Magnetic resonance spectroscopic imaging of brain injury after nasopharyngeal cancer radiation in early delayed reaction

This study aimed to investigate the value of magnetic resonance spectroscopy (MRS) imaging in assessing nasopharyngeal carcinoma radiotherapy during the early delayed reaction period. Eighty cases of nasopharyngeal cancer treated with radiotherapy within the same period underwent MRS imaging before or after radiotherapy. Of the 80 cases, 47 underwent MRS imaging on the 3rd, 4th, 6th, and 12th months after radiotherapy. The trends of the primary metabolite concentration at different time points were monitored and compared with the corresponding data after radiotherapy. Repeated measures analysis of variance was performed. At the end of radiotherapy, the N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, and NAA/Cho ratios were reduced to the lowest levels after 3 months. However, increasing trends were observed from the 4th to the 12th month. On the 12th month, stable levels were reached with statistically significant differences (F = 316.02, 53.84, 286.68; P < 0.01). MRS reflected the radiation injury-repair process in the brain of a nasopharyngeal cancer patient during early delayed reaction. This non-invasive monitoring of changes in brain tissue metabolite concentrations provides valuable information for prognosis.

Ethanol extract and isolated constituents from artemisia dracunculus inhibit esophageal squamous cell carcinoma and induce apoptotic cell death

The objective of the present study was to examine the antitumor efficacy of the ethanol extract from Artemisia dracunculus as well as the compounds isolated from it on cultured EC‑109 esophageal squamous cell carcinoma (ESCC) cells. Apoptotic activities of the compounds were also studied using flow cytometry. EC‑109 esophageal cancer cells were treated with varying concentrations of compounds 1-7 isolated from the plant as well as the ethanol extract of Artemisia dracunculus. The cytotoxicity was evaluated by MTT assay and the apoptotic studies of the compounds were determined using flow-cytometry. Effect on mitochondrial membrane potential loss ΛΨ m induced by compounds 2 and 4 was also studied in these cells. Bioassay-guided fractionation of the ethanol extract from the shoot and root parts of Artemisia dracunculus led to the isolation of 7-methoxycoumarin (1), scopoletin (2), dracumerin (3), sakuranetin (4), elimicin (5), davidigenin (6) and 6-methoxycapillarisin (7). All the compounds as well as the extract showed mild to potent cell proliferation inhibitory activities against the esophageal cell line. Sakuranetin and 6-methoxycapillarisin were found to have the most potent effects in inhibiting the cell proliferation. The 2 potent compounds, sakuranetin and 6-methoxycapillarisin were evaluated for their effects on cell cycle phase distribution (DNA damage) as well as their effects on mitochondrial membrane potential loss ΛΨ m. Both compounds induced DNA damage as well as mitochondrial membrane potential loss in esophageal cancer cells. The study suggests that compounds, Sakuranetin and 6-methoxycapillarisin isolated from Artemisia dracunculus possess potent anticancer effects by inducing DNA damage in these cells.

Bile deficiency induces changes in intestinal Cl(-) and HCO3 (-) secretions in mice

AIMS

Biliary tract obstruction is a common clinical lesion. However, the effect of biliary tract obstruction on intestinal secretion is poorly understood. In this study, we made an investigation on intestinal HCO3 (-) and Cl(-) secretions in an experimental model of murine biliary duct ligation.

METHODS

Murine intestinal mucosal HCO3 (-) and Cl(-) secretions were examined in vitro in Ussing chambers by pH-stat and short-circuit current (Isc ) techniques. The mRNA and protein expressions of the cystic fibrosis transmembrane conductance regulator (CFTR) and the Na(+) -K(+) -2Cl(-) cotransporter (NKCC1) were analysed by real-time PCR, western blot and immunohistochemistry.

RESULTS

Basal Cl(-) secretion and forskolin-stimulated duodenal and jejunal mucosal HCO3 (-) and Cl(-) secretions in mice with common biliary duct ligation were markedly elevated, compared with controls (P < 0.05 and P < 0.01). Further experiments showed that basal Cl(-) secretion and forskolin-stimulated duodenal and jejunal mucosal HCO3 (-) and Cl(-) secretions in mice with external bile drainage were also markedly elevated. CFTRinh -172 inhibited forskolin-stimulated HCO3 (-) and Cl(-) secretions. The mRNA and protein expression levels of CFTR and NKCC1 in the intestinal mucosa with both biliary duct ligation and external bile drainage were markedly higher than those in controls (P < 0.001). Bile acid administration restored the changes in function and expression of CFTR and NKCC1 in the intestinal mucosa.

