BACKGROUND Patients with high‐grade soft tissue sarcomas are at high risk of developing local disease recurrence and metastatic disease. [F‐18]‐fluorodeoxy‐D‐glucose (FDG) positron emission tomography (PET) scans are hypothesized to detect histopathologic response to therapy and to predict risk of tumor progression in patients with various malignancies. Serial FDG‐PET scans were taken to determine the correlation between FDG uptake and patient outcomes in patients receiving multimodality treatment of extremity sarcomas. METHODS Forty‐six patients with high‐grade localized sarcomas were studied. The maximum standardized uptake values (SUVmax) of tumors were measured before receipt of neoadjuvant chemotherapy and again before surgery. Resected specimens were examined for residual viable tumor. Patients were followed up at least annually for evidence of local and distant recurrence of disease and survival. RESULTS Patients with a baseline tumor SUVmax ≥ 6 and < 40% decrease in FDG uptake were at high risk of systemic disease recurrence estimated to be 90% at 4 years from the time of initial diagnosis. Patients whose tumors had a ≥ 40% decline in the SUVmax in response to chemotherapy were at a significantly lower risk of recurrent disease and death after complete resection and adjuvant radiotherapy. CONCLUSIONS The FDG‐PET scan was found to be a useful method with which to predict the outcomes of patients with high‐grade extremity soft tissue sarcomas treated with chemotherapy. The pretreatment tumor SUVmax and change in SUVmax after neoadjuvant chemotherapy independently identified patients at high risk of tumor recurrence. The FDG‐PET scan showed promise as a tool to identify the patients with sarcoma who are most likely to benefit from chemotherapy. Cancer 2005. © 2004 American Cancer Society.
We are developing a new class of Brain-Computer Interface that we call a Brain-Muscle-Computer Interface, in which surface electromyography (sEMG) recordings from a single muscle site are used to control the movement of a cursor. Previous work in our laboratory has established that subjects can learn to navigate a cursor to targets by manipulating the sEMG from a head muscle (the Auricularis Superior). Subjects achieved two-dimensional control of the cursor by simultaneously regulating the power in two frequency bands that were chosen to suit the individuals. The purposes of the current pilot study were to investigate (i) subjects' abilities to manipulate power in separate frequency bands in other muscles of the body and (ii) whether subjects can adapt to preselected frequency bands. We report pilot study data suggesting that subjects can learn to perform cursor-to-target tasks on a mobile phone by contracting the Extensor Pollicis Longus (a muscle located on the wrist) using frequency bands that are the same for every individual. After the completion of a short training protocol of less than 30 minutes, three subjects achieved 83%, 60% and 60% accuracies (with mean time-to-targets of 3.4 s, 1.4 s and 2.7 s respectively). All three subjects improved their performance, and two subjects decreased their time-to-targets following training. These results suggest that subjects may be able to use the Extensor Pollicis Longus to control the BMCI and adapt to preselected frequency bands. Further testing will more conclusively investigate these preliminary findings.
This article presents an outcomes review of breast cancer patients identified from the cancer registries of four area hospitals. These patients had family histories of breast cancer, ovarian carcinoma, or both and were treated with conservative surgery and radiation to the involved breast. Patients were as follows: group 1, one first-degree relative ( n = 165, one synchronous bilateral breast cancer); group 2, > or =2 first-degree relatives ( n = 21); group 3, one second-degree relative ( n = 20); and group 4, > or =2 second-degree relatives ( n = 18). The total of patients and breast cancer events was 224 and 225, respectively. Group 5 was a subgroup of 53 patients with a substantial risk (>10%) of a BRCA1 or BRCA2 mutation. After a median follow-up of 3.9 years, 5 patients had local failure (2%), and 5 developed a contralateral breast cancer (2%). There were no significant differences in local failure rates between groups (p = 1.0): group 1, 5 of 166 (3%); group 2, 0 of 21 (0%); group 3, 0 of 20 (0%); and group 4, 0 of 18 (0%). Local failure for group 5 was 2% (1 of 53). Four of 143 patients (3%) with a minimum 3 years of follow-up (median, 5.6 years) had local failure, and 5 (4%) developed a contralateral breast cancer. A univariate analysis was statistically significant for differentiation only (well, 0 of 67; moderately, 1 of 57 [1.8%]; poor, 3 of 26 [11.5%], p = 0.008). Overall survival for groups 1-4 did not differ significantly. Although follow-up has been relatively short, we have not found that breast cancer patients with various degrees of family histories of breast/ovarian carcinoma have had a detrimental outcome when treated with conservative therapy.
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