Impact of xylose epimerase on sugar assimilation and sensing in recombinant Saccharomyces cerevisiae carrying different xylose-utilization pathways

BACKGROUND

Over the last decades, many strategies to procure and improve xylose consumption in Saccharomyces cerevisiae have been reported. This includes the introduction of efficient xylose-assimilating enzymes, the improvement of xylose transport, or the alteration of the sugar signaling response. However, different strain backgrounds are often used, making it difficult to determine if the findings are transferrable both to other xylose-consuming strains and to other xylose-assimilation pathways. For example, the influence of anomerization rates between α- and β-xylopyranose in pathway optimization and sugar sensing is relatively unexplored.

RESULTS

In this study, we tested the effect of expressing a xylose epimerase in S. cerevisiae strains carrying different xylose-consuming routes. First, XIs originating from three different species in isogenic S. cerevisiae strains were tested and the XI from Lachnoclostridium phytofermentans was found to give the best performance. The benefit of increasing the anomerization rate of xylose by adding a xylose epimerase to the XI strains was confirmed, as higher biomass formation and faster xylose consumption were obtained. However, the impact of xylose epimerase was XI-dependent, indicating that anomer preference may differ from enzyme to enzyme. The addition of the xylose epimerase in xylose reductase/xylitol dehydrogenase (XR/XDH)-carrying strains gave no improvement in xylose assimilation, suggesting that the XR from Spathaspora passalidarum had no anomer preference, in contrast to other reported XRs. The reduction in accumulated xylitol that was observed when the xylose epimerase was added may be associated with the upregulation of genes encoding endogenous aldose reductases which could be affected by the anomerization rate. Finally, xylose epimerase addition did not affect the sugar signaling, whereas the type of xylose pathway (XI vs. XR/XDH) did.

CONCLUSIONS

Although xylose anomer specificity is often overlooked, the addition of xylose epimerase should be considered as a key engineering step, especially when using the best-performing XI enzyme from L. phytofermentans. Additional research into the binding mechanism of xylose is needed to elucidate the enzyme-specific effect and decrease in xylitol accumulation. Finally, the differences in sugar signaling responses between XI and XR/XDH strains indicate that either the redox balance or the growth rate impacts the SNF1/Mig1p sensing pathway.

[Scan acquisition parameter optimization for the treatment of moving tumors in radiotherapy]

AIM OF THE STUDY

In the case of lung tumor treatment, to adjust 3D helical computed tomography (CT) acquisition parameters using a dynamic phantom and compare to the theory the volumes of a moving object.

MATERIALS AND METHODS

Three helical CT acquisitions were compared using a Big Bore CT scan : an "initial" 3D CT scan (constructor parameters), an "optimized" 3D CT scan which parameters are chosen to obtain an axial slow scan like acquisition and a 4D CT scan. We used a phantom composed by a ball filled with water set on a dynamic platform moving in the antero-posterior or cranio-caudal direction with a 14 mm amplitude and a 4s period. For each acquisition and modality (static and dynamic), we quantified the ball volume by automatic contouring and we estimated relative errors.

RESULTS

For an antero-posterior displacement, the volume of the moving ball is under estimated by 14.1 % with the "initial" scan, by 0.2 % with the "optimized" scan and over estimated by 0.8 % with the averaged 4D scan. For a cranio-caudal displacement, it is under estimated by about 22 % with the "initial" scan and by about 1 % with the "optimized" scan and the averaged 4D scan.

CONCLUSION

Volume measurements performed with the dynamic phantom allowed us to validate the "optimized" 3D CT scan parameters because it accurately reflects the volume of a moving object. Radiotherapy departments without 4D CT should adapt scan parameters for internal target volume definition.

Bonnes pratiques pour la radiothérapie asservie à la respiration

Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart...) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience.

