Radio-chemotherapy as a preoperative treatment for advanced rectal cancer. Evaluation of down-staging and morbidity

Background: The standard therapy for patients with clinically resectable rectal cancer is generally considered to be surgery, If the patient is diagnosed with advanced disease, postoperative radiochemotherapy (RCT) is usually recommended. In our study we aimed to investigate and analyze the effectiveness and toxicity of preoperative pelvic radiotherapy in combination with 5-fluorouracil (5-FU) in locally advanced rectal cancer. Patients and Methods: From June 1999 to September 2001 we evaluated 50 consecutive patients {[}37 male and 13 female; average age 65.1 (range 46-79.5) years] with locally advanced rectal carcinoma. 32 patients were staged as uT3, 14 as uT4, and 4 as uT2. Regarding N-staging, 22 patients were diagnosed as ONO. 2 patients had distant metastases, with liver metastases in both instances. Conformal irradiation was performed with a box technique 4-field technique) with a dose of 45 Gy (5 x 1.8 Gy per week for a total of 25 sessions). From days 1-5 and 29-33, all patients received 5-FU (500 mg/m(2) per day, as a continuous i.v. injection). Results: Remission was observed in 28 patients (56%), with down-staging of at least one T-stage. A better success rate was achieved for patients with deep-seated tumors (64% of the patients in this group). Complete remission was observed in 4 patients (8.0%) and progression in 3 (6.0%). 15 patients had no detectable change in tumor staging (30.0%). A surgical R0 resection could be achieved in 43 patients, an R1 resection (minimal margins in 7. Side effects and toxicity (common toxicity criteria) of RCT included grade I-II dysuria in 5 patients (10%), grade I-II diarrhea in 20 patients (40%), and severe diarrhea in 2 patients (4.0%). Grade I-II skin reaction was noticed in 22 patients (44.0%), severe skin reaction only in 1 patient. Regarding acute postoperative morbidity, abscess and fistula formation was noted in 8 patients (16.0%), with anastomosis leakage in 7 (14%). Conclusion: Preoperative radiotherapy appears to be a feasible therapeutic approach with moderate toxicity and the potential to induce down-staging. The data presented in this study confirm the preliminary reports on this neoadjuvant treatment

Porphyrias associated with malignant tumors: Results of treatment with ionizing irradiation

Background: Porphyrin metabolism disorders, known as porphyria, represent inherited or acquired diseases. The development of porphyria due to light sensibility occurs especially with exposure to wavelengths in the range of 300-700 nm. Skin reactions and neurovisceral dysfunctions are known side effects of ionizing irradiation. It can be postulated that during or after ionizing irradiation treatment of patients affected with tumor and porphyria, severe side effects might appear, in contrast to patients without porphyria. This paper describes the treatment of 2 patients affected with tumor and concomitant porphyria. Patients: One female patient suffering from intermittent porphyria and breast cancer and one male patient suffering from porphyria cutanea tarda and bladder cancer were treated with ionizing irradiation (electrons and photons). No abnormalities nor any severe general or local side effects could be observed. Conclusion: Radiation therapy is not a `stimulating' factor in activating porphyria symptoms

Gαq and its \u3ci\u3eAkt\u3c/i\u3eions

No abstract available

Quality of life (QoL) as predictive mediator variable for survival in patients with intracerebral neoplasma during radiotherapy

Background: The prognosis for patients with malignant astrocytoma or brain metastases is often fatal despite intensive therapy. Therefore we wished to elucidate whether the quality of life (QoL) is a determinant of overall survival (OAS). Patients and Methods: From 1997 to 2000 153 patients with brain tumours were screened; 39 patients (26%) refused to participate and further 47 patients were excluded (cerebral impairment 14%, amaurosis/language problems 3%, Karnofsky performance score < 50% 7%, death 8%, non-compliance 7%). Thus, 57 patients were analysed (33 with primary brain tumours, 24 with brain metastases). With the FACT-G questionnaire cancer-specific aspects of health-related QoL were assessed. Results: Patients with metastases showed a lower QoL in the physical sphere than patients with astrocytoma, but there were no significant differences in OAS. Median survival of patients with good QoL was 31.3 months versus 14.2 months in patients with bad QoL. Only the two variables `living with a spouse' and FACT-G sum score had a statistically significant influence on survival (p = 0.033 and p = 0.003) modelled by the Cox-PH regression. Patients who did not live with a spouse had shorter survival times than the other patients. Conclusion: Health-related QoL can serve to identify a patient group with higher risks of death

