1
|
Mancarella D, Ellinghaus H, Sigismondo G, Veselinov O, Kühn A, Goyal A, Hartmann M, Fellenberg J, Krijgsveld J, Plass C, Popanda O, Schmezer P, Bakr A. Deposition of onco-histone H3.3-G34W leads to DNA repair deficiency and activates cGAS/STING-mediated immune responses. Int J Cancer 2024; 154:2106-2120. [PMID: 38353495 DOI: 10.1002/ijc.34883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/08/2024] [Accepted: 01/24/2024] [Indexed: 04/14/2024]
Abstract
Mutations in histone H3.3-encoding genes causing mutant histone tails are associated with specific cancers such as pediatric glioblastomas (H3.3-G34R/V) and giant cell tumor of the bone (H3.3-G34W). The mechanisms by which these mutations promote malignancy are not completely understood. Here we show that cells expressing H3.3-G34W exhibit DNA double-strand breaks (DSBs) repair defects and increased cellular sensitivity to ionizing radiation (IR). Mechanistically, H3.3-G34W can be deposited to damaged chromatin, but in contrast to wild-type H3.3, does not interact with non-homologous end-joining (NHEJ) key effectors KU70/80 and XRCC4 leading to NHEJ deficiency. Together with defective cell cycle checkpoints reported previously, this DNA repair deficiency in H3.3-G34W cells led to accumulation of micronuclei and cytosolic DNA following IR, which subsequently led to activation of the cyclic GMP-AMP synthase/stimulator of interferon genes (cGAS/STING) pathway, thereby inducing release of immune-stimulatory cytokines. These findings suggest a potential for radiotherapy for tumors expressing H3.3-G34W, which can be further improved by combination with STING agonists to induce immune-mediated therapeutic efficacy.
Collapse
Affiliation(s)
- Daniela Mancarella
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Henrik Ellinghaus
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gianluca Sigismondo
- Division of Proteomics of Stem Cells and Cancer, German Cancer Research Center (DKFZ), and Heidelberg University Medical Faculty, Heidelberg, Germany
| | - Olivera Veselinov
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexander Kühn
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Ashish Goyal
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mark Hartmann
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Section Translational Cancer Epigenomics, Division of Translational Medical Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jörg Fellenberg
- Department of Experimental Orthopaedics, Orthopaedic University Hospital Heidelberg, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - Jeroen Krijgsveld
- Division of Proteomics of Stem Cells and Cancer, German Cancer Research Center (DKFZ), and Heidelberg University Medical Faculty, Heidelberg, Germany
| | - Christoph Plass
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Odilia Popanda
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Schmezer
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ali Bakr
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| |
Collapse
|
2
|
Hirai R, Mori S, Suyari H, Ishikawa H. Improving respiratory signal prediction with a deep neural network and simple changes to the input and output data format. Phys Med Biol 2024; 69:085023. [PMID: 38382107 DOI: 10.1088/1361-6560/ad2b92] [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: 08/30/2023] [Accepted: 02/21/2024] [Indexed: 02/23/2024]
Abstract
Objective.To improve respiratory gating accuracy and radiation treatment throughput, we developed a generalized model based on a deep neural network (DNN) for predicting any given patient's respiratory motion.Approach.Our model uses long short-term memory (LSTM) based on a recurrent neural network (RNN), and improves upon common techniques. The first improvement is that the data input is not a one-dimensional sequence, but two-dimensional block data. This shortens the input sequence length, reducing computation time. Second, the output is not a scalar, but a sequence prediction. This increases the amount of available data, allowing improved prediction accuracy. For training and evaluation of our model, 434 sets of real-time position management data were retrospectively collected from clinical studies. The data were separated in a ratio of 4:1, with the larger set used for training models and the remaining set used for testing. We measured the accuracy of respiratory signal prediction and amplitude-based gating with prediction windows equaling 133, 333, and 533 ms. This new model was compared with the original LSTM and a non-recurrent DNN model.Main results.The mean absolute errors with the prediction window at 133, 333 and 533 ms were 0.036, 0.084, 0.119 with our model; 0.049, 0.14, 0.246 with the original LSTM-based model; and 0.041, 0.119, 0.16 with the non-recurrent DNN model, respectively. The computation time were 0.66 ms with our model; 0.63 ms the original LSTM-based model; 1.60 ms the non-recurrent DNN model, respectively. The accuracies of amplitude-based gating with the same prediction window settings and a duty cycle of approximately 50% were 98.3%, 95.8% and 92.7% with our model, 97.6%, 93.9% and 87.2% with the original LSTM-based model; and 97.9%, 94.3% and 89.5% with the non-recurrent DNN model, respectively.Significance.Our RNN algorithm for respiratory signal prediction successfully estimated tumor positions. We believe it will be useful in respiratory signal prediction technology.
Collapse
Affiliation(s)
- Ryusuke Hirai
- National Institutes for Quantum Science and Technology, Quantum Life and Medical Science Directorate, Institute for Quantum Medical Science, Inage-ku, Chiba 263-8555, Japan
- Corporate Research and Development Center, Toshiba Corporation, Kanagawa 212-8582, Japan
- Department of Information and Image Sciences, Faculty of Engineering, Chiba University, 263-8522, Japan
| | - Shinichiro Mori
- National Institutes for Quantum Science and Technology, Quantum Life and Medical Science Directorate, Institute for Quantum Medical Science, Inage-ku, Chiba 263-8555, Japan
| | - Hiroki Suyari
- Department of Information and Image Sciences, Faculty of Engineering, Chiba University, 263-8522, Japan
| | - Hitoshi Ishikawa
- QST hospital, National Institutes for Quantum Science and Technology, Inage-ku, Chiba 263-8555, Japan
| |
Collapse
|
3
|
Id Said B, Eskander A, Kapadia A, Husain ZA. A narrative review of oncologic emergencies in patients with head and neck cancers: initial management and the role of radiation therapy. Ann Palliat Med 2024; 0:apm-22-1074. [PMID: 38600816 DOI: 10.21037/apm-22-1074] [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] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND OBJECTIVE Head and neck cancers (HNCs) encompass a complex group of malignancies with high morbidity, often leading to critical emergencies such as pain crises, airway obstruction and hemorrhage. This review aims to outline an evidence-based approach to the multidisciplinary management of HNC oncologic emergencies with a focus on the role of emergent radiotherapy (RT). METHODS A literature search was performed using Medline, Embase and the Cochrane Central Register of Controlled Trials databases with a focus on three common oncological emergencies using the following keywords: "head and neck cancer", "radiation OR radiotherapy", "pain", "bleeding OR haemorrhage", and "airway obstruction". All English language articles published up to April 2022 were screened to identify studies pertaining to the management of oncologic emergencies in HNC. KEY CONTENT AND FINDINGS The management of oncologic emergencies in HNC present a unique set of challenges that require early recognition and aggressive treatment. In this narrative review, we summarize the evidence supporting the role of RT in the management of HNC patients presenting with pain crisis, malignant airway obstruction and acute haemorrhage. We demonstrate that while RT can be used as a primary or adjunct therapy, optimal management depends on the involvement of a multi-disciplinary team that includes head and neck surgeons, interventional radiology and palliative care. CONCLUSIONS RT plays a critical role in the multidisciplinary management of HNC oncological emergencies. Further prospective and comparative studies are needed to assess optimal management strategies.
Collapse
Affiliation(s)
- Badr Id Said
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology - Head and Neck Surgery, Odette Cancer Centre, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | - Anish Kapadia
- Department of Medical Imaging, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | - Zain A Husain
- Department of Radiation Oncology, Southern California Permanente Medical Group, Ontario, CA, USA
| |
Collapse
|
4
|
MacDonald KM, Khan S, Lin B, Hurren R, Schimmer AD, Kislinger T, Harding SM. The proteomic landscape of genotoxic stress-induced micronuclei. Mol Cell 2024; 84:1377-1391.e6. [PMID: 38423013 DOI: 10.1016/j.molcel.2024.02.001] [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: 08/02/2023] [Revised: 12/20/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
Micronuclei (MN) are induced by various genotoxic stressors and amass nuclear- and cytoplasmic-resident proteins, priming the cell for MN-driven signaling cascades. Here, we measured the proteome of micronuclear, cytoplasmic, and nuclear fractions from human cells exposed to a panel of six genotoxins, comprehensively profiling their MN protein landscape. We find that MN assemble a proteome distinct from both surrounding cytoplasm and parental nuclei, depleted of spliceosome and DNA damage repair components while enriched for a subset of the replisome. We show that the depletion of splicing machinery within transcriptionally active MN contributes to intra-MN DNA damage, a known precursor to chromothripsis. The presence of transcription machinery in MN is stress-dependent, causing a contextual induction of MN DNA damage through spliceosome deficiency. This dataset represents a unique resource detailing the global proteome of MN, guiding mechanistic studies of MN generation and MN-associated outcomes of genotoxic stress.
Collapse
Affiliation(s)
- Kate M MacDonald
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Shahbaz Khan
- Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Brian Lin
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Rose Hurren
- Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Aaron D Schimmer
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Thomas Kislinger
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Shane M Harding
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 2C4, Canada; Department of Radiation Oncology and Immunology, University of Toronto, Toronto, ON M5T 1P5, Canada.
| |
Collapse
|
5
|
Vainer I, Tzelnick S, Kurman N, Popovtzer A, Soudry E. Post- radiation middle ear effusion in NPC patients: Analysis of patient, tumour, and radiation factors. Clin Otolaryngol 2024. [PMID: 38572684 DOI: 10.1111/coa.14159] [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: 04/30/2023] [Revised: 02/17/2024] [Accepted: 03/17/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate whether patient, tumour and radiation therapy factors are associated with development of middle ear effusion (MEE) in nasopharyngeal carcinoma (NPC) patients. DEIGN, SETTINGS, AND PARTICIPANTS A retrospective review of NPC patients treated between January 2000 and June 2018 at Rabin Medical Center. Patient factors, tumour factors, radiation doses, and radiation fields were collected and outlined if needed (middle ear, eustachian tube [ET], tensor veli palatini [TVP], and levator palatini [LVP] muscles), then analysed and compared between patients with MEE and those without and between sides in patients with unilateral MEE. MAIN OUTCOME MEASURES AND RESULTS Seventy-three patients were enrolled. Most were males (71.2%) with advanced-stage diseases (78%). At the time of diagnosis 14 patients (19.2%) presented with MEE. Following radiation, 18 patients, with no evidence of MEE at presentation, developed MEE. Tumour stage, histology, and laterality were not associated with development of MEE. Comparison of mean radiation field dosages including-gross target volume, clinical target volume, and patient target volume showed no association with post-radiation MEE. In addition, no difference was found in the radiation doses to the middle ear, ET or the LVP nor the TVP between ears with and without MEE. CONCLUSIONS Post-irradiation MEE remains a common adverse effect in NPC patients. Surprisingly, tumour stage, tumour laterality, and histology were not associated with MEE. Similar findings were observed for total radiation doses and specific doses to the middle ear, ET, and ET muscles.
Collapse
Affiliation(s)
- Igor Vainer
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Tzelnick
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noga Kurman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - Aron Popovtzer
- Sharett Institute of Oncology, Hadassah Medical Center, Jerusalem, Israel
| | - Ethan Soudry
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
6
|
Gronbeck C, Jain NP, Zhou AE, Feng H. Volume and Distribution of Radiotherapy Performed by Dermatologists from 2016-2021: A National Medicare Trend Analysis. J Am Acad Dermatol 2024:S0190-9622(24)00555-3. [PMID: 38582239 DOI: 10.1016/j.jaad.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/17/2024] [Accepted: 04/01/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Christian Gronbeck
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - Neelesh P Jain
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - Albert E Zhou
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - Hao Feng
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT.
| |
Collapse
|
7
|
Picano E, Vano E. Updated Estimates of Radiation Risk for Cancer and Cardiovascular Disease: Implications for Cardiology Practice. J Clin Med 2024; 13:2066. [PMID: 38610831 PMCID: PMC11012972 DOI: 10.3390/jcm13072066] [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: 02/20/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
This review aims to furnish an updated assessment of the societal healthcare load, including cancer and cardiovascular disease resulting from diagnostic radiologic operations. The previously projected additional cancer risk of 0.9% in a United States 2004 study referred to radiological conditions in 1996 with an X-ray exposure of 0.50 millisievert (mSv) per capita annually. Radiological exposure (radiology + nuclear medicine) has escalated to 2.29 mSv (2016) per capita per year. Low-dose exposures were previously assumed to have a lower biological impact, since they allow the DNA repair system to mitigate molecular damage. However, epidemiological data matured and disproved this assumption, as shown by updated cancer risk assessments derived from the World Health Organization 2013 and the German Institute of Radioprotection 2014 data. The risk of cardiovascular disease aligns within the same order of magnitude as cancer risk and compounds it, as shown by a comprehensive meta-analysis of 93 studies. The collective societal burden arising from the augmented risks of cancer and cardiovascular disease attributable to diagnostic radiology and nuclear medicine is higher than previously thought.
