Disease control and functional outcome in three modern combined organ preserving regimens for locally advanced squamous cell carcinoma of the head and neck (SCCHN)

<p>Abstract</p> <p>Purpose</p> <p>To report our experience on disease control and functional outcome using three modern combined-modality approaches for definitive radiochemotherapy of locally advanced SCCHN with modern radiotherapy techniques: radiochemotherapy (RChT), radioimmunotherapy (RIT) with cetuximab, or induction chemotherapy with docetaxel, cisplatin, and 5-FU (TPF) combined with either RChT or RIT.</p> <p>Methods</p> <p>Toxicity and outcome was retrospectively analysed in patients receiving definitive RChT, RIT, or induction chemotherapy followed by RChT or RIT between 2006 and 2009. Outcome was estimated using Kaplan-Meier analyses, toxicity was analysed according to CTCAE v 3.0.</p> <p>Results</p> <p>Thirty-eight patients were treated with RChT, 38 patients with RIT, 16 patients received TPF followed by either RChT or RIT. Radiotherapy was mostly applied as IMRT (68%). Long-term toxicity was low, only one case of grad III dysphagia requiring oesophageal dilatation, no case of either xerostomia ≥ grade II or cervical plexopathy were observed. Median overall survival (OS) was 25.7 months (RChT) and 27.7 months (RIT), median locoregional progression-free survival (PFS) was not reached yet. Subgroup analysis showed no significant differences between TPF, RChT, and RIT despite higher age and co-morbidities in the RIT group. Results suggested improved OS, distant and overall PFS for the TPF regimen.</p> <p>Conclusion</p> <p>Late radiation effects in our cohort are rare. No significant differences in outcome between RChT and RIT were observed. Adding TPF suggests improved progression-free and overall survival, impact of TPF on locoregional PFS was marginal, therefore radiotherapeutic options for intensification of local treatment should be explored.</p

Odorous childhoods and scent(ed) worlds of learning: A sensory history of health and outdoor education initiatives in Western Europe (1900s-1960s)

This paper develops a sensory history of health and outdoor education initiatives which featured (non-)formal schooling, analyzing these as belonging to (a) scent(ed) and more generally sense(d) world(s) of learning. Working with photographs as sensory objects of affect, and using as examples Belgian and Luxembourg open-air schools and associated sanitary and social welfare provisions, the paper explores issues so far under-researched in sensuous scholarship internationally: those of precise educational purposes, methods, processes and effects of sensory engagement, particularly pertaining to “smell”. Sensory practices and experiences and uses of senses generally are thereby traced in/as “situated, embodied” movements inextricably “enmeshed” with symbolism. The paper argues that while the educational goals underpinning the initiatives investigated and the approaches and practices characterizing these have changed, some (un)intended effects still have an impact today, for instance through Forest School as given shape in the United Kingdom. The concept of “odorous”, or rather “sensuous childhoods”, is proposed to denote ways that particular target groups have come to be imagined as in need of explicitly sensorial health and outdoor education