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AIM: In this study, efficacy of collapsed cone algorithm-generated intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) were evaluated for treatment of thoracic esophageal cancer. MATERIALS AND METHODS: Ten previously treated patients with VMAT were considered for evaluation. The planning parameters were evaluated in terms of max dose, mean dose, Homogeneity Index, Conformity Index for planning target volume, and organ at risk doses. Total monitor unit, treatment time, and gamma passing index were also reported. RESULTS: The target dose coverage of the VMAT and IMRT plans achieved the clinical dosimetric criteria for all ten patients in the evaluation. Under the condition of equivalent target dose distribution, the VMAT plan's Conformity Index, monitor unit, treatment time, and gamma passing index rate were superior than in the IMRT plan, and the result was statistically significant. CONCLUSION: Collapsed cone algorithm-based VMAT can have a more effective and better approach for esophageal cancer than IMRT.
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Neoplasias Esofágicas , Radioterapia de Intensidade Modulada , Humanos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Neoplasias Esofágicas/radioterapia , Tórax , Algoritmos , Órgãos em RiscoRESUMO
Global climate change has significantly impacted the production of various crops, particularly long-term fruit-bearing plants such as citrus. This study analyzed the fruit quality of 12 citrus orchards (Citrus Sinensis L.Osbeck cv. Bingtang) in a subtropical region in Yunnan, China from 2014 to 2022. The results indicated that high rainfall (>220 mm) and low cumulative temperature (<3150 °C) promoted increases in titratable acidity (>1.8 %) in young fruits. As the fruits further expanded (with a horizontal diameter increasing from 50 to 65 mm), excessive rainfall (300-400 mm), lower cumulative temperature (<2400 °C), and a reduced diurnal temperature range (<10 °C) hindered decreases in titratable acidity. Conversely, low rainfall (<220 mm), high cumulative temperature (>3150 °C), and a high diurnal temperature range (>14 °C) promoted the accumulation of soluble solids in young fruits (9 %) at 120 days after flowering (DAF). Furthermore, low rainfall (<100 mm) favored the accumulation of soluble solids (1.5 %) during fruit expansion (195-225DAF). To quantify the relationship between fruit acidity and climate variables at 120 DAF, we developed a regression model, which was further validated by actual measurements and accurately predicted fruit acidity in 2023. Our findings have the potential to assist citrus growers in optimizing cultivation techniques for the production of high-quality citrus under increasingly variable climatic conditions.
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Citrus sinensis , Citrus , Mudança Climática , China , Temperatura Baixa , FrutasRESUMO
Background: In Radiotherapy, computation of dose is important since in a small field with heterogeneity, dose is usually computed with discrepancies. Objective: The present study was aimed to evaluate the dosimetry of treatment planning algorithms in lung equivalent heterogeneous medium for Volumetric Modulated Arc Therapy (VMAT) with step and shoot Intensity-Modulated Radiation Therapy (ss-IMRT), and dynamic Intensity-Modulated Radiation Therapy (d-IMRT). Material and Methods: In this experimental study, Computerized Imaging Reference System (CIRS) phantom was used with an inhomogeneous Racemosa wood cylinder for two types of tumors, namely, Left Lung Central Tumor (LCT) and Left Lung Peripheral Tumor (LPT) in the CIRS left lung cavity. The computed tomography (CT) datasets were employed with the generation of VMAT, d-IMRT and ss-IMRT plans for the LCT and LPT irradiated with 6 MV photon beams. In this study, the accuracy and efficacy of two algorithms: Monte Carlo (MC) and the Pencil Beam (PB), from the Monaco treatment planning system (TPS), were tested by using Gafchromic EBT3 films and CIRS thorax phantom. Results: Regardless of treatment techniques, both algorithms exhibited higher divergence in LPT than LCT. In both LCT and LPT, the highest deviation was near the tumor-lung junction. However, the deviation was higher in the PB algorithm than MC algorithm, with a minimally acceptable variation of -0.8%. Conclusion: The MC algorithm shows more consistency for EBT3 measured dose in lung equivalent heterogeneous medium. However, accurate dose predictions are complicated due to electronic disequilibrium within and at the interface of inhomogeneity. These constraints may cause variations from the anticipated outcomes of the treatments.
