ BNL) c) Tests of both cathodes in superconducting RF photoguns (SBU) and copper RF photoguns (LBNL) Our work made extensive use of synchrotron radiation materials science techniques, such as powder-­ and single-­crystal diffraction, x-­ray fluorescence, EXAFS and variable energy XPS. BNL and LBNL have many complementary facilities at the two light sources associated with these laboratories (NSLS and ALS, respectively); use of these will be a major thrust of our program and bring our understanding of these complex materials to a new level. In addition, CHESS at Cornell will be used to continue seamlessly throughout the NSLS dark period and

  5. An ecological analysis of PM2.5 concentrations and lung cancer mortality rates in China.

    Science.gov (United States)

    Fu, Jingying; Jiang, Dong; Lin, Gang; Liu, Kun; Wang, Qiao

    2015-11-24

    To explore the association between Particulate Matter (PM)2.5 (particles with an aerodynamic diameter less than 2.5 µm) and lung cancer mortality rates and to estimate the potential risk of lung cancer mortality related to exposure to high PM2.5 concentrations. Geographically weighted regression was performed to evaluate the relation between PM2.5 concentrations and lung cancer mortality for males, females and for both sexes combined, in 2008, based on newly available long-term data. Lung cancer fatalities from long-term exposure to PM2.5 were calculated according to studies by Pope III et al and the WHO air quality guidelines (AQGs). 31 provinces in China. PM2.5 was associated with the lung cancer mortality of males, females and both sexes combined, in China, although there were exceptions in several regions, for males and females. The number of lung cancer fatalities calculated by the WHO AQGs ranged from 531,036 to 532,004, whereas the number calculated by the American Cancer Society (ACS) reached 614,860 after long-term (approximately 3-4 years) exposure to PM2.5 concentrations since 2008. There is a positive correlation between PM2.5 and lung cancer mortality rate, and the relationship between them varies across the entire country of China. The number of lung cancer fatalities estimated by ACS was closer to the actual data than those of the WHO AQGs. Therefore, the ACS estimate of increased risk of lung cancer mortality from long-term exposure to PM2.5 might be more applicable for evaluating lung cancer fatalities in China than the WHO estimate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. A readout unit for high rate applications

    CERN Document Server

    Toledo, J; Domínguez, D; Guirao-Elias, A; Müller, H

    2002-01-01

    The LHCb readout unit (RU) is a custom entry stage to the readout network of a data-acquisition or trigger system. It performs subevent building from multiple link inputs toward a readout network via a PCI network interface or alternatively toward a high-speed link, via an S-link interface. Incoming event fragments are derandomized, buffered and assembled into single subevents. This process is based on a low- overhead framing convention and matching of equal event numbers. Programmable logic is used both in the input and output stages of the RU module, which may be configured either as a data-link multiplexer or as entry stage to a readout or trigger network. All FPGAs are interconnected via the PCI bus, which is hosted by a networked microprocessor card. Its main tasks are remote FPGA configuration and initialization of the PCI cards. The RU hardware architecture has been optimized for a throughput of up to 200 MB/s at a 1 MHz trigger rate, as required by the most demanding application, the LHCb level-1 trig...

  7. Six-fold difference in the stomach cancer mortality rate between northern and southern Iran.

    Science.gov (United States)

    Zendehdel, Kazem; Marzban, Maryam; Nahvijou, Azin; Jafari, Nahid

    2012-12-01

    Stomach cancer is the most common cancer in Iran. A multi-ethnic population and wide variation in the environmental risk factors may lead to variations in cancer risk within this country. We have designed an ecological study and evaluated geographical variation regarding mortality from stomach cancer and its established risk factors in Iran.  We used the Iranian National Causes of Death Registry and estimated the age-standardized mortality rates (ASMR) of stomach cancer in 29 Iranian provinces, stratified by sex and area of residence (rural/urban).  The average ASMR of stomach cancer among Iranian males was 15 per 100,000 and for females it was 8.1 per 100,000. The highest and lowest mortality rates were observed in Kurdistan with an ASMR of 29.1 per 100,000 in northwestern Iran and Hormozgan that had an ASMR of 5.0 per 100,000 in southern Iran. Males had approximately a two-fold higher ASMR compared to females, as did rural residents when compared with urban residents. The prevalence of H. pylori infection was about 90% in the province of Ardabil (a high-risk area) and 27% in the province of Sistan-Baluchistan (a low-risk area).  The wide geographical variation and high mortality rate of stomach cancer in Iran is likely due to differences in the exposure to the environmental risk factors among people living in the high- and low-risk areas, particularly H. pylori infection, a well-established risk factor of stomach cancer.

  8. High voltage high repetition rate pulse using Marx topology

    Science.gov (United States)

    Hakki, A.; Kashapov, N.

    2015-06-01

    The paper describes Marx topology using MOSFET transistors. Marx circuit with 10 stages has been done, to obtain pulses about 5.5KV amplitude, and the width of the pulses was about 30μsec with a high repetition rate (PPS > 100), Vdc = 535VDC is the input voltage for supplying the Marx circuit. Two Ferrite ring core transformers were used to control the MOSFET transistors of the Marx circuit (the first transformer to control the charging MOSFET transistors, the second transformer to control the discharging MOSFET transistors).

  9. Aerobic glycolysis and high level of lactate in cancer metabolism and microenvironment

    Directory of Open Access Journals (Sweden)

    Bo Jiang

    2017-03-01

    Full Text Available Metabolic abnormalities is a hallmark of cancer. About 100 years ago, Nobel laureate Otto Heinrich Warburg first described high rate of glycolysis in cancer cells. Recently more and more novel opinions about cancer metabolism supplement to this hypothesis, consist of glucose uptake, lactic acid generation and secretion, acidification of the microenvironment and cancer immune evasion. Here we briefly review metabolic pathways generating lactate, and discuss the function of higher lactic acid in cancer microenvironments.

  10. High mitogenomic evolutionary rates and time dependency.

    NARCIS (Netherlands)

    Subramanian, S.; Denver, D.R.; Millar, C.D.; Heupink, T.; Aschrafi, A.; Emslie, S.D.; Baroni, C.; Lambert, D.M.

    2009-01-01

    Using entire modern and ancient mitochondrial genomes of Adelie penguins (Pygoscelis adeliae) that are up to 44000 years old, we show that the rates of evolution of the mitochondrial genome are two to six times greater than those estimated from phylogenetic comparisons. Although the rate of

  11. Incidence and mortality rates of colorectal cancer in Malaysia

    Science.gov (United States)

    2016-01-01

    OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate. PMID:26971697

  12. Incidence and mortality rates of colorectal cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Muhammad Radzi Abu Hassan

    2016-03-01

    Full Text Available OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR was calculated as the proportion of CRC cases (incidence and deaths (mortality from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35, followed by the Malay (18.95, and Indian (17.55 ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively. The 2011 (44.7% CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46 than females (8.05. CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

  13. Incidence and mortality rates of colorectal cancer in Malaysia.

    Science.gov (United States)

    Abu Hassan, Muhammad Radzi; Ismail, Ibtisam; Mohd Suan, Mohd Azri; Ahmad, Faizah; Wan Khazim, Wan Khamizar; Othman, Zabedah; Mat Said, Rosaida; Tan, Wei Leong; Mohammed, Siti Rahmah Noor Syahireen; Soelar, Shahrul Aiman; Nik Mustapha, Nik Raihan

    2016-01-01

    This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

  14. Administrative Database Research Overestimates the Rate of Interval Colon Cancer.

    Science.gov (United States)

    Gotfried, Jonathan; Bernstein, Marc; Ehrlich, Adam C; Friedenberg, Frank K

    2015-07-01

    Our study reexamines the prevalence of interval colorectal cancer (I-CRC) by manually reviewing CRC cases at a single institution. In 2% to 8% of patients with CRC, diagnosis occurs during the interval 6 to 36 months after a cancer-free colonoscopy. Rates are often determined by linking the date of colonoscopy with cancer registry information. We examined all colonoscopies from 1993 to 2011. These examinations were linked with Pennsylvania Cancer Registry data. Matched charts were manually reviewed. We determined whether the CRC was "prevalent" or, for patients with a previous colonoscopy, whether they were interval or noninterval based on time from last colonoscopy. For interval cases, we identified "administrative errors" that could falsely increase the number of reported I-CRC. Over the study period, 43,661 colonoscopies were performed, with 1147 (2.6%) positive for CRC after excluding cases (n=52) in which patients had IBD, previous surgery, or nonadenocarcinoma malignancy. Prevalent CRCs totaled 1062 (92.6%). Noninterval CRCs (diagnosed over 36 mo from index colonoscopy) were present in 40 (3.5%). There remained 45 (3.9%) potential I-CRC cases. However, after manual review, 21 cases were found to be administrative errors. Therefore, the accurate proportion of colonoscopies that found an I-CRC was 2.1% (95% confidence interval, 1.5%-3.2%). The prevalence of I-CRC at our institution before adjustment was comparable with previously reported rates. This proportion was 47% lower after adjusting for administrative errors placing our figure at the lower end of reported I-CRC incidence. Reported rates of I-CRC may be falsely elevated due to errors unique to merging administrative databases.

  15. The correlation between rates of cancer and autism: an exploratory ecological investigation.

    Directory of Open Access Journals (Sweden)

    Hung-Teh Kao

    2010-02-01

    Full Text Available Autism is associated with high rates of genomic aberrations, including chromosomal rearrangements and de novo copy-number variations. These observations are reminiscent of cancer, a disease where genomic rearrangements also play a role. We undertook a correlative epidemiological study to explore the possibility that shared risk factors might exist for autism and specific types of cancer.To determine if significant correlations exist between the prevalence of autism and the incidence of cancer, we obtained and analyzed state-wide data reported by age and gender throughout the United States. Autism data were obtained from the U.S. Department of Education via the Individuals with Disabilities Education Act (IDEA (2000-2007, reported annually by age group and cancer incidence data were obtained from the Centers for Disease Control and Prevention (CDC (1999-2005. IDEA data were further subdivided depending on the method used to diagnose autism (DSM IV or the Code of Federal Regulations, using strict or expanded criteria. Spearman rank correlations were calculated for all possible pairwise combinations of annual autism rates and the incidence of specific cancers. Following this, Bonferroni's correction was applied to significance values. Two independent methods for determining an overall combined p-value based on dependent correlations were obtained for each set of calculations. High correlations were found between autism rates and the incidence of in situ breast cancer (p < or = 10(-10, modified inverse chi square, n = 16 using data from states that adhere strictly to the Code of Federal Regulations for diagnosing autism. By contrast, few significant correlations were observed between autism prevalence and the incidence of 23 other female and 22 male cancers.These findings suggest that there may be an association between autism and specific forms of cancer.

  16. The correlation between rates of cancer and autism: an exploratory ecological investigation.

    Science.gov (United States)

    Kao, Hung-Teh; Buka, Stephen L; Kelsey, Karl T; Gruber, David F; Porton, Barbara

    2010-02-23

    Autism is associated with high rates of genomic aberrations, including chromosomal rearrangements and de novo copy-number variations. These observations are reminiscent of cancer, a disease where genomic rearrangements also play a role. We undertook a correlative epidemiological study to explore the possibility that shared risk factors might exist for autism and specific types of cancer. To determine if significant correlations exist between the prevalence of autism and the incidence of cancer, we obtained and analyzed state-wide data reported by age and gender throughout the United States. Autism data were obtained from the U.S. Department of Education via the Individuals with Disabilities Education Act (IDEA) (2000-2007, reported annually by age group) and cancer incidence data were obtained from the Centers for Disease Control and Prevention (CDC) (1999-2005). IDEA data were further subdivided depending on the method used to diagnose autism (DSM IV or the Code of Federal Regulations, using strict or expanded criteria). Spearman rank correlations were calculated for all possible pairwise combinations of annual autism rates and the incidence of specific cancers. Following this, Bonferroni's correction was applied to significance values. Two independent methods for determining an overall combined p-value based on dependent correlations were obtained for each set of calculations. High correlations were found between autism rates and the incidence of in situ breast cancer (p autism. By contrast, few significant correlations were observed between autism prevalence and the incidence of 23 other female and 22 male cancers. These findings suggest that there may be an association between autism and specific forms of cancer.

  17. [Changes of mortality rate for cervical cancer during 1970's and 1990's periods in China].

    Science.gov (United States)

    Yang, Ling; Huangpu, Xiao-mei; Zhang, Si-wei; Lu, Feng-zhu; Sun, Xiu-di; Sun, Jie; Mu, Ren; Li, Lian-di; Qiao, You-lin

    2003-08-01

    To describe the distribution changes of the mortality rate for cervical cancer in China between the 1970's and 1990's and provide the scientific evidence for the prevention and control strategies for cervical cancer campaign in China between next century. Data from two National Surveys for the Causes of Death in 1970's and 1990's in China. The crude and adjusted mortality rates for the cervical cancer and the distributions based on age and area were calculated and described. The comparison of the differences of changes between two mortality rates periods and together with its trends were shown based on the age-standardized. During two decades, the mortality rate for cervical cancer was 10.7 per 100,000 in 1970's which declined to 3.89 per 100,000 in 1990's, and from the 3rd ranking among all female malignant tumors to the 6th in 1990's (decreased about 63.64%). But the declination was not evenly. There have still been some high-risk areas, most located in rural countries in the mid-west of China, with rates remain unchanged and even at the highest level in the world, such as Wudu in Gansu and Yangcheng in Shanxi. A big difference was showed between rural country and city, but in both of them, the mortality rates in 1990's were significantly much lower than in 1970's (P = 0.001) at each five-year age group. And in the city, there was a much sharper increased trend in young women in 1990's. The mortality rate for cervical cancer campaign in China has been substantially declined during past twenty years, but it's still a major health problem for women, especially in rural China. The focus of the prevention and control for the cervical cancer in the next century should put on rural areas, especially in mid-west of China and young women in the city.

  18. Comparable cell survival between high dose rate flattening filter free and conventional dose rate irradiation.

    Science.gov (United States)

    Verbakel, Wilko F A R; van den Berg, Jaap; Slotman, Ben J; Sminia, Peter

    2013-04-01

    Investigation of clonogenic cell survival and cell proliferation following single dose and fractionated delivery of high dose rate flattening filter free (FFF) irradiation compared to conventional dose rates. The human astrocytoma D384, glioma T98 and lung carcinoma SW1573 cell lines were irradiated using either a single dose (0-12 Gy) or a fractionated protocol of 5 daily fractions of 2 Gy (D384) or 3 Gy (SW1573). Cells were irradiated inside a phantom using fixed gantry beams of a linear accelerator. A sliding window technique created homogeneous dose distributions over the surface of the cell cultures. Irradiations using standard beams (6 MV, 600 MU/min.) and high dose rate FFF beams (10 MV, 2400 MU/min.) were compared. Cell survival was determined by clonogenic assay. In the fractionated irradiation set-up, the number of clonogenic cells was estimated by including tumor cell proliferation during the overall treatment time in the analysis. All cell lines showed equal cell survival following irradiation using either the FFF beams or conventional flattened (FF) beams. This was observed after single dose exposure (0-12 Gy) as well as after fractionated irradiation (p = 0.08 for D384 and 0.20 for SW1373 cell lines). FFF irradiation with a dose rate of 2400 MU/min and four times higher dose per pulse compared to irradiation with FF beams did not change cell survival for three human cancer cell lines up to a fraction dose of 12 Gy compared to irradiation using FF beams.

  19. A Comparison Between Low-Dose-Rate Brachytherapy With or Without Androgen Deprivation, External Beam Radiation Therapy With or Without Androgen Deprivation, and Radical Prostatectomy With or Without Adjuvant or Salvage Radiation Therapy for High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ciezki, Jay P., E-mail: ciezkij@ccf.org [Taussig Cancer Institute, Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Weller, Michael; Reddy, Chandana A.; Kittel, Jeffrey; Singh, Harguneet; Tendulkar, Rahul; Stephans, Kevin L. [Taussig Cancer Institute, Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Ulchaker, James; Angermeier, Kenneth; Stephenson, Andrew; Campbell, Steven; Haber, Georges-Pascal; Klein, Eric A. [Glickman Urological and Kidney Institute, Department of Urology, Cleveland Clinic, Cleveland, Ohio (United States)

    2017-04-01

    Purpose: We compare the efficacy and toxicity among the 3 major modalities available used to treat high-risk prostate cancer (HRCaP). Methods and Materials: From 1996 to 2012, 2557 HRCaP patients were treated: 734 received external beam radiation therapy (EBRT) with or without androgen deprivation therapy (ADT), 515 received low-dose-rate prostate brachytherapy (LDR) with or without ADT, and 1308 received radical prostatectomy (RP) with or without EBRT. Biochemical relapse-free survival (bRFS), clinical relapse-free survival (cRFS), and prostate cancer–specific mortality (PCSM) were assessed. Toxicity was assessed using the Common Terminology Criteria for Adverse Events, version 4.03. The log-rank test compared bRFS and cRFS among the modalities, and Cox regression identified factors associated with bRFS and cRFS. Gray's test compared differences in late toxicity and PSCM among the modalities. Competing risk regression identified factors associated with PCSM. Results: The median follow-up time and age were 63.5 months and 65 years, respectively. The bRFS at 5 and 10 years, respectively, was 74% and 53% for EBRT, 74% and 52% for LDR, and 65% and 47% for RP (P=.0001). The cRFS at 5 and 10 years, respectively, was 85% and 73% for EBRT, 90% and 76% for LDR, and 89% and 75% for RP (P=.121). The PCSM at 5 and 10 years, respectively, was 5.3% and 11.2% for EBRT, 3.2% and 3.6% for LDR, and 2.8% and 6.8% for RP (P=.0004). The 10-year cumulative incidence of ≥grade 3 genitourinary toxicity was 8.1% for EBRT, 7.2% for LDR, and 16.4% for RP (P<.0001). The 10-year cumulative incidence of ≥grade 3 gastrointestinal toxicity was 4.6% for EBRT, 1.1% for LDR, and 1.0% for RP (P<.0001). Conclusion: HRCaP treated with EBRT, LDR, or RP yields efficacy showing better bRFS for LDR and EBRT relative to RP, equivalence for cRFS, and a PCSM advantage of LDR and RP over EBRT. The toxicity is lowest for LDR.

  20. ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rodda, Sree [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Tyldesley, Scott [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Morris, W. James, E-mail: jmorris@bccancer.bc.ca [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Keyes, Mira [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Halperin, Ross [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Pai, Howard [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency, Vancouver Island Centre, Victoria, British Columbia (Canada); McKenzie, Michael; Duncan, Graeme [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Morton, Gerard [Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Hamm, Jeremy [Department of Population Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Murray, Nevin [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Medicine, University of British Columbia, Vancouver, British Columbia (Canada)

    2017-06-01

    Purpose: To report the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. Methods and Materials: ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68 years, who were then randomized to either a standard arm that included 12 months of androgen deprivation therapy and pelvic irradiation to 46 Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5 years. Results: The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5 years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (P<.001). Compared with the cumulative incidence, the 5-year prevalence of grade 3 GU morbidity was substantially lower for both arms (8.6% vs 2.2%, P=.058). The 5-year cumulative incidence of grade 3 GI events was 8.1% for LDR-PB, versus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5 years, versus 37% after DE-EBRT (P=.30). Conclusions: The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of

  1. Contemporary Incidence and Mortality Rates of Neuroendocrine Prostate Cancer.

    Science.gov (United States)

    Alanee, Shaheen; Moore, Aaron; Nutt, Max; Holland, Bradley; Dynda, Danuta; El-Zawahry, Ahmed; McVary, Kevin T

    2015-07-01

    The purpose of the study was to provide an update ever the incidence and mortality for neuroendocrine prostate cancer (NEPC) in the United States. Using a large national database, we examined changes in age-adjusted incidence (AAIR), mortality rates (MR) and 5-year cancer-specific survival (CSS) for 378 patients diagnosed with NEPC between 1992 and 2011. Analysis was performed for all NEPC and for its two major sub-groups [small cell carcinoma (SCC) and neuroendocrine carcinoma (NEC)]. AAIR of NEPC continues to rise in recent years (2004-2011:+6.8%/year, p>0.05). AAIR of SCC has been increasing significantly by 6.94%/year since 2001 (from 0.470 to 0.582/1,000,000 person years, pAAIR of SCC is increasing with no change in the MR of NEPC over the past 20 years. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Analysis of mitochondrial DNA in Tibetan gastric cancer patients at high altitude

    OpenAIRE

    Jiang, Jun; Zhao, Jun-Hui; Wang, Xue-lian; DI, JI; Liu, Zhi-Bo; LI, GUO-YUAN; WANG, MIAO-ZHOU; Li, Yan; Chen, Rong; Ge, Ri-Li

    2015-01-01

    The highest risk areas of gastric cancer are currently Japan, Korea and China; Qinghai, a high-altitude area, has one of the highest gastric cancer rates in China. The incidence of gastric cancer is higher in the Tibetan ethnic group compared to that in the Han ethnic group in Qinghai. This study was conducted to determine the clinical characteristics of mitochondrial DNA (mtDNA) mutations and copy numbers among Tibetans with gastric cancer residing at high altitudes and investigate the assoc...

  3. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor.

    Science.gov (United States)

    Shore, Roy; Walsh, Linda; Azizova, Tamara; Rühm, Werner

    2017-10-01

    Estimated radiation risks used for radiation protection purposes have been based primarily on the Life Span Study (LSS) of atomic bomb survivors who received brief exposures at high dose rates, many with high doses. Information is needed regarding radiation risks from low dose-rate (LDR) exposures to low linear-energy-transfer (low-LET) radiation. We conducted a meta-analysis of LDR epidemiologic studies that provide dose-response estimates of total solid cancer risk in adulthood in comparison to corresponding LSS risks, in order to estimate a dose rate effectiveness factor (DREF). We identified 22 LDR studies with dose-response risk estimates for solid cancer after minimizing information overlap. For each study, a parallel risk estimate was derived from the LSS risk model using matching values for sex, mean ages at first exposure and attained age, targeted cancer types, and accounting for type of dosimetric assessment. For each LDR study, a ratio of the excess relative risk per Gy (ERR Gy(-1)) to the matching LSS ERR risk estimate (LDR/LSS) was calculated, and a meta-analysis of the risk ratios was conducted. The reciprocal of the resultant risk ratio provided an estimate of the DREF. The meta-analysis showed a LDR/LSS risk ratio of 0.36 (95% confidence interval [CI] 0.14, 0.57) for the 19 studies of solid cancer mortality and 0.33 (95% CI 0.13, 0.54) when three cohorts with only incidence data also were added, implying a DREF with values around 3, but statistically compatible with 2. However, the analyses were highly dominated by the Mayak worker study. When the Mayak study was excluded the LDR/LSS risk ratios increased: 1.12 (95% CI 0.40, 1.84) for mortality and 0.54 (95% CI 0.09, 0.99) for mortality + incidence, implying a lower DREF in the range of 1-2. Meta-analyses that included only cohorts in which the mean dose was risk ratio of 1.06 (95% CI 0.30, 1.83) for solid cancer mortality and 0.58 (95% CI 0.10, 1.06) for mortality + incidence data. The

  4. Effect of low-dose-rate irradiation on the division potential of cells in vitro. V. Human skin fibroblasts from donors with a high risk of cancer. [/sup 60/Co

    Energy Technology Data Exchange (ETDEWEB)

    Diatloff, C.; Macieira-Coelho, A.

    1979-07-01

    Skin fibroblasts from normal donors, donors with ataxia-telanglectasia or Fanconi's anemia, and from 1 cancer patient were treated with repeated ..gamma.. radiation at about 16 rads per hour. The remaining division potential of all fibroblasts, except for the Fanconi's anemia cells, was reduced to different extents by radiation. The growth potential of Fanconl's anemia cells was increased in all the irradiated cultures. The increase was 54% in the group that survived the longest. These results were identical to those obtained with fibroblasts from certain species that have a high probability of transformation.

  5. Estimating the personal cure rate of cancer patients using population-based grouped cancer survival data.

    Science.gov (United States)

    Binbing Yu; Tiwari, Ram C; Feuer, Eric J

    2011-06-01

    Cancer patients are subject to multiple competing risks of death and may die from causes other than the cancer diagnosed. The probability of not dying from the cancer diagnosed, which is one of the patients' main concerns, is sometimes called the 'personal cure' rate. Two approaches of modelling competing-risk survival data, namely the cause-specific hazards approach and the mixture model approach, have been used to model competing-risk survival data. In this article, we first show the connection and differences between crude cause-specific survival in the presence of other causes and net survival in the absence of other causes. The mixture survival model is extended to population-based grouped survival data to estimate the personal cure rate. Using the colorectal cancer survival data from the Surveillance, Epidemiology and End Results Programme, we estimate the probabilities of dying from colorectal cancer, heart disease, and other causes by age at diagnosis, race and American Joint Committee on Cancer stage.

  6. Prostate cancer detection rate at second and third biopsy. Predictive factors and risk groups for cancer diagnosis.

    Science.gov (United States)

    Castello-Porcar, Ana; García-Morata, Francisco; Martinez-Jabaloyas, Jose María

    2014-09-01

    The diagnosis of prostate cancer is obtained with the performance of a prostate biopsy. Repetition of biopsies is required in patients with negative biopsies when there is high suspicion for cancer. The objective of this study is to know the prostate cancer detection rate in second and third prostatic biopsies and to identify the clinical factors with predictive value for positivity. We also want to establish risk groups for cancer diagnosis after one or two previous negative biopsies. Retrospective study of patients undergoing a second or third prostatic biopsy. We determined the rate of cancer diagnosis for both. We performed univariate and multivariate analysis (multiple logistic regression) to analyse any relationship between clinical variables (PSA, PSA density, PSA F/T ratio, PSA velocity, digital rectal examination, transrectal ultrasonography, prostate volume, time between biopsies, pathological result and number of cores obtained in the first biopsy) and positivity in the second and third biopsies. Logistic regression analysis was performed to know which factors are predictors for positivity in 2nd and 3 th biopsies. According to the probabilities obtained, different risk groups were established. 4.532 patients underwent prostate biopsy between 1999 and 2010. 663 patients were included for second biopsy and 191 for third biopsy. Detection rates for prostate cancer were 24,3% and 17.8% respectively. According to the multivariate analysis, the probability for positivity on second biopsy increases when first biopsy was sextant (p=0,049), patients were >65 years old (p=0,005) and PSA density was >0,15 (p=0,000). Four risk groups were established with a range of probability for prostate cancer between 7 and 37%. For third biopsy, predictive variables were: suspicious digital rectal examination (p=0,007), age >64 years (p=0,009), and PSA density >0,20 (p=0,001). Also risk groups were established with probabilities between 1,6 and 61%. Detection rate for

  7. Impact of consanguinity on cancer in a highly endogamous population.

    Science.gov (United States)

    Bener, Abdulbari; El Ayoubi, Hanadi R; Chouchane, Lotfi; Ali, Awab I; Al-Kubaisi, Aisha; Al-Sulaiti, Haya; Teebi, Ahmad S

    2009-01-01

    Many epidemiological studies have indicated that inbreeding has little or no effect on the incidence of cancer. Due to the high prevalence of consanguinity in Qatar (54%), its influence may nevertheless be of special importance. The aim of this study was to examine whether parental consanguinity affects the risk of cancer in a local Arab highly inbred population. Matched case-control study. The study was carried out in Al-Amal cancer hospital and primary health care centers in Qatar over a period from August 2008 to February 2009. The study included 370 Qataris and other Arab expatriates with various types of cancers and 635 controls matched by age and ethnicity. A questionnaire that included socio-demographic information, type of consanguinity, medical history, and tumor grade was designed to collect the information of cases and controls. The study revealed that the rate of parental consanguinity was similar in both cases (29.5%) and controls (29.9%) with a higher inbreeding coefficient in controls (0.017-/+0.03), compared to cancer patients (0.0155-/+0.03). Other Arab expatriates had a higher incidence of cancer (61.1%) than Qataris (38.9%). The inbreeding coefficient was higher in male cancer patients (0.0189-/+0.03), but lower in female cancer patients (0.014-/+0.03) as compared to controls. Controls were more inbred in the overall studied subjects (23.6%) and women (23.8%) than cases. The coefficient of inbreeding was lower in patients with breast (0.014), skin (0.012), thyroid (0.008) and female genital (0.014) cancers, whereas it was higher in cases for leukemia and lymphoma (0.018), colorectal (0.025) and prostate (0.017), with no significant difference between cases and controls. No significant differences were observed between cases and controls in the parental consanguinity, mean coefficient of inbreeding and proportion of more inbred subjects. The study findings revealed that although the consanguinity rate is high in our Arab population, it has no

  8. High frame rate synthetic aperture duplex imaging

    DEFF Research Database (Denmark)

    Stuart, Matthias Bo; Tomov, Borislav Gueorguiev; Pihl, Michael Johannes

    2013-01-01

    Conventional color flow images are limited in velocity range and can either show the high velocities in systole or be optimized for the lower diastolic velocities. The full dynamics of the flow is, thus, hard to visualize. The dynamic range can be significantly increased by employing synthetic ap...

