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Fiorino C, Palumbo D, Mori M, Palazzo G, Pellegrini AE, Albarello L, Belardo A, Canevari C, Cossu A, Damascelli A, Elmore U, Mazza E, Pavarini M, Passoni P, Puccetti F, Slim N, Steidler S, Del Vecchio A, Di Muzio NG, Chiti A, Rosati R, De Cobelli F. Early regression index (ERI) on MR images as response predictor in esophageal cancer treated with neoadjuvant chemo-radiotherapy: Interim analysis of the prospective ESCAPE trial. Radiother Oncol 2024; 194:110160. [PMID: 38369025 DOI: 10.1016/j.radonc.2024.110160] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE The early regression index (ERI) predicts treatment response in rectal cancer patients. Aim of current study was to prospectively assess tumor response to neoadjuvant chemo-radiotherapy (nCRT) of locally advanced esophageal cancer using ERI, based on MRI. MATERIAL AND METHODS From January 2020 to May 2023, 30 patients with esophageal cancer were enrolled in a prospective study (ESCAPE). PET-MRI was performed: i) before nCRT (tpre); ii) at mid-radiotherapy, tmid; iii) after nCRT, 2-6 weeks before surgery (tpost); nCRT delivered 41.4 Gy/23fr with concurrent carboplatin and paclitaxel. For patients that skipped surgery, complete clinical response (cCR) was assessed if patients showed no local relapse after 18 months; patients with pathological complete response (pCR) or with cCR were considered as complete responders (pCR + cCR). GTV volumes were delineated by two observers (Vpre, Vmid, Vpost) on T2w MRI: ERI and other volume regression parameters at tmid and tpost were tested as predictors of pCR + cCR. RESULTS Complete data of 25 patients were available at the time of the analysis: 3/25 with complete response at imaging refused surgery and 2/3 were cCR; in total, 10/25 patients showed pCR + cCR (pCR = 8/22). Both ERImid and ERIpost classified pCR + cCR patients, with ERImid showing better performance (AUC:0.78, p = 0.014): A two-variable logistic model combining ERImid and Vpre improved performances (AUC:0.93, p < 0.0001). Inter-observer variability in contouring GTV did not affect the results. CONCLUSIONS Despite the limited numbers, interim analysis of ESCAPE study suggests ERI as a potential predictor of complete response after nCRT for esophageal cancer. Further validation on larger populations is warranted.
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Affiliation(s)
- C Fiorino
- Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy.
| | - D Palumbo
- Radiology, IRCCS San Raffaele Hospital, Milano, Italy
| | - M Mori
- Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy
| | - G Palazzo
- Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy
| | | | - L Albarello
- Pathology, IRCCS San Raffaele Hospital, Milano, Italy
| | - A Belardo
- Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy
| | - C Canevari
- Nuclear Medicine, IRCCS San Raffaele Hospital, Milano, Italy
| | - A Cossu
- Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy
| | - A Damascelli
- Radiology, IRCCS San Raffaele Hospital, Milano, Italy
| | - U Elmore
- Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy
| | - E Mazza
- Oncology, IRCCS San Raffaele Hospital, Milano, Italy
| | - M Pavarini
- Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy
| | - P Passoni
- Radiotherapy, IRCCS San Raffaele Hospital, Milano, Italy
| | - F Puccetti
- Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy
| | - N Slim
- Radiotherapy, IRCCS San Raffaele Hospital, Milano, Italy
| | - S Steidler
- Radiology, IRCCS San Raffaele Hospital, Milano, Italy
| | - A Del Vecchio
- Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy
| | - N G Di Muzio
- Radiotherapy, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy
| | - A Chiti
- Nuclear Medicine, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy
| | - R Rosati
- Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy
| | - F De Cobelli
- Radiology, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy
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Fodor A, Brombin C, Deantoni CL, Giannini L, Ferrario F, Villa SL, Mangili P, Rancoita PMV, Cozzarini C, Picchio M, Del Vecchio A, Fiorino C, Di Serio MCS, Chiti A, Di Muzio NG. Extended nodal radiotherapy for prostate cancer relapse guided with [11C]-choline PET/CT: ten-year results in patients enrolled in a prospective trial. Eur J Nucl Med Mol Imaging 2024; 51:590-603. [PMID: 37747578 DOI: 10.1007/s00259-023-06445-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
AIMS To report long-term outcomes of relapsed prostate cancer (PC) patients treated in a prospective single-arm study with extended-nodal radiotherapy (ENRT) and [11C]-choline positron emission tomography (PET)/computed tomography (CT)-guided simultaneous integrated boost (SIB) to positive lymph nodes (LNs). METHODS From 12/2009 to 04/2015, 60 PC patients with biochemical relapse and positive LNs only were treated in this study. ENRT at a median total dose (TD) = 51.8 Gy/28 fr and PET/CT-guided SIB to positive LNs at a median TD = 65.5 Gy was prescribed. Median PSA at relapse was 2.3 (interquartile range, IQR:1.3-4.0) ng/ml. Median number of positive LNs: 2 (range: 1-18). Androgen deprivation therapy (ADT) was prescribed for 48 patients for a median of 30.7 (IQR: 18.5-43.1) months. RESULTS Median follow-up from the end of salvage treatment was 121.8 (IQR: 116.1, 130.9) months; 3-, 5-, and 10-year BRFS were 45.0%, 36.0%, and 24.0%, respectively; DMFS: 67.9%, 57.2%, and 45.2%; CRFS: 62.9%, 53.9%, and 42.0%; and OS: 88.2%, 76.3%, and 47.9%, respectively. Castration resistance (p < 0.0001) and ≥ 6 positive LN (p = 0.0024) significantly influenced OS at multivariate analysis. Castration resistance (p < 0.0001 for both) influenced DMFS and CRFS in multivariate analysis. CONCLUSIONS In PC relapsed patients treated with ENRT and [11C]-choline-PET/CT-guided SIB for positive LNs, with 10-year follow-up, a median Kaplan-Meier estimate CRFS of 67 months and OS of 110 months were obtained. These highly favorable results should be confirmed in a prospective, randomized trial.
