The c-Abl-RACK1-FAK signaling axis promotes renal fibrosis in mice through regulating fibroblast-myofibroblast transition.

BACKGROUND: Renal fibrosis is a prevalent manifestation of chronic kidney disease (CKD), and effective treatments for this disease are currently lacking. Myofibroblasts, which originate from interstitial fibroblasts, aggregate in the renal interstitium, leading to significant accumulation of extracellular matrix and impairment of renal function. The nonreceptor tyrosine kinase c-Abl (encoded by the Abl1 gene) has been implicated in the development of renal fibrosis. However, the precise role of c-Abl in this process and its involvement in fibroblast-myofibroblast transition (FMT) remain poorly understood. METHODS: To investigate the effect of c-Abl in FMT during renal fibrosis, we investigated the expression of c-Abl in fibrotic renal tissues of patients with CKD and mouse models. We studied the phenotypic changes in fibroblast or myofibroblast-specific c-Abl conditional knockout mice. We explored the potential targets of c-Abl in NRK-49F fibroblasts. RESULTS: In this study, fibrotic mouse and cell models demonstrated that c-Abl deficiency in fibroblasts mitigated fibrosis by suppressing fibroblast activation, fibroblast-myofibroblast transition, and extracellular matrix deposition. Mechanistically, c-Abl maintains the stability of the RACK1 protein, which serves as a scaffold for proteins such as c-Abl and focal adhesion kinase at focal adhesions, driving fibroblast activation and differentiation during renal fibrosis. Moreover, specifically targeting c-Abl deletion in renal myofibroblasts could prove beneficial in established kidney fibrosis by reducing RACK1 expression and diminishing the extent of fibrosis. CONCLUSIONS: Our findings suggest that c-Abl plays a pathogenic role in interstitial fibrosis through the regulation of RACK1 protein stabilization and myofibroblast differentiation, suggesting a promising strategy for the treatment of CKD.

Structure-dependent degradation of phthalate esters with persulfate oxidation activated by thermal in soil.

Phthalate esters (PAEs) have become one of the most concerned emerging organic pollutants in the world, due to the toxicity to human health, and hard to remove it efficiently. In this study, the degradation performance of DBP and DEHP in the soil by water bath heating activated sodium persulfate (PS) method under different factors were studied, in which the degradation rate of DBP and DEHP were improved with the increasing of temperature, PS concentration and water/soil ratio, and higher diffusion efficiency treatments methods, due to the improved mass transfer from organic phase to aqueous media. However, the degradation rate of DEHP was much lower than that of DBP, because DEHP in the soil was more difficult to contact with SO4•- for reaction on soil surface, and the degradation rate of PAEs in soil was significantly lower than that in water. Redundancy analysis of degradation rate of DBP and DEHP in water demonstrated that the key factors that determine the degradation rate is time for DBP, and cosolvent dosage for DEHP, indicating that the solubility and diffusion rate of PAEs from soil to aqueous are predominance function. This study provides comprehensive scenes in PAEs degradation with persulfate oxidation activated by thermal in soil, reveal the difference of degradation between DBP and DEHP is structure-dependent. So that we provide fundamental understanding and theoretical operation for subsequent filed treatment of various structural emerging pollutants PAEs contaminated soil with thermal activated persulfate.

Occurrence of Phthalate Acid Esters (PAEs) in Protected Agriculture Soils and Implications for Human Health Exposure.

This study explored occurrence of phthalic acid esters (PAEs) in protected agriculture soils and assessed their potential health risks to humans. Results showed that DEHP and DBP were the most abundant PAEs congeners, with mean concentrations of 318.68 µg/kg and 137.56 µg/kg, respectively. DOP and BBP concentrations were relatively low, and DMP and DEP were not detected in all samples. DBP concentrations were higher than the allowable concentration standard value. Additionally, soil pH and organic matter were key environmental parameters which may play the vital roles to the occurrence of organic pollutants. Heath risk assessment results indicated that dermal contact was the predominant human exposure route under non-dietary conditions, and children obtained higher health risk scores than adults. In summary, the overall health risk scores were at an acceptable level. These results provide insights for assessing soil environmental safety and ecological risks in protected agricultural soil.

Magnetic-gold nanoparticle-mediated paper-based biosensor for highly sensitive colorimetric detection of food adulteration.

