BACKGROUND:One of the most common and deadly complications of melanoma is brain metastases. The outcomes of advanced melanoma patients who developed brain metastases were reviewed to identify significant prognostic factors for overall survival (OS). METHODS: An institutional database of advanced melanoma patients enrolled on clinical trials in the Department of Melanoma Medical Oncology from 1986 to 2004 was reviewed and patients who developed brain metastases were identified. Date of diagnosis, patient age, pattern of brain involvement, timing relative to extracranial metastases, prior response to systemic therapy, and treatments given for brain metastases were assessed as potential prognostic factors for OS. RESULTS: Among 743 melanoma patients enrolled in clinical trials for regional or systemic metastatic disease, 330 (44%) patients developed brain metastases. The median OS after the diagnosis of brain metastases was 4.7 months. Diagnosis before 1996, increased number of parenchymal brain metastases, leptomeningeal involvement, and development of brain metastases after receiving systemic therapy for extracranial metastases were found to be significant prognostic factors for OS. Among patients who received systemic therapy as the initial treatment of brain metastases, patients who previously responded to systemic therapies had longer survival than patients who had not responded. CONCLUSIONS: The era, pattern, and timing of melanoma brain metastases were found to be strongly associated with survival. Previous responsiveness to systemic therapies did not predict better outcomes overall, but it did correlate with improved survival for patients with brain metastases who were treated with systemic therapies. These factors may be used in guiding patient management and for stratifying patients in clinical trials. Cancer 2011;117:1687-96.
Catalytic activity for CH 4 oxidation and resistance to SO 2 poisoning were tested for three LaCo 1-X Fe X O 3 prepared by reactive grinding. The catalysts prepared by this method showed well-crystallized perovskite structure and various specific surface areas. The activity in CH 4 oxidation correlates well with BET specific surface area. TPDO experiments showed very large quantities of desorbed β-oxygen that could not be correlated to the activity for CH 4 oxidation. Resistance to sulfur poisoning in the same reaction was tested at 500 °C with 25 ppmv SO 2 added to the feed. Two steps were distinguished during the poisoning reaction. The first one followed an exponential decrease of conversion versus time. The time to reach the end of this step was shown to be directly proportional to the specific surface area. In this step, deactivation was found to be reversible. During regeneration, some sulfur species were found to desorb from the catalyst. The second step was found to be a linear diminution of conversion with time. The slopes of these lines were found to be the same for the three catalysts. A total of 860 h is necessary to deactive the catalyst with the higher specific surface area, and the quantity of sulfur accumulated in the catalyst was found to vary linearly with the poisoning time. XRD showed significant conversion of the catalyst into La 2 (SO 4 ) 3 , Co 3 O 4 , and iron oxide. The complex poisoning behavior is discussed and associated to the observed differences in the catalyst morphology.
This retrospective analysis aimed to identify the prognostic factors that influenced long-term survival of patients with metastatic melanoma. The medical records for 616 chemo-naive patients who were treated with systemic therapy on eight phase II/III clinical trials were reviewed. Clinical characteristics, disease stage, metastatic sites, baseline serum albumin, LDH, and response to treatment were compared between the treatment groups and significant prognostic factors were identified. Cox proportional-hazards regression analysis identified treatment with biochemotherapy, younger age, normal baseline serum albumin and LDH levels, ECOG P.S. < 2 and absence of visceral metastasis as favorable prognostic factors for long-term survival.
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