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Affiliation(s)
- A Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - C Brombin
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - C L Deantoni
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Giannini
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Ferrario
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S L Villa
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - P Mangili
- Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - P M V Rancoita
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - C Cozzarini
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Picchio
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Del Vecchio
- Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Fiorino
- Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M C S Di Serio
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - A Chiti
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - N G Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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Cicchetti A, Mangili P, Fodor A, Mori M, Chiara A, Deantoni C, Pasetti M, Palazzo G, Ubeira Gabellini MG, Rancati T, Del Vecchio A, Muzio NGD, Fiorino C. Dosimetry Predictors of Late Skin Reactions after Whole Breast Radiotherapy on a Large Mono-Institutional Cohort of Patients. Int J Radiat Oncol Biol Phys 2023; 117:e171. [PMID: 37784780 DOI: 10.1016/j.ijrobp.2023.06.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To develop an NTCP model predicting late skin toxicity using dosimetric parameters from the breast dermis to identify possible RT constraints on such a structure. MATERIALS/METHODS The skin structure was defined as the 5 mm inner isotropic expansion from the outer CT body contour. It was retrospectively segmented on a large mono-Institutional cohort of early-stage breast cancer patients enrolled between 2009 and 2017 (n = 1066). Patients were treated with tangential-field RT, delivering 40 Gy in 15 fractions without a RT boost. Toxicity was reported during FU using SOMA/LENT scoring. The study endpoint was moderate-severe late toxicity consisting of Fibrosis-Atrophy-Telangiectasia-Pain (FATP G2+) developed within 42 months after RT completion. Automatic delineation of skin and DVH extraction were accomplished by scripting using the MIM_assistant software. Also, the impact of changes in the dose calculation algorithms during enrolment time was quantified. A logistic model was created by combining multifactorial variables, considering both clinical factors and the absolute skin DVH (cc). Variance Inflation Factor (VIF) was performed to reduce the multicollinearity. Repeated 5-fold cross-validation with SMOTE approach to overcome the class unbalance was applied for model feature selection. The predictive model was then developed on the entire population due to the limited G2+ events. RESULTS The FATP G2+ rate was 3.8% with 40/1066 experiencing late toxicity. Among them, a 40% had already developed acute symptoms after RT completion showing a consequential effect. The multicollinearity analysis selected 27 clinical-treatment-dosimetric factors. After repeated (20 times) 5-fold cross-validation, the best-performing model included Post-Surgery Cosmetic alterations, Aromatase Inhibitors (as a protective factor), V20 Gy (50% of the prescribed dose - DVH plateau region) and V42 Gy (105% of the prescribed dose - DVH high-dose tail). Accuracy and f1-score were 0.76 and 0.58 in both training and test sets, providing good reliability for selected variables. AUC for the final model on the entire population was 0.76+/-0.04. CONCLUSION We quantified the association between fibrosis and skin DVH when delivering 40 Gy in 15fr. The model suggested an independent role of V20 and V42 Gy and a heavy risk modulation by surgical effects and aromatase inhibitors. This last factor could interfere with adipose tissue and water-content distribution within the breast. For this purpose, a CT-based densitometry characterization of toxicity patients is ongoing.
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Affiliation(s)
- A Cicchetti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Data Science Unit, Milan, Italy
| | - P Mangili
- San Raffaele Scientific Institute, Milan, Italy
| | - A Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Mori
- San Raffaele Scientific Institute - IRCCS, Milano, Italy
| | - A Chiara
- San Raffaele Scientific Institute, Milan, Italy
| | - C Deantoni
- San Raffaele Scientific Institute, Milan, Italy
| | - M Pasetti
- San Raffaele Scientific Institute, Milano, Italy
| | - G Palazzo
- San Raffaele Scientific Institute, Milan, Italy
| | | | - T Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Data Science Unit, Milan, Italy
| | | | - N G Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Fiorino
- San Raffaele Scientific Institute - IRCCS, Milano, Italy
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Sosa-Marrero C, Acosta O, Pasquier D, Thariat J, Delpon G, Fiorino C, Rancatti T, Malard O, Foray N, de Crevoisier R. Voxel-wise analysis: A powerful tool to predict radio-induced toxicity and potentially perform personalised planning in radiotherapy. Cancer Radiother 2023; 27:638-642. [PMID: 37517974 DOI: 10.1016/j.canrad.2023.06.024] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023]
Abstract
Dose - volume histograms have been historically used to study the relationship between the planned radiation dose and healthy tissue damage. However, this approach considers neither spatial information nor heterogenous radiosensitivity within organs at risk, depending on the tissue. Recently, voxel-wise analyses have emerged in the literature as powerful tools to fully exploit three-dimensional information from the planned dose distribution. They allow to identify anatomical subregions of one or several organs in which the irradiation dose is associated with a given toxicity. These methods rely on an accurate anatomical alignment, usually obtained by means of a non-rigid registration. Once the different anatomies are spatially normalised, correlations between the three-dimensional dose and a given toxicity can be explored voxel-wise. Parametric or non-parametric statistical tests can be performed on every voxel to identify the voxels in which the dose is significantly different between patients presenting or not toxicity. Several anatomical subregions associated with genitourinary, gastrointestinal, cardiac, pulmonary or haematological toxicity have already been identified in the literature for prostate, head and neck or thorax irradiation. Voxel-wise analysis appears therefore first particularly interesting to increase toxicity prediction capability by identifying specific subregions in the organs at risk whose irradiation is highly predictive of specific toxicity. The second interest is potentially to decrease the radio-induced toxicity by limiting the dose in the predictive subregions, while not decreasing the dose in the target volume. Limitations of the approach have been pointed out.
