Study protocol of the Asian XELIRI ProjecT(AXEPT):a multinational,randomized,non-inferiority,phase Ⅲ trial of second-line chemotherapy for metastatic colorectal cancer, comparing the eicacy and safety of XELIRI with or without bevacizumab versus FOLFIRI w

Background: Capecitabine and irinotecan combination therapy(XELIRI) has been examined at various dose levels to treat metastatic colorectal cancer(m CRC). Recently, in the Association of Medical Oncology of the German Cancer Society(AIO) 0604 trial, tri?weekly XELIRI plus bevacizumab, with reduced doses of irinotecan(200 mg/m^2 on day 1) and capecitabine(1600 mg/m^2 on days 1–14), repeated every 3 weeks, has shown favorable tolerability and eicacy which were comparable to those of capecitabine and oxaliplatin(XELOX) plus bevacizumab. The doses of capecit?abine and irinotecan in the AIO trial are considered optimal. In a phase I/II study, XELIRI plus bevacizumab(BIX) as second?line chemotherapy was well tolerated and had promising eicacy in Japanese patients.Methods: The Asian XELIRI Projec T(AXEPT) is an East Asian collaborative, open?labelled, randomized, phase Ⅲ clinical trial which was designed to demonstrate the non?inferiority of XELIRI with or without bevacizumab versus standard FOLFIRI(5?fluorouracil, leucovorin, and irinotecan combination) with or without bevacizumab as second?line chemo?therapy for patients with m CRC. Patients with 20 years of age or older, histologically conirmed m CRC, Eastern Coop?erative Oncology Group performance status 0–2, adequate organ function, and disease progression or intolerance of the irst?line regimen will be eligible. Patients will be randomized(1:1) to receive standard FOLFIRI with or with?out bevacizumab(5 mg/kg on day 1), repeated every 2 weeks(FOLIRI arm) or XELIRI with or without bevacizumab(7.5 mg/kg on day 1), repeated every 3 weeks(XELIRI arm). A total of 464 events were estimated as necessary to show non?inferiority with a power of 80% at a one?sided α of 0.025, requiring a target sample size of 600 patients. The 95% conidence interval(CI) upper limit of the hazard ratio was pre?speciied as less than 1.3.Conclusion: The Asian XELIRI Projec T is a multinational phase III trial being conducted to provide evidence for XELIRI with or without bevacizumab as a second?line treatment option of mCRC.

Analysis and optimization of high-power pulse transformer for SXFEL

A C-band accelerator structure was used to accelerate electrons at the Shanghai soft X-ray free-electron laser test facility (SXFEL-TF) in Shanghai Institute of Applied Physics (SINAP). The microwave system of this accelerator structure used a 110 MW pulse modulator and a klystron (PV-5050) to provide the power supply. A pulse transformer is a crucial device in a modulator klystron system and plays significant roles in voltage level transformation, matching impedances, and polarity inversion. This study presents the optimization of a high-voltage pulse transformer. The design considerations of reducing flattop ringing and flattop droop, and shortening leading edge are provided. The model simulation, mechanical design, and the relevant experimental results are also presented.

Recent trends in the prevalence and distribution of colonic diverticula in Japan evaluated using computed tomography colonography

BACKGROUND Computed tomography colonography(CTC)may be superior to colonoscopy and barium enema for detecting diverticula.However,few studies have used CTC to diagnose diverticula.AIM To evaluate the current prevalence and distribution of colonic diverticula in Japan using CTC.METHODS This study was conducted as part of the Japanese National Computed Tomographic Colonography Trial,which included 1181 participants from 14 hospitals in Japan.We analyzed the prevalence and distribution of colonic diverticula and their relationships with age and sex.The relationship between the diverticula and the length of the large intestine was also analyzed.RESULTS Diverticulosis was present in 48.1%of the participants.The prevalence of diverticulosis was higher in the older participants(P<0.001 for trend).The diverticula seen in younger participants were predominantly located in the right-sided colon.Older participants had a higher frequency of bilateral type(located in the rightand left-sided colon)diverticulosis(P<0.001 for trend).The length of the large intestine with multiple diverticula in the sigmoid colon was significantly shorter in those without diverticula(P<0.001).CONCLUSION The prevalence of colonic diverticulosis in Japan is higher than that previously reported.The prevalence was higher,and the distribution tended to be bilateral in older participants.