Food adulteration presents a significant challenge due to the evasion of legal oversight and the difficulty of identification. Addressing this issue, there is an urgent need for on-site, rapid, visually based small-scale equipment, along with large-scale screening technology, to enable prompt results without providing opportunities for dishonest traders to react. Colorimetric reactions offer advantages in terms of speed, visualization, and miniaturization. However, there is a scarcity of suitable colorimetric reactions for food adulteration detection, and interference from colored food impurities and easily comparable color results affects accuracy. To overcome limitations, this study introduces a novel approach utilizing polydopamine magnetic nanoparticles to enrich DNA in food samples, effectively eliminating interfering components. By employing gold nanoparticles to generate magnetic-gold nanoparticles, a single magnetic bead achieves simultaneous enrichment, impurity removal, and detection. The use of paper-based biosensors and visualization equipment allows for the visualization and digital analysis of results, achieving a low detection limit of 4.59 nmol mL-1. The method also exhibits high accuracy and repeatability, with a RSD ranging from 1.6 % to 4.0 %. This innovative colorimetric method addresses the need for rapid, miniaturized, and large-scale detection, thus providing a solution for food adulteration challenges.

CaO assisted mechanochemical remediation of lindane-contaminated soil.

In this study, the planetary ball milling with CaO addition was used to remediate lindane-contaminated soil. Based on Hertzian theory, a mathematical model was proposed to simulate the trajectory of grinding ball and the local energy transfer during a planetary operation at the disk rotation velocities of 150-250 rpm. Besides, the influence of different parameters on lindane removal in soil was investigated, whose results showed that disk rotation velocity and reagent-to-soil ratio had a positive effect, while soil moisture, initial concentration of lindane, and mass of polluted soil demonstrated a negative influence. The mechanochemical method exhibited a higher degradation performance at 3 wt% CaO addition, and a disk rotation velocity of 250 rpm. Active species generated by ball collisions in the presence of CaO, especially superoxide (·O2-) demonstrated a significant role in participating in the lindane conversion. In combination with GCMS and XPS analysis, the proposed model provides insight into mechanochemical remediation process from physical and chemical perspectives, which mainly includes four main steps: mixing, inducing, chemical reaction, and structure destruction.

Caffeinated Chewing Gum Improves Basketball Shooting Accuracy and Physical Performance Indicators of Trained Basketball Players: A Double-Blind Crossover Trial.

(1) Background: This study investigated the effects of caffeinated chewing gum on the basketball-specific performance of trained basketball players. A double-blind, randomized crossover design was employed. (2) Methods: Fifteen participants (age: 20.9 ± 1.0 years; height: 180.9 ± 5.4 cm; mass: 77.2 ± 7.5 kg; training age: 8.2 ± 0.3 years) were recruited and divided into a caffeine trial (CAF) and placebo trial (PL). The participants in the CAF trial chewed gum containing 3 mg/kg of caffeine for 10 min, while those in the PL trial chewed a placebo gum without caffeine. Following a 15 min rest, all the participants completed basketball-specific performance tests. (3) Results: The free throw accuracy for the CAF trial was significantly higher than that for the PL trial (CAF: 79.0 ± 4.31%; PL: 73.0 ± 9.16%; p = 0.012; Cohen's d = 0.94). Additionally, the CAF trial demonstrated significantly better performance in the 20 m segmented dash (CAF: 2.94 ± 1.12 s; PL: 3.13 ± 0.10 s; p < 0.001; Cohen's d =1.8) and squats (p < 0.05), and exhibited lower fatigue indexes (CAF: 3.6 ± 1.6%; PL: 5.2 ± 1.6%; p = 0.009; Cohen's d =1.0). (4) Conclusions: These findings suggest that chewing gum containing 3 mg/kg of caffeine offers moderate-to-large improvements in key performance aspects relevant to professionally trained basketball players.

Magnetic solid phase extraction coupled to HPLC-UV for highly sensitive analysis of mono-hydroxy polycyclic aromatic hydrocarbons in urine.