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Affiliation(s)
- C Sosa-Marrero
- Université de Rennes, CLCC Eugène-Marquis, Inserm, LTSI - UMR 1099, 35000 Rennes, France
| | - O Acosta
- Université de Rennes, CLCC Eugène-Marquis, Inserm, LTSI - UMR 1099, 35000 Rennes, France
| | - D Pasquier
- Radiotherapy Department, centre Oscar-Lambret, 59000 Lille, France; Université de Lille, CNRS, école centrale de Lille, Cristal UMR 9189, Lille, France
| | - J Thariat
- Department of Radiation Oncology, centre François-Baclesse, 14000 Caen, France
| | - G Delpon
- Medical physics department, institut de cancérologie de l'Ouest, IMT Atlantique, Nantes université, CNRS/IN2P3, Subatech, Nantes, France
| | - C Fiorino
- Medical Physics, San Raffaele Scientific Institute, Via Olgettina 690, 20132 Milan, Italy
| | - T Rancatti
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - O Malard
- Service de chirurgie oto-rhinolaryngologique (ORL) et chirurgie cervicofaciale, Hôtel-Dieu, CHU de Nantes, Nantes, France
| | - N Foray
- Centre Léon-Bérard, Inserm U1296 "Radiation: Defense/Health/Environment", 69008 Lyon, France
| | - R de Crevoisier
- Université de Rennes, CLCC Eugène-Marquis, Inserm, LTSI - UMR 1099, 35000 Rennes, France; Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France.
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Iacovacci J, Palorini F, Cicchetti A, Fiorino C, Rancati T. Dependence of the AUC of NTCP models on the observational dose-range highlights cautions in comparison of discriminative performance. Phys Med 2023; 113:102654. [PMID: 37579522 DOI: 10.1016/j.ejmp.2023.102654] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/19/2023] [Accepted: 08/05/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Normal tissue complication probability (NTCP) models are probabilistic models that describe the risk of radio-induced toxicity in tissues or organs. In the field of radiotherapy, the area under the ROC curve (AUC) is widely used to estimate the performance in risk prediction of NTCP models. METHODS In this work, we derived an analytical expression of the AUC for the logistic NTCP model in the case of both symmetrical and asymmetrical dose (to the normal tissue) windows around D50. Using numerical simulations, we studied the behavior of the AUC in general clinical settings, enforcing non-logistic NTCP models (Lyman-Kutcher-Burman and LogEUD) and including risk factors beyond the dose. We validated our findings using real-world radiotherapy data sets of prostate cancer patients. RESULTS Our analytical expression of the AUC made explicit the dependence on both the steepness of the logistic curve (β) and the dose window width (w), showing that an increase of w pushes AUC towards higher values. Increasing values of the AUC with increasing values of w were consistently observed across simulated data sets with diverse clinical settings from published studies and real clinical data sets. CONCLUSION Our results reveal that the AUC of NTCP models inherits intrinsic characteristics from the clinical setting of the data set on which the models are developed, and warn against the use of the AUC to compare the performance of models constructed upon data from trials in which substantially different dose ranges were administered or accounting for different risk factors beyond the dose.
