Distant Component Research Articles

Prospective Feasibility and Phase 1/2 Trial of Preoperative Proton Beam Therapy With Concurrent Chemotherapy for Resectable Stage IIIA or Superior Sulcus Non-Small Cell Lung Cancer

This is the first prospective clinical trial (NCTXXXX) evaluating proton beam therapy (PBT) with concurrent chemotherapy as part of trimodality management for resectable stage IIIA or superior sulcus non-small cell lung cancer (NSCLC). The starting PBT dose level was 50.4 Gy in 1.8 Gy fractions (feasibility study), followed by sequential dose escalation to determine maximum tolerated dose (MTD) of PBT based on dose-limiting toxicities (DLTs) (phase I/II study). DLTs were defined as 30-day postoperative mortality, grade ≥4 hematologic toxicity requiring >14-day treatment breaks, or any grade ≥3 non-hematologic/esophagitis/pneumonitis toxicities attributable to PBT. Primary outcomes included feasibility, MTD, and pathologic complete response (pCR) rate. Twenty patients underwent neoadjuvant PBT and chemotherapy, of which 19 subsequently underwent surgery. There were 13 patients in the feasibility study (at 50.4 Gy) and 6 in the phase I/II study (at 59.4 Gy). The trial closed early due to slow accrual prior to reaching the MTD. Treatment was deemed feasible. There were no DLTs, including no post-operative deaths within 30 days. Two patients (10%) experienced PBT-related acute grade 3 adverse events (post-operative atrial fibrillation and esophagitis/dysphagia); no grade 4-5 acute non-hematologic adverse events were noted. Overall and nodal pCR rates were 5/19 (26%) and 8/18 (44%), respectively; nodal pCR was 4/13 (31%) at 50.4 Gy versus 4/5 (80%) at 59.4 Gy (p=0.12). Median follow-up was 8.5 years. Median and 5-year progression-free survival were 1.8 years and 25%, and median and 5-year overall survival were 3.6 years and 40%, respectively. Eleven patients experienced disease failure, most with a distant component (10 of 11). Concurrent PBT and chemotherapy is feasible as part of trimodality management with favorable oncologic outcomes and low toxicity rates.

Salvage radiotherapy for relapsed/refractory non‐Hodgkin lymphoma following CD19 chimeric antigen receptor T-cell (CART) therapy

CD19-targeting chimeric antigen receptor T-cell (CART) therapy is a promising treatment for relapsed/refractory non-Hodgkin lymphoma, but most patients experience post-CART progression. We describe our institutional experience of salvage radiotherapy (SRT) in this setting. Of 94 patients who received CART therapy from 2018 to 2020, 21 received SRT for post-CART progression. Patients were divided into two groups: locoregional disease (n=9 [43%], all disease encompassable within an RT field) and advanced disease (n=12 [57%]). Patterns of failure, progression-free survival (PFS), overall survival (OS), and toxicity were assessed. Median time from CART infusion to SRT was 4.0months (range, 0.6-11.5months). In the locoregional disease group, 8/9 patients (89%) were treated with comprehensive SRT to a median dose of 37.5Gy in a median of 15 fractions. In the advanced disease group, all patients (n=12) were treated with focal SRT to a median dose of 20.8Gy in a median of 5 fractions. Median follow-up post-SRT was 15.2months. In-field response was observed in 8/9 (89%) in the locoregional disease and 8/9 (89%) evaluable patients in the advanced disease groups. 17/18 evaluable patients (94%) patients experienced post-SRT progression, all with a distant component. Median OS was 7.4months; 21months for locoregional disease versus 2.4months for advanced disease (p=0.0002). Median PFS was 1.1month, and similarly poor regardless of group. No grade≥3 toxicities occurred. SRT post-CART therapy appears safe with encouraging in-field response but high rates of out-of-field progression, even for those presenting with locoregional disease, highlighting the need for integration of novel systemic agents.

