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DOE OSTI2016

Byzantine Reliable Broadcast in Sparse Networks

Modern large-scale networks require the ability to withstand arbitrary failures (i.e., Byzantine failures). Byzantine reliable broadcast algorithms can be used to reliably disseminate information in the presence of Byzantine failures. We design a novel Byzantine reliable broadcast protocol for loosely connected and synchronous networks. While previous such protocols all assume correct senders, our protocol is the first to handle Byzantine senders. To achieve this goal, we have developed new techniques for fault detection and fault tolerance. Our protocol is efficient, and under normal circumstances, no expensive public-key cryptographic operations are used. We implement and evaluate our protocol, demonstrating that our protocol has high throughput and is superior to the existing protocols in uncivil executions.

Byzantine broadcast↗

DOE OSTI2026

PRIME: An evaluation framework for protein representation inference and generalization in viral mutation space

Background Protein language models (PLMs) have revolutionized protein fitness prediction, yet their application to rapidly evolving viral pathogens is often confounded by extreme sequence homology. This homology leads to “data leakage” in standard random validation splits, yielding inflated performance metrics that fail to translate into real-world biosurveillance utility. Results We present Protein Representation Inference for Mutation Evaluation (PRIME), a framework that integrates domain-specific fine-tuning with a rigorous position-stratified validation protocol to evaluate viral threats. Using a dataset of 347,432 SARS-CoV-2 receptor binding domain (RBD) sequences, we demonstrate that while random training data split yields deceptive R 2 values (> 0.90), they fail to generalize to novel mutational sites. By benchmarking models up to 650 M parameters, we show that domain-specific fine-tuning of the ESM-C 600 M model with correctly stratified data provides an initial demonstration of predictive signal for binding affinity and expression at unseen mutational sites of binding affinity and expression on unseen sites (R 2 ~0.23), a significant advancement over base foundation models which exhibit no predictive power (R 2 <0). PRIME’s embedding-based clustering identified 3.03% of bat coronavirus sequences as candidates for further experimental prioritization based on their functional similarity to human-infective strains in embedding space, offering a perspective complementary to traditional phylogenetic methods. Conclusion PRIME establishes a new benchmark for the application of PLMs in pathogen surveillance. Our findings demonstrate that state-of-the-art models and fine-tuning, when paired with stratified validation, provide biologically meaningful insights into pathogen evolution and zoonotic risk.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2016

SU-F-J-16: Planar KV Imaging Dose Reduction Study

Purpose: IGRT has become an indispensable tool in modern radiotherapy with kV imaging used in many departments due to superior image quality and lower dose when compared to MV imaging. Many departments use manufacturer supplied protocols for imaging which are not always optimised between image quality and radiation dose (ALARA). Methods: Whole body phantom PBU-50 (Kyoto Kagaku ltd., Japan) for imaging in radiology has been imaged on Varian iX accelerator (Varian Medical Systems, USA) with OBI 1.5 system. Manufacturer’s default protocols were adapted by modifying kV and mAs values when imaging different anatomical regions of the phantom (head, thorax, abdomen, pelvis, extremities). Images with different settings were independently reviewed by two persons and their suitability for IGRT set-up correction protocols were evaluated. The suitable images with the lowest mAs were then selected. The entrance surface dose (ESD) for manufacturer’s default protocols and modified protocols were measured with RTI Black Piranha (RTI Group, Sweden) and compared. Image quality was also measured with kVQC phantom (Standard Imaging, USA) for different protocols. The modified protocols have been applied for clinical work. Results: For most cases optimized protocols reduced the ESD on average by a factor of 3(range 0.9–8.5). Further reduction in ESD has been observed by applying bow-tie filter designed for CBCT. The largest reduction in dose (12.2 times) was observed for Thorax lateral protocol. The dose was slightly increased (by 10%) for large pelvis AP protocol. Conclusion: Manufacturer’s default IGRT protocols could be optimised to reduce the ESD to the patient without losing the necessary image quality for patient set-up correction. For patient set-up with planar kV imaging the bony anatomy is mostly used and optimization should focus on this aspect. Therefore, the current approach with anthropomorphic phantom is more advantageous in optimization over standard kV quality control phantoms and SNR metrics.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2020

