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At least 199 records · Page 11

Quality of Life Outcomes From a Phase 2 Trial of Short-Course Radiation Therapy Followed by FOLFOX Chemotherapy as Preoperative Treatment for Rectal Cancer

Purpose: A prospective phase 2 trial of short-course (SC) radiation therapy (RT) with 25 Gy over 5 fractions, followed by 4 cycles of 5-fluorouracil, oxaliplatin, and leucovorin (mFOLFOX6) before surgery was recently completed at our institution. We present here the patient-reported quality of life (QOL) outcomes from this trial. Methods and Materials: Eighty patients with cT3/T4, any N, any M rectal adenocarcinoma planned for resection were enrolled between 2009 and 2012. The QOL data were obtained prospectively using the Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire before RT, before surgery, and 1 year after surgery. The previously validated minimally importance difference (MID) method was used to measure clinically significant QOL changes in FACT-C scores for each patient across time points. We examined the role of ostomy on QOL. We also compared QOL with disease outcomes and physician-reported toxicity. Results: The FACT-C questionnaire was completed by 97% of patients before RT, 85% immediately before surgery, and 62% 1 year after surgery. There was no statistically significant change in mean FACT-C scores from before treatment to after treatment. The majority of patients had either no change or an increase in QOL 1 year after treatment using the MID method. There were significant changes in QOL between patients with ostomy versus no ostomy 1 year after treatment for functional well-being (FWB) (14.81 vs 20.52, P=.018) and the colorectal cancer subscale (CCS) using the MID method (P=.004). Patients without ostomy reported stable changes in bowel control 1 year after surgery. There was no statistically significant correlation between QOL and disease recurrence, pathologic complete response, pathologic T stage downstaging, or acute/late toxicity. Conclusions: SC-RT and sequential mFOLFOX6 as preoperative therapy for rectal cancer results in stable patient-reported QOL outcomes 1 year after treatment. These findings in conjunction with previously reported oncologic outcomes support further evaluation of this regimen in a phase 3 setting.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

IDC Reengineering Phase 2 & 3 Cost Estimate Summary (Version 1.0.1)

Sandia National Laboratories has prepared a cost estimate budgetary planning for the IDC Reengineering Phase 2 & 3 effort. This report provides the cost estimate and describes the methodology, assumptions, and cost model details used to create the cost estimate.

42 ENGINEERING↗

Considerations for RTCA Phase 2 Low Size, Weight, and Power (SWAP) Surveillance Requirements

RTCA (Radio Technical Commission for Aeronautics) Special Committee 228 has initiated a second phase for the development of minimum operational performance standards (MOPS) for UAS (Unmanned Aircraft Systems) detect and avoid (DAA) systems. Technologies to enable UAS with less available Size, Weight, and Power (SWaP) will be considered. A white paper is in development for what topics and issues need to be addressed to develop DAA requirements for low SWAP surveillance systems. This briefing will document the issues to be investigated in SC-228. It will also serve as a review with the committee to get feedback so the white paper can be written and finalized. These topics and issues are not necessarily all the things that NASA will contribute to SC-228 during Phase 2, but what the overall committee needs to accomplish. A portion of the work will be in NASA's UAS in the NAS (National Airspace System) project plan.

Santiago, Confesor↗

Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

Purpose: To assess, in a randomized, phase 2 trial, the efficacy and safety of chemoradiotherapy with or without induction chemotherapy (ICT) of S1 and oxaliplatin for esophageal cancer. Patients and Methods: Patients with stage II, III, or IVA esophageal cancer were randomly allocated to either 2 cycles of ICT (oxaliplatin 130 mg/m{sup 2} on day 1 and S1 at 40 mg/m{sup 2} twice daily on days 1-14, every 3 weeks) followed by concurrent chemoradiotherapy (CCRT) (46 Gy, 2 Gy/d with oxaliplatin 130 mg/m{sup 2} on days 1 and 21 and S1 30 mg/m{sup 2} twice daily, 5 days per week during radiation therapy) and esophagectomy (arm A), or the same CCRT followed by esophagectomy without ICT (arm B). The primary endpoint was the pathologic complete response (pCR) rate. Results: A total of 97 patients were randomized (arm A/B, 47/50), 70 of whom underwent esophagectomy (arm A/B, 34/36). The intention-to-treat pCR rate was 23.4% (95% confidence interval [CI] 11.2-35.6%) in arm A and 38% (95% CI 24.5% to 51.5%) in arm B. With a median follow-up duration of 30.3 months, the 2-year progression-free survival rate was 58.4% in arm A and 58.6% in arm B, whereas the 2-year overall survival rate was 60.7% and 63.7%, respectively. Grade 3 or 4 thrombocytopenia during CCRT was more common in arm A than in arm B (35.4% vs 4.1%). The relative dose intensity of S1 (89.5% ± 20.6% vs 98.3% ± 5.2%, P=.005) and oxaliplatin (91.4% ± 16.8% vs 99.0% ± 4.2%, P=.007) during CCRT was lower in arm A compared with arm B. Three patients in arm A, compared with none in arm B, died within 90 days after surgery. Conclusions: Combination chemotherapy of S1 and oxaliplatin is an effective chemoradiotherapy regimen to treat esophageal cancer. However, we failed to show that the addition of ICT to the regimen can improve the pCR rate.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Palliative Short-Course Radiation Therapy in Rectal Cancer: A Phase 2 Study

