Upfront Versus Delayed Systemic Therapy in Patients With Oligometastatic Cancer Treated With SABR in the Phase 2 SABR-5 Trial.

PURPOSE: The optimal sequencing of local and systemic therapy for oligometastatic cancer has not been established. This study retrospectively compared progression-free survival (PFS), overall survival (OS), and SABR-related toxicity between upfront versus delay of systemic treatment until progression in patients in the SABR-5 trial. METHODS AND MATERIALS: The single-arm phase 2 SABR-5 trial accrued patients with up to 5 oligometastases across SABR-5 between November 2016 and July 2020. Patients received SABR to all lesions. Two cohorts were retrospectively identified: those receiving upfront systemic treatment along with SABR and those for whom systemic treatment was delayed until disease progression. Patients treated for oligoprogression were excluded. Propensity score analysis with overlap weighting balanced baseline characteristics of cohorts. Bootstrap sampling and Cox regression models estimated the association of delayed systemic treatment with PFS, OS, and grade ≥2 toxicity. RESULTS: A total of 319 patients with oligometastases underwent treatment on SABR-5, including 121 (38%) and 198 (62%) who received upfront and delayed systemic treatment, respectively. In the weighted sample, prostate cancer was the most common primary tumor histology (48%) followed by colorectal (18%), breast (13%), and lung (4%). Most patients (93%) were treated for 1 to 2 metastases. The median follow-up time was 34 months (IQR, 24-45). Delayed systemic treatment was associated with shorter PFS (hazard ratio [HR], 1.56; 95% CI, 1.15-2.13; P = .005) but similar OS (HR, 0.90; 95% CI, 0.51-1.59; P = .65) compared with upfront systemic treatment. Risk of grade 2 or higher SABR-related toxicity was reduced with delayed systemic treatment (odds ratio, 0.35; 95% CI, 0.15-0.70; P < .001). CONCLUSIONS: Delayed systemic treatment is associated with shorter PFS without reduction in OS and with reduced SABR-related toxicity and may be a favorable option for select patients seeking to avoid initial systemic treatment. Efforts should continue to accrue patients to histology-specific trials examining a delayed systemic treatment approach.

Fiber Bragg Grating Sensors for Pile Jacking Monitoring in Clay Soil.

The small deformation of the model pile in a pile jacking test makes its accurate measurement very difficult. Based on the installation method of clamping at both ends, a sensitized miniature fiber Bragg grating (FBG) strain sensor was developed to measure the pile strain of small-size model piles. This study investigated the working principle of the sensitized miniature FBG sensor and analyzed the strain transfer characteristics of the sensor by calibration test. The lateral resistance and the earth plug resistance of the model pile were measured accurately by the grooves embedded in the outer tube of the double-wall opening model pile and the sensors directly pasted on the surface of the inner tube. The results of this study show that the sensitized miniature FBG strain sensor has the advantages of high sensitivity, strong interference resistance, and high test accuracy. The FBG strain sensor was completely fixed on the pile by clamping supports at both ends, and the strain measured using the FBG strain sensor was found to be consistent with the pile deformation.

Tunnel millisecond-delay controlled blasting based on the delay time calculation method and digital electronic detonators to reduce structure vibration effects.

The reasonable delay time of millisecond-delay blasting using digital electronic detonators can significantly reduce the vibration effects induced by tunnel blasting. This study proposes a method for calculating the delay time for cut holes, easer holes and periphery holes, considering the rocks breaking effect as well as wave superposition theory. And then according to the actual layout diagram of the tunnel holes, the delay time calculation formulas of different holes are put forward. Then the delay times were calculated according to the formulas and applied in the field tests. The velocities, rocks breaking and wave superposition cancellation of the vibration using different delay times are analyzed with digital electronic detonators. Then the optimum delay times of different holes were obtained and applied to New Hongyan tunnel project. The velocity and frequency of the vibration with digital electronic detonators are analyzed, compared with non-electronic detonators. The effects of charge and delay time on the velocity and principal frequency of a blasting seismic wave are discussed. The results indicate that the delay time for the holes must be prioritized to achieve breaking effects in the rock with the simultaneous formation of a new free surface, next considering the wave superposition cancellation. When the delay time of cut holes was 5 ms, the rocks breaking effect and wave superposition cancellation effect both worked well. The velocity of the vibration induced by the cut holes blasting was about only 0.46-0.51 cm/s. When the delay time was 6 ms or much longer, the rocks breaking effect would fail. With regard to the easer holes and periphery holes, the optimum delay time of them were all 5ms. The vertical peak particle velocity was reduced from 2.974 cm/s to 0.901 cm/s with digital electronic detonators. Therefore, the velocity had decreased by 69.70% than non-electronic detonators, which was caused by reducing the single simultaneous explosive charge and setting optimum delay time. The proposed delay time calculation method is demonstrated to be sufficiently accurate and can thus be used as a guideline to reduce tunnel blasting vibrations.