text:
Radiation Oncology/RTOG Trials/9406

RTOG 94-06 (PROSTATE)
 * Title: A Phase I/II Dose Escalation Study Using 3D-CRT for Adenocarcinoma of the Prostate
 * Objectives:
 * (1) To establish the maximum tolerated dose (MTD) of radiation that can be delivered to the prostate gland and immediate surrounding tissues in patients with carcinoma of the prostate using three dimensional conformal radiation therapy (3D-CRT).
 * (2) To quantify the normal tissue toxicity rate (normal tissue complication probability [NTCP]) for rectum and bladder using 3D-CRT.
 * (3) To evaluate local control by clinical, pathologic, and PSA (stable in normal range) determinations.
 * Protocol: Dose escalation [Gy]: Level I =68.4 (1.8 Gy/fx) -> Level II = 73.8 (1.8 Gy/fx) -> Level III = 79.2 (1.8 Gy/fx) -> Level IV = 74.0 (2.0 Gy/fx) -> Level V = 78.0 (2.0 Gy/fx)
 * Eligibility: (T1b-T2b and GS >=6 and PSA >4) or (T3), N0M0
 * Grouping:
 * Group 1: Clinical stages T1b-c or T2a-b with PSA + ([Gleason -6] x 10) is <= 15.
 * Group 2: Clinical stages T1b-c or T2a-b with PSA + ([Gleason -6]x10)>15. Any clinical T2c with PSA < 70. Must be lymph node negative.
 * Group 3: Clinical stage T3 with PSA < 70. Must be lymph node negative.
 * Treatment Group:
 * Group 1: GTV=Prostate; CTV = prostate (no margin); PTV = CTV + 0.5-1.0 cm"
 * Group 2: GTV=Prostate; CTV1 = Prostate + BSV(=Bilateral seminal vesicles); CTV2 = Prostate; PTV1 = CTV + 0.5-1.0 cm; PTV2 = CTV2 + 0.5-1.0 cm
 * Group 3: GTV=Prostate+BSV; CTV = Prostate + BSV (no margin); PTV = CTV + 0.5-1.0 cm

 * Enroll Target: Dose tolerance dependent
 * Activated: May 2, 1994
 * Closed: October 31, 2000
 * Conclusion:
 * Long-Term Toxicity; 2010 PMID 19577865 -- "Long-Term Toxicity Following 3D Conformal Radiation Therapy for Prostate Cancer from the RTOG 9406 Phase I/II Dose Escalation Study." (Michalski JM, Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):14-22.) - Tolerance excellent; more late toxicity with 2 Gy/fx than with 1.8 Gy/fx
 * Publications:
 * PMID 22633552 -- Clinical Outcome of Patients Treated With 3D Conformal Radiation Therapy (3D-CRT) for Prostate Cancer on RTOG 9406. (Michalski J, Int J Radiat Oncol Biol Phys. 2012) Conclusion "Dose-escalated 3D-CRT yields favorable outcomes for localized prostate cancer. This multi-institutional experience allows comparison to other experiences with modern radiation therapy."
 * PMID 15936549 -- Toxicity after three-dimensional radiotherapy for prostate cancer on RTOG 9406 dose Level V. (Michalski JM, Int J Radiat Oncol Biol Phys. 2005) Conclusion : "Tolerance to three-dimensional conformal radiotherapy with 78 Gy in 2-Gy fractions remains better than expected compared with historical controls. The magnitude of any effect from fraction size and treatment volume requires additional follow-up."
 * PMID 14967428 -- Toxicity after three-dimensional radiotherapy for prostate cancer with RTOG 9406 dose level IV. (Michalski JM, Int J Radiat Oncol Biol Phys. 2004). Conclusion : Tolerance to three-dimensional conformal radiotherapy with 74 Gy in 2-Gy fractions remains better than expected compared with historical controls. The magnitude of any effect from fraction size requires additional follow-up.
 * ASCO Abstract -- Clinical outcome of patients treated with 3D conformal radiation therapy 3D-CRT for prostate cancer on RTOG 9406 (Michalski JM, ASCO 2005). Conclusion: The biochemical disease free survival appears comparable to other series using 3D CRT for localized prostate cancer. A randomized RTOG trial comparing 70.2 Gy vs 79.2 Gy for intermediate risk patients is ongoing.
 * ASTRO Abstract -- Clinical Outcome of Patients Treated with 3D Conformal Radiation Therapy 3D-CRT for Prostate Cancer on RTOG 9406 (Michalski, ASTRO 2004). Conclusion: Previous reports from RTOG 9406 have demonstrated safety of dose escalation using 3D CRT for treatment to radiation doses as high as 79.2Gy and 1.8Gy per day or 78Gy and 2.0Gy per day fractions. The clinical disease-free survival (without 9406 PSA definition) appears comparable to other series using 3D CRT for localized prostate cancer. Analysis using ASTRO and other more sensitive and specific definitions of radiation therapy outcome will be presented. Analyses of outcome by prognostic factors including T-stage, initial PSA, Gleason score, and the use of neoadjuvant hormone therapy is planned.
 * PMID 15590164 -- Penile bulb dose and impotence after three-dimensional conformal radiotherapy for prostate cancer on RTOG 9406: findings from a prospective, multi-institutional, phase I/II dose-escalation study. (Roach M, IJROBP 2004). Conclusion : Dose to the bulb of the penis seems to be associated with the risk of radiation-induced impotence.
 * PMID 12694838 -- Preliminary evaluation of low-grade toxicity with conformal radiation therapy for prostate cancer on RTOG 9406 dose levels I and II. (Michalski JM, IJRBOP 2003). Conclusion : Morbidity of 3D-CRT in the treatment of prostate cancer is low. It is important to continue to closely examine late effects in patients treated in RTOG 9406. The primary objective of dose escalation without an increase rate of >/= Grade 3 sequelae has been achieved. However, the reduction in Grade 3 complications may have resulted in a higher incidence of Grade 1 or 2 late effects. Because Grade 2 late effects may have a significant impact on a patient's quality of life, it is important to reduce these complications as much as possible. Clinical trials should use quality-of-life measures to determine that trade-offs between severity and rates of toxicity are acceptable to patients.
 * PMID 14529764 -- RTOG 94-06: is the addition of neoadjuvant hormonal therapy to dose-escalated 3D conformal radiation therapy for prostate cancer associated with treatment toxicity? (Valicenti RK, IJROBP 2003). Conclusion : Neoadjuvant HT did not show an independent effect on the risk of side effects after 3D-CRT in patients treated on RTOG 94-06. However, this combined modality therapy significantly increased the risk of acute GU effects compared to 3D-CRT alone in men with poor baseline urinary function.
 * ASTRO Abstract -- Toxicity Following 3D Radiation Therapy for Prostate Cancer on RTOG 9406 Dose Level V (Michalski J, ASTRO Abstract 46, 2003). Conclusion: The rate of grade 3+ toxicity from 3DCRT with 78 Gy in 2.0 Gy fractions remains better than expected compared to historical controls. However, low grade late toxicity is significantly higher in dose level V than dose level III. These differences may be dose and/or volume related.
 * PMID 12419429 -- Interim report of toxicity from 3D conformal radiation therapy (3D-CRT) for prostate cancer on 3DOG/RTOG 9406, level III (79.2 Gy). (Ryu JK, IJRBOP 2002). Conclusion : Based on excellent tolerance of 3D-CRT for stages T1 and T2 prostate cancer, further biological dose escalation has been pursued to Levels IV and V, 74 Gy and 78 Gy, respectively, at 2 Gy per day, in an attempt to reduce the total treatment duration. This trial has closed. A Phase III comparative RTOG trial is being developed to determine whether high-dose 3D-CRT improves efficacy.
 * PMID 11917289 -- Trade-off to low-grade toxicity with conformal radiation therapy for prostate cancer on Radiation Therapy Oncology Group 9406. (Michalski JM, Semin Radiat Oncol 2002). Conclusion :The primary objective of dose escalation without an increase rate of > or = grade 3 complications has been achieved. However, the reduction in grade 3 complications may have resulted in a higher incidence of grade 2 late effects. Because grade 2 late effects may have a significant impact on a patient's quality of life, it is important to reduce these complications as much as possible.
 * ASTRO Abstract -- Toxicity Following 3D Radiation Therapy For Prostate Cancer On RTOG 94-06 Dose Level IV. (Michalski JM, ASTRO 2002; Int J Radiat Oncol Biol Phys [54] (2):107, 2002.
 * Results: At dose level IV, grade 3 acute effects in 1% (Group 1) and 3% (Group 2). No grade 4 or 5. Late toxicity is low compared to historical controls: grade 3 bladder (1 in group 1, 4 in group 2), grade 3 bowel (1 in group 2), no grade 4 or 5. Late grade 2 toxicities of any type in 22% (group 1) and 15% (group 2).  No difference in rate of acute/late toxicity for 73.8 Gy/1.8 vs 74 Gy/2.0.  Trend toward more grade 3 or higher toxicity with 2 Gy fractions vs 1.8 Gy p=0.09).
 * Conclusion: Tolerance to 3DCRT with 74 Gy in 2Gy fractions remains better than expected compared to historical controls. The magnitude of any effect from fraction size requires additional follow-up.
 * ASTRO Abstract -- The Effect On Toxicity Of Induction Hormonal Therapy In Prostate Cancer Patients Receiving Dose Escalated 3D Conformal Radiation Therapy On RTOG 94-06. (Valicenti R, ASTRO 2002; Int J Radiat Oncol Biol Phys [54] (2):133-134, 2002.) Conclusion: Induction HT did not have an independent effect on the risk of side effects after 3D CRT. However, induction HT combined with 3D CRT significantly increased the risk of acute GU effects compared to 3D CRT alone in men with poor baseline urinary function. In patients receiving 3D CRT, no more than 30% of bladder volume should exceed the prescribed reference dose.
 * ASCO Abstract -- Interim Report of Toxicity from 3D Conformal Radiation Therapy (3DCRT) for Prostate Cancer on 3DOG/RTOG 9406, Level III (79.2 GY). (Ryu JK, ASCO 2001). Conclusion: The observed rate of grade 3+ late effects for G1 (2 cases) is significantly lower (p=0.0012) than the 10.5 cases that were expected from RTOG 7506 and 7706. The observed rate for G2 (1 case) is significantly lower (p=0.0038) than the 8.4 cases expected. Based on the excellent tolerance of 3DCRT for stage T1,2 prostate cancer, further dose escalation has been pursued to levels IV and V, 74 Gy and 78 Gy respectively, at 2 Gy/day, in an attempt to reduce the total treatment duration.
 * PMID 10661346 -- Preliminary report of toxicity following 3D radiation therapy for prostate cancer on 3DOG/RTOG 9406. (Michalski JM, IJRBOP 2000). Conclusion : Tolerance to high-dose 3D CRT has been better than expected in this dose escalation trial for Stage T1,2 prostate cancer compared to low-dose RTOG historical experience.
 * Michalski JM, Winter K, Purdy JA, et al.: Update of toxicity following 3D radiation therapy for prostate cancer on RTOG 9406. Int J Radiat Oncol Biol Phys 48(3 suppl): A-233, 228, 2000.
 * Roach M, Winter K, Michalski J, et al.: Mean dose of radiation to the bulb of penis correlates with risk of impotence at 24 months: preliminary analysis of Radiation Therapy Oncology Group (RTOG) phase I/II dose escalation trial 94-06. Int J Radiat Oncol Biol Phys 48(3 suppl): A-2104, 316, 2000