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Introduction: The purpose of this study was to compare the dosimetric parameters of volumetric modulated arc therapy (VMAT) treatment plans using coplanar and noncoplanar beams in patients with bilateral breast cancer/s (BBCs) in terms of organ at risk sparing and target volume coverage. The hypothesis was to test whether VMAT with noncoplanar beams can result in lesser dose delivery to critical organs such as heart and lung, which will result in lesser overall toxicity. Materials and Methods: Data of nine BBC cases treated at our hospital were retrieved. Computed tomography simulation data of these cases was used to generate noncoplanar VMAT plans and the parameters were compared with standard VMAT coplanar plans. Contouring was done using radiation therapy oncology group guidelines. Forty-five Gray in 25 fractions was planned followed by 10 Gy in five fractions boost in breast conservation cases. Results: No significant difference in planning target volume (PTV) coverage was found for the right breast/chestwall (P = 0.940), left breast/chestwall (P = 0.872), and in the total PTV (P = 0.929). Noncoplanar beams resulted in better cardiac sparing in terms of Dmean heart. The difference in mean dose was >1 Gy (8.80 ± 0.28 - 7.28 ± 0.33, P < 0.001). The Dmean, V20 and V30 values for total lung slightly favor noncoplanar beams, although there was no statistically significant difference. The average monitor units (MUs) were similar for coplanar plans (1515 MU) and noncoplanar plans (1455 MU), but the overall treatment time was higher in noncoplanar plans due to more complex setup and beam arrangement. For noncoplanar VMAT plans, the mean conformity index was slightly better although the homogeneity indices were similar. Conclusion: VMAT plans with noncoplanar beam arrangements had significant dosimetric advantages in terms of sparing of critical organs, that is Dmean of heart doses with almost equivalent lung doses and equally good target coverage. Larger studies with clinical implications need to be considered to validate this data.
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Purpose: We aimed to assess the toxicity profile and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with a combination of image-guided intensity-modulated radiation therapy (IG-IMRT) and image-guided brachytherapy (IGBT). Material and methods: 25 LACC patients were recruited in this single-arm prospective study. Whole pelvis IG-IMRT was delivered (45 Gy with simultaneously integrated nodal boost of 55 Gy in 25 fractions), with concurrent weekly cisplatin (40 mg/m2). Patients received IGBT of 7 Gy each in 4 fractions to high-risk clinical target volume (HR-CTV). First fraction was done under MRI, and subsequent fractions were performed under CT guidance. Primary endpoint was acute toxicity, and secondary endpoints were 2-year loco-regional control and late toxicity. Results: The median age was 52 years, and FIGO 2018 stage distribution was IIA2, IIB, IIIB, and IIIC1 in 12%, 40%, 20%, and 28% patients, respectively. All patients received concurrent chemotherapy with median number of 5 cycles (range, 4-5 cycles). Grade 1 and 2 diarrhea, and grade 1 cystitis was reported in 4 (16%), 3 (12%), and 2 (8%) patients, respectively. Grade 1 and 2 anemia, and grade 1 and 2 dermatitis were observed in 3 (12%) and 2 (8%), and 3 (12%) and 3 (12%) patients, respectively. No patient reported grade 3-4 acute toxicity. At median follow-up of 29.5 months (range, 25-37 months), late grade 1 bladder toxicity was observed in 1 (4%) patient. Loco-regional control at 1 and 2 years were 96% and 92%, respectively. Conclusions: The combination of IG-IMRT and IGBT yielded excellent outcomes in terms of acute toxicity and loco-regional control.
