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1.
Ann Nucl Med ; 38(6): 450-459, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38517659

RESUMO

OBJECTIVE: Radium-223 is a first alpha-emitting radionuclide treatment for metastatic castration-resistant prostate cancer (mCRPC) patients with bone metastases. Although the spread-based bone scan index (BSI) and novel index of the intensity-based two-dimensional total bone uptake (2D-TBU) from bone scintigraphy may provide useful input in radium-223 treatment, they have not been evaluated in detail yet. This study aimed to fill this gap by evaluating BSI and 2D-TBU in patients treated with radium-223. METHODS: Twenty-seven Japanese patients with mCRPC treated with radium-223 were retrospectively analyzed. The patients were evaluated via blood tests and bone scans at baseline and 3 cycles intervals of treatment. BSI and 2D-TBU were analyzed via VSBONE BSI in terms of correlations, response to radium-223 treatment, association with treatment completion, and the Kaplan-Meier survival analysis was performed. RESULTS: Nineteen patients (70.4%) completed six cycles of radium-223 treatment, whereas eight patients (29.6%) did not complete the treatment regimen. A significant difference in baseline BSI and 2D-TBU was observed between these groups of patients. Both BSI and 2D-TBU were highly correlated (r = 0.96, p < 0.001). Univariate analysis showed an association between radium-223 completion in median BSI and 2D-TBU values (p = 0.015) and completion percentage differences (91.7% vs. 45.5%; p = 0.027). The Kaplan-Meier product limit estimator showed that the median overall survival was 25.2 months (95% CI 14.0-33.6 months) in the completion group and 7.5 months (95% CI 3.3-14.2 months) in the without completion group (p < 0.001). The overall survival based on median cutoff levels showed a significant difference in 2D-TBU (p = 0.007), but not in BSI (p = 0.15). CONCLUSIONS: The 2D-TBU may offer advantages over BSI in classifying patients towards radium-223 treatment based on the degree of progression of bone metastases. This study supports the importance of preliminary assessment of bone metastasis status using BSI and 2D-TBU extracted from VSBONE BSI for radium-223 treatment decisions.


Assuntos
Neoplasias Ósseas , Osso e Ossos , Neoplasias de Próstata Resistentes à Castração , Cintilografia , Rádio (Elemento) , Humanos , Rádio (Elemento)/uso terapêutico , Masculino , Neoplasias Ósseas/secundário , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/diagnóstico por imagem , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Osso e Ossos/efeitos da radiação , Osso e Ossos/diagnóstico por imagem , Idoso de 80 Anos ou mais , Neoplasias de Próstata Resistentes à Castração/radioterapia , Neoplasias de Próstata Resistentes à Castração/patologia , Transporte Biológico , Resultado do Tratamento
2.
Sci Rep ; 11(1): 21793, 2021 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-34750437

RESUMO

The penetration of microwave power inside a human head model is improved by employing a dielectric loaded rectangular waveguide as the transmission source. A multi-layer reflection model is investigated to evaluate the combined material characteristics of different lossy human head tissues at 2.45 GHz. A waveguide loaded with a calculated permittivity of 3.62 is shown to maximise the microwave power penetration at the desired frequency. A Quartz (SiO2) loaded rectangular waveguide fed by a microstrip antenna is designed to validate the power penetration improvement inside an inhomogeneous human head phantom. A measured 1.33 dB power penetration increment is observed for the dielectric loaded waveguide over a standard rectangular waveguide at 50 mm inside the head, with an 81.9% reduction in the size of the transmission source.


Assuntos
Cabeça/efeitos da radiação , Micro-Ondas , Osso e Ossos/efeitos da radiação , Encéfalo/efeitos da radiação , Impedância Elétrica , Cabeça/diagnóstico por imagem , Humanos , Aumento da Imagem/métodos , Modelos Estatísticos , Imagens de Fantasmas , Pele/efeitos da radiação
3.
PLoS One ; 16(10): e0257605, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648511

RESUMO

The objective of this study is to develop a skeleton model for assessing active marrow dose from bone-seeking beta-emitting radionuclides. This article explains the modeling methodology which accounts for individual variability of the macro- and microstructure of bone tissue. Bone sites with active hematopoiesis are assessed by dividing them into small segments described by simple geometric shapes. Spongiosa, which fills the segments, is modeled as an isotropic three-dimensional grid (framework) of rod-like trabeculae that "run through" the bone marrow. Randomized multiple framework deformations are simulated by changing the positions of the grid nodes and the thickness of the rods. Model grid parameters are selected in accordance with the parameters of spongiosa microstructures taken from the published papers. Stochastic modeling of radiation transport in heterogeneous media simulating the distribution of bone tissue and marrow in each of the segments is performed by Monte Carlo methods. Model output for the human femur at different ages is provided as an example. The uncertainty of dosimetric characteristics associated with individual variability of bone structure was evaluated. An advantage of this methodology for the calculation of doses absorbed in the marrow from bone-seeking radionuclides is that it does not require additional studies of autopsy material. The biokinetic model results will be used in the future to calculate individual doses to members of a cohort exposed to 89,90Sr from liquid radioactive waste discharged to the Techa River by the Mayak Production Association in 1949-1956. Further study of these unique cohorts provides an opportunity to gain more in-depth knowledge about the effects of chronic radiation on the hematopoietic system. In addition, the proposed model can be used to assess the doses to active marrow under any other scenarios of 90Sr and 89Sr intake to humans.


