Efficacy and Toxicity of Different Chemotherapy Protocols for Concurrent Chemoradiation in Non-Small Cell Lung Cancer—A Secondary Analysis of the PET Plan Trial

(1) Background: The optimal chemotherapy (CHT) regimen for concurrent chemoradiation (cCRT) is not well defined. In this secondary analysis of the international randomized PET-Plan trial, we evaluate the efficacy of different CHT. (2) Methods: Patients with inoperable NSCLC were randomized at a 1:1 ratio regarding the target volume definition and received isotoxically dose-escalated cCRT using cisplatin 80 mg/m2 (day 1, 22) and vinorelbin 15 mg/m2 (day 1, 8, 22, 29) (P1) or cisplatin 20 mg/m2 (day 1–5, 29–33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P2) or carboplatin AUC1 (day 1–5, 29–33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P3) or other CHT at the treating physician’s discretion. (3) Results: Between 05/2009 and 11/2016, 205 patients were randomized and 172 included in the per-protocol analysis. Patients treated in P1 or P2 had a better overall survival (OS) compared to P3 (p = 0.015, p = 0.01, respectively). Patients treated with carboplatin had a worse OS compared to cisplatin (HR 1.78, p = 0.03), but the difference did not remain significant after adjusting for age, ECOG, cardiac function creatinine and completeness of CHT. (4) Conclusions: Carboplatin doublets show no significant difference compared to cisplatin, after adjusting for possibly relevant factors, probably due to existing selection bias

Zur Rolle der Innenverwaltung im Dritten Reich bei der Vorbereitung und Organisation des Genozids an den Europäischen Juden. Der Fall des Dr. Wilhelm Stuckart (1902 – 1953)

The author argues that the Nazi state as a modern totalitarian state needed a legal framework to “organise“ a crime on the scale of the holocaust. Laws became a tool for rationalising the process of depriving Jewish citizens of their rights, expropriating them and eventually deporting them to Ghettos and death camps. These laws were carefully designed by lawyers in the ministerial administration such as Dr. W. Stuckart, since March 1935 state-secretary in the Reich's Ministry of Interior. The SS-member Stuckart became one of the most influential civil servants in the Reich's administration despite the gradual loss of powers suffered by the Reich's Ministry of Interior as a whole in the late 1930s and early 1940s. At the infamous Wannsee-Conference on January 20, 1942 Stuckart opposed Heydrich's plans for including so-called “mixed people“ in the deportations, since he considered that such a step would not be conducive to the overall aim of achieving a “final solution of the Jewish question“ within the cautiously designed definitions of the “legal framework“ of the Nuremberg laws. Despite being no less of an ardent racial-anti-Semite as Heydrich, SS-Brigadeführer Stuck-art wanted to defend his kingdom and insisted on the deportations being carried out in an “orderly“, legalistic manner that was less likely to stir-up opposition in the majority population. After the war he was indicted in the so-called “Wilhelmstrassen- or Ministries' trial“, the last trial organised by the US-military administration in Nuremberg from 1947 to 1949. With the help of his former subordinates he successfully defended himself by presenting his “pragmatic attitude“ at the Wannsee-Conference as an act of resistance in an ongoing battle between the Nazi-party organisations and the state-administration. He thus contributed to creating the legend that the civil administration (similar to the armed forces, the “Wehrmacht“) had always remained “anständig“ (decent) while party- and SS-circles were to be blamed for the “excesses“ of the “Third Reich“. His successful defence and his bad state of health lead the Nuremberg judges to pass a mild sentence which enabled him to pursue his re-integration into German post-war society. The perception that the civil-service, very much like the “Wehrmacht“, had remained “anständig“ “ decent“ has shaped historical interpretation ever since which presented the lawyers in the administration as mere – more or less willing – executioners of the political will of the party-leadership. The example of Stuckart demonstrates however, that some of them did not acquiesce into passive complicity and that their work was absolutely essential to make monstrous crimes such as the holocaust possible