Collapse
Affiliation(s)
- Eugenio Picano
- Cardiology Clinic, University Center Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia
| | - Eliseo Vano
- Cardiology Department, Medical Faculty, Complutense University, 28040 Madrid, Spain;
| |
Collapse
|
8
|
Rzadki K, Baqri W, Yermakhanova O, Habbous S, Das S. Choreographed expansion of services results in decreased patient burden without compromise of outcomes: An assessment of the Ontario experience. Neurooncol Pract 2024; 11:178-187. [PMID: 38496909 PMCID: PMC10940827 DOI: 10.1093/nop/npad076] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Background Neuro-oncology care in Ontario, Canada has been historically centralized, at times requiring significant travel on the part of patients. Toward observing the goal of patient-centered care and reducing patient burden, 2 additional regional cancer centres (RCC) capable of neuro-oncology care delivery were introduced in 2016. This study evaluates the impact of increased regionalization of neuro-oncology services, from 11 to 13 oncology centers, on healthcare utilization and travel burden for glioblastoma (GBM) patients in Ontario. Methods We present a cohort of GBM patients diagnosed between 2010 and 2019. Incidence of GBM and treatment modalities were identified using provincial health administrative databases. A geographic information system and spatial analysis were used to estimate travel time from patient residences to neuro-oncology RCCs. Results Among the 5242 GBM patients, 79% received radiation as part of treatment. Median travel time to the closest RCC was higher for patients who did not receive radiation as part of treatment than for patients who did (P = .03). After 2016, the volume of patients receiving radiation at their local RCC increased from 62% to 69% and the median travel time to treatment RCCs decreased (P = .0072). The 2 new RCCs treated 35% and 41% of patients within their respective catchment areas. Receipt of standard of care, surgery, and chemoradiation (CRT), increased by 11%. Conclusions Regionalization resulted in changes in the healthcare utilization patterns in Ontario consistent with decreased patient travel burden for patients with GBM. Focused regionalization did not come at the cost of decreased quality of care, as determined by the delivery of a standard of care.
Collapse
Affiliation(s)
- Kathryn Rzadki
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Wafa Baqri
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Steven Habbous
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Sunit Das
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
9
|
Yariv O, Amitai N, Nachalon Y, Moore A, Popovtzer A. Outcome of radiotherapy for the treatment of laryngeal squamous cell carcinoma in the very elderly population. J Laryngol Otol 2024; 138:443-447. [PMID: 36776099 DOI: 10.1017/s002221512300018x] [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] [Indexed: 02/14/2023]
Abstract
BACKGROUND Treatment selection for squamous cell carcinoma patients aged over 84 years is controversial. This retrospective chart review examined and compared characteristics of laryngeal squamous cell carcinoma in very elderly (over 84 years) and younger patients (approximately 65 years). The secondary objective was to further evaluate the outcome of radiotherapy as a treatment modality in this patient population. METHODS Of all 23 very elderly patients with laryngeal squamous cell carcinoma treated with radiotherapy, with or without surgery, in the Davidoff Cancer Center, from 1992 to 2012, 19 had sufficient data for analysis, and comprised the study group. RESULTS Median age at diagnosis was 86 years. Disease stage at diagnosis was I, II, III and IVA in 53 per cent, 21 per cent, 21 per cent and 5 per cent, respectively. Median radiotherapy dose was 60 Gy given in 25 fractions. Three patients had recurrence. No patient discontinued treatment because of toxicity. Median overall survival was 3.6 years (range, 0-10 years). CONCLUSION Very elderly laryngeal squamous cell carcinoma patients may derive a similar survival advantage as younger counterparts. Modern radiotherapy is effective and safe for treating laryngeal squamous cell carcinoma in this study population. Further, large-scale studies are needed.
Collapse
Affiliation(s)
- Orly Yariv
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nimrod Amitai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otorhinolaryngology - Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Yuval Nachalon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otorhinolaryngology - Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Assaf Moore
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aron Popovtzer
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
10
|
Gould SW, Harty MP, Cartoski M, Krishnan V, Givler N, Ostrowski J, Tsuda T. Efficacy and safety of coronary computed tomography angiography in diagnosing coronary lesions in children. Cardiol Young 2024; 34:838-845. [PMID: 37877254 DOI: 10.1017/s1047951123003438] [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] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Identification of paediatric coronary artery abnormalities is challenging. We studied whether coronary artery CT angiography can be performed safely and reliably in children. MATERIALS Retrospective analysis of consecutive coronary CT angiography scans was performed for image quality and estimated radiation dose. Both factors were assessed for correlation with electrocardiographic-gating technique that was protocoled on a case-by-case basis, radiation exposure parameters, image noise artefact parameters, heart rate, and heart rate variability. RESULTS Sixty scans were evaluated, of which 96.5% were diagnostic for main left and right coronaries and 91.3% were considered diagnostic for complete coronary arteries. Subjective image quality correlated significantly with lower heart rate, increasing patient age, and higher signal-to-noise ratio. Estimated radiation dose only correlated significantly with choice of electrocardiographic-gating technique with median doses as follows: 2.42 mSv for electrocardiographic-gating triggered high-pitch spiral technique, 5.37 mSv for prospectively triggered axial sequential technique, 3.92 mSv for retrospectively gated technique, and 5.64 mSv for studies which required multiple runs. Two scans were excluded for injection failure and one for protocol outside the study scope. Five non-diagnostic cases were attributed to breathing motion, scanning prior to peak contrast enhancement, or scan acquisition during the incorrect portion of the R-R interval. CONCLUSIONS Diagnostic-quality coronary CT angiography can be performed reliably with a low estimated radiation exposure by tailoring each scan protocol to the patient's body habitus and heart rate. We propose coronary CT angiography is a safe and effective diagnostic modality for coronary artery abnormalities in children.
Collapse
Affiliation(s)
- Sharon W Gould
- Radiology Department, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| | - M Patricia Harty
- Radiology Department, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| | - Mark Cartoski
- Nemours Cardiac Center, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| | - Vijay Krishnan
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA
| | - Nicole Givler
- Radiology Department, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| | - John Ostrowski
- Nemours Cardiac Center, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| | - Takeshi Tsuda
- Nemours Cardiac Center, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| |
Collapse
|
11
|
Skelton K, Gorayski P, Tee H, Anderson N, Le H. Travelling overseas for proton beam therapy: A retrospective interview study. J Med Radiat Sci 2024; 71 Suppl 2:10-18. [PMID: 37622485 PMCID: PMC11011578 DOI: 10.1002/jmrs.721] [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: 02/16/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Travelling for cancer treatment comes with unique challenges, particularly for a young patient and his or her family. The aims of this study were to (1) gain an understanding of the experiences of families and patients who travelled overseas (OS) from Australia for proton beam therapy (PBT) and (2) identify the supportive care needs patients and their families require when living away from home, while having PBT. METHODS This was a retrospective, qualitative study using semi-structured interviews, conducted with participants aged under 25 years and their families who travelled OS for PBT between 2017 and 2020. Data were analysed using Microsoft Excel Software, where key themes were identified and coded based on their responses. A total of 17 participants were included in interviews from seven Australian families who travelled to America or Europe for PBT. RESULTS The majority of participants reported a lack of coordination with travel and treatment arrangements prior to arrival OS. Families who stayed in hotel accommodation while OS reported greater feelings of isolation compared with those who stayed in share house-style accommodation. The acuity of cancer diagnosis played a significant part in patient experience, with those patients requiring the greatest amount of supportive care and availability of service provision at stand-alone centres reporting a lack of appropriate care provision. CONCLUSIONS This study has identified services, accommodation provisions and care coordination requirements that are largely missing from the travel and treatment experience in patients travelling OS for PBT. Future use of consumer-led working groups or committees in creating models of care for families travelling for PBT treatment could be advantageous, with many families willing to share their experiences and provide support to others who are travelling for PBT.
Collapse
Affiliation(s)
- Kelly Skelton
- Australian Bragg Centre for Proton Therapy and Research, South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- Department of Radiation OncologyRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- University of MelbourneMelbourneVictoriaAustralia
| | - Peter Gorayski
- Australian Bragg Centre for Proton Therapy and Research, South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- Department of Radiation OncologyRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- Department of Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Hui Tee
- Australian Bragg Centre for Proton Therapy and Research, South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- Department of Radiation OncologyRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Nigel Anderson
- University of MelbourneMelbourneVictoriaAustralia
- Department of Radiation OncologyOlivia Newton‐John Cancer Wellness & Research Centre, Austin HealthMelbourneSouth AustraliaAustralia
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health CareMonash UniversityClaytonVictoriaAustralia
| | - Hien Le
- Australian Bragg Centre for Proton Therapy and Research, South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- Department of Radiation OncologyRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- Department of Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| |
Collapse
|
12
|
Lee KB, Tanenbaum MT, Wang A, Tsai S, Modrall JG, Timaran CH, Kirkwood ML, Ramanan B. Impact of head and neck radiation on long-term outcomes after carotid revascularization. J Vasc Surg 2024:S0741-5214(24)00928-5. [PMID: 38570175 DOI: 10.1016/j.jvs.2024.03.441] [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: 01/30/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Radiation-induced carotid artery stenosis (RICS) is a well-described phenomenon seen after head and neck cancer radiation. Previously published literature suggests that compared to atherosclerotic disease, RICS may result in worse long-term outcomes and early restenosis. This study aims to evaluate the effect of radiation on long-term outcomes after various carotid revascularization techniques using a multi-center registry database. METHODS Patients in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) registry for carotid artery intervention (carotid endarterectomy, CEA; transfemoral carotid artery stenting, CAS; transcarotid artery revascularization, TCAR), who are 65 years or older were included in the study. VQI Vascular Implant Surveillance and Interventional Outcomes Network (VISION) Medicare-linked database was used to obtain long-term procedure-specific outcomes. Primary endpoints were 3-year death, stroke, and reintervention. We performed propensity matching between patients with prior radiation and those without. Kaplan-Meier analysis and a multivariate logistic regression model were used to analyze the outcome variables. RESULTS A total of 56472 patients had undergone carotid revascularization (CEA, n=48307; TCAR, n=4593; CAS, n=3572), 1244 patients with prior radiation and 54925 patients without prior radiation. Prior radiation group was more likely to be male (71.9% vs. 60.3%, P<0.01), to receive a stent (47.5% vs. 13.5%, P<0.01), and to be on P2Y12 inhibitor (55.2% vs. 38.3%, P<0.01). Propensity matching was performed on 1223 patients (CEA, n=655; TCAR, n=292; CAS, n=287). There were no significant differences in 30-day outcomes for death, stroke, or major adverse cardiovascular events for all three procedures (Table I). The prior radiation group had higher rates of cranial nerve injury (3.7% vs. 1.8%, p = 0.04) and 90-day readmission (23.5% vs. 18.3%, p = 0.01) after CEA. For long-term outcomes, prior radiation significantly increased mortality risk for CEA and CAS (HR 1.77, CI [1.38 - 2.27] and 1.56, CI [1.02 - 2.36], respectively). The 3-year risk of stroke for CEA in radiated patients was also significantly higher (HR 1.47, CI [1.03 - 2.09]) compared to non-radiated patients. Prior radiation did not significantly affect death and stroke in patients undergoing TCAR. Prior radiation also did not impact the rates of short and long-term reintervention after CEA, CAS, or TCAR. CONCLUSION Prior head and neck radiation significantly increases the risk for mortality and stroke for CEA and the risk for mortality after CAS. Long-term outcomes for TCAR are not significantly affected by prior radiation. TCAR may be the preferred treatment modality for patients with radiation-induced carotid stenosis.