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Purpose: Interstitial brachytherapy (ISBT) is indicated for intact cervical carcinoma (IN-CC) if intracavitary brachytherapy (ICRT) is not feasible and also in vault carcinoma (VA-C). We aimed to evaluate the doses to pelvic lymph node regions in IN-CC and VA-C treated with ISBT. Material and methods: Ten patients (6 IN-CC, 4 VA-C) were chosen for this dosimetric study. IN-CC had a central tandem in addition to the needles. External iliac (EI-N), internal iliac (II-N), obturator (OB-N) and sacral (SA-N) groups of lymph nodes were delineated. A dose of 10 grays (Gy) and 8 Gy each × 2 fractions was prescribed to the target in IN-CC and VA-C respectively. Doses received by 100%, 90% and 50% volume (D100, D90, D50) and D2cc, D1cc, D0.1cc were evaluated. Doses to lymph nodal groups in IN-CC vs. VA-C were compared using Student's t-test. Results: For 20 implants, the median number of needles was 18 (range, 16-20). Mean D90 and D2cc of the combined bilateral OB-N, II-N, EI-N and SA-N groups were 33.62 ±3.46% and 102.94 ±10.71%, 6.98 ±0.65% and 39.69 ±3.64%, 5.1 ±0.51% and 15.4 ±0.8%, 7.76 ±0.95% and 15.36 ±1.09% of the prescribed doses respectively. Patients with a central tandem (IN-CC) received significantly higher doses to external, internal iliac and sacral group of lymph nodes (p < 0.001) as compared to VA-C. Conclusions: In patients with cervical carcinoma treated with ISBT, pelvic lymph node groups received significant doses. The dose contribution to pelvic lymph nodes is higher in patients with intact cervical cancer where a central tandem is used as compared to post-operative patients.
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BACKGROUND: We prospectively assessed acute and late toxicity in post-operative oral cavity squamous cell carcinoma (PO-OCSCC) treated with adjuvant dysphagia optimized intensity-modulated radiotherapy (Do-IMRT) versus standard IMRT (S-IMRT). MATERIAL AND METHODS: Fifty-six patients of PO-SCC without indications of concurrent chemotherapy were alternatively allocated to adjuvant Do-IMRT (n = 28) versus S-IMRT (n = 28) arms. High- and low-risk planning target volume received 60 and 54 Gy, respectively, in 30 fractions over 6 weeks. Dysphagia aspiration-related structures (DARS) were contoured in both arms. While dosimetric constraints were given in Do-IMRT arm, doses to DARS were only observed without dose constraints in S-IMRT arm. Acute and late toxicity were assessed by common terminology criteria for adverse events (CTCAE) v5.0 and RTOG criteria, respectively. RESULTS: The primary site of disease was buccal mucosa (64% vs. 53%) and oral tongue (21% vs. 32%), in Do-IMRT and S-IMRT, respectively. The mean doses to DARS was significantly less with Do-IMRT (all p < 0.001) as compared to S-IMRT. Median follow-up was 24.2 months. Grade ≥2 oral pain was less in the Do-IMRT arm (50% vs. 78.6%, p = 0.05). Grade ≥2 late dysphagia at 2 years were significantly less in Do-IMRT arm (0% vs. 17.9%, p = 0.016). Two-year locoregional control was 89.2% in Do-IMRT and 78.5% in S-IMRT (p = 0.261). CONCLUSION: DARS can be spared in PO-OCSCC patients treated with Do-IMRT without compromising coverage of the target volumes. Limiting doses to DARS leads to lesser acute and late toxicity without compromising locoregional control.
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Carcinoma de Células Escamosas , Transtornos de Deglutição , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Radioterapia de Intensidade Modulada , Humanos , Radioterapia de Intensidade Modulada/efeitos adversos , Transtornos de Deglutição/etiologia , Estudos Prospectivos , Neoplasias Bucais/radioterapia , Neoplasias Bucais/etiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/etiologia , Língua/patologia , Neoplasias de Cabeça e Pescoço/etiologia , Dosagem RadioterapêuticaRESUMO
Purpose: To analyse the safety and efficacy of neoadjuvant chemoradiation (NACRT) with dose-escalated image-guided intensity modulated radiation therapy (IG-IMRT) in locally advanced (T3/4; T1-4N1-2) rectal cancers (LARCs). Materials and methods: Twenty patients with the diagnosis of LARC were recruited in this prospective interventional single-arm study treated by IG-IMRT with 45 Gray (Gy) in 25 fractions to elective nodal volumes and 55 Gy in 25 fractions to the gross primary and nodal disease with concurrent capecitabine 825 mg/m2 twice daily on radiotherapy days. Patients underwent total mesorectal excision 6-8 weeks post completion of NACRT followed by adjuvant chemotherapy (Capecitabine and oxaliplatin every 3 weekly for 6-8 cycles). Primary end point was acute toxicity assessment and secondary end points were pathological complete response (pCR) and loco-regional control (LRC). Results: Clinical T stage was T3:T4 in 19:1 and clinical N0:N1: N2 in 2:7:11 patients, respectively. With a median follow up of 21.2 months (13.8-25.6 months), 18 of 20 (90%) patients received the full course of treatment. Tumour and nodal downstaging was achieved in 78% and 84% of patients, respectively. pCR and overall complete response (defined as pCR and near CR) was achieved in 22.2% and 44.4% of patients, respectively. 2 (10%) patients completed NACRT, and achieved complete clinical response but refused surgery. Adjuvant chemotherapy course was completed by 17/18 (94.5%) patients. Grade 3 toxicities were observed in 2 (10%) patients during NACRT. All patients were disease-free at the time of the last follow up. Conclusion: Dose-escalation of NACRT therapy with IG-IMRT in LARC patients offers decent rates of pCR and overall response with excellent LRC and acceptable toxicities.