BACKGROUND: As a common pollutant, the carcinogenic properties of polycyclic aromatic hydrocarbons have garnered considerable attention. Trace metabolites of polycyclic aromatic hydrocarbons can be detected in urine as a non-invasively approach to monitor the exposure level. Nonetheless, the urine samples have the disadvantages of being large in volume and containing numerous impurities. Given the growing demand to study metabolites with low abundance and potential biomarkers, there is a pressing need for a preconcentration and high-throughput technique for effectively handling complex liquid samples. RESULTS: Polystyrene-coated magnetic nanoparticles were used to establish a novel magnetic extraction method for monohydroxy polycyclic aromatic hydrocarbons in urine samples. Polystyrene magnetic nanoparticles are an ideal absorbent for solid-phase extraction. After the material was mixed with the sample and adsorbed the target analyte, the analytes on the material were eluted and quantified using high-performance liquid chromatography. Influencing factors were optimized, and the proposed method achieved desirable sensitivity in analyzing low-abundance metabolites in large volumes of complex urine samples. The recoveries of intra-day and inter-day were 78.0-118.0 % and 81.0 %-115.0 %, respectively. The intra-day and inter-day reproducibility were less than 4.5 % and 8.6 %, respectively. The limits of detection were in the range of 0.009-0.041 ng mL-1, and the limits of quantification were in the range of 0.030-0.135 ng mL-1. SIGNIFICANCE AND NOVELTY: The application of reusable polystyrene-coated magnetic solid-phase nanoparticles as adsorbents makes the extraction of monohydroxy polycyclic aromatic hydrocarbons from urine samples economical and environmentally benign. The proposed method is simple, sensitive, and efficient compared to existing techniques. The nanoparticles are easy to prepare, showing potential for rapid screening of complex bulk bio-samples in batches with high efficiency and low budget.

Effects of Hypoxia on Proliferation and Apoptosis of Osteosarcoma Cells.

BACKGROUND: Hypoxia can happen during solid tumor growth including osteosarcoma. This study investigated the relationship of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) on osteosarcoma cell growth and apoptosis under hypoxic conditions. MATERIALS AND METHODS: Human osteosarcoma cells were cultured under normal or hypoxic conditions. Inhibitors of HIF-1α and VEGF were applied to the cells separately or in combination to block the respective proteins. Cell proliferation and apoptosis were examined by MTT and TUNEL assays, and real-time PCR and ELISA were performed for mRNA and protein expression. RESULTS: There was a dramatic decrease of cell proliferation and an elevation of apoptosis under hypoxia. Blockage of HIF-1α and VEGFR enhanced the cell growth retardation and promoted apoptotic changes. Moreover, blockage of HIF-1α significantly eliminated the expression of VEGF in the cell culture media, and vice versa. CONCLUSION: HIF-1α and VEGF work closely in regulating osteosarcoma cell growth under hypoxic conditions and blockage of either of them may subsequently influence the presence of the other.

Compliance with National Guidelines on the Treatment of Stage II­IVB Nasopharyngeal Carcinoma in a Regional Cancer Center of Southern China

Objective: It is unknown whether the treatment provided to patients with stage II-IVB NPC in southern China adheres to the 2015 NCCN guidelines. Consequently, a retrospective analysis was conducted, in order to evaluate the compliance with NCCN guidelines and identify the areas for improvement. Methods: The present study was a retrospective study that included patients with stage II-IVB NPC in southern China during the period 2013 and 2014. The treatment regimens were compared with the 2015 NCCN guidelines in order to identify potential noncompliance regarding the treatment for stage II­IVB NPC. The statistical analyses included descriptive statistics, univariate and/or multivariate analysis using SPSS version 16.0.0. Results: A total of 215 patients, including 166 men (77.21%) and 49 women (22.79%), were involved in the analysis. Although the overall rate of noncompliance with the NCCN recommendations was 23.26%, the noncompliance rate of concurrent chemoradiation (CCRT), induction of chemotherapy (IC) followed by CCRT and CCRT followed by adjuvant chemotherapy (AC) was 7.02%, 39.76% and 50.00%, respectively. Univariate analysis indicated that NCCN noncompliance regarding the treatment for stage II-IVB NPC did not exhibit a significant correlation with the parameters age, gender, insurance status, education profile, first clinic department, careers, comorbidities and overall clinical stage, but it indicated a significant association with the therapeutic schedule (P<0.05). The multivariate analysis indicated that the NCCN noncompliance regarding the treatment for stage II­IVB NPC exhibited a statistically significant difference between CCRT and CCRT followed by AC (OR=0.10, 95% CI 0.04-0.27, P<0.05 ), although the difference noted between CCRT and IC followed by CCRT was not significantly different (OR=1.71, 95% CI 0.50-5.87,P=0.40). Conclusions: The use of specific therapeutic schedules may affect the noncompliance with NCCN guidelines regarding the treatment for stage II­IVB NPC in southern China, notably with regard to the treatment schedule of CCRT followed by AC.

