Introduction of paclitaxel or anthracyclines can improve the results of chemotherapy in advanced ovarian cancer. Dose intensification (by shortening of intervals between cycles) and sequential ...administration of active regimens at least theoretically may improve chemotherapy effectiveness. 18 patients entered into a pilot trial of combination chemotherapy. Treatment consisted of cisplatin 50 mg/m2, epidoxorubicin 60 mg/m2 and cyclophosphamide 500 mg/m2 every 14 days for six cycles, followed by paclitaxel 175 mg/m2 (3-hour infusion) every 14 days for four cycles. Granulocyte colony stimulating factor at 300 mcg was employed between cycles on days 5-10. 16 out of 18 patients who entered the study received a full dose chemotherapy with a ratio between actually received and planned dose intensity of 0.8 or more. No life-threatening side effect was observed and toxicity was acceptable. This new approach based on sequential administration of active regimens at high dose intensity proved feasible, active and devoid of unacceptable toxicity. The administration the booth of paclitaxel and epidoxorubicin with cisplatin and cyclophopshamide has been rendered possible. Further studies are warranted.
There are several new strategies proposed to improve the outcome of patients with ST-elevation myocardial infarction (STEMI). One approach is the resurgent use of facilitated percutaneous coronary ...interventions (PCI). Until recently, deciding whether immediate PCI after combined treatment (facilitated PCI) is more appropriate than delayed PCI (short time) has not been investigated. The aim of this study, therefore, was to investigate the outcomes in patients initially successfully treated pharmacologically and immediate PCI < 2 hr, and in patients initially successfully treated with pharmacological therapy and with delayed PCI (12-72 h).
451 reperfused STEMI patients, aged 18 to 75 years, class I-II Killip, with an acceptable echocardiographic window and admitted within 12 hs of the onset of symptoms were randomized into two groups. All patients had to have successful reperfusion, to receive the combination of a standard tirofiban infusion or abciximab plus half dose rtPA. Thereafter, patients were sub-grouped as follows:group 1 (immediate PCI) patients had PCI within 2 h; and group 2 (delayed PCI) patients in which PCI was performed after 12 hs and within 72 hs.
The 225 reperfused (immediate-PCI) and 226 reperfused (delayed-PCI) patients (time from randomization to PCI 165 +/- 37 min in immediate PCI versus 45.1 +/- 20.2 h in delayed PCI group) showed similar results in ejection fraction, CK release and patency of the IRA. In addition, the delayed PCI group showed a significant reduction in ischemic events, restenosis and bleedings (P = 0.005, 0.01, 0.01 respectively) and significant reduced angiographic evidence of thrombus formation in the infarction-related artery (IRA) (p = 0.001).
Our data suggest the safety and possible use of delayed facilitated PCI in patients with STEMI, and that delayed PCI in patients treated with combined lytic and IIb/IIIa inhibitors appears to be as effective and possibly superior (reduced ischemic events and repeat PCI) as immediate PCI. The patients in this study were successfully reperfused, with TIMI-3 flow and our data may not apply to patients with TIMI 0-2 flow. This strategy could allow transferring the reperfused patients and performing PCI after hours < 72 hours and not immediately, thereby reducing the number of urgent PCI and costs, obtaining similar results, but mostly causing less discomfort to the patient. Our results had to be interpreted with caution, because current guidelines do not recommend the combined therapy, but suggest further studies. The study was aimed to investigate the outcomes in patients initially successfully treated pharmacologically and immediate PCI < 2 h, and in patients initially successfully treated with pharmacological therapy and delayed PCI (12-72 h). All patients had to have successful reperfusion, to receive the combination of a standard abciximab or tirofiban infusion plus half dose rtPA. Similar results were observed in both groups. Delayed PCI group showed a significant lower incidence in restenosis (0.01), minor bleedings (0.005), ischemic events (0.01) and a reduced angiographic evidence of thrombus formation in IRA (0.001). Our data suggest the safety and possible use of delayed facilitated PCI in patients with STEMI. Our results had to be interpreted with caution, because current guidelines do not recommend the combined therapy, but suggest further studies.
Within the R&D Program for the luminosity upgrade proposed for the Large Hadron Collider (LHC), silicon strip detectors (SSD) and test structures (TS) were manufactured on several high-resistivity ...substrates: p-type Magnetic Czochralski (MCz) and Float Zone (FZ), and n-type FZ. To test total dose (TID) effects they were irradiated with
60Co gammas and the impact of surface radiation damage on the detector properties was studied. Selected results from the pre-rad and post-rad characterization of detectors and TS are presented, in particular interstrip capacitance and resistance, break-down voltage, flatband voltage and oxide charge. Surface damage effects show saturation after 150
krad and breakdown performance improves considerably after 210
krad. Annealing was performed both at room temperature and at 60
°C, and large effects on the surface parameters observed.