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The culturable endophytic fungus Serendipita indica has many beneficial effects on plants, but whether and how it affects physiological activities and phosphorus (P) acquisition of tea seedlings at low P levels is unclear. The objective of this study was to analyze the effects of inoculation with S. indica on growth, gas exchange, chlorophyll fluorescence, auxins, cytokinins, P levels, and expressions of two phosphate transporter (PT) genes in leaves of tea (Camellia sinensis L. cv. Fudingdabaicha) seedlings grown at 0.5 µM (P0.5) and 50 µM (P50) P levels. Sixteen weeks after the inoculation, S. indica colonized roots of tea seedlings, with root fungal colonization rates reaching 62.18% and 81.34% at P0.5 and P50 levels, respectively. Although plant growth behavior, leaf gas exchange, chlorophyll values, nitrogen balance index, and chlorophyll fluorescence parameters of tea seedlings were suppressed at P0.5 versus P50 levels, inoculation of S. indica mitigated the negative effects to some extent, along with more prominent promotion at P0.5 levels. S. indica inoculation significantly increased leaf P and indoleacetic acid concentrations at P0.5 and P50 levels and leaf isopentenyladenine, dihydrozeatin, and transzeatin concentrations at P0.5 levels, coupled with the reduction of indolebutyric acid at P50 levels. Inoculation of S. indica up-regulated the relative expression of leaf CsPT1 at P0.5 and P50 levels and CsPT4 at P0.5 levels. It is concluded that S. indica promoted P acquisition and growth in tea seedlings under P deficit conditions by increasing cytokinins and indoleacetic acid and CsPT1 and CsPT4 expression.
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Walnut (Juglans regia) is an important nut tree species in the world, whereas walnut trees often face inadequate phosphorus (P) levels of soil, negatively limiting its growth and yield. Arbuscular mycorrhizal fungi (AMF) can colonize walnut roots, but whether and how AMF promotes walnut growth, physiological activities, and P acquisition is unclear. The present study aimed to evaluate the effects of Diversispora spurca on plant growth, chlorophyll component concentrations, leaf gas exchange, sugar and P concentrations, and expression of purple acid phosphatase (PAP) and phosphate transporter (PT) genes in leaves of J. regia var. Liaohe 1 seedling under moderate (100 µmol/L P) and low P (1 µmol/L P) levels conditions. Three months after inoculation, the root mycorrhizal colonization rate and soil hyphal length were 45.6-53.2% and 18.7-39.9 cm/g soil, respectively, and low P treatment significantly increased both root mycorrhizal colonization rate and soil hyphal length. Low P levels inhibited plant growth (height, stem diameter, and total biomass) and leaf gas exchange (photosynthetic rate, transpiration rate and stomatal conductance), while AMF colonization significantly increased these variables at moderate and low P levels. Low P treatment limited the level of chlorophyll a, but AMF colonization did not significantly affect the level of chlorophyll components, independent on soil P levels. AMF colonization also increased leaf glucose at appropriate P levels and leaf fructose at low P levels than non-AMF treatment. AMF colonization significantly increased leaf P concentration by 21.0-26.2% than non-AMF colonization at low and moderate P levels. Low P treatment reduced the expression of leaf JrPAP10, JrPAP12, and JrPT3;2 in the inoculated plants, whereas AMF colonization up-regulated the expression of leaf JrPAP10, JrPAP12, and JrPT3;2 at moderate P levels, although AMF did not significantly alter the expression of JrPAPs and JrPTs at low P levels. It is concluded that AMF improved plant growth, leaf gas exchange, and P acquisition of walnut seedlings at different P levels, where mycorrhizal promotion of P acquisition was dominated by direct mycorrhizal involvement in P uptake at low P levels, while up-regulation of host PAPs and PTs expressions at moderate P levels.
