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Sun Y, Liu P, Wang Z, Zhang H, Xu Y, Hu S, Yan Y. Efficacy and indications of gamma knife radiosurgery for recurrent low-and high-grade glioma. BMC Cancer 2024; 24:37. [PMID: 38183008 PMCID: PMC10768340 DOI: 10.1186/s12885-023-11772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE To investigate the indications and efficacy of gamma knife radiosurgery (GKRS) as a salvage treatment for recurrent low-and high-grade glioma. METHODS This retrospective study of 107 patients with recurrent glioma treated with GKRS between 2009 and 2022, including 68 high-grade glioma (HGG) and 39 low-grade glioma (LGG) cases. The Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS). The log-rank test was used to analyze the multivariate prognosis of the Cox proportional hazards model. Adverse reactions were evaluated according to the Common Terminology Criteria for Adverse Events version 4.03. The prognostic value of main clinical features was estimated, including histopathology, Karnofsky performance status (KPS), recurrence time interval, target location, two or more GKRS, surgery for recurrence, site of recurrence, left or right side of the brain and so on. RESULTS The median follow-up time was 74.5 months. The median OS and PFS were 17.0 months and 5.5 months for all patients. The median OS and PFS were 11.0 months and 5.0 months for HGG, respectively. The median OS and PFS were 49.0 months and 12.0 months for LGG, respectively. Multivariate analysis showed that two or more GKRS, left or right side of the brain and brainstem significantly affected PFS. Meanwhile, the KPS index, two or more GKRS, pathological grade, and brainstem significantly affected OS. Stratified analysis showed that surgery for recurrence significantly affected OS and PFS for LGG. KPS significantly affected OS and PFS for HGG. No serious adverse events were noted post-GKRS. CONCLUSION GKRS is a safe and effective salvage treatment for recurrent glioma. Moreover, it can be applied after multiple recurrences with tolerable adverse effects.
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Affiliation(s)
- Ying Sun
- Department of Radiation Oncology, General Hospital of Northern Theater Command, 110016, Shenyang, China
| | - Peiru Liu
- Beifang Hospital of China Medical University, 110016, Shenyang, China
| | - Zixi Wang
- Graduate School of Dalian Medical University, 116000, Dalian, China
| | - Haibo Zhang
- Department of Radiation Oncology, General Hospital of Northern Theater Command, 110016, Shenyang, China
| | - Ying Xu
- Department of Radiation Oncology, General Hospital of Northern Theater Command, 110016, Shenyang, China
| | - Shenghui Hu
- Department of Radiation Oncology, General Hospital of Northern Theater Command, 110016, Shenyang, China
| | - Ying Yan
- Department of Radiation Oncology, General Hospital of Northern Theater Command, 110016, Shenyang, China.
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Grahm Valadie O, Brown SL, Farmer K, Nagaraja TN, Cabral G, Shadaia S, Divine GW, Knight RA, Lee IY, Dolan J, Rusu S, Joiner MC, Ewing JR. Characterization of the Response of 9L and U-251N Orthotopic Brain Tumors to 3D Conformal Radiation Therapy. Radiat Res 2023; 199:217-228. [PMID: 36656561 PMCID: PMC10174721 DOI: 10.1667/rade-22-00048.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 12/21/2022] [Indexed: 01/20/2023]
Abstract
In a study employing MRI-guided stereotactic radiotherapy (SRS) in two orthotopic rodent brain tumor models, the radiation dose yielding 50% survival (the TCD50) was sought. Syngeneic 9L cells, or human U-251N cells, were implanted stereotactically in 136 Fischer 344 rats or 98 RNU athymic rats, respectively. At approximately 7 days after implantation for 9L, and 18 days for U-251N, rats were imaged with contrast-enhanced MRI (CE-MRI) and then irradiated using a Small Animal Radiation Research Platform (SARRP) operating at 220 kV and 13 mA with an effective energy of ∼70 keV and dose rate of ∼2.5 Gy per min. Radiation doses were delivered as single fractions. Cone-beam CT images were acquired before irradiation, and tumor volumes were defined using co-registered CE-MRI images. Treatment planning using MuriPlan software defined four non-coplanar arcs with an identical isocenter, subsequently accomplished by the SARRP. Thus, the treatment workflow emulated that of current clinical practice. The study endpoint was animal survival to 200 days. The TCD50 inferred from Kaplan-Meier survival estimation was approximately 25 Gy for 9L tumors and below 20 Gy, but within the 95% confidence interval in U-251N tumors. Cox proportional-hazards modeling did not suggest an effect of sex, with the caveat of wide confidence intervals. Having identified the radiation dose at which approximately half of a group of animals was cured, the biological parameters that accompany radiation response can be examined.
