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Background: In 1992, we reported the first analysis of a randomized trial comparing alternating radiotherapy and chemotherapy with radiotherapy alone in the treatment of squamous cell carcinoma of the head and neck. The results of that 3-year analysis indicated that the combined treatment had superior efficacy. Purpose: After an additional 2 years of follow-up, we again compared the efficacy of the two treatment regimens, with attention paid to differences in overall survival, progression-free survival, and locoregional relapse-free survival. Methods: One hundred fifty-seven patients with untreated, unresectable squamous cell carcinoma of the head and neck were randomly assigned to receive either chemotherapy (four courses of cisplatin [20 mg/[m.sup.2]] and fluorouracil [200 mg/[m.sup.2]], given daily for 5 consecutive days during weeks 1, 4, 7, and 10) plus radiotherapy (three courses of 20 Gy each, given in fractions of 2 Gy per day during weeks 2-3, 5-6, and 8-9) or radiotherapy alone (70 Gy total dose, given in fractions of 2 Gy per day, 5 days per week). Eighty patients received the combined therapy, and 77 were treated with radiotherapy alone. Responses, failures, and toxic effects associated with the two treatment regimens were compared. Overall survival, progression-free survival, and locoregional relapse-free survival were calculated according to the Kaplan-Meier method; the logrank test was used to compare survival parameters between the two patient groups. Reported P values are two-sided. Results: As reported previously, toxic effects associated with the combined therapy included both chemotherapy and radiotherapy-related effects; however, the incidence and severity of mucositis were nearly identical among patients in the two treatment arms. The combined treatment was associated with a statistically significant increase in the frequency of complete response (i.e., the disappearance of clinically detectable disease for at least 4 weeks) (43% for the combined-treatment group compared with 22% for the radiotherapy-only group; P = .037, chi-squared test). Five-year estimates of overall survival in the combined-treatment group compared with the radiotherapy-only group were 24% (95% confidence interval [CI] = 14%-40%) and 10% (95% CI = 4%-24%), respectively (P = .01, logrank test). The estimates of progression-free survival at 5 years in the combined-treatment group compared with the radiotherapy-only group were 21% (95% CI = 11%-37%) and 9% (95% CI = 3%-22%), respectively PI = .008, logrank test). Finally, the 5-year estimates of locoregional relapse-free survival were 64% (95% CI = 36%-84%) in the combined-treatment group and 32% (95% CI = 10%-65%) in the radiotherapy-only group (P = .038, logrank test). Conclusions and Implications: The superiority of alternating chemotherapy and radio-therapy over radiotherapy alone in treating unresectable squamous cell carcinoma of the head and neck seen at 3 years was confirmed at 5 years. However, additional trials must be conducted before considering the combined approach as standard therapy. [J Natl Cancer Inst 19%;88:583-9]

The response of the ozone column across Europe to the extreme 2020 Arctic ozone depletion was examined by analyzing ground‐based observations at 38 European stations. The ozone decrease at the northernmost site, Ny‐Ålesund (79°N) was about 43% with respect to a climatology of more than 30 years. The magnitude of the decrease declined by about 0.7% deg−1moving south to reach nearly 15% at 40°N. In addition, it was found that the variations of the ozone column at each of the selected stations in March‐May were similar to those observed at Ny‐Ålesund but with a delay increasing to about 20 days at mid‐latitudes with a gradient of approximately 0.5 days deg−1. The distributions of reconstructed ozone column anomalies over a sector covering a large European area show decreasing ozone that started from the north at the beginning of April 2020 and spread south. Such behavior was shown to be similar to that observed after the Arctic ozone depletion in 2011. Stratospheric dynamical patterns in March–May 2011 and during 2020 suggested that the migration of ozone‐poor air masses from polar areas to the south after the vortex breakup caused the observed ozone responses. A brief survey of the ozone mass mixing ratios at three stratospheric levels showed the exceptional strength of the 2020 episode. Despite the stronger and longer‐lasting Arctic ozone loss in 2020, the analysis in this work indicates a similar ozone response at latitudes below 50°N to both 2011 and 2020 phenomena. The winter polar vortex isolates a huge volume of air from external impacts that, in the absence of the sunlight, leads to a great deal of cooling and the formation of polar stratospheric clouds. Chemical reactions taking place in these clouds contribute to ozone destruction. Such spring‐time ozone depletions are regularly observed in Antarctica, but usually do not occur in the Arctic where the vortex is much less intense. However, in the past three decades several similar episodes occurred in the Arctic and the most marked of them took place in the 2011 and 2020 springs. The response of the ozone layer over Europe to the 2020 episode was studied here by analyzing the data from 38 ground measurement stations. It was found that there was a nearly 43% decrease in ozone in the Arctic, and, as it spread southward, a reduction of 15% in mid‐latitudes 15–20 days later. This spread was attributed to the transport of ozone‐poor air from the Arctic to the south after the vortex breakup. Despite the stronger depletion in 2020 and some differences in the movement of air, the response of the ozone layer was quite similar in the springs of both 2011 and 2020. The 2020 ozone depletion in the Arctic was found to impact the ozone in the mid‐latitude European areasThe magnitude of ozone decrease in the southern regions declined with respect to that in the Arctic and occurred with a delay up to 20 daysSuch a response was similar to that observed in 2011 and both were considered a result of ozone‐poor air masses transported southward The 2020 ozone depletion in the Arctic was found to impact the ozone in the mid‐latitude European areas The magnitude of ozone decrease in the southern regions declined with respect to that in the Arctic and occurred with a delay up to 20 days Such a response was similar to that observed in 2011 and both were considered a result of ozone‐poor air masses transported southward

Polar areas are the most sensitive targets of climate change. From this perspective, the continuous monitoring of the cryosphere represents a critical issue, which, at the moment, we can only partially supply with specific satellite missions. Furthermore, the integration between remote-sensed multi-spectral images and field data is crucial to validate retrieval algorithms. The micro-physical characteristics of the snow surface and the presence of liquid water in the first layer of the snowpack can be determined in addition to the spatial distribution of snow/ice covers. The aim of this work is to present the field activity carried out in Ny-Ålesund (Svalbard Islands, Norway), where an unmanned apparatus was installed to provide continuous spectral surface albedo. A full-range approach was adopted during the 2014 spring/summer period at the CNR Climate Change Tower. This setup was obtained using a spectroradiometer with a spectral range between 350 and 2500 nm integrated with a remote cosine receiver, characterized by a field of view of about 180°, mounted on a rotating support. The system was integrated with a camera aimed to acquire sky and ground images. The first results assessed the feasibility of continuous monitoring the spectral variations of snowed surfaces during the melting period. This study represents a first attempt to associate snow metamorphism to spectral variations and it supports the identification of relevant correlations with meteorological parameters.