Irregular Scene Text Detection Based on a Graph Convolutional Network.

Detecting irregular or arbitrary shape text in natural scene images is a challenging task that has recently attracted considerable attention from research communities. However, limited by the CNN receptive field, these methods cannot directly capture relations between distant component regions by local convolutional operators. In this paper, we propose a novel method that can effectively and robustly detect irregular text in natural scene images. First, we employ a fully convolutional network architecture based on VGG16_BN to generate text components via the estimated character center points, which can ensure a high text component detection recall rate and fewer noncharacter text components. Second, text line grouping is treated as a problem of inferring the adjacency relations of text components with a graph convolution network (GCN). Finally, to evaluate our algorithm, we compare it with other existing algorithms by performing experiments on three public datasets: ICDAR2013, CTW-1500 and MSRA-TD500. The results show that the proposed method handles irregular scene text well and that it achieves promising results on these three public datasets.

Defining the Optimal Treatment Strategy in Patients With Uterine Serous Carcinoma

AimsUterine serous carcinoma (USC) is an aggressive subtype of endometrial cancer with high rates of relapse and death. As adjuvant therapy might be beneficial in early-stage disease, the impact of standard complete surgical staging is questioned. Therefore, we wanted to explore the optimal treatment strategy for women diagnosed with USC. Materials and methodsA retrospective multicentre study of women diagnosed with primary USC in the UK and the Netherlands. Treatment strategy in relation to overall survival and progression-free survival was recorded and evaluated with Kaplan–Meier and Cox regression analysis. Furthermore, primary surgical staging and/or adjuvant treatment in relation to patterns of recurrence were evaluated. ResultsIn total, 272 women with a median age of 70 years were included. Most patients presented with International Federation of Gynecology and Obstetrics (FIGO) stage I disease (44%). Overall, 48% of patients developed recurrent disease, most (58%) with a distant component. Women treated with chemotherapy showed significantly better overall survival (hazard ratio 0.50, 95% confidence interval 0.31–0.81; P = 0.005) and progression-free survival (hazard ratio 0.48, 95% confidence interval 0.28–0.80; P = 0.04) in multivariable analysis. Furthermore, even in surgically staged women with FIGO stage IA disease, a high recurrence rate of 42% was seen. ConclusionWomen with USC who received adjuvant chemotherapy showed better survival rates compared with those who received other or no adjuvant treatment. The benefit of adjuvant chemotherapy was observed across all tumour stages, including surgically staged FIGO stage IA. These data question the role of surgical staging in the absence of macroscopic disease in USC.

A Tale of Three Dust Populations: Variable R V and Extreme Polarization along Sight Lines toward ζ Ophiuchi

Abstract Dust permeates the interstellar medium, reddening and polarizing background starlight, but dust properties vary with local environment. In order to characterize dust in a highly irradiated diffuse cloud, we measure the reddening and optical polarization toward 27 stars surrounding the midlatitude b = +24° O9.2IV star ζ Ophiuchi, using new optical spectroscopy and polarimetry. We incrementally deredden and depolarize with distance, allowing us to distinguish dust components along these sight lines. The data indicate three distinct dust populations: a foreground component characteristic of average Milky Way dust (R V ≈ 3.1, d ≲ 180 pc), a highly polarizing mid-distance component in the vicinity of ζ Oph (R V ≈ 2.4, 200 pc < d < 300 pc), and a nonpolarizing distant component (R V ≈ 3.6, 600 pc < d < 2000 pc). Prominent 8 μm infrared striations spanning the field of view likely have high polycyclic aromatic hydrocarbon content and are illuminated by ζ Oph. Foreground-subtracted polarizations roughly align with these striations, which, we argue, lie immediately behind ζ Oph and constitute the highly polarizing mid-distance dust. This component polarizes very efficiently (P V > 9.1E(B − V)), implying a high degree of grain alignment and suggesting that the bulk of the polarization occurs in a small fraction of the volume. The large R V in the distant component reveals that dust above the Galactic plane (z > 250 pc) may contain a greater fraction of large grains than the Milky Way average.