Assuntos
Partículas beta/efeitos adversos , Medula Óssea/efeitos da radiação , Osso e Ossos/efeitos da radiação , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Simulação por Computador , Feminino , Hematopoese/efeitos da radiação , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Método de Monte Carlo , Doses de Radiação , Radiometria , Processos Estocásticos , Adulto Jovem
5.
Radiat Oncol ; 16(1): 134, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289863

RESUMO

BACKGROUND: Both patient-specific dose recalculation and γ passing rate analysis are important for the quality assurance (QA) of intensity modulated radiotherapy (IMRT) plans. The aim of this study was to analyse the correlation between the γ passing rates and the volumes of air cavities (Vair) and bony structures (Vbone) in target volume of head and neck cancer. METHODS: Twenty nasopharyngeal carcinoma and twenty nasal natural killer T-cell lymphoma patients were enrolled in this study. Nine-field sliding window IMRT plans were produced and the dose distributions were calculated by anisotropic analytical algorithm (AAA), Acuros XB algorithm (AXB) and SciMoCa based on the Monte Carlo (MC) technique. The dose distributions and γ passing rates of the targets, organs at risk, air cavities and bony structures were compared among the different algorithms. RESULTS: The γ values obtained with AAA and AXB were 95.6 ± 1.9% and 96.2 ± 1.7%, respectively, with 3%/2 mm criteria (p > 0.05). There were significant differences (p < 0.05) in the γ values between AAA and AXB in the air cavities (86.6 ± 9.4% vs. 98.0 ± 1.7%) and bony structures (82.7 ± 13.5% vs. 99.0 ± 1.7%). Using AAA, the γ values were proportional to the natural logarithm of Vair (R2 = 0.674) and inversely proportional to the natural logarithm of Vbone (R2 = 0.816). When the Vair in the targets was smaller than approximately 80 cc or the Vbone in the targets was larger than approximately 6 cc, the γ values of AAA were below 95%. Using AXB, no significant relationship was found between the γ values and Vair or Vbone. CONCLUSION: In clinical head and neck IMRT QA, greater attention should be paid to the effect of Vair and Vbone in the targets on the γ passing rates when using different dose calculation algorithms.


Assuntos
Osso e Ossos/patologia , Neoplasias de Cabeça e Pescoço/patologia , Linfoma Extranodal de Células T-NK/patologia , Carcinoma Nasofaríngeo/patologia , Órgãos em Risco/efeitos da radiação , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Intensidade Modulada/métodos , Algoritmos , Osso e Ossos/efeitos da radiação , Raios gama , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Linfoma Extranodal de Células T-NK/radioterapia , Método de Monte Carlo , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/radioterapia , Prognóstico , Dosagem Radioterapêutica
6.
Cancer Res ; 81(18): 4808-4821, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34321243

RESUMO

In studies of electron and proton radiotherapy, ultrahigh dose rates of FLASH radiotherapy appear to produce fewer toxicities than standard dose rates while maintaining local tumor control. FLASH-proton radiotherapy (F-PRT) brings the spatial advantages of PRT to FLASH dose rates (>40 Gy/second), making it important to understand if and how F-PRT spares normal tissues while providing antitumor efficacy that is equivalent to standard-proton radiotherapy (S-PRT). Here we studied PRT damage to skin and mesenchymal tissues of muscle and bone and found that F-PRT of the C57BL/6 murine hind leg produced fewer severe toxicities leading to death or requiring euthanasia than S-PRT of the same dose. RNA-seq analyses of murine skin and bone revealed pathways upregulated by S-PRT yet unaltered by F-PRT, such as apoptosis signaling and keratinocyte differentiation in skin, as well as osteoclast differentiation and chondrocyte development in bone. Corroborating these findings, F-PRT reduced skin injury, stem cell depletion, and inflammation, mitigated late effects including lymphedema, and decreased histopathologically detected myofiber atrophy, bone resorption, hair follicle atrophy, and epidermal hyperplasia. F-PRT was equipotent to S-PRT in control of two murine sarcoma models, including at an orthotopic intramuscular site, thereby establishing its relevance to mesenchymal cancers. Finally, S-PRT produced greater increases in TGFß1 in murine skin and the skin of canines enrolled in a phase I study of F-PRT versus S-PRT. Collectively, these data provide novel insights into F-PRT-mediated tissue sparing and support its ongoing investigation in applications that would benefit from this sparing of skin and mesenchymal tissues. SIGNIFICANCE: These findings will spur investigation of FLASH radiotherapy in sarcoma and additional cancers where mesenchymal tissues are at risk, including head and neck cancer, breast cancer, and pelvic malignancies.


