The preparation of functional macrocycles
via dynamic covalent
chemistry (DCC) is an attractive synthetic strategy due to its thermodynamic
control over the products. The use of alkyne metathesis has emerged
as an efficient DCC method for synthesis of conjugated arylene-ethynylene
macrocycles (AEMs), but the scope has been mostly limited to rigid
and angle-persistent benzenoid-based structures. Introducing functional
groups to macrocycle backbones increases flexibility by relaxing conformational
constraints, which often leads to broad product distributions. Here
we expand the scope of alkyne metathesis to functionalized macrocycles
by systematically exploring how conformation and connectivity interplay
to affect product distribution. With a divergent approach, we prepared
a series of conjugated polymer analogues and synthesized the corresponding
macrocycles via depolymerization. The importance of conformational
constraints was reinforced by the results, but it was discovered that
minimizing the monomer’s torsional axes provides high yields
of functional macrocycles, even those with increased flexibility.
We believe that this strategy is applicable in other areas of DCC
and self-assembly to enable efficient preparation of organic materials
with flexible functional groups.
BACKGROUND
Clinical workup and treatment guidelines have been published by the National Comprehensive Cancer Network (NCCN) to ensure patients are treated uniformly and appropriately. This study sought to retrospectively review patients with a new diagnosis of sarcoma who were treated in a National Cancer Institute (NCI) designated center and determine compliance rates with guidelines for sarcoma.
AIM
To evaluate our compliance of NCCN sarcoma guidelines at a major NCI designated center and to report instances of deviation that could be used for future studies to improve patient care.
METHODS
Data was collected retrospectively as an internal review and quality assessment of 35 newly diagnosed and treated patients. Demographic data were recorded and information concerning whether patients had appropriate imaging, biopsy and management. Variables of interest were expressed as raw numbers and percentages.
RESULTS
Primary site imaging was obtained in 100% of cases. Chest and full-body imaging were obtained in 97% and 100% of indicated cases, respectively. Tissue was obtained preoperatively in 97% of cases. Imaging was reviewed at multidisciplinary Treatment Planning Conference (TPC) in 97% of cases. Pathology was reviewed in 94% of cases in TPC. Both tumor, node, metastasis staging and plan of care were reviewed in 100% of cases in TPC. Treatment guidelines were followed in 94% of cases reviewed.
CONCLUSION
This study evaluated the workup and treatment provided by a single NCI designated sarcoma service to a series of patients with pathologies defined with the NCCN sarcoma treatment guidelines. Although adherence to NCCN was reported to be very high future prospective studies are required to investigate whether NCCN guidelines impact patient outcomes.
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