Role of adjuvant therapy in stage IIIC2 endometrial cancer

ObjectiveThe role of the different types of adjuvant treatments in endometrial cancer with para-aortic node metastases is unclear. The aim of this study was to report oncologic outcomes after adjuvant...

ANALYSIS OF MASSIVE OPEN ONLINE COURSES UTILIZATION IN EDUCATIONAL PROCESS OF A UNIVERSITY BASED ON SPECIALITY «PRE-SCHOOL EDUCATION»

The article deals with the question of massive open online courses utilization in educational process of higher education institutions; the background for the courses implementation is analysed, advantages and disadvantages of their utilization to provide distant component of educational process are estimated. In the framework of the research on peculiarities of MOOCs implementation in electronic learning courses in Borys Grinchenko Kyiv University a survey was hold for students of the specialty “Pre-school education” of the second (Master’s) level, where 50 respondents, who completed massive open online courses during their study, took part. According to the result of the survey it was defined that the majority of the students (from 68% to 78% depending on the course) were completely satisfied with the format of study and consider it one of the ways for their professional development in the future. The article describes the difficulties faced by the students in the process of work with MOOCs; possible ways to overcome them were defined. Accordance of possibilities provided with massive open online courses with the requests of modern students to the ways of extracurricular learning implementation was analysed. Positive aspects of the courses utilization as a part of electronic learning courses were highlighted including motivational factor about completing corresponding MOOCs. In addition, the question of readiness of academics to use massive open online courses in their professional activities was taken into consideration. Lecturers of Borys Grinchenko Kyiv University were surveyed; the results showed that only 30% of teaching staff had previous experience of using MOOCs in educational process, however, around 80% of respondents are interested in further study and practical utilization of such resources.

Prediction of a Red Nova Outburst in KIC 9832227

Abstract We present the first identification of a candidate precursor for an imminent red nova. Our prediction is based on the example of the precursor to the red nova V1309 Sco, which was retrospectively found to be a contact binary with an exponentially decreasing period. We explore the use of this distinctive timing signature to identify precursors, developing the observational and analysis steps needed. We estimate that our Galaxy has roughly 1–10 observable precursors. Specifically, we lay out the observational case for KIC 9832227, which we identified as a tentative candidate two years ago (Molnar et al. 2015, AAS Meeting #225 Abstracts 415.05). Orbital timing over the past two years has followed the tentative exponential fit. As of late 2015, the period time derivative went beyond the range found in other systems ( ), a necessary criterion for a serious candidate. We estimate time of merger is the year 2022.2 ± 0.7. Double absorption line spectra confirm directly the 0.458-day light-curve is the orbital period of a contact binary system and yield a mass ratio . Closer analysis of the Kepler timing data shows evidence of a component C with orbital period days and . An alternative interpretation of the long-term timing trend, that is, a light travel-time delay due to the orbit around a distant component D, is ruled out by the spectroscopic data for any nondegenerate star. Additional measurements are needed to test further the merging hypothesis and to use fully this fortuitous opportunity.

