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Langbøl M, Rovelt J, Saruhanian A, Saruhanian S, Tiedemann D, Baskaran T, Bocca C, Vohra R, Cvenkel B, Lenaers G, Kolko M. Distinct Metabolic Profiles of Ocular Hypertensives in Response to Hypoxia. Int J Mol Sci 2023; 25:195. [PMID: 38203366 PMCID: PMC10779258 DOI: 10.3390/ijms25010195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Glaucoma is a neurodegenerative disease that affects the retinal ganglion cells (RGCs). The main risk factor is elevated intraocular pressure (IOP), but the actual cause of the disease remains unknown. Emerging evidence indicates that metabolic dysfunction plays a central role. The aim of the current study was to determine and compare the effect of universal hypoxia on the metabolomic signature in plasma samples from healthy controls (n = 10), patients with normal-tension glaucoma (NTG, n = 10), and ocular hypertension (OHT, n = 10). By subjecting humans to universal hypoxia, we aim to mimic a state in which the mitochondria in the body are universally stressed. Participants were exposed to normobaric hypoxia for two hours, followed by a 30 min recovery period in normobaric normoxia. Blood samples were collected at baseline, during hypoxia, and in recovery. Plasma samples were analyzed using a non-targeted metabolomics approach based on liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS). Multivariate analyses were conducted using principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA), and univariate analysis using the Wilcoxon signed-rank test and false discovery rate (FDR) correction. Unique metabolites involved in fatty acid biosynthesis and ketone body metabolism were upregulated, while metabolites of the kynurenine pathway were downregulated in OHT patients exposed to universal hypoxia. Differential affection of metabolic pathways may explain why patients with OHT initially do not suffer or are more resilient from optic nerve degeneration. The metabolomes of NTG and OHT patients are regulated differently from control subjects and show dysregulation of metabolites important for energy production. These dysregulated processes may potentially contribute to the elevation of IOP and, ultimately, cell death of the RGCs.
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Affiliation(s)
- Mia Langbøl
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
| | - Jens Rovelt
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Arevak Saruhanian
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
| | - Sarkis Saruhanian
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Veterinary & Animal Sciences, University of Copenhagen, 2000 Frederiksberg, Denmark
| | - Daniel Tiedemann
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Thisayini Baskaran
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
| | - Cinzia Bocca
- Faculté de Santé, Institut MITOVASC, UMR CNRS 6015, INSERM U1083, Université d’Angers, 49933 Angers, France; (C.B.); (G.L.)
- Département de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), 49933 Angers, France
| | - Rupali Vohra
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Barbara Cvenkel
- Department of Ophthalmology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Guy Lenaers
- Faculté de Santé, Institut MITOVASC, UMR CNRS 6015, INSERM U1083, Université d’Angers, 49933 Angers, France; (C.B.); (G.L.)
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (M.L.); (J.R.); (A.S.); (S.S.); (D.T.); (T.B.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
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Tönißen A, Müller-Stephan L, Tiedemann D, Gentz J, Martinsson G, Köhne M, Burger D, Sieme H. Cap assisted hysteroscopy enables retrograde catheterization and hydrotubation of the equine oviduct. PFERDEHEILKUNDE 2022. [DOI: 10.21836/pem20220101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Langbøl M, Saruhanian S, Baskaran T, Tiedemann D, Mouhammad ZA, Toft-Kehler AK, Jun B, Vohra R, Bazan NG, Kolko M. Increased Antioxidant Capacity and Pro-Homeostatic Lipid Mediators in Ocular Hypertension-A Human Experimental Model. J Clin Med 2020; 9:jcm9092979. [PMID: 32942740 PMCID: PMC7563216 DOI: 10.3390/jcm9092979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022] Open
Abstract
The main risk factor for primary open-angle glaucoma (POAG) is increased intraocular pressure (IOP). It is of interest that about half of the patients have an IOP within the normal range (normal-tension glaucoma, NTG). Additionally, there is a group of patients with a high IOP but no glaucomatous neurodegeneration (ocular hypertension, OHT). Therefore, risk factors other than IOP are involved in the pathogenesis of glaucoma. Since the retina has a very high oxygen-demand, decreased autoregulation and a fluctuating oxygen supply to the retina have been linked to glaucomatous neurodegeneration. To assess the significance of these mechanisms, we have utilized a human experimental model, in which we stress participants with a fluctuating oxygen supply. Levels of oxidative stress molecules, antioxidants, and lipid mediators were measured in the plasma. Patients with NTG, OHT, and control subjects were found to have similar levels of oxidative stress markers. In contrast, patients with OHT had a higher level of total antioxidant capacity (TAC) and pro-homeostatic lipid mediators. Thus, we suggest that OHT patients manage fluctuating oxygen levels more efficiently and, thus, are less susceptible to glaucomatous neurodegenerations, due to enhanced systemic antioxidant protection.