Principe et mise en œuvre de la radiothérapie en conditions stéréotaxiques extracrânienne

We fully describe an innovative radiotherapy technique called Stereotactic Body Radiation Therapy (SBRT), and explain how this technique is commonly used for clinical purpose at the anticancer center Léon-Bérard (Lyon, France). In this technique, a non-invasive stereotactic body frame is used to locate the tumor site with a great precision. This frame is combined with a system, which enables to track the respiratory motions (Active Breathing Control (ABC) or diaphragmatic compression (DC)) in order to reduce the treatment margins for organ motion due to breathing. Thus, the volume of normal tissues that will be irradiated is considerably reduced. The dosimetry is realized with 3 CT exams performed in treatment conditions. The 3D patient "repositioning" is done with a volume CT acquisition (kV) combined with orthogonal images (kV and MV). The SBRT requires a system to limit the organ motions. Although the ABC seems to be more fastidious for patient, it would enable to use smaller margins than with DC technique. Nevertheless, the ABC is not compatible with volume CT acquisitions, which considerably improve the patient repositioning. In conclusion, the quality of repositioning and the high level of conformation enable to deliver high equivalent doses (>100 Gy) in hypofractionated mode, without increasing the treatment toxicity. The SBRT employs the last technologic innovations in radiotherapy and is therefore considered as a new efficient tool for solid tumors treatment.

[Preliminary results of the assessment of intensity modulated radiotherapy (IMRT) for prostatic and head and neck tumors (STIC 2001)]

INTRODUCTION

Between May 2002 and May 2004, eight French comprehensive cancer centres did a prospective nonrandomized study including 200 patients, 100 with cancer of the prostate and 100 with head and neck cancers. Half of each patient group was treated by IMRT and the others by RTC 3D. This clinical study was associated with an economic study and a physics study. We report here the first results.

PATIENTS AND METHODS

For the clinical study, the analysis of the data of the first 88 patients irradiated for a prostatic cancer shows that 39 received RTC and 49 IMRT with a mean dose of 78 Gy at the ICRU point at 2 Gy per fraction. For H&N tumours, the preliminary analysis was done on the 87 first patients with a mean follow-up of 11.5 months (2 to 25 months) and a median of 8.4 months for the IMRT groups and 13.2 months for the RTC group. The economic study was done on the first 157 patients included during the first 18 months: 71 treated by RTC (35 for H&N and 36 for prostate) and 86 treated by IMRT (38 for H&N and 48 for prostate). The assessment of the direct costs was realized by a micro-costing technique. The physical study compared dose distributions for both techniques and has created quality control recommendations.

RESULTS

Clinical studies of the acute reactions do not show any difference between groups, but we want to point out the short follow-up and the relatively high dose delivered to cancers of the prostate. The physics study demonstrates that IMRT is technically feasible in good clinical conditions with high quality assurance, a good reproducibility and precision. Dosimetric data show that IMRT could certainly spare organs at risk more than RTC for H&N tumours. The direct costs of "routine" treatments for H&N tumours were 4922 euros for IMRT versus 1899 euros for RTC and for the prostatic cancers 4911 euros for IMRT versus 2357 for RTC.

[Is conformational radiotherapy progressing? What are its difficulties and limits?]

Increase local control rate is the main objective of 3D conformal radiotherapy (3DCRT) through sparing surrounding tissues and more precise target volume irradiation. Limits are however present for each step of the procedure (immobilisation device, anatomical data acquisition, dose calculation and optimisation, treatment verification and execution). Dose distribution is clearly better with 3DCRT and allows dose escalation. However, clinical data comparing irradiation techniques are rare and do not allow to consider yet 3DCRT as a standard treatment. Medical and medico-economical studies are warranted both for 3DCRT and IMRT in order to prove their utility and justify their cost.

Impact of tissues heterogeneities on monitor units calculation and ICRU dose point: analysis of 30 cases of prostate cancer treated with 18-MV photons after three-dimensional planning

PURPOSE

Analysis of dose specification of tissue heterogeneities.

METHODS AND MATERIALS

Three-dimensional dose distribution analyses of 30 patients with localized prostate cancer were reviewed with and without tissue heterogeneity correction. The number of monitor units for each portal entrance (more than 300 different fields) was calculated and the impact of targeting and number of portal entrances was also integrated.

RESULTS

The presence of gas in the rectum induces an overdosage of 0.6%, pubic bone induces an underdosage of -1.5%, and femoral heads are responsible for 6% underdosage. For the treatment as a whole, the underdosage is correlated with targeting techniques and weighting of each portal entrance (range, -0.5% to -3.2%).

CONCLUSION

Dose calculation must take into account tissue heterogeneities and more precise guidelines for dose prescription are mandatory for further intercomparison.

