Optimal Number Of Cycles Research Articles

Optimal number of runs for unreliable equipments under uncertain conditions in the 'public utilities'

Utility enterprise (UE) appears as a business strategy for small, medium–sized and large utilities. However, to support the operations of a UE, preventive maintenance (PM) timetable under the real conditions is considered to be the most significant scheduling in the contemporary public utility industries. Running equipment should be assumed to worsen when it is in operation, along with increment in the rate of failure. In this research, we come up with a model that is useful to determine the optimal number of cycles and the sequence of preventive maintenance schedules that minimise the long time cost. The equipment is subjected to preventive maintenance either on failure or after having reached an anticipated age, which of them happens first. Some useful factors of the cost function are developed to characterise the optimal policy. The paper encompasses the beneficial aspects of the new system implementation in a transportation company.

Modification of glassy carbon electrode with a polymer/mediator composite and its application for the electrochemical detection of iodate

A modified glassy carbon electrode was prepared by depositing a composite of polymer and mediator on a glassy carbon electrode (GCE). The mediator, flavin adenine dinucleotide (FAD) and the polymer, poly(3,4-ethylenedioxythiophene) (PEDOT) were electrochemically deposited as a composite on the GCE by applying cyclic voltammetry (CV). This modified electrode is hereafter designated as GCE/PEDOT/FAD. FAD was found to significantly enhance the growth of PEDOT. Electrochemical quartz crystal microbalance (EQCM) analysis was performed to study the mass changes in the electrode during the electrodeposition of PEDOT, with and without the addition of FAD. The optimal cycle number for preparing the modified electrode was determined to be 9, and the corresponding surface coverage of FAD (ΓFAD) was ca. 5.11×10−10molcm−2. The amperometric detection of iodate was performed in a 100mM buffer solution (pH 1.5). The GCE/PEDOT/FAD showed a sensitivity of 0.78μAμM−1cm−2, a linear range of 4–140μM, and a limit of detection of 0.16μM for iodate. The interference effects of 250-fold Na+, Mg2+, Ca2+, Zn2+, Fe2+, Cl−, NO3−, I−, SO42− and SO32−, with reference to the concentration of iodate were negligible. The long-term stability of GCE/PEDOT/FAD was also investigated. The GCE/PEDOT/FAD electrode retained 82% of its initial amperometric response to iodate after 7 days. The GCE/PEDOT/FAD was also applied to determine iodate in a commercial salt.

A prospective randomized phase II trial evaluating maintenance GM-CSF in an intermittent chemotherapy (chemo) regimen for metastatic castration-resistant prostate cancer (mCRPC): A DoD prostate cancer clinical trials consortium trial.

35 Background: The optimal number of cycles of docetaxel for patients (pts) with mCRPC is not known, and in practice, treatment breaks are common. The current study was designed to test the safety and efficacy of utilizing 6 cycles of standard docetaxel with chemo free intervals in patients who achieve and maintain a response to docetaxel. Methods: Pts with mCRPC, no prior chemo, and KPS > 60% were eligible. Pts were treated with “induction” docetaxel 75 mg/m2 q 3 weeks, and prednisone 5 mg po bid. PSAWG1 criteria were used to define response and progression. After 6 cycles, responding pts stopped chemo and were randomized to observation (Obs) or to GM-CSF, 250 mcg/m2 daily for 14 days out of every 28-day cycle. Pts were followed with monthly PSA and imaging every 2 cycles until progression, at which point docetaxel was reinitiated for another 6 cycles, followed by the same “off chemo” regimen. The primary endpoint was the time to progression while on chemo (time to chemo resistance). Results: 114 pts have been enrolled: 3 are undergoing induction, and 111 are therefore evaluable. Of these pts, 82 completed induction, (10 did not due to PD, 9 due to adverse events (AE), 10 due to pt or MD choice). Of 111 evaluable pts, 48 (43%) had a response to chemo and were eligible for randomization. 22 were randomized to Obs and 26 to GM-CSF. Of 48 randomized pts, 25 restarted chemo, all for PSA PD. (23 pts did not re-start chemo because of AE, other therapy being started, or pt choice; 1 pt is still on GM-CSF.) 6/25 (24%) pts experienced a response to the 2nd series of chemo, and 1/6 (17%) to the 3rd. The time to chemo re-initiation (n=25) was 3.1 mos in Obs pts and 4.2 mos in GM-CSF pts. Conclusions: 43% of patients met criteria for undergoing intermittent chemo. The response proportion to the 1st, 2nd, and 3rd series of docetaxel was 43%, 24% and 17%, respectively. GM-CSF may modestly delay the time to chemo re-initiation, but the sample size is small and insufficient to assess the impact of GM-CSF on time to chemo resistance.