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Nutritional enhancement has been reported to effectively relieve infected symptoms of Huanglongbing, one of the most destructive diseases of citrus. However, few studies focused on the role of plant nutrition in citrus plant-vector (Asian citrus psyllid; Diaphorina citri Kuwayama) interactions, which is regarded as an important part to develop an effective management strategy. METHOD: In the present study, a hydroponic culture was carried out to evaluate the effects of boron deficiency on psyllid feeding process to decode the molecular/biochemical basis of host-psyllid interaction. RESULTS: Boron deficiency was observed to play a major role in accelerating the release of volatile organic compounds, especially methyl salicylate, affecting the shikimic acid pathway through an elevated synthesis of shikimic acid, l-phenylalanine, 3-phenylpyruvic acid and salicylic acid. These changes made citrus leaf more attractive to psyllid adults. Meanwhile, boron deficiency evidently decreased the boron concentration of leaf cell wall fractions, thereby, weakened the structural stability by affecting pectin and cellulose formations. A significant decrease of cell wall mechanical strength was observed in boron-deficiency leaf, which could be the critical reasons to reduce piercing and to increase phloem ingestion during psyllid feeding. CONCLUSION: Our study demonstrated that boron deficiency facilitated the feeding behavior of psyllid adults through elevated release of methyl salicylate, coupled with weakened mechanical properties of cell wall.
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Citrus , Hemípteros , Compostos Orgânicos Voláteis , Animais , Hemípteros/fisiologia , Compostos Orgânicos Voláteis/metabolismo , Boro/metabolismo , Boro/farmacologia , Ácido Chiquímico/metabolismo , Citrus/metabolismo , Folhas de Planta/fisiologia , Doenças das PlantasRESUMO
Objectives: The management of inoperable oral cavity squamous cell carcinoma (OC-SCC) is onerous. We aimed to retrospectively analyse the outcome of our cohort of inoperable OC-SCC treated with definitive concurrent chemoradiotherapy (CTRT) with or without induction chemotherapy (IC). Methods: Data of 100 patients (January 2017 to May 2022) of histopathologically proven inoperable OC-SCC treated with definitive CTRT with weekly cisplatin 40 mg/m2 were retrieved from our departmental archives. Radiotherapy (RT) was delivered with three-dimensional conformal plan (66-70 Gy). Toxicities were evaluated using acute morbidity scoring criteria of Radiation Therapy Oncology Group. The response was evaluated as per WHO criteria. Progression free survival (PFS) was calculated from the date of the start of treatment (IC/CTRT) using Kaplan Meier method. Results: Median age was 45 years (range 30-80 years). The primary site was oral tongue (59%), retro-molar trigon (15%), buccal mucosa (15%) and others (11%). The stage was III: IVA: IVB in 16:70:14 patients respectively. 72% patients received IC (platinum ± 5 FU ± taxane). Grade 3 skin toxicity, oral mucositis and dysphagia was noted in 13 (13%), 19 (19%) and 13 (13%) patients respectively. The median follow-up duration was 30.5 months (range 6-62 months). Complete response (CR), partial response, progressive disease and death at the time of the last follow-up were 49%, 25%, 15% and 11% respectively. 2-year PFS rate was 49.5%. Stage III patients had a higher CR rate (81.2% versus 42.8%; p = 0.0051) and higher 2-year PFS (81.2% versus 46.4%; p = 0.0056) in comparison to stage IV patients. Conclusion: Inoperable patients of OC-SCC treated with definitive CTRT with or without IC yielded CR in approximately half of patients with acceptable toxicity profiles.