The Amundsen-Nobile Climate Change Tower (CCT) is one of the important scientific platforms operating in Ny-Ålesund, Svalbard. The CCT is equipped with a consistent set of meteorological sensors installed at different heights to provide continuous measurements of the atmospheric parameters that affect the climate and its variability. In this paper, some features of the main meteorological parameters observed during the 6 years of measurements since November 2009 are presented in order to describe the thermodynamic characteristic of the lower layers of the atmosphere and the peculiarities of CCT. Monthly and seasonal behavior of temperature, humidity and wind as well as radiation budget and albedo variability are also shown. Such preliminary statistical description aims to provide an overview of the phenomenology occurring in the Kongsfjord area, useful to proceed with further analysis of the arctic climatic system. Even if the time series are not long enough to consider the parameters variability on a climatological time scale, useful assumptions can be made for detailed analysis concerning turbulence studies, data intercomparison at different time and space scales, validation of theory and numerical model results. CCT dataset is stored in a dedicated built-in digital infrastructure that allows other users, in the frame of international cooperations, to visualize, access and download the data and contribute to strengthen the collaboration within the scientific community operating in Svalbard.

The object of this study was to investigate the different modal behavior of ultrafine aerosol particles collected at the Gruvebadet observatory located in Ny-Ålesund (Svalbard Islands, 78°55′N, 11°56′E). Aerosol particle size distribution was measured in the size range from 10 to 470 nm typically from the beginning of spring to the beginning of fall during four (non-consecutive) years (2010, 2011, 2013 and 2014). The median concentration for the whole period taken into account was 214 particles cm−3, oscillating between the median maximum in July with a concentration of 257 particles cm−3and a median minimum in April with 197 particles cm−3. The median total number concentration did not present a well-defined seasonal behavior, as shown by contrast looking at the sub/modal number concentration, where distinct trends appeared in the predominant accumulation concentration recorded during April/May and the preponderant concentration of Aitken particles during the summer months. Lastly, the short side-by-side spring 2013 campaign performed at the Zeppelin observatory with a differential mobility particle sizer was characterized by an aerosol concentration mean steady difference between the two instruments of around 14 %, thereby supporting the reliability of the device located at Gruvebadet.

The present report shortly summarises the conclusions about the ozone column and solar UV irradiance variability that were achieved through the analysis of the data obtained from the narrow-band filter radiometer UV-RAD, operating at Ny-Ålesund from 2008 to 2014. The polar summer gives the opportunity to register the solar irradiance 24 h per day during several months that provides comparatively long continuous time series as regards for the short- (diurnal) and medium-term (monthly) variations. To exclude the hypothesis about the artificial nature of the large amplitudes registered in the short-term ozone column variations, which can be due to the measurement or methodological errors, they were related to the corresponding variations in the solar UV radiation. In addition, these oscillations were studied using the methods developed for the analysis of non-linear dynamical systems that revealed a complex chaotic interaction between the ozone column and five other atmospheric factors. This approach leads to the conclusion that the short-term variations can be predicted for 10–20 h if a long history is available. The effect of a sporadic phenomenon, such as the ozone depletion event, occurred over Arctic in the spring of 2011, which can be considered an impulse perturbation of the medium-term ozone variations, on the mid-latitude ozone column and surface solar UV irradiance has been studied by analysing the data collected from six surface stations.

Daily PM10 aerosol samples were collected at the Gruvebadet observatory, Ny-Ålesund (Svalbard Islands), during the spring-summer 2014 Italian Arctic Campaign. A total of 136 samples were analysed for ion (inorganic anions and cations, selected organic anions) composition aiming to evaluate the seasonal pattern of sulfate, as a key component of the Arctic haze. Ionic balances indicated a strong sulfate seasonality with mean spring concentration about 1.5 times higher than that measured in summer. The spring and summer aerosol was almost neutral, indicating that ammonia was the major neutralizing agent for atmospheric acidic species. The linear regression between sulfate from potential acidic sources (non-sea salt sulfate and non-crustal sulfate) and ammonium indicated that the mean sulfate/ammonium ratio was intermediate between semi-(NH4HSO4) and complete ((NH4)2SO4) neutralization. Using sea-salt sodium as sea-spray marker, non-sea-salt calcium as crustal marker and methanesulfonic acid as biogenic marker, a detailed source apportionment for sulfate was carried out. The anthropogenic input (calculated as the differences between total sulfate and the sum of sea-salt, crustal and biogenic contributes) was found to be the most relevant contribution to the sulfate budget in the Ny-Ålesund aerosol in summer and, especially, in spring. In this last season, crustal, sea-salt, biogenic and anthropogenic sources accounted for 3.3, 12.0, 11.5 and 74.8 %, respectively.

