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Huang B, Wu G, Peng C, Peng X, Huang M, Ding J, Zhang H, Wu X. miR-126 regulates the proliferation, migration, invasion, and apoptosis of non-small lung cancer cells via AKT2/HK2 axis. IUBMB Life 2023; 75:186-195. [PMID: 34320278 DOI: 10.1002/iub.2531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/29/2021] [Accepted: 07/07/2021] [Indexed: 12/22/2022]
Abstract
This study tended to clarify the role of miR-126 in non-small cell lung cancer (NSCLC) cell biological behaviors in vitro, containing cell proliferation, migration, invasion, and apoptosis. miRNA expression microarray related to NSCLC was accessed from gene expression omnibus (GEO) database and subjected to differential analysis using the "limma" package. Real-time quantitative PCR was conducted to assess the expression of miR-126 in NSCLC cell lines. wIn vitro experiments including 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), wound healing assay, Transwell, and flow cytometry assay were used for evaluating the effect of miR-126 on cell proliferation, migration, invasion, and apoptosis. Additionally, target mRNA for miR-126 was predicted and further validated by bioinformatics analysis and dual-luciferase reporter assay, respectively. It suggested that miR-126 was significantly down-regulated in NSCLS based on the expression microarray, and similar expression trend was exhibited in cancer cell lines. In the meantime, overexpression of miR-126 was found to result in inhibition of cell proliferation, migration, and invasion while promotion of cell apoptosis, with reductions in protein expression of AKT2 and phosphorylated HK2 (p-HK2) as well. AKT2, identified to be a direct target of miR-126 in NSCLC as judged by dual-luciferase reporter assay. Additionally, overexpression of AKT2 was observed to have the ability of elevating p-HK2 protein expression and reversing the effect of miR-126 on NSCLC cell proliferation, migration, and invasion. Given the above findings, we can see that miR-126 exerts its role in NSCLC cell proliferation, migration, invasion, and apoptosis with the aid of AKT2/HK2 axis.
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Affiliation(s)
- Bin Huang
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Gongzhi Wu
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Chongxiong Peng
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Xuyang Peng
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Mingjiang Huang
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Jianyang Ding
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Huaizhong Zhang
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Xuhui Wu
- Department of Cardiothoracic Surgery, Lishui People's Hospital/The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, China
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Bloudek B, Wirtz HS, Hepp Z, Timmons J, Bloudek L, McKay C, Galsky MD. Oncology Simulation Model: A Comprehensive and Innovative Approach to Estimate and Project Prevalence and Survival in Oncology. Clin Epidemiol 2022; 14:1375-1386. [PMID: 36404878 PMCID: PMC9673939 DOI: 10.2147/clep.s377093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/21/2022] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE We demonstrate a new model framework as an innovative approach to more accurately estimate and project prevalence and survival outcomes in oncology. METHODS We developed an oncology simulation model (OSM) framework that offers a customizable, dynamic simulation model to generate population-level, country-specific estimates of prevalence, incidence of patients progressing from earlier stages (progression-based incidence), and survival in oncology. The framework, a continuous dynamic Markov cohort model, was implemented in Microsoft Excel. The simulation runs continuously through a prespecified calendar time range. Time-varying incidence, treatment patterns, treatment rates, and treatment pathways are specified by year to account for guideline-directed changes in standard of care and real-world trends, as well as newly approved clinical treatments. Patient cohorts transition between defined health states, with transitions informed by progression-free survival and overall survival as reported in published literature. RESULTS Model outputs include point prevalence and period prevalence, with options for highly granular prevalence predictions by disease stage, treatment pathway, or time of diagnosis. As a use case, we leveraged the OSM framework to estimate the prevalence of bladder cancer in the United States. CONCLUSION The OSM is a robust model that builds upon existing modeling practices to offer an innovative, transparent approach in estimating prevalence, progression-based incidence, and survival for oncologic conditions. The OSM combines and extends the capabilities of other common health-economic modeling approaches to provide a detailed and comprehensive modeling framework to estimate prevalence in oncology using simulation modeling and to assess the impacts of new treatments on prevalence over time.