Feasibility and morbidity of combined hyperthermia and radiochemotherapy in recurrent rectal cancer - Preliminary results

Background: The local recurrence rate of colorectal cancer has been significantly reduced due to the use of combined radiochemotherapy. Despite this improvement regarding locally advanced tumour recurrences, the treatment strategy for pre-treated patients remains difficult and unresolved. Patients and Methods: We analysed treatment and follow-up data of 14 patients with local recurrence of rectal cancer who were treated with radiation therapy (RT), chemotherapy (CT) and regional hyperthermia (RHT) from November 1997 to December 2001. Nine of these patients had received irradiation and CT (=pre-treated patients) in the past. For this group, 30.6-39.6 Gy RT, 5-fluorouracil (5-FU) as a continuous infusion over 5 days per week (350 mg/m(2)/24 h) combined with RHT twice a week was given. The 5 remaining patients (=not pre-treated) received conformal irradiation of 45 Gy with a boost between 9 and 14.4 Gy, combined with continuous infusion of 5-FU on days 1-4, and 29-33 (500 mg/m(2)/24 h), and RHT twice a week. Response to therapy was evaluated by means of computed tomography (CT) or magnetic resonance imaging (MRI) and by clinical follow-up. Results: Among 13 evaluated cases, the overall objective response rate was 54% (5 complete responses, 2 partial responses). At mean follow-up of 13.9 months (range 5-32 months) 7 patients were alive. Conclusion: The therapeutic regimen appears to be active in the treatment of local recurrences of rectal cancer. Larger-scaled studies are needed to evaluate the potency of hyperthermia in this therapeutic strategy

High Spatial Resolution Thermal-Infrared Spectroscopy with ALES: Resolved Spectra of the Benchmark Brown Dwarf Binary HD 130948BC

We present 2.9-4.1 micron integral field spectroscopy of the L4+L4 brown dwarf binary HD 130948BC, obtained with the Arizona Lenslets for Exoplanet Spectroscopy (ALES) mode of the Large Binocular Telescope Interferometer (LBTI). The HD 130948 system is a hierarchical triple system, in which the G2V primary is joined by two co-orbiting brown dwarfs. By combining the age of the system with the dynamical masses and luminosities of the substellar companions, we can test evolutionary models of cool brown dwarfs and extra-solar giant planets. Previous near-infrared studies suggest a disagreement between HD 130948BC luminosities and those derived from evolutionary models. We obtained spatially-resolved, low-resolution (R~20) L-band spectra of HD 130948B and C to extend the wavelength coverage into the thermal infrared. Jointly using JHK photometry and ALES L-band spectra for HD 130948BC, we derive atmospheric parameters that are consistent with parameters derived from evolutionary models. We leverage the consistency of these atmospheric quantities to favor a younger age (0.50 \pm 0.07 Gyr) of the system compared to the older age (0.79 \pm 0.22 Gyr) determined with gyrochronology in order to address the luminosity discrepancy.Comment: 17 pages, 9 figures, Accepted to Ap

Coping of cancer patients during and after radiotherapy - a follow-up of 2 years

Aim: We wanted to understand coping strategies specific to different phases up to two years after radiotherapy, to identify patients who are at higher risk of mood disturbances and to characterise the association between coping strategies and psychosocial adaptation. Patients and Methods: From 1997 to 2001, 2,169 patients with different diagnoses were screened (27.8% refused to participate). Data of 276 patients from the beginning of radiotherapy (ti1) and 5 follow-up investigations (ti6/2 years) could be analysed. With the FKV ( Freiburg Questionnaire Coping with Disease) cancer-specific coping aspects were assessed. The association between coping styles and psychosocial adaptation was evaluated using the Questionnaire on Stress in Cancer Patients (QSC) and the questionnaire on Functional Assessment of Cancer Treatment (FACT-G). Results: `Active problem-orientated' coping and `distractions' are the most important coping strategies. Only `active problem-orientated' and `depressive' coping showed a significant decrease. We observed higher means on the scales of the FKV in women. Marital status ( single, married, divorced/widowed) had a significant influence on active problem-orientated coping and spirituality. Age, children, education, T/M status and curative/ palliative intention of treatment had no influence on coping styles. Breast cancer patients and lymphoma patients demonstrated the highest use of coping strategies after radiotherapy with a significant decrease of `active problem-orientated coping'. Depressive coping and minimizing importance at ti1 were associated with high psychosocial distress and low quality of life (QoL) at ti6. Conclusion: The correlation of coping mechanisms at the beginning of radiotherapy with low QoL and high psychosocial stress at 2 years could help to identify patients at risk for low psychosocial adaptation. Psychooncologically trained teams of physicians would best correspond to this profile of needs and would contribute significantly to an ameliorated adaptation of patients to cancer which could lead to higher life satisfaction