Global warming affects the Arctic two/four times faster than any other region of the planet. The components of the climate system strongly react to changes with an immediate impact on the environment and on the whole living system. As a consequence of the increasing concern, in the last two decades the research in the Arctic has rapidly grown, with the aim to better understand processes and amplification mechanisms as well as to assess consequences at mid-latitudes and on the rest of the planet. Italian scientists have provided a relevant contribution to the Arctic science with a wide range of research activities conducted so far, not only at Ny-Ålesund (Svalbard Islands), where the Italian National Research Council (CNR) manages the “Dirigibile Italia Arctic Station”, but also at Thule (Greenland) and on the surrounding seas, and in the Arctic Ocean. The strategic objectives of the wide range of activities developed since 2008 aim to reinforce the flagship sites (super-sites) as key components of an integrated pan-Arctic observing network, where it is possible to study the complex dimensions of the Arctic regional climate system and to fully develop multidisciplinary research activities in a framework of international cooperation. This special issue presents a collection of reports on recent scientific achievements and provides the state-of-the-art and future perspectives of Italian research in the Arctic.

Multitudes of measurements are needed to understand the environment and its evolution. The Arctic region is a fundamental observation area for climate change evaluation: climate change comes first and comes faster in the arctic.The higher accuracy required to quickly capture trends; the extreme range and conditions of sensors exposure; a robust comparability asked by the different measurement networks; the need of dedicated calibration procedures, together with the logistical problems associated with such remote location, motivate the proposal for a joint effort to address metrology experience and activities for Arctic research applications. The Ny-Ålesund international research base and community offers a unique infrastructure to directly link metrological traceability to on site polar measurements. The contribution reports a study on the implementation of specific calibration procedures, metrological validation of measurements and instrument tests, uncertainties evaluations including quantities of influence, and the feasibility of a metrology laboratory in Ny-Ålesund.

The diurnal variations observed in the ozone column at Ny-Ålesund, Svalbard during different periods of 2009, 2010 and 2011 have been examined to test the hypothesis that they could be a result of a chaotic process. It was found that each of the attractors, reconstructed by applying the time delay technique and corresponding to any of the three time series can be embedded by 6-dimensional space. Recurrence plots, depicted to characterise the attractor features revealed structures typical for a chaotic system. In addition, the two positive Lyapunov exponents found for the three attractors, the fractal Hausdorff dimension presented by the Kaplan–Yorke estimator and the feasibility to predict the short-term ozone column variations within 10–20 h, knowing the past behaviour make the assumption about their chaotic character more realistic. The similarities of the estimated parameters in all three cases allow us to hypothesise that the three time series under study likely present one-dimensional projections of the same chaotic system taken at different time intervals. [ABSTRACT FROM AUTHOR]

Purpose:: To compare late rectal toxicity rates after three-dimensional conformal radiotherapy to the prostate alone (P-3D-CRT) and whole-pelvis intensity-modulated radiotherapy along with a prostate boost (WP-IMRT/PB) to the same nominal total dose to the prostate.Patients and Methods:: 68 patients treated with conformal radiotherapy to the prostate only to 76 Gy at the National Institute for Cancer Research, Genoa, Italy, represented the first group (P-3D-CRT). The second group consisted of 45 patients treated at the University of Texas Medical Branch (UTMB), Galveston, TX, USA, with IMRT covering the pelvic nodes and seminal vesicles to 54 Gy at 1.8 Gy per fraction and the prostate to 60 Gy in the same 30 fractions. A separate phase boosted the prostate to 76 Gy (WP-IMRT/PB). Major aspects of planning were remarkably similar at both institutions leaving the inclusion or not of pelvic nodes as the main treatment-related difference between the two groups. Late rectal toxicity was prospectively scored according to the RTOG scale. All patients have a 12-month minimum follow-up, and mean follow-up, similar in both groups, is 25.9 months (SD [standard deviation]: 8.4 months).Results:: At 2 years, the estimated cumulative incidence of grade 2 late rectal toxicity is 6% 4% for WP-IMRT/PB and 21.2% 6% for P-3D-CRT (p = 0.06). The difference became significant (HR [hazard ratio] = 0.1, 95% CI [confidence interval]: 0.0–0.6; p = 0.01) at multivariate analysis. None of the patients developed grade 3+ toxicity.Conclusion:: Despite the larger treated volume, WP-IMRT/PB allows more rectal sparing than P-3D-CRT.

The ultraviolet narrowband filter radiometer (UV-RAD) designed by the authors to take ground-based measurements of UV solar irradiance, total ozone, and biological dose rate is described, together with the main characteristics of the seven blocked filters mounted on it, all of which have full widths at half maxima that range 0.67 to 0.98 nm. We have analyzed the causes of cosine response and calibration errors carefully to define the corresponding correction terms, paying particular attention to those that are due to the spectral displacements of the filter transmittance peaks from the integer wavelength values. The influence of the ozone profile on the retrieved ozone at large solar zenith angles has also been examined by means of field measurements. The opportunity of carrying out nearly monochromatic irradiance measurements offered by the UV-RAD allowed us to improve the procedure usually followed to reconstruct the solar spectrum at the surface by fitting the computed results, using radiative transfer models with field measurements of irradiance. Two long-term comparison campaigns took place, showing that a mean discrepancy of +0.3% exists between the UV-RAD total ozone values and those given by the Brewer #63 spectroradiometer and that mean differences of +0.3% and -0.9% exist between the erythemal dose rates determined with the UV-RAD and those obtained with the Brewer #63 and the Brewer #104 spectroradiometers, respectively.

Precise calculations of the total Rayleigh-scattering optical depth have been performed at 88 wavelengths ranging from 0.20 to 4.00 µm for the six well-known standard atmosphere models by integrating the volume Rayleigh-scattering coefficient along the vertical atmospheric path from sea level to a 120-km height. The coefficient was determined by use of an improved algorithm based on the Ciddor algorithm [ Appl. Opt.35, 1566 ( 1996)], extended by us over the 0.20–0.23-µm wavelength range to evaluate the moist air refractive index as a function of wavelength, air pressure, temperature, water-vapor partial pressure, and CO_2 volume concentration. The King depolarization factor was also defined taking into account the moisture conditions of air. The results indicate that the influence of water vapor on Rayleigh scattering cannot be neglected at tropospheric altitudes: for standard atmospheric conditions represented in terms of the U.S. Standard Atmosphere (1976) model, the relative variations produced by water vapor in the Rayleigh scattering parameters at a 0.50-µm wavelength turn out to be equal to −0.10% in the moist air refractivity at sea level (where the water-vapor partial pressure is equal to ≈7.8 hPa), −0.04% in the sea-level King factor, −0.24% in the sea-level Rayleigh-scattering cross section, and −0.06% in the Rayleigh-scattering optical depth.

