Inequalities in mortality of men by oral and pharyngeal cancer in Barcelona, Spain and São Paulo, Brazil, 1995–2003

Abstract Background Large inequalities of mortality by most cancers in general, by mouth and pharynx cancer in particular, have been associated to behaviour and geopolitical factors. The assessment of socioeconomic covariates of cancer mortality may be relevant to a full comprehension of distal determinants of the disease, and to appraise opportune interventions. The objective of this study was to compare socioeconomic inequalities in male mortality by oral and pharyngeal cancer in two major cities of Europe and South America. Methods The official system of information on mortality provided data on deaths in each city; general censuses informed population data. Age-adjusted death rates by oral and pharyngeal cancer for men were independently assessed for neighbourhoods of Barcelona, Spain, and São Paulo, Brazil, from 1995 to 2003. Uniform methodological criteria instructed the comparative assessment of magnitude, trends and spatial distribution of mortality. General linear models assessed ecologic correlations between death rates and socioeconomic indices (unemployment, schooling levels and the human development index) at the inner-city area level. Results obtained for each city were subsequently compared. Results Mortality of men by oral and pharyngeal cancer ranked higher in Barcelona (9.45 yearly deaths per 100,000 male inhabitants) than in Spain and Europe as a whole; rates were on decrease. São Paulo presented a poorer profile, with higher magnitude (11.86) and stationary trend. The appraisal of ecologic correlations indicated an unequal and inequitably distributed burden of disease in both cities, with poorer areas tending to present higher mortality. Barcelona had a larger gradient of mortality than São Paulo, indicating a higher inequality of cancer deaths across its neighbourhoods. Conclusion The quantitative monitoring of inequalities in health may contribute to the formulation of redistributive policies aimed at the concurrent promotion of wellbeing and social justice. The assessment of groups experiencing a higher burden of disease can instruct health services to provide additional resources for expanding preventive actions and facilities aimed at early diagnosis, standardized treatments and rehabilitation.

Studies of Heavy Baryons in DELPHI and Radiation Monitoring in DØ

Between the years 1992 and 1995 about 3.5 million hadronic Z decays were collected by the DELPHI detector at CERN. This data has been used to measure the production and lifetime of the beauty strange baryon Ξb, in the inclusive decay channel Ξb →Ξ-ℓ- X. The Ξ- baryon was reconstructed through the decay Ξ- → Λ π-, using a constrained fit method for cascade decays. An iterative discriminant analysis was used for the Ξb selection. A search for the Ξb baryon was also performed using an alternative method of reconstructing the Ξ- baryon. A measurement of the production of the charmed strange baryon Ξc in the decay channel Ξc → Ξ-π+ using the same data is also presented. The radiation monitoring system of the Silicon Microstrip Tracker in the DØ detector is studied and used to estimate the radiation dose received by the Silicon detector during normal running conditions of the TeVatron accelerator.

Systematic investigation of automated plan generation for breast cancer including beam angle and isocenter selection

Il tumore al seno è il più comune tra le donne nel mondo. La radioterapia è comunemente usata dopo la chirurgia per distruggere eventuali cellule maligne rimaste nel volume del seno. Nei trattamenti di radioterapia bisogna cercare di irradiare il volume da curare limitando contemporaneamente la tossicità nei tessuti sani. In clinica i parametri che definiscono il piano di trattamento radioterapeutico sono selezionati manualmente utilizzando un software di simulazione per trattamenti. Questo processo, detto di trial and error, in cui i differenti parametri vengono modificati e il trattamento viene simulato nuovamente e valutato, può richiedere molte iterazioni rendendolo dispendioso in termini di tempo. Lo studio presentato in questa tesi si concentra sulla generazione automatica di piani di trattamento per irradiare l'intero volume del seno utilizzando due fasci approssimativamente opposti e tangenti al paziente. In particolare ci siamo concentrati sulla selezione delle direzioni dei fasci e la posizione dell'isocentro. A questo scopo, è stato investigata l'efficacia di un approccio combinatorio, nel quale sono stati generati un elevato numero di possibili piani di trattamento utilizzando differenti combinazioni delle direzioni dei due fasci. L'intensità del profilo dei fasci viene ottimizzata automaticamente da un algoritmo, chiamato iCycle, sviluppato nel ospedale Erasmus MC di Rotterdam. Inizialmente tra tutti i possibili piani di trattamento generati solo un sottogruppo viene selezionato, avente buone caratteristiche per quel che riguarda l'irraggiamento del volume del seno malato. Dopo di che i piani che mostrano caratteristiche ottimali per la salvaguardia degli organi a rischio (cuore, polmoni e seno controlaterale) vengono considerati. Questi piani di trattamento sono matematicamente equivalenti quindi per selezionare tra questi il piano migliore è stata utilizzata una somma pesata dove i pesi sono stati regolati per ottenere in media piani che abbiano caratteristiche simili ai piani di trattamento approvati in clinica. Questo metodo in confronto al processo manuale oltre a ridurre considerevol-mente il tempo di generazione di un piano di trattamento garantisce anche i piani selezionati abbiano caratteristiche ottimali nel preservare gli organi a rischio. Inizialmente è stato utilizzato l'isocentro scelto in clinica dal tecnico. Nella parte finale dello studio l'importanza dell'isocentro è stata valutata; ne è risultato che almeno per un sottogruppo di pazienti la posizione dell'isocentro può dare un importante contributo alla qualità del piano di trattamento e quindi potrebbe essere un ulteriore parametro da ottimizzare. 