  9. Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital.

    Science.gov (United States)

    Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

    2017-05-18

    patients with data on their Duke's staging, independent predictors of poor colorectal cancer (5-year) survival were male sex (Hazard Ratio [HR]: 1.41; 95% CI: 1.12, 1.76), Chinese ethnicity (HR: 1.41; 95% CI: 1.07,1.85), elevated (≥ 5.1 ng/ml) pre-operative carcino-embryonic antigen (CEA) level (HR: 2.13; 95% CI: 1.60, 2.83), Duke's stage C (HR: 1.68; 95% CI: 1.28, 2.21), Duke's stage D (HR: 4.61; 95% CI: 3.39, 6.28) and emergency surgery (HR: 1.52; 95% CI: 1.07, 2.15). The survival rates of colorectal cancer among our patients were comparable with those of some Asian countries but lower than those found in more developed countries. Males and patients from the Chinese ethnic group had lower survival rates compared to their counterparts. More advanced staging and late presentation were important predictors of colorectal cancer survival. Health education programs targeting high risk groups and emphasizing the importance of screening and early diagnosis, as well as the recognition of symptoms and risk factors should be implemented. A nationwide colorectal cancer screening program should be designed and implemented to increase early detection and improve survival outcomes.

  10. [Comparison of two gastric cancer screening schemes in a high-risk population].

    Science.gov (United States)

    Lü, Yan-li; Li, Yi; Liu, Guang-shun; Wu, Qi; Liu, Wei-dong; Li, Shi-jie; Cao, Chang-qi; Wu, Xiu-zhen; Liu, Dong-mei; Zhang, Lei; Zhang, Lan-fu; Ma, Jun-ling; Pan, Kai-feng; Zhang, Lian; You, Wei-cheng

    2013-05-01

    To evaluate the effects of two gastric cancer screening schemes for early detection of gastric cancer in a high-risk population. A cluster random sampling method was used to select local residents aged 40-69 years from Linqu County, Shandong Province. "Serum pepsinogen initial screening combined with further endoscopic examination (PG scheme)" and "direct endoscopic examination (endoscopy scheme)" were conducted. The associations between screening schemes and detection rates of gastric cancer, and early gastric cancer/high-grade intraepithelial neoplasia were evaluated by unconditional logistic regression analysis. Overall, 3654 and 2290 participants completed PG and endoscopy schemes, respectively. A total of 11 (0.30%) cases of gastric cancer and 10 (0.27%) cases of high-grade intraepithelial neoplasia were detected by PG scheme, of which 7 (0.19%) cases were early gastric cancer. While, 19 (0.83%) cases of gastric cancer and 10 (0.44%) cases of high-grade intraepithelial neoplasia were detected by endoscopy scheme, with 12 (0.52%) cases of early gastric cancer. Compared with the PG scheme, the endoscopy scheme had a significantly higher detection rates of gastric cancer (OR = 2.83, 95%CI 1.34-5.98), and early gastric cancer/high-grade intraepithelial neoplasia (OR = 2.12, 95%CI 1.12-4.02). The endoscopy scheme is more effective in the detection of gastric cancer in a high-risk population, particularly for early gastric cancer/high-grade intraepithelial neoplasia than the PG scheme.

  11. High readmission rate after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, K L; Berg, S K; Thygesen, Lau Caspar

    2015-01-01

    age (hazard ratio (95% CI): 1.3 (1.0-1.6)), male sex (1.2 (1.0-1.5)), mitral valve surgery (1.3 (1.0-1.6)), and infective endocarditis after surgery (1.8 (1.1-3.0), p: 0.01) predicted readmission, whereas higher age (2.3 (1.0-5.4)), higher comorbidity score (3.2 (1.8-6.0)), and infective endocarditis......BACKGROUND: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. METHODS: Using a nationwide survey with linkage to Danish registers with one year follow-up, we...... included all adults 6-12 months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n = 867). Participants completed a questionnaire regarding health-status (n = 742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were...

  12. High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Yufeng Zhou

    2014-01-01

    Full Text Available Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered.

  13. High data rate optical transceiver terminal

    Science.gov (United States)

    Clarke, E. S.

    1973-01-01

    The objectives of this study were: (1) to design a 400 Mbps optical transceiver terminal to operate from a high-altitude balloon-borne platform in order to permit the quantitative evaluation of a space-qualifiable optical communications system design, (2) to design an atmospheric propagation experiment to operate in conjunction with the terminal to measure the degrading effects of the atmosphere on the links, and (3) to design typical optical communications experiments for space-borne laboratories in the 1980-1990 time frame. As a result of the study, a transceiver package has been configured for demonstration flights during late 1974. The transceiver contains a 400 Mbps transmitter, a 400 Mbps receiver, and acquisition and tracking receivers. The transmitter is a Nd:YAG, 200 Mhz, mode-locked, CW, diode-pumped laser operating at 1.06 um requiring 50 mW for 6 db margin. It will be designed to implement Pulse Quaternary Modulation (PQM). The 400 Mbps receiver utilizes a Dynamic Crossed-Field Photomultiplier (DCFP) detector. The acquisition receiver is a Quadrant Photomultiplier Tube (QPMT) and receives a 400 Mbps signal chopped at 0.1 Mhz.

  14. [Urethral stricture rate after prostate cancer radiotherapy : Five-year data of a certified prostate cancer center].

    Science.gov (United States)

    Kranz, J; Maurer, G; Maurer, U; Deserno, O; Schulte, S; Steffens, J

    2017-03-01

    A urethral stricture is a scar of the urethral epithelium which can cause obstructive voiding dysfunction with consequential damage of the upper urinary tract. Almost 45% of all strictures are iatrogenic; they develop in 2-9% of patients after radical prostatectomy, but can also occur after prostate cancer radiotherapy. This study provides 5‑year data of a certified prostate cancer center (PKZ) in terms of urethral strictures. Between 01/2008 and 12/2012 a total of 519 men were irradiated for prostate cancer (LDR and HDR brachytherapy as well as external beam radiation). The entire cohort was followed-up prospectively according to a standardized protocol (by type of irradiation). Short segment urethral strictures were treated by urethrotomy, recurrent and long segment stenosis with buccal mucosa urethroplasty. A total of 18 of 519 (3.4%) patients developed a urethral stricture post-therapeutically, which recurred in 66% of cases after the first operative treatment. The largest risk for developing a urethral stricture is attributed to the HDR brachytherapy (8.9%). Urethral strictures after prostate cancer radiotherapy should be diagnosed and treated in time for long-term preservation of renal function. The rate of radiogenic urethral strictures (3.4%) is equivalent to those after radical prostatectomy. Due to a high rate of recurrences, urethrotomy has a limited importance after irradiation.

  15. A Multicountry Ecological Study of Cancer Incidence Rates in 2008 with Respect to Various Risk-Modifying Factors

    Directory of Open Access Journals (Sweden)

    William B. Grant

    2013-12-01

    Full Text Available Observational and ecological studies are generally used to determine the presence of effect of cancer risk-modifying factors. Researchers generally agree that environmental factors such as smoking, alcohol consumption, poor diet, lack of physical activity, and low serum 25-hdyroxyvitamin D levels are important cancer risk factors. This ecological study used age-adjusted incidence rates for 21 cancers for 157 countries (87 with high-quality data in 2008 with respect to dietary supply and other factors, including per capita gross domestic product, life expectancy, lung cancer incidence rate (an index for smoking, and latitude (an index for solar ultraviolet-B doses. The factors found to correlate strongly with multiple types of cancer were lung cancer (direct correlation with 12 types of cancer, energy derived from animal products (direct correlation with 12 types of cancer, inverse with two, latitude (direct correlation with six types, inverse correlation with three, and per capita gross national product (five types. Life expectancy and sweeteners directly correlated with three cancers, animal fat with two, and alcohol with one. Consumption of animal products correlated with cancer incidence with a lag time of 15–25 years. Types of cancer which correlated strongly with animal product consumption, tended to correlate weakly with latitude; this occurred for 11 cancers for the entire set of countries. Regression results were somewhat different for the 87 high-quality country data set and the 157-country set. Single-country ecological studies have inversely correlated nearly all of these cancers with solar ultraviolet-B doses. These results can provide guidance for prevention of cancer.

  16. Permanent stoma rates: a misleading marker of quality in rectal cancer surgery.

    Science.gov (United States)

    Codd, R J; Evans, M D; Davies, M; Harris, D A; Chandrasekaran, T V; Khot, U P; Morgan, A R; Beynon, J

    2014-04-01

    The latest National Bowel Cancer Audit Programme (NBOCAP) audit identified our colorectal unit as an outlier with regard to the high permanent stoma rate. The aim of this study was to perform an audit of the rationale for stoma formation in patients undergoing rectal cancer resection in our unit. A review was conducted of all rectal cancer operations between April 2011 and March 2013. Preoperative staging investigations and operation reports were reviewed to identify the reasons for nonrestorative surgery. Postoperative histology reports were used to identify circumferential resection margin (CRM) involvement and tumour height. One-hundred and twenty-five patients underwent surgery for rectal cancer, of whom 102 underwent elective resection with curative intent. The permanent stoma rate was 63.2% when emergency and palliative procedures were included and 54.9% when only elective curative cases were considered. Tertiary referrals made up 31.4% of elective cases. The main reasons for nonrestorative surgery included multivisceral resection (n = 24) for locally advanced cancer and operations for lesions close to the anal sphincter (n = 21). The median length of stay was 8 days, the 90-day mortality was 2.9% and the rate of CRM involvement was 2.0%. Our unit provides multivisceral surgery for locally advanced rectal cancer and receives a substantial number of tertiary referrals. Many of the rectal cancers referred are locally advanced or threaten the anal sphincter. This study demonstrates that the complexity of a unit's case-mix can have a profound effect on the permanent stoma rate. Stoma rates taken at face value do not therefore provide an accurate representation of surgical quality. What does this paper add to the literature? The study reviews the practice of a colorectal surgical unit with an interest in multivisceral surgery with regard to the permanent stoma rate. The reasons for nonrestorative surgery are analysed, and the problems associated with the use of

  17. Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009.

    Science.gov (United States)

    Ali, Hala; Sinnott, Sarah-Jo; Corcoran, Paul; Deady, Sandra; Sharp, Linda; Kabir, Zubair

    2016-12-20

    Oral cancer is a significant public health problem world-wide and exerts high economic, social, psychological, and physical burdens on patients, their families, and on their primary care providers. We set out to describe the changing trends in incidence and survival rates of oral cancer in Ireland between 1994 and 2009. National data on incident oral cancers [ICD 10 codes C01-C06] were obtained from the National Cancer Registry Ireland from 1994 to 2009. We estimated annual percentage change (APC) in oral cancer incidence during 1994-2009 using joinpoint regression software (version 4.2.0.2). The lifetime risk of oral cancer to age 79 was estimated using Irish incidence and population data from 2007 to 2009. Survival rates were also examined using Kaplan-Meier curves and Cox proportional hazard models to explore the influence of several demographic/lifestyle covariates with follow-up to end 2012. Data were obtained on 2,147 oral cancer incident cases. Men accounted for two-thirds of oral cancer cases (n = 1,430). Annual rates in men decreased significantly during 1994-2001 (APC = -4.8 %, 95 % CI: -8.7 to -0.7) and then increased moderately (APC = 2.3 %, 95 % CI: -0.9 to 5.6). In contrast, annual incidence increased significantly in women throughout the study period (APC = 3.2 %, 95 % CI: 1.9 to 4.6). There was an elevated risk of death among oral cancer patients who were: older than 60 years of age; smokers; unemployed or retired; those living in the most deprived areas; and those whose tumour was sited in the base of the tongue. Being married and diagnosed in more recent years were associated with reduced risk of death. Oral cancer increased significantly in both sexes between 1999 and 2009 in Ireland. Our analyses demonstrate the influence of measured factors such as smoking, time of diagnosis and age on observed trends. Unmeasured factors such as alcohol use, HPV and dietary factors may also be contributing to increased trends. Several of

  18. Effect of information seeking and avoidance behavior on self-rated health status among cancer survivors.

    Science.gov (United States)

    Jung, Minsoo; Ramanadhan, Shoba; Viswanath, Kasisomayajula

    2013-07-01

    Social determinants, such as socioeconomic status (SES) and race/ethnicity are linked to striking health disparities across the cancer continuum. One important mechanism linking social determinants and health disparities may be communication inequalities that are caused by differences in accessing, processing and utilizing cancer information. In this context, we examined health information-seeking/avoidance as a potential mediator between social determinants and self-rated health (SRH) status among cancer survivors. Data came from the 2008 well-informed, thriving and surviving (WITS) study of post-treatment cancer survivors (n=501). We examined the mediating effect of health communication-related behavior between SES and disparities in SRH. The likelihood of belonging to the Low SRH group was higher among patients who had avoided health information and whose family members had not sought health information on behalf of the survivor, those in the lowest household income bracket, and those who had high school or less education after adjusting for potential confounders. Differences in SRH among cancer survivors are associated with SES as well as communication inequalities. It is necessary to provide a supportive environment in which health information is made available if disparities in health-related quality of life among cancer survivors are to be reduced. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. The Effect of Minimum Wage Rates on High School Completion

    Science.gov (United States)

    Warren, John Robert; Hamrock, Caitlin

    2010-01-01

    Does increasing the minimum wage reduce the high school completion rate? Previous research has suffered from (1. narrow time horizons, (2. potentially inadequate measures of states' high school completion rates, and (3. potentially inadequate measures of minimum wage rates. Overcoming each of these limitations, we analyze the impact of changes in…

  20. Correlation Among Cancer Incidence and Mortality Rates and Internet Searches in the United States.

    Science.gov (United States)

    Wehner, Mackenzie R; Nead, Kevin T; Linos, Eleni

    2017-09-01

    Population-level disease metrics are critical to guide the distribution of resources and implementation of public health initiatives. Internet search data reflect population interest in health topics and may be an alternative metric of disease characteristics when traditional sources are lacking, such as in basal and squamous cell carcinomas, which are not included in national cancer registries. However, these data are not yet well validated or understood. To evaluate whether state-specific normalized internet search volume correlates with incidence and mortality rates of common cancers in the United States, including melanoma. This was a cross-sectional analysis of Google search volume index data and US cancer incidences and mortalities of 8 of the most incident cancers in the United States in 2009 to 2013, at the state level, per the National Program of Cancer Registries. Participants were people performing Google searches and patients diagnosed as having cancers reported to cancer registries. Correlation between Google search volumes, normalized to total Google search volume, and National Program of Cancer Registries recorded cancer incidence and mortality rates. By state, relative Google search volume statistically significantly correlated with cancer incidence rates in 5 of 8 commonly diagnosed cancers in the United States (colon cancer: R = 0.61; P search volume also correlated with mortality rates. Population-level internet search behavior may be a valuable real-time tool to estimate cancer incidence and mortality rates, especially for cancers not included in national registries, such as basal and squamous cell carcinomas.

  1. High regression rate, high density hybrid fuels Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This SBIR program will investigate high energy density novel nanofuels combined with high density binders for use with an N2O oxidizer. Terves has developed...

  2. Fasting proinsulin levels are significantly associated with 20 year cancer mortality rates. The Hoorn Study.

    Science.gov (United States)

    Walraven, I; van 't Riet, E; Stehouwer, C D A; Polak, B C P; Moll, A C; Dekker, J M; Nijpels, G

    2013-05-01

    Proinsulin is possibly associated with cancer through activation of insulin receptor isoform A. We sought to investigate the associations between proinsulin and 20 year cancer mortality rates. The study was performed within the Hoorn Study, a population-based study of glucose metabolism in individuals aged 50-75 years in the Dutch population. Fasting proinsulin levels were measured twice by a double-antibody radioimmunoassay. Participants were continuously followed to register mortality; causes of death were derived from medical records. Cox survival analyses were performed to assess the 20 year risk of death from cancer in relation to proinsulin. All analyses were adjusted for age and sex, with additional adjustments for traditional risk factors. The effect modification of glucose metabolism and sex was tested. Proinsulin levels were measured in 438 individuals (41% normal glucose tolerance, 35.7% impaired glucose metabolism, 23.3% type 2 diabetes). Of these participants, 53 died from cancer. After adjustment for age and sex, proinsulin >16.5 pmol/l (the upper tertile) was significantly associated with a twofold risk of cancer mortality (HR 2.01, 95% CI 1.16, 3.46) compared with individuals with lower proinsulin levels. Additional adjustment for glucose metabolism, BMI and smoking did not substantially change the results (HR 1.91, 95% CI 1.04, 3.52). No interaction with glucose metabolism or sex was observed. Individuals with fasting proinsulin levels >16.5 pmol/l have a twofold risk of cancer mortality over a 20 year time span. These findings provide population-based evidence for the independent association between high proinsulin levels and cancer mortality rates.

  3. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  4. An automated optimization tool for high-dose-rate (HDR) prostate brachytherapy with divergent needle pattern

    NARCIS (Netherlands)

    Borot, Maxence; Maenhout, M.; de Senneville, B. Denis; Hautvast, G.; Binnekamp, D.; Lagendijk, J. J. W.; van Vulpen, M.; Moerland, M. A.

    2015-01-01

    Focal high-dose-rate (HDR) for prostate cancer has gained increasing interest as an alternative to whole gland therapy as it may contribute to the reduction of treatment related toxicity. For focal treatment, optimal needle guidance and placement is warranted. This can be achieved under MR guidance.

  5. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  6. HIFU therapy for patients with high risk prostate cancer

    Science.gov (United States)

    Solovov, V. A.; Vozdvizhenskiy, M. O.; Matysh, Y. S.

    2017-03-01

    Objectives. Patients with high-risk prostate cancer undergoing radical prostatectomy, external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) or ADT alone. The widely accepted definition of high-risk prostate was first proposed by D'Amico based on a pretreatment Gleason score of ≥8, clinical stage T3, PSA level ≥20 ng/mL. There is no trial that compares traditional methods of treatment of such patients with HIFU therapy. Here we explored the effectiveness of the HIFU in multimodal treatment for patients with high risk prostate cancer. Materials & Methods. 701 patients with high risk prostate cancer were treated in our center between September 2007 and December 2013. Gleason score were 8-10, stage T3N0M0, age 69 (58-86) years, mean PSA before treatment 43.3 (22.1-92.9) ng/ml, mean prostate volume - 59.3 (38-123) cc. 248 patients were treated by HIFU. We compare this group of patients with patients who undertook EBRT: number 196, and ADT: number 257. Mean follow-up time 58 months (6-72). Results. The 5-year overall survival rates in patients after HIFU were 73.8 %, after EBRT - 63.0 % and after ADT - 18.1%. Conclusions. Our experience showed that HIFU therapy in combined treatment were successful for high risk prostate cancer.

  7. Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011

    OpenAIRE

    Kim, Yeerae; Park, Jinju; Nam, Byung-Ho; Ki, Moran

    2015-01-01

    Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA) and native Asians (from Korea,...

  8. High-Rate Strong-Signal Quantum Cryptography

    Science.gov (United States)

    Yuen, Horace P.

    1996-01-01

    Several quantum cryptosystems utilizing different kinds of nonclassical lights, which can accommodate high intensity fields and high data rate, are described. However, they are all sensitive to loss and both the high rate and the strong-signal character rapidly disappear. A squeezed light homodyne detection scheme is proposed which, with present-day technology, leads to more than two orders of magnitude data rate improvement over other current experimental systems for moderate loss.

  9. Development of a Rating Tool for Mobile Cancer Apps: Information Analysis and Formal and Content-Related Evaluation of Selected Cancer Apps.

    Science.gov (United States)

    Böhme, Cathleen; von Osthoff, Marc Baron; Frey, Katrin; Hübner, Jutta

    2017-08-17

    Mobile apps are offered in large numbers and have different qualities. The aim of this article was to develop a rating tool based on formal and content-related criteria for the assessment of cancer apps and to test its applicability on apps. After a thorough analysis of the literature, we developed a specific rating tool for cancer apps based on the MARS (mobile app rating system) and a rating tool for cancer websites. This instrument was applied to apps freely available in stores and focusing on some cancer topic. Ten apps were rated on the basis of 22 criteria. Sixty percent of the apps (6/10) were rated poor and insufficient. The rating by different scientists was homogenous. The good apps had reliable sources were regularly updated and had a concrete intent/purpose in their app description. In contrast, the apps that were rated poor had no distinction of scientific content and advertisement. In some cases, there was no imprint to identify the provider. As apps of poor quality can give misinformation and lead to wrong treatment decisions, efforts have to be made to increase usage of high-quality apps. Certification would help cancer patients to identify reliable apps, yet acceptance of a certification system must be backed up.

  10. Highly efficient resistive plate chambers for high rate environment

    CERN Document Server

    Cwiok, M; Górski, M; Królikowski, J

    1999-01-01

    The full scale prototype of an inverted double gap RPC module for ME-1/1 station of the CMS detector was tested in the gamma irradiation facility at the CERN SPS muon beam. The chamber made of medium resistivity bakelite and filled with "green gas" mixture of C /sub 2/H/sub 2/F/sub 4//iso-butane/SF/sub 6/ has wide efficiency plateau and good timing properties when operated in avalanche mode under continuous irradiation with strong /sup 137/Cs source for rates up to about 5 kHz/cm/sup 2//gap. (10 refs).

  11. High rate flame synthesis of highly crystalline iron oxide nanorods

    Science.gov (United States)

    Merchan-Merchan, W.; Saveliev, A. V.; Taylor, A. M.

    2008-03-01

    Single-step flame synthesis of iron oxide nanorods is performed using iron probes inserted into an opposed-flow methane oxy-flame. The high temperature reacting environment of the flame tends to convert elemental iron into a high density layer of iron oxide nanorods. The diameters of the iron oxide nanorods vary from 10 to 100 nm with a typical length of a few microns. The structural characterization performed shows that nanorods possess a highly ordered crystalline structure with parameters corresponding to cubic magnetite (Fe3O4) with the [100] direction oriented along the nanorod axis. Structural variations of straight nanorods such as bends, and T-branched and Y-branched shapes are frequently observed within the nanomaterials formed, opening pathways for synthesis of multidimensional, interconnected networks.

  12. Adjuvant radiation therapy for the treatment of endometrial cancer: experience with combination of external radiation therapy and high-dose rate brachytherapy; Radioterapia adjuvante no tratamento do cancer de endometrio: experiencia com a associacao de radioterapia externa e braquiterapia de alta taxa de dose

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Michael Jenwei; Novaes, Paulo Eduardo Ribeiro Soares; Pellizzon, Antonio Cassio de Assis; Ferrigno, Robson; Fogaroli, Ricardo Cesar; Maia, Maria Aparecida Conte; Salvajoli, Joao Victor [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Radioterapia]. E-mail: michael.chen@ig.com.br; Nishimoto, Ines Nobuko [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Centro de Estudos

    2005-12-01

    Objective: To review the results of adjuvant external beam radiation therapy (EBRT) combined with high-dose rate brachytherapy (HDR-BT) for the treatment of endometrial carcinoma. Materials and methods: We retrospectively evaluated 141 patients treated with EBRT and HDR-BT after surgery between January 1993 and January 2001. EBRT was performed with a median dose of 45 Gy, and HDR-BT was performed with a median dose of 24 Gy, with four weekly insertions of 6 Gy. The median age of the patients was 63 years and the disease stage distribution was: CS I (FIGO), 52.4%; CS II, 13.5%; CS III, 29.8%; CS IV, 4.3%. Results: With a median follow-up of 53.7 months, the disease free survival (DFS) at five years was: CS I, 88.0%; CS II, 70.8%; CS III, 55.1%; CS IV, 50.0% (p = 0.0003). Global survival after five years was: CS I, 79.6%; CS II, 74.0%; CS III, 53.6%; CS IV, 100.0% (p = 0.0062). Factors affecting the DFS were histological grade and serous-papillary histology. Recurrence of the disease was observed in 33 cases, 13 (9.2%) of these occurred in the pelvis, vagina or vaginal vault. EBRT + HDR-BT of the vaginal vault allowed disease control in 90.8% of the cases. Conclusion: Radiation therapy is essential for loco-regional control of endometrial cancer and can achieve excellent cure rates in the initial stages. In more advanced stages, therapeutic failure frequently appears as distant metastases suggesting the need for complementary systemic therapy using new treatment modalities, particularly chemotherapy. (author)

  13. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Vinayak Muralidhar

    2016-02-01

    Full Text Available Purpose : Recent retrospective data suggest that brachytherapy (BT boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA 20 ng/ml. Material and methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results : EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258, and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270. Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022. Conclusions : Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.

  14. Pathologic Complete Response Rates After Neoadjuvant Treatment in Rectal Cancer: An Analysis of the National Cancer Database.

    Science.gov (United States)

    Lorimer, Patrick D; Motz, Benjamin M; Kirks, Russell C; Boselli, Danielle M; Walsh, Kendall K; Prabhu, Roshan S; Hill, Joshua S; Salo, Jonathan C

    2017-08-01

    Pathologic complete response (pCR) of rectal cancer following neoadjuvant therapy is associated with decreased local recurrence and increased overall survival. This study utilizes a national dataset to identify predictors of pCR in patients with rectal cancer. The National Cancer Database was queried for patients with nonmetastatic rectal cancer (2004-2014) who underwent neoadjuvant therapy and surgical resection. Unadjusted associations were assessed using rank-sum tests and χ (2) tests where appropriate. Backward elimination and forward selection multivariable logistic regression models were created to determine the relationship of annual surgical volume with pCR rate, adjusting for preoperative characteristics and radiation-surgery interval. Statistical tests were two-sided, with a significance level of p ≤ 0.05. Analyses were performed using SAS version 9.4. A total of 27,532 patients from 1179 participating hospitals met the inclusion criteria. Generalized linear mixed models demonstrated that the odds of achieving pCR was independently associated with more recent diagnosis, female sex, private insurance, lower grade, lower clinical T classification, lower clinical N classification, increasing interval between the end of radiation and surgery, and treatment at higher-volume institutions. pCR was associated with favorable tumor factors, insurance status, time between radiation and surgery, and institutional volume. It is not clear what is driving the higher rates of pCR at high-volume institutions. Research targeted at understanding processes that are associated with pCR in high-volume institutions is needed so that similar results can be achieved across the spectrum of facilities caring for patients in this population.