IBM's ibm.com business unit contracted with IBM Global Services (IGS), another business unit of IBM to develop their Interactive Solution Marketplace (ISM) application. ISM is a single point of entry on the ibm.com website for browsing and searching for a suite of solutions as opposed to individual software and hardware items. The first release of ISM experienced schedule and release content challenges. Development of the second release of ISM (ISM 2.0) became one of the first projects where IBM Global Services implemented their formal Systems Engineering and Architecture (SE&A) process. During the SE&A process implementation, particular emphasis was placed on requirements analysis and management, and on structured and scored reviews. This technical paper presents this implementation and the results in the form of a systems engineering case study. Implementation of the SE&A process during the development of ISM 2.0 was successful. ISM 2.0 was delivered on schedule, at 5% below projected cost, and it constituted the functionality and features expected and desired by stakeholders. Consensus on core stakeholder requirements was achieved early during project development, and the technical reviews allowed the team to identify and resolve key issues before proceeding into subsequent phases. This discipline, along with the expenditure of resources to develop quality requirements, greatly reduced project rework. As such, only one-tenth of anticipated defects were actually found and reported during testing. The quality of the deployed application was further validated by the minimal number of post-launch defects reported. © 2005 Wiley Periodicals, Inc. Syst Eng 8: 78–92, 2005

Aims and background Radiation-induced permanent xerostomia occurs frequently in patients affected by squamous cell carcinoma of the head and neck treated by parallel opposed lateral fields. An ipsilateral technique by using co-planar multiple-field arrangement was designed to restrict treatment to the primary tumor and neck on the same side for patients with selected lateralized squamous cell carcinoma of the head and neck.Methods From November 2001 till December 2002, 30 patients affected by squamous cell carcinoma of tonsillar fossa, retro-molar trigone, alveolar ridge and oropharyngeal lateral wall were included in this investigational trial and treated with an ipsilateral multiple field technique: in detail, oblique opposed two upper half fields were planned ipsilaterally to the squamous cell carcinoma site to cover PTV1 and PTV2, whereas an anterior-lower half field was planned to encompass the lower neck node area above clavicles. On CT scans, the contralateral parotid gland was outlined as organ at risk and the contralateral upper lymph node area was contoured as volume of interest. In selected cases, convergent oblique two wedge-pair half fields were added to opposed oblique two-field technique in order to cover only PTV2: generally, in these patients, PTV1 received 1.8 Gy per fraction and PTV2 2.2 Gy per fraction up to total doses of 54 Gy and 66 Gy, respectively.Results Ten patients received radical radiotherapy, 9 patients radical alternating chemo-radiotherapy, and 11 patients adjuvant radiotherapy. At the end of treatment, unilateral confluent mucositis was recorded in 13 (43%) patients and unilateral moist skin epidermolysis in 14 (46%) patients. Six months after the end of radiotherapy, grade 0 xerostomia was recorded in 20 (67%) patients. No patient experienced grade 2+ xerostomia. At a median follow-up of 12 months, 26 (86%) patients were alive and well; 2 patients (6%) developed contralateral neck node failure, both 4 months after the end of ipsilateral radiotherapy.Conclusions These results, although preliminary, suggest that by using an ipsilateral radiotherapy technique, symptomatic xerostomia may be avoided in selected patients with lateralized squamous cell carcinoma of the head and neck without an increased short-term risk of contralateral nodal failure.

Aims and background The role of radiotherapy after prostatectomy is controversial. This paper tries to give some guidelines for everyday practice through an analysis of literature data.Methods The potential role of radiotherapy in the adjuvant and salvage setting is discussed. We also report and interpret available literature data for both settings.Results As regards an increase in or detectable prostate-specific antigen (PSA) after radical prostatectomy, about 40–50% of patients are rendered bNED with local salvage radiotherapy, but only 10–50% are long-term (5 years) biochemically controlled. A timely salvage treatment is crucial to optimize control probability. As regards adjuvant radiotherapy for undetectable postoperative PSA in patients at high risk of failure as judged on pathology, results are more encouraging. Recent data report bNED rates ≥70% at 5 years.Conclusions Although results are far from satisfactory, salvage radiotherapy should be considered for every patient with an increased or detectable PSA after surgery. Adjuvant radiotherapy seems preferable to salvage radiotherapy for patients at high (>30%) risk of failure.

Background To report local long-term morbidity after concomitant boost radiotherapy (AFRT) or alternating chemoradiotherapy (CTRT), we analyzed the toxicity data recorded in 168 patients with advanced head and neck squamous cell carcinoma treated at our institution within phase II-III studies.Patients and Methods All patients enrolled in three consecutive phase II-III studies and followed for a minimum of three months after the end of treatment were included in the present analysis. Local late reactions were scored prospectively. The actuarial incidence of grade 2 or more (2-4) late local toxicity according to RTOG/EORTC was taken as endpoint. The median follow-up is 32.0 months (range, 3.3-138.1 months). For living patients the minimum and median follow-up are 12.1 and 69.3 months, respectively.Results The five-year actuarial incidence of grade 2+ and grade 3+ toxicity are 56.7 ± 5% and 21 ± 4%, respectively. At multivariate analysis, acute mucositis grade, complementary surgery, primary site and performance status proved to be independent predictive factors of grade 2+ late toxicity with P values of <0.001, 0.009, 0.022 and 0.033, respectively. No effect was found for treatment itself on the incidence of late toxicity, although patients treated with accelerated radiotherapy had a higher probability of confluent mucositis than patients treated with alternating chemoradiotherapy (68% vs 32%, P <0.01).Conclusions A substantial proportion of surviving patients develops late complications, although severe irreversible reactions occur in a minority of patients. Acute local toxicity can be used to predict local late toxicity that arises within five years of the end of treatment.

