1
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Su CW, Teng W, Shen EYL, Huang BS, Lin PT, Hou MM, Wu TH, Tsan DL, Hsieh CH, Wang CT, Chai PM, Lin CY, Lin SM, Lin CC. Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma. Oncologist 2024:oyae048. [PMID: 38530254 DOI: 10.1093/oncolo/oyae048] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Atezolizumab plus bevacizumab (atezo-bev) has been recommended for advanced hepatocellular carcinoma (HCC). High-dose external beam radiotherapy (RT) is recognized for its excellent local tumor control. The efficacy and safety of concurrent atezo-bev with RT for highly advanced HCC has been minimally explored. METHODS In this preliminary retrospective study, we assessed patients with highly advanced HCC, characterized by Vp4 portal vein thrombosis or tumors exceeding 50% of liver volume, who received concurrent atezo-bev and RT (group A). Group A included 13 patients who received proton radiation at a dose of 72.6 GyE in 22 fractions, and one patient who received photon radiation at a dose of 54 Gy in 18 fractions. This group was compared with 34 similar patients treated atezo-bev alone as a control (group B). The primary objectives were to evaluate the objective response rate (ORR), overall survival (OS), and safety. RESULTS Baseline characteristics were similar between groups, except for a higher incidence of Vp4 portal vein thrombosis in group A (78.6% vs. 21.4%, P = .05). Group A achieved a higher ORR (50.0% vs. 11.8%, P < .01) and a longer OS (not reached vs. 5.5 months, P = .01) after a median follow-up of 5.2 months. Multivariate analysis indicated that concurrent RT independently favored longer OS (hazard ratio: 0.18; 95% CI, 0.05-0.63, P < .01). Group A did not increase any grade adverse events (78.6% vs. 58.8%, P = .19) or severe adverse events of grade ≥ 3 (14.3% vs. 14.7%, P = .97) compared to group B. CONCLUSIONS The concurrent high-dose external beam radiotherapy appears to safely enhance the effectiveness of atezolizumab plus bevacizumab for highly advanced patients with HCC. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Chung-Wei Su
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei Teng
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Eric Yi-Liang Shen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Clinical Metabolomics Core Lab, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Bing-Shen Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Po-Ting Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Mo Hou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Tsung-Han Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Din-Li Tsan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chia-Hsun Hsieh
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Memorial Hospital), New Taipei, Taiwan
| | - Ching-Ting Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Pei-Mei Chai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chun-Yen Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chen-Chun Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Gastroenterology and Hepatology, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Memorial Hospital), New Taipei, Taiwan
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2
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Ahmad MS, Minaee N, Serrano-Contreras JI, Kaluarachchi M, Shen EYL, Boulange C, Ahmad S, Phetcharaburanin J, Holmes E, Wist J, Albaloshi AH, Alaama T, Damanhouri ZA, Lodge S. Exploring the Interactions between Obesity and Diabetes: Implications for Understanding Metabolic Dysregulation in a Saudi Arabian Adult Population. J Proteome Res 2024; 23:809-821. [PMID: 38230637 PMCID: PMC10846529 DOI: 10.1021/acs.jproteome.3c00717] [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: 10/31/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024]
Abstract
The rising prevalence of obesity in Saudi Arabia is a major contributor to the nation's high levels of cardiometabolic diseases such as type 2 diabetes. To assess the impact of obesity on the diabetic metabolic phenotype presented in young Saudi Arabian adults, participants (n = 289, aged 18-40 years) were recruited and stratified into four groups: healthy weight (BMI 18.5-24.99 kg/m2) with (n = 57) and without diabetes (n = 58) or overweight/obese (BMI > 24.99 kg/m2) with (n = 102) and without diabetes (n = 72). Distinct plasma metabolic phenotypes associated with high BMI and diabetes were identified using nuclear magnetic resonance spectroscopy and ultraperformance liquid chromatography mass spectrometry. Increased plasma glucose and dysregulated lipoproteins were characteristics of obesity in individuals with and without diabetes, but the obesity-associated lipoprotein phenotype was partially masked in individuals with diabetes. Although there was little difference between diabetics and nondiabetics in the global plasma LDL cholesterol and phospholipid concentration, the distribution of lipoprotein particles was altered in diabetics with a shift toward denser and more atherogenic LDL5 and LDL6 particles, which was amplified in the presence of obesity. Further investigation is warranted in larger Middle Eastern populations to explore the dysregulation of metabolism driven by interactions between obesity and diabetes in young adults.
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Affiliation(s)
- Muhammad Saeed Ahmad
- Department
of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, U.K.