  15. Comparison of acute and subacute genitourinary and gastrointestinal adverse events of radiotherapy for prostate cancer using intensity-modulated radiation therapy, three-dimensional conformal radiation therapy, permanent implant brachytherapy and high-dose-rate brachytherapy

    NARCIS (Netherlands)

    Morimoto, Masahiro; Yoshioka, Yasuo; Konishi, Koji; Isohashi, Fumiaki; Takahashi, Yutaka; Ogata, Toshiyuki; Koizumi, Masahiko; Teshima, Teruki; Bijl, Henk P; van der Schaaf, Arjen; Langendijk, Johannes A; Ogawa, Kazuhiko

    2014-01-01

    AIMS AND BACKGROUND: To examine acute and subacute urinary and rectal toxicity in patients with localized prostate cancer monotherapeutically treated with the following four radiotherapeutic techniques: intensity-modulated radiation therapy, three-dimensional conformal radiation therapy,

  16. Miniature High Stability High Temperature Space Rated Blackbody Radiance Source

    Science.gov (United States)

    Jones, J. A.; Beswick, A. G.

    1987-09-01

    This paper presents the design and test performance of a conical cavity type blackbody radiance source that will meet the requirements of the Halogen Occultation Experiment (HALOE) on the NASA Upper Atmospheric Research Satellite program (UARS). Since a radiance source meeting the requirements of this experiment was unavailable in the commercial market, a development effort was undertaken by the HALOE Project. The blackbody radiance source operates in vacuum at 1300 K + 0.5 K over any 15-minute interval, uses less than 7.5 watts of power, maintains a 49°C outer case temperature, and fits within the 2.5 x 2.5 x 3.0 inch envelope allocated inside the HALOE instrument. Also, the unit operates in air, during ground testing of the HALOE instrument, where it uses 17 watts of power with an outer case temperature of 66°C. The thrust of this design effort was to minimize the heat losses, in order to keep the power usage under 7.5 watts, and to minimize the amount of silica in the materials. Silica in the presence of the platinum heater winding used in this design would cause the platinum to erode, changing the operating temperature set-point. The design required the development of fabrication techniques which would provide very small, close tolerance parts from extremely difficult-to-machine materials. Also, a space rated ceramic core and unique, low thermal conductance, ceramic-to-metal joint was developed, tested and incorporated in this design. The completed flight qualification hardware has undergone performance, environmental and life testing. The design configuration and test results are discussed in detail in this paper.

  17. Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions.

    Science.gov (United States)

    Llanos, Adana A M; Warner, Wayne A; Luciani, Silvana; Lee, Tammy Y; Bajracharya, Smriti; Slovacek, Simeon; Roach, Veronica; Lamont-Greene, Marjorie

    2017-11-01

    To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries. Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries). Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region. Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation.

  18. Feasibility study of volumetric modulated arc therapy with constant dose rate for endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ruijie [Department of Radiation Oncology, Peking University Third Hospital, Beijing (China); Wang, Junjie, E-mail: junjiewang47@yahoo.com [Department of Radiation Oncology, Peking University Third Hospital, Beijing (China); Xu, Feng [Department of Biomedical Engineering, Peking University Third Hospital, Beijing (China); Li, Hua [Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing (China); Zhang, Xile [Department of Radiation Oncology, Peking University Third Hospital, Beijing (China)

    2013-10-01

    To investigate the feasibility, efficiency, and delivery accuracy of volumetric modulated arc therapy with constant dose rate (VMAT-CDR) for whole-pelvic radiotherapy (WPRT) of endometrial cancer. The nine-field intensity-modulated radiotherapy (IMRT), VMAT with variable dose-rate (VMAT-VDR), and VMAT-CDR plans were created for 9 patients with endometrial cancer undergoing WPRT. The dose distribution of planning target volume (PTV), organs at risk (OARs), and normal tissue (NT) were compared. The monitor units (MUs) and treatment delivery time were also evaluated. For each VMAT-CDR plan, a dry run was performed to assess the dosimetric accuracy with MatriXX from IBA. Compared with IMRT, the VMAT-CDR plans delivered a slightly greater V{sub 20} of the bowel, bladder, pelvis bone, and NT, but significantly decreased the dose to the high-dose region of the rectum and pelvis bone. The MUs decreased from 1105 with IMRT to 628 with VMAT-CDR. The delivery time also decreased from 9.5 to 3.2 minutes. The average gamma pass rate was 95.6% at the 3%/3 mm criteria with MatriXX pretreatment verification for 9 patients. VMAT-CDR can achieve comparable plan quality with significant shorter delivery time and smaller number of MUs compared with IMRT for patients with endometrial cancer undergoing WPRT. It can be accurately delivered and be an alternative to IMRT on the linear accelerator without VDR capability.

  19. Heart rate variability during treatment of breakthrough pain in patients with advanced cancer: a pilot study

    Directory of Open Access Journals (Sweden)

    Masel EK

    2016-12-01

    Full Text Available Eva Katharina Masel, Patrick Huber, Tobias Engler, Herbert Hans WatzkeClinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria Background: Decisions on the intensity of analgesic therapy and judgments regarding its efficacy are difficult at the end of life, when many patients are not fully conscious and pain is a very common symptom. In healthy individuals and in postoperative settings, nociception and subsequent pain relief have been shown to induce changes in the autonomic nervous system (ANS, which can be detected by measuring heart rate variability (HRV. Objectives: The changes in the ANS were studied by measuring HRV during opioid therapy for cancer breakthrough pain (CBTP in palliative-care patients with cancer and compared these changes with patient-reported pain levels on a numeric rating scale (NRS. Patients and methods: The study included ten patients with advanced cancer and baseline opioid therapy. In each patient, a 24-hour peak-to-peak HRV measurement with a sampling rate of 4,000 Hz was performed. High frequency (HF, low frequency (LF, total power, pNN50 (indicating parasympathetic activity, and log LF/HF were obtained in two intervals prior to therapy and in four intervals thereafter. Intensity of CBTP was recorded using a patient-reported NRS prior to therapy and 30 minutes afterward. Results: CBTP occurred in seven patients (three males and four females; mean age: 62 ± 5.2 years and was treated with opioids. A highly significant positive correlation was found between opioid-induced reduction in patient-reported pain intensity based on NRS and changes in log LF/HF (r > 0.700; p < 0.05. Log LF/HF decreased in patients who had a reduction in pain of >2 points on the NRS but remained unchanged in the other patients. Conclusion: Our data suggest that log LF/HF may be a useful surrogate marker for alleviation of CBTP in patients with advanced cancer and might

  20. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women.

    Science.gov (United States)

    DeSantis, Carol E; Fedewa, Stacey A; Goding Sauer, Ann; Kramer, Joan L; Smith, Robert A; Jemal, Ahmedin

    2016-01-01

    In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 231,840 new cases of invasive breast cancer and 40,290 breast cancer deaths are expected to occur among US women in 2015. Breast cancer incidence rates increased among non-Hispanic black (black) and Asian/Pacific Islander women and were stable among non-Hispanic white (white), Hispanic, and American Indian/Alaska Native women from 2008 to 2012. Although white women have historically had higher incidence rates than black women, in 2012, the rates converged. Notably, during 2008 through 2012, incidence rates were significantly higher in black women compared with white women in 7 states, primarily located in the South. From 1989 to 2012, breast cancer death rates decreased by 36%, which translates to 249,000 breast cancer deaths averted in the United States over this period. This decrease in death rates was evident in all racial/ethnic groups except American Indians/Alaska Natives. However, the mortality disparity between black and white women nationwide has continued to widen; and, by 2012, death rates were 42% higher in black women than in white women. During 2003 through 2012, breast cancer death rates declined for white women in all 50 states; but, for black women, declines occurred in 27 of 30 states that had sufficient data to analyze trends. In 3 states (Mississippi, Oklahoma, and Wisconsin), breast cancer death rates in black women were stable during 2003 through 2012. Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women. © 2015 American Cancer Society.

  1. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The

  2. The combined effect of cancer and chronic diseases on general practitioner consultation rates.

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Donker, G.A.; Rijken, P.M.; Schellevis, F.G.

    2015-01-01

    Aim: More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates. Methods: From the NIVEL Primary Care Database

  3. The combined effect of cancer and chronic diseases on general practitioner consultation rates

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Donker, G.A.; Rijken, P.M.; Schellevis, F.G.

    2015-01-01

    Aim: More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates. Methods: From the NIVEL Primary Care Database

  4. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Eiichi [Department of Radiation Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Yamazaki, Hideya, E-mail: hideya10@hotmail.com [Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto (Japan); Yoshida, Ken; Takenaka, Tadashi [Department of Radiation Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Masuda, Norikazu [Department of Surgery and Breast Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita (Japan)

    2011-11-15

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50-60 Gy in 25-30 fractions within 5-6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a Asterisk-Operator (reddish) and reduction in L Asterisk-Operator (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6-12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b Asterisk-Operator values, and EBRT did not, demonstrating that the reduction in b Asterisk-Operator values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  5. Environmental factors and high risk of esophageal cancer among men in coastal South Carolina.

    Science.gov (United States)

    Brown, L M; Blot, W J; Schuman, S H; Smith, V M; Ershow, A G; Marks, R D; Fraumeni, J F

    1988-12-21

    A case-control study involving interviews of 207 men with esophageal cancer and 422 control subjects or their next of kin was conducted to identify reasons for the unusually high rates of esophageal cancer among men in coastal South Carolina. Tobacco and alcohol, including moonshine, were identified as the major determinants of esophageal cancer risk. Increased risk was also associated with low intake of fresh fruits but not with drinking of local herbal teas. The findings suggest that efforts aimed at reducing tobacco and alcohol use will help to lower the elevated rates of esophageal cancer in coastal South Carolina.

  6. Incidence of solid organ cancers after liver transplantation: comparison with regional cancer incidence rates and risk factors.

    Science.gov (United States)

    Carenco, Christophe; Faure, Stéphanie; Herrero, Astrid; Assenat, Eric; Duny, Yohan; Danan, Guillaume; Bismuth, Michaël; Chanques, Gérald; Ursic-Bedoya, José; Jaber, Samir; Larrey, Dominique; Navarro, Francis; Pageaux, Georges-Philippe

    2015-06-01

    Increased rates of solid organ cancers post-liver transplantation have been reported, but the contribution of environmental factors and immunosuppressive therapy is not clear. This study's aims were to compare the incidence of de novo solid organ cancers after liver transplantation; identify risk factors independent of immunosuppressive therapy associated with these cancers; and assess the influence of calcineurin inhibitors on the appearance of these cancers. This single-centre study from 1991 to 2008 included 465 liver recipients who had survived for ≥1 year. Gross incidence rates were standardized by age and sex, using the global population as a reference. In addition, 322 of the 465 patients treated for ≥1 year with calcineurin inhibitors were studied. Sixty-five (13.9%) of the 465 patients developed de novo solid cancers. The overall relative risk was 3.7. Significantly increased relative risks were observed for digestive, oesophageal, colorectal, oral and lung cancers, but not for genito-urinary and breast cancers. Among the 65 patients who developed solid organ cancers, 43 died (66.1%), 41 from cancer. The two independent risk factors were pretransplant smoking [P cancers. Tacrolimus exposure level was a risk factor for de novo solid cancers [P < 0.0001; OR = 15.3 (4.5; 52.2)]. We recommend a change in immunosuppressive protocols with lifestyle/dietary guidelines and smoking cessation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Comparison of various models on cancer rate and forecasting ...

    African Journals Online (AJOL)

    Hence, the quadratic trend model was used for the forecast and the result indicated 27.5 percent annual increase in the future trend and the number of patients with cancer that will visit the hospitals within the study area. This figure is well above the national risk of getting cancer before age 75 years fixed at 10.4 percent.

  8. Comparison of various models on cancer rate and forecasting ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Niger State, project the number of patients that will visit the hospitals with cancer cases and measure progress in the management of patients with cancer. MATERIALS AND METHODS. The data collected is for five years period, 2011 to. 2015. Methods of linear regression, exponential smoothing and quadratic model were ...

  9. Image Enhancement for High frame-rate Neutron Radiography

    OpenAIRE

    Saito, Y; Ito, D.

    2015-01-01

    High frame rate neutron radiography has been utilized to investigate two-phase flow in a metallic duct. However, images obtained by high frame-rate neutron radiography suffered from severe statistical noise due to its short exposure time. In this study, a spatio-temporal filter was applied to reduce the noise in the sequence images obtained by high frame-rate neutron radiography. Experiments were performed at the B4-port of the Research Reactor Institute, Kyoto University, which has a thermal...

  10. Comparison of the impact on life quality of boosts in iodine-125 and high rate iridium-192 curie-therapy associated with a conformational radiotherapy in prostate cancers of stage II or III according to Amico; Comparaison de l'impact sur la qualite de vie des boosts par curietherapie par iode-125 et par iridium-192 de haut debit associee a une radiotherapie conformationnelle dans les cancers de la prostate de stade II ou III selon d'Amico

    Energy Technology Data Exchange (ETDEWEB)

    Guerif, S.; Chung, C.; Lavigne, B.; Boissonnade, O.; Lavigne, B.; Godon, J.B.; Bolan, G.; Fontaine, G.; Bensadoun, R.J. [Pole regional de cancerologie, Poitiers (France)

    2011-10-15

    As there is no consensus about the curie-therapy boost modality to be chosen in the case of prostate cancers of stage II or III according to Amico, and as two modalities are available (iodine-125 curie-therapy, and high dose rate curie-therapy), the authors report a comparison between these two modalities in terms of impact on life quality during the first year. They indicate the treatment procedures and discuss the results obtained in terms of urinary toxicity, an the influence of dose escalation. Life quality has also been assessed by questionnaires. Short communication

  11. Differences in symptom clusters identified using symptom occurrence rates versus severity ratings in patients with breast cancer undergoing chemotherapy.

    Science.gov (United States)

    Ward Sullivan, Carmen; Leutwyler, Heather; Dunn, Laura B; Cooper, Bruce A; Paul, Steven M; Conley, Yvette P; Levine, Jon D; Miaskowski, Christine A

    2017-06-01

    One of the unanswered questions in symptom clusters research is whether the number and types of symptom clusters vary based on the dimension of the symptom experience used to create the clusters. Given that patients with breast cancer receiving chemotherapy (CTX), report between 10 and 32 concurrent symptoms and studies of symptom clusters in these patients are limited, the purpose of this study, in breast cancer patients undergoing CTX (n = 515), was to identify whether the number and types of symptom clusters differed based on whether symptom occurrence rates or symptom severity ratings were used to create the clusters. A modified version of the Memorial Symptom Assessment Scale was used to assess for the occurrence and severity of 38 symptoms, one week after the administration of CTX. Exploratory factor analysis was used to extract the symptom clusters. Both the number and types of symptom clusters were similar using symptom occurrence rates or symptom severity ratings. Five symptom clusters were identified using symptom occurrence rates (i.e., psychological, hormonal, nutritional, gastrointestinal, epithelial). Six symptom clusters (i.e., psychological, hormonal, nutritional, gastrointestinal, epithelial, chemotherapy neuropathy) were identified using symptom severity ratings. Across the two dimensions, the specific symptoms within each of the symptom clusters were similar. Identification of symptom clusters in patients with breast cancer may be useful in guiding symptom management interventions. Future studies are warranted to determine if symptom clusters remain stable over a cycle of CTX in patients with breast cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Transit dose calculation in high dose rate brachytherapy (HDR ...

    African Journals Online (AJOL)

    Transit doses around a high dose rate 192Ir brachytherapy source were calculated using Sievert Integral at positions where the moving source was located exactly between two adjacent dwell positions. The correspond-ing transit dose rates were obtained by using energy absorption coefficients. Discrete step sizes of 0.25 ...

  13. Rural and Urban High School Dropout Rates: Are They Different?

    Science.gov (United States)

    Jordan, Jeffrey L.; Kostandini, Genti; Mykerezi, Elton

    2012-01-01

    This study estimates the high school dropout rate in rural and urban areas, the determinants of dropping out, and whether the differences in graduation rates have changed over time. We use geocoded data from two nationally representative panel household surveys (NLSY 97 and NLSY 79) and a novel methodology that corrects for biases in graduation…

  14. Pedalling rate affects endurance performance during high-intensity cycling

    DEFF Research Database (Denmark)

    Nielsen, Jens Steen; Hansen, Ernst Albin; Sjøgaard, Gisela

    2004-01-01

    The purpose of this study into high-intensity cycling was to: (1) test the hypothesis that endurance time is longest at a freely chosen pedalling rate (FCPR), compared to pedalling rates 25% lower (FCPR-25) and higher (FCPR+25) than FCPR, and (2) investigate how physiological variables, such as m...

  15. CT, MRI and ultrasound scanning rates: evaluation of cancer diagnosis, staging and surveillance in Ontario.

    Science.gov (United States)

    Coburn, Natalie; Przybysz, Raymond; Barbera, Lisa; Hodgson, David; Sharir, Sharon; Laupacis, Andreas; Law, Calvin

    2008-12-01

    To examine practice patterns and rates of computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasound (AUS) during staging, treatment and surveillance for cancer patients. Using Ontario Health Insurance Plan billing data linked to the Ontario Cancer Registry, we determined rates of CT, MRI, and AUS by body site for breast, colorectal, lung, lymphoma, and prostate cancer, from 1998 to 2002. Rates of scans were additionally examined by region of patient residence and time from cancer diagnosis. The frequency of imaging increased in nearly all scans and tumors over the study period. Rates of peri-diagnosis scans varied substantially by region, ranging from 1.7-fold variation (CT for lung cancer) to 50-fold variation (MRI for breast cancer). For breast cancer, there is possible over-utilization of CT, but overall rates of scanning appear reasonable for the other four cancers. Considerable regional variation in imaging rates suggests utilization guidelines should be developed or knowledge transfer initiatives are needed to improve compliance to existing guidelines. In breast cancer, there appears to be over-utilization of imaging. Further studies are necessary to determine utilization for each stage, the reason scans were obtained, and the impact of scans on patient outcomes. (c) 2008 Wiley-Liss, Inc.

  16. High Count Rate Single Photon Counting Detector Array Project

    Data.gov (United States)

    National Aeronautics and Space Administration — An optical communications receiver requires efficient and high-rate photon-counting capability so that the information from every photon, received at the aperture,...

  17. CASSINI HIGH RATE DETECTOR V17.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  18. CASSINI HIGH RATE DETECTOR V2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  19. CASSINI HIGH RATE DETECTOR V12.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  20. CASSINI HIGH RATE DETECTOR V8.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  1. CASSINI HIGH RATE DETECTOR V10.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  2. CASSINI HIGH RATE DETECTOR V1.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  3. CASSINI HIGH RATE DETECTOR V13.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  4. CASSINI HIGH RATE DETECTOR V9.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  5. CASSINI HIGH RATE DETECTOR V3.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  6. CASSINI HIGH RATE DETECTOR V7.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  7. CASSINI HIGH RATE DETECTOR V4.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  8. CASSINI HIGH RATE DETECTOR V11.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  9. CASSINI HIGH RATE DETECTOR V14.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  10. CASSINI HIGH RATE DETECTOR V5.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  11. CASSINI HIGH RATE DETECTOR V6.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The High Rate Detector (HRD) from the University of Chicago is an independent part of the CDA instrument on the Cassini Orbiter that measures the dust flux and...

  12. High Burn Rate Hybrid Fuel for Improved Grain Design Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A novel type of fuel providing high burning rate for hybrid rocket applications is proposed. This fuel maintains a hydrodynamically rough surface to...

  13. Quantum Communication with a High-Rate Entangled Photon Source

    Science.gov (United States)

    Wilson, Nathaniel C.; Chaffee, Dalton W.; Lekki, John D.; Wilson, Jeffrey D.

    2016-01-01

    A high generation rate photon-pair source using a dual element periodically-poled potassium titanyl phosphate (PP KTP) waveguide is described. The photon-pair source features a high pair generation rate, a compact power-efficient package, and continuous wave (CW) or pulsed operation. Characterization and test results are presented. Details and preliminary results of a laboratory free-space QKD experiment with the B92 protocol are also presented.

  14. A rate-dependent Hosford-Coulomb model for predicting ductile fracture at high strain rates

    Directory of Open Access Journals (Sweden)

    Marcadet Stephane J.

    2015-01-01

    Full Text Available The Hosford-Coulomb model incorporates the important effect of the Lode angle parameter in addition to the stress triaxiality to predict the initiation of ductile fracture. A strain-rate dependent extension of the Hosford-Coulomb model is presented to describe the results from low, intermediate and high strain rate fracture experiments on advanced high strength steels (DP590 and TRIP780. The model predictions agree well with the experimental observation of an increase in ductility as function of strain rate for stress states ranging from uniaxial to equi-biaxial tension.

  15. High strain rate response of rabbit femur bones.

    Science.gov (United States)

    Shunmugasamy, Vasanth Chakravarthy; Gupta, Nikhil; Coelho, Paulo G

    2010-11-16

    Strain rate dependence of the mechanical response of hard tissues has led to a keen interest in their dynamic properties. The current study attempts to understand the high strain rate characteristics of rabbit femur bones. The testing was conducted using a split-Hopkinson pressure bar equipped with a high speed imaging system to capture the fracture patterns. The bones were also characterized under quasi-static compression to enable comparison with the high strain rate results. The quasi-static compressive moduli of the epiphyseal and diaphyseal regions were measured to be in the range of 2-3 and 5-7GPa, respectively. Under high strain rate loading conditions the modulus is observed to increase with strain rate and attains values as high as 15GPa for epiphyseal and 30GPa for diaphyseal regions of the femur. The strength at high strain rate was measured to be about twice the quasi-static strength value. A large number of small cracks initiated on the specimen surface close to the incident bar. Coalescence of crack branches leading to fewer large cracks resulted in specimen fragmentation. In comparison, the quasi-static failure was due to shear cracking. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Are All Highly Malignant Cancer Cells Identical?

    Science.gov (United States)

    1979-01-01

    ADA3665 ARE AL HIGHL MAGNANTCANCER CELLS DENOIALU) PENNSYLVANIA HOSPITAL PHILADELPHIA DEPT OF MOLECULAR BIOLOGY G NIGET AL 199 N00014-ACA026 UNCLASFE...embryo cells or even the original fertilized ovum . If this speculation has validity, the carcinogenesis and differentiation have the same destinies but...F/G /5 N 1111 2Z111117 1 125iiI 1 1. 1111_L6. -11 O=M 1 MrCROCOP RErSOLUTICN TEST CHART N, APoP SN A’ ,- ARE ALL HIGHLY MALIGNANT CANCER CELLS

  17. Performance of high flow rate samplers for respirable particle collection.

    Science.gov (United States)

    Lee, Taekhee; Kim, Seung Won; Chisholm, William P; Slaven, James; Harper, Martin

    2010-08-01

    The American Conference of Governmental Industrial hygienists (ACGIH) lowered the threshold limit value (TLV) for respirable crystalline silica (RCS) exposure from 0.05 to 0.025 mg m(-3) in 2006. For a working environment with an airborne dust concentration near this lowered TLV, the sample collected with current standard respirable aerosol samplers might not provide enough RCS for quantitative analysis. Adopting high flow rate sampling devices for respirable dust containing silica may provide a sufficient amount of RCS to be above the limit of quantification even for samples collected for less than full shift. The performances of three high flow rate respirable samplers (CIP10-R, GK2.69, and FSP10) have been evaluated in this study. Eleven different sizes of monodisperse aerosols of ammonium fluorescein were generated with a vibrating orifice aerosol generator in a calm air chamber in order to determine the sampling efficiency of each sampler. Aluminum oxide particles generated by a fluidized bed aerosol generator were used to test (i) the uniformity of a modified calm air chamber, (ii) the effect of loading on the sampling efficiency, and (iii) the performance of dust collection compared to lower flow rate cyclones in common use in the USA (10-mm nylon and Higgins-Dewell cyclones). The coefficient of variation for eight simultaneous samples in the modified calm air chamber ranged from 1.9 to 6.1% for triplicate measures of three different aerosols. The 50% cutoff size ((50)d(ae)) of the high flow rate samplers operated at the flow rates recommended by manufacturers were determined as 4.7, 4.1, and 4.8 microm for CIP10-R, GK2.69, and FSP10, respectively. The mass concentration ratio of the high flow rate samplers to the low flow rate cyclones decreased with decreasing mass median aerodynamic diameter (MMAD) and high flow rate samplers collected more dust than low flow rate samplers by a range of 2-11 times based on gravimetric analysis. Dust loading inside the

  18. Poor self-rated health associated with an increased risk of subsequent development of lung cancer.

    Science.gov (United States)

    Riise, Hilde Kristin Refvik; Riise, Trond; Natvig, Gerd Karin; Daltveit, Anne Kjersti

    2014-02-01

    Self-rated health has shown to be a strong predictor of mortality and some major chronic diseases. The purpose of this study was to investigate whether poor self-rated health also was related to an increased risk of subsequent development of cancer. Information on self-rated health, life-style factors, and other health-related risk factors was ascertained in a cohort of 25,532 persons participating in the Hordaland Health Study in 1997-1999. Information on development of cancer during 10 years of follow-up was obtained from the Norwegian Cancer Registry. The relationship between self-rated health and development of cancer was examined using Cox regression analysis adjusting for smoking and other life-style factors. Respondents reporting a poor health showed a non-significant increased risk of overall cancer. Sub-analysis of the four most common types of cancer showed a statistically significant association between self-rated health and lung cancer. The adjusted hazard ratio was 3.88 (95% CI; 0.99, 15.8) for those rating their health as poor compared to very good (p for trend = 0.038). For the other types of cancer, we found a non-significant elevated risk associated with poor self-rated health. Respondents who perceive their health as poor had an increased risk of developing lung cancer also after adjusting for smoking. This suggests that self-rated health reflects a broad range of factors important for development of this cancer type. Nevertheless, due to the explorative analysis of the specific cancer types, these findings need to be repeated before elaborate interpretations can be made.

  19. Stretching of red blood cells at high strain rates

    Science.gov (United States)

    Mancuso, J. E.; Ristenpart, W. D.

    2017-10-01

    Most work on the mechanical behavior of red blood cells (RBCs) in flow has focused on simple shear flows. Relatively little work has examined RBC deformations in the physiologically important extensional flow that occurs at the entrance to a constriction. In particular, previous work suggests that RBCs rapidly stretch out and then retract upon entering the constriction, but to date no model predicts this behavior for the extremely high strain rates typically experienced there. In this Rapid Communication, we use high speed video to perform systematic measurements of the dynamic stretching behavior of RBCs as they enter a microfluidic constriction. We demonstrate that both the Kelvin-Voigt and Skalak viscoelastic models capture the observed stretching dynamics, up to strain rates as high as 2000 s-1. The results indicate that the effective elastic modulus of the RBC membrane at these strain rates is an order of magnitude larger than moduli measured by micropipette aspiration or other low strain rate techniques.