Gross tumor volume (GTV) and clinical target volume (CTV) delineation on planning computed tomography (pICT) for head and neck squamous cell carcinomas can be troublesome. We highlight the factors which can be crucial for the radiation oncologist in delineating GTV and CTV on pICT and provide some pratical solutions. Regarding GTV, uncertainties are correlated with transfer of information collected by physical examination and diagnostic radiology to pICT. Moreover, reproducibility of delineation can also be highly variable, particularly when diagnostic imaging quality and pICT quality are poor. Once the prescription has been made, clinical target volume identification on pICT is rarely straightforward. Whereas there are some data about the location of major lymph node stations of the neck, there are no reported guidelines on how to draw subclinical extention of primary head and neck tumors on pICT. Such volumes can be derived from those currently included in simulator films or from those addressed by the surgeon. Some examples are provided. A particular situation is represented by the adjuvant setting, when the primary tumor is removed (by surgery) or reduced (by chemotherapy). In conclusion, this paper shows some major problems associated with identification of GTV and CTV on pICT. Apart from selected cases, the use of pICT for target volume delineation (and thus for field shaping) for head and neck squamous cell carcinoma is still to be considered investigational.

Purpose To assess whether a radiotherapy time factor exists also for patients affected by head and neck squamous cell carcinoma and receiving combined chemoradiotherapy.Methods and materials From 1989 to 1997, of 121 patients affected by stage III or IV head and neck squamous cell carcinoma who underwent alternating chemotherapy and radiotherapy according to the Merlano regimen at our institution, 59 were selected for time factor analysis. Until 1995, if chemotherapy had to be delayed because of bone marrow toxicity, radiotherapy was also delayed accordingly. Since January 1996 in order to avoid treatment-free gaps, radiotherapy was delivered continuously until it was possible to resume chemotherapy. Potential predictive factors of local-regional control were included in univariate and multivariate models. The median follow-up is 26 months (5-121 months).Results As a result of change in treatment policy, mean radiotherapy duration was shorter for 25 patients treated after 1995 (group A, 8.4 weeks) than for those treated during 1995 or before (group B, 9.4 weeks) (t test, P = 0.0012). In contrast, as expected, mean chemotherapy duration remained relatively unchanged through the years (10.9 vs 10.7 weeks for groups B and A, respectively, t test, P = 0.77). At 2 years, the actuarial local-regional control rate was 53 ± 7% for the whole population. The estimated rates of local-regional control at 2 years were 49 ± 10% and 56 ± 9% for patients belonging to groups A and B, respectively. At univariate and multivariate analyses, treatment group was not predictive of local-regional control.Conclusions Our attempt to prospectively limit radiotherapy overall treatment time failed to improve outcome. The data, although obtained on a relatively limited number of patients, suggest that tumor cell repopulation during radiotherapy may not be clinically relevant when chemotherapy is part of the treatment for advanced head and neck squamous cell carcinoma.

Measurements of direct solar irradiance were taken employing 4 different sun‐photometers at near infrared wavelengths, suitable for use in atmospheric hygrometry. This technique utilising a set of spectral ratios, in and out of selected water vapour absorption bands, was applied to the measurements to obtain accurate evaluations of precipitable water. For all the hygrometric ratios given by the 4 sun‐photometers used at the 3 stations of Sagres, Monchique and Mt. Foia, during the CLEARCOLUMN experiment, we determined the calibration curves by correcting them for the Rayleigh scattering effects and, then, plotting the natural logarithms of such corrected ratios versus the square root of the water vapour mass present along the atmospheric slant path. The regression lines drawn for the various scatter diagrams were estimated to give evaluations of precipitable water with an uncertainty of less than 5%, 3% and 10% at the 3 stations, respectively. The calibration curves of the sun‐photometer located at the Sagres station were determined using the precipitable water evaluations obtained from the local radiosounding measurements taken on 5 clear‐sky days. Those of the sun‐photometers used at the Monchique and Mt. Foia stations were instead determined through intercomparison between subsets of measurements simultaneously taken with various instruments at Sagres and Mt. Foia. Using these calibration curves, we examined all the field measurements determining the time‐patterns of precipitable water at the 3 stations. During the period from 16 June to 25 July 1997, precipitable water was found to vary between 1.1 and 3.7 g cm−2at the Sagres station (with an accuracy within ±13%), between 1.0 and 2.8 g cm−2at Monchique (±11%) and between 0.8 and 3.0 g cm−2at the top of Mt. Foia (±26%).

During the CLEARCOLUMN campaign which took place at Sagres (Portugal) from 16 June to 25 July 1997, more than 2000 spectral measurements of direct solar irradiance were performed at thirteen window‐wavelengths in the 0.4–3.7 μm range, on 27 days. The measurements were performed using the IR‐RAD sun‐radiometer designed and manufactured at the Institute ISAO (FISBAT), Bologna (Italy), and carefully calibrated by applying the Langley plot method to the measurements performed on 24 October 1996, at the Schneefernerhaus Observatory on the Zugspitze (Germany). From these measurements, the values of the total atmospheric optical depth were obtained at the various wavelengths, from which the corresponding spectral values of aerosol optical depth were determined through accurate corrections for Rayleigh scattering and gaseous absorption. Such values were found to be mostly smaller than 0.1 during June and early July, presenting almost neutral spectral dependence characteristics, closely related to the prevailing oceanic origins of particulate matter. Higher values of aerosol optical thickness, mainly ranging between 0.1 and 0.5 at visible wavelengths and sharply decreasing with wavelength, were found during the rest of July in the presence of predominant contents of continental and anthropogenic aerosol particles arriving from polluted European regions. The King inversion method was applied to the spectral series of aerosol optical depth to determine the particle size‐distribution curves in the 0.2–20 μm diameter range. For 2 of these cases (one chosen for a low atmospheric loading of marine aerosols and the other for a mean content of continental/anthropogenic aerosols), the changes in the outgoing solar radiation flux produced by aerosol particles were calculated, considering different surface albedo conditions. The results obtained in the second case show that changes of opposite sign can be caused by the same atmospheric aerosol loading when passing from oceanic to continental areas.