- Drug
Metabolism Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Novia Minaee
- Health
Futures Institute, Murdoch University, Perth, WA 6150, Australia
| | | | - Manuja Kaluarachchi
- Department
of Metabolism, Digestion and Reproduction, Imperial College, London SW7 2AZ, U.K.
| | - Eric Yi-Liang Shen
- Department
of Metabolism, Digestion and Reproduction, Imperial College, London SW7 2AZ, U.K.
- Department
of Radiation Oncology, Chang Gung Memorial
Hospital and Chang Gung University, Taoyuan 333, Taiwan
| | - Claire Boulange
- Department
of Metabolism, Digestion and Reproduction, Imperial College, London SW7 2AZ, U.K.
| | - Sultan Ahmad
- Drug
Metabolism Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jutarop Phetcharaburanin
- Department
of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Elaine Holmes
- Health
Futures Institute, Murdoch University, Perth, WA 6150, Australia
- Department
of Metabolism, Digestion and Reproduction, Imperial College, London SW7 2AZ, U.K.
| | - Julien Wist
- Health
Futures Institute, Murdoch University, Perth, WA 6150, Australia
- Department
of Metabolism, Digestion and Reproduction, Imperial College, London SW7 2AZ, U.K.
- Chemistry
Department, Universidad del Valle, Cali 76001, Colombia
| | - Ahmed Hakem Albaloshi
- King
Abdulaziz Hospital and Endocrine and Diabetic Center, Jeddah 23436, Saudi Arabia
| | - Tareef Alaama
- Department
of Medicine, Faculty of Medicine, King Abdulaziz
University, Jeddah 21589, Saudi Arabia
| | - Zoheir Abdullah Damanhouri
- Drug
Metabolism Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department
of Pharmacology, Faculty of Medicine, King
Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Samantha Lodge
- Health
Futures Institute, Murdoch University, Perth, WA 6150, Australia
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Chang YC, Wu YY, Tsan DL, Yap WK, Fan KH, Chang JTC, Shen EYL. Dose-Escalated Radiation Therapy as Primary Treatment for Residual Bladder Cancer After Transurethral Resection. Adv Radiat Oncol 2024; 9:101302. [PMID: 38260237 PMCID: PMC10801638 DOI: 10.1016/j.adro.2023.101302] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/26/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose The aim of this study was to determine whether escalating the local radiation dose can improve the outcome of residual bladder cancer after transurethral resection of bladder tumor without increasing treatment-related toxicity. Methods and Materials The treatment plans and medical records of patients with bladder cancer treated with curative-intent radiation therapy between 2008 and 2020 were reviewed. Those who had residual tumors in the computed tomography simulation images were included. A cumulative radiation dose higher than 6600 cGy was defined as dose escalation. The effect of dose escalation on 3-year locoregional control, progression-free survival, and overall survival was evaluated. Results A total of 149 patients with residual tumors were identified. The median follow-up period was 27.5 months. Among them, 51 patients received an escalated radiation dose, and 98 received a standard dose in the residual tumor area. Patients in the dose-escalation group had higher 3-year locoregional control (65.6% vs 27.8%; P < .001) and progression-free survival (42.6% vs 18.2%; P < .001) than the standard-dose group. Overall survival also showed a trend favoring the dose-escalation group (54.9% vs 36.2%; P = .059). In the multivariate analyses, the differences between the dose-escalation and standard-dose groups were significant in terms of locoregional control (hazard ratio, 0.32; CI, 0.18-0.59; P = <.001) and progression-free survival (hazard ratio, 0.51; CI, 0.32-0.82; P = .005). There was no statistical difference in acute and chronic treatment-related toxicities between the 2 groups. Conclusions The outcome of residual bladder cancer after transurethral resection of bladder tumor could be improved by dose-escalated radiation therapy.