A systematic strategy for estimating hERG block potency and its implications in a new cardiac safety paradigm

Introduction: hERG block potency is widely used to calculate a drug's safety margin against its torsadogenic potential. Previous studies are confounded by use of different patch clamp electrophysiology protocols and a lack of statistical quantification of experimental variability. Since the new cardiac safety paradigm being discussed by the International Council for Harmonisation promotes a tighter integration of nonclinical and clinical data for torsadogenic risk assessment, a more systematic approach to estimate the hERG block potency and safety margin is needed. Methods: A cross-industry study was performed to collect hERG data on 28 drugs with known torsadogenic risk using a standardized experimental protocol. A Bayesian hierarchical modeling (BHM) approach was used to assess the hERG block potency of these drugs by quantifying both the inter-site and intra-site variability. A modeling and simulation study was also done to evaluate protocol-dependent changes in hERG potency estimates. Results: A systematic approach to estimate hERG block potency is established. The impact of choosing a safety margin threshold on torsadogenic risk evaluation is explored based on the posterior distributions of hERG potency estimated by this method. The modeling and simulation results suggest any potency estimate is specific to the protocol used. Discussion: This methodology can estimate hERG block potency specific to a given voltage protocol. The relationship between safety margin thresholds and torsadogenic risk predictivity suggests the threshold should be tailored to each specific context of use, and safety margin evaluation may need to be integrated with other information to form a more comprehensive risk assessment.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2012

Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program - 12184

The U.S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collection adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS and M) program: - Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. - DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. - DOE must continue to maintain constructive relationships with the U.S. Army Corps of Engineers and state and federal regulators. After review of historical site documentation, DOE reports, and USACE radiological data, DOE concluded the following: - DOE had access to adequate documentation to evaluate site conditions at the former LOOW. This is important to confirm now, while institutional knowledge of early FUSRAP work remains available. - DOE remediated the completed VPs to conditions that are protective for unrestricted residential use. Sample and walkover gamma scan results indicate that no wastes remain that exceed cleanup criteria. - Process knowledge and field observations establish that Cs-137 is the predominant radionuclide in the KAPL waste stream. Cs-137, a strong gamma emitter, was used as an indicator for remediation of KAPL waste. Other radionuclides were present in much lower relative concentrations and were likely also removed during remediation of the VPs. - KAPL contaminants were removed during remedial activities at the former LOOW as either co-located or co-mingled with other radionuclides. - For the active VPs (VP-E, VP-E', and VP-G), results of DOE's cleanup of the accessible portions of these properties indicate that KAPL waste does not remain at concentrations greater than the DOE cleanup limit: - Inaccessible areas were not associated with historic KAPL waste handling. Therefore, it is unlikely that KAPL waste remains on the active VPs. - Because gamma activity was used by DOE during remediation/verification activities for excavation control, additional USACE cleanup of FUSRAP wastes on these properties will likely result in the remediation of any co-located residual KAPL wastes to acceptable levels or identification of KAPL waste that is not co-located. - Although USACE has not established a cleanup level for Cs-137 on the active NFSS VPs, DOE assessment and remediation data indicate that assessed Cs-137 was remediated and significant Cs-137 is unlikely to remain. Because of the low likelihood of encountering significant KAPL waste on the active NFSS VPs, additional remediation is not anticipated at these properties. - USACE assessment soil sampling results on the NFSS proper indicate that KAPL waste does not exceed the DOE cleanup level for Cs-137. USACE has not established a cleanup level for Cs-137 on NFSS proper. The USACE cleanup of FUSRAP wastes on the NFSS proper will likely result in the remediation of any co-located residual KAPL wastes or identification of KAPL waste that is not co-located. DOE is drafting a report of the investigation of KAPL waste at LOOW. The report will be released to the public for comment when the draft is complete. DOE responses to stakeholder inquiries resulted in a common understanding of site conditions and site risk. DOE expects additional interaction with stakeholders at the former LOOW as USACE completes remediation of the active VPs and the NFSS proper, and these relationships will hopefully have built trust between DOE and the stakeholders that DOE will perform its duties in an open and transparent manner that includes stakeholders as stewards for remediated FUSRAP sites. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2012

Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program -12184

Remediation, Niagara Falls Storage Site, Lake Onta↗

DOE OSTI2023

Developing rapid electrochemical relithiation protocols for scalable relithiation of lithium-ion battery cathode materials

The recent and ongoing boom in electric vehicle sales has caused the circularity of the supply chain for electric vehicle battery materials to come under a great deal of scrutiny. Innovative recycling processes, or direct recycling, that offer the possibility of reducing the cost of recycling are one possible solution to regaining resources from end-of-life (EoL) electric vehicle batteries. Electrochemically shuttling lithium back into the cathode, or electrochemical relithiation, is a possible technique for restoring lithium content to NMC materials (EoL) in a direct recycling process. This study provides essential understanding towards developing an electrochemical relithiation protocol that will restore lithium loss in intercalation cathode materials that reach EoL by loss of lithium inventory (LLI) as opposed to other degradation mechanisms like loss of active material (LAM), cation mixing or phase transition. Electrochemically aged NMC cathode materials have been prepared and characterized to establish the extent of EoL material structural degradation and lithium loss. A model-informed experimental process is used to identify the optimal electrochemical relithiation protocol to minimize the time taken to relithiate EoL materials and maximize the amount of lithium restored. Protocols were evaluated based on their ability to enable rapid lithium intercalation, maintain structural uniformity in the EoL material and fully restore lithium content. An optimal protocol was identified at elevated temperatures utilizing a novel scanning voltage step.

25 ENERGY STORAGE↗

DOE OSTI2025

Harnessing land-atmosphere interactions to enhance subseasonal-to-seasonal predictability

2025 Advancing Understanding of Land-Atmosphere Interactions and Processes on S2S Predictability Workshop What: 227 registered workshop participants gathered in person (43%) and online (57%) to discuss state-of-the-art scientific understanding and modeling of land-atmosphere interactions and related processes in the context of subseasonal-to-seasonal (S2S) predictability. Topics covered sources of S2S predictability, land model initialization methods, model diagnosis and evaluation metrics, AI/ML analysis and applications, and coordination of future community multi-model S2S forecast focused experiments. To advance the science, this community workshop, organized by NSF NCAR, NOAA, NASA, and DOE, aimed to 1) identify process- and application-oriented metrics for assessing S2S prediction skill and 2) develop experimental protocols for coordinated experiments to isolate, quantify, and understand the role of land-atmosphere interactions in S2S predictability. When: June 16-18, 2025 Where: Boulder, CO, USA, and online.

Land-Atmosphere Interaction↗

DOE OSTI2013

Field Monitoring Protocol: Heat Pump Water Heaters

This document provides a standard field monitoring protocol for evaluating the installed performance of Heat Pump Water Heaters in residential buildings. The report is organized to be consistent with the chronology of field test planning and execution. Research questions are identified first, followed by a discussion of analysis methods, and then the details of measuring the required information are laid out. A field validation of the protocol at a house near the NREL campus is included for reference.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

DOE OSTI2013

Field Monitoring Protocol. Heat Pump Water Heaters

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

DOE OSTI2013

A Systematic Review of Protocols for the Three-Dimensional Morphologic Assessment of Abdominal Aortic Aneurysms Using Computed Tomographic Angiography

