Six-month depot formulation of leuprorelin acetate in the treatment of prostate cancer

Hormonal deprivation therapy is well established for the treatment of locally advanced and metastatic prostate cancer, as well as the adjuvant treatment of some patients with localized disease. Long-acting gonadotropin releasing hormone (GnRH) agonists have become a mainstay of androgen deprivation therapy, due to their efficacy, tolerability, and convenience of use. One-month, 3-month, and 4-month depot leuprorelin formulations are well established and widely used to this end. Recently, a 6-month depot leuprorelin has been approved for use in advanced and metastatic prostate cancer patients. With similar efficacy and side effect profiles to earlier formulations, 6-month depot leuprorelin is a convenient treatment option for these patients. This review will highlight the role of GnRH agonists in the treatment of prostate cancer with a focus on the clinical efficacy, pharmacology, and patient-focused outcomes of the newer 6-month 45 mg depot leuprorelin formulation in comparison to available shorter-acting products

Management of High-Risk Localized Prostate Cancer

Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM). The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control

The field description model for the LHC quadrupole superconducting magnets

The LHC control system requires an accurate forecast of the magnetic field and the multipole field errors to reduce the burden on the beam-based feed-back. The Field Description for the LHC (FIDEL) is the core of this forecast system and is based on the identification and physical decomposition of the effects that contribute to the total field in the magnet apertures. The effects are quantified using the data obtained from series magnetic measurements at CERN and they are consequently modelled empirically or theoretically depending on the complexity of the physical phenomena. This paper presents a description of the methodology used to model the field of the LHC magnets particularly focusing on the results obtained for the LHC main quadrupoles (MQ) and insertion region wide aperture quadrupoles (MQY).peer-reviewe

The dependence of the field decay on the powering history of the LHC superconducting dipole magnets

The decay of the allowed multipoles in the Large Hadron Collider (LHC) dipoles is expected to perturb the beam stability during the particle injection. The decay amplitude is largely affected by the powering history of the magnet and is particularly dependent on the pre-cycle flat-top current and duration as well as the pre-injection preparation duration. With possible prospects of having different genres of cycles during the LHC operation, the powering history effect must be taken into account in the Field Description Model for the LHC and must hence be corrected during machine operation. This paper presents the results of the modelling of this phenomenon.peer-reviewe

Magnetic determination of the current center line for the superconducting ITER TF coils

The ITER tokamak includes 18 superconducting D-shaped toroidal field (TF) coils. Unavoidable shape deformations as well as assembly errors will lead to error fields in the final configuration, which can be modeled with the knowledge of the current center line (CCL). We are building a room temperature magnetic measurement system using low frequency ac excitation current through the TF coil and arrays of pick-up coils, fabricated with printed circuit board technology. Deviations from the expected shape of the CCL will be obtained by comparing the amplitude of magnetic flux measured at several locations around the perimeter of the TF coil, with values computed assuming the nominal current distribution. We present experimental results obtained with a cable placed in one turn groove of a full scale radial plate.peer-reviewe

Parametric field modeling for the LHC main magnets in operating conditions

The first beam injections and current ramps in the LHC will require a prediction of the settings of the magnet current as well as the main correctors. For this reason we are developing a parametric model of the magnetic field generated by the LHC magnets that will provide the field dependence on current, ramp-rate, time, and history. The model of the field is fitted on magnetic field measurements performed during the acceptance tests of the magnets before their installation in the machine. In this paper we summarize the different steps necessary to select the relevant data and identify the parameters: the data extraction, the filtering and the validation of the measurements, and the fitting procedure that is used to obtain the parameters from the experimental results. The main result reported is a summary of the value of the parameters obtained with the above procedure, and describing the behavior of the magnetic field in the LHC main dipoles and quadrupoles.peer-reviewe