Assuntos
Epitélio , Tratamentos com Preservação do Órgão , Terapia com Prótons , Sarcoma/patologia , Sarcoma/radioterapia , Animais , Osso e Ossos/patologia , Osso e Ossos/efeitos da radiação , Modelos Animais de Doenças , Cães , Epitélio/efeitos da radiação , Feminino , Perfilação da Expressão Gênica , Humanos , Camundongos , Morbidade , Músculos/patologia , Músculos/efeitos da radiação , Tratamentos com Preservação do Órgão/métodos , Terapia com Prótons/efeitos adversos , Terapia com Prótons/métodos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Dosagem Radioterapêutica , Sarcoma/metabolismo , Pele/efeitos da radiação , Resultado do Tratamento
7.
Sci Rep ; 11(1): 6385, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33737537

RESUMO

Potassium is known for its effect on modifiable chronic diseases like hypertension, cardiac disease, diabetes (type-2), and bone health. In this study, a new method, neutron generator based neutron activation analysis (NAA), was utilized to measure potassium (K) in mouse carcasses. A DD110 neutron generator based NAA assembly was used for irradiation.Thirty-two postmortem mice (n= 16 males and 16 females, average weight [Formula: see text] and [Formula: see text] g) were employed for this study. Soft-tissue equivalent mouse phantoms were prepared for the calibration. All mice were irradiated for 10 minutes, and the gamma spectrum with 42K was collected using a high efficiency, high purity germanium (HPGe) detector. A lead shielding assembly was designed and developed around the HPGe detector to obtain an improved detection limit. Each mouse sample was irradiated and measured twice to reduce uncertainty. The average potassium concentration was found to be significantly higher in males [Formula: see text] compared to females [Formula: see text]. We also observed a significant correlation between potassium concentration and the weight of the mice. The detection limit for potassium quantification with the NAA system was 46 ppm. The radiation dose to the mouse was approximately 56 [Formula: see text] mSv for 10-min irradiation. In conclusion, this method is suitable for estimating individual potassium concentration in small animals. The direct evaluation of total body potassium in small animals provides a new way to estimate potassium uptake in animal models. This method can be adapted later to quantify potassium in the human hand and small animals in vivo. When used in vivo, it is also expected to be a valuable tool for longitudinal assessment, kinetics, and health outcomes.


Assuntos
Osso e Ossos/efeitos da radiação , Transporte de Íons/efeitos da radiação , Análise de Ativação de Nêutrons , Potássio/metabolismo , Animais , Osso e Ossos/diagnóstico por imagem , Modelos Animais de Doenças , Raios gama/efeitos adversos , Germânio/isolamento & purificação , Germânio/toxicidade , Masculino , Camundongos , Método de Monte Carlo , Nêutrons/efeitos adversos , Imagens de Fantasmas , Potássio/química , Potássio/isolamento & purificação , Doses de Radiação , Irradiação Corporal Total/efeitos adversos
8.
Am J Physiol Endocrinol Metab ; 320(5): E951-E966, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33719588