The morphology of infrarenal abdominal aortic aneurysms (AAAs) directly influences the perioperative outcome and long-term durability of endovascular aneurysm repair. A variety of methods have been proposed for the characterization of AAA morphology using reconstructed three-dimensional (3D) computed tomography (CT) images. At present, there is lack of consensus as to which of these methods is most applicable to clinical practice or research. The purpose of this review was to evaluate existing protocols that used 3D CT images in the assessment of various aspects of AAA morphology. An electronic search was performed, from January 1996 to the end of October 2010, using the Embase and Medline databases. The literature review conformed to PRISMA statement standards. The literature search identified 604 articles, of which 31 studies met inclusion criteria. Only 15 of 31 studies objectively assessed reproducibility. Existing published protocols were insufficient to define a single evidence-based methodology for preoperative assessment of AAA morphology. Further development and expert consensus are required to establish a standardized and validated protocol to determine precisely how morphology relates to outcomes after endovascular aneurysm repair.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2023

Evaluating the Water Cycle Over CONUS at the Watershed Scale for the Energy Exascale Earth System Model Version 1 (E3SMv1) Across Resolutions

Abstract The water cycle is an important component of the earth system and it plays a key role in many facets of society, including energy production, agriculture, and human health and safety. In this study, the Energy Exascale Earth System Model version 1 (E3SMv1) is run with low‐resolution (roughly 110 km) and high‐resolution (roughly 25 km) configurations—as established by the High Resolution Model Intercomparison Project protocol—to evaluate the atmospheric and terrestrial water budgets over the conterminous United States (CONUS) at the large watershed scale. The warm season water cycle slows down in the HR experiment relative to the LR, with decreasing fluxes of precipitation, evapotranspiration, atmospheric moisture convergence, and runoff. The reductions in these terms exacerbate biases for some watersheds, while reducing them in others. For example, precipitation biases are exacerbated at HR over the Eastern and Central CONUS watersheds, while precipitation biases are reduced at HR over the Western CONUS watersheds. The most pronounced changes with resolution to the water cycle come from reductions in precipitation and evapotranspiration. The reduction in evapotranspiration reduces the biases across nearly all of the CONUS. Additional exploratory metrics show improvements to water cycle extremes (both in precipitation and streamflow), fractional contributions of different storm types to total precipitation, and mountain snowpack.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2019

A Comparison of Phasor Communication Protocols

In this paper, we compare three approaches used for continuous transfer of real-time synchrophasor data: IEEE C37.118.2-2011, IEC TR 61850-90-5 and a new protocol being developed under the Department of Energy (DOE) project DOE-OE-859 called the Streaming Telemetry Transport Protocol (STTP). STTP is currently being advanced as a potential third standard protocol via the IEEE Power Engineering Society STTP P10 Work Group (P2664). Each of these three synchrophasor protocols is described in detail in this paper along with the basis for their operating characteristics using Internet Protocol (IP) transport. The dominant protocol for the exchange of synchrophasor data is IEEE C37.118, both in the U.S. and internationally. The most recent IEEE C37.118 standard is broken into two parts where IEEE C37.118.1-2011 (Part 1) defines the normative synchrophasor measurement requirements and IEEE C37.118.2-2011 (Part 2) defines the protocol’s data transmission format. Both the IEC TR 61850-90-5 and the emergent STTP specifications only address synchrophasor data transmission; therefore, this paper focuses on comparing the data transmission protocol elements of these standards. The primary dimensions of comparison of these three protocols explored in this paper are: structure, efficiency, susceptibility to data loss, scalability, security, and other operability functionality. Additionally, though not specifically relevant to synchrophasor data telemetry, the three protocols are evaluated with respect to flexibility for transporting non-synchrophasor precise-time data streams.

24 POWER TRANSMISSION AND DISTRIBUTION↗

DOE OSTI2023

Evaluation of Cathode Materials with Lithium-Metal Anodes: Baseline Performance and Protocol Standardization of Coin Cells

The collaborative evaluation of electrode materials across multiple research entities requires standardized electrochemical testing protocols to produce reliable, one-to-one comparisons between different systems of interest. Similar to the work done by Long et al. on protocol standardization for coin-cell testing with graphite anodes [J. Electrochem. Soc., 163, A2999, (2016)], here we introduce two standardized testing protocols designed to quickly evaluate important electrochemical properties of cathode materials using lithium-metal anodes. The two protocols measure kinetic and thermodynamic capacity losses, rate- and voltage-dependent cycling capacities, instabilities at high voltage and high cycling rate, and overpotentials at various states of charge. We then apply these protocols to four commercially available cathode materials to establish benchmark performance metrics that can be used to screen and evaluate new cathode materials.