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Affiliation(s)
- Yu-Chen Chang
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Yao-Yu Wu
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Din-Li Tsan
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Wing-Keen Yap
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Kan-Hsin Fan
- Department of Radiation Oncology, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Joseph Tung-Chieh Chang
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Eric Yi-Liang Shen
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Clinical Metabolomics Core Lab, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
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You GR, Cheng AJ, Shen EYL, Fan KH, Huang YF, Huang YC, Chang KP, Chang JT. MiR-630 Promotes Radioresistance by Induction of Anti-Apoptotic Effect via Nrf2-GPX2 Molecular Axis in Head-Neck Cancer. Cells 2023; 12:2853. [PMID: 38132173 PMCID: PMC10741482 DOI: 10.3390/cells12242853] [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: 10/31/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Head and neck cancer (HNC) ranks among the top ten prevalent cancers worldwide. Radiotherapy stands as a pivotal treatment component for HNC; however, radioresistance in cancerous cells often leads to local recurrence, becoming a substantial factor in treatment failure. MicroRNAs (miRNAs) are compact, non-coding RNAs that regulate gene expression by targeting mRNAs to inhibit protein translation. Although several studies have indicated that the dysregulation of miRNAs is intricately linked with malignant transformation, understanding this molecular family's role in radioresistance remains limited. This study determined the role of miR-630 in regulating radiosensitivity in HNC. We discovered that miR-630 functions as an oncomiR, marked by its overexpression in HNC patients, correlating with a poorer prognosis. We further delineated the malignant function of miR-630 in HNC cells. While it had a minimal impact on cell growth, the miR-630 contributed to radioresistance in HNC cells. This result was supported by decreased cellular apoptosis and caspase enzyme activities. Moreover, miR-630 overexpression mitigated irradiation-induced DNA damage, evidenced by the reduced levels of the γ-H2AX histone protein, a marker for double-strand DNA breaks. Mechanistically, the overexpression of miR-630 decreased the cellular ROS levels and initiated Nrf2 transcriptional activity, resulting in the upregulation of the antioxidant enzyme GPX2. Thus, this study elucidates that miR-630 augments radioresistance by inducing an anti-apoptotic effect via the Nrf2-GPX2 molecular axis in HNC. The modulation of miR-630 may serve as a novel radiosensitizing target for HNC.
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Affiliation(s)
- Guo-Rung You
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (G.-R.Y.); (A.-J.C.)
| | - Ann-Joy Cheng
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (G.-R.Y.); (A.-J.C.)
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (E.Y.-L.S.); (K.-H.F.)
| | - Eric Yi-Liang Shen
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (E.Y.-L.S.); (K.-H.F.)
| | - Kang-Hsing Fan
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (E.Y.-L.S.); (K.-H.F.)
- Department of Radiation Oncology, New Taipei Municipal TuCheng Hospital, New Taipei City 236017, Taiwan
| | - Yi-Fang Huang
- Department of General Dentistry, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan;
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Chen Huang
- Department of Oral and Maxillofacial Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan;
| | - Kai-Ping Chang
- Department of Otorhinolaryngology, LinKou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Joseph T. Chang
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (E.Y.-L.S.); (K.-H.F.)
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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5
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Shen EYL, U MRA, Cox IJ, Taylor-Robinson SD. The Role of Mass Spectrometry in Hepatocellular Carcinoma Biomarker Discovery. Metabolites 2023; 13:1059. [PMID: 37887384 PMCID: PMC10609223 DOI: 10.3390/metabo13101059] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the main liver malignancy and has a high mortality rate. The discovery of novel biomarkers for early diagnosis, prognosis, and stratification purposes has the potential to alleviate its disease burden. Mass spectrometry (MS) is one of the principal technologies used in metabolomics, with different experimental methods and machine types for different phases of the biomarker discovery process. Here, we review why MS applications are useful for liver cancer, explain the MS technique, and briefly summarise recent findings from metabolomic MS studies on HCC. We also discuss the current challenges and the direction for future research.