Purpose: The management of patients with symptomatic rectal cancer not amenable to curative treatment may be challenging. The aim of this phase 2 study was to evaluate the efficacy of short-course radiation therapy in patients with obstructing rectal cancer. Methods and Materials: Patients who were not candidates for surgical resection because of synchronous metastases, age, and/or comorbidities were considered eligible. The sample size was calculated based on the 2-stage design of Simon. Short-course radiation therapy was delivered with an isocentric 4-field box technique (total, 25 Gy; 5 fractions in 5 days). Chemotherapy was suspended during radiation treatment. Clinical outcome measures were symptomatic response rate, toxicity, colostomy-free survival, and overall survival. Results: From October 2003 to November 2012, 18 patients (median age, 77.5 years) were enrolled. The median follow-up was 11.5 months (range, 3-36 months). Four weeks after treatment, a complete response (ie, complete symptom resolution) was observed in 38.9% of patients and a partial response in 50.0% cases, whereas 11.1% had no response. The rates of reduction or resolution of pain and bleeding were 87.5% and 100%, respectively. The 1-, 2-, and 3-year colostomy-free survival rates were 100%, 71.4%, and 47.6%, respectively (median, 30 months). The 1-, 2-, and 3-year cumulative overall survival rates were 85.2%, 53%, and 39.8%, respectively (median, 25 months). No patients stopped treatment because of gastrointestinal or genitourinary toxicities: 38.9% of patients had grade 1 to 2 toxicity, and 16.7% had grade 3 toxicity. Only 1 patient had hematologic grade 2 toxicity, and 2 patients had grade 2 skin toxicity. Conclusions: Short-course radiation therapy may represent a safe and effective alternative treatment option in patients with obstructing rectal cancer not eligible for curative treatment, allowing colostomy to be avoided in a substantial proportion of patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

IDC Re-Engineering Phase 2 Data Model to IDC Schema Mapping.

This initial draft document contains formative data model content for select areas of Re-Engineering Phase 2 IDC System. The purpose of this document is to facilitate discussion among the stakeholders. It is not intended as a definitive proposal.

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗

Correction to: Phase 2 Open-Label Trial Investigating Percutaneous Laser Ablation for Treatment of Early-Stage Breast Cancer: MRI, Pathology, and Outcome Correlations

The article “Phase 2 Open-Label Trial Investigating Percutaneous Laser Ablation for Treatment of Early-Stage Breast Cancer: MRI, Pathology, and Outcome Correlations”, written by Barbara Schwartzberg et al., was originally published electronically on the publisher’s internet portal (currently SpringerLink) on July 9, 2018, without open access.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Survival Outcomes of Two Phase 2 Studies of Adjuvant Chemotherapy with S-1 Plus Oxaliplatin or Capecitabine Plus Oxaliplatin for Patients with Gastric Cancer After D2 Gastrectomy