Analyses of aerosol optical depth (AOD) and columnar water vapor (CWV) measurements acquired with NASA Ames Research Center's 6‐channel Airborne Tracking Sunphotometer (AATS‐6) operated aboard the R/V Professor Vodyanitskiyduring the 2nd Aerosol Characterization Experiment (ACE‐2) are discussed. Data are compared with various in situ and remote measurements for selected cases. The focus is on 10 July, when the Pelican airplane flew within 70 km of the ship near the time of a NOAA‐14/AVHRR satellite overpass and AOD measurements with the 14–channel Ames Airborne Tracking Sunphotometer (AATS‐14) above the marine boundary layer (MBL) permitted calculation of AOD within the MBL from the AATS‐6 measurements. A detailed column closure test is performed for MBL AOD on 10 July by comparing the AATS‐6 MBL AODs with corresponding values calculated by combining shipboard particle size distribution measurements with models of hygroscopic growth and radiosonde humidity profiles (plus assumptions on the vertical profile of the dry particle size distribution and composition). Large differences (30–80% in the mid‐visible) between measured and reconstructed AODs are obtained, in large part because of the high sensitivity of the closure methodology to hygroscopic growth models, which vary considerably and have not been validated over the necessary range of particle size/composition distributions. The wavelength dependence of AATS‐6 AODs is compared with the corresponding dependence of aerosol extinction calculated from shipboard measurements of aerosol size distribution and of total scattering measured by a shipboard integrating nephelometer for several days. Results are highly variable, illustrating further the great difficulty of deriving column values from point measurements. AATS‐6 CWV values are shown to agree well with corresponding values derived from radiosonde measurements during 8 soundings on 7 days and also with values calculated from measurements taken on 10 July with the AATS‐14 and the University of Washington Passive Humidigraph aboard the Pelican.

Analyses of aerosol optical depth (AOD) and columnar water vapor (CWV) measurements acquired with NASA Ames Research Center’s 6-channel Airborne Tracking Sunphotometer (AATS-6) operated aboard the R/V Professor Vodyanitskiy during the 2nd Aerosol Characterization Experiment (ACE-2) are discussed. Data are compared with various in situ and remote measurements for selected cases. The focus is on 10 July, when the Pelican airplane flew within 70 km of the ship near the time of a NOAA-14/AVHRR satellite overpass and AOD measurements with the 14−channel Ames Airborne Tracking Sunphotometer (AATS-14) above the marine boundary layer (MBL) permitted calculation of AOD within the MBL from the AATS-6 measurements. A detailed column closure test is performed for MBL AOD on 10 July by comparing the AATS-6 MBL AODs with corresponding values calculated by combining shipboard particle size distribution measurements with models of hygroscopic growth and radiosonde humidity profiles (plus assumptions on the vertical profile of the dry particle size distribution and composition). Large differences (30−80% in the mid-visible) between measured and reconstructed AODs are obtained, in large part because of the high sensitivity of the closure methodology to hygroscopic growth models, which vary considerably and have not been validated over the necessary range of particle size/composition distributions. The wavelength dependence of AATS-6 AODs is compared with the corresponding dependence of aerosol extinction calculated from shipboard measurements of aerosol size distribution and of total scattering measured by a shipboard integrating nephelometer for several days. Results are highly variable, illustrating further the great difficulty of deriving column values from point measurements. AATS-6 CWV values are shown to agree well with corresponding values derived from radiosonde measurements during 8 soundings on 7 days and also with values calculated from measurements taken on 10 July with the AATS-14 and the University of Washington Passive Humidigraph aboard the Pelican.

The present study discusses the effect of the ozone depletion that occurred over the Arctic in 2020 on the ozone column in central and southern Europe by analysing a data set obtained from ground-based measurements at six stations placed from 79 to 42°N. Over the northernmost site (Ny-Ålesund), the ozone column decreased by about 45% compared to the climatological average at the beginning of April, and its values returned to the normal levels at the end of the month. Southwards, the anomaly gradually reduced to nearly 15% at 42°N (Rome) and the ozone minimum was detected with a delay from about 6 days at 65°N to 20 days at 42°N. At the same time, the evolution of the ozone column at the considered stations placed below the polar circle corresponded to that observed at Ny-Ålesund, but at 42°–46°N, the ozone column turned back to the typical values at the end of May. This similarity in the ozone evolutional patterns at different latitudes and the gradually increasing delay of the minimum occurrences towards the south allows the assumption that the ozone columns at lower latitudes were affected by the phenomenon in the Arctic. The ozone decrease observed at Aosta (46°N) combined with predominantly cloud-free conditions resulted in about an 18% increase in the erythemally weighted solar ultraviolet irradiance reaching the Earth’s surface in May.