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Affiliation(s)
| | | | | | | | | | - Caroline McKay
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | - Matthew D Galsky
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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3
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London D, Patel DN, Donahue B, Navarro RE, Gurewitz J, Silverman JS, Sulman E, Bernstein K, Palermo A, Golfinos JG, Sabari JK, Shum E, Velcheti V, Chachoua A, Kondziolka D. The incidence and predictors of new brain metastases in patients with non-small cell lung cancer following discontinuation of systemic therapy. J Neurosurg 2022; 137:544-554. [PMID: 34891140 DOI: 10.3171/2021.9.jns212150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patients with non-small cell lung cancer (NSCLC) metastatic to the brain are living longer. The risk of new brain metastases when these patients stop systemic therapy is unknown. The authors hypothesized that the risk of new brain metastases remains constant for as long as patients are off systemic therapy. METHODS A prospectively collected registry of patients undergoing radiosurgery for brain metastases was analyzed. Of 606 patients with NSCLC, 63 met the inclusion criteria of discontinuing systemic therapy for at least 90 days and undergoing active surveillance. The risk factors for the development of new tumors were determined using Cox proportional hazards and recurrent events models. RESULTS The median duration to new brain metastases off systemic therapy was 16.0 months. The probability of developing an additional new tumor at 6, 12, and 18 months was 26%, 40%, and 53%, respectively. There were no additional new tumors 22 months after stopping therapy. Patients who discontinued therapy due to intolerance or progression of the disease and those with mutations in RAS or receptor tyrosine kinase (RTK) pathways (e.g., KRAS, EGFR) were more likely to develop new tumors (hazard ratio [HR] 2.25, 95% confidence interval [CI] 1.33-3.81, p = 2.5 × 10-3; HR 2.51, 95% CI 1.45-4.34, p = 9.8 × 10-4, respectively). CONCLUSIONS The rate of new brain metastases from NSCLC in patients off systemic therapy decreases over time and is uncommon 2 years after cessation of cancer therapy. Patients who stop therapy due to toxicity or who have RAS or RTK pathway mutations have a higher rate of new metastases and should be followed more closely.
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Affiliation(s)
| | | | - Bernadine Donahue
- 2Radiation Oncology, and
- 3Department of Radiation Oncology, Maimonides Cancer Center, Brooklyn, New York
| | | | | | | | | | | | | | | | - Joshua K Sabari
- 4Medical Oncology, NYU Langone Health, Perlmutter Cancer Center, New York University, New York; and
| | - Elaine Shum
- 4Medical Oncology, NYU Langone Health, Perlmutter Cancer Center, New York University, New York; and
| | - Vamsidhar Velcheti
- 4Medical Oncology, NYU Langone Health, Perlmutter Cancer Center, New York University, New York; and
| | - Abraham Chachoua
- 4Medical Oncology, NYU Langone Health, Perlmutter Cancer Center, New York University, New York; and
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Huang H, Zhang D, Fu J, Zhao L, Li D, Sun H, Liu X, Xu J, Tian T, Zhang L, Liu Y, Zhang Y, Zhao Y. Tsukushi is a novel prognostic biomarker and correlates with tumor-infiltrating B cells in non-small cell lung cancer. Aging (Albany NY) 2021; 13:4428-4451. [PMID: 33428594 PMCID: PMC7906171 DOI: 10.18632/aging.202403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/03/2020] [Indexed: 01/21/2023]
Abstract
A recent study has reported that tsukushi (TSKU) may be related to the development of lung cancer. However, few studies focused on if TSKU associated with the prognosis and immune infiltration cells in non-small cell lung cancer (NSCLC). The effect of TSKU expression on prognosis with NSCLC was analyzed in the PrognoScan database and validated in The Cancer Genome Atlas. The composition of tumor infiltrating cells was quantified by methylation and expression data. We combined levels of tumor infiltrating cells with TSKU to evaluate the survival of patients. The analysis of a cohort (GSE31210, N=204) of lung cancer patients demonstrated that high TSKU expression was strongly associated with poor overall survival (P =1.90E-05). The combination of high TSKU expression and low infiltration B cells identified a subtype of patients with poor survival in NSCLC. Besides, the proportion of B cells in NSCLC patients with TSKU hypermethylation were higher than those patients with TSKU hypomethylation (P <0.001). Overall, high TSKU expression combined with low infiltration of B cells may associate with a poor prognosis of NSCLC patients. TSKU might be a potential prognostic biomarker involved in tumor immune infiltration in NSCLC.