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Affiliation(s)
- Mia Langbøl
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
- Correspondence: (M.L.); (M.K.); Tel.: +45-30-50-26-62 (M.L.); +45-29-80-76-67 (M.K.)
| | - Sarkis Saruhanian
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
| | - Thisayini Baskaran
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
| | - Daniel Tiedemann
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
| | - Zaynab A. Mouhammad
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
| | - Anne Katrine Toft-Kehler
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
| | - Bokkyoo Jun
- Neuroscience Center of Excellence, Louisiana State University Health New Orleans, New Orleans, LA 70112, USA; (B.J.); (N.G.B.)
| | - Rupali Vohra
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
- Department of Veterinary and Animal Sciences, University of Copenhagen, 2000 Frederiksberg, Denmark
| | - Nicolas G. Bazan
- Neuroscience Center of Excellence, Louisiana State University Health New Orleans, New Orleans, LA 70112, USA; (B.J.); (N.G.B.)
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark; (S.S.); (T.B.); (D.T.); (Z.A.M.); (A.K.T.-K.); (R.V.)
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet-Glostrup, 2600 Glostrup, Denmark
- Correspondence: (M.L.); (M.K.); Tel.: +45-30-50-26-62 (M.L.); +45-29-80-76-67 (M.K.)
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Langbøl M, Baskaran T, Tiedemann D, Saruhanian S, Katrine Toft‐Kehler A, Koch Jensen P, Skov Jensen P, Vidiendal Olsen N, Vohra R, Kolko M. Retinal vessel diameters and systemic antioxidant capacity during hypoxia in patients with normal‐tension glaucoma and individuals with ocular hypertension. Acta Ophthalmol 2019. [DOI: 10.1111/j.1755-3768.2019.5342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Mia Langbøl
- Department of Drug Design and Pharmacology Copenhagen Denmark
| | | | | | | | | | | | | | | | - Rupali Vohra
- Department of Drug Design and Pharmacology Copenhagen Denmark
| | - Miriam Kolko
- Department of Drug Design and Pharmacology Copenhagen Denmark
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Tiedemann D, Jakobsen KK, von Buchwald C, Grønhøj C. Systematic review on location and timing of distant progression in human papillomavirus-positive and human papillomavirus-negative oropharyngeal squamous cell carcinomas. Head Neck 2018; 41:793-798. [DOI: 10.1002/hed.25458] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/31/2018] [Accepted: 08/27/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Daniel Tiedemann
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Kathrine Kronberg Jakobsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; University Hospital Rigshospitalet; Copenhagen Denmark
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Gamrad L, Mancini R, Werner D, Tiedemann D, Taylor U, Ziefuß A, Rehbock C, Klein S, Kues W, Barcikowski S, Rath D. Triplex-hybridizing bioconjugated gold nanoparticles for specific Y-chromosome sequence targeting of bull spermatozoa. Analyst 2018; 142:2020-2028. [PMID: 28487921 DOI: 10.1039/c6an02461k] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gold nanoparticles (AuNPs) are widely used in biomedical applications for drug targeting and bioimaging. This often neccesitates their functionalization with biomolecules carrying a defined biological function, yielding gold nanoparticle bioconjugates. The utilization of triplex-forming oligonucleotides (TFOs) as ligands gives access to nanoconjugates as tools for specific DNA-related nanotargeting via triplex hybridization. Since triplex hybridization with nanobioconjugates has to date not been shown on biologically relevant samples, sex-specific sperm marking may be an appropriate model system to demonstrate the opportunities of this targeting method in vitro. In this study, we focused on specific labeling of repetitive target sites enriched on the bovine Y-chromosome using triplex forming oligonucleotides. First, the functionality of a specific locked nucleic acid (LNA) sequence was confirmed on bovine free DNA and on demembranated sperm heads. Thereafter, the influence of AuNPs on triplex hybridization was spectrophotometrically analyzed employing synthetic dsDNA, genomic DNA and demembranated sperm heads. Results from the SPR-peak shift indicate that TFO-AuNP hybridize to bovine gDNA in a qualitative and significant manner. These results confirm successful triplex hybridization on biologically relevant target sites as well as the establishment of a method to use gold nanoparticles as a suitable tool for sex-selective hybridization.