Collapse
Affiliation(s)
- K Benjamin Lee
- Division of Vascular Diseases and Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Mira T Tanenbaum
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Angela Wang
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shirling Tsai
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Division of Vascular and Endovascular Surgery, Department of Surgery, Dallas VA Medical Center, Dallas, TX
| | - J Gregory Modrall
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Division of Vascular and Endovascular Surgery, Department of Surgery, Dallas VA Medical Center, Dallas, TX
| | - Carlos H Timaran
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Melissa L Kirkwood
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Bala Ramanan
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Division of Vascular and Endovascular Surgery, Department of Surgery, Dallas VA Medical Center, Dallas, TX.
| |
Collapse
|
13
|
Thor M, Lee C, Sun L, Patel P, Apte A, Grkovski M, Shepherd AF, Gelblum DY, Wu AJ, Simone CB, Chaft JE, Rimner A, Gomez DR, Deasy JO, Shaverdian N. An 18F-FDG PET/CT and Mean Lung Dose Model to Predict Early Radiation Pneumonitis in Stage III Non-Small Cell Lung Cancer Patients Treated with Chemoradiation and Immunotherapy. J Nucl Med 2024; 65:520-526. [PMID: 38485270 PMCID: PMC10995528 DOI: 10.2967/jnumed.123.266965] [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: 10/29/2023] [Revised: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
Radiation pneumonitis (RP) that develops early (i.e., within 3 mo) (RPEarly) after completion of concurrent chemoradiation (cCRT) leads to treatment discontinuation and poorer survival for patients with stage III non-small cell lung cancer. Since no RPEarly risk model exists, we explored whether published RP models and pretreatment 18F-FDG PET/CT-derived features predict RPEarly Methods: One hundred sixty patients with stage III non-small cell lung cancer treated with cCRT and consolidative immunotherapy were analyzed for RPEarly Three published RP models that included the mean lung dose (MLD) and patient characteristics were examined. Pretreatment 18F-FDG PET/CT normal-lung SUV featured included the following: 10th percentile of SUV (SUVP10), 90th percentile of SUV (SUVP90), SUVmax, SUVmean, minimum SUV, and SD. Associations between models/features and RPEarly were assessed using area under the receiver-operating characteristic curve (AUC), P values, and the Hosmer-Lemeshow test (pHL). The cohort was randomly split, with similar RPEarly rates, into a 70%/30% derivation/internal validation subset. Results: Twenty (13%) patients developed RPEarly Predictors for RPEarly were MLD alone (AUC, 0.72; P = 0.02; pHL, 0.87), SUVP10, SUVP90, and SUVmean (AUC, 0.70-0.74; P = 0.003-0.006; pHL, 0.67-0.70). The combined MLD and SUVP90 model generalized in the validation subset and was deemed the final RPEarly model (RPEarly risk = 1/[1+e(- x )]; x = -6.08 + [0.17 × MLD] + [1.63 × SUVP90]). The final model refitted in the 160 patients indicated improvement over the published MLD-alone model (AUC, 0.77 vs. 0.72; P = 0.0001 vs. 0.02; pHL, 0.65 vs. 0.87). Conclusion: Patients at risk for RPEarly can be detected with high certainty by combining the normal lung's MLD and pretreatment 18F-FDG PET/CT SUVP90 This refined model can be used to identify patients at an elevated risk for premature immunotherapy discontinuation due to RPEarly and could allow for interventions to improve treatment outcomes.
Collapse
Affiliation(s)
- Maria Thor
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York;
| | - Chen Lee
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lian Sun
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Purvi Patel
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Aditya Apte
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Milan Grkovski
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Annemarie F Shepherd
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Daphna Y Gelblum
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Abraham J Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Charles B Simone
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Jamie E Chaft
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Daniel R Gomez
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Narek Shaverdian
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; and
| |
Collapse
|
14
|
Berry CE, Abbas DB, Griffin M, Lintel H, Guo J, Kameni L, Churukian AA, Fazilat AZ, Chen K, Gurtner GC, Longaker MT, Momeni A, Wan DC. Deferoxamine topical cream superior to patch in rescuing radiation-induced fibrosis of unwounded and wounded skin. J Cell Mol Med 2024; 28:e18306. [PMID: 38613357 PMCID: PMC11015393 DOI: 10.1111/jcmm.18306] [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: 02/10/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Topical patch delivery of deferoxamine (DFO) has been studied as a treatment for this fibrotic transformation in irradiated tissue. Efficacy of a novel cream formulation of DFO was studied as a RIF therapeutic in unwounded and excisionally wounded irradiated skin. C57BL/6J mice underwent 30 Gy of radiation to the dorsum followed by 4 weeks of recovery. In a first experiment, mice were separated into six conditions: DFO 50 mg cream (D50), DFO 100 mg cream (D100), soluble DFO injections (DI), DFO 1 mg patch (DP), control cream (Vehicle), and irradiated untreated skin (IR). In a second experiment, excisional wounds were created on the irradiated dorsum of mice and then divided into four treatment groups: DFO 100 mg Cream (W-D100), DFO 1 mg patch (W-DP), control cream (W-Vehicle), and irradiated untreated wounds (W-IR). Laser Doppler perfusion scans, biomechanical testing, and histological analysis were performed. In irradiated skin, D100 improved perfusion compared to D50 or DP. Both D100 and DP enhanced dermal characteristics, including thickness, collagen density and 8-isoprostane staining compared to untreated irradiated skin. D100 outperformed DP in CD31 staining, indicating higher vascular density. Extracellular matrix features of D100 and DP resembled normal skin more closely than DI or control. In radiated excisional wounds, D100 facilitated faster wound healing and increased perfusion compared to DP. The 100 mg DFO cream formulation rescued RIF of unwounded irradiated skin and improved excisional wound healing in murine skin relative to patch delivery of DFO.
Collapse
Affiliation(s)
- Charlotte E. Berry
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Darren B. Abbas
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Michelle Griffin
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Hendrik Lintel
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Jason Guo
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Lionel Kameni
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Andrew A. Churukian
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Alexander Z. Fazilat
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Kellen Chen
- Department of SurgeryThe University of Arizona College of MedicineTucsonArizonaUSA
| | - Geoffrey C. Gurtner
- Department of SurgeryThe University of Arizona College of MedicineTucsonArizonaUSA
| | - Michael T. Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
- Institute for Stem Cell Biology and Regenerative MedicineStanford UniversityStanfordCaliforniaUSA
| | - Arash Momeni
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Derrick C. Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| |
Collapse
|
15
|
Harris E, Marignol L. Prehabilitation for Patients with Cancer Undergoing Radiation Therapy: a Scoping Review. Clin Oncol (R Coll Radiol) 2024; 36:254-264. [PMID: 38350785 DOI: 10.1016/j.clon.2024.02.002] [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: 07/06/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
AIMS Prehabilitation is a process of identifying and assessing factors that could compromise the physical and psychological health of patients undergoing cancer treatment and implementing an intervention to combat such concerns. The use of prehabilitation in cancer surgery has yielded positive outcomes in rectal, lung and abdominal cancers. Prehabilitation strategies have potential to improve the management of patients receiving radiation therapy or chemoradiation. The aim of the present study was to map the evidence of the assessment and evaluation of prehabilitation for radiation therapy patients. MATERIALS AND METHODS A database search using EMBASE and PubMed was conducted. The PRISMA guidelines were adhered to. Keywords included prehabilitation, radiation therapy/radiotherapy, chemoradiotherapy/chemoradiation, intervention and exercise. Types of prehabilitation strategy, their purposes and impact, according to cancer site, were analysed. RESULTS Prehabilitation is most commonly evaluated in head and neck cancer, whereby unimodal, physical interventions manage dysphagia. Prehabilitation for lung cancer demonstrated its ability to widen treatment options for patients. Physical prehabilitation is administered to combat adverse effects of neoadjuvant chemoradiation therapy in patients with rectal cancer. CONCLUSION Prehabilitation is adaptive and tailored to specific patient and site needs; thus it is applied across a wide range of cancer sites. More interventions by which radiation therapy is the definitive treatment modality and larger sample sizes within these studies are warranted to increase prehabilitation utilisation for patients undergoing radiation therapy.
Collapse
Affiliation(s)
- E Harris
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James's Cancer Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - L Marignol
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James's Cancer Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland.
| |
Collapse
|
16
|
Hong S, Bouchal SM, Bauman MMJ, Riviere-Cazaux C, Pumford AD, Brown PD, Yan ES, Stafford SL, Markovic SN, Link MJ, Burns TC, Jusue-Torres I, Pollock BE, Parney IF. The longitudinal risk of hemorrhage of melanoma brain metastases after Gamma Knife radiosurgery. J Neurosurg 2024; 140:938-948. [PMID: 37878000 DOI: 10.3171/2023.7.jns231225] [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: 05/27/2023] [Accepted: 07/20/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE The objective of this study was to analyze the hemorrhagic risk of melanoma brain metastases after Gamma Knife radiosurgery (GKRS). METHODS A prospective institutional database was retrospectively queried to identify patients who underwent GKRS for melanoma brain metastases between 1990 and 2021. Lesional hemorrhage was defined as definite or possible based on radiologists' readings, and severity was graded according to Common Terminology Criteria for Adverse Events. RESULTS Two hundred ninety-one patients with 1083 lesions treated in 419 sessions were identified. The mean (± SD) patient age was 60 ± 15 years, and 61% were male. The median follow-up period for overall survival (OS) was 11 (range 0-214) months with 581 patient-years. Definite/possible lesional hemorrhages occurred in 13% of lesions, with grade 3 hemorrhages observed in 4% of lesions. Surgical intervention was required in 2% of cases (5% of patients), and all resected lesions were pathologically consistent with melanoma. A decreased risk of definite/possible lesional hemorrhage was associated with a later time period between 2015 and 2021 (OR 0.45, 95% CI 0.266-0.75, p = 0.0021), increased marginal dose (OR 0.91, 95% CI 0.83-0.99, p = 0.037), antiplatelet use post-GKRS (OR 0.195, 95% CI 0.083-0.46, p < 0.001), and whole-brain radiotherapy (WBRT; OR 0.53, 95% CI 0.344-0.82, p = 0.0042). After 2015, more patients received anticoagulation, B-Raf proto-oncogene inhibitors, and immune checkpoint inhibitors, and fewer received bevacizumab (p < 0.001). The cumulative risk of lesional hemorrhage was 17%-20% at 36 months from GKRS, with 95%-96% of cases occurring within 12 months. The median patient OS was 11 (95% CI 9-13) months, and multivariate Cox regression analysis revealed that antiplatelet agents (hazard ratio [HR] 0.66, 95% CI 0.45-0.96, p = 0.031) and immune checkpoint inhibitors (HR 0.35, 95% CI 0.26-0.48, p < 0.001) were associated with longer OS, while WBRT (HR 1.36, 95% CI 1.02-1.81, p = 0.037) and definite/possible hemorrhage (HR 1.39, 95% CI 1.04-1.85, p = 0.024) were associated with shorter OS. CONCLUSIONS The definite hemorrhage risk of melanoma brain metastases after GKRS was 17% in the first 3 years and 95% of the lesional hemorrhage occurred within the 1st year. Surgical intervention was needed in 5% of patients. Antiplatelet agents and immune checkpoint inhibitors were associated with improved OS, while definite/possible hemorrhage was associated with worse OS.
Collapse
Affiliation(s)
| | | | - Megan M J Bauman
- 2Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Andrew D Pumford
- 2Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Yoda S, Maruo T, Arai H, Takahashi R, Kusaka T, Nishiyama Y, Kayanuma H. Comparison of a new immobilization method using a reusable 3-point fixation cylinder system and bite-block type immobilization methods in veterinary radiotherapy. Vet Radiol Ultrasound 2024. [PMID: 38554033 DOI: 10.1111/vru.13364] [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: 09/18/2023] [Revised: 03/12/2024] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
In veterinary radiotherapy, highly reproducible immobilization is important for accurate irradiation. Consequently, we developed a new reusable head-immobilization method for dogs using cylinders. This study aimed to compare the accuracy of our novel immobilization method using cylinders with that of bite-block type immobilization methods. Three immobilization methods were compared: bite-block only, bite-block combined with torso immobilization, and immobilization using cylinders. Five beagles with canine teeth underwent CT five times for each of the three immobilization methods. One beagle without canine teeth underwent CT 15 times using each method. Three maxillary landmarks (maxillary incisor, frontal sinus, and occipital bone) and one mandibular landmark (mandibular incisor) were established, and the errors in each immobilization method were measured. For all head landmarks, the error in the immobilization method using cylinders was the most reproducible, with the smallest errors. No significant differences were observed in the time required for immobilization. Although there were limitations (such as the use of dogs from a single breed, a single episode of anesthesia, no disassembly of the immobilization system between scans, and the same person performing the positioning on the same day), we found our new reusable immobilization method using cylinders was the most accurate among the three compared methods. This was a proof-of-principle study to evaluate head immobilization using cylinders, and further investigations are needed to confirm its clinical utility.
Collapse
Affiliation(s)
- Shinichiro Yoda
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Takuya Maruo
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Veterinary Teaching Hospital, Azabu University, Sagamihara, Kanagawa, Japan
| | - Haruka Arai
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Rihoko Takahashi
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Takuya Kusaka
- Veterinary Teaching Hospital, Azabu University, Sagamihara, Kanagawa, Japan
| | - Yuta Nishiyama
- Veterinary Teaching Hospital, Azabu University, Sagamihara, Kanagawa, Japan
| | - Hideki Kayanuma
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Veterinary Teaching Hospital, Azabu University, Sagamihara, Kanagawa, Japan
| |
Collapse
|
18
|
Yasen X, Aikebaier R, Maimaiti A, Mushajiang M. IL-33/soluble ST2 axis is associated with radiation-induced cardiac injury. Open Life Sci 2024; 19:20220841. [PMID: 38585634 PMCID: PMC10997150 DOI: 10.1515/biol-2022-0841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/24/2024] [Accepted: 02/20/2024] [Indexed: 04/09/2024] Open
Abstract
Radiotherapy for treating breast cancer is associated with cardiac damage. This study aimed to investigate the role of the interleukin (IL)-33/soluble receptor ST2 (sST2) axis in radiation-induced cardiac injury. Expressions of IL-33 and sST2 were detected in breast cancer patients following radiotherapy, radiation-induced cardiac damaged mice model, and cardiomyocytes using quantitative real-time PCR (qRT-PCR) and immunohistochemical assay. Cardiac injury was evaluated through an ultrasound imaging system and hematoxylin & eosin staining. The transcriptional factor was assessed using dual-luciferase reporter assay and chromatin immunoprecipitation. The results indicated that IL-33 and sST2 were highly expressed in breast cancer patients, which further elevated post-6 months but reduced after 12 months of radiotherapy. Radiation induces cardiac dysfunction and elevated IL-33 and sST2 levels in a time-dependent manner. However, silencing of IL-33 decreased sST2 expression to alleviate radiation-induced cardiac dysfunction. The IL-33 could be transcriptional activated by TCF7L2 by binding to IL33 promoter sites, which mutation alleviated cardiomyocyte injury caused by radiation. Additionally, radiation treatment resulted in higher levels of TCF7L2, IL-33, and sST2 in cardiomyocytes, and TCF7L2 knockdown reduced IL-33 and sST2 expression. In conclusion, TCF7L2 transcriptional-activated IL-33 mediated sST2 to regulate radiation-induced cardiac damage, providing novel insights into radiotherapy-induced cardiac damage.
