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Purpose This study aimed to assess clinical, treatment, and prognostic features in patients with brain metastases (BM) from solid tumors achieving long-term survival (LTS). Further, the accuracy of diagnosis-specific Graded Prognostic Assessment scores (ds-GPA) to predict LTS was evaluated. Methods Patients admitted for radiotherapy of BM between 2010 and 2020 at a large tertiary cancer center with survival of at least 3 years from diagnosis of BM were included. Patient, tumor, treatment characteristics and ds-GPA were compiled retrospectively. Results From a total of 1248 patients with BM, 61 (4.9%) survived ≥ 3 years. In 40 patients, detailed patient charts were available. Among LTS patients, median survival time from diagnosis of BM was 51.5 months. Most frequent primary tumors were lung cancer (45%), melanoma (20%), and breast cancer (17.5%). At the time of diagnosis of BM, 11/40 patients (27.5%) had oligometastatic disease. Estimated mean survival time based on ds-GPA was 19.7 months (in 8 cases estimated survival < 12 months). Resection followed by focal or whole-brain radiotherapy (WBRT) was often applied (60%), followed by primary stereotactic radiotherapy (SRT) (20%) or WBRT (20%). 80% of patients received systemic treatment, appearing particularly active in specifically altered non-small lung cancer (NSCLC), melanoma, and HER2-positive breast cancer. Karnofsky performance score (KPS) and the presence of oligometastatic disease at BM diagnosis were persisting prognostic factors in LTS patients. Conclusion In this monocentric setting reflecting daily pattern of care, LTS with BM is heterogeneous and difficult to predict. Effective local treatment and modern systemic therapies often appear crucial for LTS. The impact of concomitant diseases and frailty is not clear.

Supratentorial white matter is an important part of the brain and a major site of detrimental effects after whole brain radiotherapy (WBRT). It is not known if prevalence of metastases in white matter justifies standard inclusion of white matter in whole brain treatment. In this retrospective analysis we examined the frequency of metastasis in supratentorial deep cerebral white matter with cerebral magnetic resonance imaging (MRI). Deep white matter (DWM) was defined as white matter in corpus callosum with forceps anterior and posterior and centrum semiovale. Lesions extending from grey matter, gyrus or ventricles into white matter were not classified as DWM metastases. Brain MRI of 198 patients from two centres were analyzed. In total 1330 metastases were counted and only 4.6 % were located in DWM. Metastases in DWM were small (median diameter 6 mm). Only 1/41 patients (2 %) with a singular metastasis had a DWM metastasis, 2/35 patients (6 %) with 2 metastases had a DWM metastasis, 14/79 patients (18 %) with 3–9 metastases and 12/43 patients (28 %) with >9 metastases had a single or more DWM metastases (p = 0.003). There appeared to be tumor related differences with renal cell carcinoma showing significantly more DWM metastasis (6/17, 35 %), than NSCLC (11/85, 13 %, p = 0.024), breast cancer (1/20, 5 %, p = 0.019) or colorectal cancer (0/10, 0 %, p = 0.033). Overall, relevant preservation of DWM from metastases, especially in oligometastatic disease, was shown. This implies that DWM in patients with only few brain metastases is unnecessarily damaged by conventional WBRT.

Magenkarzinome und Adenokarzinome des ösophagogastralen Übergangs werden in Studien und Leitlinien trotz der teils unterschiedlichen Pathogenese, Tumorbiologie und klinischen Behandlungsalgorithmen häufig gemeinsam untersucht. Die Unterscheidung nach der Lokalisation ist jedoch insbesondere für die lokalen Therapiemaßnahmen entscheidend. Bei der onkologischen Resektion mit systematischer Lymphadenektomie unterscheiden sich Lymphabflusswege erheblich und verschiedene chirurgische Zugangswege sind zu berücksichtigen. Auch für strahlentherapeutische Therapieoptionen spielt die Tumorlokalisation eine wichtige Rolle. Im vorliegenden Beitrag wird detailliert auf folgende Themen eingegangen: Pathogenese und Pathologie, Primärdiagnostik und Staging, kurative chirurgische und endoskopische Therapie, perioperative Therapie, palliative Systemtherapie, nichtmedikamentöse Supportiv- und Palliativtherapie.