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Affiliation(s)
- L Gamrad
- Technical Chemistry I and Center for Nanointegration Duisburg-Essen (CENIDE), Universitaetsstr. 7, 45141 Essen, Germany.
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Rath D, Tiedemann D, Gamrad L, Johnson LA, Klein S, Kues W, Mancini R, Rehbock C, Taylor U, Barcikowski S. Sex-Sorted Boar Sperm - An Update on Related Production Methods. Reprod Domest Anim 2016; 50 Suppl 2:56-60. [PMID: 26174920 DOI: 10.1111/rda.12572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 01/13/2023]
Abstract
As in other mammals, sex sorting of pig sperm is based on quantitative flow cytometry. A major disadvantage of the technique is the relatively low efficiency to produce enough sorted sperm for artificial insemination. However, several approaches are on the way to make sexed pig sperm available for commercial application. In this context, for example, the growing field of nanotechnology may significantly contribute to these developments, as it provides highly efficient bio-nanoprobes, for example, based on plasmonic nanoparticles. Independent of the method, further development requires enormous investments and set-up of logistics to get the technology into the practical pig market. Only global players will be able to establish the necessary research projects, but in the end, a significant shift of sex ratios will be available for pig producers as it is already the case for the dairy industry.
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Affiliation(s)
- D Rath
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Neustadt-Mariensee, Germany
| | - D Tiedemann
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Neustadt-Mariensee, Germany
| | - L Gamrad
- Institute for Technical Chemistry I UDE, Essen, Germany.,CENIDE, Essen, Germany
| | | | - S Klein
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Neustadt-Mariensee, Germany
| | - W Kues
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Neustadt-Mariensee, Germany
| | - R Mancini
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Neustadt-Mariensee, Germany
| | - C Rehbock
- Institute for Technical Chemistry I UDE, Essen, Germany.,CENIDE, Essen, Germany
| | - U Taylor
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Neustadt-Mariensee, Germany
| | - S Barcikowski
- Institute for Technical Chemistry I UDE, Essen, Germany.,CENIDE, Essen, Germany
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Tiedemann D, Clausen ML, John SM, Angelova-Fischer I, Kezic S, Agner T. Effect of glove occlusion on the skin barrier. Contact Dermatitis 2015; 74:2-10. [DOI: 10.1111/cod.12470] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Tiedemann
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
| | - Maja Lisa Clausen
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
| | - Swen Malthe John
- Department of Dermatology, Environmental Medicine, Health Theory; Lower Saxoninan Institute of Occupational Dermatology, University of Osnabrueck; D-49069 Osnabrueck Germany
| | - Irena Angelova-Fischer
- Department of Dermatology; University of Lübeck; 23538 Lübeck Germany
- Centre for Comprehensive Inflammation Medicine, University Hospital Schleswig-Holstein Campus Lübeck; 23538 Lübeck Germany
| | - Sanja Kezic
- Coronel Institute of Occupational Health, Academic Medical Centre; 1105 AZ Amsterdam The Netherlands
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
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Nörtershäuser W, Tiedemann D, Záková M, Andjelkovic Z, Blaum K, Bissell ML, Cazan R, Drake GWF, Geppert C, Kowalska M, Krämer J, Krieger A, Neugart R, Sánchez R, Schmidt-Kaler F, Yan ZC, Yordanov DT, Zimmermann C. Nuclear charge radii of 7,9,10Be and the one-neutron halo nucleus 11Be. Phys Rev Lett 2009; 102:062503. [PMID: 19257582 DOI: 10.1103/physrevlett.102.062503] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Indexed: 05/27/2023]
Abstract
