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Treatment response lowers tumor symptom burden in recurrent and/or metastatic head and neck cancer
(2020)
Background: Head and neck squamous cell cancer (HNSCC) frequently causes severe symptoms that may be reduced, when the tumor is successfully treated. The SOCCER trial studied the association of treatment response with patient reported tumor symptom burden in first line treatment of recurrent and/or metastatic HNSCC.
Methods: In this prospective, multi-center, non-interventional trial patients were treated either with platinum-based chemotherapy and cetuximab or radiotherapy and cetuximab. Tumor symptom burden was assessed every four weeks with a questionnaire containing ten visual analogue scales (VAS, range 0–100), which were summarized to the overall VAS score.
Results: Fourhundred seventy patients were registered in 97 German centers. A total of 315 patients with at least the baseline and one subsequent questionnaire were available for analysis. Changes in the VAS score were rated as absolute differences from baseline. Negative values indicate improvement of symptoms. The overall VAS score improved significantly at the first post-baseline assessment in responders (− 2.13 vs. non-responders + 1.15, p = 0.048), and even more for the best post-baseline assessment (− 7.82 vs. non-responders − 1.97, p = 0.0005). The VAS for pain (− 16.37 vs. non-responders − 8.89, p = 0.001) and swallowing of solid food (− 16.67 vs. non-responders − 5.06, p = 0.002) improved significantly more in responders (best post-baseline assessment). In the multivariable Cox regression analysis, worse overall VAS scores were associated with worse overall survival (hazard ratio for death 1.12 per 10 points increment on the overall VAS scale, 95% CI 1.05–1.20, p = 0.0009).
Conclusion: In unselected patients beyond randomized controlled trials, treatment response lowers tumor symptom burden in recurrent and/or metastatic HNSCC.
Trial registration: ClinicalTrials.gov, NCT00122460. Registered 22 Juli 2005,
Treatment options of locoregional recurrent head and neck squamous cell cancer (HNSCC) include both local strategies as surgery or re-radiotherapy and systemic therapy. In this prospective, multi-center, non-interventional study, patients were treated either with platinum-based chemotherapy and cetuximab (CT + Cet) or re-radiotherapy and cetuximab (RT + Cet). In the current analysis, progression-free survival (PFS) and overall survival (OS) were compared in patients with locoregional recurrence. Four hundred seventy patients were registered in 97 German centers. After exclusion of patients with distant metastases, a cohort of 192 patients was analyzed (129 CT + Cet, 63 RT + Cet). Radiotherapy was delivered as re-irradiation to 70% of the patients. The mean radiation dose was 51.8 Gy, whereas a radiation dose of ≥60 Gy was delivered in 33% of the patients. Chemotherapy mainly consisted of cisplatin/5-flurouracil (40%) or carboplatin/5-flurouracil (29%). The median PFS was 9.2 months in the RT + Cet group versus 5.1 months in the CT + Cet group (hazard ratio for disease progression or death, 0.40, 95% CI, 0.27–0.57, p < 0.0001). Median OS was 12.8 months in the RT + Cet group versus 7.9 months in the CT + Cet group (hazard ratio for death, 0.50, 95% CI, 0.33–0.75, p = 0.0008). In conclusion, radiotherapy combined with cetuximab improved survival compared to chemotherapy combined with cetuximab in locally recurrent HNSCC.
CXCR4 chemokine receptor mediates prostate tumor cell adhesion through alpha5 and beta3 integrins
(2006)
The mechanisms leading to prostate cancer metastasis are not understood completely. Although there is evidence that the CXC chemokine receptor (CXCR) 4 and its ligand CXCL12 may regulate tumor dissemination, their role in prostate cancer is controversial. We examined CXCR4 expression and functionality, and explored CXCL12-triggered adhesion of prostate tumor cells to human endothelium or to extracellular matrix proteins laminin, collagen, and fibronectin. Although little CXCR4 was expressed on LNCaP and DU-145 prostate tumor cells, CXCR4 was still active, enabling the cells to migrate toward a CXCL12 gradient. CXCL12 induced elevated adhesion to the endothelial cell monolayer and to immobilized fibronectin, laminin, and collagen. Anti-CXCR4 antibodies or CXCR4 knock out significantly impaired CXCL12-triggered tumor cell binding. The effects observed did not depend on CXCR4 surface expression level. Rather, CXCR4-mediated adhesion was established by alpha5 and beta3 integrin subunits and took place in the presence of reduced p38 and p38 phosphorylation. These data show that chemoattractive mechanisms are involved in adhesion processes of prostate cancer cells, and that binding of CXCL12 to its receptor leads to enhanced expression of alpha5 and beta3 integrins. The findings provide a link between chemokine receptor expression and integrin-triggered tumor dissemination.
This paper reports on Monte Carlo simulation results for future measurements of the moduli of time-like proton electromagnetic form factors, |GE | and |GM|, using the ¯pp → μ+μ− reaction at PANDA (FAIR). The electromagnetic form factors are fundamental quantities parameterizing the electric and magnetic structure of hadrons. This work estimates the statistical and total accuracy with which the form factors can be measured at PANDA, using an analysis of simulated data within the PandaRoot software framework. The most crucial background channel is ¯pp → π+π−,due to the very similar behavior of muons and pions in the detector. The suppression factors are evaluated for this and all other relevant background channels at different values of antiproton beam momentum. The signal/background separation is based on a multivariate analysis, using the Boosted Decision Trees method. An expected background subtraction is included in this study, based on realistic angular distribuations of the background contribution. Systematic uncertainties are considered and the relative total uncertainties of the form factor measurements are presented.