  20. Solidification at the High and Low Rate Extreme

    Energy Technology Data Exchange (ETDEWEB)

    Meco, Halim [Iowa State Univ., Ames, IA (United States)

    2004-12-19

    The microstructures formed upon solidification are strongly influenced by the imposed growth rates on an alloy system. Depending on the characteristics of the solidification process, a wide range of growth rates is accessible. The prevailing solidification mechanisms, and thus the final microstructure of the alloy, are governed by these imposed growth rates. At the high rate extreme, for instance, one can have access to novel microstructures that are unattainable at low growth rates. While the low growth rates can be utilized for the study of the intrinsic growth behavior of a certain phase growing from the melt. Although the length scales associated with certain processes, such as capillarity, and the diffusion of heat and solute, are different at low and high rate extremes, the phenomena that govern the selection of a certain microstructural length scale or a growth mode are the same. Consequently, one can analyze the solidification phenomena at both high and low rates by using the same governing principles. In this study, we examined the microstructural control at both low and high extremes. For the high rate extreme, the formation of crystalline products and factors that control the microstructure during rapid solidification by free-jet melt spinning are examined in Fe-Si-B system. Particular attention was given to the behavior of the melt pool at different quench-wheel speeds. Since the solidification process takes place within the melt-pool that forms on the rotating quench-wheel, we examined the influence of melt-pool dynamics on nucleation and growth of crystalline solidification products and glass formation. High-speed imaging of the melt-pool, analysis of ribbon microstructure, and measurement of ribbon geometry and surface character all indicate upper and lower limits for melt-spinning rates for which nucleation can be avoided, and fully amorphous ribbons can be achieved. Comparison of the relevant time scales reveals that surface-controlled melt

  1. Prostate Cancer in South Africa: Pathology Based National Cancer Registry Data (1986–2006 and Mortality Rates (1997–2009

    Directory of Open Access Journals (Sweden)

    Chantal Babb

    2014-01-01

    Full Text Available Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA from the pathology based National Cancer Registry (1986–2006 and data on mortality (1997–2009 from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma. There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.

  2. Prostate cancer in South Africa: pathology based national cancer registry data (1986-2006) and mortality rates (1997-2009).

    Science.gov (United States)

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.

  3. The incidence rate of cancer in patients with schizophrenia: A meta-analysis of cohort studies.

    Science.gov (United States)

    Li, Hailong; Li, Jiasi; Yu, Xiya; Zheng, Huiwen; Sun, Xu; Lu, Yue; Zhang, Yanbo; Li, Chunbo; Bi, Xiaoying

    2017-09-21

    Numerous studies report that cancer prevalence in patients with schizophrenia might be different from the general population, but findings remain controversial. Our updated meta-analysis of cohort studies aims to analyze the data from cohort studies concerning the incidence risk of overall cancer and some site-specific cancers in patients with schizophrenia. We performed a systemic search through electronic databases. Cohort studies evaluating and describing the cancer incidence among patients with schizophrenia were included. Pooled risk ratios (RRs) were calculated for assessing the incidence risk of cancer. There were 16 cohort studies included in this meta-analysis, which combined a total of 480,356 participants with schizophrenia and 41,999 cases of cancer. Results showed that there was a slight significant decreased overall risk ratio of cancer incidence among patients with schizophrenia (RR=0.90, 95% CI 0.81-0.99). When stratified by cancer site and gender, there were significant decreased incidence risk rates of colorectal cancer (RR=0.82, 95% CI 0.69-0.98) and prostate cancer (RR=0.55, 95% CI 0.42-0.71) in those patients, moreover, the incidence rate of colorectal cancer decreased significantly in male patients (RR=0.89, 95% CI 0.81-0.98), and the incidence rate of lung cancer increased significantly in female patients (RR=1.12, 95% CI 1.01-1.25). The incidence risk of some cancers was reduced in patients with schizophrenia. Gender and type of cancer were two important confounding factors contributed to the heterogeneity that required adjustment in our cancer incidence meta-analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Metallurgical applications of shock wave and high strain rate phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Murr, L.E.; Staudhammer, K.P.; Meyers, M.A.

    1986-01-01

    This book presents the papers given at a conference on the impact testing of metals. Topics considered at the conference included dynamic consolidation, the analysis of dislocation kinetics across shocks, high-strain-rate deformation, adiabatic shear band phenomena, dynamic fracture, explosive metal working, shock synthesis and the property modification of materials, and novel concepts and applications of high pressure.

  5. High flow rate microsieve for bio medical applications

    NARCIS (Netherlands)

    van Rijn, C.J.M.; Nijdam, W.; Elwenspoek, Michael Curt

    1995-01-01

    A new composite filtration membrane having a thin filtration or sieving layer has been developed. This filtration membrane with a high pore density and a narrow pore size distribution on a macro porous support shows good separation behaviour and a high flow rate. Because of the construction method,

  6. Authoritative School Climate and High School Dropout Rates

    Science.gov (United States)

    Jia, Yuane; Konold, Timothy R.; Cornell, Dewey

    2016-01-01

    This study tested the association between school-wide measures of an authoritative school climate and high school dropout rates in a statewide sample of 315 high schools. Regression models at the school level of analysis used teacher and student measures of disciplinary structure, student support, and academic expectations to predict overall high…

  7. Performance of the Ultra-High Rate Germanium (UHRGe) System

    Energy Technology Data Exchange (ETDEWEB)

    Fast, James E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dion, Michael P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rodriguez, Douglas C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); VanDevender, Brent A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wood, Lynn S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wright, Michael E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-12-01

    This report describes the final performance achieved with the detector system developed for the Ultra High Rate Germanium (UHRGe) project. The system performance has been evaluated at low, moderate and high rates and includes the performance of real-time analysis algorithms running in the FPGA of the data acquisition system. This performance is compared to that of offline analyses of streaming waveform data collected with the same data acquisition system the performance of a commercial Multi-Channel Analyzer designed for high-resolution spectroscopy applications, the Canberra LYNX.

  8. Breakdown Limit Studies in High Rate Gaseous Detectors

    CERN Document Server

    Ivaniouchenkov, Yu; Peskov, Vladimir; Ramsey, B D

    1998-01-01

    We report results from a systematic study of breakdown limits for novel high rate gaseous detectors: MICROMEGAS, CAT and GEM, together with more conventional devices such as thin-gap parallel-mesh chambers and high-rate wire chambers. It was found that for all these detectors, the maximum achievable gain, before breakdown appears, drops dramatically with incident flux, and is sometimes inversely proportional to it. Further, in the presence of alpha particles, typical of the backgrounds in high-energy experiments, additional gain drops of 1-2 orders of magnitude were observed for many detectors. It was found that breakdowns at high rates occur through what we have termed an "accumulative" mechanism, which does not seem to have been previously reported in the literature. Results of these studies may help in choosing the optimum detector for given experimental conditions.

  9. Methodology for DSC calibration in high heating rates

    Directory of Open Access Journals (Sweden)

    Carlos Isidoro Braga

    2011-05-01

    Full Text Available Despite the large use of differential scanning calorimetry (DSC technique in advanced polymer materials characterization, the new methodology called DSC in high heating rates was developed. The heating rate during conventional DSC experiments varying from 10 to 20ºC.min-¹, sample mass from 10 to 15mg and standard aluminum sample pan weighting, approximately, 27mg. In order to contribute to a better comprehension of DSC behavior in different heating rates, this work correlates as high heating rate influences to the thermal events in DSC experiments. Samples of metallic standard (In, Pb, Sn and Zn with masses varying from 0.570mg to 20.9mg were analyzed in multiples sample heating rate from 4 to 324°C. min-¹. In order to make properly all those experiments, a precise and careful temperature and enthalpy calibrations were performed and deeply discussed. Thus, this work shows a DSC methodology able to generate good and reliable results on experiments under any researcher choice heating rates to characterize the advanced materials used, for example, for aerospace industry. Also it helps the DSC users to find in their available instruments, already installed, a better and more accurate DSC test results, improving in just one shot the analysis sensitivity and resolution. Polypropylene melting and enthalpy thermal events are also studied using both the conventional DSC method and high heating rate method.

  10. [Multi-disciplinary treatment increases the survival rate of late stage pharyngeal, laryngeal or cervical esophageal cancers treated by free jejunal flap reconstruction after cancer resection].

    Science.gov (United States)

    Zhu, Y M; Zhang, H; Ni, S; Wang, J; Li, D Z; Liu, S Y

    2016-05-23

    To investigate the survival status of patients with pharyngeal, laryngeal or cervical esophageal cancers, who received free jejunal flap (FJF) to repair the defects following tumor resection, and to analyze the effect of multi-disciplinary treatment on their survival. Fifty-eight patients with pharyngeal, laryngeal or cervical esophageal cancer underwent free jejunal flap (FJF) reconstruction after cancer resection between 2010 and 2013. All their clinical records were reviewed and analyzed. The success rate of flap transplantation was 91.4% (53/58). The 2-year overall survival rates (OSR) of cervical esophageal cancer and hypopharyngeal cancer patients were 67.5% and 49.3%, respectively, both were significantly better than that of laryngeal cancer. The main causes of death were local recurrence and distant metastases. The group with no short-term complications had a better two-year OSR (59.0%) than the group with short-term complications (46.6%), however, the difference between them was not significant (P=0.103). The 2-year survival rate of the initial treatment group was 65.0%, better than that of the salvage treatment group (49.4%), but the difference was not significant (P=0.051). For the stage III and IV patients, the multi-disciplinary treatment group had a significantly better 2-year OSR (64.7%) than the single or sequential treatment group (37.0%, P=0.016). Free jejunal flap reconstruction is an ideal option for repairing the cervical digestive tract circumferential defects caused by tumor resection with a high success rate and a low mortality. Compared with the single or sequential treatment, multi-disciplinary treatment can significantly improve the survival rate of late-stage hypopharyngeal and cervical esophageal cancer patients.

  11. Evolution of high tooth replacement rates in sauropod dinosaurs.

    Directory of Open Access Journals (Sweden)

    Michael D D'Emic

    Full Text Available BACKGROUND: Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. METHODOLOGY/PRINCIPAL FINDINGS: We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days. Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. CONCLUSIONS/SIGNIFICANCE: Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size, and derived titanosaurs and

  12. Evolution of high tooth replacement rates in sauropod dinosaurs.

    Science.gov (United States)

    D'Emic, Michael D; Whitlock, John A; Smith, Kathlyn M; Fisher, Daniel C; Wilson, Jeffrey A

    2013-01-01

    Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days). Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size), and derived titanosaurs and diplodocoids independently evolved the highest known tooth replacement rates among archosaurs.

  13. Mutational Biases Drive Elevated Rates of Substitution at Regulatory Sites across Cancer Types.

    Directory of Open Access Journals (Sweden)

    Vera B Kaiser

    2016-08-01

    Full Text Available Disruption of gene regulation is known to play major roles in carcinogenesis and tumour progression. Here, we comprehensively characterize the mutational profiles of diverse transcription factor binding sites (TFBSs across 1,574 completely sequenced cancer genomes encompassing 11 tumour types. We assess the relative rates and impact of the mutational burden at the binding sites of 81 transcription factors (TFs, by comparing the abundance and patterns of single base substitutions within putatively functional binding sites to control sites with matched sequence composition. There is a strong (1.43-fold and significant excess of mutations at functional binding sites across TFs, and the mutations that accumulate in cancers are typically more disruptive than variants tolerated in extant human populations at the same sites. CTCF binding sites suffer an exceptionally high mutational load in cancer (3.31-fold excess relative to control sites, and we demonstrate for the first time that this effect is seen in essentially all cancer types with sufficient data. The sub-set of CTCF sites involved in higher order chromatin structures has the highest mutational burden, suggesting a widespread breakdown of chromatin organization. However, we find no evidence for selection driving these distinctive patterns of mutation. The mutational load at CTCF-binding sites is substantially determined by replication timing and the mutational signature of the tumor in question, suggesting that selectively neutral processes underlie the unusual mutation patterns. Pervasive hyper-mutation within transcription factor binding sites rewires the regulatory landscape of the cancer genome, but it is dominated by mutational processes rather than selection.

  14. The effect of multiple primary rules on cancer incidence rates and trends.

    Science.gov (United States)

    Weir, Hannah K; Johnson, Christopher J; Ward, Kevin C; Coleman, Michel P

    2016-03-01

    An examination of multiple primary cancers can provide insight into the etiologic role of genes, the environment, and prior cancer treatment on a cancer patient's risk of developing a subsequent cancer. Different rules for registering multiple primary cancers (MP) are used by cancer registries throughout the world making data comparisons difficult. We evaluated the effect of SEER and IARC/IACR rules on cancer incidence rates and trends using data from the SEER Program. We estimated age-standardized incidence rate (ASIR) and trends (1975-2011) for the top 26 cancer categories using joinpoint regression analysis. ASIRs were higher using SEER compared to IARC/IACR rules for all cancers combined (3 %) and, in rank order, melanoma (9 %), female breast (7 %), urinary bladder (6 %), colon (4 %), kidney and renal pelvis (4 %), oral cavity and pharynx (3 %), lung and bronchus (2 %), and non-Hodgkin lymphoma (2 %). ASIR differences were largest for patients aged 65+ years. Trends were similar using both MP rules with the exception of cancers of the urinary bladder, and kidney and renal pelvis. The choice of multiple primary coding rules effects incidence rates and trends. Compared to SEER MP coding rules, IARC/IACR rules are less complex, have not changed over time, and report fewer multiple primary cancers, particularly cancers that occur in paired organs, at the same anatomic site and with the same or related histologic type. Cancer registries collecting incidence data using SEER rules may want to consider including incidence rates and trends using IARC/IACR rules to facilitate international data comparisons.

  15. Breast cancer survival rate according to data of cancer registry and death registry systems in Bushehr province, 2001-2013

    Directory of Open Access Journals (Sweden)

    Zahra Rampisheh

    2015-09-01

    Full Text Available Background: Breast cancer is the most common female cancer worldwide. Survival rate of breast cancer, especially as an indicator of the successful implementation of screening, diagnosis and treatment programs, has been at the center of attention of public health experts Material and Methods: In a survival study, the records of breast cancer cases in cancer registry system of Bushehr Province were extracted during 2001, March to 2013, September. These records were linked and matched with records of death registry system. After determining patients, status regarding being alive or dead, survival analysis was done. Life table, Kaplan-Mayer analysis, log rank and Breslow tests were used for computing and comparing survival rates. Results: In 300 recorded breast cancer cases, mean and standard deviation of age was 51.26±13.87. Survival rates were 95, 88, 78, 73 and 68 percent since the first year through the fifth year, respectively. Mean survival was 87.20 months (95% CI= 81.28- 93.12. There was no significant difference in mean survival regarding age and different geographical areas. Conclusion: Although survival rates of registered breast cancer patients in Bushehr Province are similar to other provinces, they are far from those of developed countries. This situation demands more extensive efforts regarding public education and improving the process of diagnosis, treatment and care of patients especially during first two years after diagnosis.

  16. Integrating GPS with GLONASS for high-rate seismogeodesy

    Science.gov (United States)

    Geng, Jianghui; Jiang, Peng; Liu, Jingnan

    2017-04-01

    High-rate GPS is a precious seismogeodetic tool to capture coseismic displacements unambiguously and usually improved by sidereal filtering to mitigate multipath effects dominating the periods of tens of seconds to minutes. We further introduced GLONASS (Globalnaya navigatsionnaya sputnikovaya sistema) data into high-rate GPS to deliver over 2000 24 h displacements at 99 stations in Europe. We find that the major displacement errors induced by orbits and atmosphere on the low-frequency band that are not characterized by sidereal repeatabilities can be amplified markedly by up to 40% after GPS sidereal filtering. In contrast, integration with GLONASS can reduce the noise of high-rate GPS significantly and near uniformly over the entire frequency band, especially for the north components by up to 40%, suggesting that this integration is able to mitigate more errors than only multipath within high-rate GPS. Integrating GPS with GLONASS outperforms GPS sidereal filtering substantially in ameliorating displacement noise by up to 60% over a wide frequency band (e.g., 2 s-0.5 days) except a minor portion between 100 and 1000 s. High-rate multi-GNSS (Global Navigation Satellite System) can be enhanced further by sidereal filtering, which should however be carefully implemented to avoid adverse complications of the noise spectrum of displacements.

  17. High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Keisei Okamoto

    2017-02-01

    Full Text Available Purpose : To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR brachytherapy in combination with external beam radiotherapy (EBRT and short-term androgen deprivation therapy (ADT. Material and methods : From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT. The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%, 61 patients with 2 high-risk factors (43%, and 22 patients with 3 high-risk factors (15% including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results : Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS rate of 97.2%, and an overall survival (OS rate of 95.5%. Conclusions : High-dose (BED ≥ 220 Gy radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further.

  18. High risk bladder cancer: current management and survival

    Directory of Open Access Journals (Sweden)

    Anna M. Leliveld

    2011-04-01

    Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

  19. Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast

    OpenAIRE

    Lee, Kunsei; Kim, Hyeongsu; Lee, Jung Hyun; Jeong, Hyoseon; Shin, Soon Ae; Han, Taehwa; Seo, Young Lan; Yoo, Youngbum; Nam, Sang Eun; Park, Jong Heon; Park, Yoo Mi

    2016-01-01

    Background The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. Methods Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rat...

  20. Recommendations of the Spanish brachytherapy group (GEB) of Spanish Society of Radiation Oncology (SEOR) and the Spanish Society of Medical Physics (SEFM) for high-dose rate (HDR) non melanoma skin cancer brachytherapy.

    Science.gov (United States)

    Rodríguez, S; Arenas, M; Gutierrez, C; Richart, J; Perez-Calatayud, J; Celada, F; Santos, M; Rovirosa, A

    2017-08-14

    Clinical indications of brachytherapy in non-melanoma skin cancers, description of applicators and dosimetry recommendations are described based on the literature review, clinical practice and experience of Spanish Group of Brachytherapy and Spanish Society of Medical Physics reported in the XIV Annual Consensus Meeting on Non Melanoma Skin Cancer Brachytherapy held in Benidorm, Alicante (Spain) on October 21st, 2016. All the recommendations for which consensus was achieved are highlighted in blue. Regular and small surfaces may be treated with Leipzig, Valencia, flap applicators or electronic brachytherapy (EBT). For irregular surfaces, customized molds or interstitial implants should be employed. The dose is prescribed at a maximum depth of 3-4 mm of the clinical target volume/planning target volume (CTV/PTV) in all cases except in flaps or molds in which 5 mm is appropriate. Interstitial brachytherapy should be used for CTV/PTV >5 mm. Different total doses and fraction sizes are used with very similar clinical and toxicity results. Hypofractionation is very useful twice or 3 times a week, being comfortable for patients and practical for Radiotherapy Departments. In interstitial brachytherapy 2 fractions twice a day are applied.

  1. Comparison of Age- Standard Incidence Rate Trends of Gynecologic and Breast Cancer in Iran and Other Countries

    Science.gov (United States)

    ARAB, Maliheh; NOGHABAEI, Giti

    2014-01-01

    Abstract Background Female cancer, especially breast and gynecologic cancers are considered multistage disease, highly influenced by risk and protective factors and/or screening preventive modalities. Consequences of all these factors result in the trend of change over time. Methods In this comparative study, based on data of national cancer registry of Iran 2004 published by Iranian Ministry of Health, age — standard incidence rate (ASR) according to the world population was calculated in all reported gynecologic and breast cancers. Source of all subjects are pathologic based. In the next step, the calculated ASR of Iran and those of the other countries in 2004 were compared to GLOBOCAN ASR reports of 2008. Results In Iran ASR of breast cancer 2004 (24.93) changed to 18.4 in 2008. Ovarian cancer ASR of 2004, 3.07 was 3.1 in 2008. Endometrial cancer ASR in 2004 (2.29) was 1.7 in 2008. Cervical cancer ASR of 1.71 in 2004 was 2.2 in 2008. Conclusions In Iran incidence trend of breast and endometrium are decreasing in the same direction of USA and Australia. Increasing trend of ovary and cervix ASR in Iran is in the inverse direction of USA and Australia which are decreasing. Future studies to find out the same trend or any changes, might develop these findings and improve consequent practical decisions based on results of this study and complementary future studies. PMID:26060699

  2. Digitized reality: Effects of high frame rate on visual perception

    OpenAIRE

    Loertscher, Miriam Laura; Iseli, Christian

    2016-01-01

    The digital revolution changed film production and its aesthetics in many ways. Although motion is a defining feature of moving images, it is also one of their most problematic aspects because of blurred images or other signal processing artifacts. An artistic research project was conducted to test the effects of high frame rates (HFR) on visual perception. Typical camera movements were recorded in different frame rates (24 / 48 / 96 fps) to generate test sequences for a cinema experiment. 69...

  3. Trends in the incidence of and survival rates for oral cavity cancer in the Korean population.

    Science.gov (United States)

    Choi, S W; Moon, E K; Park, J Y; Jung, K W; Oh, C M; Kong, H J; Won, Y J

    2014-11-01

    This study assessed trends in the incidence of and survival rates for oral cavity cancer in the Korean population. Data from the Korea Central Cancer Registry were extracted for 10,282 patients diagnosed with oral cavity cancer (C01-C06) between 1999 and 2010 to evaluate the age-standardised incidence rate, annual percentage change (APC) and 5-year relative survival rate (RSR) according to gender and age. In males, the incidence rate slightly decreased [APC of -0.2% (P = 0.6427)]; in females, the incidence rate increased [APC of 3.1% (P oral tongue cancer (C02) significantly increased [APC of 2.2% and 4.1%, respectively (P oral tongue cancer incidence was most prominent in the younger age group (cancer increased only among males [APC of 4.8% (P oral cavity cancer in females increased, whereas it stabilised or decreased in males. However, the incidence of oral tongue cancer increased in both males and females, especially in the younger age group. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. A review of reaction rates in high temperature air

    Science.gov (United States)

    Park, Chul

    1989-01-01

    The existing experimental data on the rate coefficients for the chemical reactions in nonequilibrium high temperature air are reviewed and collated, and a selected set of such values is recommended for use in hypersonic flow calculations. For the reactions of neutral species, the recommended values are chosen from the experimental data that existed mostly prior to 1970, and are slightly different from those used previously. For the reactions involving ions, the recommended rate coefficients are newly chosen from the experimental data obtained more recently. The reacting environment is assumed to lack thermal equilibrium, and the rate coefficients are expressed as a function of the controlling temperature, incorporating the recent multitemperature reaction concept.

  5. THE AMERICAN HIGH SCHOOL GRADUATION RATE: TRENDS AND LEVELS*

    Science.gov (United States)

    Heckman, James J.; LaFontaine, Paul A.

    2009-01-01

    This paper applies a unified methodology to multiple data sets to estimate both the levels and trends in U.S. high school graduation rates. We establish that (a) the true rate is substantially lower than widely used measures; (b) it peaked in the early 1970s; (c) majority/minority differentials are substantial and have not converged for 35 years; (d) lower post-1970 rates are not solely due to increasing immigrant and minority populations; (e) our findings explain part of the slowdown in college attendance and rising college wage premiums; and (f) widening graduation differentials by gender help explain increasing male-female college attendance gaps. PMID:20625528

  6. High rate tests of the LHCb RICH Upgrade system

    CERN Multimedia

    Blago, Michele Piero

    2016-01-01

    One of the biggest challenges for the upgrade of the LHCb RICH detectors from 2020 is to readout the photon detectors at the full 40 MHz rate of the LHC proton-proton collisions. A test facility has been setup at CERN with the purpose to investigate the behaviour of the Multi Anode PMTs, which have been proposed for the upgrade, and their readout electronics at high trigger rates. The MaPMTs are illuminated with a monochromatic laser that can be triggered independently of the readout electronics. A first series of tests, including threshold scans, is performed at low trigger rates (20 kHz) for both the readout and the laser with the purpose to characterise the behaviour of the system under test. Then the trigger rate is increased in two separate steps. First the MaPMTs are exposed to high illumination by triggering the pulsed laser at a high (20 MHz) repetition rate while the DAQ is readout at the same low rate as before. In this way the performance of the MaPMTs and the attached electronics can be evaluated ...

  7. High strain rate superplasticity in metals and composites

    Energy Technology Data Exchange (ETDEWEB)

    Nieh, T.G.; Wadsworth, J. [Lawrence Livermore National Lab., CA (United States); Higashi, K. [Osaka Prefecture Univ., Sakai (Japan). Dept. of Mechanicl Systems Engineering

    1993-07-01

    Superplastic behavior at very high strain rates (at or above 1 s{sup {minus}1}) in metallic-based materials is an area of increasing interest. The phenomenon has been observed quite extensively in metal alloys, metal-matrix composites (MMC), and mechanically-alloyed (MA) materials. In the present paper, experimental results on high strain rate behavior in 2124 Al-based materials, including Zr-modified 2124, SiC-reinforced 2124, MA 2124, and MA 2124 MMC, are presented. Except for the required fine grain size, details of the structural requirements of this phenomenon are not yet understood. Despite this, a systematic approach to produce high strain rate superplasticity (HSRS) in metallic materials is given in this paper. Evidences indicate that the presence of a liquid phase, or a low melting point region, at boundary interfaces is responsible for HSRS.

  8. Complex pulsing schemes for high frame rate imaging

    DEFF Research Database (Denmark)

    Misaridis, Thanassis; Fink, Mathias; Jensen, Jørgen Arendt

    2002-01-01

    High frame rate ultrasound imaging can be achieved by simultaneous transmission of multiple focused beams along different directions. However, image quality degrades by the interference among beams. An alternative approach is to transmit spherical waves of a basic short pulse with frequency codin......B. With the proposed imaging strategy of pulse train excitation, a whole image can be formed with only two emissions, making it possible to obtain high quality images at a frame rate of 20 to 25 times higher than that of conventional phased array imaging......High frame rate ultrasound imaging can be achieved by simultaneous transmission of multiple focused beams along different directions. However, image quality degrades by the interference among beams. An alternative approach is to transmit spherical waves of a basic short pulse with frequency coding...

  9. Semi-solid electrodes having high rate capability

    Energy Technology Data Exchange (ETDEWEB)

    Chiang, Yet-Ming; Duduta, Mihai; Holman, Richard; Limthongkul, Pimpa; Tan, Taison

    2017-11-28

    Embodiments described herein relate generally to electrochemical cells having high rate capability, and more particularly to devices, systems and methods of producing high capacity and high rate capability batteries having relatively thick semi-solid electrodes. In some embodiments, an electrochemical cell includes an anode, a semi-solid cathode that includes a suspension of an active material and a conductive material in a liquid electrolyte, and an ion permeable membrane disposed between the anode and the cathode. The semi-solid cathode has a thickness in the range of about 250 .mu.m-2,500 .mu.m, and the electrochemical cell has an area specific capacity of at least 5 mAh/cm.sup.2 at a C-rate of C/2.

  10. Association Between Air Temperature and Cancer Death Rates in Florida: An Ecological Study.

    Science.gov (United States)

    Hart, John

    2015-01-01

    Proponents of global warming predict adverse events due to a slight warming of the planet in the last 100 years. This ecological study tests one of the possible arguments that might support the global warming theory - that it may increase cancer death rates. Thus, average daily air temperature is compared to cancer death rates at the county level in a U.S. state, while controlling for variables of smoking, race, and land elevation. The study revealed that lower cancer death rates were associated with warmer temperatures. Further study is indicated to verify these findings.