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Objective: To compare sequential fascial dilation (SFD) versus one-shot dilation (OSD) in the pediatric patients undergoing percutaneous nephrolithotomy. Methods: The present study is an observational study. The study subjects were divided into two groups. In group 1, renal dilation was done using the SFD and in group 2, renal dilation was done using the OSD. The amount of time exposed to radiation during access to pelvicalyceal system was estimated. Complications, stone free rates, ancillary procedures for residual stones and hospital stay were compared. Modified Clavien-Dindo classification was used for grading the complications. Results: Radiation exposure and operative time were less in OSD group (95% confidence interval (CI) 3.068 to 14.072, and 2.565 to 12.435, p<0.005). The mean drop of hematocrit was statistically less significant in OSD group (p=0.032). In both groups, complications, stone free rate and hospital stay were statistically insignificant. Conclusions: OSD is feasible in the children with reduced radiation exposure and shorter operative time. The outcome was similar to SFD.
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Complete and balanced nutrition has always been the first line of plant defense due to the direct involvement of mineral elements in plant protection. Mineral elements affect plant health directly by modulating the activity of redox enzymes or improving the plant vigor indirectly by altering root exudates, and changing microflora population dynamics, rhizosphere soil nutrient content, pH fluctuation, lignin deposition, and phytoalexin biosynthesis. Nitrogen (N) is one of the most important macronutrients having a significant impact on the host-pathogen axis. N negatively affects the plant's physical defense along with the production of antimicrobial compounds, but it significantly alleviates defense-related enzyme levels that can eventually assist in systemic resistance. Potassium (K) is an essential plant nutrient, when it is present in adequate concentration, it can certainly increase the plant's polyphenolic concentrations, which play a critical role in the defense mechanism. Although no distinguished role of phosphorus (P) is observed in plant disease resistance, a high P content may increase the plant's susceptibility toward the invader. Manganese (Mn) is one of the most important micronutrients, which have a vital effect on photosynthesis, lignin biosynthesis, and other plant metabolic functions. Zinc (Zn) is a part of enzymes that are involved in auxin synthesis, infectivity, phytotoxin, and mycotoxin production in pathogenic microorganisms. Similarly, many other nutrients also have variable effects on enhancing or decreasing the host susceptibility toward disease onset and progression, thereby making integrative plant nutrition an indispensable component of sustainable agriculture. However, there are still many factors influencing the triple interaction of host-pathogen-mineral elements, which are not yet unraveled. Thereby, the present review has summarized the recent progress regarding the use of macro- and micronutrients in sustainable agriculture and their role in plant disease resistance.
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Objective: To evaluate efficacy and late toxicity of intensity-modulated radiotherapy with simultaneous integrated boost (IMRT-SIB) in definitive management of head-and-neck cancers. Methods: In this prospective interventional study, histological proven squamous cell carcinoma of oropharynx, hypopharynx, or larynx with stage T1-3 N0-3 M0 who were not candidates for concurrent chemotherapy were treated with IMRT-SIB with radical intent. Doses prescribed for IMRT-SIB to meet the clinical needs of nodal volumes were either SIB-66 schedule 66 Gray (Gy) prescribed to high risk (HR) planned target volume (PTV), 60 (Gy) to intermediate risk (IR) PTV and 54 Gy to low risk (LR) PTV in 30 fractions or SIB-70 schedule 70 Gy to PTV-HR, 59.4 Gy to PTV-IR and 56 Gy to PTV-LR in 33 fractions. Result: Forty-five patients were included. Forty-two patients were treated with SIB-66 schedule and three patients with SIB-70 schedule. The median follow-up period was 21 (6-68) months. There was residual disease in three patients. Recurrence was observed in 24 patients. Most recurrences were in HR volume (n = 19) and three patients had distant failure. Estimated 2-year locoregional control, disease-free survival, and overall survival were 55.55%, 49.7%, and 51.1%, respectively. Grade 3 late skin toxicity, subcutaneous fibrosis, and xerostomia were observed in three patients. Conclusions: Efficacy and late toxicity of IMRT-SIB observed in our study suggest it as a suitable treatment option for patients who are not fit for chemoradiation.