CONCLUSION

Bile deficiency in the intestine up-regulates the expressions of intestinal mucosal CFTR and NKCC1 and enhances intestinal mucosal HCO3 (-) and Cl(-) secretion capacity, which contributes to the understanding of intestinal physiological function for patients with biliary duct obstruction.

Screening of the residual normal ovarian tissue adjacent to orthotopic epithelial ovarian carcinomas in nude mice

The objective of this study was to explore the feasibility and methods of screening the residual normal ovarian tissue adjacent to orthotopic ovarian carcinomas in nude mice. Human epithelial ovarian cancer cells (OVCAR3) were subcutaneously implanted for a tumor source and ovarian orthotopic transplantation. The cancer tissue, proximal paraneoplastic tissue, middle paraneoplastic tissue, remote paraneoplastic tissue, and normal ovarian tissue were removed. CK-7, CA125, p53, survivin, MMP-2, and TIMP-2 expression was detected by reverse transcription polymerase chain reaction. We obtained 35 paraneoplastic residual ovarian tissues with normal biopsies from 40 cases of an orthotopic epithelial ovarian carcinoma model (87.5%). CK-7, CA125, p53, survivin, MMP-2, and TIMP-2 expression was lower in proximal paraneoplastic tissue than in cancer tissue (P < 0.05) and higher than in middle and remote paraneoplastic tissue (P < 0.01). There was no statistically significant difference between the expression of these genes in middle and proximal paraneoplastic tissue as well as among residual normal ovarian tissues with different severity (P > 0.05). In ovarian tissues of 20 normal nude mice, the expression of CK- 7, CA125, p53, survivin, MMP-2, and TIMP-2 was negative. Overall, the expression levels of CK-7, CA125, p53, survivin, MMP-2, TIMP-2, and other molecular markers showed a decreasing trend in the non-cancer tissue direction. The expression levels can be used as standards to screen residual normal ovarian tissue. We can obtain relatively safe normal ovarian tissues adjacent to epithelial ovarian cancer.

Clinical effectiveness of multimodality treatment on advanced pediatric hepatoblastoma

OBJECTIVES

To investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma and the factors affecting the prognosis.

PATIENTS AND METHODS

35 childhood patients were treated with multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. Patients were followed up every month.

RESULTS

33 patients completed the follow-up, of which 17 were in complete remission, 5 were in partial remission, 1 case got worse, and 10 died. The remission rate was 66.7% (22/33), and the overall survival rate was 69.7% (23/33). 1 patient with advanced hepatoblastoma got high-dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) treatment, and a primary lesion by 18 x 15 x 9 cm reduced to 10 x 8 x 4 cm. Remote metastases significantly alleviated, and partial remission reached six months. The overall survival was 9 months after transplantation. Patients with the mixed phenotype of hepatoblastoma had a worse prognosis than with the epithelial phenotype (p < 0.001), and patients in stage IV had a lower survival rate than in stage III (p < 0.001).

CONCLUSIONS

Multimodality treatment can effectively improve remission rate and prolong the survival of children with the advanced hepatoblastoma. In addition, alpha-fetoprotein (AFP), hepatoblastoma pathological classification and staging are of great use in prediction of prognosis.

Abstract P5-14-16: Hypofractionated breast irradiation in early-stage breast cancer patients following adjuvant chemotherapy: Evaluation of acute and late toxicities

Purpose

To evaluate the effect of adjuvant chemotherapy (CTX) on acute and late toxicity among women undergoing hypofractionated radiation therapy (HRT) following breast-conserving therapy and to assess the relative impact of breast size.