title: Radiation Oncology/RTOG Trials/9406


text:
Radiation Oncology/RTOG Trials/9202

RTOG 92-02 (PROSTATE)
 * Title: Phase III Randomized Trial of Long-Term Adjuvant Total Androgen Suppression with ZDX vs No Subsequent Treatment Following Neoadjuvant FLUT/ZDX and Radiotherapy for Locally Advanced Carcinoma of the Prostate
 * Objectives:
 * (1) Compare locoregional control, disease-free survival, and overall survival in patients with carcinoma of the prostate who are considered at high risk of relapse and receive long-term adjuvant zoladex (ZDX) vs. no adjuvant treatment following neoadjuvant ZDX/flutamide and radiotherapy.
 * (2) Compare sexual function in patients treated with these two regimens.
 * Protocol:
 * Arm 1: AST plus RT
 * Arm 2: AST plus RT followed by 24 months AST
 * Eligibility: cT2c - T4 and PSA <150 and M0
 * ''Enroll Target: 1502 patients
 * Conclusion:
 * PMID 14581419 Full_Text -- Phase III trial of long-term adjuvant androgen deprivation after neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate: the Radiation Therapy Oncology Group Protocol 92-02. (Hanks GE, JCO 2003). Conclusion :The RTOG 92-02 trial supports the addition of LT adjuvant AD to STAD with RT for T2c-4 PC. In the exploratory subset analysis of patients with Gleason scores 8 to 10, LT adjuvant AD resulted in a survival advantage.
 * Publications:
 * ASCO Abstract -- Surrogate Endpoint for Prostate Cancer-specific Survival: Validation from an Analysis of Radiation Therapy Oncology Group Protocol 92-02 (Valicenti R, ASCO 2005). Conclusion: Post-treatment PSA-DT <12 months met all of Prentice’s criteria for surrogacy. For the first time, this was accomplished for a prospectively studied patient population, and justifies strong consideration for PSA-DT< 12 months as a surrogate endpoint for prostate cancer mortality.
 * ASCO Abstract PowerPoint -- Prognostic value of abnormal p53 expression in locally advanced prostate cancer treated with androgen deprivation and radiotherapy: A study based on RTOG 9202 (Che M, ASCO Abstract 2005). Conclusion :The study confirms that abnormal p53 expression is a significant and independent adverse prognostic factor in patients with locally advanced Pca, which provides a rationale for stratifying patients according to p53 status in future prospective clinical trials.
 * PMID 15169799 -- Ki-67 staining is a strong predictor of distant metastasis and mortality for men with prostate cancer treated with radiotherapy plus androgen deprivation: Radiation Therapy Oncology Group Trial 92-02. (Pollack A, JCO 2004). Conclusion: :Ki67-SI was the most significant determinant of DM and CSD and was also associated with OD. The Ki67-SI should be considered for the stratification of patients in future trials.
 * ASCO Abstract FDA_Presentation -- Can biochemical failure (ASTRO definition) be used as a surrogate endpoint for prostate cancer survival in phase III localized prostate cancer clinical trials? Analysis of RTOG protocol 92-02 (Sandler HM, ASCO Abstract 2003). Conclusion : Of the four Prentice criteria, the first three were met. Importantly, however, the fourth criterion was not satisfied -- for those who failed biochemically, the relative risk of prostate cancer related death for patients treated with LTAD is 1.5 (p=0.05) times greater than STAD, indicating that the significance of a PSA failure event is not the same for each of the protocol arms. Thus, PSA failure may not be a satisfactory surrogate marker for prostate cancer survival in randomized clinical trials when the treatments have different duration of androgen deprivation.
 * ASCO Abstract -- Preferences for short versus long - term androgen deprivation in prostate cancer survivors. (Wilke D, ASCO 2004). Conclusion: Prostate cancer patients are willing to accept decreased survival in order to avoid the quality of life consequences of long-term androgen deprivation.
 * ASTRO Abstract -- Ki-67 Staining Is a Strong Predictor of Patient Outcome for Prostate Cancer Patients Treated with Androgen Deprivation Plus Radiotherapy: An Analysis of RTOG 92-02. (Pollack A, IJRBOP 57 (2 Suppl): S200-1, 2003). Conclusion: Ki67-SI was the most significant determinant of DM and CSD, and was also associated with OD. The relationship of Ki67-SI to patient outcome is a continuous function, wherein the higher the Ki67-SI the greater the risk of an adverse result. The 7.1% cut point has been confirmed as correlating with DM and CSD, and appears to be useful in the selection of patients who will not benefit from LTAD+RT over STAD+RT. The KI67-SI should be incorporated into the stratification of patients in future trials.
 * Hanks GE, Lu JD, Machtay M, et al.: RTOG protocol 92-02: a phase III trial of the use of long term total androgen supppression following neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 48(3 suppl): A-4, 112, 2000.
 * ASCO Abstract -- RTOG Protocol 92-02: A Phase III Trial of the Use of Long Term Androgen Suppression Following Neoadjuvant Hormonal Cytoreduction and Radiotherapy in Locally Advanced Carcinoma of the Prostate. (Hanks G, ASCO Abstract 2000). Conclusion : This study supports the continued use and study of LTAD in patients with poorly differentiated or locally advanced prostate cancers.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Radiation Oncology/RTOG Trials/9202


text:
Radiation Oncology/RTOG Trials/9020

RTOG 90-20 (PROSTATE)
 * Title: A Phase II Trial of External Beam Radiation With Etanidazole for Locally Advanced Prostate Cancer
 * Objectives:
 * (1) Determine the clinical complete response rate (as evidenced by clinical exam and reduction in PSA level to below 10 ng) following standard external beam irradiation plus etanidazole in patients with locally advanced prostate cancer.
 * (2) Evaluate disease-free survival, duration of response, and overall time to complete response in order to determine the endpoint that most sharply defines the long-term success of treatment.
 * (3) Determine the safety (i.e., absence of acute and chronic complications) of etanidazole given with whole-pelvis external beam irradiation in patients with locally advanced prostate cancer.
 * Protocol_NCI: EBRT + radiosensitization with Etanidazole
 * Eligibility: T2b-T4, M0
 * Enrolled: 36 patients
 * Conclusion:
 * PMID 8948352 -- Results of a phase II trial of external beam radiation with etanidazole (SR 2508) for the treatment of locally advanced prostate cancer (RTOG Protocol 90-20). (Lawton CA, IJRBOP 1996). Conclusion : Results of this trial regarding PSA response and clinical disappearance of disease are similar to historical controls and do not warrant further investigation of etanidazole as was done in this trial. Drug toxicity that, in the past, has been unacceptably high with other hypoxic cell sensitizers does not appear to be a significant problem with this drug.
 * Publications:
 * Bruner DW, Scott CB, McGowan D, et al.: Validation of the sexual adjustment questionnaire (SAQ) in prostate cancer patients enrolled on Radiation Therapy Oncology Group studies 90-20 and 94-08. Int J Radiat Oncol Biol Phys 42(suppl 1): A156, 202, 1998.
 * Bruner D, Scott C, McGowan D, et al.: Factors influencing sexual outcomes in prostate cancer patients enrolled on radiation therapy oncology group studies 90-20 and 94-08. [Abstract] Proceedings of the International Society for Quality of Life Research 7: 575, 1998.
 * PMID 7591900 -- RTOG's first quality of life study--RTOG 90-20: a phase II trial of external beam radiation with etanidazole for locally advanced prostate cancer. (Watkins-Bruner D, IJRBOP 1995). Conclusion: Quality of life assessments are necessary and attainable in RTOG clinical trials. Compliance rates for both institutional and patient participation were acceptable at initial and 3 month follow-up. Reasons for noncompliance were predominantly institution related and not patient related. Strategies to address both institution and patient compliance have been developed and implemented within the RTOG. Serious disagreement between patient self-reports of symptoms on the FACT QL scale and medical professional ratings on the RTOG acute toxicity rating scales of the same symptoms was 13% at 3 months follow-up. This warrants continued use of QL self-assessments in clinical trials.
 * Bruner DW, Scott C, Byhardt R, Coughlin C, Friedland J, DelRowe J. Changes in urinary function (CUF): Pilot data on the development and validation of a measure of the intrusion on quality of life caused by changes in urinary function after cancer therapy, (RTOG 91-16, 90-20). Presented at the Drug Information Association 2nd Symposium on Quality of Life Evaluation, Charleston, SC, 1994.

title: Radiation Oncology/RTOG Trials/9020


text:
Radiation Oncology/RTOG Trials/9019

RTOG 90-19 (PROSTATE)
 * Link to textbook
 * This is a SWOG-8794 Study (INT-0086, CALGB-9493, EST-9887)
 * Title: A Phase III Study of the Treatment of Pathologic Stage C Carcinoma of the Prostate With Adjuvant Radiotherapy
 * Objectives:
 * (1) To compare the disease-free survival rates in completely resected patients with pathologic stage C (T3N0M0) carcinoma of the prostate assigned to be treated with adjuvant external beam radiotherapy to that in patients assigned to receive no adjuvant therapy
 * (2) To assess the qualitative and quantitative toxicities of patients with pathologic stage C (T3N0M0) carcinoma of the prostate when treated with external beam radiotherapy.
 * Protocol:
 * Arm 1: Radical Prostatectomy
 * Arm 2: Radical Prostatectomy + 60-64 Gy EBRT
 * Eligibility: Status Post RP, +ECE or +SVI or +SM, N0M0
 * Activation: August 15, 1988 (RTOG Activation: April 20, 1992)
 * Closed: January 1, 1997
 * Publications:
 * 2007 PMID 17538167 -- "Predominant treatment failure in postprostatectomy patients is local: analysis of patterns of treatment failure in SWOG 8794." (Swanson GP, J Clin Oncol. 2007 Jun 1;25(16):2225-9.) Conclusion : Failure in high risk patients predominately local; adjuvant RT reduces risk of failure
 * 2006 PMID 17105795 — "Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial." (Thompson IM Jr et al. JAMA. 2006 Nov 15;296(19):2329-35.) Conclusion: Adjuvant radiotherapy resulted in significantly reduced risk of PSA relapse and disease recurrence, although the improvements in metastasis-free survival and overall survival were not statistically significant.
 * 2005 ASTRO Abstract Plenary #1, 2005 Webcast - "Phase III Randomized Study of Adjuvant Radiation Therapy versus Observation in Patients with Pathologic T3 Prostate Cancer (SWOG 8794)" Swanson GP et al. IJROBP Volume 63, Supplement 1, 1 October 2005, Page S1.
 * 1994 No Abstract -- "An opportunity to determine optimal treatment of pT3 prostate cancer: the window may be closing." (Thompson IM, Urology 1994). Review
 * 1992 -- "Adjuvant Radiotherapy Following Radical Prostatectomy for Pathologic Stage C Adenocarcinoma of the Prostate:  Initial Evaluation of Toxicity."  I Thompson, ED Crawford, G Miller, J Paradelo, B Blumenstein, M Wolf, C Moinpour, K Hayden. American Society of Clinical Oncology 11:212 (#663), 1992.