Fast and accurate numerical solutions in some problems of particle and radiation transport: synthetic acceleration for the method of short characteristics, Doppler-broadened scattering kernel, remote sensing of the cryosphere

The aim of this work is to present various aspects of numerical simulation of particle and radiation transport for industrial and environmental protection applications, to enable the analysis of complex physical processes in a fast, reliable, and efficient way. In the first part we deal with speed-up of numerical simulation of neutron transport for nuclear reactor core analysis. The convergence properties of the source iteration scheme of the Method of Characteristics applied to be heterogeneous structured geometries has been enhanced by means of Boundary Projection Acceleration, enabling the study of 2D and 3D geometries with transport theory without spatial homogenization. The computational performances have been verified with the C5G7 2D and 3D benchmarks, showing a sensible reduction of iterations and CPU time. The second part is devoted to the study of temperature-dependent elastic scattering of neutrons for heavy isotopes near to the thermal zone. A numerical computation of the Doppler convolution of the elastic scattering kernel based on the gas model is presented, for a general energy dependent cross section and scattering law in the center of mass system. The range of integration has been optimized employing a numerical cutoff, allowing a faster numerical evaluation of the convolution integral. Legendre moments of the transfer kernel are subsequently obtained by direct quadrature and a numerical analysis of the convergence is presented. In the third part we focus our attention to remote sensing applications of radiative transfer employed to investigate the Earth's cryosphere. The photon transport equation is applied to simulate reflectivity of glaciers varying the age of the layer of snow or ice, its thickness, the presence or not other underlying layers, the degree of dust included in the snow, creating a framework able to decipher spectral signals collected by orbiting detectors.

Successful treatment of childhood high-risk hepatoblastoma with dose-intensive multiagent chemotherapy and surgery: final results of the SIOPEL-3HR study

The primary objective was to determine the efficacy of a newly designed preoperative chemotherapy regimen in an attempt to improve the cure rate of children with high-risk hepatoblastoma.

Iterative Reconstruction Algorithm for Abdominal Multidetector CT at Different Tube Voltages: Assessment of Diagnostic Accuracy, Image Quality, and Radiation Dose in a Phantom Study

To assess the diagnostic accuracy, image quality, and radiation dose of an iterative reconstruction algorithm compared with a filtered back projection (FBP) algorithm for abdominal computed tomography (CT) at different tube voltages.

Detection of pancreatic tumors, image quality, and radiation dose during the pancreatic parenchymal phase: effect of a low-tube-voltage, high-tube-current CT technique--preliminary results

To intraindividually compare a low-tube-voltage (80 kVp), high-tube-current (675 mA) computed tomographic (CT) technique with a high-tube-voltage (140 kVp) CT protocol for the detection of pancreatic tumors, image quality, and radiation dose during the pancreatic parenchymal phase.

First-line tandem high-dose chemotherapy and autologous stem cell transplantation versus single high-dose chemotherapy and autologous stem cell transplantation in multiple myeloma, a systematic review of controlled studies

Several clinical studies have compared single with tandem (also called double) autologous stem cell transplantation (ASCT) as first-line treatment in patients with symptomatic multiple myeloma (MM), one of the leading indications for ASCT worldwide.

How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis

Background. No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). Methods. MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. Results. Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for “current use” of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. Conclusions. The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.

Radical prostatectomy in very high-risk localized prostate cancer: long-term outcomes and outcome predictors

The objective of this study was to present the long-term outcomes and determine outcome predictors in very high-risk (cT3b-T4) prostate cancer (PCa) after radical prostatectomy (RP).

The Swiss Childhood Cancer Registry: rationale, organisation and results for the years 2001-2005

QUESTIONS UNDER STUDY: Childhood cancer is a rare but severe disease. Therefore central registration of all cases is essential for surveillance and management. This paper describes the methodology and basic results of the Swiss Childhood Cancer Registry (SCCR). METHODS: The SCCR was established in 1976, originally as a national hospital-based registry of childhood malignancies. All 9 paediatric oncology-haematology clinics in Switzerland provide baseline and follow-up information on all children diagnosed with cancer. These data are registered centrally and diagnoses are coded according to the International Classification of Childhood Cancer. RESULTS: From 2001-2005, 887 cases of childhood cancer in Swiss residents under the age of 15 years were registered in the SCCR. Of these, 281 (31.7%) were leukaemias, 223 (24.0%) were CNS tumours, and 116 (13.1%) were lymphomas. The age-standardised annual incidence per 1 Million person-years (age below 15 years; world standardisation) was 154.0 (95% CI 143.7-164.3; N = 887). The incidence was higher for boys (170.2, 155.0-185.4; N = 501) than for girls (136.9, 123.0-150.8; N = 386). CONCLUSION: The close collaboration between all paediatric oncologists-haematologists in Switzerland and a university department allowed the creation of a national population-based cancer registry with detailed clinical information. The SCCR produces cancer type specific incidence and survival estimates and allows the development of nested research projects on childhood cancer aetiology, management and outcome, both on a national and on an international level.