Background: Two phase 2 trials of oxaliplatin-containing adjuvant therapy for patients with gastric cancer (GC) after D2 gastrectomy were conducted in Japan. The SOXaGC trial evaluated the tolerability and safety of adjuvant therapy with S-1 plus oxaliplatin (SOX), whereas the J-CLASSIC trial evaluated the feasibility of adjuvant therapy with capecitabine plus oxaliplatin (CAPOX). Because both were studies that did not evaluate survival results as study end points, the authors evaluated the survival outcomes for the patients in the two trials. Methods: All 62 and 100 patients in the full analysis set of the SOXaGC and J-CLASSIC trials, respectively, were included in the current study. Their information about survival outcome was collected. The primary end point was relapse-free survival (RFS), and the secondary end point was overall survival (OS). Results: For the pathologic stage (pStage 2) patients treated with CAPOX, the 3-year RFS rate was 87.8% and the 3-year OS rate was 92.7%. For the pStage 3 patients treated with SOX and CAPOX, the 3-year RFS rates were respectively 70.9% and 67.8% (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.50–1.72), whereas the 3-year OS rates were respectively 75.7% and 79.3% (HR, 1.10; 95% CI, 0.54–2.26). Subgroup analysis showed significant interactions between the treatment (SOX vs. CAPOX) and both sex (male vs. female; P = 0.024) and histologic type (diffuse vs. other, P = 0.069). Conclusions: This exploratory analysis demonstrated that SOX and CAPOX are suggested to have similar efficacy for pStage 3 GC patients after D2 gastrectomy. Differences in the treatment effect according to sex and histologic type warrant further evaluation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

IDC reengineering Phase 2 & 3 US industry standard cost estimate summary

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, using a commercial software cost estimation tool calibrated to US industry performance parameters. This is not a cost estimate for Sandia to perform the project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.

97 MATHEMATICS AND COMPUTING↗

NASA satellite communications application research, phase 2 addendum. Efficient high power, solid state amplifier for EHF communications

This document is an addendum to the NASA Satellite Communications Application Research (SCAR) Phase 2 Final Report, 'Efficient High Power, Solid State Amplifier for EHF Communications.' This report describes the work performed from 1 August 1993 to 11 March 1994, under contract number NASW-4513. During this reporting period an array of transistor amplifiers was repaired by replacing all MMIC amplifier chips. The amplifier array was then tested using three different feedhorn configurations. Descriptions, procedures, and results of this testing are presented in this report, and conclusions are drawn based on the test results obtained.

Benet, James↗

Summary of Phase 1 and Plans for Phase 2 of the Washington State Geothermal Play-Fairway Analysis

A geothermal play fairway is constituted by the collocation of heat, permeability, and saturated porosity in sufficient volume that provide adequate heat exchange at depths accessible by modern drilling technologies. The focus of Phase 1 of the Washington State play-fairway analysis (PFA) was to develop and apply a methodology to integrate detailed models of heat and permeability potential for each play (study area). The goal is to minimize risk associated with investments in geothermal exploration of greenfield projects by rigorously analyzing available data, applying favorability modeling concepts that have been successfully used at known geothermal systems, and addressing data quality and model sensitivity. The integrated results indicate locations where commercial geothermal potential is highest, based on available data. Here, these results also reveal where new data are needed to increase resolution and reduce uncertainty to minimize risk (work conducted in Phase 2), and thus successfully identify sites for exploration wells (in Phase 3).

geothermal favorability↗

Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

Purpose: Hypofractionated radiation therapy (RT) in prostate cancer can be developed only if the risk of rectal toxicity is controlled. In a multicenter phase 2 trial, hypofractionated irradiation was combined with an injection of hyaluronic acid (HA) to preserve the rectal wall. Tolerance of the injection and acute toxicity rates are reported. Methods and Materials: The study was designed to assess late grade 2 toxicity rates. The results described here correspond to the secondary objectives. Acute toxicity was defined as occurring during RT or within 3 months after RT and graded according to the Common Terminology Criteria for Adverse Events version 4.0. HA tolerance was evaluated with a visual analog scale during the injection and 30 minutes after injection and then by use of the Common Terminology Criteria at each visit. Results: From 2010 to 2012, 36 patients with low-risk to intermediate-risk prostate cancer were included. The HA injection induced a mean pain score of 4.6/10 ± 2.3. Thirty minutes after the injection, 2 patients still reported pain (2/10 and 3/10), which persisted after the intervention. Thirty-three patients experienced at least 1 acute genitourinary toxicity and 20 patients at least 1 acute gastrointestinal toxicity. Grade 2 toxicities were reported for 19 patients with urinary obstruction, frequency, or both and for 1 patient with proctitis. No grade 3 or 4 toxicities were reported. At the 3-month visit, 4 patients described grade 2 obstruction or frequency, and no patients had any grade 2 gastrointestinal toxicities. Conclusions: The injection of HA makes it possible to deliver hypofractionated irradiation over 4 weeks with a dose per fraction of > 3 Gy, with limited acute rectal toxicity.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Investigation of Rare Earth Element Extraction from North Dakota Coal-Related Feedstocks (Phase 2 Final Technical Report)