title: Radiation Oncology/RTOG Trials/9019


text:
Radiation Oncology/RTOG Trials/8610

RTOG 86-10 (PROSTATE)
 * Title: Androgen Deprivation Adjuvant to Definitive Radiotherapy in Locally Advanced Carcinoma of the Prostate
 * Objectives:
 * (1) Compare locoregional tumor control in patients with clinical Stages B2 and C carcinoma of the prostate treated with radiotherapy alone vs. zoladex/flutamide prior to and during radiotherapy.
 * (2) Compare tumor clearance rates, disease-free survival, survival, time to appearance of metastasis, serum testosterone levels, sexual function, and toxicity/morbidity of treatment in these two treatment groups.
 * Protocol_NCI:
 * Arm 1: 70 Gy EBRT only
 * Arm 2: AST x2 months followed by 70 Gy EBRT + concurrent AST
 * Eligibility: Bulky (clinically palpable > 25 cc) T2-T4, N+ allowed
 * Enrolled: 471 patients, 456 analyzable
 * Activated: April 15, 1987
 * Closed: June 1, 1991
 * Conclusion:
 * PMID 18172188 -- Short-Term Neoadjuvant Androgen Deprivation Therapy and External-Beam Radiotherapy for Locally Advanced Prostate Cancer: Long-Term Results of RTOG 8610. (Roach M, JCO 2008). Conclusion: The addition of 4 months of ADT to EBRT appears to have a dramatic impact on clinically meaningful end points in men with locally advanced disease with no statistically significant impact on the risk of fatal cardiac events.
 * PMID 11483335 -- Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. (Pilepich MV, IJROBP 2001). Conclusion: In patients with Gleason score 2--6 carcinoma of the prostate, a short course of androgen ablation administered before and during radiotherapy has been associated with a highly significant improvement in local control, reduction in disease progression, and overall survival.
 * Publications:
 * ASCO Abstract -- Stat3 as a correlate of distant metastasis in RTOG 86-10 (Torres-Roca JF, ASCO 2005). Conclusion: Stat3 activity is correlated with the development of distant metastasis in prostate cancer. This marker should be further evaluated in a larger cohort of patients.
 * PMID 15217948 -- Ki-67 staining index predicts distant metastasis and survival in locally advanced prostate cancer treated with radiotherapy: an analysis of patients in radiation therapy oncology group protocol 86-10. (Li R, Clin Cancer Res 2004). Conclusion: Higher Ki-67 SI was significantly associated with a greater risk of DM and DSS in locally advanced prostate cancer after definitive EBRT or AD + EBRT.
 * ASCO Abstract -- Influence of Number of CAG Repeats on Local Control in the RTOG 86-10 Protocol (Abdel-Wahab M, ASCO 2004). Conclusion: Measurement of CAG repeats may aid in selection of patients who achieve local control benefit from androgen deprivation.
 * ASTRO Abstract -- MDM2 as a Predictor of Prostate Cancer Outcome: An Analysis of RTOG 8610 (Khor, ASTRO 2004). Conclusion: Positive MDM2 expression was associated significantly with Gleason score and, although not significant, an increased risk of distant metastasis. While the relationship of MDM2 overexpression to DM was not statistically significant, this observation may be clinically meaningful. The cohort examined was small and with larger patient numbers, MDM2 overexpression may emerge as a significant covariate. In addition, MDM2 overexpression, like p53, may potentially be more discriminating in men with more favoravle risk prostate cancer.
 * PMID 12947069 -- Loss of p16 expression is of prognostic significance in locally advanced prostate cancer: an analysis from the Radiation Therapy Oncology Group protocol 86-10. (Chakravarti A, JCO 2003). Conclusion: Loss of p16 is significantly associated with adverse clinical outcome in cases of locally advanced prostate cancer.
 * PMID 12663710 -- Prostate cancer DNA ploidy and response to salvage hormone therapy after radiotherapy with or without short-term total androgen blockade: an analysis of RTOG 8610. (Pollack A, JCO 2003). Conclusion: Nondiploidy was associated with shorter survival, which seemed to be related to reduced response to salvage hormone therapy for those previously exposed to short-term TAB.
 * PMID 12478146 -- Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials. (Roach, J Urol 2003). Conclusion: As previously reported, tumor grade (Gleason score), palpation T stage, lymph node status, pretreatment PSA and treatment type are major predictors of overall and disease specific survival. We noted no evidence that race has independent prognostic significance in patients treated for prostate cancer in Radiation Therapy Oncology Group prospective randomized trials.
 * ASTRO Abstract -- Vascular endothelial growth factor (VEGF) expression in locally advanced prostate cancer (LAPC): secondary analysis of radiation therapy oncology group (RTOG) 8610. (Hughes, ASTRO Abstract 128, 2003; Int J Radiat Oncol Biol Phys 57 (2 Suppl): S201-2, 2003). Conclusion: This analysis represents one of the largest sample bases reviewed for VEGF expression in human prostate carcinoma patients. VEGF is highly expressed in this study population. Although no statistically significant correlation was seen between extent of VEGF expression and outcomes for patients randomized in RTOG 8610, VEGF will be further investigated as a high priority biomarker for patients from RTOG 9202 to add a broader distribution of prostate cancer patients with regard to GS for analysis. Further study will include biological correlation of VEGF IS with microvessel density in the RTOG 8610 patients.
 * ASTRO Abstract -- Monte Carlo Simulation of a Markov Model for a Phase III Clinical Trial Evaluating the Addition of Total Androgen Suppression (TAS) To Radiation Versus Radiation Alone for Locally Advanced Prostate Cancer (RTOG 86−10) (Konski, ASTRO Abstract 151, 2003; Int J Radiat Oncol Biol Phys 57 (2 Suppl): S215-6, 2003). Conclusion: Our analysis shows that adding hormonal treatment to RT improves both health outcomes and lowers costs. The expected cost is lowered by preventing failures in the future and obviating the need for additional therapies, such as hormones and chemotherapy. Despite producing lower quality of life in the short term, hormonal therapy reduces the cost and morbidity associated with future treatment failures.
 * PMID 12459350 -- Effect of a short course of neoadjuvant hormonal therapy on the response to subsequent androgen suppression in prostate cancer patients with relapse after radiotherapy: a secondary analysis of the randomized protocol RTOG 86-10. (Shipley WU, IJRBOP 2002) Conclusion: Although a 4-month course of neoadjuvant and concurrent maximum androgen suppression and RT (compared with RT alone) significantly increases the freedom from relapse rate and freedom from receiving salvage HT, it does not compromise the long-term beneficial effect of subsequent salvage HT, if needed for relapse. These findings with long follow-up in patients treated for locally advanced disease diagnosed 9-14 years previously should help allay concerns of the possible development of "resistance" to androgen suppression when 4-month courses of neoadjuvant HT are used before primary treatment.
 * ASTRO Abstract -- Cyclooxygenase 2 (COX-2) Expression in Locally Advanced Prostate Cancer: Secondary Analysis of Radiation Therapy Oncology Group (RTOG) 86-10. (Hughes L, ASTRO 2002, Int J Radiat Oncol Biol Phys [54] (2):271-272, 2002.). Conclusion: This analysis represents the largest sample base reviewed for COX-2 expression in prostate carcinoma patients. COX-2 is highly expressed in this study population. Patients with GS 7–10 locally advanced prostate cancer had greater intensity of COX-2 expression when compared with their lower GS counterparts. Due to the large degree of COX-2 expression seen in prostate carcinoma, COX-2 will be a high priority biomarker when evaluating samples from RTOG 92-02.
 * PMID 11240235 -- Subset analysis of RTOG 85-31 and 86-10 indicates an advantage for long-term vs. short-term adjuvant hormones for patients with locally advanced nonmetastatic prostate cancer treated with radiation therapy. (Horwitz EM, IJRBOP 2001). Conclusion: Adjuvant long-term hormones compared to short-term hormones resulted in statistically significant improvements in bNED control, DMF, and CSF rates for patients with locally advanced nonmetastatic prostate cancer.
 * ASCO Abstract -- A Secondary Analysis of RTOG 86-10: Does the Extent of Progression at the Time of Initiating Salvage Hormone Therapy Influence Survival in Patients with Prostate Cancer Who Failed Initial Treatment with Irradiation? (Shipley WU, ASCO 2001). Conclusion: For those patients that relapsed following irradiation and were treated with salvage HT, a more advanced extent of progression at the time of initiating salvage HT, decreased significantly disease specific survival and overall survival in this retrospective analysis. These findings warrant confirmation by a second independent study.
 * PMID 10837944 -- Predicting long-term survival, and the need for hormonal therapy: a meta-analysis of RTOG prostate cancer trials. (Roach M, IJRBOP 2000). Conclusion: Based on this meta-analysis of RTOG trials, subsets of patients can be identified who either do not appear to benefit from the use of hormonal therapy, benefit from short-term hormonal therapy, or who benefit only from long-term hormonal therapy. These observations should be confirmed by prospective randomized trials before they can be considered conclusive. In the meantime, however, these observations provide rational guidelines for deciding who should receive hormonal therapy and for how long.
 * PMID 10837943 -- Four prognostic groups predict long-term survival from prostate cancer following radiotherapy alone on Radiation Therapy Oncology Group clinical trials. (Roach, IJRBOP 2000). Conclusion: Recognition of these four risk groups provides a basis for estimating the long-term DSS for men treated with XRT alone and should facilitate the design of future prospective randomized trials.
 * Anderson PR, Winter KA, Hanks GE, et al.: Gleason score 4+3 prostate cancer patients have worse bNED outcome compared to Gleason score 3+4 treated with radiation therapy alone: subset analysis of RTOG 85-31 and 86-10. Int J Radiat Oncol Biol Phys 48(3 suppl): A-187, 205-206, 2000.
 * Shipley W, Lu JD, Pilepich MV, et al.: Does neoadjuvant hormone treatment compromise subsequent androgen suppression in prostate cancer patients who fail initial radiation therapy: a secondary analysis of RTOG-8610. Int J Radiat Oncol Biol Phys 48(3 suppl): A-115, 169-170, 2000.
 * PMID 10894874 -- Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the Radiation Therapy Oncology Group trials. (Valicenti, JCO 2000). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers.
 * Horwitz EM, Winter K, Hanks GE, et al.: Long-term outcome for patients with locally advanced non-metastatic prostate cancer treated with adjuvant hormones and radiation therapy versus radiation therapy alone: subset analysis of RTOG 85-31 and 86-10. Int J Radiat Oncol Biol Phys 45(3 suppl): A142, 220-221, 1999.
 * PMID 10022702 -- Long-term survival after radiotherapy alone: radiation therapy oncology group prostate cancer trials. (Roach M, J Urol 1999). Conclusion: In the first 10 years Gleason score was the single most important predictor of death. Gleason score should be incorporated into the current clinical staging system.
 * Scott C, Roach M, Lawton C, et al.: Q-twist analysis for prostate cancer treated with radiation therapy with or without hormonal therapy: RTOG 86-10. Qual Life Res 8(7): A48, 568, 1999.
 * ASCO Abstract -- Radiation Dose-Response Is Gleason Score Dependent on the Radiation Therapy Oncology Group Prostate Cancer Trials (Meeting abstract). (Valicenti R, ASCO 1999). Conclusion: These data suggest a significant effect for higher radiation dose to reduce the probability of dying from prostate cancer in men with poorly differentiated disease.
 * Hammond EH, Lu JD, Doggett RL, et al.: Microvessel density in prostatic biopsies in a phase III trial (RTOG 86-10). Lab Invest 78: A-481, 84a, 1998.
 * Pilepich ML, Winter K, Roach M, et al.: Phase III Radiation Therapy Oncology Group (RTOG) trial 86-10 of androgen deprivation before and during radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 42(suppl 1): A105, 177, 1998.
 * Roach M, Lu J, Pilepich M, et al.: Long term survival in 1500 men treated for prostate cancer with radiotherapy alone (XRT): based on radiation therapy oncology group protocols 7706, 7506, 8531, and 8610. [Abstract] Proceedings of the American Urological Association 1998.
 * ASCO Abstract -- Prognostic Subgroups Predict Disease Specific Survival for Men Treated With Radiotherapy Alone On Radiation Therapy Oncology Group (RTOG) Prostate Cancer Trial. (Roach M, ASCO 1998). Conclusion: Recognition of these four prognostic subgroups should allow estimates to be made of the long term DSS of men treated with radiotherapy alone for CAP.
 * PMID 8998185 -- p53 status and prognosis of locally advanced prostatic adenocarcinoma: a study based on RTOG 8610. (Grignon DJ, J Natl Cancer Inst. 1997). Conclusion: Determination of p53 protein expression status yield significant, independent prognostic information concerning the development of distant metastases, progression-free survival, and overall survival for patients with locally advanced prostate cancer who are treated primarily with radiation therapy. The interaction of radiation therapy plus hormone therapy and abnormal p53 protein expression may provide a clinical link to experimental evidence that radiation therapy and/or hormone therapy act, at least in part, by the induction of apoptosis (a cell death program) and suggests that this mechanism may be blocked in patients whose tumors have p53 mutations.
 * Grignon D, Pajak T, Hammond E, et al.: Application of the gleason grading system: a comparison of institutional and central review grading using RTOG protocols 85-31 and 86-10. [Abstract] Proceedings of the United States and Canadian Academy of Pathology Meeting 9(1): A418, 73a, 1996.
 * Grignon D, Won M, Hammond E, et al.: DNA content as a prognostic indicator in prostate cancer (PCA): a study based on RTOG protocol 86-10. [Abstract] Proceedings of the United States and Canadian Academy of Pathology Meeting 9(1): A419, 75a, 1996.
 * Grignon D, Caplan R, Sarkar F, et al.: p53 suppressor gene mutations predict for failure following combined neoadjuvant total androgen ablation and external beam radiation therapy for locally advanced prostate cancer: a study based on RTOG protocol 86-10. [Abstract] Proceedings of the American Urological Association 153(suppl 1): A293, 1995.
 * PMID 7716842 -- Androgen deprivation with radiation therapy compared with radiation therapy alone for locally advanced prostatic carcinoma: a randomized comparative trial of the Radiation Therapy Oncology Group. (Pilepich MV, Urology 1995). Conclusion: Short-term androgen deprivation with radiation therapy results in a marked increase in local control and disease-free survival compared with pelvic irradiation alone in patients with locally advanced carcinoma of the prostate. Long-term surveillance is required to assess effects on overall survival.
 * Pilepich MV, Krall J, Al-Sarraf M, et al.: A phase III trial of androgen suppression before and during radiation therapy (RT) for locally advanced prostatic carcinoma: preliminary report of RTOG protocol 8610. [Abstract] Proceedings of the American Society of Clinical Oncology 12: A-703, 229, 1993.
 * Pilepich MV, Winter K, Byhardt R, et al.: Androgen ablation adjuvant to definitive radiotherapy in carcinoma of the prostate: year 2000 update of RTOG phase III studies 86-10 and 85-31. Int J Radiat Oncol Biol Phys 48(3 suppl): A-114, 169.