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Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Radioterapia de Intensidade Modulada , Humanos , Radioterapia de Intensidade Modulada/efeitos adversos , Estudos Prospectivos , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia , Quimiorradioterapia/efeitos adversos , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/etiologiaRESUMO
Introduction: The programmed death receptor ligand 1 (PD-L1) is a cell-surface glycoprotein expressed in tumour cells (TCs) and is also upregulated in tumour infiltrating lymphocytes. The effect of PD-L1 expression on TCs and tumour-infiltrating lymphocytes (TILs) on acute radiation toxicity and response in oropharyngeal squamous cell carcinoma treated with concurrent chemoradiotherapy is less known. Material and methods: Squamous cell carcinoma of oropharynx with stage II-IVA (AJCC 8th) were recruited in this prospective observational study. Definitive radiation therapy (RT) of 70 Gray in 35 fractions at 2 Gray per fraction, 5 fractions a week in 2 phases was delivered with concurrent chemotherapy (cisplatin 40 mg/m2 weekly). Patients were assessed weekly for acute toxicities with Radiation Therapy Oncology Group criteria. Response assessment was done at 3 months post RT according to World Health Organization response assessment criteria. The programmed death receptor ligand 1 expression in TCs and TILs was correlated with acute toxicity and survival. Results: Of 51 patients, 20 (39.2%) had PD-L1 expression in TCs and 18 (35.3%) in TILs. Patients with PD-L1 expression in TCs had fewer grade ≥ 3 oral mucositis (25% vs. 58%; p = 0.02) and grade ≥ 3 dysphagia (25% vs. 55%; p = 0.046). The programmed death receptor ligand 1-tumour infiltrating lymphocytes positives had lower ≥ 3 grade oral mucositis (22% vs. 58%; p = 0.02) and ≥ 3 grade dysphagia (17% vs. 58%; p = 0.007). Two-year overall and progression-free survival rate for the PD-L1-tumour-positive vs. PD-L1-tumour-negative group was not different (p > 0.5). Conclusions: Positive PD-L1 expression is associated with fewer acute radiation toxicities, and this could be used as a potential biomarker.
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Purpose: The purpose of the study was to consider and calculate dosimetric parameters during treatment planning to improve radiobiological outcomes for cervical cancer patients treated with high-dose-rate (HDR) intracavitary brachytherapy (ICBT). Material and methods: In the present study, dose volume histograms (DVH) of 30 cervical cancer patients treated with HDR brachytherapy using computer tomography (CT)-based planning were analyzed. High-risk clinical target volume (HR-CTV) was contoured as the main target volume for all the patients, with an assumption that there was no presence of gross tumor at the time of brachytherapy. Values of target coverage volumes (100%, 150%, and 200%) were obtained from DVH, which was used to calculate different quality indices (QIs), including coverage index (CI), dose homogeneity index (DHI), overdose volume index (ODI), and dose non-uniformity ratio (DNR). Values of these QIs were further used to calculate tumor control probability (TCP). Statistical correlation between all QIs with TCP was established. Also, normal tissue complication probabilities for bladder (NTCP_B) and rectum (NTCP_R) were calculated. Results: The mean values of the various calculated parameters, including CI, DHI, ODI, DNR, TCP, NTCP_B and NTCP_R were 0.92 ±0.07, 0.26 ±0.10, 0.50 ±0.10, 0.74 ±0.10, 0.92 ±0.07, 0.08 ±0.25, and 0.36 ±0.27, respectively. Pearson's product moment correlation coefficient between CI, DHI, ODI, and DNR with regards to TCP was +0.85, -0.85, +0.84, and +0.85, respectively. Conclusions: The correlation between dosimetric and radiobiological parameters was found statistically significant, which shows the influence of dosimetric parameters on the radiobiological outcome. Therefore, these parameters should be considered during the treatment planning to improve the radiobiological outcome.
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Microorganisms have dynamic and complex interactions with their hosts. Diverse microbial communities residing near, on, and within the plants, called phytobiome, are an essential part of plant health and productivity. Exploiting citrus-associated microbiomes represents a scientific approach toward sustained and environment-friendly module of citrus production, though periodically exposed to several threats, with Huanglongbing (HLB) predominantly being most influential. Exploring the composition and function of the citrus microbiome, and possible microbial redesigning under HLB disease pressure has sparked renewed interest in recent times. A concise account of various achievements in understanding the citrus-associated microbiome, in various niche environments viz., rhizosphere, phyllosphere, endosphere, and core microbiota alongside their functional attributes has been thoroughly reviewed and presented. Efforts were also made to analyze the actual role of the citrus microbiome in soil fertility and resilience, interaction with and suppression of invading pathogens along with native microbial communities and their consequences thereupon. Despite the desired potential of the citrus microbiota to counter different pathogenic diseases, utilizing the citrus microbiome for beneficial applications at the field level is yet to be translated as a commercial product. We anticipate that advancement in multiomics technologies, high-throughput sequencing and culturing, genome editing tools, artificial intelligence, and microbial consortia will provide some exciting avenues for citrus microbiome research and microbial manipulation to improve the health and productivity of citrus plants.