V773 Cas, QS Aql, AND BR Ind: ECLIPSING BINARIES AS PARTS OF MULTIPLE SYSTEMS*

ABSTRACT Eclipsing binaries remain crucial objects for our understanding of the universe. In particular, those that are components of multiple systems can help us solve the problem of the formation of these systems. Analysis of the radial velocities together with the light curve produced for the first time precise physical parameters of the components of the multiple systems V773 Cas, QS Aql, and BR Ind. Their visual orbits were also analyzed, which resulted in slightly improved orbital elements. What is typical for all these systems is that their most dominant source is the third distant component. The system V773 Cas consists of two similar G1-2V stars revolving in a circular orbit and a more distant component of the A3V type. Additionally, the improved value of parallax was calculated to be 17.6 mas. Analysis of QS Aql resulted in the following: the inner eclipsing pair is composed of B6V and F1V stars, and the third component is of about the B6 spectral type. The outer orbit has high eccentricity of about 0.95, and observations near its upcoming periastron passage between the years 2038 and 2040 are of high importance. Also, the parallax of the system was derived to be about 2.89 mas, moving the star much closer to the Sun than originally assumed. The system BR Ind was found to be a quadruple star consisting of two eclipsing K dwarfs orbiting each other with a period of 1.786 days; the distant component is a single-lined spectroscopic binary with an orbital period of about 6 days. Both pairs are moving around each other on their 148 year orbit.

The triple system AT Mic AB + AU Mic in the β $\beta $ Pictoris association

Equal-mass stars in young open clusters and loose associations exhibit a wide spread of rotation periods, which likely originates from differences in the initial rotation periods and in the primordial disc lifetimes. We want to explore if the gravitational effects by nearby companions may play an additional role in producing the observed rotation period spread. We measure the photometric rotation periods of components of multiple stellar systems and look for correlations of the period differences among the components to their reciprocal distances. In this paper, we analysed the triple system AU Mic + AT Mic A&B in the 25-Myr beta Pictoris Association. We have retrieved from the literature the rotation period of AU Mic (P = 4.85d) and measured from photometric archival data the rotation periods of both components of AT Mic (P = 1.19d and P = 0.78d) for the first time. Moreover, we detected a high rate of flare events from AT Mic. Whereas the distant component AU Mic has evolved rotationally as a single star, the A and B components of AT Mic, separated by about 27 AU, exhibit a rotation rate a factor 5 larger than AU Mic. Moreover, the A and B components, despite have about equal mass, show a significant difference (about 40%) between their rotation periods. A possible explanation is that the gravitational forces between the A and B components of AT Mic (that are a factor about 7.3 x 10^6 more intense than those between AU Mic and AT Mic) have enhanced the dispersal of the AT Mic primordial disc, shortening its lifetime and the disc-locking phase duration, making the component A and B of AT Mic to rotate faster than the more distant AU Mic. We suspect that a different level of magnetic activity between the A and B components of AT Mic may be the additional parameter responsible for the difference between their rotation periods.

ORBITS OF SUBSYSTEMS IN FOUR HIERARCHICAL MULTIPLE STARS

ABSTRACT Seven spectroscopic orbits in nearby solar-type multiple stars are presented. The primary of the chromospherically active star HIP 9642 is a 4.8 day double-lined pair; the outer 420 year visual orbit is updated, but remains poorly constrained. HIP 12780 is a quadruple system consisting of the resolved 6.7 year pair FIN 379 Aa,Ab, for which the combined orbit, masses, and orbital parallax are determined here, and the single-lined binary Ba,Bb with a period of 27.8 days. HIP 28790 is a young quintuple system composed of two close binaries, Aa,Ab and Ba,Bb, with periods of 221 and 13 days, respectively, and a single distant component C. Its subsystem Ba,Bb is peculiar, having a spectroscopic mass ratio of 0.89 but a magnitude difference of ∼2.2 mag. HIP 64478 also contains five stars: the A-component is a 29 year visual pair with a previously known 4 day twin subsystem, while the B-component is a contact binary with a period of 5.8 hr, seen nearly pole-on.