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Affiliation(s)
- J Iacovacci
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Palorini
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Cicchetti
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C Fiorino
- Medical Physics Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - T Rancati
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Nuccio A, Torrisi M, Ogliari F, Giannini L, Pasetti M, Fodor A, Gigliotti C, Fiorino C, Arcangeli S, Bulotta A, Dell'Oca I, Cascinu S, Di Muzio N. 105P Thoracic radiotherapy and tyrosine kinase inhibitors association: Results from a monoinstitutional experience. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100963] [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: 04/05/2023] Open
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Abstract
OBJECTIVES Sepsis causes significant mortality. However, most patients who die of sepsis do not present with severe infection, hampering efforts to deliver early, aggressive therapy. It is also known that the host gene expression response to infection precedes clinical illness. This study seeks to develop transcriptomic models to predict progression to sepsis or shock within 72 hours of hospitalization and to validate previously identified transcriptomic signatures in the prediction of 28-day mortality. DESIGN Retrospective differential gene expression analysis and predictive modeling using RNA sequencing data. PATIENTS Two hundred seventy-seven patients enrolled at four large academic medical centers; all with clinically adjudicated infection were considered for inclusion in this study. MEASUREMENTS AND MAIN RESULTS Sepsis progression was defined as an increase in Sepsis 3 category within 72 hours. Transcriptomic data were generated using RNAseq of whole blood. Least absolute shrinkage and selection operator modeling was used to identify predictive signatures for various measures of disease progression. Four previously identified gene signatures were tested for their ability to predict 28-day mortality. There were no significant differentially expressed genes in 136 subjects with worsened Sepsis 3 category compared with 141 nonprogressor controls. There were 1,178 differentially expressed genes identified when sepsis progression was defined as ICU admission or 28-day mortality. A model based on these genes predicted progression with an area under the curve of 0.71. Validation of previously identified gene signatures to predict sepsis mortality revealed area under the receiver operating characteristic values of 0.70-0.75 and no significant difference between signatures. CONCLUSIONS Host gene expression was unable to predict sepsis progression when defined by an increase in Sepsis-3 category, suggesting this definition is not a useful framework for transcriptomic prediction methods. However, there was a differential response when progression was defined as ICU admission or death. Validation of previously described signatures predicted 28-day mortality with insufficient accuracy to offer meaningful clinical utility.
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Affiliation(s)
- Cassandra Fiorino
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Yiling Liu
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Ricardo Henao
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
| | - Emily R. Ko
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
- Duke Regional Hospital, Durham, NC, USA
| | - Thomas W. Burke
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Geoffrey S. Ginsburg
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Micah T. McClain
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Medical Service, Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Christopher W. Woods
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Medical Service, Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Ephraim L. Tsalik
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, USA
- Emergency Medicine Service, Durham Veterans Affairs Health Care System, Durham, NC, USA
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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Seidenfeld J, Tupetz A, Fiorino C, Limkakeng A, Silva L, Staton C, Vissoci JRN, Purakal J. Experiences of COVID-19 infection in North Carolina: A qualitative analysis. PLoS One 2022; 17:e0269338. [PMID: 35653407 PMCID: PMC9162358 DOI: 10.1371/journal.pone.0269338] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/18/2022] [Indexed: 11/02/2022] Open
Abstract
Background and aim
It has been demonstrated that marginalized populations across the U.S. have suffered a disproportionate burden of the coronavirus disease 2019 (COVID-19) pandemic, illustrating the role that social determinants of health play in health outcomes. To better understand how these vulnerable and high-risk populations have experienced the pandemic, we conducted a qualitative study to better understand their experiences from diagnosis through recovery.
Methods
We conducted a qualitative study of patients in a North Carolina healthcare system’s registry who tested positive for COVID-19 from March 2020 through February 2021, identified from population-dense outbreaks of COVID-19 (hotspots). We conducted semi-structured phone interviews in English or Spanish, based on patient preference, with trained bilingual study personnel. Each interview was evaluated using a combination of deductive and inductive content analysis to determine prevalent themes related to COVID-19 knowledge, diagnosis, disease experience, and long-term impacts.
Findings
The 10 patients interviewed from our COVID-19 hotspot clusters were of equal distribution by sex, predominantly Black (70%), aged 22–70 years (IQR 45–62 years), and more frequently publicly insured (50% Medicaid/Medicare, vs 30% uninsured, vs 20% private insurance). Major themes identified included prior knowledge of COVID-19 and patient perceptions of their personal risk, the testing process in numerous settings, the process of quarantining at home after a positive diagnosis, the experience of receiving medical care during their illness, and difficulties with long-term recovery.
Discussion
Our findings suggest areas for targeted interventions to reduce COVID-19 transmission in these high-risk communities, as well as improve the patient experience throughout the COVID-19 illness course.
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Affiliation(s)
- Justine Seidenfeld
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States of America
- * E-mail:
| | - Anna Tupetz
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Cassandra Fiorino
- Duke University School of Medicine, Durham, NC, United States of America
| | - Alexander Limkakeng
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Lincoln Silva
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Catherine Staton
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Joao R. N. Vissoci
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - John Purakal
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States of America
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Redegalli M, Schiavo Lena M, Cangi MG, Smart CE, Mori M, Fiorino C, Arcidiacono PG, Balzano G, Falconi M, Reni M, Doglioni C. Proposal for a New Pathologic Prognostic Index After Neoadjuvant Chemotherapy in Pancreatic Ductal Adenocarcinoma (PINC). Ann Surg Oncol 2022; 29:3492-3502. [PMID: 35230580 PMCID: PMC9072515 DOI: 10.1245/s10434-022-11413-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/16/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Limited information is available on the relevant prognostic variables after surgery for patients with pancreatic ductal adenocarcinoma (PDAC) subjected to neoadjuvant chemotherapy (NACT). NACT is known to induce a spectrum of histological changes in PDAC. Different grading regression systems are currently available; unfortunately, they lack precision and accuracy. We aimed to identify a new quantitative prognostic index based on tumor morphology. PATIENTS AND METHODS The study population was composed of 69 patients with resectable or borderline resectable PDAC treated with preoperative NACT (neoadjuvant group) and 36 patients submitted to upfront surgery (upfront-surgery group). A comprehensive histological assessment on hematoxylin and eosin (H&E) stained sections evaluated 20 morphological parameters. The association between patient survival and morphological variables was evaluated to generate a prognostic index. RESULTS The distribution of morphological parameters evaluated was significantly different between upfront-surgery and neoadjuvant groups, demonstrating the effect of NACT on tumor morphology. On multivariate analysis for patients that received NACT, the predictors of shorter overall survival (OS) and disease-free survival (DFS) were perineural invasion and lymph node ratio. Conversely, high stroma to neoplasia ratio predicted longer OS and DFS. These variables were combined to generate a semiquantitative prognostic index based on both OS and DFS, which significantly distinguished patients with poor outcomes from those with a good outcome. Bootstrap analysis confirmed the reproducibility of the model. CONCLUSIONS The pathologic prognostic index proposed is mostly quantitative in nature, easy to use, and may represent a reliable tumor regression grading system to predict patient outcomes after NACT followed by surgery for PDAC.
