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1.
Chaos ; 31(3): 033149, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33810745

RESUMEN

We develop and test machine learning techniques for successfully using past state time series data and knowledge of a time-dependent system parameter to predict the evolution of the "climate" associated with the long-term behavior of a non-stationary dynamical system, where the non-stationary dynamical system is itself unknown. By the term climate, we mean the statistical properties of orbits rather than their precise trajectories in time. By the term non-stationary, we refer to systems that are, themselves, varying with time. We show that our methods perform well on test systems predicting both continuous gradual climate evolution as well as relatively sudden climate changes (which we refer to as "regime transitions"). We consider not only noiseless (i.e., deterministic) non-stationary dynamical systems, but also climate prediction for non-stationary dynamical systems subject to stochastic forcing (i.e., dynamical noise), and we develop a method for handling this latter case. The main conclusion of this paper is that machine learning has great promise as a new and highly effective approach to accomplishing data driven prediction of non-stationary systems.

2.
JAMA Oncol ; 6(1): 75-82, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31750868

RESUMEN

IMPORTANCE: Mastectomy is standard for recurrence of breast cancer after breast conservation therapy with whole breast irradiation. The emergence of partial breast irradiation led to consideration of its application for reirradiation after a second lumpectomy for treatment of recurrence of breast cancer in the ipsilateral breast. OBJECTIVES: To assess the effectiveness and adverse effects of partial breast reirradiation after a second lumpectomy and whether the treatment is an acceptable alternative to mastectomy. DESIGN, SETTING, AND PARTICIPANTS: The NRG Oncology/Radiation Therapy Oncology Group 1014 trial is a phase 2, single-arm, prospective clinical trial of 3-dimensional, conformal, external beam partial breast reirradiation after a second lumpectomy for recurrence of breast cancer in the ipsilateral breast after previous whole breast irradiation. The study opened on June 4, 2010, and closed June 18, 2013. Median follow-up was 5.5 years. This analysis used all data received at NRG Oncology through November 18, 2018. Eligible patients experienced a recurrence of breast tumor that was less than 3 cm and unifocal in the ipsilateral breast more than 1 year after breast-conserving therapy with whole breast irradiation and who had undergone excision with negative margins. INTERVENTIONS: Adjuvant partial breast reirradiation, 1.5 Gy twice daily for 30 treatments during 15 days (45 Gy), using a 3-dimensional conformal technique. MAIN OUTCOMES AND MEASURES: The main outcomes of the present study were the predefined secondary study objectives of recurrence of breast cancer in the ipsilateral breast, late adverse events (>1 year after treatment), mastectomy incidence, distant metastasis-free survival, overall survival, and circulating tumor cell incidence. RESULTS: A total of 65 women were enrolled, with 58 evaluable for analysis (mean [SD] age, 65.12 [9.95] years; 48 [83%] white). Of the recurrences of breast cancer in the ipsilateral breast, 23 (40%) were noninvasive and 35 (60%) were invasive. In all 58 patients, 53 (91%) had tumors 2 cm or smaller. All tumors were clinically node negative. A total of 44 patients (76%) tested positive for estrogen receptor, 33 (57%) for progesterone receptor, and 10 (17%) for ERBB2 (formerly HER2 or HER2/neu) overexpression. Four patients had breast cancer recurrence, with a 5-year cumulative incidence of 5% (95% CI, 1%-13%). Seven patients underwent ipsilateral mastectomies for a 5-year cumulative incidence of 10% (95% CI, 4%-20%). Both distant metastasis-free survival and overall survival rates were 95% (95% CI, 85%-98%). Four patients (7%) had grade 3 and none had grade 4 or higher late treatment adverse events. CONCLUSIONS AND RELEVANCE: For patients experiencing recurrence of breast cancer in the ipsilateral breast after lumpectomy and whole breast irradiation, a second breast conservation was achievable in 90%, with a low risk of re-recurrence of cancer in the ipsilateral breast using adjuvant partial breast reirradiation. This finding suggests that this treatment approach is an effective alternative to mastectomy.


