Search

1540 Background: Through the use of cisplatin-based combination chemotherapy and radiotherapy, outcomes have improved for patients with intracranial germ cell tumor. An appropriate therapy for recurrent germ cell tumors, however, remains to be established. The present feasibility study investigates the toxicity and activity of a gemcitabine/docetaxel combination in patients with multiply relapsed germ cell tumor. Methods: Gemcitabine was administered at a dose of 1000 mg/m2 over 30 minutes on days 1, 8 followed by docetaxel (1 h-infusion) at a dose of 60 mg/m2 on day 8, with courses repeated every 21 days. Results: From 9/00 to 9/01 5 patients with a median age of 15 [13–32] years were enrolled. Patients had been pretreated with a median of 9 [3–16] platin-containing cycles and 1 patient had previously failed high-dose chemotherapy with PBSCT. All patients were considered cisplatin-refractory. Median number of applied cycles was 2 [2–4]. All patients achieved a radiological partial response with a tumor m...

Introduction: CNS germ cell tumors (GCT) include a number of histological SUbtypes for which prognosis and treatment response are extremely diverse. This prospect ive study investigated methods of selectively choosing treatment according to malignancy and histolog ical subtypes. Methods: Twenty patients with histologically verified GCT. including 14 ger· minomatous and 6 non-germinomatous tumors, were analyzed. These were divided into 3 groups. The good prognos is group including solitary pure germinoma and mature teratoma received 3 to 4 cycles of cisplatin plus etoposide followed by 24 Gy local irradiation. The intermediate group included HCGsecret ing germinoma, multifocal germinoma, immature teratoma, and mixed germ cell tumors consisting of germinoma with mature or immature teratoma. This group was treated with 3 to 6 cycles of ifosfamide, cisplatin and etoposide , followed by 24 Gy of local irradiation . The poor prognosis group including all other types with highly malignant histology received 4 to 6 cycles of the ICE regimen with concurrent 24 Gy craniospinal radiation and 30 Gy local boost. ReSUlts: Gross total removal was obtained in 6 patients. Eleven of the remaining 14 patients achieved a comp lete response , and 3 a partial response, following chemoradiat ion therapy. Thus the primary response rate was 100% (14/14). Nineteen patients (95%) remained in continuous remission for a median period of 23 months. One patient had a recurrence 39 months later, but came again in complete remission after the same therapy. All 20 patients were alive with 80 to 100% performance status. Conclusions: Results of the study advocate the accuracy of the new classification, which may enable increased disease control and reduction in the amount of radiotherapy required , especia lly for germinomas.

SUMMARY Short-term scheduling of batch processes in an on-line scheduling framework is a difficult problem because of the complexity and dynamic behaviour of batch processes. In this paper, an on-line scheduling framework for batch process management and a dispatching–simulation mechanism for short-term scheduling in the framework are presented. Moreover, an extended dispatching rule approach, which applies different dispatching rule combinations in the mechanism, and a search algorithm to find an appropriate dispatching rule combination with reasonable computational effort, are proposed. The effectiveness of the proposed approach and the search algorithm are demonstrated on an example multiproduct batch process model.

著者人数: 31名, Accepted: 2011-02-15, 資料番号: SA1002853000

Accepted: 2006-12-11, 資料番号: SA1000060000

To evaluate the efficacy and toxicity of hypofractionated stereotactic radiotherapy (HSRT) using noninvasive fixation of the skull on solitary or oligo brain metastatic patients as an alternative to stereotactic radiosurgery (SRS) using invasive fixation.The subjects were 87 patients who had 4 or fewer brain metastases (50 solitary, 37 oligometastases). Treatment was conducted on 159 metastases by using a linac-based stereotactic system. The median isocentric dose was 35 Gy in 4 fractions. Whole-brain irradiation was not applied as an initial treatment. For the salvage treatment of metachronous brain metastases, repeat HSRT or whole-brain irradiation was applied.The actuarial 1-year local tumor control rate was 81%. Treatment-related complications were observed in 4 patients in the early period (3 months) and in 2 patients in the late period. The median survival period was 8.7 months. Metachronous brain metastases occurred in 30 patients, and none of the 18 patients who were eligible for salvage HSRT refused to receive it again.Hypofractionated stereotactic radiotherapy achieved tumor control and survival equivalent to those of SRS reported in the literature. The results suggested that HSRT could be an alternative for solitary or oligo brain metastatic patients with less toxicity and less invasiveness compared to SRS.