Risk of second primary tumors following treatment of non-small cell lung cancer

Background. The rise in survival rates along with more detailed follow-up using sophisticated imaging studies among non-small lung cancer (NSCLC) patients has led to an increased risk of second primary tumors (SPT) among these cases. Population and hospital based studies of lung cancer patients treated between 1974 and 1996 have found an increasing risk over time for the development of all cancers following treatment of non-small cell lung cancer (NSCLC). During this time the primary modalities for treatment were surgery alone, radiation alone, surgery and post-operative radiation therapy, or combinations of chemotherapy and radiation (sequentially or concurrently). There is limited information in the literature about the impact of treatment modalities on the development of second primary tumors in these patients. ^ Purpose. To investigate the impact of treatment modalities on the risk of second primary tumors in patients receiving treatment with curative intent for non-metastatic (Stage I–III) non-small cell lung cancer (NSCLC). ^ Methods. The hospital records of 1,095 NSCLC patients who were diagnosed between 1980–2001 and received treatment with curative intent at M.D. Anderson Cancer Center with surgery alone, radiation alone (with a minimum total radiation dose of at least 45Gy), surgery and post-operative radiation therapy, radiation therapy in combination with chemotherapy or surgery in combination with chemotherapy and radiation were retrospectively reviewed. A second primary malignancy was be defined as any tumor histologically different from the initial cancer, or of another anatomic location, or a tumor of the same location and histology as the initial tumor having an interval between cancers of at least five years. Only primary tumors occurring after treatment for NSCLC will qualified as second primary tumors for this study. ^ Results. The incidence of second primary tumor was 3.3%/year and the rate increased over time following treatment. The type of NSCLC treatment was not found to have a striking effect upon SPT development. Increased rates were observed in the radiation only and chemotherapy plus radiation treatment groups; but, these increases did not exceed expected random variation. Higher radiation treatment dose, patient age and weight loss prior to index NSCLC treatment were associated with higher SPT development. ^

Modeling survival and the development of second primary tumors among Hodgkin's disease patients

Hodgkin's disease (HD) is a cancer of the lymphatic system. Survivors of HD face varieties of consequent adverse effects, in which secondary primary tumors (SPT) is one of the most serious consequences. This dissertation is aimed to model time-to-SPT in the presence of death and HD relapses during follow-up.^ The model is designed to handle a mixture phenomenon of SPT and the influence of death. Relapses of HD are adjusted as a covariate. Proportional hazards framework is used to define SPT intensity function, which includes an exponential term to estimate explanatory variables. Death as a competing risk is considered according to different scenarios, depending on which terminal event comes first. Newton-Raphson method is used to estimate the parameter estimates in the end.^ The proposed method is applied to a real data set containing a group of HD patients. Several risk factors for the development of SPT are identified and the findings are noteworthy in the development of healthcare guidelines that may lead to the early detection or prevention of SPT.^

Palynology on a profile from the Krusné Hory Mountains

Site details: The raised bog Fláje-Kiefern (50°429N, 13°329 E; 760 m a.s.l.; size ca. 500x500 m) lies in the Krusné Hory Mountains (Erzgebirge), Czech Republic, about 10 km from Georgenfelder Moor in Germany. Hejny and Slavík (1988) described the phytogeographic region of the Krusne Hory Mountains as 'a region of mountain flora and vegetation, with thermophilous species largely missing. In the natural forests, conifers, especially spruce (Picea excelsa) prevail. The deforested areas have been converted into meadows and pastures'. The climate is cool with annual average temperatures of about 5°C and annual precipitation of about 900 mm. The bedrock is Precambrian crystallinicum.

Lithology, age determination and pollen records of five profiles for nothern Bavaria, Germany

Palynological investigations in northeastern Bavaria (Bavarian Vogtland, Fichtelgebirge, Steinwald) reveal the Late Glacial and Postglacial history of the regional vegetation. Radiocarbon data in comparison with those from the neighbouring regions (Rhön, Oberpfälzer Wald, Bavarian Forests) show a time lag in the development of the arboreal vegetation due to migration processes. The Fichtelgebirge is the southernmost part ofnortheastern Bavaria where the early Alleröd period (pollen zone IIa) is characterised by a dominance of birch forests. Hazel reached maximal values around 8000 BP in the area from the Fichtelgebirge to the Bavarian Forests, e.g. about 600 years earlier than in the more northern Rhön mountains. For spruce there is a considerable time lag between the Bavarian Forests and the Fichtelgebirge. Spruce spreading started in the Fichtelgebirge during the older part of the Atlantic period (pollen zone VI). At the same time, spruce already was the dominant tree in the Bavarian Forests. During the younger part of the Atlantic period (pollen zone VII) spruce and mixed oak forest tree species frequently occurred in the Fichtelgebirge. At the end of pollen zone VI, spruce came to dominance. At the same time, the immigration of beech started. During the Subboreal period (pollen zone VIII), spruce remained being a dominant member in the forests and at the end of pollen zone VIII, fir began to spread rapidly. During the first part of the Subatlantic period (pollen zone IX) spruce, beech, fir and pine formed the mountainous forests in the Fichtelgebirge. In the area of the Bavarian Vogtland, however, fir was a dominant forest tree during pollen zone IX, while spruce and beech played a less important role. During the 12th century, human colonisation started in the area of the Fichtelgebirge. This is 400 years later as in the area of the Rhön mountains. Indicators for earlier forest clearances are rare or absent.

Lithology and pollen record of 4 profiles from the Bavaria, southern Germany

Palynological investigations of sediments from northern Bavaria (Rhön, Grabfeld, Lange Berge) reveal the Late Glacial and Postglacial history of the regional vegetation. The older sedirnents were found in the Rhön (Schwarzes Moor) and date back into the Bölling Period. At the end of that period pine spread into the Grabfeld. In both areas Lacher Tuff has been found. A radiocarbon date of 10,300 BP was found for the Late Glacial - Postglacial transition and one of 9300 BP for the Preboreal - Boreal transition. Hazel reached its highest values in the Rhön around 7,400 BP. During the Atlanticum a deciduous mixed oak forest covered the Rhön and Grabfeld regions. Beech dominated since the Subatlanticum. In the Lange Berge region, however, a mixed forest with Fagus, Picea, Pinus and Abies developed. In the Rhön first anthropogenic influence was found during the Latene Period. The boundary between zone IX and X has been dated at 820 A.D., and the start of extensive forest clearances at 1000 A. D. A culmination of landuse was found for the Medieval Period. At the end of that period however the Rhön was deserted. New forest clearances started around 1500 A.D., but were interrupted by the 'Thirty Years War'. Afterwards the Rhön got its present appearance.