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Affiliation(s)
- M Redegalli
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - M Schiavo Lena
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - M G Cangi
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - C E Smart
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - M Mori
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - C Fiorino
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - P G Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - G Balzano
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - M Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - M Reni
- Department of Medical Oncology, IRCCS San Raffaele Scientific Institute, Pancreas Translational and Clinical Research Centre, Milan, Italy.
| | - C Doglioni
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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10
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Faiella A, Gebbia A, Villa E, Waskiewicz J, Magli A, Avuzzi B, Garibaldi E, Cante D, Girelli G, Gatti M, Ferella L, Noris Chiorda B, Rago L, Ferrari P, Bresolin A, Piva C, Badenchini F, Rancati T, Valdagni R, Vavassori V, Munoz F, Sanguineti G, Di Muzio N, Fiorino C, Cozzarini C. PD-0414 Trend over time of patient-reported QoL domains after pelvic nodal irradiation for prostate cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02849-3] [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: 11/27/2022]
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11
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Fodor A, Deantoni C, Fiorino C, Cozzarini C, Dell'Oca I, Mangili P, Tummineri R, Zerbetto F, Sanchez Galvan A, Mandurino G, Villa S, Baroni S, Saddi J, Pacifico P, Perna L, Broggi S, Del Vecchio A, Picchio M, Gianolli L, Di Muzio N. MO-0553 ENRT+ PET-guided SIB for prostate cancer lymph nodal relapses: long-term outcomes. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02387-8] [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: 10/18/2022]
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12
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Gebbia A, Munoz F, Magli A, Cante D, Garibaldi E, Noris Chiorda B, Girelli G, Villa E, Faiella A, Waskiewicz J, Avuzzi B, Pastorino A, Moretti E, Rago L, Bresolin A, Bianconi C, Badenchini F, Rancati T, Valdagni R, Vavassori V, Gatti M, Sanguineti G, Di Muzio N, Fiorino C, Cozzarini C. PD-0415 Pelvic RT in prostate cancer: late intestinal toxicity is modulated by severity of acute symptoms. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02850-x] [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: 11/17/2022]
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13
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Castriconi R, Marrazzo L, Calusi S, Esposito P, Tudda A, Broggi S, Mangili P, del Vecchio A, Pallotta S, Fiorino C. MO-0789 Improving Knowledge-based planning for right-side whole-breast tangential field-like delivery. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02425-2] [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: 10/18/2022]
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14
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Sanchez Galvan A, Fodor A, Fiorino C, Mangilli P, Deantoni C, Cozzarini C, Tummineri R, Baroni S, Villa S, Mandurino G, Pacifico P, Arcangeli S, Di Muzio N. PO-1372 Robotic stereotactic body radiotherapy for prostate cancer : an initial monoistitutional experience. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03336-9] [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: 10/18/2022]
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15
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deantoni C, Chiara A, Mirabile A, Broggi S, Fiorino C, Fodor A, Pasetti M, Tummineri R, Zerbetto F, Baroni S, Sanchez Galvan A, Gregorc V, Dell'Oca I, Di Muzio N. PO-1100 Impact of sarcopenia in oropharyngeal cancer patients treated with radical chemo-radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03064-x] [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: 10/18/2022]
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16
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Vago R, Zuppone S, Colciago G, Fallara G, Gebbia A, Di Muzio N, Spinelli A, Fiorino C, Cozzarini C. OC-0098 Preclinical assessment of protective role of anti-androgens in reducing RT-induced bladder toxicity. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02474-4] [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: 10/18/2022]
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17
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Esposito P, Castriconi R, Mangili P, Broggi S, Fodor A, Pasetti M, Tudda A, Di Muzio N, del Vecchio A, Fiorino C. MO-0790 Knowledge-Based automatic plan optimization for left-sided whole breast tomotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02426-4] [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: 10/18/2022]
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18
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Olivieri M, Cozzarini C, Magli A, Cante D, Noris Chiorda B, Munoz F, Faiella A, Olivetta E, Signor M, Piva C, Avuzzi B, Ferella L, Pastorino A, Garibaldi E, Gatti M, Rago L, Statuto T, Broggi S, Fodor A, Deantoni C, Rancati T, Sanguineti G, Valdagni R, Di Muzio N, Fiorino C. OC-0457 Modeling outcome after salvage post-prostatectomy radiotherapy: impact of pelvic nodes irradiation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02593-2] [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: 11/16/2022]