Prospective evaluation of early lung toxicity following three-dimensional conformal radiation therapy in non-small-cell lung cancer: preliminary results

PURPOSE

Radiation pneumonitis is the restricting complication following lung cancer irradiation. The correlation between dose-volume histograms (DVHs) and pneumonitis, with a clinical, radiological, and respiratory function evaluation was assessed. Special endpoint was the evaluation of respiratory function after three-dimensional conformal radiotherapy (3D-CRT).

METHODS AND MATERIALS

Fifty-four patients with non metastatic non-small-cell lung cancer (NSCLC) were treated with a curative intent with 3D-CRT (66 Gy). Thirty-one patients were treated postoperatively (pneumonectomy in 9 patients) for residual tumor or massive nodal involvement (N2 or N3); 23 patients were treated with exclusive radiotherapy. Clinical evaluation, CT scan, and pulmonary functional tests were performed before and 6 weeks after irradiation. The DVHs were calculated applying lung density heterogeneity.

RESULTS

Twenty patients had radiation pneumonitis. Irradiation significantly decreased total lung capacity. Volume of the PTV2 (more than 200 cm(3)) was a significant prognostic factor for lung complication.

CONCLUSION

DVHs combined with initial pulmonary functional tests can predict pulmonary toxicity and could allow us to adjust volume that received total highest dose with acceptable toxicity.

Dose escalation with 3D-CRT in prostate cancer: French study of dose escalation with conformal 3D radiotherapy in prostate cancer-preliminary results

PURPOSE

To evaluate the feasibility of dose escalation in a multi-institutional study in prostate cancer patients.

METHODS AND MATERIALS

Between October 1995 and October 1998, 164 patients with localized adenocarcinoma of the prostate were treated with 3-dimensional conformal radiotherapy at one of five French institutions. The dose of radiation was escalated from 66 to 80 Gy (ICRU point). The maximum dose to the rectal wall was limited to 75 Gy.

RESULTS

Results were compared in two groups, one (group 1) receiving the standard dose (n = 46 patients; 66 to 70 Gy) and the other (group 2) receiving the escalated dose (n = 118 patients; 74 to 80 Gy). There was no difference in the characteristics of patients between the two groups. The mean follow-up time was 32 months in group 1 and 17.5 months in group 2. No statistical difference between the two groups was observed in the incidence of late gastrointestinal and urinary toxicities. The probability of achieving a posttreatment prostate-specific antigen nadir of </=1 ng/mL in the 120 patients who did not receive neoadjuvant androgen-deprivation therapy was significantly higher in the dose-escalation group and was directly related to the dose of radiation given.

CONCLUSION

This multi-institutional study demonstrated the feasibility of escalating the dose of radiation to 80 Gy in prostate cancer patients.

A study of dose delivery in small segments

PURPOSE

Use of conformal therapy techniques increases the number of beams used in order to obtain better conformation of the treated volume to the planning target volume. As the number of beams increases, the number of monitor units (MU) for each beam decreases. In this work we have studied, the influence of low MU on dose and homogeneity.

METHODS AND MATERIALS

To study the field symmetry and flatness, films were irradiated. The "dose" for each field was always 60 MU; but it was divided into different segment sizes: 2 segments of 30 MU, 3 segments of 20 MU, and so on up to 12 segments of 5 MU. After being developed, films were scanned and analyzed using a densitometer. The measurements were carried out for three X-ray energies: 6 MV, 10 MV, and 18 MV.

RESULTS

Each measurement was repeated twice for each energy, and the results were equal. The means of the symmetry and flatness values obtained for each energy are lower than the commonly accepted limits.

CONCLUSION

The dose delivered by adding small segments is equivalent to the dose delivered by a conventional segment with our Philips Linacs SL15 and SL20.

Conformal radiotherapy for paranasal sinus and nasal cavity tumors: three-dimensional treatment planning and preliminary results in 40 patients

PURPOSE

To assess the possibility to deliver a high and homogeneous irradiation with respect to maximal tolerated dose to the visual pathways for paranasal sinus and nasal cavity tumors.

METHODS AND MATERIALS

Forty patients with advanced stage malignant tumors were treated with postoperative (30) or primary (10 patients) conformal radiotherapy (CRT). Five patients were previously irradiated. Six to 15 individually shaped isocentric noncoplanar field arrangements, using a multileaf collimator were designed. Dose-volume histograms (DVH) for the planning target volumes (PTV) and the optic pathways were analyzed in 31 cases.

