To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To evaluate the survival outcomes and toxicities experienced by non-metastatic head and neck cancer (HNC) patients receiving modulated radiotherapy (RT).
Materials and methods
A total of 608 HNC patients treated consecutively from March 2010 to December 2014 with common subsites (oral cavity, oropharynx, hypopharynx, larynx and nasopharynx) of HNCs formed the study group. Eligible patients included those treated with radical or postoperative RT between March 2010 and December 2014. More than 90% patients received modulated RT [intensity-modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT)] with concurrent chemotherapy as per stage guidelines. Demographic parameters and disease-related factors were analysed. Disease-free survival (DFS) was calculated from end date of RT till last follow-up or last date of disease control. Overall survival (OS) was calculated from date of registration to last follow-up date if alive. The primary endpoint was survival. The statistical analyses were performed using SPSS version 20.0 and Kaplan–Meier method was used for calculation survival.
Among the evaluable patients, the median age was 60 years (range: 16–93) with male preponderance (male:female – 513:95). Majority were squamous cell carcinoma 93·4% (568/608). The subsites treated were oral cavity 36·8% (224). oropharynx 26·4% (161), larynx 19·7% (120), hypopharynx 10% (62) and nasopharynx 6·4% (41). RT intent was radical in 63·5% (386) and postoperative in 36·5% (222), with 59·5% (362) receiving concurrent chemotherapy. At last follow-up, 348 (57·2%) patients were alive, 169 (27·7%) patients had succumbed to disease and 120 (24·6%) patients had recurrent disease. Out of 120 recurrent cases loco-regional recurrence, nodal recurrence and distant metastases were seen in 62 (51·7%), 25 (20·8%), 33 (27·5%), respectively. In the entire study cohort at 2 year OS and DFS was 80 and 79% whereas 3 years OS and DFS was 70 and 75%, respectively.
In our study, 2 years and 3 years OS and DFS rates are found comparable to the international data with acceptable toxicity profile with the use of modulated RT. It seems to be possible because of stringent departmental protocols and good medical physics support. Our data re-validates need and benefit of advanced RT techniques like IG-IMRT and VMAT for both postoperative and radical HNC treatment at the cost of minimal long-term side effects. Future stringent follow-up and quality of life issues are being considered in a prospective manner.
Antioxidant therapies to control oxidative damage have already attracted worldwide attention in recent years. Extensive studies on phytochemicals in cell culture system and animal models have provided a wealth of information on the mechanism by which such nutraceuticals show their beneficial effect. Nutraceuticals include plant-derived factors (phytochemicals) and factors derived from animal sources as well as from microbial sources. The activities of nutraceuticals are broad and include antioxidation, modulation of enzyme activity and modification of natural hormonal activity (agonist or antagonist) to act as a precursor for one or more beneficial molecules. Antioxidants scavenge free radicals that cause cell damage. Antioxidant consumption during radiotherapy and its effects are still controversial. Some studies suggest that antioxidant supplementation during chemotherapy or radiotherapy may be beneficial and some, harmful. Wheat grass is rich in superoxide dismutase, an antioxidant enzyme. Radiotherapy causes tumour cell kill via activation of reactive oxygen species, specifically by the hydroxyl radical and needs the reactive species for effective tumour control. Wheat grass which is rich in free radical scavengers can interfere with reactive oxygen species generated by radiation for tumour cell kill and can be detrimental to the therapy per se.
To hypothesise if the antioxidant properties of wheat grass could influence tumour activity, the effects of radiation therapy on tumour cells can be nullified when wheat grass is taken during radiotherapy.
To analyse the preliminary results of CyberKnife stereotactic radiotherapy (SBRT) boost in primary head and neck cancer patients among Indian population.
Methods and materials
A total of nine patients of primary head and neck cancer were treated with CyberKnife SBRT boost after intensity-modulated radiation therapy (IMRT). The median phase 1 IMRT dose was 54 Gy/27 fractions. Histological types included squamous cell carcinoma (n=7) and adenoid cystic carcinoma (n=2). Response was evaluated using positron emission tomography/computed tomography and detailed clinical examination.
As a preliminary analysis with median follow up of 8 months (range: 6–19 months), phase 2 median tumour volume of 16·3 cc and a median dose of 5 Gy per fraction, eight patients had loco-regionally stable disease and one had distant metastasis. With objective assessment five patients had complete response. Treatment was well tolerated with no grade 3 or more acute toxicities directly related to CyberKnife boost.
CyberKnife SBRT boost is an attractive option for primary head and neck cancers especially where disease is in close proximity to critical structures hindering radical dose delivery. Future prospective analysis and optimum assessment of total biological effective dose (BED) in a properly selected case might actually benefit the use of CyberKnife SBRT boost.
Metastases to the parotid region are relatively infrequent and originate primarily from head and neck cancer. Metastases of an infraclavicular origin are uncommon. Moreover, metastasis from the carcinoma of urinary bladder (CUB) to any part of the head and neck, including parotid gland, is rare. Surgery and chemotherapy are usually offered. We report a case of solitary parotid metastasis from CUB, who was successfully treated with stereotactic body radiotherapy (SBRT) using CyberKnife. SBRT is a safe alternative in cases unwilling/unfit for surgery.