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Affiliation(s)
- Hao Huang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Ding Zhang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Jinming Fu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Liyuan Zhao
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Dapeng Li
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Hongru Sun
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Xinyan Liu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Jing Xu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Tian Tian
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Lei Zhang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Ying Liu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Yuanyuan Zhang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Yashuang Zhao
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
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Development and Validation of a Seven-Gene Signature for Predicting the Prognosis of Lung Adenocarcinoma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1836542. [PMID: 33195688 PMCID: PMC7641279 DOI: 10.1155/2020/1836542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/23/2020] [Indexed: 01/31/2023]
Abstract
Background Prognosis is a main factor affecting the survival of patients with lung adenocarcinoma (LUAD), yet no robust prognostic model of high effectiveness has been developed. This study is aimed at constructing a stable and practicable gene signature-based model via bioinformatics methods for predicting the prognosis of LUAD sufferers. Methods The mRNA expression data were accessed from the TCGA-LUAD dataset, and paired clinical information was collected from the GDC website. R package “edgeR” was employed to select the differentially expressed genes (DEGs), which were then used for the construction of a gene signature-based model via univariate COX, Lasso, and multivariate COX regression analyses. Kaplan-Meier and ROC survival analyses were conducted to comprehensively evaluate the performance of the model in predicting LUAD prognosis, and an independent dataset GSE26939 was accessed for further validation. Results Totally, 1,655 DEGs were obtained, and a 7-gene signature-based risk score was developed and formulated as risk_score = 0.000245∗NTSR1 + (7.13E − 05)∗RHOV + 0.000505∗KLK8 + (7.01E − 05)∗TNS4 + 0.000288∗C1QTNF6 + 0.00044∗IVL + 0.000161∗B4GALNT2. Kaplan-Meier survival curves revealed that the survival rate of patients in the high-risk group was lower in both the TCGA-LUAD dataset and GSE26939 relative to that of patients in the low-risk group. The relationship between the risk score and clinical characteristics was further investigated, finding that the model was effective in prognosis prediction in the patients with different age (age > 65, age < 65) and TNM stage (N0&N1, T1&T2, and tumor stage I/II). In sum, our study provides a robust predictive model for LUAD prognosis, which boosts the clinical research on LUAD and helps to explore the mechanism underlying the occurrence and progression of LUAD.
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Šileikienė V, Gurskytė V, Zeleckienė I, Bernotienė E, Čibiras S. Pulmonary artery coil embolisation prevented tumour progression in a patient with advanced squamous cell lung carcinoma. Ups J Med Sci 2020; 125:257-261. [PMID: 32352322 PMCID: PMC7721007 DOI: 10.1080/03009734.2020.1753863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Squamous cell lung carcinoma (SqCLC) is a type of non-small-cell lung cancer, accounting for 25-30% of all lung cancer cases with a median advanced stage survival of 8-11 months. Here we present a rare case of long-term survival with metastatic SqCLC following coil embolisation of the right pulmonary artery.Case presentation: The 49-year-old patient was diagnosed with stage IV (cT4N3M1) SqCLC in 2007 due to a biopsy-proven central malignant tumour in the right lung and bilateral mediastinal lymphadenopathy. A magnetic resonance imaging scan also revealed a metastatic lesion in the liver. Soon after the diagnosis, the patient experienced pulmonary haemorrhage, which was managed by obturating the intermediate bronchus and performing coil embolisation of the right pulmonary artery. The patient also received chemotherapy in 2007 and 2009 without radiological changes. At three different time points in years 2010-2019, biopsies of the primary tumour were taken. All showed dense connective tissue with no indication of cancer growth. In 2020, a positron emission tomography scan showed no pathological metabolic activity in the lungs and liver. Currently, the patient remains in a stable clinical condition with a good performance status.Conclusion: The long-term clinical benefit indicates a direct effect of coil embolisation on tumour progression. We suggest that coil embolisation of tumour-feeding arteries could be considered as a potential treatment method for patients with SqCLC.