Collapse
Affiliation(s)
- Xiaokeya Yasen
- Department of Tumor Internal Medicine, The First People’s Hospital of Kashgar Prefecture, Xinjiang, China
| | - Renaguli Aikebaier
- Department of Tumor Internal Medicine, The First People’s Hospital of Kashgar Prefecture, Xinjiang, China
| | - Atiguli Maimaiti
- Department of Tumor Internal Medicine, The First People’s Hospital of Kashgar Prefecture, Xinjiang, China
| | - Munire Mushajiang
- Department of Breast Radiotherapy, Cancer Hospital Affiliated to Xinjiang Medical University, 789 Suzhou East Street, Xinshi District, Urumqi City, Xinjiang 830000, China
| |
Collapse
|
19
|
Silverstein ML, Momeni A. A plastic surgery perspective on the choice between breast conserving surgery with radiotherapy versus mastectomy and reconstruction. Gland Surg 2024; 13:449-451. [PMID: 38601281 PMCID: PMC11002488 DOI: 10.21037/gs-23-506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/26/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Max L Silverstein
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Arash Momeni
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| |
Collapse
|
20
|
Scherrer S, Gates C, Rajapaksha H, Greer S, Stein B, Forbes T. Superoxide Radicals in Uranyl Peroxide Solids: Lasting Signatures Identified by Electron Paramagnetic Resonance Spectroscopy. Angew Chem Int Ed Engl 2024:e202400379. [PMID: 38530229 DOI: 10.1002/anie.202400379] [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: 01/06/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 03/27/2024]
Abstract
U(VI) peroxide phases (studtite and meta-studtite) are found throughout the nuclear fuel cycle and exist as corrosion products in high radiation fields. Peroxides are part of a family of reactive oxygen species (ROS) that include hydroperoxyl and superoxide species and are produced during alpha radiolysis of water. While U(VI) peroxides have been thoroughly investigated, the incorporation and stability of ROS species within studtite have not been validated. In the current study, electron paramagnetic resonance (EPR) spectroscopy was used to identify the presence of free radicals within a series of U(VI) peroxide samples containing depleted, weapons-grade, and natural uranium. Density functional theory calculations indicated that the predicted EPR signals matched well with a superoxide (O2-•) species incorporated into the studtite structure, confirming the presence of ROS in the material. Further analysis of samples that were synthesized between 1945 and 2023 indicated that there is a correlation between the radical signal and the product of specific activity multiplied by age of the sample.
Collapse
Affiliation(s)
- Sarah Scherrer
- The University of Iowa, Department of Chemistry, W374 Chemistry Building, 52242, Iowa City, UNITED STATES
| | - Cassandra Gates
- Los Alamos National Laboratory, Chemistry Division, UNITED STATES
| | | | - Samuel Greer
- Los Alamos National Laboratory, Chemistry Division, UNITED STATES
| | - Benjamin Stein
- Los Alamos National Laboratory, Chemistry Division, UNITED STATES
| | - Tori Forbes
- University of Iowa, Department of Chemistry, Chemistry Building W374, 52242, Iowa City, UNITED STATES
| |
Collapse
|
21
|
Vasudev M, Martin E, Frank MI, Meller LLT, Haidar YM. Treatment Delay and HPV Status on OPSCC With Upfront Surgery: Analysis of National Cancer Database. Otolaryngol Head Neck Surg 2024. [PMID: 38532532 DOI: 10.1002/ohn.699] [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: 08/28/2023] [Revised: 01/12/2024] [Accepted: 02/05/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE Evaluate the effect of treatment delay on survival in human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing primary surgical resection. STUDY DESIGN Retrospective cohort study using the 2010-2017 National Cancer Database. SETTING Multicenter database study. METHODS Patients >18 years old with OPSCC and known HPV status, treated surgically with or without postoperative radiation/chemotherapy were included. Two cohorts based on HPV status were grouped by time to treatment initiation (TD-TI, ≤30, 31-60, ≥61 days) and surgery to radiotherapy (TS-RT, ≤42, 43-66, ≥67 days). Univariate, Kaplan-Meier, and multivariate analyses assessed correlations between demographic and clinical factors with overall survival in treatment delay groups. RESULTS Included were 1643 HPV-positive OPSCC patients and 391 HPV-negative OPSCC patients. No associations between survival and gender, age, race, insurance, or radiotherapy length were observed. Regardless of HPV status, larger tumor size (>2 cm) and lymphovascular invasion predicted worse survival. HPV negative patients with >4 lymph nodes involved had 2.5× greater mortality risk (P = .039). Robotic surgery was associated with improved survival only in HPV positive patients (hazard ratio [HR]: 0.41, P < .001). In HPV positive patients, higher TD-TI related to lower mean survival, although this was not significant on multivariate analysis. HPV negative patients with >42 days of TS-RT had decreased survival (43-66 days, HR 1.63, P = .049; ≥67 days, HR 2.10, P = .032). CONCLUSION Longer TS-RT was associated with lower overall survival in HPV negative patients. Treatment delay was not associated with survival in HPV positive OPSCC according to multivariate analysis. These findings enhance knowledge about treatment delay effects in OPSCC, aiding providers in decisions and patient communication.
Collapse
Affiliation(s)
- Milind Vasudev
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Elaine Martin
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Madelyn I Frank
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Leo L T Meller
- School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Yarah M Haidar
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA
| |
Collapse
|
22
|
Sun L, Morikawa K, Sogo Y, Sugiura Y. MHY1485 potentiates immunogenic cell death induction and anti-cancer immunity following ir radiation. J Radiat Res 2024; 65:205-214. [PMID: 38330507 PMCID: PMC10959436 DOI: 10.1093/jrr/rrad107] [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] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/17/2023] [Indexed: 02/10/2024]
Abstract
Recent in vitro experiments showed that combined treatment with MHY1485, a low-molecular-weight compound, and X-ray irradiation significantly increased apoptosis and senescence in tumor cells, which was associated with oxidative stress, endoplasmic reticulum (ER) stress and p21 stabilization, compared to radiation treatment alone. However, evidence for MHY1485 treatment-mediated suppression of tumor growth in animals is still lacking. Furthermore, it has been shown that ER stress enhances immunogenic cell death (ICD) in tumor cells, as it can exert a favorable influence on the anti-cancer immune system. In the present study, we examined whether co-treatment of MHY1485 and X-ray irradiation induces ICD and in vivo tumor growth suppression using the CT26 and Lewis lung carcinoma murine tumor cell lines. We found that MHY1485 + X-ray treatment promotes ICD more effectively than X-ray treatment alone. MHY1485 suppresses tumor growth in vivo under co-treatment with X-rays and increases INF-γ, tumor necrosis factor, interleukin-2 and interleukin-12 levels in the spleen as well as the presence of CD8+ cells in the tumor. The results suggest that MHY1485 treatment leads to the conversion of irradiated tumors into effective vaccines. Thus, MHY1485 is a promising lead compound for use in combination with radiotherapy.
Collapse
Affiliation(s)
- Lue Sun
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan
| | - Kumi Morikawa
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan
| | - Yu Sogo
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan
| | - Yuki Sugiura
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14, Hayashi-cho, Takamatsu, Kagawa 761-0895, Japan
| |
Collapse
|
23
|
Ghoneum M, Badr El-Din NK, Alaa El-Dein M. Anti- radiation effect of MRN-100: a hydro-ferrate fluid, in vivo. J Radiat Res 2024; 65:145-158. [PMID: 38247158 PMCID: PMC10959437 DOI: 10.1093/jrr/rrad095] [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] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/01/2023] [Indexed: 01/23/2024]
Abstract
Ionizing radiation (IR) severely harms many organs, especially the hematopoietic tissue, mandating the development of protective nutraceuticals. MRN-100, a hydro-ferrate fluid, has been shown to protect γ-radiated fish against hematopoietic tissue damage and lethality. The current study aimed to examine MRN-100's protective effect against irradiated mice and explore the mechanisms underlying its effect. Mice received a single acute, sub-lethal, 5 Gy, whole body dose of X-ray IR. MRN-100 treatment was administered daily for 2-weeks pre-irradiation until 1-week post-irradiation. Spleen and blood were analysed for oxidative stress, hematological, histological and biochemical parameters. Radiation exposure markedly decreased complete blood count (CBC) parameters including hemoglobin, hematocrit, red blood cells, platelets, white blood cells and lymphocytes, and significantly increased neutrophils. In contrast, MRN-100 supplementation to irradiated mice ameliorated all CBC parameters and protected against DNA damage in both splenic cells and serum. It also had an antioxidant effect, increasing the levels of glutathione, superoxide dismutase, catalase and total antioxidant capacity, which were otherwise decreased by irradiation. MRN-100 intake reduced the oxidative stress biomarker levels of nitric oxide, protein carbonyl, malondialdehyde, reactive oxygen species and 8-hydroxydeoxyguanosine, a marker specific to DNA damage. Furthermore, MRN-100 enhanced serum iron and reversed the radiation-induced elevations of liver enzymes. Finally, MRN-100 protected splenic tissue from irradiation as observed by histology. We conclude that MRN-100 consumption may protect against oxidative stress generated by radiation exposure, suggesting that it may be employed as an adjuvant treatment to prevent radiation's severe damage to important organs.
Collapse
Affiliation(s)
- Mamdooh Ghoneum
- Department of Surgery, Charles Drew University of Medicine and Science, 1621 East 120th Street, Los Angeles, California 90059, USA
- Department of Surgery, University of California Los Angeles, 405 Hilgard Ave, Los Angeles, CA 90095, USA
| | - Nariman K Badr El-Din
- Department of Zoology, Faculty of Science, Mansoura University, Mansoura 35516, Egypt
| | - Mai Alaa El-Dein
- Department of Zoology, Faculty of Science, Mansoura University, Mansoura 35516, Egypt
| |
Collapse
|
24
|
Ng Hung Shin B, Tan S, Rhee H, Chung E. Impact of the COVID-19 pandemic on delivery of prostate cancer care in Australia: An interrupted time series analysis. Int J Cancer 2024; 154:1003-1010. [PMID: 37921494 DOI: 10.1002/ijc.34759] [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: 03/20/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 11/04/2023]
Abstract
The COVID-19 pandemic led to a major disruption to health services across the world. The aim of this population-based study was to assess the downstream effects of the pandemic on diagnostic tests and treatment activities related to prostate cancer (PC). The Australian Government Department of Health Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme databases were queried from January 2010 to June 2022. Two interrupted time series were performed Pre-COVID (January 2010 to February 2020) and peri-COVID (March 2020 to June 2022). Temporal modeling was performed to account for seasonal variation. Pre-COVID-19, monthly prostate-specific antigen (PSA) testing showed a declining trend and testing decreased by 81 tests per 100 000 annually. A single-month 38% drop in PSA testing was observed in April 2020; this corresponded to Australia's first wave. No change was observed in the rate of prostate biopsies. Peri-COVID-19 outbreaks, there was a slight shift toward the use of long-acting androgen deprivation therapy (ADT) at 4% with a predilection still for short-acting agents. with no registered change in the overall volume of radiotherapy or surgery. There were no deficits in the number of diagnostic and treatment activities for men with PC. Aside from a slight shift toward long-acting ADT use during the pandemic, no other patterns were observed. The longer-term impact such as missed diagnosis or late presentation affecting chances of survival due to COVID-19 is yet to be ascertained.