There were four major goals of this project: i) identify promising lignite or lignite-related feedstocks with total rare earth element content above 300 parts per million (ppm), ii) evaluate at the lab and bench-scale the extractability of the REE from the material, iii) determine the processing required to generate REE concentrates in excess of 2 wt%, iv) evaluate the economic feasibility of the process and develop a pathway for commercialization. In the Phase 1 study, work was primarily focused upon resource evaluation and labscale extractability of the REE, with a preliminary techno-economic assessment (TEA) conducted, whereas in the Phase 2 work, the extraction process was conducted at the bench scale, a method for cost-effective generation of higher purity mixed REE concentrates (up to 65%) was developed, and a refined TEA on the bench-scale data for a 1,000 kg coal processing test was conducted.

01 COAL, LIGNITE, AND PEAT↗

Portable Computer Technology (PCT) Research and Development Program Phase 2

The subject of this project report, focused on: (1) Design and development of two Advanced Portable Workstation 2 (APW 2) units. These units incorporate advanced technology features such as a low power Pentium processor, a high resolution color display, National Television Standards Committee (NTSC) video handling capabilities, a Personal Computer Memory Card International Association (PCMCIA) interface, and Small Computer System Interface (SCSI) and ethernet interfaces. (2) Use these units to integrate and demonstrate advanced wireless network and portable video capabilities. (3) Qualification of the APW 2 systems for use in specific experiments aboard the Mir Space Station. A major objective of the PCT Phase 2 program was to help guide future choices in computing platforms and techniques for meeting National Aeronautics and Space Administration (NASA) mission objectives. The focus being on the development of optimal configurations of computing hardware, software applications, and network technologies for use on NASA missions.

Castillo, Michael↗

First Results of a Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation (WHBI) for Early-Stage Breast Cancer

Purpose: To report early outcome analysis of a prospective institutional phase 2 trial of weekly hypofractionated breast irradiation (WHBI) for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins received whole-breast radiation therapy to 30 or 28.5 Gy in 5 weekly fractions with or without an additional boost. The eligibility criteria were the same as for NSABP (National Surgical Adjuvant Breast and Bowel Project) B39/RTOG (Radiation Therapy Oncology Group) 0413, and there were no restrictions on age, breast size, tumor grade, receptor status, or the use of cytotoxic chemotherapy for otherwise eligible patients. The primary endpoint was ipsilateral breast tumor recurrence. Patients were also evaluated for acute toxicity (Common Terminology Criteria for Adverse Events version 3.0), cosmesis (Harvard Scale), development of distant metastatic disease, and overall survival. Results: Between January 2011 and October 2015, 158 eligible patients underwent WHBI immediately following BCS. The median age was 60 years (range, 30-84 years), and the median follow-up period was 3 years. Ipsilateral breast tumor recurrence developed in a total of 2 patients (1.3%), 1 in conjunction with widespread metastatic disease. Distant metastatic disease developed in 4 patients (2.5%), and the 3-year disease-free survival and overall survival rates were 97.5% and 96.2%, respectively. The most common grade 1 or 2 acute toxicities were breast pain, radiation dermatitis, and fatigue. There were 2 grade 3 events (1.3%): pain requiring narcotic analgesics (1) and posttreatment infection requiring hospitalization (1). The rate of excellent or good cosmesis versus fair or poor cosmesis was 82.3% versus 17.7%. The rate of significant cosmetic change from baseline to last follow-up (dropping from excellent or good to fair or poor) was 11.6%. Conclusions: Early outcomes after WHBI are favorable and parallel those seen with daily hypofractionated whole-breast irradiation. With broader entry criteria than all previous reports of WHBI, this study will facilitate comparison to the results of NSABP B39/RTOG 0413. With continued follow-up, future reports will assess cosmetic stability and disease-specific outcomes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

An investigation of wing buffeting response at subsonic and transonic speeds. Phase 2: F-111A flight data analysis. Volume 3: Tabulated power spectra

Power spectral density (PSD) data for all of the flight points examined during the Phase 2 flight data analysis are presented in tabular form. Detailed descriptions of the aircraft, the flight instrumentation and the analysis techniques are given. Measured and calculated vibration mode frequencies are also presented to assist in further interpretation of the PSD data.

Benepe, D. B.↗