Prediction of radiation-induced liver disease by Lyman normal-tissue complication probability model in three-dimensional conformal radiation therapy for primary liver carcinoma.

PURPOSE: To describe the probability of RILD by application of the Lyman-Kutcher-Burman normal-tissue complication (NTCP) model for primary liver carcinoma (PLC) treated with hypofractionated three-dimensional conformal radiotherapy (3D-CRT). METHODS AND MATERIALS: A total of 109 PLC patients treated by 3D-CRT were followed for RILD. Of these patients, 93 were in liver cirrhosis of Child-Pugh Grade A, and 16 were in Child-Pugh Grade B. The Michigan NTCP model was used to predict the probability of RILD, and then the modified Lyman NTCP model was generated for Child-Pugh A and Child-Pugh B patients by maximum-likelihood analysis. RESULTS: Of all patients, 17 developed RILD in which 8 were of Child-Pugh Grade A, and 9 were of Child-Pugh Grade B. The prediction of RILD by the Michigan model was underestimated for PLC patients. The modified n, m, TD50 (1) were 1.1, 0.28, and 40.5 Gy and 0.7, 0.43, and 23 Gy for patients with Child-Pugh A and B, respectively, which yielded better estimations of RILD probability. The hepatic tolerable doses (TD5) would be MDTNL of 21 Gy and 6 Gy, respectively, for Child-Pugh A and B patients. CONCLUSIONS: The Michigan model was probably not fit to predict RILD in PLC patients. A modified Lyman NTCP model for RILD was recommended.

Radiation-induced liver disease in three-dimensional conformal radiation therapy for primary liver carcinoma: the risk factors and hepatic radiation tolerance.

PURPOSE: To identify risk factors relevant to radiation-induced liver disease (RILD) and to determine the hepatic tolerance to radiation. METHODS AND MATERIALS: The data of 109 primary liver carcinomas (PLC) treated with hypofractionated three-dimensional conformal radiation therapy (3D-CRT) were analyzed. Seventeen patients were diagnosed with RILD and 13 of 17 died of it. RESULTS: The risk factors for RILD were late T stage, large gross tumor volume, presence of portal vein thrombosis, association with Child-Pugh Grade B cirrhosis, and acute hepatic toxicity. Multivariate analyses demonstrated that the severity of hepatic cirrhosis was a unique independent predictor. For Child-Pugh Grade A patients, the hepatic radiation tolerance was as follows: (1) Mean dose to normal liver (MDTNL) of 23 Gy was tolerable. (2) For cumulative dose-volume histogram, the tolerable volume percentages would be less than: V5 of 86%, V10 of 68%, V15 of 59%, V20 of 49%, V25 of 35%, V30 of 28%, V35 of 25%, and V40 of 20%. (3) Tolerable MDTNL could be estimated by MDTNL (Gy) = -1.686 + 0.023 * normal liver volume (cm3). CONCLUSION: The predominant risk factor for RILD was the severity of hepatic cirrhosis. The hepatic tolerance to radiation could be estimated by dosimetric parameters.

[Prognostic factor of primary liver cancer treated by hypofractionated three-dimensional conformal radiotherapy].

OBJECTIVE: To evaluate the toxicity and efficacy of primary liver cancer (PLC) treated by hypofractionated three-dimensional conformal radiotherapy (3DCRT) and investigate the prognostic factors. METHODS: Between April 1999 and August 2003, 128 PLC patients received hypofractionated 3DCRT. According to UICC/AJCC staging system, there were 83 T3 patients, 45 T4, with none of them having lymph node metastasis. The mean value of gross tumor volume (GTV) was (458.92 +/- 429.8) cm(3) (6.2-2097 cm(3)). Thirty-four patients had portal vein tumor thrombosis (PVTT). 108 patients had Child-Pugh Grade A liver cirrhosis and 20 Child-Pugh Grade B liver cirrhosis. All patients received a total dose of (53.6 +/- 6.6) Gy/4-8 Gy per fraction/3 fractions per week. Forty-eight of these patients received 3DCRT combined with transarterial chemoembolization (TACE). RESULTS: Seven patients died within 3 months after the treatment were dismissed from the series. The response rate (CR + PR) was 55% (67/121). The overall 1-, 2-, and 3-year survival rate was 65.0%, 43.3%, and 33.1%, respectively. T stage (P = 0.001), GTV (P = 0.0001), PVTT (P = 0.0001) and Child-Pugh Grade (P = 0.0001) had significant impact on the overall survival. However, only GTV and Child-Pugh Grade were independent significant prognostic factors by Cox-regression analysis, (P = 0.044 and P = 0.015). CONCLUSION: T stage, GTV, PVTT and Child-Pugh Grade have significant impact on the overall survival in primary liver cancer patients treated by three-dimensional conformal radiotherapy. But only GTV and Child-Pugh Grade are independent prognostic factors.