title: Radiation Oncology/RTOG Trials/8610


text:
User:Tdvorak

Contributing randomly to Radiation Oncology as I am learning radiation oncology, which is a never-ending journey :)

ARRO Key Papers

To Look At

 * PMRT
 * Scar boost PMRT evidence
 * CSI
 * NSCLC - Operable Early vs. Advanced
 * Body radiosurgery
 * Radiation Proctitis - sucralfate trials
 * CCG 921 in medulloblastoma

 * Randomized evidence review needed:
 * SCLC
 * Limited stage: chemo +/- RT
 * PCI trials
 * Cervix
 * Hyperthermia trials

Formatting

 * Using Tables
 * Using Images; Picture tutorial

Edit Counts

 * Interiot (doesn't track past 12/2008?)
 * YAEC

Wikilinks

 * Special:Recentchangeslinked/Category:Radiation_Oncology
 * Special:Allpages
 * Special:Export

Wapedia Mobile

 * Wapedia link

title: User:Tdvorak


text:
Turing/Graphics

This is how graphics should work:

View.Set ("offscreenonly") loop Draw background picture Draw foreground stuff View.Update end loop

In most cases, you must do it like this to avoid flicker.

Example: A moving circle:

View.Set ("offscreenonly") for count : 1 .. 600   drawfilloval (count, 200, 30, 30, red) View.Update delay (10) drawfilloval (count, 200, 30, 30, white) end for

There are some commands in the example that you are probably not familiar with. A for loop is a counted loop it runs for a certain number of times. So the statement "For count : 1..600" means that the loop will run from 1 to 600, and each time it runs it will store that value in the variable "count". So the first time it will run count will have a value of 1, the second time it will be 2 and so on. "drawfilloval" does exactly what it says it draws an oval and fills it with the color specified. Delay also does what it says it pauses the program for a certain amount of time specified in the bracket, 1000 is equal to 1 sec so in the example it is 10, so program pauses for 0.01 s. The pause is needed so the program wait before it draws the white oval on top of the red one.

title: Turing/Graphics


text:
User:Jmartens

Not much to say at present, just hoping to add to the blender wiki book at this time.

title: User:Jmartens


text:
Puzzles/Physics puzzles/Levitating Straws

Puzzles | Physics puzzles | Levitating Straws

1. Take 4 ordinary straws.

2. Take a 1.5 inch square piece of napkin or any paper. Moisten it a little (saliva or water will do) twist and roll it into a stick.

3. Insert your paper stick into the ends of two straws, forming one long straw connected by the help of the paper stick.

^                    / \\                    /   \ \                   /     \  \                  /       \   \

4. Bend then stand the long straw in a triangle, ^ denotes the paper stick connecting both straws. Use a third straw to assist the straws in standing upright on a flat surface. In essence you have formed a pyramid. Two of the straws are attached the third being only an assistant.

5. Now take your fourth straw to lift all three straws into the air simultaneously, without using your hand to touch any other straw.

Note: This is not a word game, nor is there a cheap solution. If you apply some logic you will find an interesting solution.

Solution


text:
User:Bloodstained Agar~enwikibooks

 moi@fr.wikipedia.org - me@en.wikipedia.org - moi@fr.wikibooks.org - me@en.wikibooks.org -

title: User:Bloodstained Agar~enwikibooks


text:
Ada Programming/Strings

Ada supports three different types of strings. Each string type is designed to solve a different problem.

In addition, every string type is implemented for each available Characters type (Character, Wide_Character, Wide_Wide_Character) giving a complement of nine combinations.

Fixed-length string handling
Fixed-Length Strings (the predefined type String) are arrays of Character, and consequently of a fixed length. Since String is an indefinite subtype the length does not need to be known at compile time — the length may well be calculated at run time. In the following example the length is calculated from command-line argument 1:

X : String := Ada.Command_Line.Argument (1);

However once the length has been calculated and the string has been created the length stays constant. Try the following program which shows a typical mistake:

; ;  Show_Commandline_1 T_IO ; CL   ; X : String := CL.Argument (1); T_IO.Put ("Argument 1 = "); T_IO.Put_Line (X); X := CL.Argument (2); T_IO.Put ("Argument 2 = "); T_IO.Put_Line (X); Show_Commandline_1;

The program will only work when the 1st and 2nd parameter have the same length. This is even true when the 2nd parameter is shorter. There is neither an automatic padding of shorter strings nor an automatic truncation of longer strings.

Having said that, the package contains a set of procedures and functions for Fixed-Length String Handling which allows padding of shorter strings and truncation of longer strings.

Try the following example to see how it works:

; ;  ;  Show_Commandline_2 T_IO ; CL   ; S    ; SF   ; X : String := CL.Argument (1); T_IO.Put ("Argument 1 = "); T_IO.Put_Line (X); SF.Move (     Source  => CL.Argument (2),      Target  => X,      Drop    => S.Right,      Justify => S.Left,      Pad     => S.Space); T_IO.Put ("Argument 2 = "); T_IO.Put_Line (X); Show_Commandline_2;

Bounded-length string handling
Bounded-Length Strings can be used when the maximum length of a string is known and/or restricted. This is often the case in database applications where only a limited number of characters can be stored.

Like Fixed-Length Strings the maximum length does not need to be known at compile time — it can also be calculated at runtime — as the example below shows:

; ;  ;  Show_Commandline_3 T_IO Ada.Text_IO; CL   Ada.Command_Line; Max_Length (      Value_1 : Integer;       Value_2 : Integer) Integer Retval : Integer; Value_1 > Value_2 Retval := Value_1; Retval := Value_2; ;       Retval; Max_Length; Inline (Max_Length); SB     Ada.Strings.Bounded.Generic_Bounded_Length (        Max => Max_Length ( Value_1 => CL.Argument (1)'Length, Value_2 => CL.Argument (2)'Length)); X : SB.Bounded_String := SB.To_Bounded_String (CL.Argument (1)); T_IO.Put ("Argument 1 = "); T_IO.Put_Line (SB.To_String (X)); X := SB.To_Bounded_String (CL.Argument (2)); T_IO.Put ("Argument 2 = "); T_IO.Put_Line (SB.To_String (X)); Show_Commandline_3;

You should know that Bounded-Length Strings have some distinct disadvantages. Most noticeable is that each Bounded-Length String is a different type which makes converting them rather cumbersome. Also a Bounded-Length String type always allocates memory for the maximum permitted string length for the type. The memory allocation for a Bounded-Length String is equal to the maximum number of string "characters" plus an implementation dependent number containing the string length (each character can require allocation of more than one byte per character, depending on the underlying character type of the string, and the length number is 4 bytes long for the Windows GNAT Ada compiler v3.15p, for example).

Unbounded-length string handling
Last but not least there is the Unbounded-Length String. In fact: If you are not doing embedded or database programming this will be the string type you are going to use most often as it gives you the maximum amount of flexibility.

As the name suggest the Unbounded-Length String can hold strings of almost any length — limited only to the value of Integer'Last or your available heap memory. This is because Unbounded_String type is implemented using dynamic memory allocation behind the scenes, providing lower efficiency but maximum flexibility.

; ;  ;  Show_Commandline_4 T_IO Ada.Text_IO; CL   Ada.Command_Line; SU   Ada.Strings.Unbounded; X : SU.Unbounded_String := SU.To_Unbounded_String (CL.Argument (1)); T_IO.Put ("Argument 1 = "); T_IO.Put_Line (SU.To_String (X)); X := SU.To_Unbounded_String (CL.Argument (2)); T_IO.Put ("Argument 2 = "); T_IO.Put_Line (SU.To_String (X)); Show_Commandline_4;

As you can see the Unbounded-Length String example is also the shortest (disregarding the buggy first example) — this makes using Unbounded-Length Strings very appealing.

Wikibook

 * Ada Programming

Ada 2005 Reference Manual

|Strings

Programación en Ada/Tipos/Strings

title: Ada Programming/Strings


text: Template:Lineage 2/Callout

title: Template:Lineage 2/Callout


text:
Puzzles/Arithmetical puzzles/Eggs to Market

A farmer placed his eggs into the back of his pickup truck and headed to town to take them to market.