The first study of the light-travel time effect in massive LMC eclipsing binaries

Aims: New CCD observations for semidetached and detached eclipsing binaries from the Large Magellanic Cloud were carried out using the Danish 1.54-m telescope located at the La Silla Observatory in Chile. The selected systems were monitored for their times of minima, which were required to be able to study the period changes taking place in them. In addition, many new times of minima were derived from the photometric surveys OGLE-II, OGLE-III, and MACHO. Methods: The O-C diagrams of minima timings were analysed using the hypothesis of the light-travel time effect, i.e. assuming the orbital motion around a common barycenter with the distant component. Moreover, the light curves of these systems were also analysed using the program PHOEBE, which provided the physical parameters of the stars. Results: For the first time, in this study we derived the relatively short periods of modulation in these systems, which relates to third bodies. The orbital periods resulted from 3.6 to 11.3 yr and the eccentricities were found to be up to 0.64. This is the first time that this kind of analysis for the set of extragalactic sources has been performed. The Wolf-Rayet system OGLE-LMC-ECL-08823 is the most mysterious one, owing to the resultant high mass function. Another system, OGLE-LMC-ECL-19996, was found to contain a third body with a very high mass (M3,min = 26M0). One system (OGLE-LMC-ECL-09971) is suspicious because of its eccentricity, and another one (OGLE-LMC-ECL-20162) shows some light curve variability, with a possible flare-like or microlensing-like event. Conclusions: All of these results came only from the photometric observations of the systems and can be considered as a good starting point for future dedicated observations.

Correlating an atomic condensate

Quantum Optics Parts of a quantum system can be more “correlated” than what is allowed in the everyday classical world: A measurement on one part of the system can immediately affect a spatially distant component. The strongest of such correlations, Bell correlations, have been detected in small systems containing two to a handful of particles. Schmied et al. used collective measurements to detect Bell correlations among the spins of 480 Rb atoms cooled to a condensed state. This many-body correlated state may be useful as a resource in quantum information processing. Science , this issue p. [441][1] [1]: /lookup/doi/10.1126/science.aad8665

Patterns and utility of routine surveillance in high grade endometrial cancer

ObjectiveTo evaluate surveillance methods and their utility in detecting recurrence of disease in a high grade endometrial cancer population. MethodsWe performed a multi-institutional retrospective chart review of women diagnosed with high grade endometrial cancer between the years 2000 and 2011. Surveillance data was abstracted and analyzed. Surveillance method leading to detection of recurrence was identified and compared by stage of disease and site of recurrence. ResultsTwo hundred and fifty-four patients met the criteria for inclusion. Vaginal cytology was performed in the majority of early stage patients, but was utilized less in advanced stage patients. CA-125 and CT imaging were used more frequently in advanced stage patients compared to early stage. Thirty-six percent of patients experienced a recurrence and the majority of initial recurrences (76%) had a distant component. Modalities that detected cancer recurrences were: symptoms (56%), physical exam (18%), surveillance CT (15%), CA-125 (10%), and vaginal cytology (1%). All local recurrences were detected by symptoms or physical exam findings. While the majority of loco-regional and distant recurrences (68%) were detected by symptoms or physical exam, 28% were detected by surveillance CT scan or CA 125. One loco-regional recurrence was identified by vaginal cytology but no recurrences with a distant component detected by this modality. ConclusionsSymptoms and physical examination identify the majority of high grade endometrial cancer recurrences, while vaginal cytology is the least likely surveillance modality to identify a recurrence. The role of CT and CA-125 surveillance outside of a clinical trial needs to be further reviewed

Lymphovascular Space Invasion and the Treatment of Stage I Endometrioid Endometrial Cancer