25 ENERGY STORAGE↗

DOE OSTI2015

Multipinhole SPECT helical scan parameters and imaging volume

Purpose: The authors developed SPECT imaging capability on an animal PET scanner using a multiple-pinhole collimator and step-and-shoot helical data acquisition protocols. The objective of this work was to determine the preferred helical scan parameters, i.e., the angular and axial step sizes, and the imaging volume, that provide optimal imaging performance. Methods: The authors studied nine helical scan protocols formed by permuting three rotational and three axial step sizes. These step sizes were chosen around the reference values analytically calculated from the estimated spatial resolution of the SPECT system and the Nyquist sampling theorem. The nine helical protocols were evaluated by two figures-of-merit: the sampling completeness percentage (SCP) and the root-mean-square (RMS) resolution. SCP was an analytically calculated numerical index based on projection sampling. RMS resolution was derived from the reconstructed images of a sphere-grid phantom. Results: The RMS resolution results show that (1) the start and end pinhole planes of the helical scheme determine the axial extent of the effective field of view (EFOV), and (2) the diameter of the transverse EFOV is adequately calculated from the geometry of the pinhole opening, since the peripheral region beyond EFOV would introduce projection multiplexing and consequent effects. The RMS resolution results of the nine helical scan schemes show optimal resolution is achieved when the axial step size is the half, and the angular step size is about twice the corresponding values derived from the Nyquist theorem. The SCP results agree in general with that of RMS resolution but are less critical in assessing the effects of helical parameters and EFOV. Conclusions: The authors quantitatively validated the effective FOV of multiple pinhole helical scan protocols and proposed a simple method to calculate optimal helical scan parameters.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-G-206-11: The Effect of Table Height On CTDIvol and SSDE in CT Scanning: A Phantom Study

Purpose: Localizer projection radiographs acquired prior to CT scans are used to estimate patient size, affecting the function of Automatic Tube Current Modulation (ATCM) and calculation of the Size Specific Dose Estimate (SSDE). Due to geometric effects, the projected patient size varies with scanner table height and with the orientation of the localizer (AP versus PA). Consequently, variations in scanner table height may affect both CTDIvol and the calculated size-corrected dose index (SSDE). This study sought to characterize these effects. Methods: An anthropomorphic phantom was imaged using an AP localizer, followed by a diagnostic scan using ATCM and our institution’s routine abdomen protocol. This was repeated at various scanner table heights, recording the scanner-reported CTDIvol for each diagnostic scan. The width of the phantom was measured from the localizer and diagnostic images using in-house software. The measured phantom width and scanner-reported CTDIvol were used to calculate SSDE. This was repeated using PA localizers followed by diagnostic scans. Results: 1) The localizer-based phantom width varied by up to 54% of the nominal phantom width between minimum and maximum table heights. 2) Changing the table height caused a variation in scanner-reported CTDIvol of a factor greater than 4.6 when using a PA localizer and almost 2 when using an AP localizer. 3) SSDE, calculated from measured phantom size and scanner-reported CTDIvol, varied by a factor of more than 2.8 when using a PA localizer and almost 1.5 when using an AP localizer. Conclusion: Our study demonstrates that off-center patient positioning affects the efficacy of ATCM, more severely when localizers are acquired in the PA rather than AP projection. Further, patient positioning errors can cause a large variation in the calculated SSDE. This hinders interpretation of SSDE for individual patients and aggregate SSDE data when evaluating CT protocols and clinical practices.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2017