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Affiliation(s)
- O. Grahm Valadie
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
- Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan
- Department of Radiation Oncology, Wayne State University, Detroit, Michigan
| | - Stephen L. Brown
- Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan
- Department of Radiation Oncology, Wayne State University, Detroit, Michigan
- Department of Radiology, Michigan State University College of Human Medicine, East Lansing, Michigan
| | - Katelynn Farmer
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
| | | | - Glauber Cabral
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
| | - Sheldon Shadaia
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
| | - George W. Divine
- Department of Public Health Sciences, Henry Ford Hospital, Detroit Michigan
| | - Robert A. Knight
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
- Department of Physics, Oakland University, Rochester, Michigan
| | - Ian Y. Lee
- Department of Neurosurgery, Henry Ford Hospital, Detroit Michigan
| | - Jennifer Dolan
- Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan
| | - Sam Rusu
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
| | - Michael C. Joiner
- Department of Radiation Oncology, Wayne State University, Detroit, Michigan
| | - James R. Ewing
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan
- Department of Radiology, Michigan State University College of Human Medicine, East Lansing, Michigan
- Department of Neurosurgery, Henry Ford Hospital, Detroit Michigan
- Department of Physics, Oakland University, Rochester, Michigan
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Shtam T, Burdakov V, Garina A, Garaeva L, Tran NH, Volnitskiy A, Kuus E, Amerkanov D, Pack F, Andreev G, Lubinskiy A, Shabalin K, Verlov N, Ivanov E, Ezhov V, Lebedev D, Konevega AL. Experimental validation of proton boron capture therapy for glioma cells. Sci Rep 2023; 13:1341. [PMID: 36693879 PMCID: PMC9873635 DOI: 10.1038/s41598-023-28428-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Proton boron capture therapy (PBCT) has emerged from particle acceleration research for enhancing the biological effectiveness of proton therapy. The mechanism responsible for the dose increase was supposed to be related to proton-boron fusion reactions (11B + p → 3α + 8.7 MeV). There has been some experimental evidence that the biological efficiency of protons is significantly higher for boron-11-containing prostate or breast cancer cells. The aim of this study was to evaluate the sensitizing potential of sodium borocaptate (BSH) under proton irradiation at the Bragg peak of cultured glioma cells. To address this problem, cells of two glioma lines were preincubated with 80 or 160 ppm boron-11, irradiated both at the middle of 200 MeV beam Spread-Out Bragg Peak (SOBP) and at the distal end of the 89.7 MeV beam SOBP and assessed for the viability, as well as their ability to form colonies. Our results clearly show that BSH provides for only a slight, if any, enhancement of the effect of proton radiation on the glioma cells in vitro. In addition, we repeated the experiments using the Du145 prostate cancer cell line, for which an increase in the biological efficiency of proton irradiation in the presence of sodium borocaptate was demonstrated previously. The data presented add new argument against the efficiency of proton boron capture therapy when based solely on direct dose-enhancement effect by the proton capture nuclear reaction, underlining the need to investigate the indirect effects of the secondary alpha irradiation depending on the state and treatment conditions of the irradiated tissue.
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Affiliation(s)
- Tatiana Shtam
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300. .,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182. .,Institute of Cytology of Russian Academy of Sciences, St. Petersburg, Russian Federation.
| | - Vladimir Burdakov
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Alina Garina
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182.,Peter the Great St.Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg, Russian Federation
| | - Luiza Garaeva
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182.,Peter the Great St.Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg, Russian Federation
| | - Nhan Hau Tran
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,Peter the Great St.Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg, Russian Federation
| | - Andrey Volnitskiy
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Eva Kuus
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,Peter the Great St.Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg, Russian Federation.,Proton Therapy Center MIBS, St. Petersburg, Russian Federation
| | - Dmitry Amerkanov
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Fedor Pack
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Georgy Andreev
- Proton Therapy Center MIBS, St. Petersburg, Russian Federation
| | | | - Konstantin Shabalin
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Nicolay Verlov
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Evgeniy Ivanov
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300
| | - Victor Ezhov
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300
| | - Dmitry Lebedev
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300.,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182
| | - Andrey L Konevega
- Petersburg Nuclear Physics Institute Named By B.P. Konstantinov of National Research Centre "Kurchatov Institute", Leningradskaya Oblast, Mkr. Orlova Roshcha 1, Gatchina, Russian Federation, 188300. .,National Research Center "Kurchatov Institute", Akademika Kurchatova Pl. 1, Moscow, Russian Federation, 123182. .,Peter the Great St.Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg, Russian Federation.