Electrical and magnetic performance of the LHC short straight sections

The Short Straight Section (SSS) for the Large Hadron Collider arcs, containing in a common cryostat the lattice quadrupoles and correction magnets, have now entered series production. The foremost features of the lattice quadrupole magnets are a two-in-one structure containing two 56 mm aperture, two-layers coils wound from 15.1 mm wide NbTi cables, enclosed by the stainless steel collars and ferromagnetic yoke, and inserted into the inertia tube. Systematic cryogenic tests are performed at CERN in order to qualify these magnets with respect to their cryogenic and electrical integrity, the quench performance and the field quality in all operating conditions. This paper reports the main results obtained during tests and measurements in superfluid helium. The electrical characteristics, the insulation measurements and the quench performance are compared to the specifications and expected performances for these magnets. The field in the main quadrupole is measured using three independent systems: 10-m long twin rotating coils, an automatic scanner, and single stretched wire. A particular emphasis is given to the integrated transfer function which has a spread of around 12 units rms in the production and is a critical issue. The do-decapole harmonic component, which required trimming through a change in coil shims, is also discussed. Finally, the magnetic axis measurements at room temperature and at 1.9 K, providing the nominal vertical shift for installation are reported.peer-reviewe

Focusing strength measurements of the main quadrupoles for the LHC

More than 1100 quadrupole magnets of different types are needed for the Large Hadron Collider (LHC) which is in the construction stage at CERN. The most challenging parameter to measure on these quadrupoles is the integrated gradient (Gdl). An absolute accuracy of 0.1% is needed to control the beta beating. In this paper we briefly describe the whole set of equipment used for Gdl measurements: Automated Scanner system, Single Stretched Wire system and Twin Coils system, concentrating mostly on their absolute accuracies. Most of the possible inherent effects that can introduce systematic errors are discussed along with their preventive methods. In the frame of this qualification some of the magnets were tested with two systems. The results of the intersystem cross-calibrations are presented. In addition, the qualification of the measurement system used at the magnet manufacturer's is based on results of more than 40 quadrupole assemblies tested in cold conditions at CERN and in warm conditions at the vendor site.peer-reviewe

MRI-LINAC: A transformative technology in radiation oncology

Advances in radiotherapy technologies have enabled more precise target guidance, improved treatment verification, and greater control and versatility in radiation delivery. Amongst the recent novel technologies, Magnetic Resonance Imaging (MRI) guided radiotherapy (MRgRT) may hold the greatest potential to improve the therapeutic gains of image-guided delivery of radiation dose. The ability of the MRI linear accelerator (LINAC) to image tumors and organs with on-table MRI, to manage organ motion and dose delivery in real-time, and to adapt the radiotherapy plan on the day of treatment while the patient is on the table are major advances relative to current conventional radiation treatments. These advanced techniques demand efficient coordination and communication between members of the treatment team. MRgRT could fundamentally transform the radiotherapy delivery process within radiation oncology centers through the reorganization of the patient and treatment team workflow process. However, the MRgRT technology currently is limited by accessibility due to the cost of capital investment and the time and personnel allocation needed for each fractional treatment and the unclear clinical benefit compared to conventional radiotherapy platforms. As the technology evolves and becomes more widely available, we present the case that MRgRT has the potential to become a widely utilized treatment platform and transform the radiation oncology treatment process just as earlier disruptive radiation therapy technologies have done

A demonstration experiment for the forecast of magnetic field and field errors in the Large Hadron Collider

In order to reduce the burden on the beam-based feedback, the Large Hadron Collider control system is equipped with the Field Description for the LHC (FiDeL) which provides a forecast of the magnetic field and the multipole field errors. FiDeL has recently been extensively tested at CERN to determine main field tracking, multipole forecasting and compensation accuracy. This paper describes the rationale behind the tests, the procedures employed to power the main magnets and their correctors, and finally, we present the results obtained. We also give an indication of the prediction accuracy that the system can deliver during the operation of the LHC and we discuss the implications that these will have on the machine performance.peer-reviewe