Collapse
Affiliation(s)
- Brian Ng Hung Shin
- Department of Urology, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia
| | - Samuel Tan
- Department of Urology, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia
| | - Handoo Rhee
- Department of Urology, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia
- AndroUrology Centre, Brisbane, QLD, Australia
| |
Collapse
|
25
|
Zheng K, Ghosh S, Granick S. Exceptions to Fourier's Law at the Macroscale. Proc Natl Acad Sci U S A 2024; 121:e2320337121. [PMID: 38442154 PMCID: PMC10945759 DOI: 10.1073/pnas.2320337121] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
The usual basis to analyze heat transfer within materials is the equation formulated 200 years ago, Fourier's law, which is identical mathematically to the mass diffusion equation, Fick's law. Revisiting this assumption regarding heat transport within translucent materials, performing the experiments in vacuum to avoid air convection, we compare the model predictions to infrared-based measurements with nearly mK temperature resolution. After heat pulses, we find macroscale non-Gaussian tails in the surface temperature profile. At steady state, we find macroscale anomalous hot spots when the sample is topographically rough, and this is validated by using two additional independent methods to measure surface temperature. These discrepancies from Fourier's law for translucent materials suggest that internal radiation whose mean-free-path is millimeters interacts with defects to produce small heat sources that by secondary emission afford an additional, non-local mode of heat transport. For these polymer and inorganic glass materials, this suggests unique strategies of heat management design.
Collapse
Affiliation(s)
- Kaikai Zheng
- Center for Soft and Living Matter, Institute for Basic Science, Ulsan44919, South Korea
- Department of Polymer Science and Engineering, University of Massachusetts, Amherst, MA01003
| | - Shankar Ghosh
- Tata Institute for Fundamental Research, Mumbai, Maharashtra400005, India
| | - Steve Granick
- Center for Soft and Living Matter, Institute for Basic Science, Ulsan44919, South Korea
- Department of Polymer Science and Engineering, University of Massachusetts, Amherst, MA01003
| |
Collapse
|
26
|
George J, Tuli S, Patel PP, Monare B, Ramogola-Masire D, Bazzett-Matabele L, Bvochora-Nsingo M, Chiyapo S, Ralefala T, Vuylsteke P, Rendle KA, Grover S. Delays in cervical cancer treatment initiation for patients living with or without HIV in Botswana: An observational cohort analysis (2015-2019). Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00354-7. [PMID: 38462016 DOI: 10.1016/j.ijrobp.2024.02.038] [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: 09/27/2023] [Revised: 02/04/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Present delays in treatment initiation of chemoradiation or radiation alone for patients with advanced stage cervical cancer in Botswana. METHODS Women with locally advanced cervical cancer (stages IB2-IVB) were prospectively enrolled in an observational cohort study in 2015-2019. We evaluated delays at 30, 60, 90, 120, 150, and 180 or greater days between the date of diagnosis and treatment initiation. Factors associated with overall survival (OS) were modeled with multivariable Cox proportional hazards regression (aHR). Associations between delays in cervical cancer treatment initiation were evaluated via univariable logistic regression. RESULTS Among the 556 patients included (median age = 47.9 years), 386 (69.4%) were women living with HIV with a median CD4 count of 448.0 cells/μL (IQR, 283.0-647.5 cells/μL) at diagnosis. Most patients had stages II (38.1%) and III (34.5%) cervical cancer. Early-stage patients experienced longer delays in treatment initiation compared to late-stage patients (p=0.033). Early-stage patients with delays ≥90 days and pathology diagnosis between 2016-2019 (aHR 0.34, p<0.001) versus <90 days decreased the risk of mortality, while those with delays ≥90 days and pathology diagnosis before 2016 (aHR 5.67, p=0.022) versus <90 days increased the risk the mortality. Late-stage patients with delays ≥120 days and pathology diagnosis between 2018-2019 (aHR 1.98, p=0.025) versus <120 days increased the risk the mortality. Early-stage patients with pathology diagnosis between 2016-2019 (OR 2.32, p=0.043) versus before 2016 were more likely to experience delays ≥90 days and late-stage patients who traveled >100 km to the treatment facility (OR 2.83, p<0.001) versus <100 km were more likely to experience delays ≥120 days. CONCLUSIONS Delays in care are common in Botswana, particularly for those living farther from the treatment clinic and at advanced stages. This paper is among the first to show an association between treatment delays and worsened OS at advanced stages of cervical cancer, highlighting the need for interventions to help patients receive timely care in global settings.
Collapse
Affiliation(s)
- Jessica George
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA
| | - Shawna Tuli
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA
| | - Palak P Patel
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Barati Monare
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
| | | | - Lisa Bazzett-Matabele
- Department of Obstetrics & Gynecology, University of Botswana, Gaborone, Botswana; Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT
| | | | | | | | - Peter Vuylsteke
- CHU Namur, Site Sainte-Elisabeth, UCLouvain, Namur, Belgium; Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | - Katharine A Rendle
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Surbhi Grover
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| |
Collapse
|
27
|
Shu X, Wang J, Zeng H, Shao L. Progression of Notch signaling regulation of B cells under radiation exposure. Front Immunol 2024; 15:1339977. [PMID: 38524139 PMCID: PMC10957566 DOI: 10.3389/fimmu.2024.1339977] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/14/2024] [Indexed: 03/26/2024] Open
Abstract
With the continuous development of nuclear technology, the radiation exposure caused by radiation therapy is a serious health hazard. It is of great significance to further develop effective radiation countermeasures. B cells easily succumb to irradiation exposure along with immunosuppressive response. The approach to ameliorate radiation-induced B cell damage is rarely studied, implying that the underlying mechanisms of B cell damage after exposure are eager to be revealed. Recent studies suggest that Notch signaling plays an important role in B cell-mediated immune response. Notch signaling is a critical regulator for B cells to maintain immune function. Although accumulating studies reported that Notch signaling contributes to the functionality of hematopoietic stem cells and T cells, its role in B cells is scarcely appreciated. Presently, we discussed the regulation of Notch signaling on B cells under radiation exposure to provide a scientific basis to prevent radiation-induced B cell damage.
Collapse
Affiliation(s)
- Xin Shu
- Department of Occupational Health and Toxicology, School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, School of Public Health, Nanchang University, Nanchang, China
| | - Jie Wang
- Department of Histology and Embryology, School of Basic Medicine Sciences, Nanchang University, Nanchang, China
| | - Huihong Zeng
- Department of Histology and Embryology, School of Basic Medicine Sciences, Nanchang University, Nanchang, China
| | - Lijian Shao
- Department of Occupational Health and Toxicology, School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, School of Public Health, Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Interdisciplinary Science, Nanchang University, Nanchang, China
| |
Collapse
|
28
|
Sitler CA, Tian C, Hamilton CA, Richardson MT, Chan JK, Kapp DS, Leath CA, Casablanca Y, Washington C, Chappell NP, Klopp AH, Shriver CD, Tarney CM, Bateman NW, Conrads TP, Maxwell GL, Phippen NT, Darcy KM. Immuno-Molecular Targeted Therapy Use and Survival Benefit in Patients with Stage IVB Cervical Carcinoma in Commission on Cancer ®-Accredited Facilities in the United States. Cancers (Basel) 2024; 16:1071. [PMID: 38473428 DOI: 10.3390/cancers16051071] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/27/2024] [Accepted: 03/03/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE To investigate IMT use and survival in real-world stage IVB cervical cancer patients outside randomized clinical trials. METHODS Patients diagnosed with stage IVB cervical cancer during 2013-2019 in the National Cancer Database and treated with chemotherapy (CT) ± external beam radiation (EBRT) ± intracavitary brachytherapy (ICBT) ± IMT were studied. The adjusted hazard ratio (AHR) and 95% confidence interval (CI) for risk of death were estimated in patients treated with vs. without IMT after applying propensity score analysis to balance the clinical covariates. RESULTS There were 3164 evaluable patients, including 969 (31%) who were treated with IMT. The use of IMT increased from 11% in 2013 to 46% in 2019. Age, insurance, facility type, sites of distant metastasis, and type of first-line treatment were independently associated with using IMT. In propensity-score-balanced patients, the median survival was 18.6 vs. 13.1 months for with vs. without IMT (p < 0.001). The AHR was 0.72 (95% CI = 0.64-0.80) for adding IMT overall, 0.72 for IMT + CT, 0.66 for IMT + CT + EBRT, and 0.69 for IMT + CT + EBRT + ICBT. IMT-associated survival improvements were suggested in all subgroups by age, race/ethnicity, comorbidity score, facility type, tumor grade, tumor size, and site of metastasis. CONCLUSIONS IMT was associated with a consistent survival benefit in real-world patients with stage IVB cervical cancer.
Collapse
Affiliation(s)
- Collin A Sitler
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Chunqiao Tian
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD 20817, USA
| | - Chad A Hamilton
- Gynecologic Oncology Section, Women's Services and The Ochsner Cancer Institute, Ochsner Health, New Orleans, LA 70115, USA
| | - Michael T Richardson
- Department of Obstetrics and Gynecology, Los Angeles School of Medicine, University of California, Los Angeles, CA 90024, USA
| | - John K Chan
- Palo Alto Medical Foundation, California Pacific Medical Center, Sutter Health, San Francisco, CA 94010, USA
| | - Daniel S Kapp
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Charles A Leath
- Division of Gynecologic Oncology, University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL 35249, USA
| | - Yovanni Casablanca
- Gynecologic Oncology Division, Levine Cancer Institute, Atrium Health, Charlotte, NC 28204, USA
| | - Christina Washington
- Gynecologic Oncology Division, Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Nicole P Chappell
- Gynecologic Oncology Division, GW Medical Faculty Associates, George Washington University, Washington, DC 20037, USA
| | - Ann H Klopp
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Craig D Shriver
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Christopher M Tarney
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Nicholas W Bateman
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD 20817, USA
| | - Thomas P Conrads
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA 22042, USA
| | - George Larry Maxwell
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA 22042, USA
| | - Neil T Phippen
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Kathleen M Darcy
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD 20817, USA
| |
Collapse
|
29
|
Kiang JG, Woods AK, Cannon G. Effects of Hemorrhage on Hematopoietic Cell Depletion after a Combined Injury with Radiation: Role of White Blood Cells and Red Blood Cells as Biomarkers. Int J Mol Sci 2024; 25:2988. [PMID: 38474235 DOI: 10.3390/ijms25052988] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Combined radiation with hemorrhage (combined injury, CI) exacerbates hematopoietic acute radiation syndrome and mortality compared to radiation alone (RI). We evaluated the effects of RI or CI on blood cell depletion as a biomarker to differentiate the two. Male CD2F1 mice were exposed to 8.75 Gy γ-radiation (60Co). Within 2 h of RI, animals were bled under anesthesia 0% (RI) or 20% (CI) of total blood volume. Blood samples were collected at 4-5 h and days 1, 2, 3, 7, and 15 after RI. CI decreased WBC at 4-5 h and continued to decrease it until day 3; counts then stayed at the nadir up to day 15. CI decreased neutrophils, lymphocytes, monocytes, eosinophils, and basophils more than RI on day 1 or day 2. CI decreased RBCs, hemoglobin, and hematocrit on days 7 and 15 more than RI, whereas hemorrhage alone returned to the baseline on days 7 and 15. RBCs depleted after CI faster than post-RI. Hemorrhage alone increased platelet counts on days 2, 3, and 7, which returned to the baseline on day 15. Our data suggest that WBC depletion may be a potential biomarker within 2 days post-RI and post-CI and RBC depletion after 3 days post-RI and post-CI. For hemorrhage alone, neutrophil counts at 4-5 h and platelets for day 2 through day 7 can be used as a tool for confirmation.
Collapse
Affiliation(s)
- Juliann G Kiang
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 4555 South Palmer Road, Building 42, Bethesda, MD 20889-5648, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Akeylah K Woods
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 4555 South Palmer Road, Building 42, Bethesda, MD 20889-5648, USA
| | - Georgetta Cannon
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 4555 South Palmer Road, Building 42, Bethesda, MD 20889-5648, USA
| |
Collapse
|
30
|
Capan I. Wide-Bandgap Semiconductors for Radiation Detection: A Review. Materials (Basel) 2024; 17:1147. [PMID: 38473617 DOI: 10.3390/ma17051147] [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] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
In this paper, an overview of wide-bandgap (WBG) semiconductors for radiation detection applications is given. The recent advancements in the fabrication of high-quality wafers have enabled remarkable WBG semiconductor device applications. The most common 4H-SiC, GaN, and β-Ga2O3 devices used for radiation detection are described. The 4H-SiC and GaN devices have already achieved exceptional results in the detection of alpha particles and neutrons, thermal neutrons in particular. While β-Ga2O3 devices have not yet reached the same level of technological maturity (compared to 4H-SiC and GaN), their current achievements for X-ray detection indicate great potential and promising prospects for future applications.