RESUMO

Type 2 diabetes mellitus (T2DM) results in compromised bone microstructure and quality, and subsequently increased risks of fractures. However, it still lacks safe and effective approaches resisting T2DM bone fragility. Pulsed electromagnetic fields (PEMFs) exposure has proven to be effective in accelerating fracture healing and attenuating osteopenia/osteoporosis induced by estrogen deficiency. Nevertheless, whether and how PEMFs resist T2DM-associated bone deterioration remain not fully identified. The KK-Ay mouse was used as the T2DM model. We found that PEMF stimulation with 2 h/day for 8 wk remarkably improved trabecular bone microarchitecture, decreased cortical bone porosity, and promoted trabecular and cortical bone material properties in KK-Ay mice. PEMF stimulated bone formation in KK-Ay mice, as evidenced by increased serum levels of bone formation (osteocalcin and P1NP), enhanced bone formation rate, and increased osteoblast number. PEMF significantly suppressed osteocytic apoptosis and sclerostin expression in KK-Ay mice. PEMF exerted beneficial effects on osteoblast- and osteocyte-related gene expression in the skeleton of KK-Ay mice. Nevertheless, PEMF exerted no effect on serum biomarkers of bone resorption (TRAcP5b and CTX-1), osteoclast number, or osteoclast-specific gene expression (TRAP and cathepsin K). PEMF upregulated gene expression of canonical Wnt ligands (including Wnt1, Wnt3a, and Wnt10b), but not noncanonical Wnt5a. PEMF also upregulated skeletal protein expression of downstream p-GSK-3ß and ß-catenin in KK-Ay mice. Moreover, PEMF-induced improvement in bone microstructure, mechanical strength, and bone formation in KK-Ay mice was abolished after intragastric administration with the Wnt antagonist ETC-159. Together, our results suggest that PEMF can improve bone microarchitecture and quality by enhancing the biological activities of osteoblasts and osteocytes, which are associated with the activation of the Wnt/ß-catenin signaling pathway. PEMF might become an effective countermeasure against T2DM-induced bone deterioration.NEW & NOTEWORTHY PEMF improved trabecular bone microarchitecture and suppressed cortical bone porosity in T2DM KK-Ay mice. It attenuated T2DM-induced detrimental consequence on trabecular and cortical bone material properties. PEMF resisted bone deterioration in KK-Ay mice by enhancing osteoblast-mediated bone formation. PEMF also significantly suppressed osteocytic apoptosis and sclerostin expression in KK-Ay mice. The therapeutic potential of PEMF on T2DM-induced bone deterioration was associated with the activation of Wnt/ß-catenin signaling.


Assuntos
Doenças Ósseas Metabólicas/terapia , Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 2/terapia , Magnetoterapia , Osteoporose/terapia , Animais , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/genética , Doenças Ósseas Metabólicas/metabolismo , Osso e Ossos/metabolismo , Osso e Ossos/efeitos da radiação , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/genética , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Campos Eletromagnéticos , Glucose/metabolismo , Magnetoterapia/métodos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Osteogênese/fisiologia , Osteogênese/efeitos da radiação , Osteoporose/etiologia , Osteoporose/genética , Osteoporose/metabolismo , Via de Sinalização Wnt/efeitos da radiação , beta Catenina/metabolismo
9.
Appl Radiat Isot ; 170: 109598, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33545581

RESUMO

In radiation physics, the study of new alternative dosimeters is of interest to the growing branch of dosimetric characterization for radiotherapy applications. The goal of this work was to expose bone samples to high doses and evaluate their linearity response to gamma rays. The Fourier Transform Infrared (FTIR) spectrophotometry technique was employed as the evaluation technique, and based on the spectrophotometry absorbance profiles the linearity was assessed based on the following methods: Area Under the Curve (AUC), Wavenumber Method (WM), Partial Component Regression (PCR) and Partial Least-Square Regression (PLSR) methods. The bone samples were irradiated with absorbed doses of 10 Gy up to 500 Gy using a 60Co Gamma Cell-220 system. The results showed, for the calibration curves of the system, adequate linearity on all methods. In conclusion, the results indicate a good linear response and therefore an interesting potential radiation detector.


Assuntos
Osso e Ossos/efeitos da radiação , Raios gama , Dosímetros de Radiação , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Calibragem , Humanos
10.
Appl Radiat Isot ; 167: 109464, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33096410

RESUMO

During superficial radiotherapy, and for cases where bony structures lie relatively close to the surface behind the tissue region being treated, perturbations to delivered dose are expected due to the change in tissue scattering conditions and the value of buildup factor near the tissue/bone interface. The absorbed dose distribution within bone, muscle, and muscle-bone-muscle interfaces was estimated for photons within the energy range 0.05 to 1.333 MeV. The energy absorption buildup factor is computed using the (GP) fitting method for a geometry of adjacent layers within a multilayer tissue matrix where a thick slab of solid bone is located in-between slabs of muscles of the same thickness. It was observed that dose enhancement was limited only to a few millimeters close to the interface. Also, variations in dose at the interface were found significant only for low photon energies and relatively insignificant at photon energies higher than 0.06 MeV.


Assuntos
Osso e Ossos/efeitos da radiação , Raios gama , Músculo Esquelético/efeitos da radiação , Doses de Radiação , Humanos , Espalhamento de Radiação
11.
Lasers Med Sci ; 36(1): 131-137, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32372236

RESUMO

The current work explores the surface morphology of the laser-ablated bone using Yb-fiber coupled Nd:YAG laser (λ = 1064 nm) in continuous wave mode. As the laser-ablated region contains physiochemically modified carbonized and nonstructural region, it becomes unknown material for the body. Thus, biomineralization on such a laser-ablated region was assessed by in vitro immersion test in noncellular simulated body fluid. The presence of hydroxyapatite was detected in the precipitated mineral product using scanning electron microscopy equipped with energy dispersive spectroscopy, and X-ray diffraction analysis. The effect of varying laser parameters on distribution of surface morphology features was identified and its corresponding effect on biomineralization was studied.


