Impact of Endoscopic Ultrasonography on (18)F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment

INTRODUCTION: In patients with potentially resectable esophageal cancer (EC), the value of endoscopic ultrasonography (EUS) after fluorine-18 labeled fluorodeoxyglucose positron emission tomography with computed tomography ((18)F-FDG-PET/CT) is questionable. Retrospectively, we assessed the impact of EUS after PET/CT on the given treatment in EC patients. METHODS: During the period 2009-2015, 318 EC patients were staged as T1-4aN0-3M0 with hybrid (18)F-FDG-PET/CT or (18)F-FDG-PET with CT and EUS if applicable in a nonspecific order. We determined the impact of EUS on the given treatment in 279 patients who also were staged with EUS. EUS had clinical consequences if it changed curability, extent of radiation fields or lymph node resection (AJCC stations 2-5), and when the performed fine-needle aspiration (FNA) provided conclusive information of suspicious lymph node. RESULTS: EUS had an impact in 80 (28.7%) patients; it changed the radiation field in 63 (22.6%), curability in 5 (1.8%), lymphadenectomy in 48 (17.2%), and FNA was additional in 21 (7.5%). In patients treated with nCRT (n = 194), EUS influenced treatment in 53 (27.3%) patients; in 38 (19.6%) the radiation field changed, in 3 (1.5%) the curability, in 35 (18.0%) the lymphadenectomy, and in 17 (8.8%) FNA was additional. EUS influenced both the extent of radiation field and nodal resection in 31 (16.0%) nCRT patients. CONCLUSIONS: EUS had an impact on the given treatment in approximately 29%. In most patients, the magnitude of EUS found expression in the extent of radiotherapy target volume delineation to upper/high mediastinal lymph nodes

Opsporen en meten van groeiremming in recirculatiewater en gewas - Werkpakket 2 Glastuinbouw Waterproof substraat

Groeiremming is vaak een reden voor telers om het recirculatiewater te verversen en het overtollige water te lozen. Behalve een te hoog Na-gehalte of een optredende ziekte in het water is de oorzaak van groeiremming nog steeds onduidelijk. Doelstellingen van het uitgevoerde onderzoek waren het vaststellen van de oorzaak van groeiremming, voorstellen van te nemen maatregelen en het ontwikkelen van methoden om groeiremming vroegtijdig te bepalen. Via een getrapte analyse is onderzoek gedaan naar mogelijke groeiremmende componenten. De groeiremmende factor in het drainwater wordt vooral veroorzaakt door een microbiologische factor die zeer waarschijnlijk van een bacteriologische oorsprong is; gewasbeschermingsmiddelen in het drainwater blijken de groei in diverse groeitesten niet te remmen. Monitoring van de zuurstofconcentratie in het water en wortelmilieu en de metingen van de lichtbenuttingsefficiëntie in een rozengewas hebben geen relaties met optredende groeiremming aangetoond. De waarde van deze meetmethoden kon niet goed worden beoordeeld, omdat alleen groeiremming is aangetoond in het drainwater, maar niet in het rozengewa

Weerbaar substraat: praktijkproeven : ontwikkeling toets methodiek en eerste toetsing op gewasschade van tien concepten bij tomaat, komkommer en gerbera

De sector is op zoek naar nieuwe gewas bescherming zoals “weerbaar telen”. Hierbij wordt gestuurd op een ziekte- en plaag onderdrukking via het substraat en op een sterke- en productie verhogende plant. Er werden een tiental concepten onderzocht op fytotoxicit eit. De keuze van de concepten werd gebaseerd op beschikbaarheid van bouwstenen, gebruik in de praktijk, het aanschake len van meerdere mechanismen en experimentele meerwaarde. Het aanschakelen van meerdere mechanismen is belangrijk omdat dit de kans op weerbaarheid verhoogt tegen diverse ziekten en plagen. Ook werden meetmethoden verder uitgewerkt om weerbaarheid van substraat en plant in de praktijk te kunnen meten

Induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as neoadjuvant treatment for locally recurrent rectal cancer: study protocol of a multicentre, open-label, parallel-arms, randomized controlled study (PelvEx II)

Background A resection with clear margins (R0 resection) is the most important prognostic factor in patients with locally recurrent rectal cancer (LRRC). However, this is achieved in only 60 per cent of patients. The aim of this study is to investigate whether the addition of induction chemotherapy to neoadjuvant chemo(re)irradiation improves the R0 resection rate in LRRC. Methods This multicentre, international, open-label, phase III, parallel-arms study will enrol 364 patients with resectable LRRC after previous partial or total mesorectal resection without synchronous distant metastases or recent chemo- and/or radiotherapy treatment. Patients will be randomized to receive either induction chemotherapy (three 3-week cycles of CAPOX (capecitabine, oxaliplatin), four 2-week cycles of FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) or FOLFORI (5-fluorouracil, leucovorin, irinotecan)) followed by neoadjuvant chemoradiotherapy and surgery (experimental arm) or neoadjuvant chemoradiotherapy and surgery alone (control arm). Tumours will be restaged using MRI and, in the experimental arm, a further cycle of CAPOX or two cycles of FOLFOX/FOLFIRI will be administered before chemoradiotherapy in case of stable or responsive disease. The radiotherapy dose will be 25 × 2.0 Gy or 28 × 1.8 Gy in radiotherapy-naive patients, and 15 × 2.0 Gy in previously irradiated patients. The concomitant chemotherapy agent will be capecitabine administered twice daily at a dose of 825 mg/m2 on radiotherapy days. The primary endpoint of the study is the R0 resection rate. Secondary endpoints are long-term oncological outcomes, radiological and pathological response, toxicity, postoperative complications, costs, and quality of life. Discussion This trial protocol describes the PelvEx II study. PelvEx II, designed as a multicentre, open-label, phase III, parallel-arms study, is the first randomized study to compare induction chemotherapy followed by neoadjuvant chemo(re)irradiation and surgery with neoadjuvant chemo(re)irradiation and surgery alone in patients with locally recurrent rectal cancer, with the aim of improving the number of R0 resections

Development of an oxygen measurement system as a management tool in horticulture

Gases (e.g. oxygen) in the root environment are an important factor for plant development. This study aims to show whether it is possible to obtain an overview of oxygen profiles within the root zone using a limited amount of oxygen measurements in the root environment. A further aim was to demonstrate whether this technology can be used to develop a measurement tool for practical use. Therefore, a multioxygen sensor was constructed, and measurements were carried at two locations. In the greenhouse, oxygen measurements were carried during growth of roses at various horizontal and vertical positions in pots, filled with stone wool blocks. In the field, oxygen levels were detected in 3 L pots in a Rhododendron crop using peat as a growing medium. Here, optical oxygen sensors were positioned at 3 cm above the bottom, and also in the middle of the pots. The results indicate that it is possible to develop an oxygen measuring strategy which can be used to determine a representative pattern of oxygen levels in growing media. Relationships between and related growth conditions will be described, and it will be discussed for which cultivation systems oxygen measurements should have priority