Collapse
Affiliation(s)
- Ivana Capan
- Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| |
Collapse
|
31
|
Zhang S, Li M, Qiu Y, Wu J, Xu X, Ma Q, Zheng Z, Lu G, Deng Z, Huang H. Enhanced VEGF secretion and blood-brain barrier disruption: Radiation-mediated inhibition of astrocyte autophagy via PI3K-AKT pathway activation. Glia 2024; 72:568-587. [PMID: 38009296 DOI: 10.1002/glia.24491] [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: 02/17/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 11/28/2023]
Abstract
Radiation-induced damage to the blood-brain barrier (BBB) is the recognized pathological basis of radiation-induced brain injury (RBI), a side effect of head and neck cancer treatments. There is currently a lack of therapeutic approaches for RBI due to the ambiguity of its underlying mechanisms. Therefore, it is essential to identify these mechanisms in order to prevent RBI or provide early interventions. One crucial factor contributing to BBB disruption is the radiation-induced activation of astrocytes and oversecretion of vascular endothelial growth factor (VEGF). Mechanistically, the PI3K-AKT pathway can inhibit cellular autophagy, leading to pathological cell aggregation. Moreover, it acts as an upstream pathway of VEGF. In this study, we observed the upregulation of the PI3K-AKT pathway in irradiated cultured astrocytes through bioinformatics analysis, we then validated these findings in animal brains and in vitro astrocytes following radiation exposure. Additionally, we also found the inhibition of autophagy and the oversecretion of VEGF in irradiated astrocytes. By inhibiting the PI3K-AKT pathway or promoting cellular autophagy, we observed a significant amelioration of the inhibitory effect on autophagy, leading to reductions in VEGF oversecretion and BBB disruption. In conclusion, our study suggests that radiation can inhibit autophagy and promote VEGF oversecretion by upregulating the PI3K-AKT pathway in astrocytes. Blocking the PI3K pathway can alleviate both of these effects, thereby mitigating damage to the BBB in patients undergoing radiation treatment.
Collapse
Affiliation(s)
- Shifeng Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Mingping Li
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yuemin Qiu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Junyu Wu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Xue Xu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Qian Ma
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Zhihui Zheng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Gengxin Lu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Zhezhi Deng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Haiwei Huang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| |
Collapse
|
32
|
Kim EY, Granger EE, Schoenfeld JD, Silk AW, Margalit D, Tishler R, Ruiz ES. Outcomes of palliative radiation therapy for cutaneous squamous cell carcinoma: A retrospective cohort study. JAAD Int 2024; 14:26-28. [PMID: 38054197 PMCID: PMC10694558 DOI: 10.1016/j.jdin.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
- Emily Y. Kim
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Emily E. Granger
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jonathan D. Schoenfeld
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Ann W. Silk
- Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Danielle Margalit
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Roy Tishler
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Emily S. Ruiz
- Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
33
|
Aldridge RL, Gibson S, Linthicum KJ. Aedes aegypti Controls AE. Aegypti: SIT and IIT-An Overview. J Am Mosq Control Assoc 2024; 40:32-49. [PMID: 38427588 DOI: 10.2987/23-7154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
The sterile insect technique (SIT) and the incompatible insect technique (IIT) are emerging and potentially revolutionary tools for controlling Aedes aegypti (L.), a prominent worldwide mosquito vector threat to humans that is notoriously difficult to reduce or eliminate in intervention areas using traditional integrated vector management (IVM) approaches. Here we provide an overview of the discovery, development, and application of SIT and IIT to Ae. aegypti control, and innovations and advances in technology, including transgenics, that could elevate these techniques to a worldwide sustainable solution to Ae. aegypti when combined with other IVM practices.
Collapse
|
34
|
Burns RT, Orzel J, Wadensweiler P, Kenne K, Nakastuka H, Kovacevic N, Aswani Y, Ann Gormley E, Padamanabhan P, Powell CR, Vollstedt A, Takacs E. Radiation exposure during sacral neuromodulation lead placement: Multi-institutional descriptive study. Neurourol Urodyn 2024; 43:595-603. [PMID: 38318969 DOI: 10.1002/nau.25408] [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: 10/30/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES Fluoroscopy has significantly improved lead placement and decreased surgical time for implantable sacral neuromodulation (SNM). There is a paucity of data regarding radiation and safety of fluoroscopy during SNM procedures. Our study aims to characterize fluoroscopy time and dose used during SNM surgery across multiple institutions and assess for predictors of increased fluoroscopy time and radiation dose. METHODS Electronic medical records were queried for SNM procedures (Stage 1 and full implant) from 2016 to 2021 at four academic institutions. Demographic, clinical, and intraoperative data were collected, including fluoroscopy time and radiation dose in milligray (mGy). The data were entered into a centralized REDCap database. Univariate and multivariate analysis were performed to assess for predictive factors using STATA/BE 17.0. RESULTS A total of 664 procedures were performed across four institutions. Of these, 363 (54.6%) procedures had complete fluoroscopy details recorded. Mean surgical time was 58.8 min. Of all procedures, 79.6% were performed by Female Pelvic Medicine and Reconstructive Surgery specialists. There was significant variability in fluoroscopy time and dose based on surgical specialty and institution. Most surgeons (76.4%) were considered "low volume" implanters. In a multivariate analysis, bilateral finder needle testing, surgical indication, surgeon volume, and institution significantly predicted increased fluoroscopy time and radiation dose (p < 0.05). CONCLUSIONS There is significant variability in fluoroscopy time and radiation dose utilized during SNM procedures, with differences across institutions, surgeons, and subspecialties. Increased radiation exposure can have harmful impacts on the surgical team and patient. These findings demonstrate the need for standardized fluoroscopy use during SNM procedures.
Collapse
Affiliation(s)
- Ramzy T Burns
- Department of Urology, Indiana University, Indianapolis, Indiana, USA
| | - Joanna Orzel
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Paul Wadensweiler
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Kimberly Kenne
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | | | | | - Yashant Aswani
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - E Ann Gormley
- Department of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | | | - Charles R Powell
- Department of Urology, Indiana University, Indianapolis, Indiana, USA
| | - Annah Vollstedt
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Elizabeth Takacs
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| |
Collapse
|
35
|
Rinaldi I, Muthalib A, Gondhowiardjo S, Setiawan T, Gunawan A, Susanto N, Magdalena L, Winston K, Disamantiji A, Wirawan B. Relapsed isolated CNS lymphoma treated with radiotherapy and intrathecal methotrexate followed by high-dose intravenous methotrexate, rituximab, and temozolomide: A case report. Clin Case Rep 2024; 12:e8409. [PMID: 38435502 PMCID: PMC10907348 DOI: 10.1002/ccr3.8409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/09/2023] [Accepted: 12/18/2023] [Indexed: 03/05/2024] Open
Abstract
Key Clinical Message Optimized treatments for relapsed isolated CNS lymphoma (RI-SCNSL) remains under investigation. Temozolomide combination-based therapy, which is often used in glioblastoma may be used as potential treatment in RI-SCNSL. Abstract One of the most common types of non-Hodgkin lymphoma (NHL) is diffuse large B-cell lymphoma (DLBCL). Despite advances in treatment, relapsed isolated CNS lymphoma (RI-SCNSL) from DLBCL remains an issue. The optimal approach in RI-SCNSL remains an area of active investigation as currently there is no high level of evidence for the treatments due to lack of randomized studies. In this case report, we present a DLBCL patient with CNS recurrence treated radiotherapy and intrathecal methotrexate (MTX) followed by intravenous high-dose MTX, rituximab, and temozolomide. To the best of our knowledge, this is the first case report describing RI-SCNSL treated with the regiments above which also include temozolomide which is used for glioblastoma.
Collapse
Affiliation(s)
- Ikhwan Rinaldi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Department of Internal MedicineGading Pluit HospitalJakartaIndonesia
| | - Abdul Muthalib
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Department of Internal MedicineGading Pluit HospitalJakartaIndonesia
| | | | - Tjondro Setiawan
- Department of Internal MedicineGading Pluit HospitalJakartaIndonesia
| | - Andhika Gunawan
- Department of Nuclear MedicineGading Pluit HospitalJakartaIndonesia
| | - Nelly Susanto
- Department of RadiologyGading Pluit HospitalJakartaIndonesia
| | | | - Kevin Winston
- Hospital MedicineBhakti Medicare HospitalCicurugIndonesia
| | | | | |
Collapse
|
36
|
Lee IY, Hanft S, Schulder M, Judy KD, Wong ET, Elder JB, Evans LT, Zuccarello M, Wu J, Aulakh S, Agarwal V, Ramakrishna R, Gill BJ, Quiñones-Hinojosa A, Brennan C, Zacharia BE, Silva Correia CE, Diwanji M, Pennock GK, Scott C, Perez-Olle R, Andrews DW, Boockvar JA. Autologous cell immunotherapy (IGV-001) with IGF-1R antisense oligonucleotide in newly diagnosed glioblastoma patients. Future Oncol 2024; 20:579-591. [PMID: 38060340 DOI: 10.2217/fon-2023-0702] [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] [Indexed: 03/20/2024] Open
Abstract
Standard-of-care first-line therapy for patients with newly diagnosed glioblastoma (ndGBM) is maximal safe surgical resection, then concurrent radiotherapy and temozolomide, followed by maintenance temozolomide. IGV-001, the first product of the Goldspire™ platform, is a first-in-class autologous immunotherapeutic product that combines personalized whole tumor-derived cells with an antisense oligonucleotide (IMV-001) in implantable biodiffusion chambers, with the intent to induce a tumor-specific immune response in patients with ndGBM. Here, we describe the design and rationale of a randomized, double-blind, phase IIb trial evaluating IGV-001 compared with placebo, both followed by standard-of-care treatment in patients with ndGBM. The primary end point is progression-free survival, and key secondary end points include overall survival and safety.
Collapse
Affiliation(s)
- Ian Y Lee
- Henry Ford Health System, Detroit, MI 48202, USA
| | - Simon Hanft
- Westchester Medical Center, Valhalla, NY 10595, USA
| | - Michael Schulder
- Northwell Health at North Shore University Hospital, Lake Success, NY 11030, USA
| | - Kevin D Judy
- Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Eric T Wong
- Rhode Island Hospital & The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
| | | | - Linton T Evans
- Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, USA
| | - Mario Zuccarello
- University of Cincinnati Medical Center, Cincinnati, OH 45219, USA
| | - Julian Wu
- Tufts Medical Center, Boston, MA 02111, USA
| | | | | | | | - Brian J Gill
- Columbia University Medical Center, New York, NY 10019, USA
| | | | - Cameron Brennan
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Gakkhar A, Mehendale AM, Mehendale S. An Interesting Case of Macular Amyloidosis With No Significant Etiology. Cureus 2024; 16:e56248. [PMID: 38623100 PMCID: PMC11016991 DOI: 10.7759/cureus.56248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/15/2024] [Indexed: 04/17/2024] Open
Abstract
Macular amyloidosis is primary localized cutaneous amyloidosis (PLCA). It is described by the extracellular accumulation of heterogenic amyloid proteins in the skin that does not affect the systemic immune system, causing hyperpigmented patches. It is a prevalent skin disorder of young female adults, especially in India, since it affects the population with darker skin. History of frictional rub on the skin is typically present, such as using loofah or bathing scrubs or stones. The case presented below is of a 23-year-old female who presented with a hyperpigmented patch on the upper back of both sides and extensor surface of arms and did not have any history of usage of loofah on those areas, compelling us to research more on the other causative factors (genetic predisposition, infectious agents, and UV radiation are probable causative factors) for macular amyloidosis. This condition is not entirely cured; it is managed symptomatically only to improve cosmetic outcomes.
Collapse
Affiliation(s)
- Avni Gakkhar
- Preventive Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashok M Mehendale
- Preventive Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shivansh Mehendale
- Preventive Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
38
|
Lee RE, Mascenik TM, Major SC, Galiger JR, Bulik-Sullivan E, Siesser PF, Lewis CA, Bear JE, Le Suer JA, Hawkins FJ, Pickles RJ, Randell SH. Viral airway injury promotes cell engraftment in an in vitro model of cystic fibrosis cell therapy. Am J Physiol Lung Cell Mol Physiol 2024; 326:L226-L238. [PMID: 38150545 DOI: 10.1152/ajplung.00421.2022] [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: 12/13/2022] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023] Open
Abstract
Cell therapy is a potential treatment for cystic fibrosis (CF). However, cell engraftment into the airway epithelium is challenging. Here, we model cell engraftment in vitro using the air-liquid interface (ALI) culture system by injuring well-differentiated CF ALI cultures and delivering non-CF cells at the time of peak injury. Engraftment efficiency was quantified by measuring chimerism by droplet digital PCR and functional ion transport in Ussing chambers. Using this model, we found that human bronchial epithelial cells (HBECs) engraft more efficiently when they are cultured by conditionally reprogrammed cell (CRC) culture methods. Cell engraftment into the airway epithelium requires airway injury, but the extent of injury needed is unknown. We compared three injury models and determined that severe injury with partial epithelial denudation facilitates long-term cell engraftment and functional CFTR recovery up to 20% of wildtype function. The airway epithelium promptly regenerates in response to injury, creating competition for space and posing a barrier to effective engraftment. We examined competition dynamics by time-lapse confocal imaging and found that delivered cells accelerate airway regeneration by incorporating into the epithelium. Irradiating the repairing epithelium granted engrafting cells a competitive advantage by diminishing resident stem cell proliferation. Intentionally, causing severe injury to the lungs of people with CF would be dangerous. However, naturally occurring events like viral infection can induce similar epithelial damage with patches of denuded epithelium. We found that viral preconditioning promoted effective engraftment of cells primed for viral resistance.NEW & NOTEWORTHY Cell therapy is a potential treatment for cystic fibrosis (CF). Here, we model cell engraftment by injuring CF air-liquid interface cultures and delivering non-CF cells. Successful engraftment required severe epithelial injury. Intentionally injuring the lungs to this extent would be dangerous. However, naturally occurring events like viral infection induce similar epithelial damage. We found that viral preconditioning promoted the engraftment of cells primed for viral resistance leading to CFTR functional recovery to 20% of the wildtype.