Assuntos
Biomineralização/efeitos da radiação , Osso e Ossos/efeitos da radiação , Lasers de Estado Sólido , Osso e Ossos/ultraestrutura , Durapatita/química , Espectrometria por Raios X , Propriedades de Superfície , Temperatura , Difração de Raios X
12.
Electromagn Biol Med ; 40(1): 26-32, 2021 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-33251878

RESUMO

This study aimed to investigate the therapeutic effect of pulsed electromagnetic field (PEMF) on bone wound in rats as a potential therapy for bone fracture-related conditions. Male rats, aged 3 months, were used to construct model of bone wounding. Wound models were randomly selected to receive PEMF therapy at 1 to 10 mT intensity. Models that did not receive PEMF therapy were used as control. The serum concentrations of calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) were determined. Bone density and biomechanical properties of callus were measured using a tensile tester. Compared with control, rats subjected to PEMF therapy had similar weight gain, but significantly higher levels of serum Ca and ALP (P < .05) at 5 and 10 mT, while the serum level of P remained unchanged after PEMF therapy. The bone mineral density of callus increased after the therapy, particularly, after 5 and 10 mT therapy (P < .05). Biomechanical measurements showed that 21 days after the therapy, the maximum load, fracture load, elastic load and bending energy were significantly greater in rats receiving 5 and 10 mT PEMF therapy as compared with control (P < .05). Our experiments demonstrate that PEMF at 5 and 10 mT can significantly accelerate wound healing and enhance the repairing ability of bone tissue.


Assuntos
Osso e Ossos/fisiologia , Osso e Ossos/efeitos da radiação , Campos Eletromagnéticos , Cicatrização/efeitos da radiação , Fosfatase Alcalina/metabolismo , Animais , Fenômenos Biomecânicos/efeitos da radiação , Densidade Óssea/efeitos da radiação , Cálcio/metabolismo , Fósforo/metabolismo , Ratos
13.
Radiat Res ; 195(1): 77-92, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33180911

RESUMO

Administration of diethylenetriaminepentaacetic acid (DTPA) is the treatment approach used to promote the decorporation of internalized plutonium. Here we evaluated the efficacy of PEGylated liposomes coated with DTPA, primarily designed to prevent enhanced plutonium accumulation in bones, compared to marketed nonliposomal DTPA and liposomes encapsulating DTPA. The comparative effects were examined in terms of reduction of activity in tissues of plutonium-injected rats. The prompt treatment with DTPA-coated liposomes elicited an even greater efficacy than that with liposome-encapsulated DTPA in limiting skeletal plutonium. This advantage, undoubtedly due to the anchorage of DTPA to the outer layer of liposomes, is discussed, as well as the reason for the loss of this superiority at delayed times after contamination. Plutonium complexed with DTPA-coated liposomes in extracellular compartments was partly diverted into the liver and the spleen. These complexes and those directly formed inside hepatic and splenic cells appeared to be degraded, then released from cells at extremely slow rates. This transitory accumulation of activity, which could not be counteracted by combining both liposomal forms, entailed an underestimation of the efficacy of DTPA-coated liposomes on soft tissue plutonium until total elimination probably more than one month after treatment. DTPA-coated liposomes may provide the best delivery vehicle of DTPA for preventing plutonium deposition in tissues, especially in bone where nuclides become nearly impossible to remove once fixed. Additional development efforts are needed to limit the diversion or to accelerate cell release of plutonium bound to DTPA-coated liposomes, using a labile bond for DTPA attachment.


Assuntos
Quelantes/farmacologia , Ácido Pentético/análogos & derivados , Plutônio/química , Animais , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/efeitos da radiação , Quelantes/química , Humanos , Lipossomos/química , Lipossomos/farmacologia , Fígado/efeitos dos fármacos , Fígado/efeitos da radiação , Masculino , Ácido Pentético/farmacologia , Plutônio/metabolismo , Plutônio/toxicidade , Ratos , Ratos Sprague-Dawley , Baço/efeitos dos fármacos , Baço/efeitos da radiação
14.
Int J Radiat Oncol Biol Phys ; 109(5): 1219-1229, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33279595