Materials and Methods

In this retrospective study, patients treated with HRT to the whole breast (42.4 Gy in 16 fractions) followed by a boost (9.6 Gy in 4 fractions) between 2005 and 2009 were evaluated for inclusion. Early-stage (I-II) patients who underwent post-lumpectomy CTX prior to HRT were included. Patients who underwent neoadjuvant CTX were excluded; node positive patients and larger-breasted women (chest wall separation of &gt;25 cm) were included. Toxicity evaluations during HRT and at 2-4 weeks, 3, 6, 9 months, and at yearly intervals were collected and graded using the RTOG Acute and Late Toxicity scales. Relevant data was available in 43 women. The median age was 60 years (35 – 71), and women were primarily of African American (55.8%) and Hispanic (27.9%) ethnicity. The majority of patients had high-grade lesions (69.8%), were Stage II (60.4%), and had T1 primaries (55.8%). Slightly more than half the patients (53.5%) were ER+; 20% were Her2 positive, and 37.2% were triple negative. Thirty-three (76.7%) were treated in the prone position. Lumpectomy cavity boosts were given via photons (58.2%) or electrons. Chemotherapy regimens included ACT (Adriamycin, Cytoxan, and Taxol) in 33/43 (76.7%) and CMF (Cytoxan, methotrexate, and 5FU) in the remainder. The median interval between completion of adjuvant CTX and the start of HRT was 41 days. The median BMI of the women was 31.8 (18.2 – 44.4; normal weight defined as BMI of 18.5 – 24.9); 11 women (25.6%) had a separation of more than 25 cm, and the median PTV volume was 1353cc (589-4213). STATA v 11 was used for all statistical analyses.

Results

The median cosmetic evaluation follow-up was 33.5 months. Forty women (93%) experienced an acute toxicity. The majority of these (31/40) were Grade 1 dermatitis with the remainder Grade 2 dermatitis (moist desquamation). There were no reported acute toxicities &gt; Grade 2. Thirteen women (30.2%) were reported to have a late toxicity: Grade 1 skin in 9, Grade 1 subcutaneous tissue in 5, and Grade 2 subcutaneous in 2 of the 9 women with Grade 1 skin. There were no late toxicities &gt; Grade 2. The acute and late toxicity rates of our main cohort and those with larger breasts were similar to those reported in the literature. On univariate analysis, there was no significant correlation (p&gt;0.05) between toxicity and age, race, BMI, separation, tumor size, grade, or hormone receptor status, CTX regimen, and treatment position and duration. There was, however, a trend toward increased toxicity with a shorter interval between CTX completion and HRT start (p = 0.052).

Conclusions

The addition of adjuvant chemotherapy to the treatment regimen of breast conservation using HRT does not appear to lead to worse cosmetic outcomes. In addition, larger-breasted women, excluded from prior reports on HRT, were at no increased risk of acute or late toxicity. We found a trend toward significance suggesting that shorter intervals between CTX and HRT may be associated with increased toxicity.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-14-16.

Relation of excess body weight and survival in patients with esophageal adenocarcinoma: a meta-analysis

Excess body weight (body mass index >25 kg/m(2)) is common in patients with esophageal adenocarcinoma. In this study, a meta-analysis was performed by searching PubMed, Cochrane Library, EMBASE, and Science Direct databases from 1960 to June 2012. Data were extracted from studies comparing survival in obese (body mass index >30), overweight (body mass index 25-29), and normal-weight (body mass index 20-24) patients undergoing esophagectomy. A total of six studies with 1988 cases were suitable for this global meta-analysis. Compared with patients of normal weight, the hazard ratio of postoperational survival for overweight and obese patients was 0.79 (95% confidence interval 0.65-0.95, P = 0.108) and 0.80 (95% confidence interval 0.68-0.93, P = 1.00), respectably. Taken together, the excess body weight did not have the value of predicting survival for patients with esophageal adenocarcinoma.

A genome-wide analysis of the ERF gene family in sorghum

The ethylene response factor (ERF) family are members of the APETALA2 (AP2)/ERF transcription factor superfamily; they are known to play an important role in plant adaptation to biotic and abiotic stress. ERF genes have been studied in Arabidopsis, rice, grape, and maize; however, there are few reports of ERF genes in sorghum. We identified 105 sorghum ERF (SbERF) genes, which were categorized into 12 groups (A-1 to A-6 and B-1 to B-6) based on their sequence similarity, and this new method of classification for ERF genes was then further characterized. A comprehensive bioinformatic analysis of SbERF genes was performed using a sorghum genomic database, to analyze the phylogeny of SbERF genes, identify other conserved motifs apart from the AP2/ERF domain, map SbERF genes to the 10 sorghum chromosomes, and determine the tissue-specific expression patterns of SbERF genes. Gene clustering indicates that SbERF genes were generated by tandem duplications. Comparison of SbERF genes with maize ERF homologs suggests lateral gene transfer between monocot species. These results can contribute to our understanting of the evolution of the ERF gene family.