Collapse
Affiliation(s)
- Rhianna E Lee
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Teresa M Mascenik
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Sidra C Major
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Jacob R Galiger
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Emily Bulik-Sullivan
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Priscila F Siesser
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Catherine A Lewis
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - James E Bear
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Jake A Le Suer
- Center for Regenerative Medicine, Boston University and Boston Medical Center, Boston, Massachusetts, United States
- Department of Medicine, The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Finn J Hawkins
- Center for Regenerative Medicine, Boston University and Boston Medical Center, Boston, Massachusetts, United States
- Department of Medicine, The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Raymond J Pickles
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Scott H Randell
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| |
Collapse
|
39
|
Walburn T, Chen MH, Loffredo M, McMahon E, Orio PF, Nguyen PL, D'Amico AV, Sayan M. Secondary analysis of late major gastrointestinal and genitourinary toxicities in unfavorable-risk prostate cancer patients receiving docetaxel: Insights from a randomized trial. Cancer 2024. [PMID: 38427287 DOI: 10.1002/cncr.35274] [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: 12/07/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND This study sought to evaluate the late toxicity associated with neoadjuvant and concurrent docetaxel and radiation therapy in patients with prostate cancer. METHODS A secondary analysis was performed of the phase 3 multicenter randomized trial (Dana-Farber Cancer Institute 05-043) including 350 patients with nonmetastatic unfavorable-risk prostate cancer. Patients were randomized 1:1 to receive androgen deprivation therapy, radiation therapy, and docetaxel versus androgen deprivation therapy and radiation therapy. The study assessed the cumulative incidence rates of grade 2 and grade 3 or higher gastrointestinal, genitourinary, and sexual toxicity. A multivariable Fine and Gray's competing risks regression model adjusted for age at randomization and pelvic lymph node radiation therapy was used to evaluate the treatment effect of docetaxel on time to late genitourinary and gastrointestinal toxicities. RESULTS The study included 338 patients who primarily had minimal or no comorbidity (74.9%) and median age 66 years (interquartile range: 61,71). At a median follow-up of 10.2 years, docetaxel was not associated with increased risk of any grade 3 or higher (adjusted hazard ratio [AHR], 0.98; 95% confidence interval [CI], 0.36-2.67; p = .96) or grade 2 gastrointestinal (p = .75), genitourinary (p = .44), and sexual (p = .29) toxicity. Age was associated with increased grade 3 or higher (AHR, 1.08; 95% CI, 1.01-1.16; p = .03) and grade 2 gastrointestinal toxicity (AHR, 1.11; 95% CI, 1.03-1.20; p = .005). A nonsignificant trend (p = .09) toward increased late grade 3 or higher toxicity was observed for pelvic radiation therapy use. CONCLUSIONS Docetaxel combined with radiotherapy has an acceptable long-term toxicity profile.
Collapse
Affiliation(s)
- Tyler Walburn
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Marian Loffredo
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Elizabeth McMahon
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Peter F Orio
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Paul L Nguyen
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Anthony V D'Amico
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Mutlay Sayan
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| |
Collapse
|
40
|
Jaroonwanichkul S, Matthews S, Pourakbar S, Dai H, Wang-Weinman T. Multiple asymptomatic, hyperkeratotic minute filiform papules. JAAD Case Rep 2024; 45:68-70. [PMID: 38406624 PMCID: PMC10883976 DOI: 10.1016/j.jdcr.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Affiliation(s)
- Sandra Jaroonwanichkul
- Department of Dermatology, University of Missouri – Kansas City School of Medicine, Kansas City, Missouri
| | - Stephanie Matthews
- Division of Dermatology, University of Kansas Medical Center, Kansas City, Kansas
| | - Sarah Pourakbar
- Division of Dermatology, University of Kansas Medical Center, Kansas City, Kansas
| | - Hongyan Dai
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Ting Wang-Weinman
- Division of Dermatology, University of Kansas Medical Center, Kansas City, Kansas
| |
Collapse
|
41
|
Rezaee M, Adhikary A. The Effects of Particle LET and Fluence on the Complexity and Frequency of Clustered DNA Damage. DNA (Basel) 2024; 4:34-51. [PMID: 38282954 PMCID: PMC10810015 DOI: 10.3390/dna4010002] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Motivation Clustered DNA-lesions are predominantly induced by ionizing radiation, particularly by high-LET particles, and considered as lethal damage. Quantification of this specific type of damage as a function of radiation parameters such as LET, dose rate, dose, and particle type can be informative for the prediction of biological outcome in radiobiological studies. This study investigated the induction and complexity of clustered DNA damage for three different types of particles at an LET range of 0.5-250 keV/μm. Methods Nanometric volumes (36.0 nm3) of 15 base-pair DNA with its hydration shell was modeled. Electron, proton, and alpha particles at various energies were simulated to irradiate the nanometric volumes. The number of ionization events, low-energy electron spectra, and chemical yields for the formation of °OH, H°, e aq - , and H2O2 were calculated for each particle as a function of LET. Single- and double-strand breaks (SSB and DSB), base release, and clustered DNA-lesions were computed from the Monte-Carlo based quantification of the reactive species and measured yields of the species responsible for the DNA lesion formation. Results The total amount of DNA damage depends on particle type and LET. The number of ionization events underestimates the quantity of DNA damage at LETs higher than 10 keV/μm. Minimum LETs of 9.4 and 11.5 keV/μm are required to induce clustered damage by a single track of proton and alpha particles, respectively. For a given radiation dose, an increase in LET reduces the number of particle tracks, leading to more complex clustered DNA damage, but a smaller number of separated clustered damage sites. Conclusions The dependency of the number and the complexity of clustered DNA damage on LET and fluence suggests that the quantification of this damage can be a useful method for the estimation of the biological effectiveness of radiation. These results also suggest that medium-LET particles are more appropriate for the treatment of bulk targets, whereas high-LET particles can be more effective for small targets.
Collapse
Affiliation(s)
- Mohammad Rezaee
- Department of Radiation Oncology and Molecular Radiation Sciences, School of Medicine, Johns Hopkins University, 1550 Orleans St., Baltimore, MD 21231, USA
| | - Amitava Adhikary
- Department of Chemistry, Oakland University, 146 Library Drive, Rochester, MI 48309, USA
| |
Collapse
|
42
|
Elmas O, Keskin E, Keser Sahin HH, Guven B, Almisned G, Zakaly HM, Tekin H, Ene A. The effect of Annona muricata (Graviola) on the prevention of brain damage due to ionizing radiation in rats. Heliyon 2024; 10:e25932. [PMID: 38370260 PMCID: PMC10867642 DOI: 10.1016/j.heliyon.2024.e25932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 01/03/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024] Open
Abstract
In this study, it was aimed to evaluate the effect of ethanol extract of Annona Muricata (AM) leaves in the prevention of brain damage caused by ionizing radiation (IR). This study was conducted in the Experimental Animal Research Unit of a university with 28 adults female Wistar Albino rats. The experimental groups were as follows: Control group (n = 8), AM group (n = 6), IR group (n = 8), AM + IR group (n = 6). In the IR group, astrocyte hypertrophy, microglial reaction and inflammatory reaction levels were significantly higher than the control and AM groups (P < 0.001). Edema was significantly higher in the IR group compared to the control group (P=0.001). The MDA of the IR group was significantly higher compared to the control group and AM group (P=0.031, P=0.006, respectively). The MDA of the AM + IR group was significantly higher than the AM group (P=0.039). Our findings show that histomorphology and oxidant damage caused by IR can be ameliorated using AM, as demonstrated by the comparison of the controls to AM + IR recipients, which showed similar histomorphology and oxidant damage levels.
Collapse
Affiliation(s)
- Ozlem Elmas
- Department of Radiation Oncology, Bulent Ecevit University Practice and Research Hospital, Zonguldak, Turkey
| | - Emrah Keskin
- Department of Neurosurgery, Bulent Ecevit University Practice and Research Hospital, Zonguldak, Turkey
| | | | - Berrak Guven
- Department of Biochemistry, Bulent Ecevit University Practice and Research Hospital, Zonguldak, Turkey
| | - Ghada Almisned
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Hesham M.H. Zakaly
- Institute of Physics and Technology, Ural Federal University, Yekaterinburg, 620002, Russia
- Physics Department, Faculty of Science, Al-Azhar University, Assiut, Egypt
| | - H.O. Tekin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, 27272, Sharjah, United Arab Emirates
- Istinye University, Faculty of Engineering and Natural Sciences, Computer Engineering Department, Istanbul, 34396, Turkey
| | - Antoaneta Ene
- INPOLDE Research Center, Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, Dunarea de Jos University of Galati, 47 Domneasca Street, 800008 Galati, Romania
| |
Collapse
|
43
|
Kondapalli L, Overholser L, Lenneman C. Cardiac Care of Childhood Cancer Survivors: Time to Act Instead of React. J Am Coll Cardiol 2024; 83:839-842. [PMID: 38383099 DOI: 10.1016/j.jacc.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 02/23/2024]
Affiliation(s)
- Lavanya Kondapalli
- Division of Cardiology, Department of Medicine, University of Colorado, Aurora, Colorado, USA.
| | - Linda Overholser
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Carrie Lenneman
- Division of Cardiology, Department of Medicine, University of Alabama, Birmingham, Alabama, USA. https://twitter.com/CarrieLenneman
| |
Collapse
|
44
|
Bottinor W, Im C, Doody DR, Armenian SH, Arynchyn A, Hong B, Howell RM, Jacobs DR, Ness KK, Oeffinger KC, Reiner AP, Armstrong GT, Yasui Y, Chow EJ. Mortality After Major Cardiovascular Events in Survivors of Childhood Cancer. J Am Coll Cardiol 2024; 83:827-838. [PMID: 38383098 DOI: 10.1016/j.jacc.2023.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Adult survivors of childhood cancer are at risk for cardiovascular events. OBJECTIVES In this study, we sought to determine the risk for mortality after a major cardiovascular event among childhood cancer survivors compared with noncancer populations. METHODS All-cause and cardiovascular cause-specific mortality risks after heart failure (HF), coronary artery disease (CAD), or stroke were compared among survivors and siblings in the Childhood Cancer Survivor Study (CCSS) and participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Cox proportional hazard regression models were used to estimate HRs and 95% CIs between groups, adjusted for demographic and clinical factors. RESULTS Among 25,658 childhood cancer survivors (median age at diagnosis 7 years, median age at follow-up or death 38 years) and 5,051 siblings, 1,780 survivors and 91 siblings had a cardiovascular event. After HF, CAD, and stroke, 10-year all-cause mortalities were 30% (95% CI: 26%-33%), 36% (95% CI: 31%-40%), and 29% (95% CI: 24%-33%), respectively, among survivors vs 14% (95% CI: 0%-25%), 14% (95% CI: 2%-25%), and 4% (95% CI: 0%-11%) among siblings. All-cause mortality risks among childhood cancer survivors were increased after HF (HR: 7.32; 95% CI: 2.56-20.89), CAD (HR: 5.54; 95% CI: 2.37-12.93), and stroke (HR: 3.57; 95% CI: 1.12-11.37). CAD-specific mortality risk was increased (HR: 3.70; 95% CI: 1.05-13.02). Among 5,114 CARDIA participants, 345 had a major event. Although CARDIA participants were on average decades older at events (median age 57 years vs 31 years), mortality risks were similar, except that all-cause mortality after CAD was significantly increased among childhood cancer survivors (HR: 1.85; 95% CI: 1.16-2.95). CONCLUSIONS Survivors of childhood cancer represent a population at high risk for mortality after major cardiovascular events.