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19
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Mori M, Deantoni C, Olivieri M, Spezi E, Chiara A, Baroni S, Picchio M, Del Vecchio A, Di Muzio N, Fiorino C, Dell'Oca I. PO-1760 Independent validation of a PET radiomic model predicting outcome after Radiotherapy for HN cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03724-0] [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: 10/18/2022]
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20
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tudda A, Castriconi R, Benecchi G, Cagni E, Dusi F, Esposito P, Rambaldi Guidasci G, Guernieri M, Ianiro A, Landoni V, Mazzilli A, Moretti E, Oliviero C, Placidi L, Rancati T, Trojani V, Scaggion A, Fiorino C. PD-0733 Parameters influencing inter-Institute variability in KB plan prediction models for whole breast RT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02928-0] [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: 11/29/2022]
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21
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Spinelli A, Fiorino C, Schwarz M, Tommasino F, Bellinzona E, Del Vecchio A, Mangili P, Shakarami Z, Deantoni C, Cianchetti M, Attili A, Galli R, Bisio A, Perani L, Simoniello P, Fuss M, Pawelke J, Wong J, Durante M, Scifoni E. FLASH Mechanisms Track (Oral Presentations) ADVANCED DOSIMETRY AND BIOPHYSICAL MODELING FOR PRECLINICAL FLASH RADIOTHERAPY. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01518-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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Garibaldi C, Castriconi R, Lecchi M, Placidi L, Rancati T, Fiorino C. Assessment of the scientific production of the Italian Association of Medical Physicists (AIFM) in the last 5 years. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00297-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Bresolin A, Maggio A, Landoni V, Cicchetti A, Trombetta L, Ferrari P, Moretti E, Giandini T, Petrucci E, Aimonetto S, Farina B, Carillo V, Cazzulo E, Pignoli E, Salmoiraghi P, Rancati T, Fiorino C, Cozzarini C. Dose-volume effect for acute patient-reported intestinal toxicity from whole pelvis radiotherapy: an Italian multicentric study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00127-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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24
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Castriconi R, Esposito P, Mangili P, Pasetti M, Fodor A, Di Muzio N, del Vecchio A, Fiorino C. Knowledge-based (KB) automatic plan optimization can replace manual planning in tangential field irradiation for right breast cancer radiotherapy. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00128-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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25
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Tsalik EL, Fiorino C, Aqeel A, Liu Y, Henao R, Ko ER, Burke TW, Reller ME, Bodinayake CK, Nagahawatte A, Arachchi WK, Devasiri V, Kurukulasooriya R, McClain MT, Woods CW, Ginsburg GS, Tillekeratne LG, Schughart K. The Host Response to Viral Infections Reveals Common and Virus-Specific Signatures in the Peripheral Blood. Front Immunol 2021; 12:741837. [PMID: 34777354 PMCID: PMC8578928 DOI: 10.3389/fimmu.2021.741837] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Viruses cause a wide spectrum of clinical disease, the majority being acute respiratory infections (ARI). In most cases, ARI symptoms are similar for different viruses although severity can be variable. The objective of this study was to understand the shared and unique elements of the host transcriptional response to different viral pathogens. We identified 162 subjects in the US and Sri Lanka with infections due to influenza, enterovirus/rhinovirus, human metapneumovirus, dengue virus, cytomegalovirus, Epstein Barr Virus, or adenovirus. Our dataset allowed us to identify common pathways at the molecular level as well as virus-specific differences in the host immune response. Conserved elements of the host response to these viral infections highlighted the importance of interferon pathway activation. However, the magnitude of the responses varied between pathogens. We also identified virus-specific responses to influenza, enterovirus/rhinovirus, and dengue infections. Influenza-specific differentially expressed genes (DEG) revealed up-regulation of pathways related to viral defense and down-regulation of pathways related to T cell and neutrophil responses. Functional analysis of entero/rhinovirus-specific DEGs revealed up-regulation of pathways for neutrophil activation, negative regulation of immune response, and p38MAPK cascade and down-regulation of virus defenses and complement activation. Functional analysis of dengue-specific up-regulated DEGs showed enrichment of pathways for DNA replication and cell division whereas down-regulated DEGs were mainly associated with erythrocyte and myeloid cell homeostasis, reactive oxygen and peroxide metabolic processes. In conclusion, our study will contribute to a better understanding of molecular mechanisms to viral infections in humans and the identification of biomarkers to distinguish different types of viral infections.