Evaluating the value of continuing docetaxel and prednisone (DP) beyond 10 cycles in men with metastatic castration-resistant prostate cancer (mCRPC).

4582 Background: The optimal number of cycles of 3-weekly DP therapy for mCRPC has not been ascertained. An exploratory analysis was conducted comparing results of 335 men on the DP arm of the TAX-327 study, which limited chemotherapy to 10 cycles, and a recently completed randomized clinical trial of 221 men allocated to either DP+AT-101 (bcl-2 inhibitor) versus DP+placebo, which allowed up to 17 cycles of DP. Methods: Patients who initiated cycle 10 of therapy without progression in both studies were included. Per protocol, men on the TAX-327 study received 1 additional cycle, while men on the AT-101 study received up to cycle 17. Men in both arms of the AT-101 study were combined for analysis, as no significant differences in outcomes were observed. Overall survival (OS) was estimated from the cycle 10 D infusion date, using the Kaplan-Meier method. Results: The number of men receiving cycle 10 cycle was similar (Fisher's exact test p-value=0.60) between the two studies (166 or 49.6% in the TAX-327 study versus 99 or 44.8% in the AT-101 study), though of these men, death date information was more complete due to longer follow-up in TAX-327 (79.5% versus 34.4%). Six- and 12-month estimated survival from cycle 10 was 92.2% (95% CI: 86.9-95.4%) and 74.6% (CI: 67.2-80.5%) for TAX-327 patients, compared with 92.8% (CI: 85.5-96.5) and 63.4% (CI: 51.8-72.9%) for those on AT-101. Survival statistics were similar beyond cycle 10 within good, intermediate and poor risk groups. 38 (38.4%) men on the AT-101 study completed all 17 cycles. Of men on the AT-101 study, 24 and 13 had consistently declining PSA through cycles 13 and 17. Conclusions: A survival benefit was not detected with more than 10 cycles of DP chemotherapy in men with mCRPC in this hypothesis-generating exploratory analysis. A subset of men with mCRPC continue to have declines in PSA up to cycle 17 and thus may have ongoing benefit to continued chemotherapy administration. However, a randomized clinical trial is necessary to establish the optimal duration of therapy.

Optimal design of multi-subject blocked fMRI experiments

The design of a multi-subject fMRI experiment needs specification of the number of subjects and scanning time per subject. For example, for a blocked design with conditions A or B, fixed block length and block order ABN, where N denotes a null block, the optimal number of cycles of ABN and the optimal number of subjects have to be determined. This paper presents a method to determine the optimal number of subjects and optimal number of cycles for a blocked design based on the A-optimality criterion and a linear cost function by which the number of cycles and the number of subjects are restricted. Estimation of individual stimulus effects and estimation of contrasts between stimulus effects are both considered. The mixed-effects model is applied and analytical results for the A-optimal number of subjects and A-optimal number of cycles are obtained under the assumption of uncorrelated errors. For correlated errors with a first-order autoregressive (AR1) error structure, numerical results are presented. Our results show how the optimal number of cycles and subjects depend on the within- to between-subject variance ratio. Our method is a new approach to determine the optimal scanning time and optimal number of subjects for a multi-subject fMRI experiment. In contrast to previous results based on power analyses, the optimal number of cycles and subjects can be described analytically and costs are considered.

Fabrication of a Polymer/Mediator Composite Modified Electrode and its Application to Electrochemical Detection of Iodate

A polymer/mediator composite modified glassy carbon electrode (GCE) is fabricated for electrochemical detection of iodate (IO3−). Flavin adenine dinucleotide (FAD) is chosen as mediator for sensing iodate, and 3,4 ethylenedioxythiophene (EDOT) is chosen for entrapping FAD and forming a conducting polymeric matrix, poly(3,4 ethylenedioxythiophene) (PEDOT). The PEDOT/FAD modification layer is electrodeposited on the GCE by cyclic voltammetric (CV) method. It is noted that FAD can enhance the electrodeposition of PEDOT, and possible reasons are proposed to explain this phenomenon. The optimal cycle number for preparing the modified electrode is determined to be 9. The relationship between the formal potential of FAD and the pH value is studied. Two slopes, 60.4 and 29.2mV per pH unit, are recorded in the ranges of 1.5≦pH≦8.5 and 8.5≦pH≦11.5, respectively. Additionally, it is found that the oxidation current of iodate increases significantly with the decrease of pH value.