Observations of a white dwarf/cool star binary that emits from X-ray to radio wavelengths, AR Sco, reveal a close binary with a 3.56-h period, pulsing in brightness with a period of 1.97 min; these pulses are so intense that the optical flux of AR Sco can increase by a factor of four within 30 s, and the pulsing is detectable at radio frequencies. A white dwarf with a difference AR Scorpii (AR Sco) has been known as a short-period variable star for more than 40 years, and was classified as a δ-Scuti star, a common type of periodic variable. New observations reveal AR Sco as a so-far unique system, a white dwarf/cool star binary pulsing strongly over almost the entire electromagnetic spectrum, from X-ray to radio wavelengths. AR Sco's optical flux can increase by a factor of four within just 30 seconds, and the pulsations are detectable at radio frequencies. These characteristics reflect the spin of a magnetic white dwarf that is slowing down on a 10 7 -year timescale. Although the pulsations are driven by the white dwarf's spin, they originate in large part from the cool star. White dwarfs are compact stars, similar in size to Earth but approximately 200,000 times more massive 1 . Isolated white dwarfs emit most of their power from ultraviolet to near-infrared wavelengths, but when in close orbits with less dense stars, white dwarfs can strip material from their companions and the resulting mass transfer can generate atomic line 2 and X-ray 3 emission, as well as near- and mid-infrared radiation if the white dwarf is magnetic 4 . However, even in binaries, white dwarfs are rarely detected at far-infrared or radio frequencies. Here we report the discovery of a white dwarf/cool star binary that emits from X-ray to radio wavelengths. The star, AR Scorpii (henceforth AR Sco), was classified in the early 1970s as a δ-Scuti star 5 , a common variety of periodic variable star. Our observations reveal instead a 3.56-hour period close binary, pulsing in brightness on a period of 1.97 minutes. The pulses are so intense that AR Sco’s optical flux can increase by a factor of four within 30 seconds, and they are also detectable at radio frequencies. They reflect the spin of a magnetic white dwarf, which we find to be slowing down on a 10 7 -year timescale. The spin-down power is an order of magnitude larger than that seen in electromagnetic radiation, which, together with an absence of obvious signs of accretion, suggests that AR Sco is primarily spin-powered. Although the pulsations are driven by the white dwarf’s spin, they mainly originate from the cool star. AR Sco’s broadband spectrum is characteristic of synchrotron radiation, requiring relativistic electrons. These must either originate from near the white dwarf or be generated in situ at the M star through direct interaction with the white dwarf’s magnetosphere.

The Transiting Exoplanet Survey Satellite (TESS) space telescope is collecting continuous, high-precision optical photometry of stars throughout the sky, including thousands of RR Lyrae stars. In this paper, we present results for an initial sample of 118 nearby RR Lyrae stars observed in TESS Sectors 1 and 2. We use differential image photometry to generate light curves and analyze their mode content and modulation properties. We combine accurate light-curve parameters from TESS with parallax and color information from the Gaia mission to create a comprehensive classification scheme. We build a clean sample, preserving RR Lyrae stars with unusual light-curve shapes, while separating other types of pulsating stars. We find that a large fraction of RR Lyrae stars exhibit various low-amplitude modes, but the distribution of those modes is markedly different from those of the bulge stars. This suggests that differences in physical parameters have an observable effect on the excitation of extra modes, potentially offering a way to uncover the origins of these signals. However, mode identification is hindered by uncertainties when identifying the true pulsation frequencies of the extra modes. We compare mode amplitude ratios in classical double-mode stars to stars with extra modes at low amplitudes and find that they separate into two distinct groups. Finally, we find a high percentage of modulated stars among the fundamental mode pulsators, but also find that at least 28% of them do not exhibit modulation, confirming that a significant fraction of stars lack the Blazhko effect.

We present multiwavelength observations of the first recorded low state of the intermediate polar BG CMi. Optical monitoring of the source by members of the American Association of Variable Star Observers reveals a decrease of ∼0.5 mag that lasted ∼50 days in early 2025. During the low state the optical timing properties imply that BG CMi underwent a change in accretion mode, as power at the spin frequency ω dramatically dropped. An XMM-Newton observation revealed a substantial decrease in intrinsic absorption and a slight increase in intrinsic X-ray luminosity, compared to archival Suzaku data. Timing analysis of the X-ray light curves shows that power shifted from the orbital frequency Ω (prominent in Suzaku data) to 2Ω in the low-state XMM-Newton data, along with strengthening of certain orbital sidebands. We suggest that BG CMi transitioned to disk-overflow accretion, where the white dwarf accreted matter via both a disk and a stream, the latter becoming more dominant during the low state due to a decrease in the mass and size of the disk.