Treatment of clinical early-stage endometrioid endometrial cancer (EEC) in The Netherlands consists of primary hysterectomy and bilateral salpingo-oophorectomy. Adjuvant radiotherapy is given when 2 or more the following risk factors are present: 60 years or older, grade 3 histology, and 50% or more myometrial invasion. Lymphovascular space invasion (LVSI) is a predictor of poor prognosis and early distant spread. It is unclear whether adjuvant radiotherapy is sufficient in patients with LVSI-positive EEC. Eighty-one patients treated from 1999 until 2011 for stage I LVSI-positive EEC in 11 Dutch hospitals were included. The outcomes of patients with 0 to 1 risk factors were compared with those with 2 to 3 risk factors, and both were compared with the known literature. Eighteen patients presented with recurrent disease, and 12 of those recurrences had a distant component. Overall and distant recurrence rates were 19.2% and 11.5% in patients with 0 to 1 risk factors followed by observation and 25.5% and 17% in patients with 2 to 3 risk factors who received adjuvant radiotherapy. Only 1 patient with grade 1 disease had a recurrence. In stage I LVSI-positive EEC with 0 to 1 risk factors, observation might not be adequate. Moreover, despite adjuvant radiotherapy, a high overall and distant recurrence rate was observed in patients with 2 to 3 risk factors. The use of systemic treatment in these patients, with the exception of patients with grade 1 disease, should be investigated.

Does intra-operative radiation at the time of pelvic exenteration improve survival for patients with recurrent, previously irradiated cervical, vaginal, or vulvar cancer?

ObjectiveTo determine whether intra-operative radiation therapy (IORT) at the time of pelvic exenteration (PE) or laterally extended endopelvic resection (LEER) improves progression-free survival (PFS) in patients with recurrent, previously irradiated gynecologic cancers. MethodsWe conducted a single institution retrospective review of patients who had undergone a complete PE for locally recurrent gynecologic cancer. Demographic and clinicopathologic data were collected. Results32 patients were identified (2000–2012); 21 (66%) cervical cancer, 8 (25%) vaginal, and 3 (9%) vulvar cancer. All patients were previously irradiated. Twenty-one (66%) received IORT. Mean age was 51. Eight patients had a LEER, all with IORT. Median PFS and OS, respectively, for those with PE alone was 33 and 41 vs. 10 and 10months for PE+IORT compared to 9 and 17months for LEER+IORT (P=.04). Increasing tumor size negatively impacted PFS (hazard ratio 1.3; 95%CI 1.12–1.52). Margin status was not associated with survival. No patients undergoing LEER+IORT recurred only locally whereas 62% recurred with a distant component (+/− local). Patients with PE alone had mainly local (36%) and few (9%) distant recurrences compared to 31% local and 38% distant (+/− local) recurrences for those with PE+IORT. ConclusionsWe failed to demonstrate that IORT changes survival and recurrence outcomes. However, patients with clinical indications for IORT at the time of PE have worse prognosis compared to those who do not require IORT. If the need for IORT is anticipated, the surgeon may consider performing a LEER to decrease local recurrence if cure is the goal or consider palliative treatment options.

Patterns of failure for glioblastoma multiforme following limited-margin radiation and concurrent temozolomide.

BackgroundTo analyze patterns of failure in patients with glioblastoma multiforme (GBM) treated with limited-margin radiation therapy and concurrent temozolomide. We hypothesize that patients treated with margins in accordance with Adult Brain Tumor Consortium guidelines (ABTC) will demonstrate patterns of failure consistent with previous series of patients treated with 2–3 cm margins.MethodsA retrospective review was performed of patients treated at the University of Alabama at Birmingham for GBM between 2000 and 2011. Ninety-five patients with biopsy-proven disease and documented disease progression after treatment were analyzed. The initial planning target volume includes the T1-enhancing tumor and surrounding edema plus a 1 cm margin. The boost planning target volume includes the T1-enhancing tumor plus a 1 cm margin. The tumors were classified as in-field, marginal, or distant if greater than 80%, 20-80%, or less than 20% of the recurrent volume fell within the 95% isodose line, respectively.ResultsThe median progression-free survival from the time of diagnosis to documented failure was 8 months (range 3–46). Of the 95 documented recurrences, 77 patients (81%) had an in-field component of treatment failure, 6 (6%) had a marginal component, and 27 (28%) had a distant component. Sixty-three patients (66%) demonstrated in-field only recurrence.ConclusionsThe low rate of marginal recurrence suggests that wider margins would have little impact on the pattern of failure, validating the use of limited margins in accordance ABTC guidelines.