RESULTS

Median and maximal delivered doses to the PTV were 60 (+/-3) and 66 (+/-4) Gy. Dose distributions for critical organs are detailed. Median follow-up was 19 months (3 to 48). Local, nodal, and metastatic recurrences occurred in 8, 2, and 7 cases, respectively. Major prognostic factor for local recurrences was central nervous system (CNS) involvement. One patient died of meningitis. Two patients developed cataract, and 1 patient ipsilateral blindness due to vascular glaucoma.

CONCLUSION

CRT for locally advanced paranasal sinus and nasal cavity tumors enables the delivery of high homogeneous doses to the PTV with respect to critical organs, with a low toxicity and a high local control.

Curative external beam radiotherapy for prostate carcinoma: results in 231 patients treated in Lyon

BACKGROUND

Radical prostatectomy and external beam radiation therapy (EBRT) are the mainstays of treatment of prostate cancer with curative intent. The possible development of radiation proctitis and rectal bleeding are major concerns when using EBRT. Recently, conformal radiotherapy has been introduced in an attempt to improve the results of EBRT. This paper presents an overview of the Lyon experience using standard EBRT with doses of 68 Gy, and reports the preliminary results of a study of conformal radiotherapy with dose escalation.

METHODS

From 1981 to 1995, EBRT was used to treat 231 patients with localized adenocarcinomas of the prostate. The dose of EBRT was 68 Gy/34 fractions/7 weeks using a four-field box technique with 18-MeV photons. A feasibility study of conformal radiotherapy was commenced in 1996. To date, 145 patients have been treated with doses escalating from 68 to 80 Gy.

RESULTS

In the EBRT group of 231 patients, the 5-year overall survival was 80.3%. Anorectal function was scored as excellent in 90% of patients. Rectal bleeding was seen in 14.3% of patients and required local treatment in only seven. In the group treated with conformal radiotherapy, the preliminary results indicate good early tolerance.

CONCLUSION

The curative treatment of patients with prostate cancer using EBRT gives good long-term survival with low rectal toxicity. Conformal radiotherapy appears to be an interesting approach to improve local control and perhaps survival.

[Conformal radiotherapy in cancer of the upper aerodigestive tract]

The outcome of head and neck malignancies is closely related to the achievement of local tumor control. The occurrence of severe late complications is the consequence of the anatomic vicinity between dose-limiting normal tissues and the tumor, thus reducing the curative potential of radiotherapy. Conformal radiotherapy is presently actively investigated as a way to improve the dose distribution in head and neck malignancies (especially when originating from the nasopharynx or the sinuses) while protecting healthy organs. Such an approach requires a chain of sophisticated procedures, including efficient quality assurance programs, in order to achieve the proper degree of safety. The relatively limited clinical studies published to-date have already confirmed the advantage of conformal radiotherapy in terms of dose delivery. The development of beam intensity modulation is likely to further contribute to the improvement of the therapeutic ratio.

[Conformational radiotherapy with multi-leaf collimators: one year experience at the Leon-Berard Centre]

Taking advantage of the renewal of a linear accelerator, the Radiation Therapy Department of the Centre Léon Bérard implemented, in collaboration with Philips Systèmes Médicaux, a conformal therapy set-up procedure using CT-scan for 3D treatment planning and a multileaf collimator that allows achievement of numerous irregular-shaped beams via the multileaf preparation system. The various elements of this equipment make possible well defined and structured procedures for treatment planning with different steps and essential tools used by this technique. We describe the means used and indicate future improvements that will lead to automation in order to provide good quality assurance, better security and substantial time saving. During the first year, 115 patients were treated with this new technique. They presented with central nervous system tumors (32 patients), lung cancer (29 patients), prostate cancer (20 patients), paranasal sinus tumors (14 patients) and tumors located in other sites (13 patients with soft sarcoma, hepato-bilary tumor, etc).