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Li L, Yuan Y, Zuo Y. A review of the impact of FLASH radiotherapy on the central nervous system and glioma. Radiation Medicine and Protection 2022. [DOI: 10.1016/j.radmp.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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5
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Rodríguez-Camacho A, Flores-Vázquez JG, Moscardini-Martelli J, Torres-Ríos JA, Olmos-Guzmán A, Ortiz-Arce CS, Cid-Sánchez DR, Pérez SR, Macías-González MDS, Hernández-Sánchez LC, Heredia-Gutiérrez JC, Contreras-Palafox GA, Suárez-Campos JDJE, Celis-López MÁ, Gutiérrez-Aceves GA, Moreno-Jiménez S. Glioblastoma Treatment: State-of-the-Art and Future Perspectives. Int J Mol Sci 2022; 23:ijms23137207. [PMID: 35806212 PMCID: PMC9267036 DOI: 10.3390/ijms23137207] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/09/2022] [Accepted: 06/25/2022] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Glioblastoma is the most frequent and lethal primary tumor of the central nervous system. Through many years, research has brought various advances in glioblastoma treatment. At this time, glioblastoma management is based on maximal safe surgical resection, radiotherapy, and chemotherapy with temozolomide. Recently, bevacizumab has been added to the treatment arsenal for the recurrent scenario. Nevertheless, patients with glioblastoma still have a poor prognosis. Therefore, many efforts are being made in different clinical research areas to find a new alternative to improve overall survival, free-progression survival, and life quality in glioblastoma patients. (2) Methods: Our objective is to recap the actual state-of-the-art in glioblastoma treatment, resume the actual research and future perspectives on immunotherapy, as well as the new synthetic molecules and natural compounds that represent potential future therapies at preclinical stages. (3) Conclusions: Despite the great efforts in therapeutic research, glioblastoma management has suffered minimal changes, and the prognosis remains poor. Combined therapeutic strategies and delivery methods, including immunotherapy, synthetic molecules, natural compounds, and glioblastoma stem cell inhibition, may potentiate the standard of care therapy and represent the next step in glioblastoma management research.
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Affiliation(s)
- Alejandro Rodríguez-Camacho
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - José Guillermo Flores-Vázquez
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
- Correspondence:
| | - Júlia Moscardini-Martelli
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Jorge Alejandro Torres-Ríos
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Alejandro Olmos-Guzmán
- Hospital de Especialidades No.1 Centro Médico Nacional del Bajío, León 37680, Mexico; (A.O.-G.); (C.S.O.-A.)
| | - Cindy Sharon Ortiz-Arce
- Hospital de Especialidades No.1 Centro Médico Nacional del Bajío, León 37680, Mexico; (A.O.-G.); (C.S.O.-A.)
| | - Dharely Raquel Cid-Sánchez
- Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (D.R.C.-S.); (S.R.P.)
| | - Samuel Rosales Pérez
- Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (D.R.C.-S.); (S.R.P.)
| | | | - Laura Crystell Hernández-Sánchez
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Juan Carlos Heredia-Gutiérrez
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Gabriel Alejandro Contreras-Palafox
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - José de Jesús Emilio Suárez-Campos
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Miguel Ángel Celis-López
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Guillermo Axayacalt Gutiérrez-Aceves
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
| | - Sergio Moreno-Jiménez
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City 14269, Mexico; (A.R.-C.); (J.M.-M.); (J.A.T.-R.); (L.C.H.-S.); (J.C.H.-G.); (G.A.C.-P.); (J.d.J.E.S.-C.); (M.Á.C.-L.); (G.A.G.-A.); (S.M.-J.)