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Multiple functions of glomalin released by arbuscular mycorrhizal fungi are well-recognized, whereas the role of exogenous glomalins including easily extractable glomalin-related soil protein (EE-GRSP) and difficultly extractable glomalin-related soil protein (DE-GRSP) is unexplored for plant responses. Our study was carried out to assess the effects of exogenous EE-GRSP and DE-GRSP at varying strengths on plant growth and chlorophyll concentration of trifoliate orange (Poncirus trifoliata) seedlings, along with changes in root nutrient acquisition, auxin content, auxin-related enzyme and transporter protein gene expression, and element contents of purified GRSP. Sixteen weeks later, exogenous GRSP displayed differential effects on plant growth (height, stem diameter, leaf number, and biomass production): the increase by EE-GRSP and the decrease by DE-GRSP. The best positive effect on plant growth occurred at exogenous EE-GRSP at ½ strength. Similarly, the GRSP application also differently affected total chlorophyll content, root morphology (total length, surface area, and volume), and root N, P, and K content: positive effect by EE-GRSP and negative effect by DE-GRSP. Exogenous EE-GRSP accumulated more indoleacetic acid (IAA) in roots, which was associated with the upregulated expression of root auxin synthetic enzyme genes (PtTAA1, PtYUC3, and PtYUC4) and auxin influx transporter protein genes (PtLAX1, PtLAX2, and PtLAX3). On the other hand, exogenous DE-GRSP inhibited root IAA and indolebutyric acid (IBA) content, associated with the downregulated expression of root PtTAA1, PtLAX1, and PtLAX3. Root IAA positively correlated with root PtTAA1, PtYUC3, PtYUC4, PtLAX1, and PtLAX3 expression. Purified EE-GRSP and DE-GRSP showed similar element composition but varied in part element (C, O, P, Ca, Cu, Mn, Zn, Fe, and Mo) concentration. It concluded that exogenous GRSP triggered differential effects on growth response, and the effect was associated with the element content of pure GRSP and the change in auxins and root morphology. EE-GRSP displays a promise as a plant growth biostimulant in citriculture.
RESUMO
Endophytes have the ability to improve plant nutrition alongside their agronomic performance, among which arbuscular mycorrhizal fungi provide the most benefits to their host. Previously, we reported for the first time that an arbuscular mycorrhizal-like fungus Piriformospora indica had the ability to colonize roots of trifoliate orange (Poncirus trifoliata) and conferred positive effects on nutrient acquisition. Present study showed the changes in fatty acids and sugars to unravel the physiological and symbiotic association of trifoliate orange with P. indica and an arbuscular mycorrhizal fungus, Funneliformis mosseae singly or in combination. All the endophytic fungi collectively increased fructose, glucose, and sucrose content in leaves and roots, along with a relatively higher increase with P. indica inoculation than with F. mosseae alone or dual inoculation. Treatment with P. indica increased the concentration of part unsaturated fatty acids such as C18:3N6, C20:2, C20:3N6, C20:4N6, C20:3N3, C20:5N3, C22:1N9, and C24:1. Additionally, P. indica induced the increase in the concentration of part saturated fatty acids such as C6:0, C8:0, C13:0, C14:0, and C24:0. F. mosseae hardly changed the content of fatty acids, except for increase in C14:0 and C20:5N3. Double inoculation only reduced the C21:0, C10:0, C12:0, C18:3N3, and C18:1 content and increased the C20:5N3 content. These endophytic fungi up-regulated the root PtFAD2, PtFAD6, PtΔ9, and PtΔ15 gene expression level, coupled with a higher expression of PtFAD2 and PtΔ9 by P. indica than by F. mosseae. It was concluded that P. indica exhibited a stronger response, for sugars and fatty acids, than F. mosseae on trifoliate orange. Such results also reveal the Pi (an in vitro culturable fungus) as a bio-stimulator applying to citriculture.