Secondary Cancer Risk for Stage I Seminoma Patients - a Comparison of Adjuvant Treatment Versus Surveillance

Background: Post-surgical management of stage I seminoma includes: surveillance with repeated CT-scans and treatment reserved for those who relapse, or adjuvant treatment with either immediate radiation therapy (RT) or carboplatin. The cancer specific survival is close to 100%. Cure without long-term sequelae of treatment is the aim. Our goal is to estimate the risk of radiation-induced secondary cancers (SC) death from for patients undergoing S, adjuvant RT or adjuvant carboplatin (AC).Materials and Methods: We measured organ doses from CT scans (3 phases each one) of a seminoma patient who was part of the active surveillance strategy and from a man undergoing adjuvant RT 20-Gy and a 30-Gy salvage RT treatment to the para-aortic area using helical Intensity Modulated RT (Tomotherapy®) with accurate delineation of organs at risk and a CTV to PTV expansion of 1 cm. Effective doses to organs in mSv were estimated according to the tissue-weighting factors recommendations of the International Commission on Radiological Protection 103 (Ann ICRP 2007). We estimated SC incidence and mortality for a 10,000 people population based on the excess absolute risk model from the Biological Effects of Ionizing Radiation (BEIR) VII (Health Risk of Exposure to Low Levels of Ionizing Radiation, NCR, The National Academies Press Washington, DC, 2006) assuming a seminoma diagnosis at age 30, a total life expectancy of 80 years.Results: The nominal risk for a fatal secondary cancers was calculated 1.5% for 15 abdominal CT scans, 14.8% for adjuvant RT (20 Gy paraaortic field) and 22.2% for salvage RT (30 Gy). The calculation assumed that the risk of relapse on surveillance and adjuvant AC was 15% and 4% respectively and that all patients were salvaged at relapse with RT. n CT abdomen/Pelvis = secondary cancer % RT Dose and % receiving treatment = secondary cancer % Total secondary cancer risk in % Active surveillance 15 = 1.5% 30 Gy in 15% of pts = 3.3% 4.8 Adjuvant carboplatin 7 = 0.7% 30 Gy in 4% of pts = 0.88% 1.58 Adjuvant radiotherapy 7 = 0.7% 20 Gy in 100% of pts = 14.8% 15.5Conclusions: These data suggest that: 1) Adjuvant radiotherapy is harmful and should not anymore be regarded as a standard option for seminoma stage I. 2) AC seems to be an option to reduce radiation induced cancers. Limitations: the study does not consider secondary cancers due to chemotherapy with AC (unknown). The use of BEIR VII for risk modeling with higher doses of RT needs to be validated.

Cela Espín, X. i Revilla Calvo, V., Annexos de Jaume Buxeda i Garrigós i Miquel Ângel Cau Ontiveros; Mariana Pérez-Sala i Rodés; Eva Orri Terrado i Alicia Estrada Martín.: La transició del municipium d'Iluro a Alarona (Mataró). Cultura material i transformacions d"un espai urbà entre els segles V i VII dC. Laietania, 15, 2004

Aquest llibre reuneix un estudi arqueològic extraordinàriament acurat referit a tot un seguit d'actuacions detectades a partir del registre arqueològic, que caracteritzen l'espai urbà de l'antiga Iluro durant el període de l'Antiguitat tardana. S'hi estudia amb molt deteniment cadascuna de les accions detectades -així com tot el mobiliari ceràmic relacionat- amb la finalitat de situar-les correctament en el temps, però també per entendre, a través de la cultura material, la dinàmica que pren la ciutat a les darreries de l'Antiguitat; per a poder intuir, més que saber, quina societat es desenvolupa darrere d¿aquests contenidors plens de productes alimentaris arribats d¿un ultramar llunyà i alhora molt proper; una societat capaç de respondre a l¿estímul exterior amb una producció pròpia que competirà o substituirà una gran part de la que ve de fora.

Rhetorica sacra ; sive sancti Augustini De doctrina christiana liber quartus : ad usum studiosae juventutis / ed. ac notis illustravit A.-F. Maunoury,...

[La doctrine chrétienne (latin). Extrait. 1854]

Euphorbia L. subsect. Esula (Boiss. in DC.) Pax in the Iberian Peninsula. Leaf surface, chromosome numbers and taxonomic treatment

Presentem l'estudi taxonòmic dels représentants d'Euphorbia subsect. Esula a la Península Ibèrica. Prèviament, s'inclou un primer capítol dedicai a l'estudi de les epidermis foliars i un segon capítol sobre nombres cromosòmics...

A proposito de los generos Aconitum L. y Consolida (DC.) S.F.Gray en la Peninsula Iberica.

Seguimos para este taxon, en lo nomenclatural, a TAMURA & LAUENER (1979:459), mientras no se tipifique de forma adecuada A. lycoctonum L., considerado nom. ambig. ya por TUTIN (1964:212), con pocas posibilidades de que no sea diverso de A. vulparia. A. pyrenaicum L. es también algo muy distinto del taxon que nos ocupa y, en caso de no ser aceptada la proposición de que se lo considere ñamen rejiciendum, hecha por TAMURA & LAUENER (Le.: 447), seria el nombre correcto para A. barbatum Pers. (=A. squarrosum DC.) de Siberia. Otro nombre que aún podría ser prioritario, A. altissimum Miller (WARNCKE, 1964:30; TAMURA & LAUENER, l.c), no puede usarse en tanto no se localice algún material de aquel en que se basó la descripción un tanto ambigua de Miller....

Senecio pterophorus DC., a new alien species in the European mainland

Senecio pterophorus DC. is an erect, semilignose shrub (fig. 1) which grows up to 2 m high. Is a chamaephyte basipetal branch-shedder (ORSHAN, Plant pheno-morphological studies in Mediterranean type ecosystems: 210-211. 1989) whose new branches appear below inflorescences but not from the lower parts of the plant. Leaves lanceolate. Stems are annual and develop at their apex a great number of small (up to 15 mm in diameter) yellow capitula which are grouped in a corymbose-paniculated inflorescence (HARVEY & SONDER, Flora Capensis: Cape Colony, Caffraria & Port Natal 3: 386.1865).

2me catalogue d'estampes composant le cabinet de M. L... [Laterrade] Vente 20 déc. 1858... / rédigé par A. Rochoux... ; [expert] Vignères

[Vente. Estampes. 1858-12-20 - 1858-12-22. Paris]

Bulla innovationis litterarū Contra invadentes hostiliter Terras & Loca. S. R. E. ac Monitorii penalis Cōtta Iniquitatis Filium Franciscū Mariā. Le Ruuene Et eius sequaces & fautores & Consilium p̄titores machinates cuadere Terras S. R... (Janvier 1517.)

[Acte pontifical. 1517-01-00]

Asphalt Cement Containing AC-13, HR-522, Construction Report, 1985

Stopping and turning maneuvers on high traffic volume asphalt cement concrete surfaced roads and streets often causes distortion of the pavement. Distortion may show up as excessive rutting in the wheel path, shoving of the pavement and/or rippling of the surface. Often times repeated corrective work such as cold milling or heater planing is required in these areas to maintain the pavement surface in a reasonable condition. In recent years polymer additives have been developed for asphalt cement concrete paving mixes that show promise in improving the inplace stability of the pavements. AC-13 (Styrelf 13) available from Bitucote Products Company, St. Louis, Missouri is an asphalt cement that has been modified by an additive to exhibit characteristics of very high stability in asphalt mixes.