Die vorliegende Diplomarbeit lässt sich dem Gebiet der Terahertz-Physik (THz-Physik) zuordnen, also dem Gebiet der Physik, das sich mit der Erzeugung und Detektion von Ferninfrarotstrahlung beschäftigt. THz-Strahlung stellt dabei die Verbindung zwischen den elektromagnetischen Mikrowellen und den Wellen des infraroten Frequenzbereiches dar. Damit umfasst der THz-Bereich Frequenzen von etwa 100 GHz bis zu 100 THz. Die Forschung, die sich mit diesem Frequenzbereich beschäftigt, ist mittlerweile stark differenziert. Dabei geht es auf der einen Seite um die Entwicklung neuer bzw. die Weiterentwicklung und Optimierung bestehender THz-Erzeugungs- und Detektionsverfahren, auf der anderen Seite geht es um die Frage nach den möglichen Anwendungsgebieten für die entwickelten THz-Techniken. Entwickelt werden sowohl gepulste wie auch Dauerstrich-THz-Systeme, die auf einer Vielzahl verschiedener physikalischer Emissionsprozesse basieren. Die Anwendungsseite der THz-Forschung umfasst Gebiete wie die Spektroskopie, d.h. die Materialcharakterisierung und -untersuchung, aber auch komplexe biomedizinische Untersuchungsverfahren, wie z.B. die Krebsdiagnostik in der Onkologie. In der Bandbreite der weltweiten THz-Aktivitäten befindet sich diese Arbeit sowohl im Bereich der Entwicklung von THz-Techniken als auch in dem eher anwendungsbezogenen Bereich: Zunächst werden im zweiten Kapitel die verwendeten THz-Techniken und Messaufbauten vorgestellt, ebenso wie deren Funktionsweisen und speziellen Eigenschaften. Das dritte Kapitel beschäftigt sich mit der experimentellen Untersuchung von großflächigen THz-Emittern in gepulsten Lasersystemen. Diese weisen gegenüber den häufig verwendeten punktförmigen THz-Emittern einige grundlegende Unterschiede auf. Diese Unterschiede sollen zunächst durch die in das Kapitel einführenden theoretischen Grundlagen herausgearbeitet und danach anhand eines elektrooptischen Emitters und eines elektrisch vorgespannten Halbleiteremitters überprüft werden. In den folgenden Kapiteln wendet sich der Fokus dann mehr der Anwendung von THz-Strahlung zu. Dazu finden im vierten Kapitel Überlegungen und Experimente zu der Charakterisierung von, zunächst anorganischen, mehrschichtigen Systemen auf der Basis von Halbleiterstrukturen statt, die mit einem Ausblick auf eine biomedizinische Anwendung der THz-Strahlung, bei der Untersuchung von Zähnen, abgeschlossen werden. Im fünften Kapitel soll ein Silizium-Paraffin-Gemisch auf seine Stoffigenschaften untersucht werden. Für dieses Gemisch lassen sich die Stoffeigenschaften im THz-Bereich mittels des Mischungsverhältnisses der beiden Ausgangsmaterialien anpassen. Mögliche Anwendungen für ein solches Material sind indexangepasste Füllungen von Zwischenräumen, um störende Reflexionen an den jeweiligen Grenzflächen zu vermeiden; so wie die Konstruktion von Antireflexionsschichten für THz-Optiken. Beide Anwendungen werden in Form von Experimenten vorgestellt. Abschließend werden alle Ergebnisse in einem Fazit zusammengefasst, und es erfolgt ein Ausblick auf weitere Untersuchungen.
The electron-capture process was studied for Xe54+ colliding with H2 molecules at the internal gas target of the Experimental Storage Ring (ESR) at GSI, Darmstadt. Cross-section values for electron capture into excited projectile states were deduced from the observed emission cross section of Lyman radiation, being emitted by the hydrogenlike ions subsequent to the capture of a target electron. The ion beam energy range was varied between 5.5 and 30.9 MeV/u by applying the deceleration mode of the ESR. Thus, electron-capture data were recorded at the intermediate and, in particular, the low-collision-energy regime, well below the beam energy necessary to produce bare xenon ions. The obtained data are found to be in reasonable qualitative agreement with theoretical approaches, while a commonly applied empirical formula significantly overestimates the experimental findings.
1.Thedescriptionandanalysisofanimalbehavioroverlongperiodsoftimeisoneof the most important challenges in ecology. However, most of these studies are limited due to the time and cost required by human observers. The collection of data via video recordings allows observation periods to be extended. However, their evaluation by human observers is very time-consuming. Progress in automated evaluation, using suitable deep learning methods, seems to be a forward-looking approach to analyze even large amounts of video data in an adequate time frame.
2. In this study, we present a multistep convolutional neural network system for detecting three typical stances of African ungulates in zoo enclosures which works with high accuracy. An important aspect of our approach is the introduction of model averaging and postprocessing rules to make the system robust to outliers.
3. Our trained system achieves an in-domain classification accuracy of >0.92, which is improved to >0.96 by a postprocessing step. In addition, the whole system per- forms even well in an out-of-domain classification task with two unknown types, achieving an average accuracy of 0.93. We provide our system at https://github. com/Klimroth/Video-Action-Classifier-for-African-Ungulates-in-Zoos/tree/main/ mrcnn_based so that interested users can train their own models to classify im- ages and conduct behavioral studies of wildlife.
4. The use of a multistep convolutional neural network for fast and accurate clas- sification of wildlife behavior facilitates the evaluation of large amounts of image data in ecological studies and reduces the effort of manual analysis of images to a high degree. Our system also shows that postprocessing rules are a suitable way to make species-specific adjustments and substantially increase the accuracy of the description of single behavioral phases (number, duration). The results in the out-of-domain classification strongly suggest that our system is robust and achieves a high degree of accuracy even for new species, so that other settings (e.g., field studies) can be considered.