Impact of Radiotherapy, Chemotherapy and Surgery in Multimodal Treatment of Locally Advanced Esophageal Cancer

Objectives: It was the aim of this study to assess our institutional experience with definitive chemoradiation (CRT) versus induction chemotherapy followed by CRT with or without surgery (C-CRT/S) in esophageal cancer. Methods: We retrospectively analyzed 129 institutional patients with locally advanced esophageal cancer who had been treated by either CRT in analogy to the RTOG 8501 trial (n = 78) or C-CRT/S (n = 51). Results: The median, 2-and 5-year overall survival (OS) of the entire collective was 17.6 months, 42 and 24%, respectively, without a significant difference between the CRT and C-CRT/S groups. In C-CRT/S patients, surgery statistically improved the locoregional control (LRC) rates (2-year LRC 73.6 vs. 21.2%; p = 0.003); however, this was translated only into a trend towards improved OS (p = 0.084). The impact of escalated radiation doses (>= 60.0 vs. <60.0 Gy) on LRC was detectable only in T1-3 N0-1 M0 patients of the CRT group (2-year LRC 77.8 vs. 42.3%; p = 0.036). Conclusion: Definitive CRT and a trimodality approach including surgery (C-CRT/S) had a comparable outcome in this unselected patient collective. Surgery and higher radiation doses improve LRC rates in subgroups of patients, respectively, but without effect on OS. Copyright (C) 2012 S. Karger AG, Base

Hydrogen absorption in epitaxial W Nb 001 and polycrystalline Fe Nb 110 multilayers studied in situ by X ray neutron scattering techniques and X ray absorption spectroscopy

Hydrogen can be absorbed in large quantities by 100 {angstrom} thin Nb layers embedded in epitaxial W/Nb and polycrystalline Fe/Nb multilayers. The solubility and the hydrogen-induced structural changes of the host lattice are explored in-situ by small-angle neutron/X-ray reflectometry and high-angle diffraction. These measurements reveal for both systems that the relative out-of-plane expansion of the Nb layers is considerably larger than the relative increase of the Nb interplanar spacing indicating two distinctly different mechanisms of hydrogen absorption. In Fe/Nb multilayers, hydrogen expands the Nb interplanar spacing in a continuous way as function of the external pressure. In contrast, the Nb lattice expansion is discontinuous in epitaxial W/Nb multilayers: A jump in the Nb(002) Bragg reflection position occurs at a critical hydrogen pressure of 1 mbar. In-situ EXAFS spectroscopy also exhibits an irreversible expansion of the Nb lattice in the film plane for p{sub H{sub 2}}&gt; 1 mbar. This can be regarded as a structural phase transition from an exclusively out-of-plane to a three-dimensionally expanded state at low and high hydrogen pressures, respectively