The monitoring of surface albedo using radiometric measurements is a simple but effective way to study variations in snow cover and melt timing in the high northern latitudes, where there is a clear indication of warming in response to the changing global climate. In this paper, we investigate these phenomena in the Northwest region of Svalbard using a 40-year record, combining previous data from 1981 to 1997, radiation measurements from the Baseline Surface Radiation Network (BSRN) station since 1993, and the Amundsen Nobile Climate Change Tower (CCT) since 2009. A methodology has been developed to estimate the start, duration, and end date of the spring snow melt. This has been applied to the integrated dataset for the period 1981 to 2019. Our results are in good agreement with qualitative information on snow persistence provided by webcam images archived since 2000. The date of snow melt has advanced at a rate of about 3 days per decade during the period of study, from Julian calendar date (doy) 180 in the early 1980s to 165–170 in the late 2010s. There is indication the trend has accelerated since 2010. The footprint of the radiation measurements is a crucial factor in the evaluation of surface albedo; the larger the area within the field of view of the instrument, the more representative is the measure. The assimilated 40-year dataset will provide a base for future monitoring of snow persistence at Ny-Ålesund as the climate continues to change in the region. Our work highlights the importance of technical improvements made in measurement systems and combining different techniques to monitor surface albedo. In particular, terrestrial photography, combined with broadband radiation measurements, will contribute to increased knowledge of underlying processes that determine the surface energy budget in the Arctic region. In addition, the combined ground-based measurements can be used to validate those derived from space-born platforms.

The medical and nursing literature suggests a wide variety of pharmacological and nonpharmacological approaches to treatment of acute radiation skin damages (erythema, dry and moist desquamation, ulceration), but no specific and standardized therapy. The incidence of radiodermatitis has decreased with mega-voltage instruments, but it can nevertheless influence the therapeutic program and impair quality of life of patients. A study has been conducted to evaluate the tolerability and effectiveness of a nonpharmacological remedy, a mixture of hydrophobic (stearic acid) and hydrophilic (propilene glycol, glycerol, and polyunsaturated alcohols) components in a foam emulsion for the treatment of acute skin injuries following radiotherapy. Thirty-eight of 42 initial patients were evaluable: we observed a complete response in 22 (57.9), improvement in 14 (36.8), and failure in only two (5.3).

Forty consecutive adult patients under the age of 50 with acute non-lymphoblastic leukemia (ANLL) in first complete remission, underwent autologous bone marrow transplantation (ABMT) between March 1984 and April 1990. The conditioning regimen employed included cyclophosphamide and total body irradiation, followed by the administration of unpurged ABMT. The median time from diagnosis to transplant was 7 months (3-15 months), and the median time from complete remission to ABMT was 4 months (range 3-9 months). Twenty-two (51%) patients remain in complete remission 6-81 months (median 24 months) after ABMT.The causes of death were, recurrent leukemia (11 patients), parenchymal toxicities such as acute respiratory distress syndrome and veno-occlusive disease (3 patients), hemorrhage (2 patients) and infection (2 patients). Eleven patients relapsed after 3-12 months (median 5 months). This study has produced survival data comparable to those of other institutions employing TBI for either allo or autotransplants.

Purpose: It has been suggested that postoperative tumor cell proliferation may influence the outcome of advanced head and neck squamous cell carcinomas treated by surgery and postoperative radiotherapy. This Phase I pilot study was undertaken to determine the feasibility of a biphasic accelerated radiotherapy regimen with early and late concomitant boost delivery for postoperative treatment of patients with advanced head and neck cancers.

Nineteen patients with acute graft versus host disease (GvHD) following bone marrow transplantation (BMT) were treated with high dose bolus 6-methylprednisolone (BMPr), at the dose of 20 mg/kg/day i.v. for the first 3 days, 10 mg/kg/day i.v. for the following 4 days, and then at doses gradually tapered down to 1 mg/kg/day. All patients except one, who was given preventive BMPr 5 mg/kg/day i.v. on alternate days, were placed on preventive methotrexate therapy after BMT. Sixteen patients were grafted with an HLA matched, and three patients with an HLA mismatched marrow.

Measurements of the optical thicknesses produced by particulate matter extinction and nitrogen dioxide absorption at window wavelengths in the visible and near-infrared spectral range were taken with four examples of a multiwavelength sun photometer. Evaluations of the vertical content of nitrogen dioxide were made by examining these measurements with a procedure which attempts to separate gaseous absorption from particulate extinction, represented in terms of Ångström’s formula. Moreover, assuming that the vertical content of NO_2 and Ångström’s turbidity parameters are given by the average values calculated with this procedure, we obtained a set of useful correction factors for the monochromatic calibration values of the four sun photometers.

Aims and background The purpose of this phase II study was to assess the efficacy and toxicity of an accelerated radiotheraphy schedule with the concomitant boost technique in the management of patients with advanced head and neck squamous cell carcinomas (HN-SCC) of various primary sites.Methods From May 1989 to December 1992 45 patients were scheduled to receive a total dose of 75 Gy in 40 fractions over 40 days. The boost encompassing the macroscopic disease was given as a second daily dose during the last 2 weeks of the basic treatment.Results Severe mucositis was recorded in 27 (60%) patients. Late side effect occurred in 2. As regards local control the primary tumor site was the most significant prognostic factor: at a median follow-up of 24 months (range 12-52 months) the actuarial local control rate was 79%, 48% and 15% for oronasopharyngeal, laryngohypopharyngeal and oral cavity primary sites, respectively (p=0.004).Conclusions This high dose concomitant boost regimen appears feasible in advanced HN-SCC. However, our results indicate the primary tumor site as a major prognostic factor even with an accelerated treatment schedule.

Patients with intermediate or high-grade non-Hodgkin's lymphoma are rarely cured of their disease after the failure of conventional therapy. Autologous bone marrow transplantation (ABMT) offers such patients a new possibility of cure. Our purpose was to evaluate the usefulness of radiotherapy in these patients who did not achieve complete remission of disease after high-dose chemotherapy (HDCT) followed by ABMT or who had previous bulky disease. In this study we examined 10 patients: after HDCT+ABMT, 9 patients had persistent disease and 1 patient with previous bulky disease was in complete remission. All patients underwent involved-field radiotherapy administered by a 6-18 MV linear accelerator, total mean dose 4000 cGy (range, 3200-5000 cGy). At the end of radiotherapy we observed 6 complete responses and 4 progressions of disease outside the radiotherapy field. No serious side effects were observed. To date, of the 6 complete responses 2 have relapsed (after 9 and 11 months) and 4 are alive and disease free at 24 months (range, 8-39 months) after radiotherapy. In our opinion, radiotherapy is an effective treatment after HDCT+ABMT and may have a role in a prospective multidisciplinary approach.