Asunto(s)
Neoplasias de la Mama , Reirradiación , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Terapia Combinada , Femenino , Humanos , Mastectomía , Mastectomía Segmentaria , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/radioterapia , Recurrencia Local de Neoplasia/cirugía , Estudios Prospectivos
3.
Chaos ; 28(12): 123119, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30599514

RESUMEN

Reservoir computing is a neural network approach for processing time-dependent signals that has seen rapid development in recent years. Physical implementations of the technique using optical reservoirs have demonstrated remarkable accuracy and processing speed at benchmark tasks. However, these approaches require an electronic output layer to maintain high performance, which limits their use in tasks such as time-series prediction, where the output is fed back into the reservoir. We present here a reservoir computing scheme that has rapid processing speed both by the reservoir and the output layer. The reservoir is realized by an autonomous, time-delay, Boolean network configured on a field-programmable gate array. We investigate the dynamical properties of the network and observe the fading memory property that is critical for successful reservoir computing. We demonstrate the utility of the technique by training a reservoir to learn the short- and long-term behavior of a chaotic system. We find accuracy comparable to state-of-the-art software approaches of a similar network size, but with a superior real-time prediction rate up to 160 MHz.

4.
Int J Radiat Oncol Biol Phys ; 98(5): 1028-1035, 2017 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-28721885

RESUMEN

PURPOSE: To determine the associated toxicity, tolerance, and safety of partial-breast reirradiation. METHODS AND MATERIALS: Eligibility criteria included in-breast recurrence occurring >1 year after whole-breast irradiation, <3 cm, unifocal, and resected with negative margins. Partial-breast reirradiation was targeted to the surgical cavity plus 1.5 cm; a prescription dose of 45 Gy in 1.5 Gy twice daily for 30 treatments was used. The primary objective was to evaluate the rate of grade ≥3 treatment-related skin, fibrosis, and/or breast pain adverse events (AEs), occurring ≤1 year from re-treatment completion. A rate of ≥13% for these AEs in a cohort of 55 patients was determined to be unacceptable (86% power, 1-sided α = 0.07). RESULTS: Between 2010 and 2013, 65 patients were accrued, and the first 55 eligible and with 1 year follow-up were analyzed. Median age was 68 years. Twenty-two patients had ductal carcinoma in situ, and 33 had invasive disease: 19 ≤1 cm, 13 >1 to ≤2 cm, and 1 >2 cm. All patients were clinically node negative. Systemic therapy was delivered in 51%. All treatment plans underwent quality review for contouring accuracy and dosimetric compliance. All treatment plans scored acceptable for tumor volume contouring and tumor volume dose-volume analysis. Only 4 (7%) scored unacceptable for organs at risk contouring and organs at risk dose-volume analysis. Treatment-related skin, fibrosis, and/or breast pain AEs were recorded as grade 1 in 64% and grade 2 in 7%, with only 1 (<2%) grade ≥3 and identified as grade 3 fibrosis of deep connective tissue. CONCLUSION: Partial-breast reirradiation with 3-dimensional conformal radiation therapy after second lumpectomy for patients experiencing in-breast failures after whole-breast irradiation is safe and feasible, with acceptable treatment quality achieved. Skin, fibrosis, and breast pain toxicity was acceptable, and grade 3 toxicity was rare.


Asunto(s)
Neoplasias de la Mama/radioterapia , Mama/efectos de la radiación , Carcinoma Intraductal no Infiltrante/radioterapia , Mastectomía Segmentaria , Recurrencia Local de Neoplasia/radioterapia , Traumatismos por Radiación/patología , Radioterapia Conformacional/efectos adversos , Reirradiación/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Intraductal no Infiltrante/cirugía , Femenino , Fibrosis/patología , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Órganos en Riesgo/diagnóstico por imagen , Órganos en Riesgo/efectos de la radiación , Estudios Prospectivos , Oncología por Radiación , Radioterapia Conformacional/métodos , Reoperación , Piel/patología , Piel/efectos de la radiación
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