- American British Cowdray Medical Center, Cancer Center, Mexico City 01120, Mexico
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Vlasov S, Yengibaryan M, Shikhlyarova A, Sakun P, Voshedsky V, Rodionova O, Karnaukhova E, Solntseva A, Khatyushin V, Pandova O, Kuznetsova N, Kabanov S, Teplyakova M. Development of adaptive stereotactic radiotherapy method in treatment of primary malignant glial tumors in the brain. CM 2022. [DOI: 10.18137/cardiometry.2022.22.6976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
At present, there are some scattered evidence data pertaining to the use of an adaptive technique of radiotherapy in treatment of malignant glial tumors of the brain. Our evidence data obtained in MRI in the course of treatment show that the initial treatment plan may become irrelevant due to some changes observed in the tumor configuration. In its turn, it bears witness to the topicality of developing and introducing adaptive methods and techniques in the brain tumor treatment, which are capable to increase efficacy and tolerability in patients with primary malignant tumors of the brain. Aim. Our aim has been to develop an adaptive stereotactic method of radiotherapy in treatment of primary malignant brain tumors, which shall be capable to increase efficacy and tolerability of radiation therapy as well as reduce radiation dose to normal structures in the brain. Materials and methods. Our method has been elaborated with recruiting a group of 10 patients diagnosed with primary glioblastoma G IV, which have received specialized treatment at the National Medical Research Centre for Oncology at the Ministry of Health, the Russian Federation, in the period 2021-2022. The average age of the above patients is 43,4 years. All patients have undergone microsurgery covering the total resection of the tumor (3 patients) and subtotal removal of the malignant tumor (7 patients). The average time interval between the surgery and radiotherapy is 32,5 days. Before treatment, an intravenous contrast enhancement MRI of the brain with an axial pitch of 1 mm has been conducted employing the contrast T1, contrast-free T1 and T2 FLAIR modes. Planning of radiotherapy for this sort of patients has been carried out employing BrainLab Elements и Varian Medical Systems Eclipse. The CTV was defined as a 2,0 cm margin around GTV with an anatomical correction. The CTV-to-PTV margin was 0,1 cm. Doses have been administered as follows: a single dose of 2 Gy up to a total dose of 60 Gy in 30 fractions. The brain has been MRI-scanned in all patients with the use of intravenously introduced contrast agents with an axial pitch of 1 mm employing enhanced contrast/contrast-free T1 sequences and T2 FLAIR to redefine the radiotherapy targets (GTV, CTV, PTV). At fraction 30 we have completed MRI in order to estimate the treatment outcome. In the average, the radiotherapy course has taken 42-45 days, holidays included. For the purpose of the radiation therapy, used have been the Novalis Tx Varian Tx linear accelerator of kinetic energy of the beam of 6 MeV. Results We have developed our own adaptive stereotactic method of radiotherapy to treat the primary malignant glial tumors in the brain, which is capable of tracing the configuration of the post-surgery cavity, the residual tumor and the brain structures in the course of radiotherapy and adapting the therapy plan thereto that makes possible to reduce tissue volumes exposed to radiation due to a decrease in the tumoral and peritumoral volumes of the tumor and post-operative cavity. Conclusion. Our analysis has shown that in the course of radiotherapy some anatomical changes in the tumor configuration are found. An adaptive approach applied to radiation therapy allows monitoring the above changing volumes and correcting the treatment plan.
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Ren J, Xu Y, Liu J, Wu S, Zhang R, Cao H, Sun J. MAP3K8 Is a Prognostic Biomarker and Correlated With Immune Response in Glioma. Front Mol Biosci 2022; 8:779290. [PMID: 35004849 PMCID: PMC8733582 DOI: 10.3389/fmolb.2021.779290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
MAP3K8 is a serine/threonine kinase that is widely expressed in immune cells, non-immune cells, and many tumor types. The expression, clinical significance, biological role, and the underlying molecular mechanisms of MAP3K8 in glioma have not been investigated yet. Here, we discovered that MAP3K8 was aberrantly overexpressed in glioma and correlated with poor clinicopathological features of glioma by analysis on different datasets and immunohistochemistry staining. MAP3K8 is an independent prognostic indicator and significantly correlates with the progression of glioma. We also performed the function and pathway enrichment analysis of MAP3K8 in glioma to explore its biological functions and underlying molecular mechanisms in glioma. MAP3K8 co-expressed genes were mainly enriched in immune-related biological processes such as neutrophil activation, leukocyte migration, neutrophil-mediated immunity, lymphocyte-mediated immunity, T-cell activation, leukocyte cell–cell adhesion, regulation of leukocyte cell–cell adhesion, B-cell-mediated immunity, myeloid cell differentiation, and regulation of cell–cell adhesion. Single-cell RNA sequencing data and immunohistochemistry analysis demonstrated that MAP3K8 is expressed in malignant and immune cells and mainly enriched in the microglia/macrophage cells of glioma. The expression of MAP3K8 was positively correlated with immune infiltration, including effector memory CD4+ T cells, plasmacytoid dendritic cells, neutrophils, myeloid dendritic cells, mast cells, and macrophage in glioma. Further correlation analysis demonstrated that a series of inhibitory immune checkpoint molecules, chemokines, and chemokine receptors was positively correlated with the expression of MAP3K8. MAP3K8 might play an essential role in tumor immunity, and inhibition of MPA3K8 is a plausible strategy for glioma immunotherapy.