  11. A model for low dose effects of low-LET radiation delivered at high dose rates

    Science.gov (United States)

    Schöllnberger, H.; Stewart, R.D.; Mitchel, R.E.J.

    2011-01-01

    In vitro studies show that protective tumour-reducing effects occur for low dose rates (mGy per minute). To account for these phenomena, we have previously developed stochastic and deterministic multi-stage cancer models that include radiation-induced adaptations in DNA repair processes and radical scavenging. Here, these models are extended to account for the induction of radioprotective mechanisms for low doses of low LET radiation delivered at high dose rates. Cellular adaptations in DNA repair are related to temporal changes in the amount of DNA damage in a cell. The combined effects of endogenous DNA damage, background radiation and artificial irradiation are considered. PMID:22318364

  12. Cervical cancer screening coverage in a high-incidence region

    Directory of Open Access Journals (Sweden)

    Cibelli Navarro

    2015-01-01

    Full Text Available OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program. METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a women’s health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used. RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2. Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5. A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening. CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease. Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer.

  13. Feasibility and toxicity of a single fraction high-dose-rate brachytherapy followed by a course of EBRT for localized prostate cancer, a retrospective study: the Polyclinique Courlancy experience; Faisabilite et toxicite d'une seance unique de curietherapie de haut debit de dose suivie d'une irradiation externe dans le cancer localise de la prostate: etude retrospective de la polyclinique de Courlancy

    Energy Technology Data Exchange (ETDEWEB)

    Mallet, F.; Wdowczyk, D.; Bruna, A.; Joffroy, P.; Pangrazzi, T. [Centre de radiotherapie et d' oncologie, polyclinique Courlancy, Service de radiotherapie, 51 - Reims (France); Villena, P.; Herard, A.; Amory, J.P. [Cabinet d' urologie, polyclinique Courlancy, 51 - Reims (France)

    2010-01-15

    Purpose Evaluate the feasibility and toxicity of radiation dose escalation delivered with a single fraction high-dose-rate (H.D.R.) brachytherapy boost followed by external beam radiotherapy for intermediate and high risk localized prostate cancer - a retrospective study. Patients and methods: Between December 2004 and December 2008, 61 patients with intermediate risk or high-risk localized prostate cancer received a single 10 Gy fraction of interstitial H.D.R. brachytherapy followed by a 64 Gy course of external beam radiation therapy. Dose volume histograms, conformity index and side effects were systematically analyzed. Result; H.D.R. brachytherapy dosimetric criteria were respected. Early side effects (= 3 months after full treatment): 30 % reported grade 2 or grade 3 urinary toxicity and 26 % reported grade 2 or grade 3 bowel toxicity were reported. Late side effects (> 3 months): 12 % reported grade 2 or grade 3 urinary toxicity and 5 % reported grade 2 or grade 3 bowel toxicity were reported. No patients reported any grade 4 late toxicity events. Three months after treatment, 7 % grade 1, 25 % grade 2 and 39 % grade 3 erectile dysfunction were reported. Conclusion. Our mono fractionation protocol is an easy technique to implement logistically. Acute and late toxicities are acceptable and comparable to those published by various teams mostly using multi fractionation protocols. A longer follow-up is required to assess the effect of this dose escalation protocol on long-term biological control. (authors)

  14. High removal rate laser-based coating removal system

    Science.gov (United States)

    Matthews, Dennis L.; Celliers, Peter M.; Hackel, Lloyd; Da Silva, Luiz B.; Dane, C. Brent; Mrowka, Stanley

    1999-11-16

    A compact laser system that removes surface coatings (such as paint, dirt, etc.) at a removal rate as high as 1000 ft.sup.2 /hr or more without damaging the surface. A high repetition rate laser with multiple amplification passes propagating through at least one optical amplifier is used, along with a delivery system consisting of a telescoping and articulating tube which also contains an evacuation system for simultaneously sweeping up the debris produced in the process. The amplified beam can be converted to an output beam by passively switching the polarization of at least one amplified beam. The system also has a personal safety system which protects against accidental exposures.

  15. Development and validation of the Cancer Dyspnoea Scale: a multidimensional, brief, self-rating scale

    OpenAIRE

    Tanaka, K; Akechi, T; Okuyama, T.; Nishiwaki, Y.; Uchitomi, Y

    2000-01-01

    Dyspnoea is one of the most frequent and refractory symptoms in cancer patients. Lack of an appropriate assessment tool for dyspnoea seems to disturb establishment of management strategy. The purpose of this study was to develop and validate a brief self-rating scale to assess the multidimensional nature of dyspnoea in cancer patients. We developed a 12-item scale, the Cancer Dyspnoea Scale (CDS), composed of three factors (sense of effort/sense of anxiety/sense of discomfort), by using facto...

  16. Fruits and vegetables intake differentially affects estrogen receptor negative and positive breast cancer incidence rates.

    Science.gov (United States)

    Olsen, Anja; Tjønneland, Anne; Thomsen, Birthe L; Loft, Steffen; Stripp, Connie; Overvad, Kim; Møller, Susanne; Olsen, Jørgen H

    2003-07-01

    Despite intensive research, the evidence for a protective effect of fruits and vegetables on breast cancer risk remains inconclusive. Other risk factors for breast cancer seem to vary with the estrogen receptor status of the breast tumor, and it is thus possible that the inconsistent results regarding a preventive effect of fruits and vegetables are due to lack of controlling for estrogen receptor status. The objective of this study was to investigate the effect of fruit and vegetable intake on postmenopausal breast cancer and explore whether the estrogen receptor status of the tumor modifies this relation. Postmenopausal women (n = 23,798; aged 50-64 y) provided information about diet and established risk factors for breast cancer in the cohort "Diet, Cancer and Health." During follow-up, 425 cases were diagnosed with breast cancer. Associations between intake of fruits and vegetables and the breast cancer rate were analyzed using Cox's regression model. The association for all breast cancers was an incidence rate ratio (IRR) of 1.02 (95% CI, 0.98-1.06) per 100 g/d increment of total intake of fruits, vegetables and juice. For estrogen receptor-positive (ER(+)) breast cancer, a borderline significant increase in the rate was seen, IRR: 1.05 (95% CI, 1.00-1.10), whereas a preventive effect was seen for estrogen receptor-negative (ER(-)) breast cancers, IRR: 0.90 (95% CI, 0.81-0.99). In conclusion, we did not find the overall breast cancer rate to be associated with the intake of fruits and vegetables, but there seemed to be different effects for ER(+) and ER(-) breast cancer.

  17. Sensitivity to Envelope Interaural Time Differences at High Modulation Rates

    Science.gov (United States)

    Bleeck, Stefan; McAlpine, David

    2015-01-01

    Sensitivity to interaural time differences (ITDs) conveyed in the temporal fine structure of low-frequency tones and the modulated envelopes of high-frequency sounds are considered comparable, particularly for envelopes shaped to transmit similar fidelity of temporal information normally present for low-frequency sounds. Nevertheless, discrimination performance for envelope modulation rates above a few hundred Hertz is reported to be poor—to the point of discrimination thresholds being unattainable—compared with the much higher (>1,000 Hz) limit for low-frequency ITD sensitivity, suggesting the presence of a low-pass filter in the envelope domain. Further, performance for identical modulation rates appears to decline with increasing carrier frequency, supporting the view that the low-pass characteristics observed for envelope ITD processing is carrier-frequency dependent. Here, we assessed listeners’ sensitivity to ITDs conveyed in pure tones and in the modulated envelopes of high-frequency tones. ITD discrimination for the modulated high-frequency tones was measured as a function of both modulation rate and carrier frequency. Some well-trained listeners appear able to discriminate ITDs extremely well, even at modulation rates well beyond 500 Hz, for 4-kHz carriers. For one listener, thresholds were even obtained for a modulation rate of 800 Hz. The highest modulation rate for which thresholds could be obtained declined with increasing carrier frequency for all listeners. At 10 kHz, the highest modulation rate at which thresholds could be obtained was 600 Hz. The upper limit of sensitivity to ITDs conveyed in the envelope of high-frequency modulated sounds appears to be higher than previously considered. PMID:26721926

  18. Cancer Incidence Rates and Trends Among Children and Adolescents in the United States, 2001–2009

    Science.gov (United States)

    Siegel, David A.; King, Jessica; Tai, Eric; Buchanan, Natasha; Ajani, Umed A.; Li, Jun

    2015-01-01

    OBJECTIVES Cancer continues to be the leading disease-related cause of death among children and adolescents in the United States. More current information is needed to describe recent cancer trends and identify demographic and geographic variations. METHODS We analyzed data from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results statewide registries representing 94.2% of the US population to identify cancers diagnosed among persons aged 0 to 19 years during 2001–2009. Age-adjusted rates and annual percentage change for trends were calculated. Data were stratified by age, gender, race, ethnicity, and geography. RESULTS We identified 120 137 childhood and adolescent cancer cases during 2001–2009 with an age-adjusted incidence rate of 171.01 per million. The overall rate of all cancers combined remained stable over time (annual percent change [APC], 0.3%; 95% confidence interval [CI], −0.1 to 0.7). There was an increase in the overall cancer trend among African American children and adolescents (APC, 1.3%; 95% CI, 0.2 to 2.5). An increasing trend for thyroid cancer was observed among both genders (APC, 4.9%; 95% CI, 3.2 to 6.6) and specifically among adolescents and those in the Northeast, South, and West regions of the United States. Renal carcinoma incidence was increasing significantly overall (APC, 5.4%; 95% CI, 2.8 to 8.1). Extracranial and extragonadal germ cell tumors and melanoma were both significantly decreasing. CONCLUSIONS This study reports the novel finding that renal carcinoma rates are increasing among children and adolescents. This study confirms that thyroid cancer rates are increasing and further describes rising cancer rates among African Americans. PMID:25201796

  19. Compressed sensing for high frame rate, high resolution and high contrast ultrasound imaging.

    Science.gov (United States)

    Jing Liu; Qiong He; Jianwen Luo

    2015-08-01

    Compressed sensing (CS) or compressive sampling allows much lower sampling frequency than the Nyquist sampling frequency. In this paper, we propose a novel technique, named compressed sensing based synthetic transmit aperture (CS-STA), to speed up the acquisition of ultrasound imaging. Ultrasound transducer transmits plane wave with random apodizations for several times and receives the corresponding echoes. The full dataset of STA is then recovered from the recorded echoes using a CS reconstruction algorithm. Finally, a standard STA beamforming is performed on the dataset to form a B-mode image. When the number of CS-STA firings is smaller than the number of STA firings, higher frame rate is achieved. In addition, CS-STA maintains the high resolution of STA because of the CS recovered full dataset of STA, and improves the contrast due to plane wave firings. Computer simulations and phantom experiments are carried out to investigate the feasibility and performance of the proposed CS-STA method. The CS-STA method is proven to be capable of obtaining simultaneously high frame rate, high solution and high contrast ultrasound imaging.

  20. GPU accelerated OCT processing at megahertz axial scan rate and high resolution video rate volumetric rendering

    Science.gov (United States)

    Jian, Yifan; Wong, Kevin; Sarunic, Marinko V.

    2013-03-01

    In this report, we describe how to highly optimize a CUDA based platform to perform real time optical coherence tomography data processing and 3D volumetric rendering using commercially-available cost-effective graphic processing units (GPUs). The maximum complete attainable axial scan processing rate (including memory transfer and rendering frame) was 2.2 megahertz for 16 bits pixel depth and 2048 pixels/A-scan, the maximum 3D volumetric rendering speed is 23 volumes/second (size:1024×256×200). To the best of our knowledge, this is the fastest processing rate reported to date with single-chip GPU and the first implementation of real time video rate volumetric OCT processing and rendering that is capable of matching the ultrahigh-speed OCT acquisition rates.

  1. Low primary cesarean rate and high VBAC rate with good outcomes in an Amish birthing center.

    Science.gov (United States)

    Deline, James; Varnes-Epstein, Lisa; Dresang, Lee T; Gideonsen, Mark; Lynch, Laura; Frey, John J

    2012-01-01

    Recent national guidelines encourage a trial of labor after cesarean (TOLAC) as a means of increasing vaginal births after cesarean (VBACs) and decreasing the high US cesarean birth rate and its consequences (2010 National Institute of Health Consensus Statement and American College of Obstetricians and Gynecologists revised guideline). A birthing center serving Amish women in Southwestern Wisconsin offered an opportunity to look at the effects of local culture and practices that support vaginal birth and TOLAC. This study describes childbirth and perinatal outcomes during a 17-year period in LaFarge, Wisconsin. We undertook a retrospective analysis of the records of all women admitted to the birth center in labor. Main outcome measures include rates of cesarean deliveries, TOLAC and VBAC deliveries, and perinatal outcomes for 927 deliveries between 1993 and 2010. The cesarean rate was 4% (35 of 927), the TOLAC rate was 100%, and the VBAC rate was 95% (88 of 92). There were no cases of uterine rupture and no maternal deaths. The neonatal death rate of 5.4 of 1,000 was comparable to that of Wisconsin (4.6 of 1,000) and the United States (4.5 of 1,000). Both the culture of the population served and a number of factors relating to the management of labor at the birthing center have affected the rates of cesarean delivery and TOLAC. The results of the LaFarge Amish study support a low-technology approach to delivery where good outcomes are achieved with low cesarean and high VBAC rates.

  2. Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

    Science.gov (United States)

    Hoşcan, Mustafa Burak; Özorak, Alper; Oksay, Taylan; Perk, Hakkı; Armağan, Abdullah; Soyupek, Sedat; Serel, Tekin Ahmet; Koşar, Alim

    2014-07-01

    We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

  3. Electrophoretic Deposition of Gallium with High Deposition Rate

    Directory of Open Access Journals (Sweden)

    Hanfei Zhang

    2014-12-01

    Full Text Available In this work, electrophoretic deposition (EPD is reported to form gallium thin film with high deposition rate and low cost while avoiding the highly toxic chemicals typically used in electroplating. A maximum deposition rate of ~0.6 μm/min, almost one order of magnitude higher than the typical value reported for electroplating, is obtained when employing a set of proper deposition parameters. The thickness of the film is shown to increase with deposition time when sequential deposition is employed. The concentration of Mg(NO32, the charging salt, is also found to be a critical factor to control the deposition rate. Various gallium micropatterns are obtained by masking the substrate during the process, demonstrating process compatibility with microfabrication. The reported novel approach can potentially be employed in a broad range of applications with Ga as a raw material, including microelectronics, photovoltaic cells, and flexible liquid metal microelectrodes.

  4. Naturally Occurring Canine Invasive Urinary Bladder Cancer: A Complementary Animal Model to Improve the Success Rate in Human Clinical Trials of New Cancer Drugs.

    Science.gov (United States)

    Fulkerson, Christopher M; Dhawan, Deepika; Ratliff, Timothy L; Hahn, Noah M; Knapp, Deborah W

    2017-01-01

    Genomic analyses are defining numerous new targets for cancer therapy. Therapies aimed at specific genetic and epigenetic targets in cancer cells as well as expanded development of immunotherapies are placing increased demands on animal models. Traditional experimental models do not possess the collective features (cancer heterogeneity, molecular complexity, invasion, metastasis, and immune cell response) critical to predict success or failure of emerging therapies in humans. There is growing evidence, however, that dogs with specific forms of naturally occurring cancer can serve as highly relevant animal models to complement traditional models. Invasive urinary bladder cancer (invasive urothelial carcinoma (InvUC)) in dogs, for example, closely mimics the cancer in humans in pathology, molecular features, biological behavior including sites and frequency of distant metastasis, and response to chemotherapy. Genomic analyses are defining further intriguing similarities between InvUC in dogs and that in humans. Multiple canine clinical trials have been completed, and others are in progress with the aim of translating important findings into humans to increase the success rate of human trials, as well as helping pet dogs. Examples of successful targeted therapy studies and the challenges to be met to fully utilize naturally occurring dog models of cancer will be reviewed.

  5. Naturally Occurring Canine Invasive Urinary Bladder Cancer: A Complementary Animal Model to Improve the Success Rate in Human Clinical Trials of New Cancer Drugs

    Directory of Open Access Journals (Sweden)

    Christopher M. Fulkerson

    2017-01-01

    Full Text Available Genomic analyses are defining numerous new targets for cancer therapy. Therapies aimed at specific genetic and epigenetic targets in cancer cells as well as expanded development of immunotherapies are placing increased demands on animal models. Traditional experimental models do not possess the collective features (cancer heterogeneity, molecular complexity, invasion, metastasis, and immune cell response critical to predict success or failure of emerging therapies in humans. There is growing evidence, however, that dogs with specific forms of naturally occurring cancer can serve as highly relevant animal models to complement traditional models. Invasive urinary bladder cancer (invasive urothelial carcinoma (InvUC in dogs, for example, closely mimics the cancer in humans in pathology, molecular features, biological behavior including sites and frequency of distant metastasis, and response to chemotherapy. Genomic analyses are defining further intriguing similarities between InvUC in dogs and that in humans. Multiple canine clinical trials have been completed, and others are in progress with the aim of translating important findings into humans to increase the success rate of human trials, as well as helping pet dogs. Examples of successful targeted therapy studies and the challenges to be met to fully utilize naturally occurring dog models of cancer will be reviewed.

  6. High ratings of satisfaction with fertility treatment are common

    DEFF Research Database (Denmark)

    Schmidt, L; Holstein, B E; Boivin, J

    2003-01-01

    /delivery and the report of marital benefits resulting from the infertility experience. Lower social class was a significant predictor for satisfaction. CONCLUSIONS: Both men and women in fertility treatment had high ratings on medical and patient-centred care. It seemed that satisfaction with the psychosocial services...

  7. Advances in high rate anaerobic treatment: staging of reactor systems.

    NARCIS (Netherlands)

    Lier, van J.B.; Zee, van der F.P.; Tan, N.C.G.; Rebac, S.; Kleerebezem, R.

    2001-01-01

    Anaerobic wastewater treatment (AnWT) is considered as the most cost-effective solution for organically polluted industrial waste streams. Particularly the development of high-rate systems, in which hydraulic retention times are uncoupled from solids retention times, has led to a world-wide

  8. High rate of teenage pregnancy and sexually transmitted infections ...

    African Journals Online (AJOL)

    There is increased in teenage pregnancy despite the presence of dual protection practice and health care awareness programmes related to health and sexuality education in South Africa. The present study explores the underlying causes of high teenage pregnancy and sexually transmitted diseases rates, including HIV ...

  9. High Frame Rate Synthetic Aperture 3D Vector Flow Imaging

    DEFF Research Database (Denmark)

    Villagómez Hoyos, Carlos Armando; Holbek, Simon; Stuart, Matthias Bo

    2016-01-01

    , current volumetric ultrasonic flow methods are limited to one velocity component or restricted to a reduced field of view (FOV), e.g. fixed imaging planes, in exchange for higher temporal resolutions. To solve these problems, a previously proposed accurate 2-D high frame rate vector flow imaging (VFI...

  10. Minimum Variance Beamforming for High Frame-Rate Ultrasound Imaging

    DEFF Research Database (Denmark)

    Holfort, Iben Kraglund; Gran, Fredrik; Jensen, Jørgen Arendt

    2007-01-01

    emissions. An increase in resolution is seen when using only one single emission. Furthermore, it is seen that an increase of the number of emissions does not alter the FWHM. Thus, the MV beamformer introduces the possibility for high frame-rate imaging with increased resolution....

  11. Behaviour of uranium alloys at high loading rates

    Energy Technology Data Exchange (ETDEWEB)

    Rolc, S.; Pechacek, J.; Krejci, J. (Ceskoslovenska Akademie Ved, Brno (CS). Ustav Fyzikalni Metalurgie); Buchar, J.

    1991-10-01

    The mechanical behaviour of depleted uranium, uranium with molybdenum, niobium, titanium and rhenium was investigated under high strain rates. The Hopkinson split pressure bar was used. The spallation of these materials was also studied. The correlation of the spall strength, {sigma}{sub c}, with flow properties was found. 11 refs., 4 figs., 1 tab..

  12. High rates of catalytic hydrogen combustion with air over coated ...

    Indian Academy of Sciences (India)

    BHASKAR DEVU MUKRI

    2017-08-02

    Aug 2, 2017 ... High rates of catalytic hydrogen combustion with air over. Ti0.97Pd0.03O2−δ coated cordierite monolith. BHASKAR DEVU MUKRI. ∗ and M S HEGDE. Solid State and Structural Chemistry Unit, Indian Institute of Science, Bangalore 560 012, India. E-mail: bhaskardm@gmail.com. MS received 9 May 2017; ...

  13. Temporal dynamics of high repetition rate pulsed single longitudinal ...

    Indian Academy of Sciences (India)

    Theoretical and experimental studies of temporal dynamics of grazing incidence grating (GIG) cavity, single-mode dye laser pumped by high repetition rate copper vapour laser (CVL) are presented. Spectral chirp of the dye laser as they evolve in the cavity due to transient phase dynamics of the amplifier gain medium is ...

  14. Adapting high-rate anaerobic treatment to Middle East conditions

    NARCIS (Netherlands)

    Mahmoud, N.A.; Zeeman, G.; Lier, van J.B.

    2008-01-01

    High-rate anaerobic technologies offer cost-effective solutions for sewage treatment in the Middle East and Palestine in particular. The sewage characteristics in Palestine are quite different from the values elsewhere and show solids contents of more than 1000 mg chemical oxygen demand (COD)ss/L

  15. Plant respirometer enables high resolution of oxygen consumption rates

    Science.gov (United States)

    Foster, D. L.

    1966-01-01

    Plant respirometer permits high resolution of relatively small changes in the rate of oxygen consumed by plant organisms undergoing oxidative metabolism in a nonphotosynthetic state. The two stage supply and monitoring system operates by a differential pressure transducer and provides a calibrated output by digital or analog signals.

  16. Methanol conversion in high-rate anaerobic reactors

    NARCIS (Netherlands)

    Weijma, J.; Stams, A.J.M.

    2001-01-01

    An overview on methanol conversion in high-rate anaerobic reactors is presented, with the focus on technological as well as microbiological aspects. The simple C1-compound methanol can be degraded anaerobically in a complex way, in which methanogens, sulfate reducing bacteria and homoacetogens

  17. Twinning in copper deformed at high strain rates

    Indian Academy of Sciences (India)

    †Department of Physics, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa. MS received 25 February 2010; revised 13 August 2012. Abstract. Copper samples having varying microstructures were deformed at high strain rates using a split-. Hopkinson pressure bar. Transmission electron microscopy ...

  18. Prediction of glomerular filtration rate in cancer patients by an equation for Japanese estimated glomerular filtration rate.

    Science.gov (United States)

    Funakoshi, Yohei; Fujiwara, Yutaka; Kiyota, Naomi; Mukohara, Toru; Shimada, Takanobu; Toyoda, Masanori; Imamura, Yoshinori; Chayahara, Naoko; Umezu, Michio; Otsuki, Naoki; Nibu, Ken-ichi; Minami, Hironobu

    2013-03-01

    Assessment of renal function is important for safe cancer chemotherapy, and eligibility criteria for clinical trials often include creatinine clearance. However, creatinine clearance overestimates glomerular filtration rate, and various new formulae have been proposed to estimate glomerular filtration rate. Because these were developed mostly in patients with chronic kidney disease, we evaluated their validity in cancer patients without kidney disease. Glomerular filtration rate was measured by inulin clearance in 45 Japanese cancer patients, and compared with creatinine clearance measured by 24-h urine collection as well as that estimated by the Cockcroft-Gault formula, Japanese estimated glomerular filtration rate developed in chronic kidney disease patients, the Modification of Diet in Renal Disease study equation and the Chronic Kidney Disease Epidemiology Collaboration equation. The Modification of Diet in Renal Disease study and Chronic Kidney Disease Epidemiology Collaboration equations were adjusted for the Japanese population by multiplying by 0.808 and 0.813, respectively. The mean inulin clearance was 79.2 ± 18.7 ml/min/1.73 m(2). Bias values to estimate glomerular filtration rate for Japanese estimated glomerular filtration rate, the Cockcroft-Gault formula, creatinine clearance measured by 24-h urine collection, the 0.808 × Modification of Diet in Renal Disease study equation and the 0.813 × Chronic Kidney Disease Epidemiology Collaboration equation were 0.94, 9.75, 29.67, 5.26 and -0.92 ml/min/1.73 m(2), respectively. Precision (root-mean square error) was 14.7, 22.4, 39.8, 16.0 and 14.1 ml/min, respectively. Of the scatter plots of inulin clearance versus each estimation formula, the Japanese estimated glomerular filtration rate correlated most accurately with actual measured inulin clearance. The Japanese estimated glomerular filtration rate and the 0.813 × Chronic Kidney Disease Epidemiology Collaboration equation estimated glomerular

  19. Low level of consanguinity in moroccan families at high risk of breast cancer.

    Science.gov (United States)

    Elalaoui, Siham Chafai; Jaouad, Imane Cherkaoui; Laarabi, Fatima Zahra; Elgueddari, Brahim El Khalil

    2013-01-01

    Breast cancer is worldwide the most common cancer in women and is a major public health problem. Genes with high or low penetrance are now clearly implicated in the onset of breast cancer, mostly the BRCA genes. All women in families at high risk of breast cancer do not develop tumours, even when they carry the familial mutation, suggesting the existence of genetic and environmental protective factors. Several studies have shown that consanguinity is linked to a decreased or an increased risk of breast cancer, but to the best of our knowledge, there is no study concerning the association between consanguinity and the occurrence of tumours in women with high risk of breast cancer. The objective of this study was to examine whether parental consanguinity in families with genetic predisposition to breast cancer affect the risk of siblings for having this cancer. Over a six-year period, 72 different patients with a histological diagnosis of breast or ovarian cancer from 42 families were recruited for genetic counselling to the Department of Medical Genetics, Rabat. Consanguinity rate was determined in cases and compared to the consanguinity rate in the Moroccan general population. Consanguinity rates were 9.72% in patients and 15.3% in controls, but the difference was statistically not significant (p>0.001) and the mean coefficient of consanguinity was lower in breast cancer patients (0.0034) than in controls (0.0065). Despite the relatively small sample size of the current study, our results suggest that parental consanguinity in Moroccan women might not be associated with an altered risk of breast cancer. Large scale studies should be carried out to confirm our results and to develop public health programs.

  20. glomerular filtration rate profiles in paediatric patients on cancer

    African Journals Online (AJOL)

    2013-05-28

    May 28, 2013 ... The glomerular filtration rate (GFR) is widely accepted as the best index of renal function in patients. Chemotherapy is the mainstay of treatment in the paediatric oncology unit at the Kenyatta National Hospital. Objectives: To determine the glomerular filtration rate profiles of paediatric oncology patients and ...

