Lowered Cisplatin Dose And No Bleomycin In The Treatment Of Pediatric Germ Cell Tumors: Results Of The Gct-99 Protocol From The Brazilian Germ Cell Pediatric Oncology Cooperative Group

Purpose We describe the results of a risk-adapted, response-based therapeutic approach from the Brazilian GCT-99 study on germ cell tumors. Patients and Methods From May 1999 to October 2009, 579 participants were enrolled in the Brazilian GCT-99 study. Treatment, defined as specific chemotherapy regimen and number of cycles, was allocated by means of risk-group assignment at diagnosis with consideration for stage and primary tumor site. Patients at low risk received no chemotherapy. Patients at intermediate risk (IR) with a good response (GR) received four cycles of platinum and etoposide (PE), for total doses of platinum 420 mg/m2 and etoposide 2,040 mg/m2. Patients at IR with a partial response (PR) received three cycles of PE plus three cycles of ifosfamide, vinblastine, and bleomycin. Patients at high risk (HR) with a GR received four cycles of PE and ifosfamide (PEI) at total doses of platinum 420 mg/m2, etoposide 1,200 mg/m2, and ifosfamide 30 g/m2. Patients at HR with a PR received six cycles of PEI. Results The risk-group distribution was 213 LR, 138 IR, and 129 HR for 480 evaluable patients. Overall survival (OS) and event-free survival (EFS) rates at 10 years were, respectively, 90% and 88.6% in the IR-GR group (n = 126) and 74.1% and 74.1% in the IR-PR group (n = 12). Ten-year rates for the HR-GR group (n = 86) were an OS of 66.8% and an EFS of 62.5%. The HR-PR group (n = 43) had an OS of 74.8% and an EFS of 73.4%. In univariable and multivariable analysis, increased serum lactate dehydrogenase level and histology for a metastatic immature teratoma were prognostic of a worsened outcome. Conclusion Reduction of therapy to two drugs did not compromise survival outcomes for patients in the IR-GR group, and escalation of therapy with PEI did not significantly improve OS and EFS in patients at HR. © 2016 by American Society of Clinical Oncology.34660361

Root system characteristics of Marandu palisadegrass supplied with nitrogen and magnesium rates

The development of root system of forage grasses is influenced by the supply of mineral nutrients. The experiment was carried out in a greenhouse in Piracicaba, São Paulo State, with the objective of evaluating the effect of nitrogen and magnesium rates on dry mass yield, total length and surface, specific length and surface, and concentrations of nitrogen, magnesium, calcium and potassium in the root system of Brachiaria brizantha Stapf. cv. Marandu. It was studied five rates of nitrogen (2, 9, 16, 23 and 30 mmol L-1) and five rates of magnesium (0.05, 0.70, 1.35, 2.00 and 2.65 mmol L-1) in nutrient solutions in an incomplete 5² factorial arrangement, which resulted in the following combinations: 2/0.05; 2/1.35; 2/2.65; 9/0.70; 9/2.00; 16/0.05; 16/1.35; 16/2.65; 23/0.70; 23/2.00; 30/0.05; 30/1.35 and 30/2.65. The experimental design was a randomized block with four replications. Plants had two growth periods, and after the second harvest the roots were separated from the plant tops. Combination of the high rates of nitrogen and magnesium resulted in expressive increases in rooty dry matter yield, in the length and in the root surface of marandu palisadegrass. High rates of nitrogen and magnesium resulted in short root specific length and surface. Combinations of high rates of nitrogen and magnesium increased nitrogen concentration or decreased potassium concentration in the roots. Calcium concentration in the roots was increased by nitrogen rates and decreased by magnesium rates. Magnesium rates resulted in increase in magnesium concentration in the roots of marandu palisadegrass