Role of hypofractionated stereotactic radiotherapy for primary optic nerve sheath meningioma

Background

Optic nerve sheath meningiomas (ONSM) are rare tumors potentially causing visual deficits. This study aims to report the anatomic and visual outcomes of patients with primary ONSM treated with hypofractionated stereotactic radiotherapy (HF-SRT).

Methods

Data of 36 patients treated with HF-SRT between 2008 and 2019 were retrospectively collected. The clinical target volume (CTV) was equal to the gross tumor volume and a 2 mm was added for the planning target volume. All responses other than progression were accepted as local control (LC). The VA grading was performed under 3 groups to provide an even distribution; 20/400 or worse, 20/40-20/400, and 20/40 or better.

Results

Median HF-SRT dose was 25 Gy and the median CTV was 1.94 cc. After a median of 106 months of follow-up, the tumor regressed in 23 (64%), was stable in 9 (25%), and progressed in 4 (11%) eyes. The overall rate of LC was 89% with 2-, 5-, 10-, and 15-year rate of 100%, 94%, 84%, and 84%, respectively. Treatment-related late toxicity rate was 11%. The VA was stable in 27 (75%) eyes, improved in 5 (14%) eyes, and worsened in 4 (11%) eyes, respectively, after HF-SRT. Female gender was the only independent predictor of an improved VA.

Conclusions

Hypofractionated stereotactic radiotherapy is a safe and satisfactory treatment option for primary ONSM without severe toxicity. It may be advisable to commence treatment before an established visual deficit of 20/400 or worse occurs, to make the most of the functional benefit.

Radiotherapy for benign diseases in Turkey: a patterns of care survey of the Turkish Society for Radiation Oncology (TROD 05-002)

PURPOSE

We aimed to investigate the patterns of radiotherapy (RT) care in cases of benign diseases in Turkey.

METHODS

A questionnaire survey was sent to all radiation oncology (RO) departments in Turkey. The number of patients treated for benign disease between 2015 and 2020 was requested. A list of benign conditions was given, and information on the number of patients per disease, single and total doses prescribed, weekly fractions, radiation type, energy, and device was requested.

RESULTS

Of the 138 RO departments, 29 (21%) responded. The data received concerned 15 (52%) university, 10 (34%) public, and four (14%) private hospitals. A total of 130,846 patients were treated with RT in these departments. Of these patients, 6346 (4.85%) were treated for benign conditions. The most common benign diseases treated with RT were meningioma (35%), plantar fasciitis (19%), schwannoma (16%), arteriovenous malformation (11%), and pituitary adenoma (7%). Most centers performed RT for paraganglioma, heterotopic ossification, vertebral hemangioma, and Graves' ophthalmopathy, but none treated arthrosis. Wide variations were observed across the departments. Radiosurgery for intracranial pathologies was performed intensively in four centers. By contrast, RT for plantar fasciitis was predominantly treated in five centers, one of which had more than 1000 patients.

CONCLUSION

The ratio of patients who underwent RT for benign diseases in Turkey among all patients who underwent RT was 4.85%. The common pattern of RT in 72% of patients was radiosurgery for intracranial benign diseases, followed by low-dose RT for plantar fasciitis in 19%.

Identification of Protein-Protein Interaction Bridges for Multiple Sclerosis

Motivation

Identifying and prioritizing disease-related proteins is an important scientific problem to develop proper treatments. Network science has become an important discipline to prioritize such proteins. Multiple sclerosis (MS), an autoimmune disease for which there is still no cure, is characterized by a damaging process called demyelination. Demyelination is the destruction of myelin, a structure facilitating fast transmission of neuron impulses, and oligodendrocytes, the cells producing myelin, by immune cells. Identifying the proteins that have special features on the network formed by the proteins of oligodendrocyte and immune cells can reveal useful information about the disease.

Results

We investigated the most significant protein pairs that we define as bridges among the proteins providing the interaction between the two cells in demyelination, in the networks formed by the oligodendrocyte and each type of two immune cells (i.e., macrophage and T-cell) using network analysis techniques and integer programming. The reason we investigated these specialized hubs was that a problem related to these proteins might impose a bigger damage in the system. We showed that 61% to 100% of the proteins our model detected, depending on parametrization, have already been associated with MS. We further observed the mRNA expression levels of several proteins we prioritized significantly decreased in human peripheral blood mononuclear cells (PBMCs) of MS patients. We therefore present a model, BriFin, which can be used for analyzing processes where interactions of two cell types play an important role.

Availability

BriFin is available at https://github.com/BilkentCompGen/brifin.

Supplementary information

Supplementary data are available at Bioinformatics online.

Investigation of the protective effects of intraperitoneal melatonin in rats receiving laryngeal radiotherapy

OBJECTIVES

To examine the protective effects of melatonin on laryngeal radiation damage.

MATERIALS AND METHODS

31 rats were divided into 4 groups as follows: 1) the control (C) group (n=7), was only injected with intraperitoneal ethanol solution; 2) the melatonin (M) group (n=8), was injected intraperitoneal melatonin solution with 5 mg/kg; 3) the radiotherapy (RT) group (n=8) was given laryngeal radiation after intraperitoneal injection of ethanol solution; 4) the M + RT group (n=8), RT was given 30 minutes after 5 mg/kg dose of melatonin solution was injected. Drug and radiation applications were continued for 5 days. The weight changes of the rats were recorded. At the end of the study, inflammation, neutrophil migration and lymphoid aggregates, collagen distribution, laryngeal glandular structures and biochemical analysis of laryngeal tissues [malondialdehyde (MDA), total oxidant status (TOS) and total antioxidant status (TAS)] were determined.