  1. During stress, heart rate variability moderates the impact of childhood adversity in women with breast cancer.

    Science.gov (United States)

    Tell, Dina; Mathews, Herbert L; Burr, Robert L; Witek Janusek, Linda

    2018-03-01

    Childhood adversity has long-lasting neuro-biological effects that can manifest as exaggerated stress responsivity to environmental challenge. These manifestations include a dysregulated hypothalamic-pituitary-adrenocortical (HPA) axis as well as increased levels of inflammatory mediators in response to stress. In this investigation, vagal parasympathetic activity was assessed for its capacity to moderate the relationship between childhood adversity and stress responsivity (cortisol and inflammation) during an acute laboratory challenge (Trier Social Stress Test-TSST). Thirty women recently diagnosed with breast cancer underwent the TSST during which their heart rate was recorded and saliva samples collected for measurement of cortisol and the proinflammatory cytokine, IL-6. Vagal activity during the TSST was calculated as the high-frequency (HF) component of heart rate variability (HRV). Vagal activity during the TSST moderated the effect of childhood adversity on both the cortisol and the IL-6 response. Women who had lower vagal stress-reactivity during the TSST and reported greater childhood adversity showed a larger rise in cortisol and IL-6 when compared to women with lower childhood adversity. The findings demonstrate that women with exposure to childhood adversity and low vagal stress-reactivity (reduced parasympathetic activity) exhibit an elevated stress response characterized by greater cortisol and proinflammatory cytokine release. Inflammatory burden and HPA dysregulation subsequent to stress may impair cancer control.

  2. The main natural lows of high-rate coal pyrolysis

    Directory of Open Access Journals (Sweden)

    Chemyavsky Nikola V.

    2003-01-01

    Full Text Available The importance of coal pyrolysis studies for the development of energy technologies is evident, since pvrolysis is the first stage of any process of coal thermal conversion. In combustion, pyrolysis determines conditions of coal ignition and the rate of char after-burning, in gasification, pyrolysis determines total yield of gasification products. It must be noted that in modern energy technologies pyrolysis occurs at high late of coal particle heating (=10 K/s for different fluidized bed, or FB-technologies or super-high-rate (>10**5 K/s for entrained-flow gasification, and in some of them at high pressure. In CETI during last 12 years the detailed study of pyrolysis in FB laboratory-scale PYROLYSIS-D plant and entramed-flow pilot-scale GSP-01 plant, was carried out. In this paper main results of mentioned investigations are given. Kinetic constants for bituminous coals and anthracite high heating rates in entrained flow for high temperatures (>1500 °C and >1900 °C, and in fluidized bed conditions in temperature range 972-1273 K. In order to describe data obtained in fluidized bed conditions, G--model based method of calculation of devolatization dynamics was suited to FB heating conditions. Calculated and experimental kinetic data are in good agreement. The result proves that at FB-pvrolysis conditions intrinsic mass-transfer limitations are negligible and devolatilization is really kinetic-controlled.

  3. Miniaturized Stretchable and High-Rate Linear Supercapacitors

    Science.gov (United States)

    Zhu, Wenjun; Zhang, Yang; Zhou, Xiaoshuang; Xu, Jiang; Liu, Zunfeng; Yuan, Ningyi; Ding, Jianning

    2017-07-01

    Linear stretchable supercapacitors have attracted much attention because they are well suited to applications in the rapidly expanding field of wearable electronics. However, poor conductivity of the electrode material, which limits the transfer of electrons in the axial direction of the linear supercapacitors, leads to a serious loss of capacity at high rates. To solve this problem, we use gold nanoparticles to decorate aligned multiwall carbon nanotube to fabricate stretchable linear electrodes. Furthermore, we have developed fine stretchable linear supercapacitors, which exhibited an extremely high elasticity up to 400% strain with a high capacitance of about 8.7 F g-1 at the discharge current of 1 A g-1.

  4. Impact of receiver and constellation on high rate GNSS phase rate measurements to monitor ionospheric irregularities

    Science.gov (United States)

    Ghoddousi-Fard, Reza

    2017-11-01

    High rate (1 Hz) GPS and GLONASS phase rate measurements from the global Real Time International GNSS Service (RT-IGS) network are used to monitor ionospheric irregularities. In this paper, impact of different receiver types and satellite constellations on GNSS-derived indices are studied. Constellation dependent background phase noise is quantified at RT-IGS stations for different receiver categories. Improved sampling of the ionosphere is achieved using multiple constellations. Correlation of hourly mean values of dual constellation GNSS indices with hourly magnetic ranges at a co-located auroral magnetic observatory slightly increased compared to when single constellation is used.

  5. Magnetic Implosion for Novel Strength Measurements at High Strain Rates

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.; Preston, D.L.; Bartsch, R.R.; Bowers, R.L.; Holtkamp, D.; Wright, B.L.

    1998-10-19

    Recently Lee and Preston have proposed to use magnetic implosions as a new method for measuring material strength in a regime of large strains and high strain rates inaccessible to previously established techniques. By its shockless nature, this method avoids the intrinsic difficulties associated with an earlier approach using high explosives. The authors illustrate how the stress-strain relation for an imploding liner can be obtained by measuring the velocity and temperature history of its inner surface. They discuss the physical requirements that lead us to a composite liner design applicable to different test materials, and also compare the code-simulated prediction with the measured data for the high strain-rate experiments conducted recently at LANL. Finally, they present a novel diagnostic scheme that will enable us to remove the background in the pyrometric measurement through data reduction.

  6. A High Rate Tension Device for Characterizing Brain Tissue

    CERN Document Server

    Rashid, Badar; Gilchrist, Michael; 10.1177/1754337112436900

    2013-01-01

    The mechanical characterization of brain tissue at high loading velocities is vital for understanding and modeling Traumatic Brain Injury (TBI). The most severe form of TBI is diffuse axonal injury (DAI) which involves damage to individual nerve cells (neurons). DAI in animals and humans occurs at strains > 10% and strain rates > 10/s. The mechanical properties of brain tissues at these strains and strain rates are of particular significance, as they can be used in finite element human head models to accurately predict brain injuries under different impact conditions. Existing conventional tensile testing machines can only achieve maximum loading velocities of 500 mm/min, whereas the Kolsky bar apparatus is more suitable for strain rates > 100/s. In this study, a custom-designed high rate tension device is developed and calibrated to estimate the mechanical properties of brain tissue in tension at strain rates < 90/s, while maintaining a uniform velocity. The range of strain can also be extended to 100% de...

  7. Systematic Uncertainties in High-Rate Germanium Data

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, Andrew J.; Fast, James E.; Fulsom, Bryan G.; Pitts, William K.; VanDevender, Brent A.; Wood, Lynn S.

    2016-10-06

    For many nuclear material safeguards inspections, spectroscopic gamma detectors are required which can achieve high event rates (in excess of 10^6 s^-1) while maintaining very good energy resolution for discrimination of neighboring gamma signatures in complex backgrounds. Such spectra can be useful for non-destructive assay (NDA) of spent nuclear fuel with long cooling times, which contains many potentially useful low-rate gamma lines, e.g., Cs-134, in the presence of a few dominating gamma lines, such as Cs-137. Detectors in use typically sacrifice energy resolution for count rate, e.g., LaBr3, or visa versa, e.g., CdZnTe. In contrast, we anticipate that beginning with a detector with high energy resolution, e.g., high-purity germanium (HPGe), and adapting the data acquisition for high throughput will be able to achieve the goals of the ideal detector. In this work, we present quantification of Cs-134 and Cs-137 activities, useful for fuel burn-up quantification, in fuel that has been cooling for 22.3 years. A segmented, planar HPGe detector is used for this inspection, which has been adapted for a high-rate throughput in excess of 500k counts/s. Using a very-high-statistic spectrum of 2.4*10^11 counts, isotope activities can be determined with very low statistical uncertainty. However, it is determined that systematic uncertainties dominate in such a data set, e.g., the uncertainty in the pulse line shape. This spectrum offers a unique opportunity to quantify this uncertainty and subsequently determine required counting times for given precision on values of interest.

  8. High-frame-rate echocardiography with reduced sidelobe level.

    Science.gov (United States)

    Hasegawa, Hideyuki; Kanai, Hiroshi

    2012-11-01

    Echocardiography has become an indispensable modality for diagnosis of the heart. It enables observation of the shape of the heart and estimation of global heart function based on B-mode and M-mode imaging. Methods for echocardiographic estimation of myocardial strain and strain rate have also been developed to evaluate regional heart function. Furthermore, it has been recently shown that echocardiographic measurements of transmural transition of myocardial contraction/relaxation and propagation of vibration caused by closure of the heart valve would be useful for evaluation of myocardial function and viscoelasticity. However, such measurements require a frame rate (typically >200 Hz) much higher than that achieved by conventional ultrasonic diagnostic equipment. We have recently realized a high frame rate of about 300 Hz with a full field of view of 90° using diverging transmit beams and parallel receive beamforming. Although high-frame-rate imaging was made possible by this method, the side lobe level was slightly larger than that of the conventional method. To reduce the side lobe level, phase coherence imaging has recently been developed. Using this method, the spatial resolution is improved and the side lobe level is also reduced. However, speckle-like echoes, for example, echoes from the inside of the heart wall, are also suppressed. In the present study, a method for reducing the side lobe level while preserving speckle-like echoes was developed. The side lobe level was evaluated using a wire phantom. The side lobe level of the high-frame-rate imaging using unfocused diverging beams was improved by 13.3 dB by the proposed method. In in vivo measurements, a B-mode image of the heart of a 23-year-old healthy male could be obtained while preserving the speckle pattern in the heart wall at a frame rate of 316 Hz with a full field of view of 90°.

  9. Highly variable rates of genome rearrangements between hemiascomycetous yeast lineages.

    Directory of Open Access Journals (Sweden)

    2006-03-01

    Full Text Available Hemiascomycete yeasts cover an evolutionary span comparable to that of the entire phylum of chordates. Since this group currently contains the largest number of complete genome sequences it presents unique opportunities to understand the evolution of genome organization in eukaryotes. We inferred rates of genome instability on all branches of a phylogenetic tree for 11 species and calculated species-specific rates of genome rearrangements. We characterized all inversion events that occurred within synteny blocks between six representatives of the different lineages. We show that the rates of macro- and microrearrangements of gene order are correlated within individual lineages but are highly variable across different lineages. The most unstable genomes correspond to the pathogenic yeasts Candida albicans and Candida glabrata. Chromosomal maps have been intensively shuffled by numerous interchromosomal rearrangements, even between species that have retained a very high physical fraction of their genomes within small synteny blocks. Despite this intensive reshuffling of gene positions, essential genes, which cluster in low recombination regions in the genome of Saccharomyces cerevisiae, tend to remain syntenic during evolution. This work reveals that the high plasticity of eukaryotic genomes results from rearrangement rates that vary between lineages but also at different evolutionary times of a given lineage.

  10. Precise muon drift tube detectors for high background rate conditions

    Energy Technology Data Exchange (ETDEWEB)

    Engl, Albert

    2011-08-04

    The muon spectrometer of the ATLAS-experiment at the Large Hadron Collider consists of drift tube chambers, which provide the precise measurement of trajectories of traversing muons. In order to determine the momentum of the muons with high precision, the measurement of the position of the muon in a single tube has to be more accurate than {sigma}{<=}100 {mu}m. The large cross section of proton-proton-collisions and the high luminosity of the accelerator cause relevant background of neutrons and {gamma}s in the muon spectrometer. During the next decade a luminosity upgrade to 5.10{sup 34} cm{sup -2}s{sup -1} is planned, which will increase the background counting rates considerably. In this context this work deals with the further development of the existing drift chamber technology to provide the required accuracy of the position measurement under high background conditions. Two approaches of improving the drift tube chambers are described: - In regions of moderate background rates a faster and more linear drift gas can provide precise position measurement without changing the existing hardware. - At very high background rates drift tube chambers consisting of tubes with a diameter of 15 mm are a valuable candidate to substitute the CSC muon chambers. The single tube resolution of the gas mixture Ar:CO{sub 2}:N{sub 2} in the ratio of 96:3:1 Vol %, which is more linear and faster as the currently used drift gas Ar:CO{sub 2} in the ratio of 97:3 Vol %, was determined at the Cosmic Ray Measurement Facility at Garching and at high {gamma}-background counting rates at the Gamma Irradiation Facility at CERN. The alternative gas mixture shows similar resolution without background. At high background counting rates it shows better resolution as the standard gas. To analyse the data the various parts of the setup have to be aligned precisely to each other. The change to an alternative gas mixture allows the use of the existing hardware. The second approach are drift tubes

  11. Autism Linked to Increased Oncogene Mutations but Decreased Cancer Rate.

    Science.gov (United States)

    Darbro, Benjamin W; Singh, Rohini; Zimmerman, M Bridget; Mahajan, Vinit B; Bassuk, Alexander G

    2016-01-01

    Autism spectrum disorder (ASD) is one phenotypic aspect of many monogenic, hereditary cancer syndromes. Pleiotropic effects of cancer genes on the autism phenotype could lead to repurposing of oncology medications to treat this increasingly prevalent neurodevelopmental condition for which there is currently no treatment. To explore this hypothesis we sought to discover whether autistic patients more often have rare coding, single-nucleotide variants within tumor suppressor and oncogenes and whether autistic patients are more often diagnosed with neoplasms. Exome-sequencing data from the ARRA Autism Sequencing Collaboration was compared to that of a control cohort from the Exome Variant Server database revealing that rare, coding variants within oncogenes were enriched for in the ARRA ASD cohort (p<1.0 x 10(-8)). In contrast, variants were not significantly enriched in tumor suppressor genes. Phenotypically, children and adults with ASD exhibited a protective effect against cancer, with a frequency of 1.3% vs. 3.9% (p<0.001), but the protective effect decreased with age. The odds ratio of neoplasm for those with ASD relative to controls was 0.06 (95% CI: 0.02, 0.19; p<0.0001) in the 0 to 14 age group; 0.35 (95% CI: 0.14, 0.87; p = 0.024) in the 15 to 29 age group; 0.41 (95% CI: 0.15, 1.17; p = 0.095) in the 30 to 54 age group; and 0.49 (95% CI: 0.14, 1.74; p = 0.267) in those 55 and older. Both males and females demonstrated the protective effect. These findings suggest that defects in cellular proliferation, and potentially senescence, might influence both autism and neoplasm, and already approved drugs targeting oncogenic pathways might also have therapeutic value for treating autism.

  12. Autism Linked to Increased Oncogene Mutations but Decreased Cancer Rate.

    Directory of Open Access Journals (Sweden)

    Benjamin W Darbro

    Full Text Available Autism spectrum disorder (ASD is one phenotypic aspect of many monogenic, hereditary cancer syndromes. Pleiotropic effects of cancer genes on the autism phenotype could lead to repurposing of oncology medications to treat this increasingly prevalent neurodevelopmental condition for which there is currently no treatment. To explore this hypothesis we sought to discover whether autistic patients more often have rare coding, single-nucleotide variants within tumor suppressor and oncogenes and whether autistic patients are more often diagnosed with neoplasms. Exome-sequencing data from the ARRA Autism Sequencing Collaboration was compared to that of a control cohort from the Exome Variant Server database revealing that rare, coding variants within oncogenes were enriched for in the ARRA ASD cohort (p<1.0 x 10(-8. In contrast, variants were not significantly enriched in tumor suppressor genes. Phenotypically, children and adults with ASD exhibited a protective effect against cancer, with a frequency of 1.3% vs. 3.9% (p<0.001, but the protective effect decreased with age. The odds ratio of neoplasm for those with ASD relative to controls was 0.06 (95% CI: 0.02, 0.19; p<0.0001 in the 0 to 14 age group; 0.35 (95% CI: 0.14, 0.87; p = 0.024 in the 15 to 29 age group; 0.41 (95% CI: 0.15, 1.17; p = 0.095 in the 30 to 54 age group; and 0.49 (95% CI: 0.14, 1.74; p = 0.267 in those 55 and older. Both males and females demonstrated the protective effect. These findings suggest that defects in cellular proliferation, and potentially senescence, might influence both autism and neoplasm, and already approved drugs targeting oncogenic pathways might also have therapeutic value for treating autism.

  13. Testing of fiber composites at high strain rates

    Science.gov (United States)

    Daniel, I. M.; Liber, T.

    1978-01-01

    An experimental investigation was conducted to determine strain rate effects in fiber composites. Unidirectional composite specimens of boron/epoxy, graphite/epoxy, S-glass/epoxy and Kevlar/epoxy were tested at tensile strain rates of up to 27 m/m/sec. Longitudinal, transverse and in-plane shear properties, including modulus, Poisson's ratio, strength and ultimate strain, were determined by testing 0-, 90and 10-degree unidirectional coupons. Strains were measured by means of strain gages bonded on the coupons and loads were measured by means of a strain gage load cell. All specimens were loaded in an electrohydraulic loading system. The 0-degree properties which are governed by the fibers do not vary much with strain rate except for the Kevlar/epoxy material which shows an increase in both modulus and strength. The strain rate effects on 90-degree properties were small with a general trend toward higher strength with increasing strain rate. The most noticeable effect was on in-plane shear properties with shear strength values at high strain rates approximately fifteen percent higher than static values.

  14. High triacylglycerol turnover rate in human skeletal muscle

    DEFF Research Database (Denmark)

    Sacchetti, Massimo; Saltin, Bengt; Olsen, David B

    2004-01-01

    could be due to the observed decline in plasma insulin concentration (-74%, P skeletal muscle in post-absorptive healthy individuals is esterified into IMTAG, due to its high turnover rate (29 h pool(-1)). An increase in FA level...... into IMTAG in vastus lateralis muscle was determined during two consecutive 4-h periods (2-6 h and 6-10 h). Fifty to sixty per cent of the FA taken up from the circulation were esterified into IMTAG, whereas 32 and 42% were oxidized between 2-6 and 6-10 h, respectively. IMTAG fractional synthesis rate was 3...

  15. High shear rate rheometry of low-viscosity liquids

    Science.gov (United States)

    Lodge, Arthur S.

    1987-11-01

    A new instrument called LODGE STRESSMETER was developed to measure the shear elasticity and viscosity of general and multigrade oils at high shear rates. This will make possible the measurements of normal stress difference N1 for values of shear rate up to 5 x 10 to the 5th power is temperature of 150 C. New surprising data show (as yet unexplained) the the N1 contribution to the minimum oil film thickness could be as much as 75 percent of the contribution from viscosity. This raises hope for the use of oils with lower viscosity, leading to improved fuel economy and an increase in the range of motorized vehicles.

  16. High Data Rate Optical Wireless Communications Based on Ultraviolet Band

    KAUST Repository

    Sun, Xiaobin

    2017-10-01

    Optical wireless communication systems based on ultraviolet (UV)-band has a lot inherent advantages, such as low background solar radiation, low device dark noise. Besides, it also has small restrictive requirements for PAT (pointing, acquisition, and tracking) because of its high atmospheric scattering with molecules and aerosols. And these advantages are driving people to explore and utilize UV band for constructing and implementing a high-data-rate, less PAT communication links, such as diffuse-line-of-sight links (diffuse-LOS) and non-line-of-sight (NLOS). The responsivity of the photodetector at UV range is far lower than that of visible range, high power UV transmitters which can be easily modulated are under investigation. These factors make it is hard to realize a high-data-rate diffuse-LOS or NLOS UV communication links. To achieve a UV link mentioned above with current devices and modulation schemes, this thesis presents some efficient modulation schemes and available devices for the time being. Besides, a demonstration of ultraviolet-B (UVB) communication link is implemented utilizing quadrature amplitude modulation (QAM) orthogonal frequency-division multiplexing (OFDM). The demonstration is based on a 294-nm UVB-light-emitting-diode (UVB-LED) with a full-width at half-maximum (FWHM) of 9 nm, and according to the measured L-I-V curve, we set the bias voltage as 7V for maximum the ac amplitude and thus get a high signal-noise-ratio (SNR) channel, and the light output power is 190 μW with such bias voltage. Besides, there is a unique silica gel lens on top of the LED to concentrate the beam. A -3-dB bandwidth of 29 MHz was measured and a high-speed near-solar-blind communication link with a data rate of 71 Mbit/s was achieved using 8-QAM-OFDM at perfect alignment, and 23.6 Mbit/s using 2-QAM-OFDM when the angle subtended by the pointing direction of the UVB-LED and photodetector (PD) is 12 degrees, thus establishing a diffuse-line-of-sight (LOS) link

  17. Dynamic High-Temperature Characterization of an Iridium Alloy in Compression at High Strain Rates

    Energy Technology Data Exchange (ETDEWEB)

    Song, Bo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Experimental Environment Simulation Dept.; Nelson, Kevin [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Mechanics of Materials Dept.; Lipinski, Ronald J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Advanced Nuclear Fuel Cycle Technology Dept.; Bignell, John L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Structural and Thermal Analysis Dept.; Ulrich, G. B. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Radioisotope Power Systems Program; George, E. P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Radioisotope Power Systems Program

    2014-06-01

    Iridium alloys have superior strength and ductility at elevated temperatures, making them useful as structural materials for certain high-temperature applications. However, experimental data on their high-temperature high-strain-rate performance are needed for understanding high-speed impacts in severe elevated-temperature environments. Kolsky bars (also called split Hopkinson bars) have been extensively employed for high-strain-rate characterization of materials at room temperature, but it has been challenging to adapt them for the measurement of dynamic properties at high temperatures. Current high-temperature Kolsky compression bar techniques are not capable of obtaining satisfactory high-temperature high-strain-rate stress-strain response of thin iridium specimens investigated in this study. We analyzed the difficulties encountered in high-temperature Kolsky compression bar testing of thin iridium alloy specimens. Appropriate modifications were made to the current high-temperature Kolsky compression bar technique to obtain reliable compressive stress-strain response of an iridium alloy at high strain rates (300 – 10000 s-1) and temperatures (750°C and 1030°C). Uncertainties in such high-temperature high-strain-rate experiments on thin iridium specimens were also analyzed. The compressive stress-strain response of the iridium alloy showed significant sensitivity to strain rate and temperature.

  18. Annual cancer incidence rates for Hispanics in the United States: surveillance, epidemiology, and end results, 1992-1996.

    Science.gov (United States)

    Canto, M T; Chu, K C

    2000-06-01

    The expansion of the Surveillance, Epidemiology, and End Results (SEER) program and the determination of annual population estimates by county level for different racial/ethnic groups since 1990 allow the calculation of annual cancer incidence rates for Hispanics. Incidence rates were calculated for 11 SEER areas representing 25% of the Hispanic population. Standard regression analyses of log-transformed rates were used to determine the trends of the rates. An important measure of the cancer burden among Hispanics is the rank order of their cancers. For Hispanic males, the five major cancers (in declining order) are prostate, lung and bronchus, colon/rectum, non-Hodgkin lymphoma, and stomach cancers. For Hispanic females, the top five cancers are breast, colon/rectum, lung and bronchus, cervix, and endometrial cancers. Another measure of cancer burden is their rates relative to white non-Hispanics. Hispanic males have rates greater than white non-Hispanic males for stomach (1.6 times greater) and liver and IBD cancers (2.2), whereas Hispanic females have greater rates for cervix (2.2 times greater), liver and IBD (2.0), stomach (2.1), and gallbladder cancers (3.3). Other measures of cancer burden include the trends in Hispanic rates. Hispanic males have significant declining trends for all sites, prostate cancer, and urinary bladder cancer, and an increasing trend for liver and IBD cancers. Hispanic females have significant declining trends for cervix and urinary bladder cancers. The SEER cancer incidence rates and trends provide a general overview of the cancer burden among Hispanics residing in the SEER sites. This type of information is critical for determining interventions to reduce the cancer burden among Hispanics in the United States. Copyright 2000 American Cancer Society.

  19. Denominators: An attempt to adjust for cancer incidence and mortality rates and its role in cancer registries

    Directory of Open Access Journals (Sweden)

    Manoj Kalita

    2015-01-01

    Full Text Available Cancer is an important public health burden in India and around the Globe. Incident cases of cancer are reported continuously, and trends in incidence rates vary among five yearly age group. In India National census is carried out after every 10 years since 1951, the latest census is carried out in 2011. As Incident cases of cancer are reported continuously for 5 year age group and estimation of rates and trends for a given year of interest fall in-between two census period population estimation of five yearly age group, which serves as Denominator sense importance. Denominator serves as the most essential part of any cancer registry program as it used for calculation of various rates for five yearly age group such as age-standardized rate, crude rate, truncated rate, cumulative risk etc., Calculated by different registries and Individual Researchers, Government organizations, etc. Currently most of the registries used individual exponential growth rate and differential distribution method to estimate the growth rate. However, it is found that the calculated rates and risk be suffering from bias most of the time since some method over and underestimate the growth rate while some does not able to maintain consistency. Here, an attempt is made to adjust the world standard population with two census period to estimate the five yearly age group for a given year of interest of a geographical region falls in-between two census period. It is also shown here that how the proposed model "age-adjusted population growth model" maintain the overall growth as in exponential growth model and difference distribution method also maintains the estimated growth rate is as found in difference distribution method. Further, it is tried to highlight the points how these method overcomes the problems compared with other methods that are currently used by registries.

  20. Denominators: An attempt to adjust for cancer incidence and mortality rates and its role in cancer registries.

    Science.gov (United States)

    Kalita, Manoj; Nirmolia, Tulika

    2015-01-01

    Cancer is an important public health burden in India and around the Globe. Incident cases of cancer are reported continuously, and trends in incidence rates vary among five yearly age group. In India National census is carried out after every 10 years since 1951, the latest census is carried out in 2011. As Incident cases of cancer are reported continuously for 5 year age group and estimation of rates and trends for a given year of interest fall in-between two census period population estimation of five yearly age group, which serves as Denominator sense importance. Denominator serves as the most essential part of any cancer registry program as it used for calculation of various rates for five yearly age group such as age-standardized rate, crude rate, truncated rate, cumulative risk etc., Calculated by different registries and Individual Researchers, Government organizations, etc. Currently most of the registries used individual exponential growth rate and differential distribution method to estimate the growth rate. However, it is found that the calculated rates and risk be suffering from bias most of the time since some method over and underestimate the growth rate while some does not able to maintain consistency. Here, an attempt is made to adjust the world standard population with two census period to estimate the five yearly age group for a given year of interest of a geographical region falls in-between two census period. It is also shown here that how the proposed model "age-adjusted population growth model" maintain the overall growth as in exponential growth model and difference distribution method also maintains the estimated growth rate is as found in difference distribution method. Further, it is tried to highlight the points how these method overcomes the problems compared with other methods that are currently used by registries.