The depletion depth of irradiated n-type silicon microstrip detectors can be inferred from both the reciprocal capacitance and from the amount of collected charge. Capacitance voltage (
C–
V) ...measurements at different frequencies and temperatures are being compared with the bias voltage dependence of the charge collection on an irradiated n-type magnetic Czochralski silicon detector. Good agreement between the reciprocal capacitance and the median collected charge is found when the frequency of the
C–
V measurement is selected such that it scales with the temperature dependence of the leakage current. Measuring
C–
V characteristics at prescribed combinations of temperature and frequency allows then a realistic estimate of the depletion characteristics of irradiated silicon strip detectors based on
C–
V data alone.
Magnetic Czochralski (MCz) silicon is currently being considered as a promising material for the development of radiation tolerant detectors for future high luminosity HEP experiments. Silicon wafers ...grown by the MCz method have been processed by
ITC-IRST (Trento, Italy) with a layout designed by the
SMART collaboration. The diodes produced with n-type MCz material have undergone various irradiation campaigns, using 24
GeV/
c (SPS-CERN) protons,
26
MeV
(FZK-Karlsruhe) protons and reactor neutrons (JSI-Ljubljana), with fluences up to
10
16
1
MeV equivalent neutrons
(
n
eq
)
cm
-
2
. This paper investigates space charge sign inversion effects after these irradiation levels. Samples have been characterized by reverse current and capacitance measurements before and after irradiation, and by Transient Current Technique (TCT) after irradiation. Results of the study of depletion voltage as a function of fluence and of TCT signal shapes show that Space Charge Sign Inversion has already occurred in the devices at a fluence of
4.2
×
10
14
n
eq
cm
-
2
after 26
MeV proton irradiation, and at
5
×
10
14
n
eq
cm
-
2
after neutron irradiation.
We report on the processing and characterization of microstrip sensors and pad detectors produced on n- and p-type Magnetic Czochralski (MCz), Epitaxial (EPI) and Float Zone (FZ) silicon within the ...SMART project to develop radiation-hard silicon position sensitive detectors for future colliders. Each wafer contains 10 microstrip sensors with different geometries, several diodes and test structures. The isolation in the strip detectors produced on p-type material has been achieved by means of a uniform p-spray implantation, with doping of 3×10
12
cm
−2 (low-dose p-spray) and 5×10
12
cm
−2 (high-dose p-spray). The samples have undergone irradiations with 26
MeV protons and reactor neutrons up to ∼10
16
cm
−2 1
MeV equivalent neutrons (n
eq/cm
2), and have been completely characterized before and after irradiation in terms of leakage current, depletion voltage and breakdown voltage. The current damage parameter
α has been determined for all substrates. MCz diodes show less pronounced dependence of effective doping concentration
N
eff on the fluence when compared to standard FZ silicon, giving results comparable to diffusion oxygenated FZ devices for all irradiation sources. The observed increase of
N
eff with fluence can be interpreted in EPI material as a net donor introduction process, overcompensating the usual acceptor introduction process. This effect is stronger for 26
MeV proton irradiation than for neutron irradiation.
The charge collected from beta source particles in single pad detectors produced on p-type Magnetic Czochralski (MCz) silicon wafers has been measured before and after irradiation with 26
MeV ...protons. After a 1
MeV neutron equivalent fluence of
1
×
10
15
cm
-
2
the collected charge is reduced to 77% at bias voltages below 900
V. This result is compared with previous results from charge collection measurements.
The results of the pre- and post-irradiation characterization of
n- and
p-type magnetic Czochralski silicon micro-strip sensors are reported. This work has been carried out within the INFN funded ...SMART project aimed at the development of radiation-hard semiconductor detectors for the luminosity upgrade of the large Hadron collider (LHC). The detectors have been fabricated at ITC-IRST (Trento, Italy) on 4
in wafers and the layout contains 10 mini-sensors. The devices have been irradiated with 24
GeV/c and 26
MeV protons in two different irradiation campaigns up to an equivalent fluence of 3.4×10
15 1-MeV
n/cm
2. The post-irradiation results show an improved radiation hardness of the magnetic Czochralski mini-sensors with respect to the reference float-zone sample.
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