Treatment of Advanced Lung Cancer

Lung cancer is the number 1 cancer-cause of death in the United States. The majority of the lung cancer patients are diagnosed with advanced disease. Platinum-based doublet chemotherapy is the standard chemotherapy in the treatment of advanced non-small-cell lung cancer (NSCLC) though non-platinum-based chemotherapy is an alternative possibility. Monoclonal antibodies that inhibit the binding of vascular endothelial growth factors (VEGF), such as bevacizumab, or the epidermal growth factors (EGFR), such as cetuximab, have been shown to significantly prolonged overall survival (OS) in combination with platinum-based doublet chemotherapy in the first line treatment of NSCLC. The optimal number of cycles of first line chemotherapy is between 3 and 4. Maintenance therapy with noncross- resistant agents after first line treatment is still considered as investigational at this time. The oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI),erlotinib, has been approved for use as second line or beyond in the treatment of NSCLC based on superior survival benefit over best supportive care. NSCLC patients with EGFR activation mutations generally had better response to erlotinib and are generally found in Asian, never-smokers, females, and adenocarcinoma histology. Studies have shown that lung cancer in never-smokers is a clinical entity and had superior overall survival. Studies are underway to determine which patients will benefit from platinum-based chemotherapy. Randomized trials have shown that elderly patients or patients with performance status (PS) 2 also benefited from chemotherapy.

An application of Genetic Algorithm in solving an inventory model with advance payment and interval valued inventory costs

The purpose of this research is to solve the mixed integer constrained optimization problem with interval coefficient by a real-coded genetic algorithm (RCGA) with ranking selection, whole arithmetical crossover and non-uniform mutation for non-integer decision variables. In the ranking selection, as well as in finding the best solution in each generation of RCGA, recently developed modified definitions of order relations between interval numbers with respect to decision-making are used. Also, for integer decision variables, new types of crossover and mutation are introduced. This methodology is applied to solve a finite time horizon inventory model with constant lead-time, uniform demand rate and a discount by paying an amount of money in advance. Moreover, different inventory costs are considered to be interval valued. According to the consumption of items during lead-time and reorder level, two cases may arise. For each case, the mathematical model becomes a constrained nonlinear mixed integer problem with interval objective. Our objective is to determine the optimal number of cycles in the finite time horizon, lot-size in each cycle and optimal profit. The model is illustrated with some numerical examples and sensitivity analysis has been done graphically with the variation of different inventory parameters.

Evolution of R-CHOP therapy for older patients with diffuse large B-cell lymphoma

Non-Hodgkin’s lymphoma is the fifth most common malignancy in adults in the USA. This disorder is especially relevant in the elderly patient population, as the median age of patients with this disorder is 65 years. Almost half of these disorders in older patients are of a diffuse large B-cell (DLBCL) subtype. The therapy of DLBCL has undergone a renaissance in the past decade, with the addition of rituximab to standard regimens, such as cyclophosphamide– doxorubicin–vincristine–prednisone (CHOP). Over this time, there have been several large Phase III treatment trials in which the CHOP and rituximab-CHOP (R-CHOP) regimens have been prospectively compared, including three trials confined to the elderly patient population. In these trials, it has been demonstrated repeatedly that the addition of rituximab results in an improved outcome, with higher response rates and prolongation in parameters including progression-free, event-free, disease-free and overall survival. In addition, this regimen has been well tolerated, even in older patients. Based upon these data, the R-CHOP regimen has now been established as the standard for initial therapy of DLBCL in older patients with DLBCL. However, issues still remain with regard to the ideal schedule of R-CHOP administration, specifically the optimal number of cycles of therapy (six vs eight), as well as cycle length (14 vs 21 days).