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Affiliation(s)
- Ephraim L. Tsalik
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
- Emergency Department Service, Durham Veterans Affairs Health Care System, Durham, NC, United States
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Cassandra Fiorino
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Ammara Aqeel
- Duke Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC, United States
| | - Yiling Liu
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Ricardo Henao
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, United States
| | - Emily R. Ko
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
- Department of Medicine, Duke Regional Hospital, Durham, NC, United States
| | - Thomas W. Burke
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Megan E. Reller
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | | | | | | | | | | | - Micah T. McClain
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Medical Service, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Christopher W. Woods
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Medical Service, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Geoffrey S. Ginsburg
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
| | - L. Gayani Tillekeratne
- Duke Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Medical Service, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Klaus Schughart
- Department of Infection Genetics, Helmholtz Centre for Infection Research, Braunschweig, Germany
- University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, United States
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26
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Mahle R, Fiorino C, Torres-Rodriguez E, Gordee A, Kuchibhatla M, Burlotos A, Purakal J. 48 Health Beliefs Regarding Social Determinants of Health Screening in the Emergency Department. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.056] [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: 11/25/2022]
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27
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Purakal J, Seidenfeld J, Tupetz A, Vissoci J, Silva L, Fiorino C, Phillips A, Limkakeng A, Staton C. 94EMF COVID-19 Infection Experiences and Social Determinants of Health in North Carolina: A Qualitative Analysis. Ann Emerg Med 2021. [PMCID: PMC8536271 DOI: 10.1016/j.annemergmed.2021.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Fodor A, Brombin C, Mangili P, Pasetti M, Tummineri R, Longobardi B, Zerbetto F, Castriconi R, Esposito P, Broggi S, Dell’Oca I, Deantoni C, Sanchez Galvan A, Perna L, Deli A, Chiara A, Rancoita P, Fiorino C, Del Vecchio A, Di Serio M, Di Muzio N. PO-1139 Skin toxicity in 1325 breast cancer patients treated with hypofractionated RT without boost. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07590-3] [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: 11/28/2022]
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29
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Esposito P, Castriconi R, Mangili P, Broggi S, Fodor A, Longobardi B, Pasetti M, Perna L, Di Muzio N, Del Vecchio A, Fiorino C. OC-0468 Implementation of a Knowledge-Based automated approach for whole breast tangential field planning. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06917-6] [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: 10/20/2022]
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30
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Purakal J, Seidenfeld J, Tupetz A, Vissoci J, Silva L, Limkakeng A, Fiorino C, Phillips A, Staton C. 30EMF COVID-19 Infection Experiences and Social Determinants of Health in North Carolina: A Qualitative Analysis. Ann Emerg Med 2021. [PMCID: PMC8335433 DOI: 10.1016/j.annemergmed.2021.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Fodor A, Deantoni C, Tummineri R, Fiorino C, Dell’Oca I, Mori M, Broggi S, Pasetti M, Perna L, Villa S, Mandurino G, Sanchez Galvan A, Baroni S, Pacifico P, Del Vecchio A, Di Muzio N. PO-1189 Stereotactic radiotherapy for lung oligometastases from colorectal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07640-4] [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: 11/29/2022]
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32
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Olivieri M, Magli A, Cante D, Noris Chiorda B, Munoz F, Faiella A, Olivetta E, Signor M, Piva C, Avuzzi B, Ferella L, Pastorino A, Broggi S, Fodor A, Deantoni C, Rancati T, Sanguineti G, Valdagni R, Di Muzio N, Cozzarini C, Fiorino C. PD-0782 Predicting bRFS after salvage post-prostatectomy RT with a “one-size-fits-all” TCP-based formula. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07061-4] [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: 11/30/2022]
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33
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Slim N, Pacifico P, Passoni P, Tummineri R, Ronzoni M, Pedica F, Fiorino C, Deli A, Casadei Gardini A, Cascinu S, De Cobelli F, Aldrighetti L, Di Muzio N. PO-1212 Outcome of adjuvant hypofractionated radiotherapy concomitant to chemotherapy in bile duct carcinoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07663-5] [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: 11/16/2022]
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34
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deantoni C, Fodor A, Cozzarini C, Tummineri R, Sanchez Galvan A, Villa S, Baroni S, Mandurino G, Pacifico P, Castriconi R, Fiorino C, Di Muzio N. PD-0910 Radical radiotherapy in lymph node or bone metastatic prostate cancer: a single institution series. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07189-9] [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: 10/20/2022]
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35
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Sanchez Galvan A, Deli A, Fodor A, Tummineri R, Villa S, Baroni S, Mandurino G, Pacifico P, Deantoni C, Slim N, Zerbetto F, Fiorino C, Broggi S, Del Vecchio A, Arcangeli S, Di Muzio N. PO-1069 Multiple Brain Metastases concomitantly treated with robotic SRS/SRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07520-4] [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: 11/30/2022]
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36
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Noris Chiorda B, Munoz F, Sanguineti G, Cante D, Waskiewicz J, Avuzzi B, Vavassori V, Gatti M, Girelli G, Magli A, Pastorino A, Ferella L, Faiella A, Piva C, Ferrari P, Villa E, Farina B, Moretti E, Rancati T, Badenchini F, Bresolin A, Valdagni R, Di Muzio N, Fiorino C, Cozzarini C. PD-0769 Patient-reported acute intestinal toxicity and impact on patient QoL after WPRT for prostate cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07048-1] [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: 10/20/2022]
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37