Population-based treatment and outcomes of Stage I uterine serous carcinoma

ObjectiveUterine serous carcinoma (USC) is a rare type of endometrial cancer that often recurs in patients with Stage I disease. Our objective was to evaluate treatment and outcomes in Stage I USC in the context of a population-based study. MethodsThis was a population-based retrospective cohort study of all patients with Stage I USC in British Columbia, Canada from 2004 to 2012. The British Columbia Cancer Agency (BCCA) recommends three cycles of paclitaxel and carboplatin chemotherapy followed by pelvic radiotherapy for all women with Stage I USC and any myometrial invasion (Stage IA MI−). If no myometrial invasion (Stage IA MI−), no postoperative treatment is given. Patient and disease characteristics, surgery, adjuvant therapy, recurrence rates and sites, and 5-year disease-free survival rates were evaluated. ResultsOf the 127 patients with Stage I USC, 41 were Stage IA MI−, 56 Stage IA MI+, and 30 Stage IB. Median follow-up was 25months (2–98months). Five year disease-free survival rates were 80.7%, 74.4%, and 48.5% for Stages IA MI−, IA MI+, and IB, respectively, and recurrence rates according to BCCA guidelines were 10%, 2.9% and 30%, respectively. Of the 18 with recurrences, 13 had a distant component (72.2%). There were no pelvic recurrences among those receiving adjuvant radiotherapy. ConclusionOur current protocol of observation alone postoperatively for Stage IA MI− and chemoradiotherapy for Stage IA MI+ is associated with a low recurrence rate. In contrast, those with Stage IB USC have a higher recurrence rate despite chemoradiotherapy, and likely require alternate treatment strategies.

SYSTEM ADS 48: VISUAL BINARY OR MULTIPLE SYSTEM

In this paper, we analyze seven components of system ADS 48. Its number in the Washington Double Star Catalog is 00057+4549. We use the measuring results from our CCD frames obtained between 1994 and 2011. Our aim is to establish which of these components are gravitationally bound, i.e., have an orbital motion around the mass center, and which of them are mutually very distant in space so that only their projections are close in the field of view. In addition to the measurements, we also apply different criteria based on celestial mechanics. Out of seven considered components, only the closest pair STT 547 AB is in orbital motion around the mass center. The other components, except that with the largest separation, are merely projected stars. The most distant component has common proper motion with pair AB.

Unique sextuple system: 65 Ursae Majoris

Context. 65 UMa belongs to rather small group of stellar systems of higher multiplicity, whose inner and outer orbits are well-known. Methods: Photometric, spectroscopic, and interferometric data were analyzed, revealing the basic physical properties of the system 65 UMa. A disentangling technique is used to perform the spectra decomposition. This combined approach allows us to study the long-term period changes in the system, identifying the period variation due to the motion on the visual orbit, in addition to a short-term modulation. Results: We find that the system contains one more component, hence 65 UMa is a sextuple hierarchical system. The most inner pair of components consists of an eclipsing binary orbiting around a barycenter on a circular orbit, both components being almost identical of spectral type about A7. This pair orbits on an eccentric orbit around a barycenter, and the third component orbits with a period of about 640 days. This motion is reflected in the period variation in the minima times of the eclipsing pair, as well as in the radial velocities of the primary, secondary, and tertiary components. Moreover, this system orbits around a barycenter with the distant component resolved interferometrically, whose period is of about 118 years. Two more distant components (4" and 63") are also probably gravitationally bound to the system. The nodal period of the eclipsing-pair orbit is on the order of only a few centuries, which makes this system even more interesting for a future prospective detection of changing the depths of minima. Conclusions: We identify a unique solution of the system 65 UMa, decomposing the individual components and even shifting the system to higher multiplicity. The study of this kind of multiple can help us to understand the origin of stellar systems. Besides 65 UMa, only another 11 sextuple systems have been studied.