The joint evaluated fission and fusion nuclear data library 3.3 is described. New evaluations for neutron-induced interactions with the major actinides 235 U , 238 U and 239 Pu , on 241 Am and 23 Na , 59 Ni , Cr, Cu, Zr, Cd, Hf, W, Au, Pb and Bi are presented. It includes new fission yields, prompt fission neutron spectra and average number of neutrons per fission. In addition, new data for radioactive decay, thermal neutron scattering, gamma-ray emission, neutron activation, delayed neutrons and displacement damage are presented. JEFF-3.3 was complemented by files from the TENDL project. The libraries for photon, proton, deuteron, triton, helion and alpha-particle induced reactions are from TENDL-2017. The demands for uncertainty quantification in modeling led to many new covariance data for the evaluations. A comparison between results from model calculations using the JEFF-3.3 library and those from benchmark experiments for criticality, delayed neutron yields, shielding and decay heat, reveals that JEFF-3.3 performes very well for a wide range of nuclear technology applications, in particular nuclear energy.

Many giant stars are magnetically active, which causes rotational variability, chromospheric emission lines, and X-ray emission. Large outbursts in these emission features can set limits on the magnetic field strength and thus constrain the mechanism of the underlying dynamo. HD 251108 is a Li-rich active K-type giant. We find a rotational period of 21.3 days with color changes and additional long-term photometric variability. Both can be explained with very stable stellar spots. We followed the decay phase of a superflare for 28 days with NICER and from the ground. We track the flare decay in unprecedented detail in several coronal temperature components. With a peak flux around 1034 erg s−1 (0.5–4.0 keV) and an exponential decay time of 2.2 days in the early decay phase, this is one of the strongest flares ever observed, yet it follows trends established from samples of smaller flares, for example, for the relations between Hα and X-ray flux, indicating that the physical process that powers the flare emission is consistent over a large range of flare energies. We estimate a flare loop length about 2–4 times the stellar radius. No evidence is seen for abundance changes during the flare.

EX Lupi, a low-mass young stellar object, went into an accretion-driven outburst in 2022 March. The outburst caused a sudden phase change of ∼112° ± 5° in periodically oscillating multiband lightcurves. Our high-resolution spectra obtained with the High Resolution Spectrograph (HRS) on board the Southern African Large Telescope also revealed a consistent phase change in the periodically varying radial velocities (RVs), along with an increase in the RV amplitude of various emission lines. The phase change and increase in RV amplitude morphologically translates to a change in the azimuthal and latitudinal location of the accretion hotspot over the stellar surface, which indicates a reconfiguration of the accretion funnel geometry. Our three-dimensional magnetohydrodynamic simulations reproduce the phase change for EX Lupi. To explain the observations, we explored the possibility of forward shifting of the dipolar accretion funnel as well as the possibility of the emergence of a new accretion funnel. During the outburst, we also found evidence of the hotspot’s morphology extending azimuthally asymmetrically with a leading hot edge and cold tail along the stellar rotation. Further, our high-cadence photometry showed that the accretion flow has clumps. We also detected possible clumpy accretion events in the HRS spectra that showed episodically highly blueshifted wings in the Ca ii IR triplet and Balmer H lines.

The chemokine CXCL12 promotes glioblastoma (GBM) recurrence after radiotherapy (RT) by facilitating vasculogenesis. Here we report outcomes of the dose-escalation part of GLORIA (NCT04121455), a phase I/II trial combining RT and the CXCL12-neutralizing aptamer olaptesed pegol (NOX-A12; 200/400/600 mg per week) in patients with incompletely resected, newly-diagnosed GBM lacking MGMT methylation. The primary endpoint was safety, secondary endpoints included maximum tolerable dose (MTD), recommended phase II dose (RP2D), NOX-A12 plasma levels, topography of recurrence, tumor vascularization, neurologic assessment in neuro-oncology (NANO), quality of life (QOL), median progression-free survival (PFS), 6-months PFS and overall survival (OS). Treatment was safe with no dose-limiting toxicities or treatment-related deaths. The MTD has not been reached and, thus, 600 mg per week of NOX-A12 was established as RP2D for the ongoing expansion part of the trial. With increasing NOX-A12 dose levels, a corresponding increase of NOX-A12 plasma levels was observed. Of ten patients enrolled, nine showed radiographic responses, four reached partial remission. All but one patient (90%) showed at best response reduced perfusion values in terms of relative cerebral blood volume (rCBV). The median PFS was 174 (range 58-260) days, 6-month PFS was 40.0% and the median OS 389 (144-562) days. In a post-hoc exploratory analysis of tumor tissue, higher frequency of CXCL12 + endothelial and glioma cells was significantly associated with longer PFS under NOX-A12. Our data imply safety of NOX-A12 and its efficacy signal warrants further investigation. Recent studies show that targeting CXCL12 can improve the effect of radiotherapy (RT) in preclinical models of glioblastoma (GBM). Here, the authors report the safety and preliminary efficacy of a phase I/II clinical trial investigating an L-RNA aptamer-based CXCL12 inhibitor (NOX-A12) in combination with RT in patients with newly-diagnosed GBM.