Due to the high surface area and good bio-compatibility of nano structured ZnO, it finds good utility in biosensor applications. In this work we have fabricated highly dense ZnO nano bundles with the assistance of self assembled poly methylsilisesquoxane (PMSSQ) matrix which has been realized in a carpet like configuration with implanted ZnO nano-seeds. Such high aspect ratio structures (∼50) with carpet like layout have been realized for the first time using solution chemistry. Nanoparticles of PMMSQ are mixed with a nano-assembler Poly-propylene glycol (PPG) and Zinc Oxide nanoseeds (5-15 nm). The PPG acts by assembling the PMSSQ nanoparticles and evaporates from this film thus creating the highly porous nano-assembly of PMMSQ nanoparticles with implanted Zinc Oxide seeds. Nano-wire bundles with a high overall surface roughness are grown over this template by a daylong incubation of an aqueous solution of hexamethylene tetra amine and Zinc nitrate. Characterization of the fabricated structures has been extensively performed using FESEM, EDAX, and XRD. We envision these films to have potential of highly dense immobilization platforms for antibodies in immunosensors. The principle advantage in our case is a high aspect ratio of the nano-bundles and a high level of roughness in overall surface topology of the carpet outgrowing the zinc-oxide nanowire bundles. Antibody immobilization has been performed by modifying the surface with protein-G followed by Goat anti salmonella antibody. Antibody activity has been characterized by using 3D profiler, Bio-Rad Protein assay and UV-Visible spectrophotometer.
In this paper, the design analysis of a multi-way and high-power radial combiner is presented. This combiner incorporates a rigid stripline-type combining structure. This analysis, based on an equivalent circuit model and segmentation of the radial transmission line, provides simple design formulae. The developed methodology, after fine-tuning with the help of an electromagnetic full-wave simulator, is physically demonstrated by developing a high-power (16 kW average) and high combining-efficiency (98.9%) 16-way combiner at the center frequency of 505.8 MHz. Its efficient and repeatable performance, fabrication-friendly structure, and absence of the heat-related problem, caused by the isolation resistor, are the main features of this design.
Tungsten silicide (WSix) films, deposited by chemical vapour deposition are normally amorphous in nature, and need to be annealed at high temperature to obtain low resistivity required for interconnections and metallization layers in VLSI circuits. In this paper, we focus on this annealing process for films deposited on Si and SiO2 substrate, and having Si/W ratio of 2.4. The characterization methods used were time-resolved X-ray diffraction, Resistivity measurement, and Rutherford backscattering spectroscopy analysis. We observe that 30 minutes is not sufficient for complete transformation of the WSi2.4 films on Si substrate. We also report on the dependence of annealing behaviour of nonstoichiometric WSixfilm on the substrate type.
We use discrete dipole approximation (DDA) to study the scattering properties of composite grains made up of host silicate spheroids and graphite inclusions. We calculate the extinction cross sections of the composite grains in the wavelength region 0.20–0.55 μm and study the extinction of the composite grains as a function of graphite inclusions. We present the composite grain model and discuss the results.
Airway obstruction secondary to bleeding from warfarin therapy is difficult to manage and uncommon but has been previously described. Previous reports have emphasized the need for reversal of therapy using vitamin K and fresh frozen plasma (FFP). Where a definitive airway has been required, cricothyroidotomy or tracheostomy seem to have been favoured. Several authors have reported failed attempts at endotracheal intubation due to the obstructive effects of a sublingual haematoma. We report here a case which illustrates how endotracheal intubation can be used successfully under the right conditions. It also highlights the superiority of prothrombin complex concentrate over FFP in achieving rapid reversal of abnormal international normalized ratio in the emergency situation.
A mathematical model has been used to compute temperature profiles in ceramic preforms that are heated by microwaves. The temperature profiles were then input to a second part of the model describing chemical vapor infiltration of the preform, that is the diffusion of gaseous reactants, heterogeneous reaction, and evolution of the pore structure. Equations were solved numerically for parameters corresponding to the infiltration of SiC preforms by pyrolysis of trichloromethylsilane. While based on some simplifications, the model leads to the conclusion that infiltration proceeds more rapidly, and to a greater extent, with microwave heating/external cooling than in isothermal infiltration. The model suggests that infiltration might be optimized by manipulation of microwave power and external cooling. The computed extent of infiltration is seen to be very sensitive to the initial pore size.
A case of trigemino-facial zoster presenting as Superior Orbital Fissure Syndrome is reported. Geniculate ganglion involvement was limited to the vestibular branch of the cochleo-vestibular nerve, without any hearing impairment of facial palsy. this case clearly illustrates that herpes zoster cranialis is a polyneuropathy of multifocal asynchronous viral activity and can present in numerous forms.
Email your librarian or administrator to recommend adding this to your organisation's collection.