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Affiliation(s)
- Jing Ren
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Yixin Xu
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, China
| | - Jia Liu
- Department of Pathology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Sicheng Wu
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Ruihan Zhang
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Haowei Cao
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Jinmin Sun
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China.,Laboratory of Clinical and Experimental Pathology, Department of Pathology, Xuzhou Medical University, Xuzhou, China
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El-Benhawy SA, Sakr OA, Fahmy EI, Ali RA, Hussein MS, Nassar EM, Salem SM, Abu-Samra N, Elzawawy S. Assessment of Serum Hypoxia Biomarkers Pre- and Post-radiotherapy in Patients with Brain Tumors. J Mol Neurosci 2022; 72:2303-12. [PMID: 36121548 DOI: 10.1007/s12031-022-02065-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/02/2022] [Indexed: 12/13/2022]
Abstract
Hypoxia is a prevalent hallmark of many malignant neoplasms. The aim was to assess the serum hypoxia biomarkers HIF-1α, VEGF, osteopontin, erythropoietin, caveolin-1, GLUT-1, and LDH pre- and post-radiotherapy in patients with brain tumors. The study was conducted on 120 subjects were divided into two groups: group I: 40 healthy volunteers as control group. Group II: 80 brain tumor patients were subdivided into glioblastoma subgroup: 40 glioblastoma patients, meningioma subgroup: 40 malignant meningioma patients. Two venous blood samples were collected from every patient prior to and following RT and one sample from controls. Biomarkers were assayed by ELISA. In glioblastoma subgroup, HIF-1α, VEGF, and LDH were significantly increased after RT. On the contrary, these biomarkers were significantly decreased after RT in malignant meningioma subgroup. Osteopontin was significantly increased after RT in both subgroups. Regarding erythropoietin, it was significantly decreased in both subgroups when compared to before RT. Caveolin-1 showed a significant increase in glioblastoma subgroup after RT comparing to before RT. GLUT-1 was significantly increased after RT in both subgroups comparing to before RT. Association of significant elevation of hypoxia biomarkers either pre- or post-RT with aggressive tumor such as glioblastoma indicates that, they are markers of malignancy and may have a role in tumor development and progression.
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Politko MO, Tsidulko AY, Pashkovskaya OA, Kuper KE, Suhovskih AV, Kazanskaya GM, Klyushova LS, Sokolov DK, Volkov AM, Kliver EE, Zheravin AA, Aidagulova SV, Grigorieva EV. Multiple Irradiation Affects Cellular and Extracellular Components of the Mouse Brain Tissue and Adhesion and Proliferation of Glioblastoma Cells in Experimental System In Vivo. Int J Mol Sci 2021; 22:13350. [PMID: 34948147 DOI: 10.3390/ijms222413350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 12/11/2022] Open
Abstract
Intensive adjuvant radiotherapy (RT) is a standard treatment for glioblastoma multiforme (GBM) patients; however, its effect on the normal brain tissue remains unclear. Here, we investigated the short-term effects of multiple irradiation on the cellular and extracellular glycosylated components of normal brain tissue and their functional significance. Triple irradiation (7 Gy*3 days) of C57Bl/6 mouse brain inhibited the viability, proliferation and biosynthetic activity of normal glial cells, resulting in a fast brain-zone-dependent deregulation of the expression of proteoglycans (PGs) (decorin, biglycan, versican, brevican and CD44). Complex time-point-specific (24–72 h) changes in decorin and brevican protein and chondroitin sulfate (CS) and heparan sulfate (HS) content suggested deterioration of the PGs glycosylation in irradiated brain tissue, while the transcriptional activity of HS-biosynthetic system remained unchanged. The primary glial cultures and organotypic slices from triple-irradiated brain tissue were more susceptible to GBM U87 cells’ adhesion and proliferation in co-culture systems in vitro and ex vivo. In summary, multiple irradiation affects glycosylated components of normal brain extracellular matrix (ECM) through inhibition of the functional activity of normal glial cells. The changed content and pattern of PGs and GAGs in irradiated brain tissues are accompanied by the increased adhesion and proliferation of GBM cells, suggesting a novel molecular mechanism of negative side-effects of anti-GBM radiotherapy.
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