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Affiliation(s)
- Eric Yi-Liang Shen
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City 333, Taiwan
- Clinical Metabolomics Core Laboratory, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City 333, Taiwan
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London W2 1NY, UK
| | - Mei Ran Abellona U
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London W2 1NY, UK
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK
| | - I. Jane Cox
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London SE5 9NT, UK
- Faculty of Life Sciences & Medicine, King’s College London, London SE5 8AF, UK
| | - Simon D. Taylor-Robinson
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London W2 1NY, UK
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6
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Shen EYL, Hung TM, Tsan DL, Cheng NM, Kang CJ, Huang SF, Hsu CL, Lin CY, Wang HM, Hsieh JCH, Cheng AJ, Fan KH, Chang JTC. Utilization of the lymph node-to-primary tumor ratio of PET standardized uptake value and circulating Epstein-Barr virus DNA to predict distant metastasis in nasopharyngeal carcinoma. Radiother Oncol 2022; 177:1-8. [PMID: 35568282 DOI: 10.1016/j.radonc.2022.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/25/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND PURPOSE To determine the clinical impact of integrating Epstein-Barr virus (EBV) DNA and lymph node-to-primary tumor ratio (NTR) of positron emission tomography (PET) standardized uptake value (SUV) in predicting distant metastasis, such as distant metastasis-free survival (DMFS), in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS We retrospectively reviewed patients diagnosed with non-disseminated NPC between 2010 and 2017. The optimal cut-off values of EBV DNA and SUV NTR were determined using receiver operating characteristic analysis. The prognostic values of SUV NTR and EBV DNA on DMFS and overall survival were evaluated using the Kaplan-Meier method. Univariate and multivariable analyses were performed using the Wald Chi-squared test and Cox proportional hazards regression, respectively. RESULTS A total of 488 patients were included in the analysis. The median follow-up period was 61.6 months. The optimal cut-off values of EBV DNA and SUV NTR were 3377.5 copies per mL and 0.64, respectively. The five-year DMFS for patients with high vs low EBV DNA and SUV NTR levels were 64.9% vs 86.6% (p < 0.001) and 78.7% vs 87.4% (p = 0.021), respectively. In subgroup analysis, the high-risk group with high levels of pretreatment EBV DNA and SUV NTR had worse DMFS in either American Joint Committee on Cancer (AJCC) stage I-III or IVA-B (p = 0.001 and <0.001, respectively). Univariate and multivariable analyses showed the statistical significance of EBV DNA, SUV NTR, and their composite in DMFS (p < 0.001 for EBV DNA; p = 0.022 for SUV NTR; p < 0.001 for their composite). CONCLUSION This study showed that EBV DNA and SUV NTR have independent and additive values as prognosticators for distant metastasis in patients with NPC, suggesting that these two individual factors, except the AJCC staging system, should be included in future studies.
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Affiliation(s)
- Eric Yi-Liang Shen
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, United Kingdom
| | - Tsung-Min Hung
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Din-Li Tsan
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan; Department of Radiation Oncology and Proton Therapy Center, Keelung Chang Gung Memorial Hospital and Chang Gung University, Keelung City, Taiwan
| | - Nai-Ming Cheng
- Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Chung-Jan Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Shiang-Fu Huang
- Department of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Cheng-Lung Hsu
- Division of Medical Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Hung-Ming Wang
- Division of Medical Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Jason Chia-Hsun Hsieh
- Division of Medical Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Ann-Joy Cheng
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Kang-Hsing Fan
- Department of Radiation Oncology, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.
| | - Joseph Tung-Chieh Chang
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
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7
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U MRA, Shen EYL, Cartlidge C, Alkhatib A, Thursz MR, Waked I, Gomaa AI, Holmes E, Sharma R, Taylor-Robinson SD. Optimized Systematic Review Tool: Application to Candidate Biomarkers for the Diagnosis of Hepatocellular Carcinoma. Cancer Epidemiol Biomarkers Prev 2022; 31:1261-1274. [PMID: 35545293 DOI: 10.1158/1055-9965.epi-21-0687] [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: 05/31/2021] [Revised: 09/17/2021] [Accepted: 05/09/2022] [Indexed: 12/24/2022] Open
Abstract
This review aims to develop an appropriate review tool for systematically collating metabolites that are dysregulated in disease and applies the method to identify novel diagnostic biomarkers for hepatocellular carcinoma (HCC). Studies that analyzed metabolites in blood or urine samples where HCC was compared with comparison groups (healthy, precirrhotic liver disease, cirrhosis) were eligible. Tumor tissue was included to help differentiate primary and secondary biomarkers. Searches were conducted on Medline and EMBASE. A bespoke "risk of bias" tool for metabolomic studies was developed adjusting for analytic quality. Discriminant metabolites for each sample type were ranked using a weighted score accounting for the direction and extent of change and the risk of bias of the reporting publication. A total of 84 eligible studies were included in the review (54 blood, 9 urine, and 15 tissue), with six studying multiple sample types. High-ranking metabolites, based on their weighted score, comprised energy metabolites, bile acids, acylcarnitines, and lysophosphocholines. This new review tool addresses an unmet need for incorporating quality of study design and analysis to overcome the gaps in standardization of reporting of metabolomic data. Validation studies, standardized study designs, and publications meeting minimal reporting standards are crucial for advancing the field beyond exploratory studies.