On the way to the market he encounterd a toll gate and did not have any money. So, the farmer gave the toll keeper half of his eggs plus half an egg. The farmer drove on and arrived at a second toll gate and again having no money gave that toll keeper half his eggs plus half an egg. The farmers next stop was the market.

When he arrived at the market he had one egg left. How many eggs did the farmer have when he left his farm?

For the Egg-zact answer: solution

Submitted by Jean Junker


text:
User:Patricknoddy~enwikibooks

About Me
Hello, I'm Patricknoddy I know a lot about History, espescially Presidents. I met Bob Wise, a former governor of West Virginia. I currently live in Valdosta, Georgia. I've also met Raymond Peak, the mayor of Hurricane, West Virginia, my former hometown.

WikiBooks Started by Me
For more info on me go to: wikipedia:User:Patricknoddy.

title: User:Patricknoddy~enwikibooks


text:
Puzzles/Arithmetical puzzles/Eggs to Market/Solution

He started with 7 eggs. How?

See Below:

At the market the farmer had 1 egg.

Working backward from toll gate two, the only way that could happen is by giving up half his eggs plus half an egg (dividing 3 into half to get 1.5 plus .5 to give up 2 eggs, leaving 1 egg).

Again working backward from toll gate one, the only way that could happen is by giving up half his eggs plus half an egg (dividing 7 into half to get 3.5 plus .5 to give up 4 eggs, leaving 3 eggs).

So, the farmer left the farm with 7 eggs!

(this proof is contributed by Pankaj Kumar)

Mathematical proof:

To calculate exact value of eggs, lets back-track;

At market, farmer has 1 egg.

Lets assume, farmer has x   eggs before passing Toll-Gate2 (before paying half eggs and an half egg)

Total eggs paid at Toll-Gate2 will be : gate2 = ( (x/2) + (1/2) )

After passing, he is left with 1 egg.

Which gives,

( x - gate2 ) = 1

Replacing gate2

'''x - ( (x/2) + (1/2) ) = 1

x - ( (x+1) / 2 ) = 1

( 2x - x - 1 ) / 2 = 1

x - 1 = 2

x = 3

So, before passing Toll-Gate2 farmer has 3 eggs.

Now, assume before passing Toll-Gate1 farmer has y  eggs ( at initial stage he as this many eggs)

Total eggs paid at Toll-Gate1 will be :

gate1 = ( (y/2) + (1/2) )

After passing, he is left with 3 egg.

Which gives,

( y - gate1 ) = 3

Replacing gate1

y - ( (y/2) + (1/2) ) = 3

y - ( (y+1) / 2 ) = 3

( 2y - y - 1 ) / 2 = 3

y - 1 = 6

y = 7

So, the farmer left the farm with 7 eggs!


text:
User:JeanJunker

My name is Jean Junker and I live in Texas. I am just beginning my foray into the Wiki World on June 2005.

title: User:JeanJunker


text:
Cookbook talk:Cuisine of Lebanon

See [] for Homous, Megadra etc.

If this is a Wiki Cookbook, then who is the person with the grandmother? Does that mean no one else is to contribute recipes to this page? I hope not.

I made some very basic typographical changes (spelling error and a couple of dropped spaces) and added a Baba Ghanouzh/Ghanouj recipe. Feel free to edit the recipe. Leila

title: Cookbook talk:Cuisine of Lebanon


text:
Radiation Oncology/RTOG Trials/8531

RTOG 85-31 (PROSTATE)

See pages: Prostate/Node Positive, Prostate/Hormones
 * Title: Phase III Comparison of Adjuvant Therapy with Zoladex vs Observation Only Following Definitive Radiotherapy for Unfavorable Prognosis Adenocarcinoma of the Prostate
 * Objectives:
 * 1) Evaluate the relative effectiveness of elective vs. therapeutic androgen deprivation with Zoladex with regard to disease progression and survival among patients with adenocarcinoma of the prostate who are at high risk for relapse and tumor-related death, including patients with evidence of involvement of regional lymphatics or gross extension of palpable tumor beyond the prostate (clinical or pathological Stage C)
 * 2) Assess the side effects associated with long-term administration of Zoladex.
 * Protocol:
 * Arm 1: 65-70 Gy EBRT
 * Arm 2: 65-70 Gy EBRT + indefinite AST started during last week of RT
 * Eligibility:
 * (A2 and B with LN+) or (C) with no "bulky" (>25cc) disease unless spread to extra-pelvic nodes, M0
 * If s/p RP, must have +SM and/or +SVI
 * Enrolled: 977 patients
 * Conclusion:
 * PMID 15817329 -- Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma--long-term results of phase III RTOG 85-31. (Pilepich MV, IJRBOP 2005). Conclusion: In a population of patients with unfavorable prognosis carcinoma of the prostate, androgen suppression applied as an adjuvant after definitive RT was associated not only with a reduction in disease progression but in a statistically significant improvement in absolute survival. The improvement in survival appeared preferentially in patients with a Gleason score of 7-10.
 * Publications:
 * PMID 15681524 -- Androgen suppression plus radiation versus radiation alone for patients with stage D1/pathologic node-positive adenocarcinoma of the prostate: updated results based on national prospective randomized trial Radiation Therapy Oncology Group 85-31. (Lawton CA, JCO 2005). Conclusion: Pending the results of randomized trials, patients with adenocarcinoma of the prostate who have pathologically involved pelvic lymph nodes (pathologic node-positive or clinical stage D1) should be considered for external-beam irradiation plus immediate hormonal manipulation rather than radiation alone with hormone manipulation at the time of relapse.
 * PMID 12478146 -- Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials. (Roach M, J Urol 2003). Conclusion: As previously reported, tumor grade (Gleason score), palpation T stage, lymph node status, pretreatment PSA and treatment type are major predictors of overall and disease specific survival. We noted no evidence that race has independent prognostic significance in patients treated for prostate cancer in Radiation Therapy Oncology Group prospective randomized trials.
 * ASCO Abstract -- Phase III trial of androgen suppression adjuvant to definitive radiotherapy. Long term results of RTOG study 85-31. (Pilepich MV, ASCO 2003). Conclusion: Adjuvant androgen suppression has resulted in significant improvement in all end points.
 * PMID 11240235 -- Subset analysis of RTOG 85-31 and 86-10 indicates an advantage for long-term vs. short-term adjuvant hormones for patients with locally advanced nonmetastatic prostate cancer treated with radiation therapy. (Horwitz EM, IJRBOP 2001). Conclusion: Based on this analysis, adjuvant long-term hormones compared to short-term hormones resulted in statistically significant improvements in bNED control, DMF, and CSF rates for patients with locally advanced nonmetastatic prostate cancer.
 * PMID 11240234 -- Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. (Lawton CA, IJRBOP 2001). Conclusion: Use of long-term adjuvant androgen deprivation in addition to definitive radiation therapy results in a highly significant improvement in regards to local control, freedom from distant metastasis, and biochemical free survival in unfavorable prognosis patients with carcinoma of the prostate.
 * ASCO Abstract -- Subset analysis of RTOG 85-31 and 86-10 indicates an advantage for long-term vs. short-term adjuvant hormones for patients with locally advanced nonmetastatic prostate cancer treated with radiation therapy. (Horwitz EM, ASCO 2001). Conclusion: Based on this analysis, adjuvant long-term hormones compared to short-term hormones resulted in statistically significant improvements in bNED control, DMF, and CSF rates for patients with locally advanced nonmetastatic prostate cancer.
 * Anderson PR, Winter KA, Hanks GE, et al.: Gleason score 4+3 prostate cancer patients have worse bNED outcome compared to Gleason score 3+4 treated with radiation therapy alone: subset analysis of RTOG 85-31 and 86-10. Int J Radiat Oncol Biol Phys 48(3 suppl): A-187, 205-206, 2000.
 * PMID 11146150 -- Statistical power for a long-term survival trial with a time-dependent treatment effect. (Lu J, Control Clin Trials 2000). Conclusion: Having examined the loss in statistical power by the interim analyses under the alternative hypothesis with a lag time, we recommend that the lower sequential boundary not be used in a long-term survival clinical trial.
 * PMID 10837944 -- Predicting long-term survival, and the need for hormonal therapy: a meta-analysis of RTOG prostate cancer trials. (Roach M, IJRBOP 2000). Conclusion: Based on this meta-analysis of RTOG trials, subsets of patients can be identified who either do not appear to benefit from the use of hormonal therapy, benefit from short-term hormonal therapy, or who benefit only from long-term hormonal therapy. These observations should be confirmed by prospective randomized trials before they can be considered conclusive. In the meantime, however, these observations provide rational guidelines for deciding who should receive hormonal therapy and for how long.
 * PMID 10894874 -- Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the Radiation Therapy Oncology Group trials. (Valicenti R, JCO 2000). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers.
 * Pilepich MV, Winter K, Byhardt R, et al.: Androgen ablation adjuvant to definitive radiotherapy in carcinoma of the prostate: year 2000 update of RTOG phase III studies 86-10 and 85-31. Int J Radiat Oncol Biol Phys 48(3 suppl): A-114, 169.
 * PMID 10475361 -- Does androgen suppression enhance the efficacy of postoperative irradiation? A secondary analysis of RTOG 85-31. Radiation Therapy Oncology Group. (Corn BW, Urology 1999). Conclusion: Patients with prostate cancer and indications for postoperative RT should be considered for combined RT and hormonal manipulation. Because statistically significant advantages for this experimental approach could not be defined for all end points studied (in particular, overall survival), efforts should be made to enroll these patients in the recently activated RTOG trial (96-01) comparing RT plus placebo to the combination of RT plus Casodex in the postoperative setting.
 * Horwitz EM, Winter K, Hanks GE, et al.: Long-term outcome for patients with locally advanced non-metastatic prostate cancer treated with adjuvant hormones and radiation therapy versus radiation therapy alone: subset analysis of RTOG 85-31 and 86-10. Int J Radiat Oncol Biol Phys 45(3 suppl): A142, 220-221, 1999.
 * ASCO Abstract -- Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen deprivation following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. (Lawton CA, ASCO 1999; Proceedings of the American Society of Clinical Oncology 18: A1195, 311a, 1999.). Conclusion: Use of long term adjuvant androgen deprivation in addition to definitive radiation therapy results in a highly significant improvement with regards to local control, freedom from distant metastasis, and biochemical disease free survival in unfavorable prognosis patients with carcinoma of the prostate.
 * PMID 10022702 -- Long-term survival after radiotherapy alone: radiation therapy oncology group prostate cancer trials. (Roach M, J Urol 1999). Conclusion: In the first 10 years Gleason score was the single most important predictor of death. Gleason score should be incorporated into the current clinical staging system.
 * Valicenti R, Lu JD, Grignon D, et al.: Radiation dose-response is Gleason score dependent on the Radiation Therapy Oncology Group prostate cancer trials. [Abstract] Proceedings of the American Society of Clinical Oncology 18: A1194, 311a, 1999.
 * Roach M, Lu J, Pilepich M, et al.: Long term survival in 1500 men treated for prostate cancer with radiotherapy alone (XRT): based on radiation therapy oncology group protocols 7706, 7506, 8531, and 8610. [Abstract] Proceedings of the American Urological Association 1998.
 * Roach M III, Lu J, Pilepich MV, et al.: Prognostic subgroups predict disease specific survival for men treated with radiotherapy alone on Radiation Therapy Oncology Group (RTOG) prostate cancer trials. [Abstract] Proceedings of the American Society of Clinical Oncology 17: A1201, 312a, 1998.
 * Grignon D, Pajak T, Winter K, et al.: Central review vs. institutional gleason grading and its impact on phase III clinical trial analysis: a review of RTOG protocol 85-31. [Abstract] Proceedings of the United States and Canadian Academy of Pathology Meeting, Mod Pathol 10: A436, 77a, 1997.
 * PMID 9276357 -- Androgen suppression plus radiation versus radiation alone for patients with D1 (pN+) adenocarcinoma of the prostate (results based on a national prospective randomized trial, RTOG 85-31). Radiation Therapy Oncology Group. (Lawton CA, IJRBOP 1997). Conclusion: Patients with adenocarcinoma of the prostate and pathologically involved pelvic lymph nodes (pN+ or clinical stage D1) should be seriously considered for external beam irradiation plus immediate hormonal manipulation over radiation alone with hormonal manipulation at the time of relapse.
 * PMID 9060541 -- Phase III trial of androgen suppression using goserelin in unfavorable-prognosis carcinoma of the prostate treated with definitive radiotherapy: report of Radiation Therapy Oncology Group Protocol 85-31. (Pilepich MV, JCO 1997). Conclusion: Application of androgen suppression as an adjuvant to definitive radiotherapy has been associated with a highly significant improvement in local control and freedom from disease progression. At this point, with a median follow-up time of 4.5 years, a significant improvement in survival has been observed only in patients with centrally reviewed tumors with a Gleason score of 8 to 10.
 * Winter K, Grignon D, Pajak T, et al.: Subjective pathology tumor grading: impact on design and analysis of Radiation Therapy Oncology Group prostate trial 85-31. [Abstract] Proceedings of the Society for Clinical Trials and the International Society for Clinical Biostatistics 18: A124, 186S-187S, 1997.
 * Winter K, Grignon D, Pajak TF, et al.: The need for central pathology tumor grading in prostate cancer using Radiation Therapy Oncology Group (RTOG) 85-31. Int J Radiat Oncol Biol Phys 39(suppl 2): A1007, 219, 1997.
 * Grignon D, Pajak T, Hammond E, et al.: Application of the gleason grading system: a comparison of institutional and central review grading using RTOG protocols 85-31 and 86-10. [Abstract] Proceedings of the United States and Canadian Academy of Pathology Meeting 9(1): A418, 73a, 1996.
 * Lawton CA, Pajak TF, Byhardt R, et al.: Androgen suppression plus radiation vs. radiation alone for patients with D1 (pN+) adenocarcinoma of the prostate (results based on a national prospective randomized trial RTOG 85-31). Int J Radiat Oncol Biol Phys 36(suppl 1): A139, 228, 1996.
 * Pilepich M, Caplan R, Byhardt R, et al.: Phase III trial of adjuvant androgen suppression using goserelin in patients with carcinoma of the prostate treated with definitive radiotherapy (results of RTOG 85-31). Int J Radiat Oncol Biol Phys 32(suppl 1): A95, 188, 1995.
 * ASCO Abstract -- Phase III trial of androgen suppression using goserelin in unfavorable prognosis carcinoma of the prostate treated with definitive radiotherapy (report of RTOG protocol 85-31). (Pilepich MV, ASCO 1995); Proceedings of the American Society of Clinical Oncology 14: A631, 239, 1995). Conclusion: Adjuvant androgen suppression with goserelin has been associated with a significant improvement in local control and progression-free survival. Longer follow-up will be necessary to substantiate an impact on overall survival.

