Surveillance or metastasis-directed Therapy for OligoMetastatic Prostate cancer recurrence (STOMP): study protocol for a randomized phase II trial

Background: Metastases-directed therapy (MDT) with surgery or stereotactic body radiotherapy (SBRT) is emerging as a new treatment option for prostate cancer (PCa) patients with a limited number of metastases (<= 3) at recurrence - so called "oligometastases". One of the goals of this approach is to delay the start of palliative androgen deprivation therapy (ADT), with its negative impact on quality of life. However, the lack of a control group, selection bias and the use of adjuvant androgen deprivation therapy prevent strong conclusions from published studies. The aim of this multicenter randomized phase II trial is to assess the impact of MTD on the start of palliative ADT compared to patients undergoing active surveillance. Methods/Design: Patients with an oligometastatic recurrence, diagnosed on choline PET/CT after local treatment with curative intent, will be randomised in a 1:1 ratio between arm A: active surveillance only and arm B: MTD followed by active surveillance. Patients will be stratified according to the location of metastasis (node vs. bone metastases) and PSA doubling time ( 3 months). Both surgery and SBRT are allowed as MDT. Active surveillance means 3-monthly PSA testing and re-imaging at PSA progression. The primary endpoint is ADT-free survival. ADT will be started in both arms at time of polymetastatic disease (>3 metastatic lesions), local progression or symptoms. The secondary endpoints include progression-free survival, quality of life, toxicity and prostate-cancer specific survival. Discussion: This is the first randomized phase 2 trial assessing the possibility of deferring palliative ADT with MDT in oligometastatic PCa recurrence

The Early Royal Society and Visual Culture

Recent studies have fruitfully examined the intersection between early modern science and visual culture by elucidating the functions of images in shaping and disseminating scientific knowledge. Given its rich archival sources, it is possible to extend this line of research in the case of the Royal Society to an examination of attitudes towards images as artefacts –manufactured objects worth commissioning, collecting and studying. Drawing on existing scholarship and material from the Royal Society Archives, I discuss Fellows’ interests in prints, drawings, varnishes, colorants, images made out of unusual materials, and methods of identifying the painter from a painting. Knowledge of production processes of images was important to members of the Royal Society, not only as connoisseurs and collectors, but also as those interested in a Baconian mastery of material processes, including a “history of trades”. Their antiquarian interests led to discussion of painters’ styles, and they gradually developed a visual memorial to an institution through portraits and other visual records.AH/M001938/1 (AHRC

Battle family papers, W.0010

Abstract: Letters, calling cards, scripture cards, and a small journal of this Tuskegee, Alabama, family.Scope and Content Note: The collection includes letters, calling cards, scripture cards, and a small journal of twenty-six pages. The letters are dated between 1855 and 1871 and represent at least two generations of family correspondence. Two of the early letters are from Junius Battle to Sallie (Sarah Hunter) in Tuskegee, Alabama, before their November 1859 wedding, and one dated July 14, 1871, is apparently from mother to son (signed "Mamana" and is addressed to "Master Junius K. Battle"), encouraging him to "be a good boy, mind every word your Grandma says, and be sure to write very soon."There is also a seemingly unrelated 1855 black-bordered letter from the committee of the Means Society of S. Masonic College to a Virginia Jennings of Oxford, announcing the death of a Miss Kate Phillips, "a worthy member of our society" and advised Jennings of the proper type of arm band to wear, what it should be made of, and how long it should be worn. It is unclear where the letter is directed; the envelope only says "Miss Virginia Jennings, Oxford."The collection also contains two engraved cards (3.5" x 2"), two religious themed cards (2.25" x 1.75"), and one empty envelope.Biographical/Historical Note: Sallie (Sarah) Hunter, the oldest daughter of John and Sarah Shorter Hunter, was born in Alabama probably in 1842. She married Junius K. Battle on 29 November 1859 in Barbour County, Alabama. The couple had at least one son, also named Junius K. Battle