A deep learning MRI-based signature may provide risk-stratification strategies for nasopharyngeal carcinoma.

OBJECTIVE: As the prognosis of nasopharyngeal carcinoma (NPC) is influenced by various factors, making it difficult for clinical physicians to predict the outcome, the objective of this study was to develop a deep learning-based signature for risk stratification in NPC patients. METHODS: A total of 293 patients were enrolled in the study and divided into training, validation, and testing groups with a ratio of 7:1:2. MRI scans and corresponding clinical information were collected, and the 3-year disease-free survival (DFS) was chosen as the endpoint. The Res-Net18 algorithm was used to develop two deep learning (DL) models and another solely based on clinical characteristics developed by multivariate cox analysis. The performance of both models was evaluated using the area under the curve (AUC) and the concordance index (C-index). Discriminative performance was assessed using Kaplan-Meier survival analysis. RESULTS: The deep learning approach identified DL prognostic models. The MRI-based DL model showed significantly better performance compared to the traditional model solely based on clinical characteristics (AUC: 0.8861 vs 0.745, p = 0.04 and C-index: 0.865 vs 0.727, p = 0.03). The survival analysis showed significant survival differences between the risk groups identified by the MRI-based model. CONCLUSION: Our study highlights the potential of MRI in predicting the prognosis of NPC through DL algorithm. This approach has the potential to become a novel tool for prognosis prediction and can help physicians to develop more valid treatment strategies in the future.

Composition tunability of semiconductor radiosensitizers for low-dose X-ray induced photodynamic therapy.

Radiation therapy is one of the most commonly used methods in clinical cancer treatment, and radiosensitizers could achieve enhanced therapeutic efficacy by incorporating heavy elements into structures. However, the secondary excitation of these high-Z elements-doped nanosensitizers still imply intrinsic defects of low efficiency. Herein, we designed Bi-doped titanium dioxide nanosensitizers in which high-Z Bi ions with adjustable valence state (Bi3+ or Bi4+) replaced some positions of Ti4+ of anatase TiO2, increasing both X-rays absorption and oxygen vacancies. The as-prepared TiO2:Bi nanosensitizers indicated high ionizing radiation energy-transfer efficiency and photocatalytic activity, resulting in efficient electron-hole pair separation and reactive oxygen species production. After further modification with cancer cell targeting peptide, the obtained nanoplatform demonstrated good performance in U87MG cell uptakes and intracellular radicals-generation, severely damaging the vital subcellular organs of U87MG cells, such as mitochondrion, membrane lipid, and nuclei etc. These combined therapeutic actions mediated by the composition-tunable nanosensitizers significantly inhibited the U87MG tumor growth, providing a refreshing strategy for X-ray induced dynamic therapy of malignant tumors.

Anoikis related genes may be novel markers associated with prognosis for ovarian cancer.

The aim of this study was to determine the prognostic significance of anoikis related genes (ARGs) in ovarian cancer (OC) and to develop a prognostic signature based on ARG expression. We analyzed cohorts of OC patients and used nonnegative matrix factorization (NMF) for clustering. Single-sample gene-set enrichment analysis (ssGSEA) was employed to quantify immune infiltration. Survival analyses were performed using the Kaplan-Meier method, and differences in survival were determined using the log-rank test. The extent of anoikis modification was quantified using a risk score generated from ARG expression. The analysis of single-cell sequencing data was performed by the Tumor Immune Single Cell Hub (TISCH). Our analyses revealed two distinct patterns of anoikis modification. The risk score was used to evaluate the anoikis modification patterns in individual tumors. Three hub-genes were screened using the LASSO (Least Absolute Shrinkage and Selection Operator) method and patients were classified into different risk groups based on their individual score and the median score. The low-risk subtype was characterized by decreased expression of hub-genes and better overall survival. The risk score, along with patient age and gender, were considered to identify the prognostic signature, which was visualized using a nomogram. Our findings suggest that ARGs may play a novel role in the prognosis of OC. Based on ARG expression, we have developed a prognostic signature for OC that can aid in patient stratification and treatment decision-making. Further studies are needed to validate these results and to explore the underlying mechanisms.