Nuclear charge radii of ;{7,9,10,11}Be have been determined by high-precision laser spectroscopy. On-line measurements were performed with collinear laser spectroscopy in the 2s_{1/2}-->2p_{1/2} transition on a beam of Be+ ions. Collinear and anticollinear laser beams were used simultaneously, and the absolute frequency determination using a frequency comb yielded an accuracy in the isotope-shift measurements of about 1 MHz. Combining this with accurate calculations of the mass-dependent isotope shifts yields nuclear charge radii. The charge radius decreases from 7Be to 10Be and then increases for the halo nucleus 11Be. When comparing our results with predictions of ab initio nuclear-structure calculations we find good agreement. Additionally, the nuclear magnetic moment of 7Be was determined to be -1.3995(5)micro_{N} and that of 11Be was confirmed with an accuracy similar to previous beta-NMR measurements.
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Affiliation(s)
- W Nörtershäuser
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
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Žáková M, Geppert C, Herlert A, Kluge HJ, Sánchez R, Schmidt-Kaler F, Tiedemann D, Zimmermann C, Nörtershäuser W. Towards a nuclear charge radius determination for beryllium isotopes. ACTA ACUST UNITED AC 2007. [DOI: 10.1007/s10751-006-9490-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tiedemann D. Oncology today: ovarian cancer. RN 2000; 63:36-41; quiz 42. [PMID: 11062665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
While researchers work to improve treatment and come up with an accurate way to detect the disease early on, ovarian cancer will kill 14,000 women in the United States this year. Here's an update on this particularly insidious form of cancer: how it's managed today and treatment options for the future.
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Affiliation(s)
- D Tiedemann
- Veterans Affair Medical Center, VA Connecticut Healthcare System, West Haven, USA
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Greifzu S, Tiedemann D. Prostate cancer: the pros and cons of treatment. RN 1995; 58:22-6; quiz 27. [PMID: 7792507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Papac RJ, Son Y, Bien R, Tiedemann D, Keohane M, Yesner R. Improved local control of thoracic disease in small cell lung cancer with higher dose thoracic irradiation and cyclic chemotherapy. Int J Radiat Oncol Biol Phys 1987; 13:993-8. [PMID: 3036753 DOI: 10.1016/0360-3016(87)90036-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Over the past decade, improvement in survival has developed for patients with small cell lung carcinoma (SCLC) due to treatment strategies that include: cyclic combination chemotherapy, thoracic irradiation, and prophylactic cranial irradiation. In this study, we assess the outcome of treatment with initial cyclic combination chemotherapy including: cyclophosphamide, VP 16-123 and methotrexate combined with radiotherapy (RT), 6000 cGY [corrected] to the thorax for patients with limited disease and 3000 cGy [corrected] for patients with extensive disease. Forty-six patients are evaluated: 26 patients with limited disease and 20 with extensive disease. In patients who received 6000 cGy [corrected], to thoracic lesions, in combination with chemotherapy, administered for 3 courses prior to and following RT, the rate of clinically detected failure in the thorax was 3.8%. Morbidity was considered acceptable, although the occurrence of encephalopathy in 6 of 19 cases who received cranial irradiation, 3000 cGy [corrected], and concomitant chemotherapy was a serious consequence. Control of the primary tumor achieved by the use of higher dose RT is shown to be superior to that observed at lower doses of RT. This suggests that for the small cohort of patients whose disease is truly limited at the time of diagnosis, therapeutic regimens, which include higher dose RT, could increase the number of long term survivors of SCLC.
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