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Udkomne Bøger.

Udkomne Bøger

Selection criteria for early breast cancer patients in the DBCG proton trial – The randomised phase III trial strategy

Background and purpose Adjuvant radiotherapy of internal mammary nodes (IMN) improves survival in high-risk early breast cancer patients but inevitably leads to more dose to heart and lung. Target coverage is often compromised to meet heart/lung dose constraints. We estimate heart and lung dose when target coverage is not compromised in consecutive patients. These estimates are used to guide the choice of selection criteria for the randomised Danish Breast Cancer Group (DBCG) Proton Trial.Materials and methods 179 breast cancer patients already treated with loco-regional IMN radiotherapy from 18 European departments were included. If the clinically delivered treatment plan did not comply with defined target coverage requirements, the plan was modified retrospectively until sufficient coverage was reached. The choice of selection criteria was based on the estimated number of eligible patients for different heart and lung dose thresholds in combination with proton therapy capacity limitations and dose-response relationships for heart and lung.Results Median mean heart dose was 3.0 Gy (range, 1.1-8.2 Gy) for left-sided and 1.4 Gy (0.4-11.5 Gy) for right-sided treatment plans. Median V17Gy/V20Gy (hypofractionated/normofractionated plans) for ipsilateral lung was 31% (9-57%). The DBCG Radiotherapy Committee chose mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37% as thresholds for inclusion in the randomised trial. Using these thresholds, we estimate that 22% of patients requiring loco-regional IMN radiotherapy will be eligible for the trial.Conclusion The patient selection criteria for the DBCG Proton Trial are mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37%

Historia de la investigación en la simbiosis leguminosa-bacteria: una perspectiva didáctica

After cereals, legumes constitute the second most important family of crops for human and animal consumption. However, in contrast to the former, legumes are capable of growing in arid soils of low fertility, due to their ability to establish symbiotic associations with soil bacteria called rhizobia. These microorganisms form special organs in the roots of legumes called nodules, where atmospheric dinitrogen (N₂) is transformed into ammonium that is exported to the plant for growth. Since their discovery in legume nodules until today, knowledge of the bacteria capable of establishing symbiosis with these plants has advanced in many aspects. Especially, advances in molecular techniques for bacterial identification and access to unexplored places have confirmed that the interaction of legumes with rhizobia is older, and that N₂-fixing bacteria are more abundant and diverse, than considered previously. Here, we attempt to relate the history of an association whose development is key in the history of mankind as we know it now.<br><br>Después de los cereales, las leguminosas constituyen la segunda familia en importancia para la alimentación humana y animal. Sin embargo, en contraste con ellos, las leguminosas son capaces de crecer en suelos áridos, de escasa fertilidad, lo que se debe a su capacidad para establecer asociaciones simbióticas con bacterias del suelo llamadas rhizobia. Estos microorganismos forman unos órganos especiales en las raíces de las leguminosas, los nódulos, donde el dinitrógeno (N₂) atmosférico se transforma en amonio que se exporta a la planta para su crecimiento. Desde su descubrimiento en los nódulos de las leguminosas hasta nuestros días, el conocimiento de las bacterias capaces de establecer simbiosis con estas plantas ha avanzado en múltiples aspectos. Sobre todo, los avances en las técnicas moleculares de identificación bacteriana y el acceso a lugares inexplorados ha permitido confirmar que la interacción de las leguminosas con los rhizobia es más antigua de lo que se creía y que las bacterias fijadoras de dinitrógeno (N₂) son más abundantes y diversas de lo que se había pensado. Trataremos de describir la historia de una asociación cuyo desarrollo ha sido, y es, clave en la historia de la humanidad tal como la conocemos ahora