Dosimetric differences between intensity-modulated radiotherapy based on equivalent uniform dose and dose-volume optimization in stage III non-small cell lung cancer.

OBJECTIVE: To determine the dosimetric differences between biological and physical functions of equivalent uniform dose (EUD) and dose volume (DV) therapy in patients with phase III non-small cell lung cancer. METHODS: Four different radiotherapy plans (DV+DV, DV-EUD+DV, EUD+EUD and EUD-DV+EUD) were developed for 15 patients with stage III NSCLC. To study physical function (DV+DV) the target area was optimized by introducing the conditions of biological function optimization, while the organs at risk were optimized by means of physical function (DV-EUD+DV). Biological function optimization (EUD+EUD) was performed for the target area by applying conditions of physical function optimization while biological function optimization (EUD-DV+DV) was conducted for the organs at risk to compare dosimetric parameters among the four groups of treatment plans. RESULTS: PTV: D2%, D98%, D50%, V105% and Dmax of both the DV-EUD+DV group and EDU-DV+EUD group were the minimum (P<0.05). The minimum and average dose of the EUD+EUD group showed an increasing trend and high-dose area became observable. For homogeneity index (HI), DV-EUD+DV group and EUD-DV+EUD results were compared with the other groups (P<0.05), no significant difference was observed statistically between the DV-EUD+DV group and EUD DV+EUD (P=0.659). With regard to conformability index (CI), the results of the four groups showed no significant difference (P>0.05). For the organs at risk, the mean dose of lung tissue (MLD), V5, V10, V20, V30, heart V30, V40, and Dmean also revealed no significant difference (P>0.05). For the spinal cord, the D1 % of the EUD+EUD group and EUD-DV+EUD groups were significantly different (P<0.05) than the other groups. While no significant difference (P=0.32) was found between the EUD+EUD and EUD-DV+EUD groups. When comparing the number of machine unions (MU) no significant difference was revealed (P>0.05) among the results of the 4 groups. CONCLUSION: The methods featuring optimization of physical and biological functions are effective in improving the uniformity of target area to have better outcome of the treatment. Biological function optimization or the combination of biological and physical function optimization is conducive to significantly reduce the required dose for the spinal cord.

Fractionated Stereotactic Radiation Therapy Using Volumetric Modulated Arc Therapy in Patients with Solitary Brain Metastases.

PURPOSE: To analyze retrospectively the clinical efficacy and safety for patients treated with fractionated stereotactic radiation therapy (FSRT) using volumetric modulated arc therapy. METHODS: Between 2016 and 2017, 46 patients with solitary brain metastasis who underwent FSRT consisting of 25-40 Gy/5 fractions were recruited in this study. All targets within the same course received different prescriptions according to size. Toxicities were graded according to the Common Terminology Criteria for Adverse Events version 4.0. RESULTS: The median follow-up was 11 months (3-53 months). The 6-month and 12-month local control rate calculated by Kaplan-Meier estimate was, respectively, 95% and 86%. Tumor diameter < 2.5 cm obtained 100% improved 12-month local control rate compared with 66% in those with ≥2.5 cm (P < 0.001). The 12-month local control calculated by Kaplan-Meier estimate was 95% in tumors with >30 Gy treatment and only 60% in tumors with ≤30 Gy treatment (P = 0.001). Multivariate analysis revealed that the prescription dose ≤ 30 Gy resulted in increased local failure (hazard ratio (HR), 0.14 (range, 0.019-0.95; P = .046)). Grade 3 or worse toxic effects were found in 5 (11%) patients, and no patient experienced surgical resection for symptomatic radioactive necrosis. CONCLUSIONS: FSRT for solid brain metastasis appears to have the advantages of a high rate of local control with a minimal risk of severe toxicity and deserves application in the clinical practice.

Near-infrared spectroscopy coupled with chemometrics algorithms for the quantitative determination of the germinability of Clostridium perfringens in four different matrices.

Clostridium perfringens (C. perfringens) has the ability to form metabolically-dormant spores that can survive food preservation processes and cause food spoilage and foodborne safety risks upon germination outgrowth. This study was conducted to investigate the effects of different AGFK concentrations (0, 50, 100, 200 mM/mL) on the spore germination of C. perfringens in four matrices, including Tris-HCl, FTG, milk, and chicken soup. C. perfringens spore germinability was investigated using near infrared spectroscopy (NIRS) combined with chemometrics. The spore germination rate (S), the OD600%, and the Ca2+-DPA% were measured using traditional spore germination methods. The results of spore germination assays showed that the optimum germination rate was obtained using 100 mM/L concentrations of AGFK in the FTG medium, and the S, OD600% and Ca2+-DPA% were 98.6%, 59.3% and 95%, respectively. The best prediction models for the S, OD600% and Ca2+-DPA% were obtained using SNV as the preprocessing method for the original spectra, with the competitive adaptive weighted resampling method (CARS) as the characteristic variables related to the selected spore germination methods from NIRS data. The results of the S showed that the optimum model was built by CARS-PLSR (RMSEV = 0.745, Rc = 0.897, RMSEP = 0.769, Rp = 0.883). For the OD600%, interval partial least squares regression (CARS-siPLS) was performed to optimize the models. The calibration yielded acceptable results (RMSEV = 0.218, Rc = 0.879, RMSEP = 0.257, Rp = 0.845). For the Ca2+-DPA%, the optimum model with CARS-siPLS yielded acceptable results (RMSEV = 44.7, Rc = 0.883, RMSEP = 50.2, Rp = 0.872). This indicated that quantitative determinations of the germinability of C. perfringens spores using NIR technology is feasible. A new method based on NIR was provided for rapid, automatic, and non-destructive determination of the germinability of C. perfringens spores.