RESUMO

PURPOSE: External beam radiation therapy (EBRT) with brachytherapy boost reduces cancer recurrence in patients with prostate cancer compared with EBRT monotherapy. However, randomized controlled trials or large-scale observational studies have not compared brachytherapy boost types directly. METHODS AND MATERIALS: This observational cohort study used linked national cancer registry data, radiation therapy data, administrative hospital data, and mortality records of 54,642 patients with intermediate-risk, high-risk, and locally advanced prostate cancer in England. The records of 11,676 patients were also linked to results from a national patient survey collected at least 18 months after diagnosis. Competing risk regression analyses were used to compare gastrointestinal (GI) toxicity, genitourinary (GU) toxicity, skeletal-related events (SRE), and prostate cancer-specific mortality (PCSM) at 5 years with adjustment for patient and tumor characteristics. Linear regression was used to compare Expanded Prostate Cancer Index Composite 26-item version domain scores (scale, 0-100, with higher scores indicating better function). RESULTS: Five-year GI toxicity was significantly increased after low-dose-rate brachytherapy boost (LDR-BB) (32.3%) compared with high-dose-rate brachytherapy boost (HDR-BB) (16.7%) or EBRT monotherapy (18.7%). Five-year GU toxicity was significantly increased after both LDR-BB (15.8%) and HDR-BB (16.6%), compared with EBRT monotherapy (10.4%). These toxicity patterns were matched by the mean patient-reported bowel function scores (LDR-BB, 77.3; HDR-BB, 85.8; EBRT monotherapy, 84.4) and the mean patient-reported urinary obstruction/irritation function scores (LDR-BB, 72.2; HDR-BB, 78.9; EBRT monotherapy, 83.8). Five-year incidences of SREs and PCSM were significantly lower after HDR-BB (2.4% and 2.7%, respectively) compared with EBRT monotherapy (2.8% and 3.5%, respectively). CONCLUSIONS: Compared with EBRT monotherapy, LDR-BB has worse GI and GU toxicity and HDR-BB has worse GU toxicity. HDR-BB has a lower incidence of SREs and PCSM than EBRT monotherapy.


Assuntos
Braquiterapia/efeitos adversos , Neoplasias da Próstata/radioterapia , Osso e Ossos/efeitos da radiação , Braquiterapia/métodos , Estudos de Coortes , Inglaterra , Trato Gastrointestinal/efeitos da radiação , Humanos , Modelos Lineares , Masculino , Gradação de Tumores , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Dosagem Radioterapêutica , Reirradiação/efeitos adversos , Reirradiação/métodos , Sistema de Registros/estatística & dados numéricos , Análise de Regressão , Sistema Urogenital/efeitos da radiação
15.
PLoS One ; 15(11): e0242151, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33186401

RESUMO

The radiochemical analysis of plutonium activity in urine is the main method for indirect estimation of doses of internal exposure from plutonium incorporation in professional workers. It was previously shown that late-in-life acute diseases, particularly those that affect the liver, can promote accelerated rates of release of plutonium from the liver with enhanced excretion rates. This initial study examines the relationships of some chronic diseases on plutonium excretion as well as the terminal relative distribution of plutonium between the liver and skeleton. Fourteen cases from former workers at the Mayak Production Association (Mayak PA) who provided from 4-9 urine plutonium bioassays for plutonium, had an autopsy conducted after death, and had sufficient clinical records to document their health status were used in this study. Enhanced plutonium excretion was associated with more serious chronic diseases, including cardiovascular diseases and other diseases that involved the liver. These chronic diseases were also associated with relatively less plutonium found in the liver relative to the skeleton determined by analyses conducted after autopsy. These data further document health conditions that affect plutonium biokinetics and organ deposition and retention patterns and suggest that health status should be considered when conducting plutonium bioassays as these may alter subsequent dosimetry and risk models.


Assuntos
Doenças Profissionais/epidemiologia , Exposição Ocupacional , Plutônio/efeitos adversos , Plutônio/urina , Adulto , Consumo de Bebidas Alcoólicas , Autopsia , Bioensaio , Osso e Ossos/efeitos da radiação , Doença Crônica , Nível de Saúde , Humanos , Cinética , Fígado/efeitos da radiação , Pessoa de Meia-Idade , Doenças Profissionais/urina , Centrais Elétricas , Radiometria , Estudos Retrospectivos , Risco , Federação Russa
16.
Int J Radiat Biol ; 96(12): 1608-1613, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33074066