Makorin-2 Is a Neurogenesis Inhibitor Downstream of Phosphatidylinositol 3-Kinase/Akt (PI3K/Akt) Signal

Makorin-2 belongs to the makorin RING zinc finger gene family, which encodes putative ribonucleoproteins. Here we cloned the Xenopus makorin-2 (mkrn2) and characterized its function in Xenopus neurogenesis. Forced overexpression of mkrn2 produced tadpoles with dorso-posterior deficiencies and small-head/short-tail phenotype, whereas knockdown of mkrn2 by morpholino antisense oligonucleotides induced double axis in tadpoles. In Xenopus animal cap explant assay, mkrn2 inhibited activin, and retinoic acid induced animal cap neuralization, as evident from the suppression of a pan neural marker, neural cell adhesion molecule. Surprisingly, the anti-neurogenic activity of mkrn2 is independent of the two major neurogenesis signaling cascades, BMP-4 and Wnt8 pathways. Instead, mkrn2 works specifically through the phosphatidylinositol 3-kinase (PI3K) and Akt-mediated neurogenesis pathway. Overexpression of mkrn2 completely abrogated constitutively active PI3K- and Akt-induced, but not dominant negative glycogen synthase kinase-3beta (GSK-3beta)-induced, neural cell adhesion molecule expression, indicating that mkrn2 acts downstream of PI3K and Akt and upstream of GSK-3beta. Moreover, mkrn2 up-regulated the mRNA and protein levels of GSK-3beta. These results revealed for the first time the important role of mkrn2 as a new player in PI3K/Akt-mediated neurogenesis during Xenopus embryonic development.

Mesh Deformation Strategy Optimized by the Adjoint Method on Unstructured Meshes

An adjoint-based optimization procedure is proposed for improving the robustness and extending the range of linear-elasticity-based mesh deformation techniques. Using the values of the modulus of elasticity E defined in each mesh cell as the design variables, the procedure seeks to determine an optimum distribution of E throughout the mesh, in order to minimize a global objective function which reflects the skewness or lack of quality of the deformed mesh. The technique is applied to highly-stretched mixed element meshes in two and three dimensions on complex geometries, and is shown to be capable of recovering a valid mesh in a small number of optimization cycles for cases where the non-optimized linear-elasticity approach fails. However, the solution of the optimization problem remains relatively costly in terms of cpu time, compared to a non-optimized mesh deformation calculation, making this technique best suited for precomputing improved E distributions prior to the simulation, or for use as a plug-in module to be invoked in cases where the non-optimized procedure fails.

Early, intermediate and advanced Hodgkin's lymphoma: modern treatment strategies

Treatment strategies of early stage Hodgkin lymphoma (HL) have changed during recent years. Until recently, extended field (EF) irradiation has been considered the standard treatment. However, due to the recognition of the high relapse rate and the fatal long-term effects, EF radiotherapy (radiation to initially involved and adjacent lymph node areas) is now being abandoned by most study groups. Instead, for favourable early stage disease, short duration chemotherapy for control of occult lesions is combined with involved field irradiation (IF-RT; restricted only to initially involved lymph node areas). Most groups and centres give four courses of adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) followed by IF-RT [30–35 gray (Gy)][1]. Many of the ongoing and recently completed studies were developed in an attempt to reduce the long-term complications of treatment without increasing mortality from HL. These include studies that evaluate reduction of radiation dose or field size; combined modality treatment in an attempt to identify the optimal chemotherapy regimen; the optimal number of cycles of chemotherapy; and to determine the optimal radiation volume and dose when combined with chemotherapy. Table 1 summarizes the most prominent ongoing or recently terminated international trials [2, 3].

Optimization of inspection schedule for a surface-breaking crack subject to fatigue loading

Inspections play an essential role in the damage tolerance approach to control fatigue damage. In this paper a method is presented to optimize the cost-effectiveness of inspection scheduling for single and multiple inspections during the expected lifetime. Detailed results are given for a surface-breaking crack of depth a in a cyclic tension field. The original crack depth is treated as a random variable with a known probability density function. The crack growth is governed by the Paris law, and the inspection technique has a known probability of detection. The component fails when the crack depth reaches a critical value a cr . As a part of the damage-tolerant approach, the component is replaced only when the depth of the detected crack is larger than a pre-defined value a r . For a pre-determined number of cycles that defines the expected lifetime the optimal number of cycles for the inspection scheduling has been obtained by minimizing a total cost function. The total cost function is the sum of the cost functions for failure, component replacement and inspection. These functions have been expressed is terms of the relevant probabilities. Analytical and numerical results are given for one, two and multiple inspections. These results show the effects of the magnitude of a r , and the probability of detection (POD) of the inspection technique on the optimum schedule of inspections.

