191 research outputs found

    Grid Fin Stabilization of the Orion Launch Abort Vehicle

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    Wind tunnel tests were conducted by Nielsen Engineering & Research (NEAR) and Rose Engineering & Research (REAR) in conjunction with the NASA Engineering & Safety Center (NESC) on a 6%-scale model of the Orion launch abort vehicle (LAV) configured with four grid fins mounted near the base of the vehicle. The objectives of these tests were to 1) quantify LAV stability augmentation provided by the grid fins from subsonic through supersonic Mach numbers, 2) assess the benefits of swept grid fins versus unswept grid fins on the LAV, 3) determine the effects of the LAV abort motors on grid fin aerodynamics, and 4) generate an aerodynamic database for use in the future application of grid fins to small length-to-diameter ratio vehicles similar to the LAV. The tests were conducted in NASA Ames Research Center's 11x11-foot transonic wind tunnel from Mach 0.5 through Mach 1.3 and in their 9x7-foot supersonic wind tunnel from Mach 1.6 through Mach 2.5. Force- and moment-coefficient data were collected for the complete vehicle and for each individual grid fin as a function of angle of attack and sideslip angle. Tests were conducted with both swept and unswept grid fins with the simulated abort motors (cold jets) off and on. The swept grid fins were designed with a 22.5deg aft sweep angle for both the frame and the internal lattice so that the frontal projection of the swept fins was the same as for the unswept fins. Data from these tests indicate that both unswept and swept grid fins provide significant improvements in pitch stability as compared to the baseline vehicle over the Mach number range investigated. The swept fins typically provide improved stability as compared to the unswept fins, but the performance gap diminished as Mach number was increased. The aerodynamic performance of the fins was not observed to degrade when the abort motors were turned on. Results from these tests indicate that grid fins can be a robust solution for stabilizing the Orion LAV over a wide range of operating conditions

    Salvage surgery for squamous cell carcinoma of the head and neck in the era of immunotherapy: Is it time to clarify our guidelines?

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146561/1/cncr31717_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146561/2/cncr31717.pd

    Selecting a comparison group for 5-year oral and pharyngeal cancer survivors: Two methods

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    BACKGROUND: To assess potential long-term consequences of cancer treatment, studies that include comparison groups are needed. These comparison groups should be selected in a way that allows the subtle long-range effects of cancer therapy to be detected and distinguishes them from the effects of aging and other risk factors. The purpose of this investigation was to test two methods of recruiting a comparison group for 5-year oral and pharyngeal cancer survivors (peer-nominated and listed sample) with emphasis on feasibility and the quality of the match. METHODS: Participants were drawn from a pool of 5-year survivors treated at a large Southeastern hospital. A peer-nominated sample was solicited from the survivors. A listed sample matched on sex, age, and zip code was purchased. Telephone interviews were conducted by a professional call center. RESULTS: The following represent our key findings: The quality of matching between survivors and listed sample was better than that between survivors and peer-nominated group in age and sex. The quality of matching between the two methods on other key variables did not differ except for education, with the peer method providing a better match for the survivors than the listed sample. The yield for the listed sample method was greater than for the peer-nominated method. The cost per completed interview was greater for the peer-nominated method than the listed sample. CONCLUSION: This study not only documents the methodological challenges in selecting a comparison group for studies examining the late effects of cancer treatment among older individuals but also documents challenges in matching groups that potentially have disproportionate levels of comorbidities and at-risk health behaviors

    Unilateral versus bilateral nodal irradiation:Current evidence in the treatment of squamous cell carcinoma of the head and neck

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    Cancers of the head and neck region often present with nodal involvement. There is a long-standing convention within the community of head and neck radiation oncology to irradiate both sides of the neck electively in almost all cases to include both macroscopic and microscopic disease extension (so called elective nodal volume). International guidelines for the selection and delineation of the elective lymph nodes were published in the early 2000s and were updated recently. However, diagnostic imaging techniques have improved the accuracy and reliability of nodal staging and as a result, small metastases that used to remain undetected and were thus in the past included in the elective nodal volume, will now be included in high-dose volumes. Furthermore, the elective nodal areas are situated close to the parotid glands, the submandibular glands and the swallowing muscles. Therefore, irradiation of a smaller, more selected volume of the elective nodes could reduce treatment-related toxicity. Several researchers consider the current bilateral elective neck irradiation strategies an overtreatment and show growing interest in a unilateral nodal irradiation in selected patients. The aim of this article is to give an overview of the current evidence about the indications and benefits of unilateral nodal irradiation and the use of SPECT/CT-guided nodal irradiation in squamous cell carcinomas of the head and neck

    Radiation-Induced Sarcomas of the Head and Neck : A Systematic Review

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    Introduction As a result of the increased use of radiotherapy (RT) and improved long-term overall survival of patients with cancers of the head and neck (HN), the frequency of radiation-induced sarcomas of the head and neck (RISHN) may be increasing. The main objective of this systematic review was to determine the existing evidence on the frequency, treatment, and outcome of RISHN. Methods Using PRISMA guidelines we conducted a systematic review of the literature published from 2000 to 2020. Results Our review includes data of 560 patients from 64 articles. The total frequency of RISHNs among the reviewed series was 0.15%. The most frequent location of the primary tumor treated by RT was the nasopharynx. The mean RT dose used was 62 Gy, mean latency interval between irradiation and occurrence of RISHN was 11.1 years, and the most common RISHN location was the sinonasal region. Osteosarcoma was the principal histology, followed by fibrosarcoma. Surgery was the most frequently applied treatment modality. Of all patients with RISHN, 40.7% died of this disease after a mean interval of 13.9 months. Conclusions Notwithstanding the increased use of RT, the number of reported RISHNs has not increased substantially during the past two decades. Surgery with wide margins forms the best therapeutic option for these cases, but the outcome remains poor.Peer reviewe

    Current management of stage IV nasopharyngeal carcinoma without distant metastasis

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    Up to one in four patients with nasopharyngeal carcinoma present with non-metastatic stage IV disease (i.e. T4 or N3). Distinct failure patterns exist, despite the routine adoption of contemporary treatment modalities such as intensity modulated radiotherapy and systemic chemotherapy. Concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy or induction chemotherapy followed by CCRT are commonly employed in this setting, with the latter emerging as the preferred option. Additionally, emerging radiation technologies like proton therapy has become available offering new opportunities for prevention of radiation-induced side effects. This article reviews not only the current treatment strategies, but also discusses novel ways to tackle this challenging disease with respect to the patterns of failure

    Management of locally recurrent nasopharyngeal carcinoma

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    As a consequence of the current excellent loco-regional control rates attained using the generally accepted treatment paradigms involving intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC), only 10-20% of patients will suffer from local and/or nodal recurrence after primary treatment. Early detection of recurrence is important as localized recurrent disease is still potentially salvageable, but this treatment often incurs a high risk of major toxicities. Due to the possibility of radio-resistance of tumors which persist or recur despite adequate prior irradiation and the limited tolerance of adjacent normal tissues to sustain further additional treatment, the management of local failures remains one of the greatest challenges in this disease. Both surgical approaches for radical resection and specialized re-irradiation modalities have been explored. Unfortunately, available data are based on retrospective studies, and the majority of them are based on a small number of patients or relatively short follow-up. In this article, we will review the different salvage treatment options and associated prognostic factors for each of them. We will also propose a treatment algorithm based on the latest available evidence and discuss the future directions of treatment for locally recurrent NPC.Peer reviewe
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