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Affiliation(s)
- Mei Ran Abellona U
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Eric Yi-Liang Shen
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | | | - Alzhraa Alkhatib
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
- National Liver Unit, Menoufiya University, Shbeen El Kom, Egypt
| | - Mark R Thursz
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Imam Waked
- National Liver Unit, Menoufiya University, Shbeen El Kom, Egypt
| | - Asmaa I Gomaa
- National Liver Unit, Menoufiya University, Shbeen El Kom, Egypt
| | - Elaine Holmes
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
- Health Futures Institute, Murdoch University, Perth WA, Australia
| | - Rohini Sharma
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Simon D Taylor-Robinson
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
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8
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Shen EYL, Tsan DL, Chiang YY, Lin SY. Treatment-related sequelae in Hodgkin's lymphoma after mediastinal irradiation. Int J Hematol 2021; 115:363-370. [PMID: 34817791 DOI: 10.1007/s12185-021-03264-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many studies have investigated treatment-related sequelae in Hodgkin's lymphoma (HL) in high-prevalence areas, but very few have been conducted in low-prevalence areas, including Taiwan and Japan. MATERIALS AND METHODS We retrospectively reviewed 101 HL patients who had received mediastinal radiotherapy between January 1997 and April 2013. RESULTS Nine patients had cardiac events and nine patients developed second malignancies. Univariate analysis showed that bulkiness of disease was significantly associated with higher incidence of cardiac events (HR 7.70, 95% CI 1.60-38.00, p = 0.012). Disease stage and cumulative dose of radiotherapy were significantly correlated with incidence of radiation pneumonitis (HR 1.40, 95% CI 1.00-2.10, p = 0.043 and HR 1.10, 95% CI 1.00-1.20, p = 0.009, respectively). All cases of grade III-IV radiation pneumonitis happened in patients receiving a radiation dose higher than 35 Gy and developed within 4 months after radiotherapy. CONCLUSIONS Despite the similar incidence rates of treatment-related sequelae among HL survivors between areas with high and low prevalence of HL, cardiac events and second malignancies cannot be overlooked in HL survivors in low-prevalence areas.
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Affiliation(s)
- Eric Yi-Liang Shen
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.,Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Din-Li Tsan
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Yin-Yin Chiang
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
| | - Shinn-Yn Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. .,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
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9
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Oleribe OO, Nwanyanwu O, Shen EYL, Taylor-Robinson SD. Revisiting public health programming in Nigeria: challenges and solutions. Int J Gen Med 2019; 12:161-166. [PMID: 31118741 PMCID: PMC6506777 DOI: 10.2147/ijgm.s203172] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/28/2019] [Indexed: 11/23/2022] Open
Abstract
Public health programming has three main components – capacity development, service provision and documentation with monitoring. However, most funders and programmers now focus on just documentation and monitoring. In this communication, the authors extensively discuss the need for the full complement of public health programming and why it is important to restructure supportive site visits to make them both empowering and impactful to the health care workers resulting in higher quality of public health services and documentation with monitoring. The authors are of the view that following problem identification, comprehensive capacity development of field workers will engender quality service provision and appropriate documentation and monitoring.
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Affiliation(s)
| | | | - Eric Yi-Liang Shen
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan 333, Taiwan
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10
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Tseng YD, Cutter DJ, Plastaras JP, Parikh RR, Cahlon O, Chuong MD, Dedeckova K, Khan MK, Lin SY, McGee LA, Shen EYL, Terezakis SA, Badiyan SN, Kirova YM, Hoppe RT, Mendenhall NP, Pankuch M, Flampouri S, Ricardi U, Hoppe BS. Evidence-based Review on the Use of Proton Therapy in Lymphoma From the Particle Therapy Cooperative Group (PTCOG) Lymphoma Subcommittee. Int J Radiat Oncol Biol Phys 2017; 99:825-842. [PMID: 28943076 DOI: 10.1016/j.ijrobp.2017.05.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/24/2017] [Accepted: 05/02/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Yolanda D Tseng
- Department of Radiation Oncology, University of Washington, Seattle Cancer Care Alliance Proton Therapy Center, Seattle, Washington
| | - David J Cutter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John P Plastaras
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rahul R Parikh
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Oren Cahlon
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael D Chuong
- Miami Cancer Institute at Baptist Health South Florida, Miami, Florida
| | - Katerina Dedeckova
- Proton Therapy Department, Proton Therapy Center, Prague, Czech Republic
| | - Mohammad K Khan
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Shinn-Yn Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Lisa A McGee
- Department of Radiation Oncology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Eric Yi-Liang Shen
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan
| | - Stephanie A Terezakis
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Shahed N Badiyan
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Youlia M Kirova
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Richard T Hoppe
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Nancy P Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida; University of Florida Health Proton Therapy Institute, Jacksonville, Florida
| | - Mark Pankuch
- Northwestern Medicine Chicago Proton Center, Warrenville, Illinois
| | - Stella Flampouri
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida; University of Florida Health Proton Therapy Institute, Jacksonville, Florida
| | | | - Bradford S Hoppe
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida; University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
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