Optimized RT-PCR Method for Assaying Expression of Monocyte Chemotactic Protein Type 1 (MCP-1) in Rabbit Aorta

The reverse transcription polymerase chain reaction (RT-PCR) is one of the most useful molecular biology methods in opening the way to understanding of the mechanisms of atherosclerosis on the gene structure and/or expression level. We optimized this technique for assaying expression of the monocyte chemotactic protein type 1 (MCP-1) gene in rabbit aorta with respect to the temperature profile, yield to cycle number, interference of genomic DNA with the RNA matrix, and repeatability. Variability of expression of the constitutive GAPDH gene was also examined. The study was done in 18 New Zealand rabbits allocated to two groups and fed a standard chow for 2 (S1) or 3 (S2) months. The experiment ended with removal of part of the ascending rabbit aorta, from which RNA was isolated. The optimal temperature for binding of specific primers to the MCP-1 and GAPDH genes was 63 degrees C, and the optimal number of cycles for PCR amplification was 22 for MCP-1 and 26 for GAPDH. The GAPDH amplicon size was 465 base pairs in the presence or absence of reverse transcriptase showing contamination of the RNA matrix with genomic DNA. Repeatability of the RT-PCR method was 8.7%, and variability of expression of the GAPDH gene was 7.7%. Thus, RT-PCR adjusted for contaminating genomic DNA provides a reliable way of assaying expression of the MCP-1 gene in rabbit aorta.

European Lung Cancer Working Party Clinical Practice Guidelines. Non-Small Cell Lung Cancer: III. Metastatic disease

The present guidelines on the management of advanced non-small cell lung cancer (NS CLC) were formulated by the ELCWP in October 2006. They are designed to answer the following twelve questions: 1) What benefits can be expected from chemotherapy and what are the treatment objectives? 2) What are the active chemotherapeutic drugs for which efficacy has been shown? 3) Which are the most effective platinum-based regimens? 4) Which is the indicated dosage of cisplatin? 5) Can carboplatin be substituted for cisplatin? 6) Which is the optimal number of cycles to be administered? 7) Can non-platinum based regimens be substituted for platinum based chemotherapy as first-line treatment? 8) Is there an indication for sequential chemotherapy? 9) What is the efficacy of salvage chemotherapy and which drugs should be used in that indication? 10) What is the place of targeted therapies? 11) What is the place of chemotherapy in the management of a patient with brain metastases? 12) Which specific drugs can be used for the patient with bone metastases?

Drug Discovery in the Kinase Inhibitory Field Using the Nested Chemical Library™ Technology

Kinase inhibitors are at the forefront of modern drug research, where mostly three technologies are used for hit-and-lead finding: high throughput screening of random libraries, three-dimensional structure-based drug design based on X-ray data, and focused libraries around limited number of new cores. Our novel Nested Chemical Library (NCL) (Vichem Chemie Research Ltd., Budapest, Hungary) technology is based on a knowledge base approach, where focused libraries around selected cores are used to generate pharmacophore models. NCL was designed on the platform of a diverse kinase inhibitory library organized around 97 core structures. We have established a unique, proprietary kinase inhibitory chemistry around these core structures with small focused sublibraries around each core. All the compounds in our NCL library are stored in a big unified Structured Query Language database along with their measured and calculated physicochemical and ADME/toxicity (ADMET) properties, together with thousands of molecular descriptors calculated for each compound. Biochemical kinase inhibitory assays on selected, cloned kinase enzymes for a few hundred NCL compound sets can provide sufficient biological data for rational computerized design of new analogues, based on our pharmacophore model-generating 3DNET4W QSPAR (quantitative structure-property/activity relationships) approach. Using this pharmacophore modeling approach and the ADMET filters, we can preselect synthesizable compounds for hit-and-lead optimization. Starting from this point and integrating the information from QSPAR, high-quality leads can be generated within a small number of optimization cycles. Applying NCL technology we have developed lead compounds for several validated kinase targets.

Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF

Natural cycle IVF, in which the one oocyte that naturally develops is used for IVF, offers a low-risk and patient-friendly procedure, but lacks efficacy due to untimely LH-surges and therefore cancellation of cycles. In modified natural cycle IVF, a GnRH-antagonist is used to prevent LH-surges, thus lowering cancellation rates, while maintaining a monofollicular cycle and therefore a very low risk of multiple pregnancies and a zero risk of OHSS. The easy repeatability in consecutive cycles is an advantage of the modified natural cycle IVF protocol, however, the optimal number of cycles per patient is unknown.