RESUMO

PURPOSE: Radium-223 has demonstrated efficacy in improving overall survival (OS) and in delaying symptomatic skeletal-related events (SREs). Bone Health Agents (BHA), i.e. RANK ligand inhibitor (Denosumab) and bisphosphonate such as zoledronic acid, are indicated to prevent SREs without a clear survival benefit. SREs on patient health have a high impact and it is, therefore, important to consider the role of new therapies with BHA to better understand the involvement of combination therapy. The primary aim of this multicentric study is to assess OS in mCRPC patients treated with Radium-223 in combination with BHA. MATERIALS AND METHODS: 430 consecutive patients treated with Radium-223 alone or in combination with BHA, affected by mCRPC, from January 2015 to July 2019 in six Italian Nuclear Medicine Units, were included. Furthermore, data were collected at baseline, after every Radium-223 administration, and during follow-up, at 3 and 6 months and 1 year after the 6th cycle. Clinical data have been evaluated before starting treatment with Radium-223 and at the end of treatment and/or at progression. Patients who received target bone therapy with BHA before Radium-223 treatment together with patients who did not receive this therapy at all (NO BHA GROUP), were compared to patients treated with concomitant Radium-223 and BHA (BHA GROUP). RESULTS: In univariate models (p < .05) several clinical aspects have an impact on OS: concomitant BHA (p = .018), BMI (p .001), ECOG PS (p = .000), Baseline Hb (p = .000), Baseline PSA (p = .000), Baseline tALP (p = .000), Baseline LDH (p = .000), and Baseline neutrophils (p = .009). Baseline Hb, Baseline tALP, and Baseline LDH have been confirmed as statistically significant parameters in multivariate models. Indeed, concomitant BHA has not a significant impact on OS (p = .244) in multivariate models. CONCLUSIONS: At univariate analysis, our data showed that NO BHA GROUP and BHA GROUP differ in OS by 7 months (95%CI: (1-16.4), p = .02). This is not confirmed at multivariate analysis where after adjusting for other baseline factors, BHA is not significant anymore. This is clearly explained as bias by indication: patients with the same levels of tALP, Hb, and LDH receiving or not receiving BHA are expected to have a similar survival. Our results support and confirm the role of Radium-223 therapy on OS and, furthermore, appear to confirm that BHA treatment has not a survival benefit.


Assuntos
Osso e Ossos/efeitos da radiação , Neoplasias de Próstata Resistentes à Castração/patologia , Neoplasias de Próstata Resistentes à Castração/radioterapia , Rádio (Elemento)/uso terapêutico , Idoso , Fosfatase Alcalina/metabolismo , Medula Óssea/fisiologia , Medula Óssea/efeitos da radiação , Humanos , L-Lactato Desidrogenase/metabolismo , Masculino , Metástase Neoplásica , Neoplasias de Próstata Resistentes à Castração/metabolismo , Rádio (Elemento)/efeitos adversos , Análise de Sobrevida
17.
Theranostics ; 10(25): 11837-11861, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052249

RESUMO

Recently, the rapid development of biomaterials has induced great interest in the precisely targeted treatment of bone-related diseases, including bone cancers, infections, and inflammation. Realizing noninvasive therapeutic effects, as well as improving bone tissue regeneration, is essential for the success of bone­related disease therapies. In recent years, researchers have focused on the development of stimuli-responsive strategies to treat bone-related diseases and to realize bone regeneration. Among the various external stimuli for targeted therapy, near infrared (NIR) light has attracted considerable interests due to its high tissue penetration capacity, minimal damage toward normal tissues, and easy remote control properties. The main objective of this systematic review was to reveal the current applications of NIR light-assisted phototherapy for bone-related disease treatment and bone tissue regeneration. Database collection was completed by June 1, 2020, and a total of 81 relevant studies were finally included. We outlined the various therapeutic applications of photothermal, photodynamic and photobiomodulation effects under NIR light irradiation for bone­related disease treatment and bone regeneration, based on the retrieved literatures. In addition, the advantages and promising applications of NIR light-responsive drug delivery systems for spatiotemporal-controlled therapy were summarized. These findings have revealed that NIR light-assisted phototherapy plays an important role in bone-related disease treatment and bone tissue regeneration, with significant promise for further biomedical and clinical applications.


Assuntos
Doenças Ósseas/terapia , Regeneração Óssea/efeitos da radiação , Raios Infravermelhos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Fotoquimioterapia/métodos , Terapia Fototérmica/métodos , Animais , Doenças Ósseas/fisiopatologia , Regeneração Óssea/efeitos dos fármacos , Regeneração Óssea/fisiologia , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/fisiopatologia , Osso e Ossos/efeitos da radiação , Ensaios Clínicos como Assunto , Modelos Animais de Doenças , Sistemas de Liberação de Medicamentos/métodos , Humanos , Nanopartículas/administração & dosagem , Resultado do Tratamento
18.
J Appl Oral Sci ; 28: e20200191, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32997090