New particle formation in the Arctic atmosphere is an important source of aerosol particles. Understanding the processes of Arctic secondary aerosol formation is crucial due to their significant impact on cloud properties and therefore Arctic amplification. We observed the molecular formation of new particles from low‐volatility vapors at two Arctic sites with differing surroundings. In Svalbard, sulfuric acid (SA) and methane sulfonic acid (MSA) contribute to the formation of secondary aerosol and to some extent to cloud condensation nuclei (CCN). This occurs via ion‐induced nucleation of SA and NH3and subsequent growth by mainly SA and MSA condensation during springtime and highly oxygenated organic molecules during summertime. By contrast, in an ice‐covered region around Villum, we observed new particle formation driven by iodic acid but its concentration was insufficient to grow nucleated particles to CCN sizes. Our results provide new insight about sources and precursors of Arctic secondary aerosol particles. Cloud properties are sensitive to the formation of new aerosol particles in the Arctic atmosphere, yet little is known about the chemistry and processes controlling this phenomenon. Here, based on comprehensive in situ measurements, we identify the very first steps of atmospheric new particle formation, that is, formation of small clusters from compounds present in the gas phase, and candidates for the subsequent growth of these clusters to larger sizes, at two Arctic sites: one surrounded by open waters, the other one by sea ice. We show how environmental differences affect secondary aerosol formation via emissions and atmospheric chemistry of aerosol precursor gases. Our results provide previously unidentified insight into how future changes in the Polar environment could be reflected in the chain of processes linking the Arctic biosphere and cryosphere to atmospheric aerosol particles, clouds, and climate. Secondary aerosol formation studied at two sites in the atmosphere of the high ArcticIn situ measurements observing precursor gases and further following the growth of particles up to cloud condensation nuclei sizesWe observed significant differences of new particle formation above open ocean versus sea ice surroundings Secondary aerosol formation studied at two sites in the atmosphere of the high Arctic In situ measurements observing precursor gases and further following the growth of particles up to cloud condensation nuclei sizes We observed significant differences of new particle formation above open ocean versus sea ice surroundings

Aims and background Malignant melanoma is one of the most radioresistant tumors. It can be treated with combinated hyperthermia and radiation therapy.Methods From January 1991 through June 1992, 7 patients, 1 male and 6 female, aged 40-88 years (mean 75), with skin and nodal postsurgical recurrences of melanoma, were treated with a combination of radiation therapy and hyperthermia. Two patients presented systemic disease when they reached our observation, but all of them were without symptoms. None of them underwent surgical excision of the recurrence before or during thermoradiotherapy. None received chemotherapy for these recurrences or had received radiotherapy in the past. They were irradiated with electron beams, with electron energies selected according to the depth of the lesions. The total dose was 40 Gy in 10 fractions in 5 weeks. Hyperthermia was administered for 10 minutes to 1 hour after irradiation. An inductive method of radiofrequency heating at 434 of 915 MHz was used depending on the depth of the lesions. In all of these treatments a ionized water bolus was used. The prescribed hyperthermic dose was 42 °C for half a hour. The treatments were carried out twice a week for 5 weeks. A fiberoptic multichannel thermometer was used for thermometry.Results Four patients (57 %) achieved a complete response, 2 patients (29 %) a partial response, and 1 patient (14 %) stabilization. We found no correlation between tumor volume and response rate. Site effects and complications of the treatment were minimal (moderate erythema).Conclusions Our results are in the wide range of values reported in the literature.

Introducing a Quality Assurance methodology appears particularly useful in Radiation Oncology due to the complexity of the procedures involved and the heterogeneity of the standards adopted, if any, in the great majority of the Centers. There are two possible ways of evaluating quality in the Health Environment: a formal, Institutional certification, or a voluntary one obtained through a mechanism of peer review. The European Society for Therapeutic Radiology and Oncology (ESTRO) started in 1994 with the publication of a methodological Report intended to be adopted by the individual national Societies, and this paper is an invitation to do it.

Non-Hodgkin's lymphomas constitute the most common malignancy of the orbit. Characteristics and treatment modality are not well defined due to the rarity of this tumor. Between 1988 and 1990, five patients with orbital lymphomas were treated in the authors' department. There were three females and two males ranging in age from 55 to 83 years. Three patients were stage I E, one patient was stage IV E and one was stage II E. Two patients received chemotherapy and radiation therapy. Radiation alone was administered to three patients. Median radiation dose was 3500 cGy. Late effects of radiotherapy have not been recorded up to the present. Local control was 100% but three patients had systemic progression disease. Up to date all the patients are alive.

A small-size meteorological mast, BEAR (Budget of Energy for Arctic regions) has been developed as a part of a new autonomous buoy for monitoring the sea ice mass balance. BEAR complements observations of the thickness and thermodynamic properties of the ice/snow pack determined by the so-called Ice-T (Ice-Thickness) buoy, giving access to bulk fluxes and energy budget at the surface, using meteorological measurements. The BEAR mast has been tested with success during ten days in April-May 2010 at Ny Alesund, in the Svalbard archipelago (Norway) showing that meteorological data were close to measurements at the same level of the Italian Climate Change Tower (CCT) from the ISAC-CNR. A discussion is undertaken on bulk fluxes determination and uncertainties. Particularly, the strategy to systematically use different relevant fluxes parameterizations is pointed out to explore flux range uncertainty before to analyze energy budget. Net radiation, bulk fluxes and energy budget are estimated using as average 10 minutes, 24 hours and the ten days of the experiment. The observation period was very short, but we observe a spring transition when the net radiation begins to warm the surface while the very small turbulent heat flux cools the surface.