Charming penguins in B => K* pi, K (rho,omega,phi) decays

We evaluate the decays B => K* pi, K (rho,omega,phi) adding the long distance charming penguin contributions to the short distance: Tree+Penguin amplitudes. We estimate the imaginary part of the charming penguin by an effective field theory inspired by the Heavy Quark Effective Theory and parameterize its real part. The final results for branching ratios depend on only two real parameters and show a significant role of the charming penguins. The overall agreement with the available experimental data is satisfactory.Comment: 13 pages, 1 figur

The LEECH Exoplanet Imaging Survey: Limits on Planet Occurrence Rates Under Conservative Assumptions

We present the results of the largest $L^{\prime}$ ($3.8~\mu$m) direct imaging survey for exoplanets to date, the Large Binocular Telescope Interferometer (LBTI) Exozodi Exoplanet Common Hunt (LEECH). We observed 98 stars with spectral types from B to M. Cool planets emit a larger share of their flux in $L^{\prime}$ compared to shorter wavelengths, affording LEECH an advantage in detecting low-mass, old, and cold-start giant planets. We emphasize proximity over youth in our target selection, probing physical separations smaller than other direct imaging surveys. For FGK stars, LEECH outperforms many previous studies, placing tighter constraints on the hot-start planet occurrence frequency interior to $\sim20$ au. For less luminous, cold-start planets, LEECH provides the best constraints on giant-planet frequency interior to $\sim20$ au around FGK stars. Direct imaging survey results depend sensitively on both the choice of evolutionary model (e.g., hot- or cold-start) and assumptions (explicit or implicit) about the shape of the underlying planet distribution, in particular its radial extent. Artificially low limits on the planet occurrence frequency can be derived when the shape of the planet distribution is assumed to extend to very large separations, well beyond typical protoplanetary dust-disk radii ($\lesssim50$ au), and when hot-start models are used exclusively. We place a conservative upper limit on the planet occurrence frequency using cold-start models and planetary population distributions that do not extend beyond typical protoplanetary dust-disk radii. We find that $\lesssim90\%$ of FGK systems can host a 7 to 10 $M_{\mathrm{Jup}}$ planet from 5 to 50 au. This limit leaves open the possibility that planets in this range are common.Comment: 31 pages, 13 figures, accepted to A

LABOCA observations of nearby, active galaxies

We present large scale 870 micron maps of the nearby starburst galaxies NGC253, NGC4945 and the nearest giant elliptical radio galaxy Centaurus A (NGC 5128) obtained with the newly commissioned Large Apex Bolometer Camera (LABOCA) operated at the APEX telescope. Our continuum images reveal for the first time the distribution of cold dust at a angular resolution of 20" across the entire optical disks of NGC253 and NGC4945 out to a radial distance of 10' (7.5 kpc). In NGC5128 our LABOCA image also shows, for the first time at submillimeter wavelengths, the synchrotron emission associated with the radio jet and the inner radio lobes. From an analysis of the 870 micron emission in conjunction with ISO-LWS, IRAS and long wavelengths radio data we find temperatures for the cold dust in the disks of all three galaxies of 17-20 K, comparable to the dust temperatures in the disk of the Milky Way. The total gas mass in the three galaxies is determined to be 2.1, 4.2 and 2.8 x 10^9 solar masses for NGC253, NGC4945 and NGC5128, respectively. A detailed comparison between the gas masses derived from the dust continuum and the integrated CO(1-0) intensity in NGC253 suggests that changes of the CO luminosity to molecular mass conversion factor are mainly driven by a metallicity gradient and only to a lesser degree by variations of the CO excitation. An analysis of the synchrotron spectrum in the northern radio lobe of NGC5128 shows that the synchrotron emission from radio to the ultraviolet wavelengths is well described by a broken power law and that the break frequency is a function of the distance from the radio core as expected for aging electrons. We derive an outflow speed of ~0.5c at a distance of 2.6kpc from the center, consistent with the speed derived in the vicinity of the nucleus.Comment: 12 pages, 11 figures. Accepted for publication in A&