title: Radiation Oncology/RTOG Trials/8531


text:
Radiation Oncology/RTOG Trials/8307

RTOG 83-07 (PROSTATE)
 * Title: Phase II Megestrol Acetate vs Diethylstilbestrol Adjuvant to Radiotherapy for Locally Advanced Stage B/C Carcinoma of the Prostate
 * Objectives:
 * (1) Evaluate the relative effectiveness and toxicity of megestrol acetate versus diethylstilbestrol as pre-adjuvants to radiotherapy; the principal endpoints are tumor clearance rates and serum testosterone levels.
 * (2) Compare the two treatment options with respect to local-regional control, disease-free interval, and survival.
 * (3) Assess the effect of both treatments on sexual function.
 * Protocol
 * Arm 1: Megestrol x 2 months followed by 65-70 Gy EBRT + Megestrol
 * Arm 2: Diethylstilbestrol x 2 months followed by 65-70 Gy EBRT + Diethylstilbestrol
 * Eligibility: Stage B2 or C, LN+ ok if below aortic bifurcation, M0
 * Enrolled: 203 patients
 * Conclusion:
 * PMID 7721614 -- Phase II trial of hormonal cytoreduction with megestrol and diethylstilbestrol in conjunction with radiotherapy for carcinoma of the prostate: outcome results of RTOG 83-07. (Pilepich MV, IJRBOP 1995). Conclusion: The results of the study indicate comparable efficacy (using tumor clearance as an end point) of DES and Megestrol. Although DES appears more effective in suppressing testosterone, it is also associated with a higher incidence of drug-related toxicity.
 * Publications:
 * PMID 10837944 -- Predicting long-term survival, and the need for hormonal therapy: a meta-analysis of RTOG prostate cancer trials. (Roach M, IJRBOP 2000). Conclusion: Based on this meta-analysis of RTOG trials, subsets of patients can be identified who either do not appear to benefit from the use of hormonal therapy, benefit from short-term hormonal therapy, or who benefit only from long-term hormonal therapy. These observations should be confirmed by prospective randomized trials before they can be considered conclusive. In the meantime, however, these observations provide rational guidelines for deciding who should receive hormonal therapy and for how long.
 * PMID 7591889 -- Correlation of survival with quantitative tissue staining of prostate specific acid phosphatase in patients with prostate carcinoma by using microscopic image analysis: a preliminary report of correlative studies on RTOG protocols 75-06, 77-06, and 83-07. (Zhou R, IJRBOP 1995). Conclusion: Quantitative image analysis of the IPSAP stain predicts survival in patients treated with external beam radiotherapy with and without prior hormonal therapy.
 * PMID 2646266 -- Hormonal cytoreduction in locally advanced carcinoma of the prostate treated with definitive radiotherapy: preliminary results of RTOG 83-07. (Pilepich MV, IJRBOP 1989). Conclusion: The results of the study indicate comparable efficacy (using tumor clearance as an end-point) of DES and Megestrol. While DES appears more effective in suppressing testosterone it is also associated with a higher incidence of toxicity. The cytoreduction (using either DES, Megestrol, or an alternative regimen) concept remains to be tested in a Phase III study comparing it to radiotherapy alone.

title: Radiation Oncology/RTOG Trials/8307


text:
Electronics/Analog Circuits

As explained later, digital signals can only take one of two values at any one point. Analog signals, however, can take any value within a range. In modern electronics, many traditionally analog circuits are being replaced with digital ICs for various reasons:
 * Reduced cost:
 * Digital ICs can be programmed, meaning many different analog circuits can each be replaced with the same IC, reducing cost. For example, the same DSP chip might replace many different analog filters.
 * Digital ICs can be easily expanded to put multiple functions on the same chip. For example, a DSP chip replacing multiple analog filters at the same time.
 * Digital ICs can be reprogrammed without modifying the circuit, simplifying prototyping and field upgrades.
 * Increased versatility:
 * A digital IC can have its settings changed arbitrarily while it is being operated, these settings can even be changed by software. The equivalent in an analog circuit might require expensive and complicated switching techniques.
 * Numeric precision: once a signal is converted to digital data, distortion and circuit noise are no longer a significant issue. A cheap modern watch driven by a digital circuit (such as a quartz oscillator and a counter) is more precise than any analog or mechanical clock.
 * Ease of storage: digital data, once recorded, does not degrade as easily as analog data.

Digital circuits are also becoming more prevalent where there are no analog analogues, such as computers. Although analogue computers exist, their utility is severely limited by comparison.

Analog circuits are still more suitable for many functions. One important category is interfaces. Digital circuits are usually inferior to analog circuits for receiving and transmitting signals.
 * A common digital interface, the differential line, needs an analog circuit to function well. The receiver must filter out common mode interference by computing the analog difference between the two lines.  Most digital interfaces are designed as analog, only a few legacy interfaces (which have poor performance) use entirely digital circuits.
 * Many radio signals are simply too high frequency to work with existing digital circuits. Radio modulators, demodulators, mixers, transmitters, and receivers are still analog.  Some signals are even too high frequency for transistor circuits of any kind to amplify efficiently, such as microwave signals, which are still transmitted using vacuum tubes.
 * Signals must be conditioned before conversion to digital to avoid aliasing: analog filters remove unwanted parts of signals.
 * Many devices, such as monitors, require analog control. Even LCD monitors require analog circuits, although they need not be as sophisticated as CRT analog circuits.
 * Audio equipment requires analog circuits. Speakers must be driven by analog signals, microphones produce analog signals.  Signal of a microphone must be conditioned before conversion to digital, this usually entails sophisticated analog circuits such as preamplifers, compressors, and filters.

title: Electronics/Analog Circuits


text:
Cookbook:Chicken-fried Steak

| Texas cuisine

Chicken Fried Steak is a hearty food dish in the southern USA. The dish is commonly served with mashed potatoes smothered in chicken fried steak gravy.

It is, simply, a cut of steak (usually cheap round steak) pounded until tender, breaded like you would bread chicken, and fried in oil. Milk, salt, flour and pepper are added to the grease drippings and used to make a thick gravy, which is generously poured over the steak and, usually, mashed potatoes. Many people think the gravy makes the steak!

Ingredients

 * White flour as needed plus 3 tbsp
 * 2 tbsp freshly-ground black pepper
 * 1 tbsp kosher salt
 * 2 eggs, beaten
 * 1 cup whole milk, combined with ¼ cup heavy cream
 * 3 ea. beef steaks, ½ inch thick
 * 3 tbsp bacon drippings, divided
 * 2 tbsp smoked paprika
 * ⅓ cup chicken broth

Procedure

 * 1) Pour 2 tbsp drippings into a 12-inch cast-iron skillet. Preheat the pan over medium high heat. Wet hand, drip 1 drop of water in pan to test the heat. If it sizzles, it's hot enough.
 * 2) Trim each steak.
 * 3) Beat eggs with seasonings, then dip steaks into eggs.
 * 4) Thoroughly dredge steak in flour on both sides.
 * 5) When the pan is hot enough, put steaks in pan in a triangle formation. Fry until golden brown, about 4 minutes per side.
 * 6) Remove steak(s) from pan and place in a 200°F oven.
 * 7) Pour remaining drippings into pan and lower heat to medium. Add flour and cook, whisking, until light blonde color is achieved.
 * 8) Add chicken broth to pan, and whisk to deglaze pan. Add cream mixture and bring to a boil. Reduce heat to low and cook until gravy coats back of spoon. Don't let the gravy get too thick.
 * 9) Drizzle gravy over steaks and serve.

title: Cookbook:Chicken-fried Steak


text:
Electronics/Boolean Algebra

Boolean Algebra
Boolean Algebra was created by George Boole (1815 - 1864) in his paper An Investigation of the Laws of Thought, on Which Are Founded the Mathematical Theories of Logic and Probabilities, published in 1854. It had few applications at the time, but eventually scientists and engineers realized that his system could be used to create efficient computer logic. The Boolean system has two states: True (T) or False (F). This can be represented in several different ways as on or off, one or zero, yes or no, etc. These states are manipulated by three fundamental operations called logical operators: AND, OR and NOT. These operators take certain inputs and produce an output based on a predetermined table of results. For example, the AND operator takes two (or more) inputs and returns an 'on' result only when both (or all) inputs are 'on'.
 * In these tables T means "True", or "Yes", or 1 (in electronics), and
 * F means "False", or "No" or 0 (in electronics).
 * For example, the 1st line of the AND table says that if A is F and B is F then the result also is F. This is also said often as If A is 0 and B is also 0, then A AND B = 0 times 0 = 0
 * Also at the bottom of the AND table 1 times 1 is 1.
 * Looking at the OR table, use plus instead of times: 0 plus 0 is 0, where again 0 is F and 1 is T. Only 0 and 1 exist, therefore if the result of the addition is more than 1, then change it to 1.
 * The 3rd table shows NEGATION: whatever it is, change it to the other; 0 is changed into 1, and 1 is changed into 0.

