Trophic relationships of zooplankton in the eastern Mediterranean based on stable isotope measurements

Abundance and stable isotope composition of large and small mesozooplankton were analyzed in samples taken with 333 and 100 μm nets, respectively, at four sites in the eastern Mediterranean down to 4200 m depth in October 2001. Large mesozooplankton (333 μm nets) was sieved into five size fractions, and the δ13C and δ15N values of the fractions were measured as well as the δ15N values of total small mesozooplankton (100 μm nets) and specific mesozooplankton taxa. These measurements allow insights into the source of the diet and the trophic level relative to sinking and suspended particulate organic matter. Overall, biomass and abundance of zooplankton was low, reflecting the oligotrophic character of the eastern Mediterranean. Stable nitrogen isotope values of mesozooplankton were low (1–4‰) and close to zero in suspended particles at the surface. This indicates that the fixation of atmospheric nitrogen probably contributes to the N-pool in the eastern Mediterranean. Such low values were also found in sinking particles in deep waters and in most zooplankton size classes. However, suspended particles and mesozooplankton in the size class 0.5–1 mm, which was primarily composed of the deep-sea species Lucicutia longiserrata, showed higher values at depths below 1000 m. There is some indication that L. longiserrata was able to utilize the suspended particle pool in the deep eastern Mediterranean

Stereotactic Body Radiation Therapy as an Alternative Treatment for Patients with Hepatocellular Carcinoma Compared to Sorafenib: A Propensity Score Analysis

Background and Aims: Stereotactic body radiation therapy (SBRT) has emerged as a safe and effective treatment for patients with hepatocellular carcinoma (HCC), but its role in patients with advanced HCC is not yet defined. In this study, we aim to assess the efficacy and safety of SBRT in comparison to sorafenib treatment in patients with advanced HCC. Methods: We included 901 patients treated with sorafenib at six tertiary centers in Europe and Asia and 122 patients treated with SBRT from 13 centers in Germany and Switzerland. Medical records were reviewed including laboratory parameters, treatment characteristics and development of adverse events. Propensity score matching was performed to adjust for differences in baseline characteristics. The primary endpoint was overall survival (OS) and progression-free survival. Results: Median OS of SBRT patients was 18.1 (10.3-25.9) months compared to 8.8 (8.2-9.5) in sorafenib patients. After adjusting for different baseline characteristics, the survival benefit for patients treated with SBRT was still preserved with a median OS of 17.0 (10.8-23.2) months compared to 9.6 (8.6-10.7) months in sorafenib patients. SBRT treatment of intrahepatic lesions in patients with extrahepatic metastases was also associated with improved OS compared to patients treated with sorafenib in the same setting (17.0 vs. 10.0 months, p = 0.012), whereas in patients with portal vein thrombosis there was no survival benefit in patients with SBRT. Conclusions: In this retrospective comparative study, SBRT showed superior efficacy in HCC patients compared to patients treated with sorafenib. (c) 2018 S. Karger AG, Base

Planning benchmark study for SBRT of early stage NSCLC

Purpose The aim was to evaluate stereotactic body radiation therapy (SBRT) treatment planning variability for early stage nonsmall cell lung cancer (NSCLC) with respect to the published guidelines of the Stereotactic Radiotherapy Working Group of the German Society for Radiation Oncology (DEGRO). Materials and methods Planning computed tomography (CT) scan and the structure sets (planning target volume, PTV; organs at risk, OARs) of 3 patients with early stage NSCLC were sent to 22 radiotherapy departments with SBRT experience: each department was asked to prepare a treatment plan according to the DEGRO guidelines. The prescription dose was 3 fractions of 15 Gy to the 65% isodose. Results In all, 87 plans were generated: 36 used intensity-modulated arc therapy (IMAT), 21 used three-dimensional conformal radiation therapy (3DCRT), 6 used static field intensity-modulated radiation therapy (SF-IMRT), 9 used helical radiotherapy and 15 used robotic radiosurgery. PTV dose coverage and simultaneously kept OARs doses were within the clinical limits published in the DEGRO guidelines. However, mean PTV dose (mean 58.0 Gy, range 52.8-66.4 Gy) and dose conformity indices (mean 0.75, range 0.60-1.00) varied between institutions and techniques (p <= 0.02). OARs doses varied substantially between institutions, but appeared to be technique independent (p = 0.21). Conclusion All studied treatment techniques are well suited for SBRT of early stage NSCLC according to the DEGRO guidelines. Homogenization of SBRT practice in Germany is possible through the guidelines; however, detailed treatment plan characteristics varied between techniques and institutions and further homogenization is warranted in future studies and recommendations. Optimized treatment planning should always follow the ALARA (as low as reasonably achievable) principle