Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma.

BACKGROUND: International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low. METHODS: We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000. PRIMARY ENDPOINT: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses. RESULTS: In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50-60 Gy (n = 20) or 20-49 Gy (n = 69), stereotactic body RT of 35-50 Gy (SBRT) (n = 36), or brachytherapy of 12-25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0-148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03-0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12-0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22-1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established. CONCLUSIONS: This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.

Variational Ansatz for the Ground State of the Quantum Sherrington-Kirkpatrick Model.

We present an Ansatz for the ground states of the quantum Sherrington-Kirkpatrick model, a paradigmatic model for quantum spin glasses. Our Ansatz, based on the concept of generalized coherent states, very well captures the fundamental aspects of the model, including the ground state energy and the position of the spin glass phase transition. It further enables us to study some previously unexplored features, such as the nonvanishing longitudinal field regime and the entanglement structure of the ground states. We find that the ground state entanglement can be captured by a simple ensemble of weighted graph states with normally distributed phase gates, leading to a volume law entanglement, contrasting with predictions based on entanglement monogamy.

Hydrous ferric oxide: evaluation of Cd-HFO surface complexation models combining Cd(K) EXAFS data, potentiometric titration results, and surface site structures identified from mineralogical knowledge.

The surface properties of ferrihydrite were studied by combining wet chemical data, Cd(K) EXAFS data, and a surface structure and protonation model of the ferrihydrite surface. Acid-base titration experiments and Cd(II)-ferrihydrite sorption experiments were performed within 3<-log[H(+)]<10.5 and 0.5<[Cd(t)]<12 mM in 0.3 M NaClO(4) at 25 degrees C, where [Cd(t)] refers to total Cd concentration. Measurements at -5.5triple bond Fe-OH(-1/2),logk((int))=-8.29, assuming the existence of a unique intrinsic microscopic constant, logk((int)), and consequently the existence of a single significant type of acid-base reactive functional groups. The surface structure model indicates that these groups are terminal water groups. The Cd(II) data were modeled assuming the existence of a single reactive site. The model fits the data set at low Cd(II) concentration and up to 50% surface coverage. At high coverage more Cd(II) ions than predicted are adsorbed, which is indicative of the existence of a second type of site of lower affinity. This agrees with the surface structure and protonation model developed, which indicates comparable concentrations of high- and low-affinity sites. The model further shows that for each class of low- and high-affinity sites there exists a variety of corresponding Cd surface complex structure, depending on the model crystal faces on which the complexes develop. Generally, high-affinity surface structures have surface coordinations of 3 and 4, as compared to 1 and 2 for low-affinity surface structures.

Solubility of Tris(hydroxymethyl)aminomethane in Water-Methanol Solvent Mixtures and Medium Effects in the Dissociation of the Protonated Base.

The dissociation constant of the protonated form of tris(hydroxymethyl)aminomethane has been measured at 25 °C in water-methanol solvents containing 30, 50, 70, and 90 wt percent methanol by means of potentiometric titrations. The solubility of tris(hydroxymethyl)aminomethane at 15, 25, and 35 °C in water-methanol solvents containing from 0 to 100 percent methanol has been determined. The results are discussed in terms of free energies of transfer and "medium effects" for hydrochloric acid, tris(hydroxymethyl)aminomethane, and tris(hydroxymethyl)aminomethane hydrochloride.