Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes

Introduction: Adjuvant radiotherapy is an established component in the management of metastatic cutaneous squamous cell carcinoma (SCC) involving the parotid gland. Radiotherapy technique, dose and volumes are seldom described sufficiently to allow close examination. We report our treatment outcomes and focus on treatment-related factors that affect outcomes in this cohort. Methods: We performed a retrospective review of patients with metastatic cutaneous SCCs who underwent parotidectomy with or without ipsilateral neck dissection. All patients received adjuvant radiotherapy. Demographics, clinical data and treatment details were collected from an intuitional electronic database. Individual patient-level radiotherapy technique, volumes and doses were reviewed. Results: Between July 2008 and July 2018, 60 patients met our inclusion criteria. Median follow-up duration was 32.7 months. The mean age was 66.4 years. The majority of patients (49 patients) received full neck irradiation. The 2-year and 5-year loco-regional failure-free survival was 87% (95% confidence interval (CI): 0.74–0.93) and 71% (95% CI: 0.52, 0.83), respectively. The 2-year and 5-year overall survival was 76% (95% CI: 0.62, 0.85) and 60% (95% CI: 0.45, 0.72), respectively. There were 15 cases of loco-regional failures, with 6 cases with dermal involvement. Lymphovascular invasion (LVI) was associated with higher loco-regional failure (hazard ratio: 8.43, 95% CI: 1.85–38.39, P = 0.005) and cancer-specific mortality (hazard ratio: 5.40, 95% CI: 1.40–20.87, P = 0.015). Treatment technique, intensity-modulated radiation therapy (IMRT) vs 3D conformal radiotherapy (3D CRT), bolus use, perineural invasion (PNI) and surgical margins were not significantly associated with loco-regional failure. Conclusion: We demonstrated high loco-regional control rates with routine use of comprehensive adjuvant radiotherapy. The presence of LVI was identified as a strong predictor for recurrence. Further analysis will help to define optimal radiation dose and techniques

Unconstrained Hamiltonian Formulation of SU(2) Gluodynamics

SU(2) Yang-Mills field theory is considered in the framework of the generalized Hamiltonian approach and the equivalent unconstrained system is obtained using the method of Hamiltonian reduction. A canonical transformation to a set of adapted coordinates is performed in terms of which the Abelianization of the Gauss law constraints reduces to an algebraic operation and the pure gauge degrees of freedom drop out from the Hamiltonian after projection onto the constraint shell. For the remaining gauge invariant fields two representations are introduced where the three fields which transform as scalars under spatial rotations are separated from the three rotational fields. An effective low energy nonlinear sigma model type Lagrangian is derived which out of the six physical fields involves only one of the three scalar fields and two rotational fields summarized in a unit vector. Its possible relation to the effective Lagrangian proposed recently by Faddeev and Niemi is discussed. Finally the unconstrained analog of the well-known nonnormalizable groundstate wave functional which solves the Schr\"odinger equation with zero energy is given and analysed in the strong coupling limit.Comment: 20 pages REVTEX, no figures; final version to appear in Phys. Rev. D; minor changes, notations simplifie

Energy confinement in Doublet III with high-Z limiters

This report describes the experimental measurements and data analysis techniques used to evaluate the energy confinement in noncircular plasmas produced in Doublet III. Major aspects of the confinement measurements and analysis techniques are summarized. Machine parameters, diagnostic systems and discharge parameters relavent to the confinement measurements are given. Magnetic analysis techniques used to determine the plasma shape are reviewed. Scaling of the on-axis values of electron temperature, confinement time and Z/sub eff/ with plasma density is presented. Comparison with scaling results from other circular tokamaks is discussed. Numerical and analytic techniques developed for calculating the plasma energy confinement time and self-consistent profiles of density, temperature, current, and flux in non-circular geometries are described. These techniques are applied to the data and used to determine the central and global electron energy confinement time for a typical doublet plasma. Additional aspects of the confinement such as the radial dependence of the electron thermal conductivity and the estimated ion temperature are explored with the aid of a non-circular transport simulation code. The results of the confinement measurements are summarized and discussed. A brief summary of the theoretically expected effects of noncircularity on plasma confinement is included for reference as Appendix I