  1. An endemic areas with a long-time biggest and smallest incidence rates for the lung cancer within Silesia voivodeship

    Directory of Open Access Journals (Sweden)

    Brunon Zemła

    2013-03-01

    Full Text Available Background: The monitoring of the lung malignant neoplasms incidence provides reliable data (particularly to medical and administrative services in order that they could work out and undertake current and a long-term decisions concerning with organisation of fight against cancer (including costs of cancer treatment, investments in oncology, anticancer education, etc.. But existing need most rationally resolves in a struggle with lung cancer (and other cancer. Therefore an attempts looking for the endemic areas with a long-lasting appear the biggest and smallest lung cancer incidence rates in the Silesia population. It is aim of this work. Materials and methods: The monitoring of the malignant neoplasm ills, among others of the lung cancer, is based on obligatory procedure of reporting them on a form MZN1a (from 1962 year. After verifications used in this work – 27 796 cases total for males and females suffering for the lung cancer within Silesia voivodeship in the years 1999-2009. Age-specific (for 5-year age groups, crude and age-standardized rates (with the use direct method by M. Spiegelman and with the use of the age-structure of “world population” (by R. Doll – were calculated. Comparisons of rate values (between endemic areas made of the use O.S. Miettinen and P. Katz procedures. Results: Silesia voivodeship it is the region of high risk lung cancer incidence in comparison to other ones in Poland. Lung cancer incidence among women is – in comparison to men – lower. But, just as among men – it is strongly differentiated according to counties. However, in comparison two periods – 1999-2002 : 2006-2009 – standardized incidence rates among females have been increasing from 14.0/100 thousands to 15.6/100ths, i.e. about 11.5%, and among males have been decreasing distinctly: from 66.9/100ths to 53.6/100ths, i.e. about 20%. The biggest frequency of ill (statistically significant high caused by the lung cancer among men concern

  2. High Pressure Burn Rate Measurements on an Ammonium Perchlorate Propellant

    Energy Technology Data Exchange (ETDEWEB)

    Glascoe, E A; Tan, N

    2010-04-21

    High pressure deflagration rate measurements of a unique ammonium perchlorate (AP) based propellant are required to design the base burn motor for a Raytheon weapon system. The results of these deflagration rate measurements will be key in assessing safety and performance of the system. In particular, the system may experience transient pressures on the order of 100's of MPa (10's kPSI). Previous studies on similar AP based materials demonstrate that low pressure (e.g. P < 10 MPa or 1500 PSI) burn rates can be quite different than the elevated pressure deflagration rate measurements (see References and HPP results discussed herein), hence elevated pressure measurements are necessary in order understand the deflagration behavior under relevant conditions. Previous work on explosives have shown that at 100's of MPa some explosives will transition from a laminar burn mechanism to a convective burn mechanism in a process termed deconsolidative burning. The resulting burn rates that are orders-of-magnitude faster than the laminar burn rates. Materials that transition to the deconsolidative-convective burn mechanism at elevated pressures have been shown to be considerably more violent in confined heating experiments (i.e. cook-off scenarios). The mechanisms of propellant and explosive deflagration are extremely complex and include both chemical, and mechanical processes, hence predicting the behavior and rate of a novel material or formulation is difficult if not impossible. In this work, the AP/HTPB based material, TAL-1503 (B-2049), was burned in a constant volume apparatus in argon up to 300 MPa (ca. 44 kPSI). The burn rate and pressure were measured in-situ and used to calculate a pressure dependent burn rate. In general, the material appears to burn in a laminar fashion at these elevated pressures. The experiment was reproduced multiple times and the burn rate law using the best data is B = (0.6 {+-} 0.1) x P{sup (1.05{+-}0.02)} where B is the burn

  3. Oral and pharyngeal cancer mortality rates in Mexico, 1979-2003.

    Science.gov (United States)

    Anaya-Saavedra, Gabriela; Ramírez-Amador, Velia; Irigoyen-Camacho, María Esther; Zimbrón-Romero, Araceli; Zepeda-Zepeda, Marco Antonio

    2008-01-01

    In Mexico, information on oral and pharyngeal cancer (OPC) is scarce. The purpose of this study was to explore the trends in OPC mortality rates in Mexico from 1979 through 2003 and to describe the distribution of OPC deaths for selected socio-demographic variables for the period of 2001-2003. Annual crude and age-adjusted mortality rates were obtained by gender and site of lesion, using the 2003 WHO World standard million population. The Poisson regression model was used to detect a trend in the mortality rates, testing the hypothesis beta(1) = 0. Also, the annual percentage change (APC) was computed over the age-adjusted rates. The total number of OPC deaths during the period 1979-2003 was 15,576. The age-adjusted mortality rate was 1.13/100,000 in 1979 and 1.08/100,000 in 2003. Oral cancer was more frequently found than salivary gland and pharyngeal cancer (41.5% vs. 13.4% and 17.1%). The tongue (19%) was the most frequent oral affected site. The Poisson regression analysis indicated a stationary trend in cancer mortality rate; also, the APC regression model showed no increase or decrease in OPC from 1979 to 2003. Oral and pharyngeal cancer mortality rates in Mexico were low compared to most countries, and remained stable in the past two decades.

  4. Are suicide rates higher in the cancer population? An investigation using forensic autopsy data.

    Science.gov (United States)

    de la Grandmaison, Geoffroy Lorin; Watier, Laurence; Cavard, Stéphanie; Charlier, Philippe

    2014-01-01

    Previous population-based studies have identified increased suicide rates among cancer patients. Available post mortem data on the contribution of cancer to completed suicide are limited, however. This study examines forensic autopsy data in order to assess whether cancer is significantly more frequent in a suicide population compared with a control population. In total, 232 cases were included in both the suicide and the control groups. Based on a complete standard histological examination, cancer was significantly more often found in the suicide group than in the control one (8.6% vs. 3.9%, p=0.03). The multivariate analysis also showed that the presence of cancer increased the risk of suicide. Moreover, cancer was not known to the deceased in 70% of cases, while the most frequent mental disease found in cancer-related suicide cases was depression (75%). In the 20 cancer-related suicide cases analysed herein, it was difficult to ascertain whether malignancy was the only motive for committing suicide, as cancer could be considered to be either a major causative factor for suicide or an incidental finding. Therefore, further research is warranted with the help of the psychological autopsy method to investigate the link between suicide and cancer further. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Prostate cancer incidence rates have started to decrease in central Italy.

    Science.gov (United States)

    Crocetti, Emanuele; Ciatto, Stefano; Buzzoni, Carlotta; Zappa, Marco

    2010-01-01

    The widespread use of prostate-specific antigen (PSA) testing has dramatically changed the epidemiology of prostate cancer. Growing incidence rates have been documented in almost all western countries following the increased usage of PSA screening. In the United States after a period of huge increase in incidence, rates have decreased to values lower than those of the pre-PSA era. Similar changes have been documented also in the area of the Tuscany Cancer Registry, central Italy, where prostate cancer incidence rates doubled from the early 1990s to 2003 and afterwards decreased. This is the first evidence, to our knowledge, of a decline in prostate cancer incidence in Italy following the screening-related increase.

  6. Detection of prostate cancer: comparison of cancer detection rates of sextant and extended ten-core biopsy protocols.

    Science.gov (United States)

    Ojewola, R W; Tijani, K H; Jeje, E A; Anunobi, C C; Ogunjimi, M A; Ezenwa, E V; Ogundiniyi, O S

    2012-09-01

    To compare the cancer detection rates of sextant and ten- core biopsy protocol amongst patients being evaluated for prostate cancer. This is a prospective study involving 125 men with suspicion of prostate cancer. They all had an extended 10-core transrectal digitally-guided prostatic biopsy using Tru-Cut needle. Indications for biopsy were presence of one or more of the following: elevated Prostate Specific Antigen (PSA), abnormal Digital Rectal Examination (DRE) findings and abnormal prostate scan. Sextant biopsies were collected first, followed by four lateral biopsies in all patients. Both groups of specimen were kept and analyzsed separately by the same pathologist. The cancer detection rates of sextant and extended (combination of sextant and lateral) 10-core biopsy protocols were determined and compared. Pearson's Chi square and McNemar tests at two degrees of freedom with level of significance set at 0.05 ( P sextant biopsy protocol detected 52 cancers (85.2%) while the lateral biopsy protocol detected 58 cases (95.1%). Three (3) cancers were detected by the sextant protocol only while the lateral protocol detected nine (9) cancers where sextant technique was negative for malignancy. Ten-core extended protocol showed a statistically significant increase of 14.8% over the traditional sextant. (P=0.046). The overall complication rate of ten-core biopsy was 26.4% and the procedure was well tolerated in most patients. We conclude that a ten-core prostate biopsy protocol significantly improves cancer detection and should be considered as the optimum biopsy protocol.

  7. High-rate measurement-device-independent quantum cryptography

    DEFF Research Database (Denmark)

    Pirandola, Stefano; Ottaviani, Carlo; Spedalieri, Gaetana

    2015-01-01

    Quantum cryptography achieves a formidable task - the remote distribution of secret keys by exploiting the fundamental laws of physics. Quantum cryptography is now headed towards solving the practical problem of constructing scalable and secure quantum networks. A significant step in this direction...... than those currently achieved. Our protocol could be employed to build high-rate quantum networks where devices securely connect to nearby access points or proxy servers....

  8. MIMO-OFDM for High Rate Underwater Acoustic Communications

    Science.gov (United States)

    2009-10-01

    Doppler estimation The channel Doppler effect can be viewed as caused by carrier frequency offsets (CFO) among the transmitters and the receivers [14...at es in H z 500m 1500m Fig. 4. Doppler estimates for one packet of 64 OFDM blocks at receiver 1; this Doppler shift is due to unintentional...IEEE JOURNAL OF OCEANIC ENGINEERING (TO APPEAR) 1 MIMO- OFDM for High Rate Underwater Acoustic Communications Baosheng Li, Student Member, IEEE, Jie

  9. Elucidating high-dimensional cancer hallmark annotation via enriched ontology.

    Science.gov (United States)

    Yan, Shankai; Wong, Ka-Chun

    2017-09-01

    Cancer hallmark annotation is a promising technique that could discover novel knowledge about cancer from the biomedical literature. The automated annotation of cancer hallmarks could reveal relevant cancer transformation processes in the literature or extract the articles that correspond to the cancer hallmark of interest. It acts as a complementary approach that can retrieve knowledge from massive text information, advancing numerous focused studies in cancer research. Nonetheless, the high-dimensional nature of cancer hallmark annotation imposes a unique challenge. To address the curse of dimensionality, we compared multiple cancer hallmark annotation methods on 1580 PubMed abstracts. Based on the insights, a novel approach, UDT-RF, which makes use of ontological features is proposed. It expands the feature space via the Medical Subject Headings (MeSH) ontology graph and utilizes novel feature selections for elucidating the high-dimensional cancer hallmark annotation space. To demonstrate its effectiveness, state-of-the-art methods are compared and evaluated by a multitude of performance metrics, revealing the full performance spectrum on the full set of cancer hallmarks. Several case studies are conducted, demonstrating how the proposed approach could reveal novel insights into cancers. https://github.com/cskyan/chmannot. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Avalanche photo-detection for high data rate applications

    Science.gov (United States)

    Coldenstrodt-Ronge, H. B.; Silberhorn, C.

    2007-10-01

    Avalanche photo-detection is commonly used in applications which require single-photon sensitivity. We examine the limits of using avalanche photo-diodes (APD) for characterizing photon statistics at high data rates. To identify the regime of linear APD operation, we employ a ps-pulsed diode laser with variable repetition rates between 0.5 MHz and 80 MHz. We modify the mean optical power of the coherent pulses by applying different levels of well-calibrated attenuation. The linearity at high repetition rates is limited by the APD dead time and a nonlinear response arises at higher photon-numbers due to multiphoton events. Assuming Poissonian input-light statistics we ascertain the effective mean photon-number of the incident light with high accuracy. Time multiplexed detectors (TMD) allow us to accomplish photon-number resolution by 'photon chopping'. This detection setup extends the linear response function to higher photon-numbers and statistical methods may be used to compensate for nonlinearity. We investigate this effect, compare it to the single APD case and show the validity of the convolution treatment in the TMD data analysis.

  11. Semi-solid electrodes having high rate capability

    Energy Technology Data Exchange (ETDEWEB)

    Chiang, Yet-Ming; Duduta, Mihai; Holman, Richard; Limthongkul, Pimpa; Tan, Taison

    2017-11-28

    Embodiments described herein relate generally to electrochemical cells having high rate capability, and more particularly to devices, systems and methods of producing high capacity and high rate capability batteries having relatively thick semi-solid electrodes. In some embodiments, an electrochemical cell includes an anode and a semi-solid cathode. The semi-solid cathode includes a suspension of an active material of about 35% to about 75% by volume of an active material and about 0.5% to about 8% by volume of a conductive material in a non-aqueous liquid electrolyte. An ion-permeable membrane is disposed between the anode and the semi-solid cathode. The semi-solid cathode has a thickness of about 250 .mu.m to about 2,000 .mu.m, and the electrochemical cell has an area specific capacity of at least about 7 mAh/cm.sup.2 at a C-rate of C/4. In some embodiments, the semi-solid cathode slurry has a mixing index of at least about 0.9.

  12. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009.

    Science.gov (United States)

    Chuck, Kumban Walter; Hwang, Minji; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Park, Boyoung

    2017-01-01

    To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, pgastric cancer; 60.5 vs. 71.5%, pcancer; and 49.1 vs. 59.6%, pcancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, pcancer (38.8 vs. 44.6%, pcancer (35.1 vs. 51.2%, pscreening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

  13. Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Richard L Haddad

    2012-01-01

    Conclusions: A low threshold to re-biopsy post-HIFU reveals a high local failure rate of 82%. Oncological efficacy is questioned, and using high threshold to biopsy may therefore be overestimating the effectiveness of HIFU as a primary treatment for localized prostate cancer.

  14. [Developing the predictive model for the group at high risk for colon cancer].

    Science.gov (United States)

    Lee, Ae Kyoung; Lee, Sang-Yi; Park, Il Soo; Kim, Su Young; Yoon, Tae-Ho; Jeong, Baek-Geun

    2006-09-01

    We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.

  15. Glomerular filtration rate profiles in paediatric patients on cancer ...

    African Journals Online (AJOL)

    Background: An accurate estimation of renal function in children is important in optimising the dose of many drugs used in paediatric oncology for allowing clinical monitoring of the nephrotoxic effects of cytotoxic agents such as cisplatin. The glomerular filtration rate (GFR) is widely accepted as the best index of renal ...

  16. High Strain Rate and Shock-Induced Deformation in Metals

    Science.gov (United States)

    Ravelo, Ramon

    2012-02-01

    Large-scale non-equilibrium molecular Dynamics (MD) simulations are now commonly used to study material deformation at high strain rates (10^9-10^12 s-1). They can provide detailed information-- such as defect morphology, dislocation densities, and temperature and stress profiles, unavailable or hard to measure experimentally. Computational studies of shock-induced plasticity and melting in fcc and bcc single, mono-crystal metals, exhibit generic characteristics: high elastic limits, large directional anisotropies in the yield stress and pre-melting much below the equilibrium melt temperature for shock wave propagation along specific crystallographic directions. These generic features in the response of single crystals subjected to high strain rates of deformation can be explained from the changes in the energy landscape of the uniaxially compressed crystal lattice. For time scales relevant to dynamic shock loading, the directional-dependence of the yield strength in single crystals is shown to be due to the onset of instabilities in elastic-wave propagation velocities. The elastic-plastic transition threshold can accurately be predicted by a wave-propagation stability analysis. These strain-induced instabilities create incipient defect structures, which can be quite different from the ones, which characterize the long-time, asymptotic state of the compressed solid. With increase compression and strain rate, plastic deformation via extended defects gives way to amorphization associated with the loss in shear rigidity along specific deformation paths. The hot amorphous or (super-cooled liquid) metal re-crystallizes at rates, which depend on the temperature difference between the amorphous solid and the equilibrium melt line. This plastic-amorphous transition threshold can be computed from shear-waves stability analyses. Examples from selected fcc and bcc metals will be presented employing semi-empirical potentials of the embedded atom method (EAM) type as well as

  17. Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009

    Directory of Open Access Journals (Sweden)

    Ruffo Freitas-Junior

    2012-07-01

    Full Text Available OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO. Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%. Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%, Rio Grande do Sul (APC = -0.8% and Rio de Janeiro (APC = -0.6% presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%, Paraiba (APC=11.9%, and Piaui (APC=10.9%. CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.

  18. Scale dependence of rock friction at high work rate

    Science.gov (United States)

    Yamashita, Futoshi; Fukuyama, Eiichi; Mizoguchi, Kazuo; Takizawa, Shigeru; Xu, Shiqing; Kawakata, Hironori

    2015-12-01

    Determination of the frictional properties of rocks is crucial for an understanding of earthquake mechanics, because most earthquakes are caused by frictional sliding along faults. Prior studies using rotary shear apparatus revealed a marked decrease in frictional strength, which can cause a large stress drop and strong shaking, with increasing slip rate and increasing work rate. (The mechanical work rate per unit area equals the product of the shear stress and the slip rate.) However, those important findings were obtained in experiments using rock specimens with dimensions of only several centimetres, which are much smaller than the dimensions of a natural fault (of the order of 1,000 metres). Here we use a large-scale biaxial friction apparatus with metre-sized rock specimens to investigate scale-dependent rock friction. The experiments show that rock friction in metre-sized rock specimens starts to decrease at a work rate that is one order of magnitude smaller than that in centimetre-sized rock specimens. Mechanical, visual and material observations suggest that slip-evolved stress heterogeneity on the fault accounts for the difference. On the basis of these observations, we propose that stress-concentrated areas exist in which frictional slip produces more wear materials (gouge) than in areas outside, resulting in further stress concentrations at these areas. Shear stress on the fault is primarily sustained by stress-concentrated areas that undergo a high work rate, so those areas should weaken rapidly and cause the macroscopic frictional strength to decrease abruptly. To verify this idea, we conducted numerical simulations assuming that local friction follows the frictional properties observed on centimetre-sized rock specimens. The simulations reproduced the macroscopic frictional properties observed on the metre-sized rock specimens. Given that localized stress concentrations commonly occur naturally, our results suggest that a natural fault may lose its

  19. Use of ultrasound in image-guided high-dose-rate brachytherapy: enumerations and arguments

    Science.gov (United States)

    Kataria, Tejinder; Gupta, Deepak; Goyal, Shikha; Bisht, Shyam Singh; Basu, Trinanjan; Abhishek, Ashu

    2017-01-01

    Inherently, brachytherapy is the most conformal radiotherapeutic technique. As an aid to brachytherapy, ultrasonography (USG) serves as a portable, inexpensive, and simple to use method allowing for accurate, reproducible, and adaptive treatments. Some newer brachytherapy planning systems have incorporated USG as the sole imaging modality. Ultrasonography has been successfully used to place applicator and dose planning for prostate, cervix, and anal canal cancers. It can guide placement of brachytherapy catheters for all other sites like breast, skin, and head and neck cancers. Traditional USG has a few limitations, but recent advances such as 3-dimensional (3D) USG and contrast USG have enhanced its potential as a dependable guide in high-dose-rate image-guided brachytherapy (HDR-IGBT). The authors in this review have attempted to enumerate various aspects of USG in brachytherapy, highlighting its use across various sites. PMID:28533803

  20. Use of ultrasound in image-guided high-dose-rate brachytherapy: enumerations and arguments

    Directory of Open Access Journals (Sweden)

    Susovan Banerjee

    2017-04-01

    Full Text Available Inherently, brachytherapy is the most conformal radiotherapeutic technique. As an aid to brachytherapy, ultrasonography (USG serves as a portable, inexpensive, and simple to use method allowing for accurate, reproducible, and adaptive treatments. Some newer brachytherapy planning systems have incorporated USG as the sole imaging modality. Ultrasonography has been successfully used to place applicator and dose planning for prostate, cervix, and anal canal cancers. It can guide placement of brachytherapy catheters for all other sites like breast, skin, and head and neck cancers. Traditional USG has a few limitations, but recent advances such as 3-dimensional (3D USG and contrast USG have enhanced its potential as a dependable guide in high-dose-rate image-guided brachytherapy (HDR-IGBT. The authors in this review have attempted to enumerate various aspects of USG in brachytherapy, highlighting its use across various sites.

  1. Understanding the relationship between the Centers for Medicare and Medicaid Services' Hospital Compare star rating, surgical case volume, and short-term outcomes after major cancer surgery.

    Science.gov (United States)

    Kaye, Deborah R; Norton, Edward C; Ellimoottil, Chad; Ye, Zaojun; Dupree, James M; Herrel, Lindsey A; Miller, David C

    2017-11-01

    Both the Centers for Medicare and Medicaid Services' (CMS) Hospital Compare star rating and surgical case volume have been publicized as metrics that can help patients to identify high-quality hospitals for complex care such as cancer surgery. The current study evaluates the relationship between the CMS' star rating, surgical volume, and short-term outcomes after major cancer surgery. National Medicare data were used to evaluate the relationship between hospital star ratings and cancer surgery volume quintiles. Then, multilevel logistic regression models were fit to examine the association between cancer surgery outcomes and both star rankings and surgical volumes. Lastly, a graphical approach was used to compare how well star ratings and surgical volume predicted cancer surgery outcomes. This study identified 365,752 patients undergoing major cancer surgery for 1 of 9 cancer types at 2,550 hospitals. Star rating was not associated with surgical volume (P cancer surgery outcomes (mortality, complication rate, readmissions, and prolonged length of stay). The adjusted predicted probabilities for 5- and 1-star hospitals were 2.3% and 4.5% for mortality, 39% and 48% for complications, 10% and 15% for readmissions, and 8% and 16% for a prolonged length of stay, respectively. The adjusted predicted probabilities for hospitals with the highest and lowest quintile cancer surgery volumes were 2.7% and 5.8% for mortality, 41% and 55% for complications, 12.2% and 11.6% for readmissions, and 9.4% and 13% for a prolonged length of stay, respectively. Furthermore, surgical volume and the star rating were similarly associated with mortality and complications, whereas the star rating was more highly associated with readmissions and prolonged length of stay. In the absence of other information, these findings suggest that the star rating may be useful to patients when they are selecting a hospital for major cancer surgery. However, more research is needed before these ratings can

  2. Knowledge about Cervical Cancer and Barriers of Screening Program among Women in Wufeng County, a High-Incidence Region of Cervical Cancer in China

    Science.gov (United States)

    Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling

    2013-01-01

    Purpose Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area. Participants and Methods A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Results Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Conclusion Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates. PMID:23843976

  3. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

    Science.gov (United States)

    Jia, Yao; Li, Shuang; Yang, Ru; Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling

    2013-01-01

    Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women's willingness to undergo cervical cancer screening in the Wufeng area. A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Women who were willing to undergo screenings had higher knowledge levels. "Anxious feeling once the disease was diagnosed" (47.6%), "No symptoms/discomfort" (34.1%) and "Do not know the benefits of cervical cancer screening" (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Efforts are needed to increase women's knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.

  4. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

    Directory of Open Access Journals (Sweden)

    Yao Jia

    Full Text Available Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women's willingness to undergo cervical cancer screening in the Wufeng area.A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening.Women who were willing to undergo screenings had higher knowledge levels. "Anxious feeling once the disease was diagnosed" (47.6%, "No symptoms/discomfort" (34.1% and "Do not know the benefits of cervical cancer screening" (13.4% were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics.Efforts are needed to increase women's knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.

  5. Extremely High Mutation Rate of HIV-1 In Vivo.

    Directory of Open Access Journals (Sweden)

    José M Cuevas

    Full Text Available Rates of spontaneous mutation critically determine the genetic diversity and evolution of RNA viruses. Although these rates have been characterized in vitro and in cell culture models, they have seldom been determined in vivo for human viruses. Here, we use the intrapatient frequency of premature stop codons to quantify the HIV-1 genome-wide rate of spontaneous mutation in DNA sequences from peripheral blood mononuclear cells. This reveals an extremely high mutation rate of (4.1 ± 1.7 × 10-3 per base per cell, the highest reported for any biological entity. Sequencing of plasma-derived sequences yielded a mutation frequency 44 times lower, indicating that a large fraction of viral genomes are lethally mutated and fail to reach plasma. We show that the HIV-1 reverse transcriptase contributes only 2% of mutations, whereas 98% result from editing by host cytidine deaminases of the A3 family. Hypermutated viral sequences are less abundant in patients showing rapid disease progression compared to normal progressors, highlighting the antiviral role of A3 proteins. However, the amount of A3-mediated editing varies broadly, and we find that low-edited sequences are more abundant among rapid progressors, suggesting that suboptimal A3 activity might enhance HIV-1 genetic diversity and pathogenesis.

  6. High monetary reward rates and caloric rewards decrease temporal persistence.

    Science.gov (United States)

    Fung, Bowen J; Bode, Stefan; Murawski, Carsten

    2017-02-22

    Temporal persistence refers to an individual's capacity to wait for future rewards, while forgoing possible alternatives. This requires a trade-off between the potential value of delayed rewards and opportunity costs, and is relevant to many real-world decisions, such as dieting. Theoretical models have previously suggested that high monetary reward rates, or positive energy balance, may result in decreased temporal persistence. In our study, 50 fasted participants engaged in a temporal persistence task, incentivised with monetary rewards. In alternating blocks of this task, rewards were delivered at delays drawn randomly from distributions with either a lower or higher maximum reward rate. During some blocks participants received either a caloric drink or water. We used survival analysis to estimate participants' probability of quitting conditional on the delay distribution and the consumed liquid. Participants had a higher probability of quitting in blocks with the higher reward rate. Furthermore, participants who consumed the caloric drink had a higher probability of quitting than those who consumed water. Our results support the predictions from the theoretical models, and importantly, suggest that both higher monetary reward rates and physiologically relevant rewards can decrease temporal persistence, which is a crucial determinant for survival in many species. © 2017 The Authors.

  7. High rate of adaptive evolution in two widespread European pines.

    Science.gov (United States)

    Grivet, Delphine; Avia, Komlan; Vaattovaara, Aleksia; Eckert, Andrew J; Neale, David B; Savolainen, Outi; González-Martínez, Santiago C

    2017-11-07

    Comparing related organisms with differing ecological requirements and evolutionary histories can shed light on the mechanisms and drivers underlying genetic adaptation. Here, by examining a common set of hundreds of loci, we compare patterns of nucleotide diversity and molecular adaptation of two European conifers (Scots pine and maritime pine) living in contrasted environments and characterized by distinct population genetic structure (low and clinal in Scots pine, high and ecotypic in maritime pine) and demographic histories. We found higher nucleotide diversity in Scots pine than in maritime pine, whereas rates of new adaptive substitutions (ωa ), as estimated from the Distribution of Fitness Effects (DFE), were similar across species, and among the highest found in plants. Sample size and population genetic structure did not appear to have resulted in significant bias in estimates of ωa . Moreover, population contraction-expansion dynamics for each species did not differentially affect differentially the rate of adaptive substitution in these two pines. Several methodological and biological factors may underlie the unusually high rate of adaptive evolution of Scots pine and maritime pine. By providing two new case studies with contrasting evolutionary histories, we contribute to disentangling the multiple factors potentially affecting adaptive evolution in natural plant populations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Taylor dispersion analysis in coiled capillaries at high flow rates.

    Science.gov (United States)

    Lewandrowska, Anna; Majcher, Aldona; Ochab-Marcinek, Anna; Tabaka, Marcin; Hołyst, Robert

    2013-04-16

    Taylor Dispersion Analysis (TDA) has been performed for analytes moving at high flow rates in long, coiled capillaries. A thin injection zone of the analyte is stretched by the flow and final distribution of concentration of the analyte at the end of the capillary has the gaussian shape. The high flow rates in coiled capillary generate vortices. They convectively mix the analyte across the capillary. This mixing reduces the width of the gaussian distribution several times in comparison to the width obtained in a straight capillary in standard TDA. We have determined an empirical, scaling equation for the width as a function of the flow rate, molecular diffusion coefficient of the analyte, viscosity of the carrier phase, internal radius of the cylindrical capillary, and external radius of the coiled capillary. This equation can be used for different sizes of capillaries in a wide range of parameters without an additional calibration procedure. Our experimental results of flow in the coiled capillary could not be explained by current models based on approximate solutions of the Navier-Stokes equation. We applied the technique to determine the diffusion coefficients of the following analytes: salts, drugs, single amino acids, peptides (from dipeptides to hexapeptides), and proteins.