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Affiliation(s)
- Virginija Šileikienė
- Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Viktorija Gurskytė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- CONTACT Viktorija Gurskytė Faculty of Medicine, Vilnius University, M. K. Čiurlionio str. 21/27, LT-03101, Vilnius, Lithuania
| | - Ingrida Zeleckienė
- Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Elena Bernotienė
- Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Sigitas Čibiras
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Kotake M, Kuwako T, Imai H, Tomizawa Y, Kaira K, Yoshii A, Ochiai M, Miura Y, Osaki T, Sakurai R, Takei K, Minato K, Saito R. Phase II Study of Weekly Nanoparticle Albumin-Bound Paclitaxel as Second- or Third-Line Therapy in Patients with Advanced Non-Small Cell Lung Cancer. Chemotherapy 2020; 65:21-28. [PMID: 32674095 DOI: 10.1159/000508715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Treatment outcomes in patients with advanced non-small cell lung cancer (NSCLC) are poor due to limited treatment options. OBJECTIVE We conducted a multicenter, single-arm phase II study to prospectively assess the efficacy and safety of weekly nab-PTX in patients with advanced NSCLC with failed cytotoxic chemotherapy. METHODS Patients with advanced NSCLC having adequate organ functions with a performance status of 0-1 were enrolled. A 100 mg/m2 dose of nab-paclitaxel was administered on days 1, 8, and 15 of a 28-day cycle. Primary endpoint was the objective response rate (ORR). Secondary endpoints were disease control rate (DCR), toxicity profile, progression-free survival (PFS), and overall survival (OS). RESULTS Between September 2013 and May 2016, 35 patients were enrolled. The ORR was 31.4%, and the DCR was 74.3%. The median PFS was 3.6 months, and the median OS was 11.4 months. The most common grade 3 or 4 toxicities included neutropenia (54.3%), leukopenia (42.9%), and anemia (11.4%). Two patients discontinued chemotherapy due to pneumonitis. CONCLUSIONS Nab-PTX may be a later-line chemotherapeutic option for previously treated advanced NSCLC.
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Affiliation(s)
- Mie Kotake
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan, .,Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan,
| | - Tomohito Kuwako
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Yoshio Tomizawa
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Akihiro Yoshii
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Mai Ochiai
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Yosuke Miura
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan.,Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takashi Osaki
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Reiko Sakurai
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan.,Oncology Center, Gunma University Hospital, Maebashi, Japan
| | - Kousuke Takei
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan.,Division of Respiratory Medicine, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Ryusei Saito
- Department of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
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Sosa Iglesias V, van Hoof SJ, Vaniqui A, Schyns LE, Lieuwes N, Yaromina A, Spiegelberg L, Groot AJ, Verhaegen F, Theys J, Dubois L, Vooijs M. An orthotopic non-small cell lung cancer model for image-guided small animal radiotherapy platforms. Br J Radiol 2018; 92:20180476. [PMID: 30465693 DOI: 10.1259/bjr.20180476] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
METHODS: An orthotopic non-small cell lung cancer model in NMRI-nude mice was established to investigate the complementary information acquired from 80 kVp microcone-beam CT (micro-CBCT) and bioluminescence imaging (BLI) using different angles and filter settings. Different micro-CBCT-based radiation-delivery plans were evaluated based on their dose-volume histogram metrics of tumor and organs at risk to select the optimal treatment plan. RESULTS: H1299 cell suspensions injected directly into the lung render exponentially growing single tumor nodules whose CBCT-based volume quantification strongly correlated with BLI-integrated intensity. Parallel-opposed single angle beam plans through a single lung are preferred for smaller tumors, whereas for larger tumors, plans that spread the radiation dose across healthy tissues are favored. CONCLUSIONS: Closely mimicking a clinical setting for lung cancer with highly advanced preclinical radiation treatment planning is possible in mice developing orthotopic lung tumors. ADVANCES IN KNOWLEDGE: BLI and CBCT imaging of orthotopic lung tumors provide complementary information in a temporal manner. The optimal radiotherapy plan is tumor volume-dependent.
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Affiliation(s)
- Venus Sosa Iglesias
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | | | - Ana Vaniqui
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Lotte Ejr Schyns
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Natasja Lieuwes
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Ala Yaromina
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Linda Spiegelberg
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Arjan J Groot
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Frank Verhaegen
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Jan Theys
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Ludwig Dubois
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Marc Vooijs
- 1 Department of Radiotherapy, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
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