These simple operators are good because they allow us to create very simple logic circuits: if user put in a quarter AND the Coke button is pressed, drop a Coke

There are ways, however, to combine these expressions to make much more complex but useful digital circuits. By using multiple operators on the same inputs, it is possible to create much more complex outputs. An expression like: A and B or C would have a truth table of the following:

This truth table follows the rules If A and B are true, or C is true, then X is true

Exercise: Go through each case in the table and check it using the above statement.

Formal Mathematical Operators
AND is represented by $$\wedge$$ or $$\cdot \,$$ that is A AND B would be $$A \wedge B \,$$ or $$A \cdot  B \,$$.

OR is represented by $$\vee$$ or $$+ \,$$ that is A OR B would be $$A \vee B$$ and $$A+B \,$$.

NOT is represented by $$\lnot$$ or $$\bar{}$$ that is NOT A is $$\neg A$$ or $$\bar{A}$$.

If these three operators are combined then the NOR and NAND can be created. So A NOR B is $$\neg (A \vee B)$$ or $$\overline{A+B}$$. NAND is $$\neg (A \wedge B) \,$$ or $$\overline{A\cdot B}$$. Other notations are valid as well, and many different combinations of them arise in mathematics and engineering. No universal standard has been agreed upon. However, most sources will make explicit the particular notation used.

Boolean Algebra Laws
Boolean Algebra, like regular algebra, has certain rules. These rules are Associativity, Distributivity, Commutativity and De Morgan's Laws. Associativity, Commutativity and Distributivity only apply to the AND and OR operators. Some of these laws may seem trivial in normal Algebra but in other algebras they are not.

Associativity
Associativity is the property of algebra that the order of evaluation of the terms is immaterial.
 * $$A \vee (B \vee C) = (A \vee B) \vee C $$
 * $$A \wedge (B \wedge C) = (A \wedge B) \wedge C $$

Or
 * $$A+(B+C)=(A+B)+C \,$$
 * $$A\cdot(B\cdot C)=(A\cdot B)\cdot C \,$$

 * Associativity

Distributivity
Distibutivity is the property that an operator can be applied to the terms within the brackets.
 * $$A \wedge (B \vee C) = (A \wedge B) \vee (A \wedge C)$$

Or
 * $$A\cdot (B+C)=(A\cdot B)+(A\cdot C) \,$$

 * Distributivity

Commutativity
Commutativity is the property that order of application of an operator is immaterial.
 * $$A \wedge B = B \wedge A$$
 * $$A \vee B = B \vee A$$

Or
 * $$A\cdot B=B\cdot A \,$$
 * $$A+B=B+A \,$$
 * Commutativity

De Morgan's Law
De Morgan's Law is a consequence of the fact that the not or negation operator is not distributive.
 * $$\neg(P\wedge Q)=(\neg P)\vee(\neg Q)$$
 * $$\neg(P\vee Q)=(\neg P)\wedge(\neg Q)$$

Or
 * $$\overline{P\cdot Q}=\bar {P}+ \bar {Q}$$
 * $$\overline{P+Q}=\bar {P}\cdot \bar {Q}$$

Rules
All of these Laws Result in a number of rules used for the reduction of Boolean Algebra.

Or
 * 1) $$A \wedge A=A \,$$
 * 2) $$A\vee A=A \,$$
 * 3) $$A\wedge 1=A \,$$
 * 4) $$A\vee 1=1 \,$$
 * 5) $$A\wedge 0=0 \,$$
 * 6) $$A\vee 0=A \,$$
 * 7) $$A\wedge \neg {A}=0 \,$$
 * 8) $$A\vee \neg {A}=1 \,$$
 * 9) $$\neg (\neg {A})=A \,$$
 * 10) $$A\vee \neg {A}\wedge B= A \vee B$$
 * 11) $$\neg {A} \vee A\wedge B= \neg {A} \vee B$$
 * 1) $$A\cdot A=A \,$$
 * 2) $$A+A=A \,$$
 * 3) $$A\cdot 1=A \,$$
 * 4) $$A+1=1 \,$$
 * 5) $$A\cdot 0=0 \,$$
 * 6) $$A+0=A \,$$
 * 7) $$A\cdot \bar {A}=0 \,$$
 * 8) $$A+\bar {A}=1 \,$$
 * 9) $$\overline {\bar {A}}=A \,$$
 * 10) $$A+\bar {A}\cdot B= A + B$$
 * 11) $$\bar {A} + A\cdot B= \bar {A} + B$$

Examples
Simplify the following Expressions. Or
 * 1) $$B \wedge A \wedge \neg {A}$$
 * 2) $$A \wedge \neg {B} \vee A \wedge B$$
 * 1) $$B\cdot A\cdot \bar {A}$$
 * 2) $$A\cdot \bar {B} + A\cdot B$$

For number 1 using rule 7. We get.

 * $$B\wedge 0=0 \,$$

Or
 * $$B\cdot 0=0 \,$$

Which happens to be rule 5 so the answer is zero. In number 2 we can take out A. Given
 * $$A \wedge( \neg {B} \vee B)$$

Or
 * $$A\cdot (\bar {B} + B)$$

The Expression within brackets is rule 8. So the answer is A.

title: Electronics/Boolean Algebra


text:
Radiation Oncology/RTOG Trials/7706

RTOG 77-06 (PROSTATE)
 * Title: Phase III Prostatic Irradiation vs Pelvic Irradiation plus Prostate Boost for Stage A2/B Prostatic Adenocarcinoma
 * Objectives:
 * (1) Determine the value of irradiation of the prostate only vs. pelvic irradiation with prostate boost in patients with Stages A2 and B adenocarcinoma of the prostate.
 * (2) Compare the morbidity and complications of these two radiotherapeutic regimens.
 * Eligibility: Stage A2 and B, N0M0
 * Protocol:
 * Arm 1: 65 Gy prostate field EBRT
 * Arm 2: 45 Gy pelvic field EBRT + 20 Gy prostate boost
 * Enrolled: 453 patients
 * Conclusion:
 * PMID 3058656 -- Elective pelvic irradiation in stage A2, B carcinoma of the prostate: analysis of RTOG 77-06. (Asbell, IJRBOP 1988). Conclusion: The results of the study revealed no statistically significant benefit of elective pelvic irradiation.
 * Publications:
 * PMID 12478146 -- Race and survival of men treated for prostate cancer on radiation therapy oncology group phase III randomized trials. (Roach, J Urol 2003). Conclusion: As previously reported, tumor grade (Gleason score), palpation T stage, lymph node status, pretreatment PSA and treatment type are major predictors of overall and disease specific survival. We noted no evidence that race has independent prognostic significance in patients treated for prostate cancer in Radiation Therapy Oncology Group prospective randomized trials.
 * PMID 10837944 -- Predicting long-term survival, and the need for hormonal therapy: a meta-analysis of RTOG prostate cancer trials. (Roach, IJRBOP 2000). Conclusion: Based on this meta-analysis of RTOG trials, subsets of patients can be identified who either do not appear to benefit from the use of hormonal therapy, benefit from short-term hormonal therapy, or who benefit only from long-term hormonal therapy. These observations should be confirmed by prospective randomized trials before they can be considered conclusive. In the meantime, however, these observations provide rational guidelines for deciding who should receive hormonal therapy and for how long.
 * PMID 10837943 -- Four prognostic groups predict long-term survival from prostate cancer following radiotherapy alone on Radiation Therapy Oncology Group clinical trials. (Roach, IJRBOP 2000). Conclusion: Recognition of these four risk groups provides a basis for estimating the long-term DSS for men treated with XRT alone and should facilitate the design of future prospective randomized trials.
 * PMID 10894874 -- Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the Radiation Therapy Oncology Group trials. (Valicenti, JCO 2000). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers.
 * PMID 10022702 -- Long-term survival after radiotherapy alone: radiation therapy oncology group prostate cancer trials. (Roach M, J Urol 1999). Conclusion: In the first 10 years Gleason score was the single most important predictor of death. Gleason score should be incorporated into the current clinical staging system.
 * ASCO Abstract -- Radiation Dose-Response Is Gleason Score Dependent on the Radiation Therapy Oncology Group Prostate Cancer Trials (Meeting abstract). (Valicenti R, ASCO 1999). Conclusion: These data suggest a significant effect for higher radiation dose to reduce the probability of dying from prostate cancer in men with poorly differentiated disease.
 * PMID 9531360 -- Impact of surgical staging in evaluating the radiotherapeutic outcome in RTOG #77-06, a phase III study for T1BN0M0 (A2) and T2N0M0 (B) prostate carcinoma. (Asbell, IJRBOP 1998). Conclusion: At 12-year median follow-up, there still was no survival difference in those patients treated prophylactically to the pelvic nodes and prostatic bed vs. the prostatic bed alone. Those patients not surgically staged with only LAG for lymph node evaluation were less accurately staged, as reflected by a statistically significant reduced survival and earlier metastases.
 * Roach M, Lu J, Pilepich M, et al.: Long term survival in 1500 men treated for prostate cancer with radiotherapy alone (XRT): based on radiation therapy oncology group protocols 7706, 7506, 8531, and 8610. [Abstract] Proceedings of the American Urological Association 1998.
 * ASCO Abstract -- Prognostic subgroups predict disease specific survival for men treated with radiotherapy alone on Radiation Therapy Oncology Group (RTOG) prostate cancer trials. (Roach M, ASCO 1998; Proceedings of the American Society of Clinical Oncology 17: A1201, 312a, 1998.
 * ASCO Abstract -- Impact of surgical staging in evaluating the radiotherapeutic outcome in RTOG phase III study for T1b-T2NOMO prostatic carcinoma: RTOG #77-06. (Asbell SO, ASCO 1995; Proceedings of the American Society of Clinical Oncology 14: A-1681, 512, 1995
 * PMID 7591889 -- Correlation of survival with quantitative tissue staining of prostate specific acid phosphatase in patients with prostate carcinoma by using microscopic image analysis: a preliminary report of correlative studies on RTOG protocols 75-06, 77-06, and 83-07. (Zhou, IJRBOP 1995). Conclusion: Quantitative image analysis of the IPSAP stain predicts survival in patients treated with external beam radiotherapy with and without prior hormonal therapy
 * PMID 7523341 -- PSA confirmation of cure at 10 years of T1B, T2, N0, M0 prostate cancer patients treated in RTOG protocol 7706 with external beam irradiation. (Hanks GE, IJRBOP 1994). Conclusion: Prostatic specific antigen adds to the accuracy of determining clinical long-term cure and shows that 65-88% of patients who are clinical no evidence of disease are "biochemical" cures as well. These correlation percentages are quite similar to the largest contemporary surgical series, and strongly support the concept and fact of cure of prostate cancer with radiation.
 * PMID 8270458 -- Patterns of Care and RTOG studies in prostate cancer: long-term survival, hazard rate observations, and possibilities of cure. (Hanks GE, IJRBOP 1994). Conclusion: These data make a strong argument for the long-term cure of prostate cancer by external beam radiation, and support the continued use and study of radiation therapy as a curative modality in prostate cancer. No similar national data is available for any other method of management.
 * PMID 1587749 -- Comparison of pathologic and clinical evaluation of lymph nodes in prostate cancer: implications of RTOG data for patient management and trial design and stratification. (Hanks GE, IJRBOP 1992). Conclusion: The clinical determination of nodal status, therefore, has no prognostic value in contrast to pathologic determination and should not be used for stratifying patients in clinical trials. The CT scans often used to evaluate nodal status are more useful if delayed until they can be done as part of the treatment planning process where the CT has value. When imaging tests suggest positive lymph nodes in prostate cancer patients, the imaging finding is confirmed by biopsy.
 * PMID 1917621 -- The effect of overall treatment time on the outcome of definitive radiotherapy for localized prostate carcinoma: the Radiation Therapy Oncology Group 75-06 and 77-06 experience. (Lai PP, IJRBOP 1991). Conclusion: The incidence of late complications was not related to the number of elapsed treatment days. Therefore, the overall treatment time does not have an impact on the outcome of definitive radiotherapy for localized prostate carcinoma. It is hypothesized that prostate carcinoma behaves as late-reacting tissue in which there is little, if any, accelerated repopulation of clonogenic tumor cells during the later half of a protracted course of radiotherapy.
 * PMID 1917610 -- Outcome for lymph node dissection negative T-1b, T-2 (A-2,B) prostate cancer treated with external beam radiation therapy in RTOG 77-06. (Hanks GE, IJRBOP 1991). Conclusion: The outcome of this group is equal or superior to reports of radical prostatectomy in similar stage patients.
 * PMID 2808056 -- Impact of surgical staging in evaluating the radiotherapeutic outcome in RTOG phase III study for A2 and B prostate carcinoma. (Asbell, IJRBOP 1989). Conclusion: Compared to the lymphangiography group, the staging lymphadenectomy group showed better overall survival (87% to 76% at 5 years, p = .02), better disease-free survival (76% to 63% at 5 years, p = .008) and better metastases-free survival (88% to 82% at 5 years, p = .04). There was no difference between the groups in local control. The lymphangiography evaluation of pelvic nodes was clearly inferior for demonstration of the absence of pelvic node metastasis as reflected by reduced survival and increased metastasis.
 * PMID 3597142 -- Correlation of radiotherapeutic parameters and treatment related morbidity--analysis of RTOG Study 77-06. (Pilepich, IJRBOP 1987). Conclusion: Within the range of pelvic doses used in this study a significant dose effect could not be detected. Total doses to the prostate of more than 7000 cGy were associated with an increased risk of rectal bleeding. Certain treatment techniques, (AP/PA irradiation of the pelvic lymphatics) were associated with an increased incidence of bowel complications.
 * PMID 6483687 -- Surgical staging in carcinoma of the prostate: the RTOG experience. Radiation Therapy Oncology Group. (Pilepich, Prostate 1984). Conclusion: The incidence of postirradiation lymphedema was found to be strongly dependent upon the extent of dissection.
 * PMID 6346857 -- Preliminary report on phase III RTOG studies of extended-field irradiation in carcinoma of the prostate. (Pilepich, Am J Clin Oncol 1983). Conclusion: The use of paraaortic fields in RTOG 75-06 and pelvic fields in RTOG 77-06 have not resulted in a significant increase of GI or GU morbidity at this time. The only statistically significant trend was the incidence of postirradiation genital and lower extremity edema which strongly correlated with the extent of staging lymphadenectomy.
 * PMID 7155987 -- Some questions raised by histologic study of RTOG protocols 75-06 and 77-06 as illustrated by selected samples. (Terry, Prostate 1982).