Moderne Pharmakotherapie des Morbus Hodgkin

High cure rates have been achieved in the treatment for patients with Hodgkin's disease in the past 30 years. Depending on stage at diagnosis and further risk factors up to 95% of patients with Hodgkin's disease can be cured with first-line treatment. Modern therapeutic strategies aim at both reducing therapy-induced late toxicities while maintaining effective tumor control. Patients with early stage Hodgkin's disease are now treated with a short course of chemotherapy for control of occult disease and involved field (IF) irradiation. For patients with early unfavourable stages, effectiveness of treatment shall be optimised by introducing the escalated BEACOPP schedule which has been established in the treatment of advanced stages. Questions to be answered in the treatment of advanced stages concern the optimal number of cycles of an effective chemotherapy regimen and the necessity of additional radiation therapy. The role of erythropoetin and PET-imaging is currently being evaluated in ongoing trials. In the future, new therapeutic approaches with biological agents will be of interest.

Essential Role of p38 Mitogen-activated Protein Kinase in Contact Hypersensitivity

The present study was designed to elucidate the role of p38 mitogen-activated protein kinase (p38) in the pathogenesis of inflammation, using a mouse contact hypersensitivity (CHS) model induced by 2,4-dinitro-1-fluorobenzene (DNFB). Ear swelling was induced by challenge with DNFB, accompanied by infiltration of mononuclear cells, neutrophils, and eosinophils and a marked increase in mRNA levels of cytokines such as interleukin (IL)-2, interferon (IFN)-gamma, IL-4, IL-5, IL-1beta, IL-18, and tumor necrosis factor-alpha in the challenged ear skin. Both ear swelling and the number of infiltrated cells in DNFB-challenged ear skin were significantly inhibited by treatment with SB202190, a p38 inhibitor. Furthermore, the DNFB-induced expression of all cytokines except IL-4 was significantly inhibited by treatment with SB202190. Ribonuclease protection assay revealed that the mRNA levels of chemokines such as IP-10 and MCP-1 in ear skin were markedly increased at 24 h after challenge with DNFB. The induction of these chemokines was significantly inhibited by treatment with SB202190. In p38alpha +/- mice, both ear swelling and infiltration of cells induced by DNFB were reduced compared with those in wild-type mice. However, induction of cytokines by DNFB was also observed in p38alpha +/- mice, although the induction of IFN-gamma, IL-5, and IL-18 was typically reduced compared with that in wild-type mice. Challenge with DNFB slightly induced IP-10 and MCP-1 mRNA in p38alpha +/- mice, with weaker signals than those in SB202190-treated wild-type mice. These results suggest that p38 plays a key role in CHS and is an important target for the treatment of CHS.

Treatment of elderly patients with intermediate- and high-grade non-Hodgkin's lymphoma: a retrospective population-based study.

Nowadays more people are becoming older. The median age of a patient with non-Hodgkin's lymphoma (NHL) at diagnosis is over 60 years. The incidence of NHL in elderly has increased in the last decades. Therefore, in the future, NHL will be diagnosed more often in the elderly. Data of all patients in the south-east of the Netherlands with newly diagnosed NHL between January 1991 and January 1995 were analysed in a retrospective multicentre population-based study to investigate if and how elderly patients (> 60 years) with advanced NHL (Ann Arbor Staging > or = IIB) of intermediate- and high-grade malignancy were treated. Treatment modalities applied, outcome, and causes of death were evaluated. Treatment was considered inadequate if it deviated from the standard anthracycline-containing chemotherapy (CNOP/CHOP) for a minimum of six cycles. The entry criteria were met by 68 patients. Of these patients, 57 (83.8%) were treated and 11 (16.2%) were not treated. The treatment consisted of CHOP (36 patients), CNOP (6 patients), chlorambucil (13 patients), or COP (2 patients). Forty-two of 68 patients had adequate treatment, but 14 of 42 (33.3%) patients had a suboptimal numbers of cycles (< 6). Of 28 patients with adequate chemotherapy, only 16 had the optimal number of cycles and dose; the result is that the treatment of 76.5% (52/68) of patients differed from that of their younger counterparts. The most important reason for treatment not being optimal was high age (23%) or poor performance (35%). In the appropriately treated patients, 62.5% (10/16) had a complete response. Survival in the CHOP/CNOP-treated group was better than in other groups. The main cause of death in the total study group was NHL. The results cannot be explained by the different international prognostic index. A significant subset (76.5%) of elderly people with intermediate/high-grade NHL received suboptimal therapy, mainly because of a suboptimal performance status. However, a significant part of the patients (23%) were not treated optimally because of high age, despite a good performance. For improving the overall survival in the elderly, it is not only the schedule that is important, but also the intention to treat the elderly patient.