Minimize Solvent Oxidation with NO X Pre-Scrubbing

A novel method to remove nitrogen dioxide (NO 2 ) from the flue gas of coal-fired power plants with CO 2 capture was further developed for commercial implementation. The technology leverages the equipment and chemistry in an existing (sulfur dioxide) SO 2 polishing scrubber upstream of the main CO 2 capture unit to remove the NO 2 , preventing degradation of the CO 2 capture solvent and formation of nitrosamines (environmental hazards). The research in this report focuses on further evaluation of the chemical additives and operating conditions associated with the NO 2 removal process to define conditions for commercial scale testing and deployment. Experimental work systematically evaluated a series of potential additives to minimize the oxidation of sulfite in a representative SO 2 pre-scrubber solution (sulfite, in turn, absorbs NO 2 ). The additive combinations and concentrations were varied alongside important process conditions such as temperature, oxygen concentration, and metals present in solution to mimic the conditions expected in a commercial system. Important results of the parametric experimental work include identifying a new, potent sulfite oxidation inhibitor, revealing the importance of combining inhibitors with metal chelating agents, validation of a low-cost additive process, and development of a new semi-empirical model to represent mechanisms associated with sulfite oxidation. In addition, the experimental work reveled the impact of operating at higher temperatures (representative of a field test unit), which will guide the selection and concertation of additives as well. Engineering analysis found that waste solutions from the pre-scrubber with NO 2 additives may potentially be integrated with existing processes on site (e.g., flue gas desulfurization unit). In addition, techno-economic analysis identified potential net savings as large as $1.30/tonne CO 2 captured and quantified the potential benefit of low cost additive options actively being pursued by the development team. Finally, the experimental results and engineering analysis supported the development of a detailed field testing plan and protocol to evaluate the technology at near-commercial scale. The field test preparation included development of procedures to introduce chemical additives to an existing SO 2 polishing unit and identification of representative flue gas conditions based on a review of existing plants. These activities will have direct bearing on operation and design of commercial units.

20 FOSSIL-FUELED POWER PLANTS↗

DOE OSTI2015

A Prospective Phase 2 Trial of Reirradiation With Stereotactic Body Radiation Therapy Plus Cetuximab in Patients With Previously Irradiated Recurrent Squamous Cell Carcinoma of the Head and Neck

Purpose: Salvage options for unresectable locally recurrent, previously irradiated squamous cell carcinoma of the head and neck (rSCCHN) are limited. Although the addition of reirradiation may improve outcomes compared to chemotherapy alone, significant toxicities limit salvage reirradiation strategies, leading to suboptimal outcomes. We therefore designed a phase 2 protocol to evaluate the efficacy of stereotactic body radiation therapy (SBRT) plus cetuximab for rSCCHN. Methods and Materials: From July 2007 to March 2013, 50 patients >18 years of age with inoperable locoregionally confined rSCCHN within a previously irradiated field receiving ≥60 Gy, with a Zubrod performance status of 0 to 2, and normal hepatic and renal function were enrolled. Patients received concurrent cetuximab (400 mg/m{sup 2} on day −7 and then 250 mg/m{sup 2} on days 0 and +8) plus SBRT (40-44 Gy in 5 fractions on alternating days over 1-2 weeks). Primary endpoints were 1-year locoregional progression-free survival and National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0 graded toxicity. Results: Median follow-up for surviving patients was 18 months (range: 10-70). The 1-year local PFS rate was 60% (95% confidence interval [CI]: 44%-75%), locoregional PFS was 37% (95% CI: 23%-53%), distant PFS was 71% (95% CI: 54%-85%), and PFS was 33% (95% CI: 20%-49%). The median overall survival was 10 months (95% CI: 7-16), with a 1-year overall survival of 40% (95% CI: 26%-54%). At last follow-up, 69% died of disease, 4% died with disease, 15% died without progression, 10% were alive without progression, and 2% were alive with progression. Acute and late grade 3 toxicity was observed in 6% of patients respectively. Conclusions: SBRT with concurrent cetuximab appears to be a safe salvage treatment for rSCCHN of short overall treatment time.

62 RADIOLOGY AND NUCLEAR MEDICINE↗