RESULTS

In the M+RT group, the first day and the 30th weight differences were significantly increased when compared with the RT group (p=0.050). Inflammation, neutrophil migration, lymphoid aggregate, disorganized collagen distribution and loss of glandular tissues were found statistically more in the RT group than in the C group (p<0.05). MDA and TOS levels were in the M + RT group exhibited better values than they did in the RT group (p<0.05). TAS levels was markedly increased in the M + RT group than in the RT group (p<0.001).

CONCLUSION

Administration of melatonin to rats prior receiving laryngeal radiation, decreases the level of oxidative stress markers and increases the level of anti-oxidative markers.

Turkish translation and validation of the Xerostomia Inventory

Objectives

The Xerostomia Inventory (XI) was developed to assess the severity of dryness in patients with xerostomia. It has a long and a short form with three- and five-point Guttman-type response options. In this study, we aimed to translate the XI into Turkish, to assess the validity and reliability of both response options in patients with head & neck cancer (HNC) or Sjögren syndrome (SS), and to select the optimal version for Turkish patients.

Patients and methods

Between January 2019 and June 2019, the XI was translated into Turkish (XI-T) and applied to patients aged ≥18 years with HNC and SS. All patients were applied two tests including both the three- and five-point options. The internal consistency was assessed by Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Content validity was based on expert opinion and patient reviews.

Results

A total of 186 patients (109 males, 77 females; median age: 54 years; range, 19 to 78 years) answered the XI-T. The number of patients with HNC and SS was 143 (77%) and 43 (23%), respectively. Median XI-T score was 17 for the three-point, and 24 for the five-point option, respectively. Overall internal consistency was satisfactory for both options (α=0.81 and α=0.89, respectively). Overall test-retest reliability was satisfactory and ICCs ranged between 0.71 and 0.92 for the three-point, and 0.36 and 0.94 for the five-point option, respectively. Assessments based on expert opinions and patient reviews also favored the content validity of the scale.

Conclusion

The XI-T with both three- and five-point options is a valid and reliable tool to evaluate the presence and severity of dryness in patients with HNC and SS who experience xerostomia. The three-point option is more comprehensible and can be preferred over the five-point option in the Turkish population.

The role of ABO blood groups in glial neoplasms

INTRODUCTION

There are numerous diseases that are claimed to have a correlation with AB0 blood groups. Analysis on distribution of blood groups in primary brain tumors and clinical value has revealed conflicting results. The purpose of this study is to evaluate the association between AB0 blood groups and glial neoplasms (GN) and their effects on prognosis.

METHODS

A retrospective cross sectional study was performed. Patients admitted between 2000-2014 and had a diagnosis of GN were evaluated. Blood groups of patients were analyzed and compared with the National blood group data obtained from Turkish Red Crescent Society. The prognostic significance of AB0 blood groups was analyzed within glioblastoma multiforme (GBM), anaplastic astrocytoma and grade 1-2 astrocytoma.

RESULTS

759 patients with a diagnosis of glial neoplasia were evaluated. Distribution of AB0 blood groups in the different grades of Glial neoplasia was similar with the national blood group frequencies. There was not a statistically significant difference between grades of glial neoplasia and healthy control patients. Median overall survival (mOS) of GBM patients were 12.9 months in A (95% CI, 10.2-15.5), 13.4 months in B (95% CI, 7.3-19.5), 5.7 months in AB (95% CI, 0.8-10.6), 12.8 months in 0 blood groups (95% CI, 8.6-16.8) (p = .46). mOS of anaplastic astrocytoma patients were 24.4 months in A (95% CI, 15.2-33.6), 47.2 months in B (95% CI, 9.9-84.5), 37.8 months in AB (95% CI, 10.2-80.3), 29.2 months in 0 blood groups (95% CI, 21.2-33.4) (p = .96). mOS in grade 1-2 were 84.2, 90.6 and 144 months for A, AB and 0 blood groups respectively.

CONCLUSIONS

In our patient group, when compared with general population, there seems to be no association between frequencies of AB0 blood groups and Glial Neoplasia. In addition, the AB0 blood groups have no prognostic impact on glial neoplasms.

Prognostic Significance of Indicators of Systemic Inflammatory Responses in Glioblastoma Patients

Background: High-grade gliomas, with glioblastomas as the most frequently observed histologic subtype, are the most common primary brain tumours in adults. It is considered that inflammatory responses play a major role in malignancies, including tumour progression. This study aimed to determine the prognostic significance of the neutrophil to lymphocyte ratio (NLR) and the thrombocyte to lymphocyte ratio (PLR) as indicators of systemic inflammatory response (SIR) in glioblastoma patients. Methods: A total of 90 patients treated for glioblastoma were retrospectively evaluated. Absolute counts were used to generate NLR and PLR. A SIR was considered to be present with an NLR ≥5 and/or PLR ≥150. Results: Median follow-up time was 11.3 months (range: 1-70 months). The 1-year and 2-year overall survival rates were 55.2% and 19.5%, respectively. Univariate analysis showed that there was no correlation between overall survival and gender (p=0.184), comorbid disease (p = 0.30), clinical presentation (p = 0.884), or tumour lateralization (p = 0.159). Multivariate analysis showed that overall survival was significantly correlated with SIR based on NLR (HR: 2.41), and ECOG performance status (HR: 1.53). The prognostic factors that affected survival, other than SIR, were Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.003), and tumour localization (p = 0.006). Conclusion: The present findings confirm that NLR based on peripheral blood counts prior to treatment can be used as a prognostic factor in patients with glioblastoma. Since tumour aggression increases and survival decreases as the NLR value rises, choice of treatment modality is facilitated for glioblastoma patients.