title: Radiation Oncology/RTOG Trials/7706


text:
Electronics/Basic gates

Basic Gates
There are 5 basic gates used in performing logic operations in Digital Electronic namely BUFFER gate, NOT gate, AND gate, OR gate, XOR gate. Each Logic Gate has A Symbol for easy to identify, a Mathematical Expression to identify mathematic logic operation and a Truth Table to completely describe operation of the Logic Gate

Five Basic Logic Gates

 * {| class="wikitable" width=100%

! Digital gates !! Symbol!! Logic Operation !! Mathematic Expression
 * BUFFER|| [[Image:Buffer ANSI Labelled.svg|100px|Cổng Tiếp (Buffer Gate)]] || Y = BUFFER A || Y = A
 * NOT || [[Image:NOT_ANSI_Labelled.svg|100px]] || Y = NOT A || Y = $$\bar {A}$$
 * AND || [[Image:AND_ANSI_Labelled.svg|100px]] || Y = A AND B || Y = A . B
 * OR || [[Image:Logic-gate-or-us.png|100px]] || Y = A OR B || Y = A + B
 * XOR || [[Image:XOR_ANSI_Labelled.svg|100px]] || Y = A XOR B || Y = $${A \oplus B}$$
 * }
 * OR || [[Image:Logic-gate-or-us.png|100px]] || Y = A OR B || Y = A + B
 * XOR || [[Image:XOR_ANSI_Labelled.svg|100px]] || Y = A XOR B || Y = $${A \oplus B}$$
 * }
 * XOR || [[Image:XOR_ANSI_Labelled.svg|100px]] || Y = A XOR B || Y = $${A \oplus B}$$
 * }
 * }

The Truth Table of the five basic logic gates above
 * {| class="wikitable" width=100%

! A !! B !! Q = A !! Q = NOT A !! Q = A AND B !! Q = A OR B !! Q = A XOR B
 * 0 || 0 || 0 ||1 || 0 || 0 || 0
 * 0 || 1 || 0 || 1 || 0 ||1 || 1
 * 1 || 0 || 1 || 0 || 0 ||1 || 1
 * 1 || 1 || 1 || 0 || 1 ||1 || 0
 * }
 * 1 || 0 || 1 || 0 || 0 ||1 || 1
 * 1 || 1 || 1 || 0 || 1 ||1 || 0
 * }
 * }
 * }

Complement of Basic Logic gates

 * {| class="wikitable" width=100%

!Basic Gates !! Combination Gates!! Symbol !! Mathematical Expression
 * BUFFER|| Logic-gate-inv-us.png [[Image:Logic-gate-inv-us.png|100px|Cổng NOT (NOT Gate)]] || Buffer_ANSI_Labelled.svg || Q = is NOT NOT A Y = A
 * BUFFER|| Logic-gate-inv-us.png [[Image:Logic-gate-inv-us.png|100px|Cổng NOT (NOT Gate)]] || Buffer_ANSI_Labelled.svg || Q = is NOT NOT A Y = A

 * NOT || Buffer_ANSI_Labelled.svg [[Image:Logic-gate-inv-us.png|100px|Cổng NOT (NOT Gate)]] || [[Image:Logic-gate-inv-us.png|100px|Cổng NOT (NOT Gate)]] || Y = is NOT A

 * NAND || Logic-gate-and-us.png [[Image:Logic-gate-inv-us.png|100px|Cổng NOT (NOT Gate)]] || NAND_ANSI_Labelled.svg || Q = NOT A AND B

 * NOR || Logic-gate-or-us.png [[Image:Logic-gate-inv-us.png|100px|Cổng NOT (NOT Gate)]] || Logic-gate-nor-us.png || Y = NOT A OR B

 * XNOR || XOR_ANSI_Labelled.svg Logic-gate-inv-us.png || XNOR_ANSI_Labelled.svg || Q = NOT A XOR B
 * }
 * }

The Truth table of the combination gates above

 * {| class="wikitable" width=100%

! A !! B !! Q = A !! Q = NOT A !! Q = A NAND B !! Q = A NOR B !! Q = A XNOR B
 * 0 || 0 || 0 ||1 || 1 || 1 || 1
 * 0 || 1 || 0 || 1 || 1 || 0 || 0
 * 1 || 0 || 1 || 0 || 1 || 0 || 0
 * 1 || 1 || 1 || 0 || 0 || 0 || 1
 * }
 * 1 || 0 || 1 || 0 || 1 || 0 || 0
 * 1 || 1 || 1 || 0 || 0 || 0 || 1
 * }
 * }
 * }

Summary

 * {| class=wikitable width=100%

!rowspan=2|Gates !rowspan=2|Function !colspan=2|Symbol !ANSI!!IEC !Buffer !NOT gate (Inverter) !AND gate !NAND gate (NOT−AND) !OR gate !NOR gate (NOT−OR) !XOR gate (Exclusive-OR) !XNOR gate (NOT−exclusive−OR)
 * $$Q=A$$
 * [[File:Buffer ANSI Labelled.svg]]
 * [[File:Buffer IEC Labelled.svg]]
 * $$Q=\overline{A}$$
 * [[File:NOT ANSI Labelled.svg]]
 * [[File:NOT IEC Labelled.svg]]
 * $$Q = A \cdot B$$
 * [[File:AND ANSI Labelled.svg]]
 * [[File:AND IEC Labelled.svg]]
 * $$Q = \overline{A \cdot B}$$
 * [[File:NAND ANSI Labelled.svg]]
 * [[File:NAND IEC Labelled.svg]]
 * $$Q = A + B$$
 * [[File:OR ANSI Labelled.svg]]
 * [[File:OR IEC Labelled.svg]]
 * $$Q = \overline{A + B}$$
 * [[File:NOR ANSI Labelled.svg]]
 * [[File:NOR IEC Labelled.svg]]
 * $$Q = A \oplus B$$
 * [[File:XOR ANSI Labelled.svg]]
 * [[File:XOR IEC Labelled.svg]]
 * $$Q = \overline{A \oplus B}$$
 * [[File:XNOR ANSI Labelled.svg]]
 * [[File:XNOR IEC Labelled.svg]]
 * }

 * {| class="wikitable" style="text-align:center; margin:auto;"

! width=3%| A !! width=3% | B !! width= 9% | Q = A !! width= 9% | Q = NOT A !! width= 9% | Q = A AND B !! width= 9% | Q = A OR B !! width= 9% | Q = A XOR B !! width= 9% | Q = A NAND B !! width= 9% | Q = A NOR B !! width= 9% | Q = A XNOR B
 * 0 || 0 || 0 ||1 || 0 || 0 || 0 || 1 ||1 || 1
 * 0 || 1 || 0 || 1 || 0 ||1 || 1 || 1 ||0 || 0
 * 1 || 0 || 1 || 0 || 0 ||1 || 1 || 1 ||0 || 0
 * 1 || 1 || 1 || 0 || 1 ||1 || 0 || 0 ||0 || 1
 * }
 * 1 || 0 || 1 || 0 || 0 ||1 || 1 || 1 ||0 || 0
 * 1 || 1 || 1 || 0 || 1 ||1 || 0 || 0 ||0 || 1
 * }
 * }
 * }

title: Electronics/Basic gates