Non-randomized therapy trial to determine the safety and efficacy of heavy ion radiotherapy in patients with non-resectable osteosarcoma

<p>Abstract</p> <p>Background</p> <p>Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. For effective treatment, local control of the tumor is absolutely critical, because the chances of long term survival are <10% and might effectively approach zero if a complete surgical resection of the tumor is not possible. Up to date there is no curative treatment protocol for patients with non-resectable osteosarcomas, who are excluded from current osteosarcoma trials, e.g. <it>EURAMOS1</it>. Local photon radiotherapy has previously been used in small series and in an uncontrolled, highly individualized fashion, which, however, documented that high dose radiotherapy can, in principle, be used to achieve local control. Generally the radiation dose that is necessary for a curative approach can hardly be achieved with conventional photon radiotherapy in patients with non-resectable tumors that are usually located near radiosensitive critical organs such as the brain, the spine or the pelvis. In these cases particle Radiotherapy (proton therapy (PT)/heavy ion therapy (HIT) may offer a promising new alternative. Moreover, compared with photons, heavy ion beams provide a higher physical selectivity because of their finite depth coverage in tissue. They achieve a higher relative biological effectiveness. Phase I/II dose escalation studies of HIT in adults with non-resectable bone and soft tissue sarcomas have already shown favorable results.</p> <p>Methods/Design</p> <p>This is a monocenter, single-arm study for patients ≥ 6 years of age with non-resectable osteosarcoma. Desired target dose is 60-66 Cobalt Gray Equivalent (Gy E) with 45 Gy PT (proton therapy) and a carbon ion boost of 15-21 GyE. Weekly fractionation of 5-6 × 3 Gy E is used. PT/HIT will be administered exclusively at the Ion Radiotherapy Center in Heidelberg. Furthermore, FDG-PET imaging characteristics of non-resectable osteosarcoma before and after PT/HIT will be investigated prospectively. Systemic disease before and after PT/HIT is targeted by standard chemotherapy protocols and is not part of this trial.</p> <p>Discussion</p> <p>The primary objectives of this trial are the determination of feasibility and toxicity of HIT. Secondary objectives are tumor response, disease free survival and overall survival. The aim is to improve outcome for patients with non-resectable osteosarcoma.</p> <p>Trail Registration</p> <p>Registration number (ClinicalTrials.gov): NCT01005043</p

Sicherung von Dämmen, Deichen und Stauanlagen : Handbuch für Theorie und Praxis ; Vol. V - 2015

Die Universität Siegen beschäftigt sich seit über 15 Jahren wissenschaftlich und im Bereich der anwendungsorientierten Forschung mit diesem Thema und hat dazu mittlerweile fünf Symposien durchgeführt. Mit der Veröffentlichung soll die langjährige Tradition als etablierte wissenschaftliche Plattform mit einem Wissensaustausch auf europäischer Ebene fortgesetzt werden. Die Bearbeitung dieser Thematik erfolgt auf der Basis der bewährten Kooperation zwischen Geotechnik und Wasserbau an der Universität Siegen. Aktuelle Ereignisse, wie z.B. die aus England oder Australien im Februar des Jahres 2014, machen uns aber auch deutlich, dass ein absoluter Schutz gegen Extremereignisse nicht möglich ist. Sie zeigen aber auch, dass dort wo technischer Hochwasserschutz konsequent umgesetzt wurde Schäden vermieden werden konnten. Wir sind nach den Ereignissen in den vergangenen Jahren aufgefordert wissenschaftlich noch leistungsfähigere und duktilere Systeme zu entwickeln. Weiter ist die Wissenschaft in der Pflicht, die Zivile Sicherheit im Hochwasser-schutz permanent zu bewerten, zu bearbeiten und ganzheitliche-interdisziplinäre und länderübergreifende Lösungen für die Zivilgesellschaft einzufordern

Better spiritual support for people living with early stage dementia: Developing the diamond conversation model

This dataset is for replication and follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

Spiritual conversation model for patients and loved ones in palliative care: a validation study

This dataset is for follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

How to attune to spiritual sources of strength of people with mild to moderate dementia

This dataset is for replication and follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

How to attune to spiritual sources of strength of people with mild to moderate dementia

This dataset is for replication and follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

How can existential or spiritual strengths be fostered in palliative care? An interpretative synthesis of recent literature

This dataset is for replication and follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

How to provide existential and spiritual support to people with mild to moderate dementia and their loved ones. A pilot study.

This dataset is for replication and follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

Spiritual conversation model for patients and loved ones in palliative care: a validation study

This dataset is for follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description

Better spiritual support for people living with early stage dementia: Developing the diamond conversation model

This dataset is for replication and follow-up research purposes. It consists of all key documents from data collection to data analysis of the research project. See the readme document for the relevant procedure and document description