BACKGROUND:The authors report preliminary results from a prospective multicenter study (Nasopharyngeal Carcinoma [NPC] 2003 German Society of Pediatric Oncology and Hematology/German Children's Oncology Group [NPC‐2003‐GPOH/DCOG]).METHODS:From 2003 to 2010, 45 patients (ages 8‐20 years), including 1 patient with stage II NPC and 44 patients with stage III/IV NPC, were recruited to the study. The patient with stage II disease received radiotherapy (59.4 grays [Gy]). The patients with stage III/IV disease received 3 courses of neoadjuvant chemotherapy with cisplatin, 5‐fluorouracil, and folinic acid. The cumulative irradiation dose was 54 Gy in 5 patients, who achieved complete remission after neoadjuvant chemotherapy, and 59.4 Gy in the remaining 40 patients. All patients received concomitant cisplatin during the first week and last week of irradiation. After irradiation, all patients received interferon beta for 6 months. Tumor response was evaluated by magnetic resonance imaging studies and positron emission tomography scans.RESULTS:After the completion of treatment, 43 of 45 patients were in complete remission. In 2 patients, only a partial response was achieved, followed by distant metastases (1 patient) or local progression and distant metastases (1 patient), 6 months and 10 months after diagnosis, respectively. Another patient developed a solitary pelvic bone metastasis 21 months after diagnosis. After a median follow‐up of 30 months (range, 6‐95 months), the event‐free survival rate was 92.4%, and the overall survival was 97.1%. Acute toxicity consisted mainly of leucopenia, mucositis, and nausea; and late toxicity consisted of hearing loss and hypothyroidism.CONCLUSIONS:Combined therapy with neoadjuvant chemotherapy, radiochemotherapy, and interferon beta was well tolerated and resulted in a very good outcome that was superior to the outcomes of published results from all other pediatric NPC study groups. Cancer 2012. © 2012 American Cancer Society.

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We describe a case of visceral leishmaniasis in a 15-month-old German child. Diagnosis was significantly delayed because the patient had no history of travel to known endemic areas. Congenital or blood transfusion-associated leishmaniasis was ruled out. Possible modes of transmission (including a potential new autochthonous focus of the disease in central Europe) are discussed.

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We have studied the effect of the chemical composition on the structure in the system Cr-Al-C by combinatorial thin film synthesis. Thin films with a laterally graded chemical composition were deposited using magnetron sputtering from elemental targets. By changing the Cr/C ratio from 1.72 to 3.48 and the Cr/Al ratio from 1.42 to 4.18 the formation of Cr 2 AlC, Cr 2 Al and Cr 23 C 6 phases was observed. Furthermore, based on X-ray diffraction a single phase Cr 2 AlC composition region is identified (Cr/C ratio between 1.72 and 1.93, Cr/Al ratio between 1.42 and 2.03) in the Cr-Al-C phase diagram. As the Cr/C ratio of 1.93 is increased the formation of Cr 2 Al and Cr 23 C 6 was observed in addition to Cr 2 AlC. Throughout the studied composition range the lattice parameters of Cr 2 AlC were independent of the chemical composition: a=2.865 ±0.007 +0.005 , c = 12.80 ±0.05 +0.08 . Furthermore, we find that a deviation from the stoichiometric composition of up to 6.3 at% for Al still results in the formation of a Cr 2 AlC single phase field. Possible pathways to accommodate the observed deviation from stoichiometry are discussed. The so-called M n+1 AX n phases (M is an early transition metal, A is an A-group element, and X is C and/or N and n=1±3) have recently attracted attention due to their unusual properties. [1] Generally speaking, they combine metallic behaviour such as good thermal and electrical conductivity, [2,3] plasticity, [4±7] excellent thermal shock resistance [2,4,8] with ceramic attributes for example high stiffness [9,10] and high temperature oxidation resistance. [4,11,12] While the Ti-Si-C system is comparatively well investigated with respect to synthesis, [2] properties, [1,2,4,13] and theory [3,10,14,15] only little is known about the Cr-Al-C system. Ab initio calculations of the structure [16] has been published and found to compare well with the structure measured for bulk samples [17] as well as for thin films grown by physical vapour deposition. [18] Furthermore, the solubility of stoichiometric Cr 2-x Ti x AlC and Cr 2-x V x AlC

In osteosarcoma, intraarterial (IA) administration of systemic treatment has been advocated to improve local tumor response preparing for, or even obviating, definitive surgery. Because data from the literature did not unequivocally support the local superiority of IA infusion, a comparative study was started in 1986. Preoperative chemotherapy consisted of 45 mg/m2 of doxorubicin on days 1 and 2; 12 g/m2 of high-dose methotrexate on days 15 and 22; and 3 g/m2 of ifosfamide on days 29, 30, 50, and 51 followed on days 31 and 52 by intravenous (IV) versus IA tourniquet infusion of cisplatin (DDP). A strict randomization of patients was not feasible. A balanced distribution of risk factors was strived for by stratifying and allocating the appropriate patients centrally. The infusion time was prolonged from 1 to 5 hours in the IV group, and the DDP dose was reduced from 150 to 120 mg/m2 in both arms when intolerable ototoxicity became apparent. A multivariate analysis was performed to exclude a bias on the response rates from risk factor distribution and from modifications of DDP infusion time and dosage. The overall fraction of histologic good responders (greater than 90% necrosis) was not found to be different after IA versus IV treatment (34/50 [68%] vs. 41/59 [69%]). Intraarterial instead of IV use of DDP within an aggressive systemic treatment does not seem to improve the local tumor response.

These participating institutions recruited patients into the study and are listed in alphabetical order. The number of patients recruited appears after each researcher's name. Departments of Pediatric Hematology and Oncology 1 and

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