  9. High Rate Proton Irradiation of 15mm Muon Drifttubes

    CERN Document Server

    INSPIRE-00295941

    2012-01-01

    Future LHC luminosity upgrades will significantly increase the amount of background hits from photons, neutrons and protons in the detectors of the ATLAS muon spectrometer. At the proposed LHC peak luminosity of 5*10^34 1/cm^2s, background hit rates of more than 10 kHz/cm^2 are expected in the innermost forward region, leading to a loss of performance of the current tracking chambers. Based on the ATLAS Monitored Drift Tube chambers, a new high rate capable drift tube detecor using tubes with a reduced diameter of 15mm was developed. To test the response to highly ionizing particles, a prototype chamber of 46 15mm drift tubes was irradiated with a 20 MeV proton beam at the tandem accelerator at the Maier-Leibnitz Laboratory, Munich. Three tubes in a planar layer were irradiated while all other tubes were used for reconstruction of cosmic muon tracks through irradiated and non-irradiated parts of the chamber. To determine the rate capability of the 15mm drift-tubes we investigated the effect of the proton hit ...

  10. A 2-stage ovarian cancer screening strategy using the Risk of Ovarian Cancer Algorithm (ROCA) identifies early-stage incident cancers and demonstrates high positive predictive value.

    Science.gov (United States)

    Lu, Karen H; Skates, Steven; Hernandez, Mary A; Bedi, Deepak; Bevers, Therese; Leeds, Leroy; Moore, Richard; Granai, Cornelius; Harris, Steven; Newland, William; Adeyinka, Olasunkanmi; Geffen, Jeremy; Deavers, Michael T; Sun, Charlotte C; Horick, Nora; Fritsche, Herbert; Bast, Robert C

    2013-10-01

    A 2-stage ovarian cancer screening strategy was evaluated that incorporates change of carbohydrate antigen 125 (CA125) levels over time and age to estimate risk of ovarian cancer. Women with high-risk scores were referred for transvaginal ultrasound (TVS). A single-arm, prospective study of postmenopausal women was conducted. Participants underwent an annual CA125 blood test. Based on the Risk of Ovarian Cancer Algorithm (ROCA) result, women were triaged to next annual CA125 test (low risk), repeat CA125 test in 3 months (intermediate risk), or TVS and referral to a gynecologic oncologist (high risk). A total of 4051 women participated over 11 years. The average annual rate of referral to a CA125 test in 3 months was 5.8%, and the average annual referral rate to TVS and review by a gynecologic oncologist was 0.9%. Ten women underwent surgery on the basis of TVS, with 4 invasive ovarian cancers (1 with stage IA disease, 2 with stage IC disease, and 1 with stage IIB disease), 2 ovarian tumors of low malignant potential (both stage IA), 1 endometrial cancer (stage I), and 3 benign ovarian tumors, providing a positive predictive value of 40% (95% confidence interval = 12.2%, 73.8%) for detecting invasive ovarian cancer. The specificity was 99.9% (95% confidence interval = 99.7%, 100%). All 4 women with invasive ovarian cancer were enrolled in the study for at least 3 years with low-risk annual CA125 test values prior to rising CA125 levels. ROCA followed by TVS demonstrated excellent specificity and positive predictive value in a population of US women at average risk for ovarian cancer. Copyright © 2013 American Cancer Society.

  11. Lower Cancer Rates Among Druze Compared to Arab and Jewish Populations in Israel, 1999-2009.

    Science.gov (United States)

    Atzmon, Iris; Linn, Shai; Portnov, Boris A; Richter, Elihu; Keinan-Boker, Lital

    2017-06-01

    The Druze are a small ethnic minority in Israel amounting to about 130,000 residents (or 1.7 % of the total population of the country). Unlike other population groups, the Druze strive to keep their own traditions and marry mainly inside their own community. During the last decade, cancer morbidity among both Jews and Arabs in Israel has been increasing, while data on the Druze are little known and have not been analyzed and compared to other population groups to date. To compare cancer morbidity rates among Druze, Arabs and Jews in Israel during 1999-2009, gender-specific and age-standardized incidence rates of all site cancers and specific cancers of three population groups (Jews, Arabs and Druze) were received from the Israel National Cancer Registry for the period 1999-2009. Based on these rates, periodical incidence rates were calculated and mutually compared across the groups stratified by gender. As the analysis shows, the Druze had significantly lower cancer rates compared to both Arabs and Jews. Thus, for all site cancers, there were significantly higher cancer rates in Jewish males versus Druze males (RR = 1.39, 95 % CI = 1.16-1.65) and in Jewish females versus Druze females (RR = 1.53, 95 % CI = 1.27-1.85), but not statistically significant for Arab males versus Druze males (RR = 1.12 95 % CI = 0.93-1.35). Lung cancer rates in Arab males were also higher compared to Druze males (RR = 1.84, 95 % CI = 1.13-3.00). Jewish males had statistically significant higher rates of prostate cancer compared to Druze males (RR = 2.47, 95 % CI = 1.55-3.91). For thyroid and colon cancers, risks were not significantly different at the 95 % CI level; however, the risks were significantly different at the 90 % CI level (RR = 3.62, 90 % CI 1.20-11.02 and RR = 1.69, 90 % CI = 1.03-2.77, respectively). Jewish females had significantly higher rates of invasive breast cancer (RR = 2.25, 95 % CI = 1.55-3.25), in situ cervical cancer (RR

  12. High-strain, high-strain-rate deformation of tantalum and tantalum-tungsten alloys

    OpenAIRE

    Vecchio, K.

    1994-01-01

    Under certain high strain rate conditions, plastic deformation can be assumed to be adiabatic, and a significant temperature increase can occur at large strains. In this study, tantalum and tantalum-tungsten alloys were subjected to high shear strains at high strain rate using a specially-designed stepped specimen in a Hopkinson bar. Upon completion of the deformation, the region is cooled to below one-half of the temperature achieved due to the adiabatic heating in less than one millisecond....

  13. Radiotherapy combined with intracavitary irradiation for uterine cervical cancer. Study of survival rate, patterns of recurrence and complication

    Energy Technology Data Exchange (ETDEWEB)

    Kusuda, Junko; Mizutani, Yoshiyuki; Yoshino, Ayako; Takayama, Makoto; Furuya, Yoshiro (Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine); Takei, Ryoji

    1994-09-01

    Survival rates and patterns of recurrence in 137 patients with uterine cervical cancer were determined. These patients were treated by radiotherapy with high-dose rate intracavitary irradiation using remote afterloading system (RALS) at Kyorin University Hospital from Oct. 1987 to Dec. 1992. Age range was from 29 to 87 years. According to clinical staging of UICC, stages I, II, III, and IV were observed in 29, 62, 33, and 13 cases respectively. Cumulative 5-year survival rate of all cases was 72%. Cumulative 5-year survival rates were 100% for stage I, 81% for stage II, 38% for stage III, and 27% for stage IV. Cumulative 5-year survival rates of the postoperative radiotherapy and radical radiotherapy groups were 75% and 90% respectively. There was significant difference of survival rates between the postoperative radiotherapy group and the radical radiotherapy group. As patterns of recurrence, extrapelvic metastasis was more frequent than local recurrence. In stages II and III, recurrent patterns were extrapelvic matastasis in most cases. Of 18 cases with extrapelvic metastasis, there were 10 cases of paraaortic lymph node metastasis. With increase in the control rate of parraortic lymph node metastasis, survival rate of patients with uterine cervical cancer increased. Four of 5 cases with local recurrence controled by intracavitary irradiation is effective for local recurrence control. Rectal and bladder complications following radiotherapy were observed in 25 cases. However, all cases with complication after radiotherapy were treated conservatively, excluding 1 case (vasicorectal fistula). (author).

  14. Liver resection rate following downsizing chemotherapy with cetuximab in metastatic colorectal cancer: UK retrospective observational study.

    Science.gov (United States)

    Malik, H; Khan, A Z; Berry, D P; Cameron, I C; Pope, I; Sherlock, D; Helmy, S; Byrne, B; Thompson, M; Pulfer, A; Davidson, B

    2015-04-01

    The high objective response rate to cetuximab along with chemotherapy in patients with colorectal liver metastases makes it an effective downsizing protocol to facilitate surgery in those with initially unresectable disease. Adoption of this strategy has been variable in the UK. A retrospective observational study was conducted in 7 UK specialist liver surgical centres to describe the liver resection rate following a downsizing protocol of cetuximab and chemotherapy and to evaluate the quality and efficiency of processes by which the treatment was provided. Data were collected in 2012 by reviewing medical records of patients with colorectal metastases confined to the liver, defined as unresectable without downsizing therapy at first review by a specialist Multi Disciplinary Team (MDT). Sixty patients were included; 29 (48%) underwent liver resection following cetuximab and chemotherapy. Of the 29, 17 (59% or 28% of all patients) achieved R0 resection and 7 (24% or 12% of all patients) R1 resection. All treated patients were KRAS wild-type. In specialist liver surgical centres, where patients are evaluated for liver resection, optimal management by MDT using KRAS testing, cetuximab and chemotherapy results in a 28% R0 resection rate in patients with initially unresectable colorectal cancer liver metastases. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Are we underestimating the rates of incontinence after prostate cancer treatment? Results from NHANES.

    Science.gov (United States)

    Daugherty, Michael; Chelluri, Raju; Bratslavsky, Gennady; Byler, Timothy

    2017-10-01

    Local therapy for prostate cancer (PCa) includes radical prostatectomy (RP) and radiotherapy (XRT), both of which share a complication of urinary incontinence. Post-treatment incontinence has been reported to occur 6-69%, yet no truly patient-centered report has been compiled. We evaluated patient-reported incontinence rates and bother scores after treatment for prostate cancer. The NHANES database was queried for all men who reported a diagnosis and treatment of PCa from 2001 to 2010. A control arm of men without a diagnosis of PCa age 60-80 years was constructed for baseline incontinence rates. Incontinence was patient-reported and obtained through questionnaires. Three additional cohorts were created for patients treated with RP, XRT or combination RP and XRT. We identified 316 men treated for prostate cancer, of which 136 reported RP and 125 reported XRT, who were compared to 3534 controls. Men that underwent RP experience significant incontinence rates of 23% compared to 12% of those patients treated with XRT, whereas those patients with combined therapy had incontinence rates of 52% (p incontinence did not differ between treatment groups, but stress incontinence was significantly higher in surgical patients. These data from a nationwide sample of patient-reported urinary outcomes have limited interviewer bias and report significantly higher incontinence rates, which may impact prostate cancer discussions. This further underscores the importance of patient-reported outcomes in the evaluation of treatment success and counseling for patients with prostate cancer.

  16. [Analysis of results of endoscopic screening of esophageal, gastric cardia and gastric cancers in high risk population].

    Science.gov (United States)

    Zhang, Jiangong; Wang, Furang; Zhang, Yabing; Quan, Peiliang; Liu, Shuzheng; Sun, Xibin; Lu, Jianbang

    2014-02-01

    To summarize the results of endoscopic screening of esophageal, gastric cardiac and gastric cancers in the high-risk population, and analyze the influencing factors such as age, gender and biopsy rate on their detection and early diagnosis rates. Nine high incidence cities and counties of esophageal cancer in Henan province were included in this study. People aged 40-69 years were set to the target population. Excluding contraindications for gastroscopy, in accordance with the national technical scheme of early cancer diagnosis and treatment, gastroscopic screening and biopsy pathology for human esophageal, cardiac and gastric cancers were carried out. During the 3-year period, a total of 40 156 subjects were screened. Among them, 18 459 cases of various precancerous lesions (46.0%) were detected. The cancer detection rate was 2.3% (916 cases), including 763 cases of early cancers. The diagnosis rate of early cancers was 83.3%. Precancerous lesions were detected in 9297 cases (23.2%) for esophagus and 9162 cases (22.8%) for gastric cardia as well as stomach, respectively. The results of this study demonstrate that endoscopic screening is feasible for early detection, diagnosis and treatment of esophageal, gastric cardia and gastric cancers among high risk population in high incidence area. Exploration analysis of relevant affecting factors may help to further improve the screening project for early diagnosis and treatment of those cancers.

  17. Brain cancer mortality rates increase with Toxoplasma gondii seroprevalence in France

    Science.gov (United States)

    Vittecoq, Marion; Elguero, Eric; Lafferty, Kevin D.; Roche, Benjamin; Brodeur, Jacques; Gauthier-Clerc, Michel; Missé, Dorothée; Thomas, Frédéric

    2012-01-01

    The incidence of adult brain cancer was previously shown to be higher in countries where the parasite Toxoplasma gondii is common, suggesting that this brain protozoan could potentially increase the risk of tumor formation. Using countries as replicates has, however, several potential confounding factors, particularly because detection rates vary with country wealth. Using an independent dataset entirely within France, we further establish the significance of the association between T. gondii and brain cancer and find additional demographic resolution. In adult age classes 55 years and older, regional mortality rates due to brain cancer correlated positively with the local seroprevalence of T. gondii. This effect was particularly strong for men. While this novel evidence of a significant statistical association between T. gondii infection and brain cancer does not demonstrate causation, these results suggest that investigations at the scale of the individual are merited.

  18. GPU accelerated processing of astronomical high frame-rate videosequences

    Science.gov (United States)

    Vítek, Stanislav; Švihlík, Jan; Krasula, Lukáš; Fliegel, Karel; Páta, Petr

    2015-09-01

    Astronomical instruments located around the world are producing an incredibly large amount of possibly interesting scientific data. Astronomical research is expanding into large and highly sensitive telescopes. Total volume of data rates per night of operations also increases with the quality and resolution of state-of-the-art CCD/CMOS detectors. Since many of the ground-based astronomical experiments are placed in remote locations with limited access to the Internet, it is necessary to solve the problem of the data storage. It mostly means that current data acquistion, processing and analyses algorithm require review. Decision about importance of the data has to be taken in very short time. This work deals with GPU accelerated processing of high frame-rate astronomical video-sequences, mostly originating from experiment MAIA (Meteor Automatic Imager and Analyser), an instrument primarily focused to observing of faint meteoric events with a high time resolution. The instrument with price bellow 2000 euro consists of image intensifier and gigabite ethernet camera running at 61 fps. With resolution better than VGA the system produces up to 2TB of scientifically valuable video data per night. Main goal of the paper is not to optimize any GPU algorithm, but to propose and evaluate parallel GPU algorithms able to process huge amount of video-sequences in order to delete all uninteresting data.

  19. Precise muon drift tube detectors for high background rate conditions

    CERN Document Server

    Engl, Albert; Dünnweber, Wolfgang

    The muon spectrometer of the ATLAS-experiment at the Large H adron Collider consists of drift tube chambers, which provide the precise m easurement of trajec- tories of traversing muons. In order to determine the moment um of the muons with high precision, the measurement of the position of the m uon in a single tube has to be more accurate than σ ≤ 100 m. The large cross section of proton-proton-collisions and th e high luminosity of the accelerator cause relevant background of neutrons and γ s in the muon spectrome- ter. During the next decade a luminosity upgrade [1] to 5 10 34 cm − 2 s − 1 is planned, which will increase the background counting rates consider ably. In this context this work deals with the further development of the existing drift chamber tech- nology to provide the required accuracy of the position meas urement under high background conditions. Two approaches of improving the dri ft tube chambers are described: • In regions of moderate background rates a faster and more lin ear ...

  20. Handling high data rate detectors at Diamond Light Source

    Science.gov (United States)

    Pedersen, U. K.; Rees, N.; Basham, M.; Ferner, F. J. K.

    2013-03-01

    An increasing number of area detectors, in use at Diamond Light Source, produce high rates of data. In order to capture, store and process this data High Performance Computing (HPC) systems have been implemented. This paper will present the architecture and usage for handling high rate data: detector data capture, large volume storage and parallel processing. The EPICS area Detector frame work has been adopted to abstract the detectors for common tasks including live processing, file format and storage. The chosen data format is HDF5 which provides multidimensional data storage and NeXuS compatibility. The storage system and related computing infrastructure include: a centralised Lustre based parallel file system, a dedicated network and a HPC cluster. A well defined roadmap is in place for the evolution of this to meet demand as the requirements and technology advances. For processing the science data the HPC cluster allow efficient parallel computing, on a mixture of ×86 and GPU processing units. The nature of the Lustre storage system in combination with the parallel HDF5 library allow efficient disk I/O during computation jobs. Software developments, which include utilising optimised parallel file reading for a variety of post processing techniques, are being developed in collaboration as part of the Pan-Data EU Project (www.pan-data.eu). These are particularly applicable to tomographic reconstruction and processing of non crystalline diffraction data.

  1. High Posttransplant Cancer Incidence in Renal Transplanted Patients With Pretransplant Cancer.

    Science.gov (United States)

    Hellström, Vivan; Lorant, Tomas; Döhler, Bernd; Tufveson, Gunnar; Enblad, Gunilla

    2017-06-01

    Patients with previous cancer have increasingly been accepted for renal transplantation. Posttransplant cancer risk and survival rates of these patients are unknown. Our objective was to assess the risk of posttransplant cancer in this patient group. In this retrospective, nested case-control study, we assessed the outcome of all (n = 95) renal transplanted patients with pretransplant cancer diagnoses in the Uppsala-Örebro region, Sweden. The control group was obtained from the Collaborative Transplant Study registry and included European patients without pretransplant cancer. The other control group comprised the entire renal transplanted population in Uppsala. Development of recurrent cancer, de novo cancer, and patient survival were determined. Patients with pretransplant cancer showed higher incidence of posttransplant cancers and shorter survival compared with the control groups (P cancer treatments and favorable prognoses, almost half of the patients experienced a posttransplant cancer. These observations do not justify abstaining from transplanting all patients with previous malignancies, because more than 50% of the patients survive 10 years posttransplantation. A careful oncological surveillance pretransplant as well as posttransplant is recommended.

  2. Optimization of synthesis and peptization steps to obtain iron oxide nanoparticles with high energy dissipation rates

    Energy Technology Data Exchange (ETDEWEB)

    Mérida, Fernando [Deparment of Chemical Engineering, University of Puerto Rico, Mayagüez, P.O. Box 9046, Mayagüez, PR 00680 (United States); Chiu-Lam, Andreina [Department of Chemical Engineering, University of Florida, P.O. Box 116005, Gainesville, FL 32611-6005 (United States); Bohórquez, Ana C. [J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, P.O. Box 116131, Gainesville, FL 32611-6131 (United States); Maldonado-Camargo, Lorena [Department of Chemical Engineering, University of Florida, P.O. Box 116005, Gainesville, FL 32611-6005 (United States); Pérez, María-Eglée; Pericchi, Luis [Department of Mathematics, University of Puerto Rico, Río Piedras, P.O. Box 70377, San Juan, PR 00936-8377 (United States); Torres-Lugo, Madeline [Deparment of Chemical Engineering, University of Puerto Rico, Mayagüez, P.O. Box 9046, Mayagüez, PR 00680 (United States); Rinaldi, Carlos, E-mail: carlos.rinaldi@bme.ufl.edu [Department of Chemical Engineering, University of Florida, P.O. Box 116005, Gainesville, FL 32611-6005 (United States); J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, P.O. Box 116131, Gainesville, FL 32611-6131 (United States)

    2015-11-15

    Magnetic Fluid Hyperthermia (MFH) uses heat generated by magnetic nanoparticles exposed to alternating magnetic fields to cause a temperature increase in tumors to the hyperthermia range (43–47 °C), inducing apoptotic cancer cell death. As with all cancer nanomedicines, one of the most significant challenges with MFH is achieving high nanoparticle accumulation at the tumor site. This motivates development of synthesis strategies that maximize the rate of energy dissipation of iron oxide magnetic nanoparticles, preferable due to their intrinsic biocompatibility. This has led to development of synthesis strategies that, although attractive from the point of view of chemical elegance, may not be suitable for scale-up to quantities necessary for clinical use. On the other hand, to date the aqueous co-precipitation synthesis, which readily yields gram quantities of nanoparticles, has only been reported to yield sufficiently high specific absorption rates after laborious size selective fractionation. This work focuses on improvements to the aqueous co-precipitation of iron oxide nanoparticles to increase the specific absorption rate (SAR), by optimizing synthesis conditions and the subsequent peptization step. Heating efficiencies up to 1048 W/g{sub Fe} (36.5 kA/m, 341 kHz; ILP=2.3 nH m{sup 2} kg{sup −1}) were obtained, which represent one of the highest values reported for iron oxide particles synthesized by co-precipitation without size-selective fractionation. Furthermore, particles reached SAR values of up to 719 W/g{sub Fe} (36.5 kA/m, 341 kHz; ILP=1.6 nH m{sup 2} kg{sup −1}) when in a solid matrix, demonstrating they were capable of significant rates of energy dissipation even when restricted from physical rotation. Reduction in energy dissipation rate due to immobilization has been identified as an obstacle to clinical translation of MFH. Hence, particles obtained with the conditions reported here have great potential for application in nanoscale thermal

  3. Unification of favourable intermediate-, unfavourable intermediate-, and very high-risk stratification criteria for prostate cancer.

    Science.gov (United States)

    Zumsteg, Zachary S; Zelefsky, Michael J; Woo, Kaitlin M; Spratt, Daniel E; Kollmeier, Marisa A; McBride, Sean; Pei, Xin; Sandler, Howard M; Zhang, Zhigang

    2017-11-01

    To improve on the existing risk-stratification systems for prostate cancer. This was a retrospective investigation including 2 248 patients undergoing dose-escalated external beam radiotherapy (EBRT) at a single institution. We separated National Comprehensive Cancer Network (NCCN) intermediate-risk prostate cancer into 'favourable' and 'unfavourable' groups based on primary Gleason pattern, percentage of positive biopsy cores (PPBC), and number of NCCN intermediate-risk factors. Similarly, NCCN high-risk prostate cancer was stratified into 'standard' and 'very high-risk' groups based on primary Gleason pattern, PPBC, number of NCCN high-risk factors, and stage T3b-T4 disease. Patients with unfavourable-intermediate-risk (UIR) prostate cancer had significantly inferior prostate-specific antigen relapse-free survival (PSA-RFS, P prostate cancer-specific mortality (PCSM, P prostate cancer. Similarly, patients with very high-risk (VHR) prostate cancer had significantly worse PSA-RFS (P prostate cancer. Moreover, patients with FIR and low-risk prostate cancer had similar outcomes, as did patients with UIR and SHR prostate cancer. Consequently, we propose the following risk-stratification system: Group 1, low risk and FIR; Group 2, UIR and SHR; and Group 3, VHR. These groups have markedly different outcomes, with 8-year distant metastasis rates of 3%, 9%, and 29% (P < 0.001) for Groups 1, 2, and 3, respectively, and 8-year PCSM of 1%, 4%, and 13% (P < 0.001) after EBRT. This modified stratification system was significantly more accurate than the three-tiered NCCN system currently in clinical use for all outcomes. Modifying the NCCN risk-stratification system to group FIR with low-risk patients and UIR with SHR patients, results in modestly improved prediction of outcomes, potentially allowing better personalisation of therapeutic recommendations. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  4. Survival Rate of Patients with Colorectal Cancer in Charmahal and Bakhtiari Province, Iran, 2000- 2010

    Directory of Open Access Journals (Sweden)

    M vakili

    2016-03-01

    Full Text Available Background & Aim: Cancers are the second cause of death after cardiovascular diseases globally. Colorectal cancer is the third most prevalent cancer in the world. This cancer is the third leading cause of death in America and one of the most prevalent cancers of the gastrointestinal tract in Iran. The purpose of this study was to estimate the survival rate of patients with gastric cancer in Chaharmahal and Bakhtiari province, Iran. Methods: The present observational (the analytical type study was conducted using the longitudinal and survival study methods. The population study included all patients with gastric cancer in Chaharmahal and Bakhtiari province, Iran. The samples were selected by the census method and all the patients diagnosed with colorectal between the years 2000 to 2010 (estimated to be about 452 cases. After collecting the data and coding them, they were inserted into the SPSS 16 and STATA 12 software. To investigate the survival and the factors influencing the survival time of patients which was the main objective of this study, the Kaplan-Meier method was used. In order to compare the survival function in different subgroups, the log rank test or generalized Wilcoxon test was used. Results: From the total 452 patients with colorectal cancer, 232 cases were male (51.3% and 220 were females (48.7%, respectively. The mean age of patients was 59.12 ±19.99 years at the time of diagnosis. The median age of patients was 60 years. The probability of survival at 1, 5 and 10 years after diagnosis of colorectal cancer in both sexes using the Kaplan-Meier was 85.7%, 71.9,% 52.5% respectively. Conclusion: Although the survival rate of patients with colorectal cancer in Chaharmahal and Bakhtiari province was at a desirable level, the need for further studies to identify prognostic factors is essential.

  5. Association of arsenic exposure with lung cancer incidence rates in the United States.

    Directory of Open Access Journals (Sweden)

    Joseph J Putila

    Full Text Available Although strong exposure to arsenic has been shown to be carcinogenic, its contribution to lung cancer incidence in the United States is not well characterized. We sought to determine if the low-level exposures to arsenic seen in the U.S. are associated with lung cancer incidence after controlling for possible confounders, and to assess the interaction with smoking behavior.Measurements of arsenic stream sediment and soil concentration obtained from the USGS National Geochemical Survey were combined, respectively, with 2008 BRFSS estimates on smoking prevalence and 2000 U.S. Census county level income to determine the effects of these factors on lung cancer incidence, as estimated from respective state-wide cancer registries and the SEER database. Poisson regression was used to determine the association between each variable and age-adjusted county-level lung cancer incidence. ANOVA was used to assess interaction effects between covariates.Sediment levels of arsenic were significantly associated with an increase in incident cases of lung cancer (P<0.0001. These effects persisted after controlling for smoking and income (P<0.0001. Across the U.S., exposure to arsenic may contribute to up to 5,297 lung cancer cases per year. There was also a significant interaction between arsenic exposure levels and smoking prevalence (P<0.05.Arsenic was significantly associated with lung cancer incidence rates in the U.S. after controlling for smoking and income, indicating that low-level exposure to arsenic is responsible for excess cancer cases in many parts of the U.S. Elevated county smoking prevalence strengthened the association between arsenic exposure and lung cancer incidence rate, an effect previously unseen on a population level.

  6. The Relationship Between Area Poverty Rate and Site-Specific Cancer Incidence in the United States

    Science.gov (United States)

    Boscoe, Francis P; Johnson, Christopher J; Sherman, Recinda L; Stinchcomb, David G; Lin, Ge; Henry, Kevin A

    2014-01-01

    BACKGROUND The relationship between socioeconomic status and cancer incidence in the United States has not traditionally been a focus of population-based cancer surveillance systems. METHODS Nearly 3 million tumors diagnosed between 2005 and 2009 from 16 states plus Los Angeles were assigned into 1 of 4 groupings based on the poverty rate of the residential census tract at time of diagnosis. The sex-specific risk ratio of the highest-to-lowest poverty category was measured using Poisson regression, adjusting for age and race, for 39 cancer sites. RESULTS For all sites combined, there was a negligible association between cancer incidence and poverty; however, 32 of 39 cancer sites showed a significant association with poverty (14 positively associated and 18 negatively associated). Nineteen of these sites had monotonic increases or decreases in risk across all 4 poverty categories. The sites most strongly associated with higher poverty were Kaposi sarcoma, larynx, cervix, penis, and liver; those most strongly associated with lower poverty were melanoma, thyroid, other nonepithelial skin, and testis. Sites associated with higher poverty had lower incidence and higher mortality than those associated with lower poverty. CONCLUSIONS These findings demonstrate the importance and relevance of including a measure of socioeconomic status in national cancer surveillance. Cancer 2014;120:2191–2198. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. A majority of cancer sites exhibit significant associations with area poverty rates. Those associated with higher poverty had lower incidence but higher mortality than those associated with lower poverty. PMID:24866103