Anaplastic thyroid carcinoma: changing trends of treatment strategies and associated overall survival
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
Authors: Waechter, Sabine; Vorlaender, C.; Schabram, J.; Mintziras, I.; Fuelber, I.; Manoharan, J.; Holzer, K.; Bartsch, D. K.; Maurer, E.
Abstract
Purpose The prognosis of anaplastic thyroid cancer (ATC) is poor. Despite various attempts to modify common treatment modalities, including surgery, external beam radiation (EBRT) and chemotherapy (CTX), no standardized treatment is yet established. This study aimed to analyze the changing trends of treatment concepts and associated overall survival (OS) over the last two decades. Methods A retrospective analysis was conducted on 42 patients with histologically confirmed ATC. The outcome measures included the evaluation of clinical characteristics and treatments performed with regard to OS. Results Median OS for all tumor stages was 6 (range 1 week-79) months, 6.5 months for stage IVA/B and 4 months for stage IVC carcinoma patients. Twenty-one patients with stage IVA/B carcinomas underwent curative treatment, including thyroidectomy with lymphadenectomy (TTX plus LAD, n = 11) or multimodal treatment with TTX plus LAD and EBRT plus/minus CTX (n = 10). The median OS of patients with stage IVA/B carcinomas was significantly prolonged after multimodal treatment than after surgery alone (25 vs. 3 months, p = 0.04). Fifteen of 18 patients with stage IVC carcinomas received palliative, 3 patients multimodal treatment. The median OS of stage IVC patients after trimodal therapy was not significantly longer than after debulking procedures (6 vs. 7 months, p = 0.25). In the time period 1999-2009, only 4 (21%) patients received multimodal treatment compared to 9 (39%) in the period from 2009 to 2019, but this did not result in a significantly prolonged survival in the latter period (8.5 vs. 15 months, p = 0.61). Conclusion Concurrent radio- and/or chemotherapy in combination with surgery seems to result in improved survival in stage IVA/B ATC, whereas this is not the case in patients with stage IVC tumors. Novel treatment regimens are urgently needed to improve the dismal prognosis of ATC.
Monitoring of electron bunch length by using Terahertz coherent transition radiation
NUCLEAR INSTRUMENTS & METHODS IN PHYSICS RESEARCH SECTION B-BEAM INTERACTIONS WITH MATERIALS AND ATOMS
Authors: Su, Xiaolu; Yan, Lixin; Du, Yingchao; Zhang, Zhen; Zhou, Zheng; Wang, Dong; Zheng, Lianmin; Tian, Qili; Huang, Wenhui; Tang, Chuanxiang
Abstract
In this paper, ultrashort bunch length monitoring was demonstrated based on Terahertz (THz) coherent transition radiation (CTR) in Tsinghua Thomson scattering X-ray (TTX) source. The radiation produced by electron bunch is split into three paths: one of them is used to detect the total energy, while the other two paths are filtered with different THz band-pass filters before detection. The bunch length variation can be obtained by calculating the ratio between the filtered energy and the total energy. The bunch is compressed by a chicane and via changing the current of chicane, the ratio of filtered energy and total energy changed correspondingly. It is a simple supplemental approach to monitor the bunch length during beam conditioning and facility operation. Bunch arrival-time jitter and nonlinear effects in chicane are observed in the experiment during the measurement of filtered energy and total energy. (C) 2017 Elsevier B.V. All rights reserved.