Neoadjuvant treatment in oesophageal cancer: The needs for future trials

In view of the poor survival after surgery alone for oesophageal cancer, combination with chemotherapy seems rational. A concept of upfront chemotherapy is discussed and seems especially useful for these tumours. The published randomized trials, studying the effect of neoadjuvant chemotherapy do, however, not (yet) show an improved overall survival, apart from one study with a significant median survival benefit at an interim evaluation. The responding patients have in all trials a far better survival than the non-responders. The numbers of patients are small and results of other ongoing and future trials should be awaited. New trials testing high-dose chemotherapy with bone marrow support should be initiated

Chemotherapy in cancer of the esophagus

Al though cancer of the esophagus has been recogni zed as a fatal disease as long ago as the start of the Christian era, the present outlook remains dismal. Less than 10 percent of patients with seemingly localized disease, surgically treated with curative intent, will survive five years or more. Dysphagia, the initial symptom in most patients, usually occurs late in the course of the disease, when the esophageal wall has been infiltrated or penetrated. At this time, in the majority of patients, metastases are present in surrounding lymphe nodes and/or other organs. Until recently, chemotherapy had no role in the treatment of this disease. It was generally used as a last resort I after primary surgery or radiation therapy, in patients with a poor performance status. With the availability of new drugs, used in various combinations, and sometimes in conjunction with other forms of cancer treatment, a modest success is standing out against the horizon. This thesis includes an overview of the current knowledge on chemotherapy in esophageal cancer (chapter 1), several clinical studies on the efficacy and toxicity of various drugs and combinations of drugs in metastatic esophageal cancer (chapters 2-5), a comparative study on preoperative chemotherapy in patients with operable esophageal cancer (chapter 6) I and an exploratory study, after chemotherapy to evaluate the benefit of (chapter 7) in patients salvage surgery with metastatic esophageal cancer. In addition, two laboratory experiments on the presence of human papilloma virus and the role of the Multidrug Resistance Protein in esophageal cancer are covered (chapters 8,9)

Conditional linear-optical measurement schemes generate effective photon nonlinearities

We provide a general approach for the analysis of optical state evolution under conditional measurement schemes, and identify the necessary and sufficient conditions for such schemes to simulate unitary evolution on the freely propagating modes. If such unitary evolution holds, an effective photon nonlinearity can be identified. Our analysis extends to conditional measurement schemes more general than those based solely on linear optics.Comment: 16 pages, 2 figure

Ifosfamide in advanced adenocarcinoma of the oesophagus or oesophageal-gastric junction area

Abstract 25 previously untreated patients with inoperable or metastatic adenocarcinoma of the oesophagus or oesophageal-gastric junction area were treated with ifosfamide 6 g/m2 over 48 hours, combined with mesna 6 g/m2. 1 complete response and 1 partial response were seen among 23 patients evaluable, with a response duration of 29+ months and 7 months, respectively. Toxicity was not severe: grade 3 infection in 2 patients, grade 3 leucopenia in 3 patients and grade 3 nausea in 4 patients. No life-threatening episodes or central nervous system toxicity were encountered. Ifosfamide has limited activity in adenocarcinoma of the oesophageal-gastric junction area

Disease monitoring by the tumour maskers Cyfra 21.1 and TPA in patients with non-small cell lung cancer

We evaluated the use of two tumour markers Cyfra 21.1 and tissue polypeptide antigen (TPA) for disease monitoring. Assessment of response to WHO criteria was compared to response assessment according to changes in the tumour marker levels. The criteria defined for marker response were a 65% decrease for a partial response and a 40% increase for progressive disease. When response evaluations with a positive lead time were included, 72% of 115 evaluations for Cyfra 21.1 and 59% of 107 evaluations for TPA yielded the same result. Most discordant evaluations were caused by those evaluations whereby the patient achieved a partial response according to the WHO criteria and had normalisation of the marker. Less cases with a positive lead time, more negative lead times, and more patients with progressive disease without an increase of the marker were seen with TPA compared to Cyfra 21.1. In conclusion, Cyfra 21.1 follows the changes in the tumour load better than TPA. Rising levels of both markers nearly always indicate disease progression, and such knowledge easily obtained may prevent the continuation of ineffective treatment

Creation of maximally entangled photon-number states using optical fiber multiports

We theoretically demonstrate a method for producing the maximally path-entangled state (1/Sqrt[2]) (|N,0> + exp[iN phi] |0,N>) using intensity-symmetric multiport beamsplitters, single photon inputs, and either photon-counting postselection or conditional measurement. The use of postselection enables successful implementation with non-unit efficiency detectors. We also demonstrate how to make the same state more conveniently by replacing one of the single photon inputs by a coherent state.Comment: 4 pages, 1 figure. REVTeX4. Replaced with published versio

Prognostic significance of tissue polypeptidespecific antigen (TPS) in patients with advanced non-small cell lung cancer

In this study, we evaluated the prognostic value of the tumour marker, tissue polypeptide-specific antigen (TPS), in 203 patients with non-small cell lung cancer (NSCLC), and related this to several other known prognostic factors. TPS was significantly correlated with lactate dehydrogenase (LDH), γ-glutamyltranspeptidase and alkaline phosphatase, and the median level of TPS in patients with stage 4 disease was significantly higher as compared to stage 3A and 3B disease. In the univariate analysis, performance status, stage of disease, LDH, alkaline phosphatase, a histology of undifferentiated large cell carcinoma and TPS all had a statistically significant association with survival. Multivariate analysis showed that stage of disease, performance status, histology and TPS were the most important prognostic factors. TPS has prognostic significance for survival in patients with advanced NSCLC, independent from performance status and stage of disease

Demonstration of Feed-Forward Control for Linear Optics Quantum Computation

One of the main requirements in linear optics quantum computing is the ability to perform single-qubit operations that are controlled by classical information fed forward from the output of single photon detectors. These operations correspond to pre-determined combinations of phase corrections and bit-flips that are applied to the post-selected output modes of non-deterministic quantum logic devices. Corrections of this kind are required in order to obtain the correct logical output for certain detection events, and their use can increase the overall success probability of the devices. In this paper, we report on the experimental demonstration of the use of this type of feed-forward system to increase the probability of success of a simple non-deterministic quantum logic operation from approximately 1/4 to 1/2. This logic operation involves the use of one target qubit and one ancilla qubit which, in this experiment, are derived from a parametric down-conversion photon pair. Classical information describing the detection of the ancilla photon is fed-forward in real-time and used to alter the quantum state of the output photon. A fiber optic delay line is used to store the output photon until a polarization-dependent phase shift can be applied using a high speed Pockels cell

Conditional generation of arbitrary multimode entangled states of light with linear optics

We propose a universal scheme for the probabilistic generation of an arbitrary multimode entangled state of light with finite expansion in Fock basis. The suggested setup involves passive linear optics, single photon sources, strong coherent laser beams, and photodetectors with single-photon resolution. The efficiency of this setup may be greatly enhanced if, in addition, a quantum memory is available.Comment: 7 pages, 5 figure