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Cozzarini C, Magli A, Cante D, Andreoli L, Pastorino A, Faiella A, Fodor A, Deantoni C, Zerbetto F, Tonetto F, Noris Chiorda B, Piva C, Olivetta E, Avuzzi B, Gandaglia G, Fossati N, Fiorino C, Sanguineti G, Valdagni R, Briganti A, Montorsi F, Di Muzio N. PO-1354 Time Dependence of PSADT prognostic threshold in men treated with post-prostatectomy salvage RT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07805-1] [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: 12/01/2022]
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38
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BROGGI S, Castriconi R, Tudda A, Deantoni C, Fodor A, Longobardi B, Perna L, Mangili P, Di Muzio N, Del Vecchio A, Fiorino C. PD-0747 Knowledge-based approach for DVH prediction in robotic spine SBRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07026-2] [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: 11/25/2022]
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Cozzarini C, Sanguineti G, Vavassori V, Munoz F, Avuzzi B, Garibaldi E, Cante D, Waskiewicz J, Magli A, Faiella A, Villa E, Ferella L, Gatti M, Noris Chiorda B, Piva C, Ferrari P, Rancati T, Badenchini F, Girelli G, Moretti E, Valdagni R, Bresolin A, Di Muzio N, Fiorino C. PD-0767 Predictors of urinary incontinence 2 years after RT with different intents for prostate cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07046-8] [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: 10/20/2022]
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40
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Cozzarini C, Magli A, Cante D, Noris Chiorda B, Munoz F, Faiella A, Olivetta E, Marco Andrea S, Piva C, Avuzzi B, Ferella L, Pastorino A, Fodor A, Deantoni C, Fossati N, Gandaglia G, Sanguineti G, Valdagni R, Fiorino C, Briganti A, Montorsi F, Di Muzio N. PH-0660 Independent role of dose-escalation and prophylactic WPRT in salvage RT after radical prostatectomy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07392-8] [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: 10/20/2022]
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41
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Cicchetti A, Fiorino C, Passoni P, Mangili P, Slim N, del Vecchio A, Di Muzio N, Broggi S. PO-1563 A dose-escalation for early-regression based ART for rectal cancer: a planning feasibility study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08014-2] [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: 10/20/2022]
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42
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Cozzarini C, Magli A, Cante D, Noris Chiorda B, Munoz F, Faiella A, Olivetta E, Signor M, Piva C, Avuzzi B, Ferella L, Pastorino A, Fodor A, Deantoni C, Nicola F, Gandaglia G, Sanguineti G, Valdagni R, Fiorino C, Briganti A, Montorsi F, Di Muzio N. Independent role of dose-escalation and prophylactic lymph-nodal irradiation in salvage radiotherapy after prostatectomy. A retrospective, multi-institute analysis on 725 men treated with high-dose radiotherapy and eight years follow-up. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01555-4] [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: 10/20/2022]
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Spinelli A, Bresolin A, Zuppone S, Fallara G, Vago R, Fiorino C, Cozzarini C. PO-1806: Early radio-induced bladder wall thickening in rats: optimizing the methodology and first evidences. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01824-7] [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: 11/15/2022]
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44
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Di Muzio N, Deantoni C, Cozzarini C, Dell'Oca I, Zerbetto F, Mangili P, Broggi S, Pasetti M, Chiara A, Borroni F, Tummineri R, Perna L, Calandrino R, Fiorino C, Fodor A. PO-1173: Long term results of IG-IMRT in high risk prostate cancer patients: a monoinstitutional experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01191-9] [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: 10/22/2022]
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45
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Cusumano D, Boldrini L, Yadav P, Gao Y, Chiloiro G, Piras A, Broggi S, Lenkowicz J, Placidi L, Musunuru H, Dinapoli N, Barbaro B, Azario L, Gambacorta M, De Spirito M, Basetti M, Yang Y, Fiorino C, Valentini V. PH-0715: External validation of ERITCP as response predictor in rectal cancer using MR-guided Radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00737-4] [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: 11/30/2022]
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46
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Fodor A, Mangili P, Brombin C, Zerbetto F, Longobardi B, Borroni F, Tummineri R, Pasetti M, Rancoita P, Perna L, Dell'Oca I, Deantoni C, Esposito P, Deli A, Rossi E, Chiara A, Broggi S, Slim N, Passoni P, Cattaneo M, Bolognesi A, Fiorino C, Di Serio M, Di Muzio N. PO-0955: Molecular subtypes and local control in 1054 breast cancer patients treated with de-escalated 3DCRT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00973-7] [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: 10/22/2022]
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47
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Broggi S, Gumina C, Mori M, Cattaneo G, Palmisano A, Di Chiara A, Ronzoni M, Slim N, De Cobelli F, Calandrino R, Rosati R, Di Muzio N, Fiorino C, Passoni P. PD-0539: Chemo-modulation of rectal cancer pathological response: prediction of an early regression index. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00561-2] [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: 10/22/2022]
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48
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Rossi E, Fiorino C, Fodor A, Cattaneo G, Deantoni C, Zerbetto F, Calandrino R, Broggi S, Di Muzio N. PO-1603: Residual intra-fraction error in tracked spinal SBRT: effect of site, fractionation and patient pain. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01621-2] [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: 11/25/2022]
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Fiorino C, Jeraj R. SP-0034: Medical physicists will substantially contribute to modeling biological effects in the era of personalized Radiation Oncology. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00060-8] [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: 10/22/2022]
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50
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Castriconi R, Fiorino C, Cozzarini C, Broggi S, Di Muzio N, Cattaneo G, Calandrino R. OC-0103: Clinical implementation of Knowledge-based (KB) planning optimization for Helical-Tomotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00129-8] [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: 10/22/2022]
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