Effect of Stereotactic Body Radiation Therapy Combined with Thermoplastic Fixation on Set-Up Errors in Breast Cancer Patients Undergoing Radiotherapy.

Objective: To investigate the effect of stereotactic radiotherapy (SBRT) combined with thermoplastic fixation on set-up error in breast cancer (BC) patients undergoing radiotherapy. Methods: Ninety BC patients undergoing radiotherapy who were treated in our hospital (May 2019-May 2020) were selected as the research objects and equally divided into the experimental group and control group according to the order of hospitalization, with 45 patients in each group. The control group received conventional radiotherapy combined with breast bracket, and the experimental group received SBRT combined with thermoplastic fixation. The incidences of adverse reactions, 1-year survival rates, and set-up errors were compared between the two groups. Results: Compared with the control group, the experimental group had much lower total incidence of adverse reactions and remarkably higher 1-year survival rate. The translational errors (X direction, Y direction, and Z direction), translational errors after rotation (X direction, Y direction, and Z direction), and rotation errors (X direction, Y direction, and Z direction) in the experimental group were obviously lower compared with those in the control group. Conclusion: Implementing SBRT combined with thermoplastic fixation in BC patients undergoing radiotherapy can effectively improve set-up efficiency and treatment accuracy and reduce set-up errors. Compared with the breast bracket, the combination of SBRT and thermoplastic fixation has higher application value, and further studies are conducive to providing patients with a better solution plan.

X-ray-Activated Simultaneous Near-Infrared and Short-Wave Infrared Persistent Luminescence Imaging for Long-Term Tracking of Drug Delivery.

Both short-wave infrared (SWIR: 900-1700 nm) and near-infrared (NIR: 650-900 nm) luminescence possess lower optical scattering and higher signal-to-noise in deep tissues than conventional luminescence, gaining increasing attention in biomedicine. Herein, we designed mesoporous silica-coated Yb-doped magnesium germanate nanoparticles (mMGOs) with excellent two-in-one NIR and SWIR persistent luminescence after X-ray irradiation by simply regulating the valence of rare-earth ions, which also possess high cargo loading and a controlled release profile in the tumor region. The investigations in vitro and in vivo showed that mMGOs were repeatedly activated to realize rechargeable persistent luminescence imaging for tracking cargo delivery in mice. Moreover, the stimulative drug-release profile inhibited tumor growth effectively. Both of the X-ray excited two-in-one NIR and SWIR persistent luminescence imaging not only allowed for rechargeable imaging of deep tumors but also achieved long-term tracking with a remarkable tumor inhibition effect.

Value of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in prediction of the overall survival of esophageal cancer patients treated with chemoradiotherapy.

This study is to investigate the value of the metabolic parameters measured by sequential FDG PET/CT in predicting the overall survival of patients with esophageal squamous cell carcinoma (ESCC). A total of 160 patients who were newly diagnosed as ESCC patients and treated with chemoradiotherapy were included in this study. The FDG PET/CT was carried out prior to radiotherapy (PET1), when the cumulative dose of radiotherapy reached 50 Gy (PET2), at the end of radiotherapy (PET3) and 1 month after radiotherapy (PET4). The max of the standard uptake value (SUVmax) of the primary tumor, the metabolic tumor volume (MTV) and the total lesion glycolisis (TLG) prior to treatment were measured. The correlation of the measured parameters and the derived parameters of SUVmax with the overall survival was analyzed. The relatively reduced percentage of the SUVmax of PET3 and PET4 to the SUVmax of PET1 and PET2, had predictive value for the overall survival. The area under researcher operation curve (ROC) was between 0.62 and 0.73 (P < 0.01). The MTV and TLG prior to treatment might be used to predict the overall survival, and the area under ROC were both 0.69 (P < 0.001). Sequential FDG PET/CT scanning is useful to predict the overall survival of chemoradiotherapy for ESCC. The metabolic parameters and the derived parameters of FDG PET/CT have predictive values for overall survival.