[Effect of bizhongxiao decotion on TNF-alpha and interleukin-1beta in plasma of rats with C II-induced rheumatoid arthritis].

OBJECTIVE: To observe the influence of bizhongxiao decotion (BZXD) on the plasma TNF-alpha and IL-1beta in rats with C II-induced arthritis (CIA) and to explore the mechanism of BZXD in the treatment of rheumatoid arthritis. METHODS: We divided 75 rats into 4 groups randomly. The rat experimented arthritis model was established by subcutaneous injection with collagen II. The plasma TNF-alpha and IL-1beta levels were detected with the radio-immunity assay at different time spots. RESULTS: The incidence of arthritis in the rats immunized with C II was approximately 88%. The plasma TNF-alpha and IL-1beta levels of the model group, BZXD group and methotrexate (MTX) group were notably higher than those of the normal group (P < 0.05). The plasma TNF-alpha and IL-1beta levels of the model group were higher than those of the MTX control group and BZXD treatment group at different time spots (P < 0. 01). The plasma TNF-alpha and IL-1beta levels rose step by step, but those of the BZXD group and MTX group decreased gradually. Moreover, the plasma TNF-alpha and IL-1beta levels of the rats of BZXD group were lower than those of the MTX group (P < 0. 05). CONCLUSION: TNF-alpha and IL-1beta play a very important role in the formation and development of rheumatoid arthritis. Both BZXD and MTX can notably decrease the plasma TNF-alpha and IL-1beta levels, but the effect of BZXD is better than that of MTX.

[Treatment of laryngeal granuloma].

OBJECTIVE: To study treatment method of laryngeal nonspecific granuloma. METHOD: Twenty-five patients with histopathologically identified laryngeal nonspecific granuloma were retrospective reviewed from 1998-2005. All patients were surgically treated by laser laryngomicrosurgery under general anesthesia, postoperative non-operative therapies included anti-gastroesophageal reflux medication, topical inhalant steroid (Beclometasone, Fluticasone) and voice therapy. Two patients were treated with 12 Gy of low-dose radiotherapy after surgery. RESULT: Laryngeal nonspecific granuloma have remarkable tendency of recurrence despite of surgery and non-surgical managements. Recurrence of laryngeal nonspecific granuloma occurs between 2-3 months postoperatively and requires repeated operation for 3 5 times. For intubation granuloma, 6 out of 8 were healed. Six out of eight contact granulomas were healed. Six of gastroesophageal reflux granulomas were healed. Glottic carcinoma was demonstrated in one case after 2 sessions of combined managements. Two patients were completely healed by low-dose radiotherapy of 12 Gy. CONCLUSION: Laryngeal nonspecific granuloma have an obvious tendency of recurrence, however, surgery is an important therapy. Combined non-surgical therapies (anti-gastroesophageal reflux medication, topical inhalant steroid and voice therapy) are necessary. In case which routine ways fail to control recurrence, low-dose radiotherapy is recommended because of its safety and satisfied effect.

Prediction of radiation induced liver disease using artificial neural networks.

