Physical examination during chemoradiation predicts outcome of locally advanced head and neck cancer. Secondary results of a randomized phase III trial (SAKK 10/94)

OBJECTIVES To analyze the prognostic value of clinical tumor response during chemoradiation for locally advanced head and neck cancer. PATIENTS AND METHODS The locoregional response at 50.4Gy was assessed by physical examination (PE) in patients treated within the randomized trial SAKK 10/94 using hyperfractionated radiotherapy (RT), median total dose 74.4Gy with or without cisplatin 20mg/m(2) chemotherapy on 5 consecutive days during weeks 1 and 5 or 6 of RT. Response was classified as a complete response (CR), complete response with uncertainty (Cru), partial response (PR), stable disease (SD), or progressive disease (PD). The primary endpoint was time to treatment failure (TTF) due to any cause. Secondary endpoints included locoregional-recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Univariate and multivariate Cox proportional hazards (PH) models were applied to analyze the associations between survival endpoints and clinical tumor response. RESULTS A total of 136, 131 and 97 patients were evaluable for response at the primary tumor, lymph nodes and both sites combined, respectively. At 50.4Gy 57/136 (42%), 46/131 (35%) and 21/97 (22%) patients had a good response (CR/Cru vs. PR/SD) at the primary tumor, the lymph nodes, and both sites combined, respectively. The median follow-up times were 11.4, 9.6 and 11.4years for the three groups. Good responses were all significantly associated with improved TTF, LRRFS, DMFS and OS in univariate analysis whereas good response at the primary tumor and lymph nodes remained significantly associated with TTF and OS after multivariate Cox PH models. CONCLUSIONS Locoregional response at 50.4Gy was identified as predictor of oncologic outcome. PE during treatment should not be underestimated in clinical practice.

The role of postoperative prophylactic antibiotics in the treatment of facial fractures: a randomised, double-blind, placebo-controlled pilot clinical study. Part 3: Le Fort and zygomatic fractures in 94 patients

The aim of this study was to evaluate the difference between the effect of a 5-day and a 1-day postoperative course of antibiotics on the incidence of infection after midfacial fractures. A total of 98 patients with displaced Le Fort or zygomatic fractures that required operation were randomly assigned into 2 groups, both of which were given amoxicillin/clavulanic acid 1.2g intravenously every 8h from the time of admission until 24h postoperatively. The 5-day group was then given amoxicillin/clavulanic acid 625mg orally 8-hourly for another 4 days. The 1-day group was given placebo orally at the same time points. Patients were followed up 1, 2, 4, 6, and 12 weeks, and 6 months, postoperatively. The development of an infection of the wound was the primary end point. Ninety-four of the 98 patients completed the study. Two of the 45 patients in the 5-day group (4%) and 2/49 in the 1-day group (4%) developed postoperative wound infections. One in each group had a purulent infection, while the others had only wound breakdown. Two patients of the 5-day group and one in the 1-day group developed rashes on the trunk. There were no significant differences in the incidence of infection or side effects between the groups. In midfacial fractures a 1-day course of antibiotics postoperatively is as effective in preventing infective complications as a 5-day regimen.

Ms. hebr. oct. 94 - Derashot u-minhagim

Vorbesitzer: Abraham Merzbacher

Ms. Barth. 94 - Antiphonarium (Sommerteil) für St. Bartholomaeus

Vorbesitzer: Bartholomaeusstift Frankfurt am Main

Impact of weight loss on survival after chemoradiation for locally advanced head and neck cancer: secondary results of a randomized phase III trial (SAKK 10/94).

BACKGROUND To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer. METHODS From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end. RESULTS The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 - 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes. CONCLUSIONS Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival.

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 94 - Aufzählung zwischenzeitlicher Aktivitäten anlässlich einer längeren Schreibpause

u.a.: Lubber; Dumas;

Ms. Praed. 94 (Ausst. 72) - Summarius in quartum Sententiarum Petri Lombardi

Vorbesitzer: Dominikanerkloster Frankfurt am Main

Ausst. 94 - Maria mit der Einhornjagd

Das Blatt stammt aus der Inkunabel Inc. oct. 320 (Ohly/Sack 3003)

Ms.Ff.F.Stoltze 3. 94 - Brief von E. Gottlieb an Friedrich Stoltze

"Zum Himmel sei dein Angesicht gekehrt", "Euch neid' ich nicht, ihr armen Thoren", Frankfurter Latern, Übersetzung von Gedichten in das Elsässische, "Hast du die dreißig Gulde krieht", "Der Dambor un die Bäckermahd"

Der Winter 94/95 in San Remo

Paul Bräuer

Ms. lat. oct. 94 - Psalterium

Vorbesitzer: LOP; Maria Frankhe; Hans Adam von Reisach; Maria von Wobeser (geb. Scherbius)

Über die Organisation der Kaiserlichen Schutztruppe in Deutsch-Ostafrika und die kriegerischen Operationen daselbst während der Jahre 1893/94 : Vortrag

von von Schele

Durch Afrika von Ost nach West : Resultate und Begebenheiten einer Reise von der Deutsch-Ostafrikanischen Küste bis zur Kongomündung in den Jahren 1893/94

von G. A. von Götzen

Adamaua : Bericht über die Expedition des Deutschen Kamerun-Komitees in den Jahren 1893/94

von Siegfried Passarge