RESUMO

OBJECTIVE: This study analyzed the effect of ionizing radiation on bone microarchitecture and biomechanical properties in the bone tissue surrounding a dental implant. METHODOLOGY: Twenty rabbits received three dental morse taper junction implants: one in the left tibia and two in the right tibia. The animals were randomized into two groups: the nonirradiated group (control group) and the irradiated group, which received 30 Gy in a single dose 2 weeks after the implant procedure. Four weeks after the implant procedure, the animals were sacrificed, and the implant/bone specimens were used for each experiment. The specimens (n=10) of the right tibia were examined by microcomputed tomography to measure the cortical volume (CtV, mm3), cortical thickness (CtTh, mm) and porosity (CtPo, %). The other specimens (n=10) were examined by dynamic indentation to measure the elastic modulus (E, GPa) and Vickers hardness (VHN, N/mm2) in the bone. The specimens of the left tibia (n=10) were subjected to pull-out tests to calculate the failure load (N), displacement (mm) up to the failure point and interface stiffness (N/mm). In the irradiated group, two measurements were performed: close, at 1 mm surrounding the implant surface, and distant, at 2.5 mm from the external limit of the first measurement. Data were analyzed using one-way ANOVA, Tukey's test and Student's t-test (α=0.05). RESULTS: The irradiated bone closer to the implant surface had lower elastic modulus (E), Vickers hardness (VHN), Ct.Th, and Ct.V values and a higher Ct.Po value than the bone distant to the implant (P<0.04). The irradiated bone that was distant from the implant surface had lower E, VHN, and Ct.Th values and a higher Ct.Po value than the nonirradiated bone (P<0.04). The nonirradiated bone had higher failure loads, displacements and stiffness values than the irradiated bone (P<0.02). CONCLUSION: Ionizing radiation in dental implants resulted in negative effects on the microarchitecture and biomechanical properties of bone tissue, mainly near the surface of the implant.


Assuntos
Osso e Ossos/efeitos da radiação , Implantes Dentários , Radiação Ionizante , Animais , Fenômenos Biomecânicos , Osseointegração , Coelhos , Microtomografia por Raio-X
19.
Molecules ; 25(18)2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32967275

RESUMO

Background [18F]FDG Positron Emission Tomography cannot differentiate between sterile inflammation and infection. Therefore, we, aimed to develop more specific radiotracers fitted for differentiation between sterile and septic infection to improve the diagnostic accuracy. Consequently, the clinicians can refine the treatment of, for example, prosthesis-related infection. METHODS: We examined different target points; Staphylococcus aureus biofilm (68Ga-labeled DOTA-K-A9 and DOTA-GSGK-A11), bone remodeling ([18F]NaF), bacterial cell membranes ([68Ga]Ga-Ubiquicidin), and leukocyte trafficking ([68Ga]Ga-DOTA-Siglec-9). We compared them to the well-known glucose metabolism marker [18F]FDG, in a well-established juvenile S. aureus induced osteomyelitis (OM) pig model. RESULTS: [18F]FDG accumulated in the OM lesions seven days after bacterial inoculation, but disappointingly we were not able to identify any tracer accumulation in OM with any of the supposedly more specific tracers. CONCLUSION: These negative results are, however, relevant to report as they may save other research groups from conducting the same animal experiments and provide a platform for developing and evaluating other new potential tracers or protocol instead.


Assuntos
Osso e Ossos/microbiologia , Osso e Ossos/efeitos da radiação , Osteomielite/microbiologia , Osteomielite/radioterapia , Staphylococcus aureus/fisiologia , Animais , Modelos Animais de Doenças , Traçadores Radioativos , Staphylococcus aureus/efeitos da radiação , Suínos
20.
Int J Mol Sci ; 21(18)2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32961958

RESUMO

High-intensity laser therapy (HILT) and photobiomodulation therapy (PBMT) are two types of laser treatment. According to recent clinical reports, PBMT promotes wound healing after trauma or surgery. In addition, basic research has revealed that cell differentiation, proliferation, and activity and subsequent tissue activation and wound healing can be promoted. However, many points remain unclear regarding the mechanisms for wound healing induced by PBMT. Therefore, in this review, we present an example from our study of HILT and PBMT irradiation of tooth extraction wounds using two types of lasers with different characteristics (diode laser and carbon dioxide laser). Then, the effects of PBMT on the wound healing of bone tissues are reviewed from histological, biochemical, and cytological perspectives on the basis of our own study of the extraction socket as well as studies by other researchers. Furthermore, we consider the feasibility of treatment in which PBMT irradiation is applied to stem cells including dental pulp stem cells, the theme of this Special Issue, and we discuss research that has been reported on its effect.


Assuntos
Diferenciação Celular/efeitos da radiação , Polpa Dentária/efeitos da radiação , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Células-Tronco/efeitos da radiação , Cicatrização/efeitos da radiação , Animais , Osso e Ossos/efeitos da radiação , Polpa Dentária/citologia , Lasers de Gás/uso terapêutico , Lasers Semicondutores/uso terapêutico , Masculino , Ligamento Periodontal/efeitos da radiação , Ratos , Ratos Wistar , Células-Tronco/citologia , Extração Dentária
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