[Radiation tolerance of patients after pneumonectomy for bronchial cancer: role of pulmonary function tests]

Radiation is often necessary after pneumonectomy, either immediately or due to local cancer recurrence. High radiation doses represent a challenge due to the limited tolerance of the lung and the necessity of preserving and protecting the remaining lung parenchyma. The use of CT scan based-treatment planning allows delivery of high radiation doses. To evaluate the radiation tolerance of the lung after high radiation dose, we compared pulmonary function tests performed before surgery and after radiation therapy. Ten male patients (mean age, 56 years old; age range, 45-73) were irradiated after pneumonectomy for lung cancer. All patients had a CT scan-based treatment planning. The mean radiation dose was 56 Gy (45-66 Gy) delivered with a linear accelerator and multiple complex fields. Two or more sets of pulmonary function tests were available (before surgery and 2 to 6 months after radiation). No patient developed clinical radiation pneumonitis and most of the patients had a minimal paramediastinal fibrosis at CT scan. Postirradiation pulmonary lung tests were compared to the theoretical values of the estimated defect observed after pneumonectomy. No significant decrease in forced expiratory volume in 1 s/inspiratory vital capacity (FEV1/IVC) was observed in ten evaluable patients; the observed values were comparable to those expected after pneumonectomy without irradiation (FEV1/IVC: 61 to 100%), showing that irradiation did not alter pulmonary function. Computerized tomography-based treatment planning and the use of complex beam positioning allowed optimal lung parenchymal preservation. Through this procedure, high doses of radiation can be delivered to the mediastinum and bed tumor. Comparison of pulmonary function tests performed before surgery and after radiation showed no alteration of lung function, even after high doses. Optimal tools required for the evaluation of radiation on lung parenchyma are still to be defined.

[Conforming radiotherapy in 1995: technological acquisitions and clinical prospects]

Conformal radiation therapy represents a considerable and attractive challenge in oncology. Its aim is mainly to improve local control by increasing the dose with an acceptable rate of complications. This work overviews the world literature on this subject. The technical and theoretical requirements are highlighted. These requirements include a precise definition of the target volume by digital imaging (essentially CT scan), but also clear view of the target volume and the organs at risk, a specific collimation of the beam, 3-D dose calculations, optimation procedures, and a rigid immobilization of the patient with verification of his position. Moreover, the clinical applications of conformal radiation therapy are reviewed and discussed.

Radiosensitivity in vitro of clonogenic and non-clonogenic glioblastoma cells obtained from a human brain tumour

Cells obtained from a human glioblastoma (G5) were characterized and used to develop an assay measuring their radiosensitivity in vitro. Surviving fractions were estimated 12 days after irradiation by image analysis of the total surface occupied by the cells. This report evaluates 4 experimental factors which may influence the radiosensitivity in vitro of G5 cells: passage number, delay between plating and irradiation, cell density and clonal heterogeneity. The radiosensitivity of the G5 cell line was found to be passage-independent at least between passages 12 and 75. Experimental conditions influence the radiosensitivity as surviving fraction at 2 Gy (SF2) range from 90% (5,000 cells/well, irradiation 72 h after seeding) to 49% (2,500 cells per well, irradiation 24 h after seeding). The heterogeneity of the radiosensitivity is large at the clonal level as SF2 of six clones isolated from the G5 line were 45%, 50%, 72%, 74%, 79% and 84%. Finally, when G5 cells were irradiated at low cell density and at the beginning of the growth phase, the radiosensitivity measured with this assay is comparable to that obtained with a standard colony assay. We propose that this assay may be useful to determine the intrinsic radiosensitivity of cells obtained from human tumours.

[Dosimetry with thermoluminescence during mammography]

A dosimetry study using lithium fluoride TL dosimeters was carried out during mammography in 34 patients in order to evaluate in vivo the dose of mammography rays received by these patients. The measures are made for one breast only, using two views: cranio-caudal and medio-lateral views with compression. The results show that skin entrance doses are going from 0.20 to 1.67 cGy in cranio-caudal view and from 0.15 to 1.75 cGy in medio-lateral view. The skin exit doses are from 0.001 to 0.21 cGy in cranio-caudal view and from 0.001 to 0.13 cGy in medio-lateral view. The midplane doses estimated from the skin entrance dose and the graph of the deep yield are from 0.07 to 0.48 cGy. These doses are comparable with those founded by other authors, and though maximum, they stay very low. This is important for detect the breast cancer in order to reduce radiation risks.