Collapse
Affiliation(s)
- Wendy Bottinor
- Virginia Commonwealth University, Richmond, Virginia, USA.
| | - Cindy Im
- University of Minnesota, Minneapolis, Minnesota, USA
| | - David R Doody
- Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | | | | | - Borah Hong
- Seattle Children's Hospital, Seattle, Washington, USA
| | | | | | - Kirsten K Ness
- St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | | | | | - Yutaka Yasui
- St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Eric J Chow
- Fred Hutchinson Cancer Center, Seattle, Washington, USA; Seattle Children's Hospital, Seattle, Washington, USA; University of Washington, Seattle, Washington, USA
| |
Collapse
|
45
|
Wang ZJ, Xue YY, Tang N, Huang G, Nie X, Lai SK, He BP, Ma WY, Sheng JK, Gou SL. Synergistic Radiation Effects in PPD CMOS Image Sensors Induced by Neutron Displacement Damage and Gamma Ionization Damage. Sensors (Basel) 2024; 24:1441. [PMID: 38474978 DOI: 10.3390/s24051441] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024]
Abstract
The synergistic effects on the 0.18 µm PPD CISs induced by neutron displacement damage and gamma ionization damage are investigated. The typical characterizations of the CISs induced by the neutron displacement damage and gamma ionization damage are presented separately. The CISs are irradiated by reactor neutron beams up to 1 × 1011 n/cm2 (1 MeV neutron equivalent fluence) and 60Co γ-rays up to the total ionizing dose level of 200 krad(Si) with different sequential order. The experimental results show that the mean dark signal increase in the CISs induced by reactor neutron radiation has not been influenced by previous 60Co γ-ray radiation. However, the mean dark signal increase in the CISs induced by 60Co γ-ray radiation has been remarkably influenced by previous reactor neutron radiation. The synergistic effects on the PPD CISs are discussed by combining the experimental results and the TCAD simulation results of radiation damage.
Collapse
Affiliation(s)
- Zu-Jun Wang
- National Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, Xi'an 710024, China
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China
| | - Yuan-Yuan Xue
- National Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, Xi'an 710024, China
| | - Ning Tang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China
| | - Gang Huang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China
| | - Xu Nie
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China
| | - Shan-Kun Lai
- School of Materials Science and Engineering, Xiangtan University, Xiangtan 411105, China
| | - Bao-Ping He
- National Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, Xi'an 710024, China
| | - Wu-Ying Ma
- National Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, Xi'an 710024, China
| | - Jiang-Kun Sheng
- National Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, Xi'an 710024, China
| | - Shi-Long Gou
- National Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, Xi'an 710024, China
| |
Collapse
|
46
|
Hwang SY, Woo HY, Heo J, Kim HJ, Park YJ, Yi KY, Lee YR, Park SY, Chung WJ, Jang BK, Tak WY. Outcome of Atezolizumab Plus Bevacizumab Combination Therapy in High-Risk Patients with Advanced Hepatocellular Carcinoma. Cancers (Basel) 2024; 16:838. [PMID: 38398229 PMCID: PMC10887033 DOI: 10.3390/cancers16040838] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Real-world data regarding treatment with atezolizumab plus bevacizumab in high-risk patients with advanced HCC are lacking. In this multicenter retrospective cohort study, a total of 215 patients with advanced HCC received atezolizumab plus bevacizumab treatment at four tertiary hospitals. High-risk patients were those with grade Vp4 portal vein thrombus, bile duct invasion, or more than 50% liver infiltration. In total, 98 (45.6%) were the high-risk population, 186 (86.5%) were considered to be Child-Pugh class A, and 128 (59.5%) had previously received neoadjuvant or concomitant radiation treatment. Median overall survival (OS) was 11.25 months (95% CI, 9.50-13.10), and the median progression-free survival (PFS) was 8.00 months (95% CI, 6.82-9.18). In the high-risk population, the median OS was 10 months (95% CI, 8.19-11.82) and the median PFS was 6.50 months (95% CI, 3.93-9.08). In the high-risk population, multivariate analysis indicated that radiation therapy and lower ALBI grade were associated with better OS and PFS. A total of 177 (82.3%) patients experienced adverse events of any grade, the most common being proteinuria (23.7%). Atezolizumab plus bevacizumab treatment showed consistent efficacy and tolerability in both the total and high-risk population. Radiation therapy combined with atezolizumab plus bevacizumab treatment might be helpful to improve PFS and OS in high-risk populations.
Collapse
Affiliation(s)
- Sang Youn Hwang
- Department of Internal Medicine, Dongnam Institute of Radiologic & Medical Sciences, Busan 46033, Republic of Korea; (S.Y.H.); (H.J.K.)
| | - Hyun Young Woo
- Department of Internal Medicine, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea; (H.Y.W.); (Y.J.P.); (K.Y.Y.)
| | - Jeong Heo
- Department of Internal Medicine, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea; (H.Y.W.); (Y.J.P.); (K.Y.Y.)
| | - Hyung Jun Kim
- Department of Internal Medicine, Dongnam Institute of Radiologic & Medical Sciences, Busan 46033, Republic of Korea; (S.Y.H.); (H.J.K.)
| | - Young Joo Park
- Department of Internal Medicine, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea; (H.Y.W.); (Y.J.P.); (K.Y.Y.)
| | - Ki Youn Yi
- Department of Internal Medicine, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea; (H.Y.W.); (Y.J.P.); (K.Y.Y.)
| | - Yu Rim Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (Y.R.L.); (S.Y.P.)
| | - Soo Young Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (Y.R.L.); (S.Y.P.)
| | - Woo Jin Chung
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Republic of Korea; (W.J.C.); (B.K.J.)
| | - Byoung Kuk Jang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Republic of Korea; (W.J.C.); (B.K.J.)
| | - Won Young Tak
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (Y.R.L.); (S.Y.P.)
| |
Collapse
|
47
|
Schrand TV, Iovoli AJ, Almeida ND, Yu H, Malik N, Farrugia M, Singh AK. Differences between Survival Rates and Patterns of Failure of Patients with Lung Adenocarcinoma and Squamous Cell Carcinoma Who Received Single-Fraction Stereotactic Body Radiotherapy. Cancers (Basel) 2024; 16:755. [PMID: 38398146 PMCID: PMC10886818 DOI: 10.3390/cancers16040755] [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: 01/16/2024] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
We investigated the survival and patterns of failure in adenocarcinoma (ADC) and squamous cell carcinoma (SCC) in early stage non-small cell lung cancer (NSCLC) treated with single-fraction stereotactic body radiation therapy (SF-SBRT) of 27-34 Gray. A single-institution retrospective review of patients with biopsy-proven early stage ADC or SCC undergoing definitive SF-SBRT between September 2008 and February 2023 was performed. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes included local failure (LF), nodal failure (NF), and distant failure (DF). Of 292 eligible patients 174 had adenocarcinoma and 118 had squamous cell carcinoma. There was no significant change in any outcome except distant failure. Patients with ADC were significantly more likely to experience distant failure than patients with SCC (p = 0.0081). In conclusion, while SF-SBRT produced similar LF, NF, DFS, and OS, the higher rate of distant failure in ADC patients suggests that ongoing trials of SBRT and systemic therapy combinations should report their outcomes by histology.
Collapse
Affiliation(s)
- Tyler V. Schrand
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (T.V.S.); (A.J.I.); (N.D.A.); (N.M.); (M.F.)
- Department of Chemistry, Bowling Green State University, Bowling Green, OH 43403, USA
| | - Austin J. Iovoli
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (T.V.S.); (A.J.I.); (N.D.A.); (N.M.); (M.F.)
| | - Neil D. Almeida
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (T.V.S.); (A.J.I.); (N.D.A.); (N.M.); (M.F.)
| | - Han Yu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Nadia Malik
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (T.V.S.); (A.J.I.); (N.D.A.); (N.M.); (M.F.)
| | - Mark Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (T.V.S.); (A.J.I.); (N.D.A.); (N.M.); (M.F.)
| | - Anurag K. Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (T.V.S.); (A.J.I.); (N.D.A.); (N.M.); (M.F.)
| |
Collapse
|
48
|
Wang D, Zhou Q, Yin Y, Lu D, Hu L, Richmond RH, Moon HB, Yan B, Jiang G. Implications of Fukushima's Radioactive Water Discharge on Global Environmental Sustainability. Environ Sci Technol 2024. [PMID: 38330250 DOI: 10.1021/acs.est.4c00955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
- Dingyi Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Yongguang Yin
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Dawei Lu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Ligang Hu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Robert H Richmond
- Kewalo Marine Laboratory, University of Hawaii at Manoa, Honolulu, Hawaii 96813, United States
| | - Hyo-Bang Moon
- Department of Marine Science and Convergence Engineering, Hanyang University ERICA, Ansan 15588, Republic of Korea
| | - Bing Yan
- Institute of Environmental Research at the Greater Bay Area, Key Laboratory for Water Quality and Conservation of the Pearl River Delta, Ministry of Education, Guangzhou University, Guangzhou 510006, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| |
Collapse
|
49
|
Dibs K, Gogineni E, Jhawar SM, Baliga S, Grecula JC, Mitchell DL, Palmer J, Haglund K, Andraos TY, Zoller W, Ewing A, Bonomi M, Bhateja P, Tinoco G, Liebner D, Rocco JW, Old M, Gamez ME, Chakravarti A, Konieczkowski DJ, Blakaj DM. Scalp Ir radiation with 3D-Milled Bolus: Initial Dosimetric and Clinical Experience. Cancers (Basel) 2024; 16:688. [PMID: 38398079 PMCID: PMC10887235 DOI: 10.3390/cancers16040688] [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: 01/09/2024] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND AND PURPOSE A bolus is required when treating scalp lesions with photon radiation therapy. Traditional bolus materials face several issues, including air gaps and setup difficulty due to irregular, convex scalp geometry. A 3D-milled bolus is custom-formed to match individual patient anatomy, allowing improved dose coverage and homogeneity. Here, we describe the creation process of a 3D-milled bolus and report the outcomes for patients with scalp malignancies treated with Volumetric Modulated Arc Therapy (VMAT) utilizing a 3D-milled bolus. MATERIALS AND METHODS Twenty-two patients treated from 2016 to 2022 using a 3D-milled bolus and VMAT were included. Histologies included squamous cell carcinoma (n = 14, 64%) and angiosarcoma (n = 8, 36%). A total of 7 (32%) patients were treated in the intact and 15 (68%) in the postoperative setting. The median prescription dose was 66.0 Gy (range: 60.0-69.96). RESULTS The target included the entire scalp for 8 (36%) patients; in the remaining 14 (64%), the median ratio of planning target volume to scalp volume was 35% (range: 25-90%). The median dose homogeneity index was 1.07 (range: 1.03-1.15). Six (27%) patients experienced acute grade 3 dermatitis and one (5%) patient experienced late grade 3 skin ulceration. With a median follow-up of 21.4 months (range: 4.0-75.4), the 18-month rates of locoregional control and overall survival were 75% and 79%, respectively. CONCLUSIONS To our knowledge, this is the first study to report the clinical outcomes for patients with scalp malignancies treated with the combination of VMAT and a 3D-milled bolus. This technique resulted in favorable clinical outcomes and an acceptable toxicity profile in comparison with historic controls and warrants further investigation in a larger prospective study.
Collapse
Affiliation(s)
- Khaled Dibs
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Emile Gogineni
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Sachin M. Jhawar
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Sujith Baliga
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - John C. Grecula
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Darrion L. Mitchell
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Joshua Palmer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Karl Haglund
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Therese Youssef Andraos
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Wesley Zoller
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Ashlee Ewing
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Marcelo Bonomi
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - Priyanka Bhateja
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - Gabriel Tinoco
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - David Liebner
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - James W. Rocco
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (J.W.R.); (M.O.)
| | - Matthew Old
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (J.W.R.); (M.O.)
| | - Mauricio E. Gamez
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA;
| | - Arnab Chakravarti
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - David J. Konieczkowski
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Dukagjin M. Blakaj
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| |
Collapse
|
50
|
Asana Marican HT, Shen H. Dynamics of Chromosome Aberrations and Cell Death in Zebrafish Embryos Exposed to 137Cs Total-Body Ir radiation. Environ Sci Technol 2024; 58:2204-2213. [PMID: 38269402 DOI: 10.1021/acs.est.3c05389] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Ionizing radiation exposure induces significant DNA damage and cell death in aquatic species. Accurate sensing and quantification play pivotal roles in environmental monitoring and surveillance. Zebrafish (Danio rerio) is a well-suited animal model for research into this aspect, especially with recent development of cytogenetic and transgenic tools. In this study, we present time-course studies of chromosome aberrations and cell death in zebrafish embryos exposed to 2 Gy 137Cs total-body irradiation. Using a cytogenetic approach, we quantified chromosome and chromatid aberrations in irradiated embryos at 6, 14, 20, and 24 h postirradiation. Metaphases with aberrations showed rapid declining kinetics, accompanied by incomplete karyotypes and irregular chromatin contents. Using an apoptosis-reporting transgenic zebrafish, we found increasing cell death along these time points, with the embryonic eyes and brain contributing the majority of the cell death volumes. We provide evidence that self-proliferating progenitor cells form the underlying linkage between the two kinetics and their positions define radiosensitive niches in zebrafish embryos. Our results provide detailed chromosome aberration and cell death dynamics in 137Cs-irradiated zebrafish embryos and unveil the appropriate timeline and tissue positions for accurate sensing and quantification of radiation-induced damages in zebrafish embryos.
Collapse
Affiliation(s)
- Halida Thanveer Asana Marican
- Singapore Nuclear Research and Safety Initiative, National University of Singapore, CREATE Tower, 1 Create Way, Singapore 138602, Singapore
| | - Hongyuan Shen
- Singapore Nuclear Research and Safety Initiative, National University of Singapore, CREATE Tower, 1 Create Way, Singapore 138602, Singapore
| |
Collapse
|