Concomitant Cisplatin and Hyperfractionated Radiotherapy in Locally Advanced Head and Neck Cancer: Ten-year Follow-up of a Randomized Phase III Trial (SAKK 10/94)

Purpose/Objective(s): To analyze the long-term outcome of treatment with concomitant cisplatin and hyperfractionated radiotherapy in locally advanced head and neck cancer compared with hyperfractionated radiotherapy alone.Materials/Methods: From July 1994 to July 2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiotherapy (median dose 74.4 Gy; 1.2 Gy twice daily) or the same radiotherapy combined with two cycles of concomitant cisplatin (20mg/m2 for 5 consecutive days of weeks 1 and 5). The primary endpoint was time to any treatment failure; secondary endpoints were locoregional failure, metastatic failure, overall survival, and late toxicity assessed according to RTOG criteria. The trial was registered at the National Institutes of Health (www.clinicaltrials.gov; identifier number: NCT00002654).Results: Median follow-up was 9.5 years (range, 0.1 - 15.4 years). Median time to any treatment failure was not significantly different between treatment arms (p = 0.19). Locoregional control (p\0.05), distant metastasis-free survival (p = 0.02) and cancer specific survival (p = 0.03) were significantly improved in the combined treatment arm, with no difference in late toxicity between treatment arms. However, overall survival was not significantly different (p = 0.19). Conclusions: After long-term follow-up combined treatment with cisplatin and hyperfractionated, radiotherapy maintained an improved locoregional control, distant metastasis-free survival, and cancer specific survival as compared to hyperfractionated radiotherapy alone with no difference in late toxicity.Author Disclosure: P. Ghadjar, None; M. Simcock, None; G. Studer, None; A.S. Allal, None; M. Ozsahin, None; J. Bernier, None; M. To¨ pfer, None; F. Zimmermann, None; C. Glanzmann, None; D.M. Aebersold, None.

Friday Facts, March 25, 2011, Vol. 94

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

Detection of serum antibodies against Leishmania 94 kDa antigen in visceral and cutaneous leishmaniosis due to Leishmania infantum.

Leishmania promastigotes polypeptides are analyzed by immunoblotting with sera from patients infected with different Leishmania species and presenting visceral or cutaneous infections. These sera recognize Leishmania polypeptides in several molecular masses. The major findings of this study are as follow. 1) The Leishmania 94 kDa antigen, which is specifically recognized by all sera from L. infantum-infected patients with visceral infection, is recognized by some sera from L. infantum-infected patients presenting cutaneous infection. 2) All patients with cutaneous infections due to L. tropica, L. amazonensis, or L. guyanensis do not develop anti-94 kDa antibodies, whatever the Leishmania species used as antigens. 3) Difference in electrophoretic mobilities is seen between the 94 kDa antigen identified by sera from Leishmania infantum-infected patients, and the antigen both recognized by the Concavalin A lectin and a rabbit antiserum raised against deglycosylated Promastigote Surface Protease.

Laboratory Testing of SHRP SPS-2 P.C.C. Mixes, MLR-94-5, 1995

This research evaluated the concrete strength of two mixes which were used in the Polk County project NHS-500-1(3)--10-77 and were developed to meet a contract requirement of 900 psi third-point 28-day flexural strength. Two concrete mixes, the Proposed Mix and the Enhanced Mix, were tested for strength. Based on the experimental results, it was found that the addition of 50 lb of cementitious materials did not significantly increase concrete strength. The requirement of 900 psi 28-day third-point flexural strength (MOR-TPL) was not achieved by this amount of addition of cementitious materials.

Coarse Aggregate Gradations for P.C. Concrete, MLR-94-8, 1995

The effect of coarse aggregate gradation and cement content on strength of concrete was studied. Concrete made of Iowa Department of Transportation Standard Mix C-3 and Aggregate Gradation No. 3 were selected as reference. C-3 proportions were used for mixes #1 and #2. C-3 mix with 10% reduction of the cement content was used for mix #3. C-3 mix with 20% reduction of the cement content was used for mix #4. On the other hand, mix #1 used coarse aggregate of Gradation No. 3, while mixes #2, #3, and #4 used coarse aggregate mix of 65% concrete stone and 35% 3/8 in. chips. It was found that strengths of portland cement concrete decrease with decreasing cement factor. On the other hand, 35% of chip replacement for coarse aggregate increases strengths of concrete. By replacing 35% of coarse aggregate with chips, one could reduce cement factor 10% and achieve equivalent strengths.

Heat Dissipation and Crack Control in Massive Concrete at the Burlington Bridge, MLR-94-1, 1995

The large concrete placements at the Burlington Bridge were expected to cause great temperature differentials within the individual placements. In an attempt to reduce cracking due to the large temperature differentials, the Iowa Department of Transportation required that contractors continuously monitor the temperatures and temperature differentials in the concrete placement to assure that the temperature differentials did not exceed 35 deg F. It was felt that if temperature differentials remained below 35 deg F, cracking would be minimized. The following is a summary of the background of the project, and what occurred during individual concrete placements. The following conclusions were drawn: 1) Side temperatures are cooler and more greatly affected by ambient air temperatures; 2) When the 35 deg F limit was exceeded, it was almost exclusively the center to side differential; 3) The top temperature increases substantially when a new pour is placed; 4) The use of ice and different cement types did seem to affect the overall temperature gain and the amount of time taken for any one placement to reach a peak, but did not necessarily prevent the differentials from exceeding the 35 deg F limit, nor prevent cracking in any placement; and 5) Larger placements have a greater tendency to exceed the differential limit.

Freeze-Thaw Durability of Concretes with and without Class C Fly Ash, MLR-94-9 Phase I, 1997

The freeze-thaw resistance of concretes was studied. Nine concrete mixes, made with five cements and cement-Class C fly ash combinations, were exposed to freeze-thaw cycling following 110 to 222 days of moist curing. Prior to the freeze-thaw cycling, the specimens were examined by a low-vacuum scanning electron microscope (SEM) for their microstructure. The influence of a wet/dry treatment was also studied. Infilling of ettringite in entrained air voids was observed in the concretes tested. The extent of the infilling depends on the period of moist curing as well as the wet/dry treatment. The concretes with 15% Class C fly ash replacement show more infilling in their air voids. It was found that the influence of the infilling on the freeze-thaw durability relates to the air spacing factor. The greater the spacing factor, the more expansion under the freeze-thaw cycling. The infilling seems to decrease effective air content and to increase effective spacing factor. The infilling also implies that the filled air voids are water-accessible. These might lead to concrete more vulnerable to the freeze-thaw attack. By combining the above results with field observations, one may conclude that the freeze-thaw damage is a factor related to premature deterioration of portland cement concrete pavements in Iowa.