OBJECTIVE: To evaluate the efficiency of predicting radiation induced liver disease (RILD) with an artificial neural network (ANN) model. METHODS AND MATERIALS: From August 2000 to November 2004, a total of 93 primary liver carcinoma (PLC) patients with single lesion and associated with hepatic cirrhosis of Child-Pugh grade A, were treated with hypofractionated three-dimensional conformal radiotherapy (3DCRT). Eight out of 93 patients were diagnosed RILD. Ninety-three patients were randomly divided into two subsets (training set and verification set). In model A, the ratio of patient numbers was 1:1 for training and verification set, and in model B, the ratio was 2:1. RESULTS: The areas under receiver-operating characteristic (ROC) curves were 0.8897 and 0.8831 for model A and B, respectively. Sensitivity, specificity, accuracy, positive prediction value (PPV) and negative prediction value (NPV) were 0.875 (7/8), 0.882 (75/85), 0.882 (82/93), 0.412 (7/17) and 0.987 (75/76) for model A, and 0.750 (6/8), 0.800 (68/85), 0.796 (74/93), 0.261 (6/23) and 0.971 (68/70) for model B. CONCLUSION: ANN was proved high accuracy for prediction of RILD. It could be used together with other models and dosimetric parameters to evaluate hepatic irradiation plans.

Effect of Bizhongxiao Decotion (BZXD) on Some Cytokines in Plasma of Rats with CII-induced Rheumatoid Arthritis.

OBJECTIVE: To investigate the influence of bizhongxiao decoction (BZXD) which is a Traditional Chinese medicine for RA including, on the plasma TNF-α and IL-1ß in rats with CII-induced arthritis (CIA) and explore the protective mechanism of BZXD in the treatment of rheumatoid arthritis. METHODS: 75 SD rats were divided into four groups randomly. Normal control group (n=5) not be treated any more. The CIA rat was established by subcutaneous injection with bovine II collagen (B II C) and complete Freund, s adjuvant (CFA) after 7d breeding. The CIA rats were divided into the CIA group (n=16), BZXD group (n=29) treated with BZXD and the MTX group (n=25) treated with methotrexate. All rats were killed after various intervals (25, 30, 35, 40, or 45d). At the end of each time interval, we collected the blood of each rat. To detect TNF-α and IL-1ß in plasma with radio-immunity kit. RESULTS: BIIC and CFA can be used to copying CIA model. The incidence of arthritis was 88%. The plasma TNF-α and IL-1ß levels of CIA group, BZXD group and MTX group were notably higher than those of normal control group (p<0.05), moreover, the CIA group was higher than those of the MTX group and BZXD group at various interval (p<0.01). TNF-α and IL-1ß rose step by step in CIA group but decreased in BZXD group and MTX group gradually. Moreover, in BZXD group were lower than those in MTX group (p<0.05). CONCLUSION: TNF-α and IL-1ß play a very important role in the formation and development of RA. BZXD can notably decrease the plasma TNF-α and IL-1ß levels, which was better than MTX.

Hypofractionated three-dimensional conformal radiation therapy for primary liver carcinoma.

BACKGROUND: The purpose of the current study was to evaluate the tolerance and efficacy of hypofractionated three-dimensional conformal radiotherapy (3DCRT) with or without transarterial chemoembolization (TACE) for technically unresectable or medically inoperable primary liver carcinoma (PLC). METHODS: Between April 1999 and August 2003, 128 patients with a clinical diagnosis of PLC received hypofractionated 3DCRT at Cancer Hospital, Guangxi Medical University. Both hypofractionated 3DCRT and TACE were used to treat 48 of these 128 patients. Liver cirrhosis of Child-Pugh Grade A was found in 108 patients, and Grade B was found in 20 patients. The mean gross tumor volume (GTV) was 459 +/- 430 cm3. A mean total irradiation dose of 53.6 +/- 6.6 Gy was delivered at an average fraction of 4.88 +/- 0.47 Gy, 3 times a week using 8-MV photons. RESULTS: The median follow-up time after 3DCRT was 12 months (range, 2-56 mos.). The immediate response rate was 55%. The overall survival rates at 1, 2, and 3 years were 65%, 43%, and 33%, respectively, with a median survival of 20 months (range, 7-31 mos.). Radiation Therapy Oncology Group (RTOG) Grade 2 acute gastrointestinal complications developed in 8 patients, whereas 4 patients developed Grade 3 late gastrointestinal complications. Radiation-induced liver disease (RILD) developed in 19 (15%) patients, of which 12 had Child-Pugh Grade B liver cirrhosis, and 7 had Grade A. GTV and associated liver cirrhosis were identified by Cox regression analysis as independent predictors for survival (P = 0.044 and 0.015). CONCLUSIONS: Hypofractionated 3DCRT is effective in carefully selected patients with PLC. Gastrointestinal complications and RILD were the most distinct complications.