Accelerated partial breast irradiation: Current evidence and future developments.

Whole breast irradiation after breast-conserving surgery for early breast cancer has become one of the standard treatment modes for breast cancer and yields the same effect as radical surgery. Accelerated partial breast irradiation (APBI) as a substitute for whole breast irradiation for patients with early breast cancer is a hot spot in clinical research. APBI is characterised by simple high-dose local irradiation of the tumour bed in a short time, thus improving convenience for patients and saving costs. The implementation methods of APBI mainly include brachytherapy, external beam radiation therapy, and intraoperative radiotherapy. This review provides an overview of the clinical effects and adverse reactions of the main technologies of APBI and discusses the prospects for the future development of APBI.

Comparison of post-chemoradiotherapy pneumonitis between Asian and non-Asian patients with locally advanced non-small cell lung cancer: a systematic review and meta-analysis.

Background: Pneumonitis is a common complication for patients with locally advanced non-small cell lung cancer undergoing definitive chemoradiotherapy (CRT). It remains unclear whether there is ethnic difference in the incidence of post-CRT pneumonitis. Methods: PubMed, Embase, Cochrane Library, and Web of Science were searched for eligible studies from January 1, 2000 to April 30, 2023. The outcomes of interest were incidence rates of pneumonitis. The random-effect model was used for statistical analysis. This meta-analysis was registered with PROSPERO (CRD42023416490). Findings: A total of 248 studies involving 28,267 patients were included. Among studies of CRT without immunotherapy, the pooled rates of pneumonitis for Asian patients were significantly higher than that for non-Asian patients (all grade: 66.8%, 95% CI: 59.2%-73.9% vs. 28.1%, 95% CI: 20.4%-36.4%; P < 0.0001; grade ≥2: 25.1%, 95% CI: 22.9%-27.3% vs. 14.9%, 95% CI: 12.0%-18.0%; P < 0.0001; grade ≥3: 6.5%, 95% CI: 5.6%-7.3% vs. 4.6%, 95% CI: 3.4%-5.9%; P = 0.015; grade 5: 0.6%, 95% CI: 0.3%-0.9% vs. 0.1%, 95% CI: 0.0%-0.2%; P < 0.0001). Regarding studies of CRT plus immunotherapy, Asian patients had higher rates of all-grade (74.8%, 95% CI: 63.7%-84.5% vs. 34.3%, 95% CI: 28.7%-40.2%; P < 0.0001) and grade ≥2 (34.0%, 95% CI: 30.7%-37.3% vs. 24.6%, 95% CI: 19.9%-29.3%; P = 0.001) pneumonitis than non-Asian patients, but with no significant differences in the rates of grade ≥3 and grade 5 pneumonitis. Results from subgroup analyses were generally similar to that from the all studies. In addition, the pooled median/mean of lung volume receiving ≥20 Gy and mean lung dose were relatively low in Asian studies compared to that in non-Asian studies. Interpretation: Asian patients are likely to have a higher incidence of pneumonitis than non-Asian patients, which appears to be due to the poor tolerance of lung to radiation. Nevertheless, these findings are based on observational studies and with significant heterogeneity, and need to be validated in future large prospective studies focusing on the subject. Funding: None.

Hsa_circ_0080608 Attenuates Lung Cancer Progression by Functioning as a Competitive Endogenous RNA to Regulate the miR-661/ADRA1A Pathway.

Circular RNAs (circRNAs) participate in the progression of human cancers and have been broadly elucidated. Here, we aimed to elucidate the roles and functional mechanisms of hsa_circ_0080608 (circ_0080608) in lung cancer. Quantitative real-time PCR (qPCR) was performed to assess the mRNA expression levels of circ_0080608, miR-661, and adrenoceptor alpha 1A (ADRA1A). Western blotting was performed to measure ADRA1A protein levels. CCK-8, colony formation, and Transwell assays were performed to determine the effect of circ_0080608 on cell proliferation and migration. Animal models were used to assess how circ_0080608 influences tumor progression in vivo. The binding relationships of miR-661's with circ_0080608 and ADRA1A was confirmed using dual-luciferase reporter and RIP assays. Circ_0080608 exhibited relatively low expression in lung cancer samples and cells. Lung cancer cells overexpressing circ_0080608 exhibited reduced migratory and proliferative abilities. Additionally, circ_0080608 binds to miR-661 and operates as a competing endogenous RNA (ceRNA) and shares a miR-661 binding site with the 3' UTR of ADRA1A. Furthermore, circ_0080608 inversely regulates miR-661 expression, consequently restraining the aggressive behavior of lung cancer cells. Lung cancer cells overexpressing ADRA1A also exhibit repressed migratory and proliferative abilities. However, reintroduction of miR-661 led to a decline in ADRA1A expression, thereby attenuating the functional effects of ADRA1A. Circ_0080608 impedes lung cancer progression by regulating the miR-661/ADRA1A pathway. Our findings provide new insights into the progression of lung cancer.

MiR-490-3p Sponged by lncRNA NEAT1 Can Attenuate Lung Adenocarcinoma Progression by Suppressing the RhoA/ROCK Signaling Pathway.

OBJECTIVE: Long noncoding RNAs (lncRNAs) are crucial regulators of lung adenocarcinoma (LUAD) progression. Herein, we explored the role of miR-490-3p and the underlying molecular mechanism involving key lncRNAs and pathways in LUAD. METHODS: Reverse transcription-quantitative PCR (RT-qPCR) was performed to detect the expression of lncRNA NEAT1 and miR-490-3p in LUAD cells and tissues. Western blotting was used to determine protein expression levels of the Ras homologous gene family member A/Rho-related protein kinase (RhoA/ROCK) signal pathway marker. Considering cell functions, Cell Counting Kit-8 (CCK-8), Transwell, and xenograft experiments were employed to evaluate LUAD cell proliferation, migration, and tumor growth, respectively. The relationship between miR-490-3p and lncRNA NEAT1 was analyzed using a luciferase reporter assay. RESULTS: Herein, we found that miR-490-3p expression was significantly low in LUAD cells and tissues. MiR-490-3p overexpression markedly suppressed tumor growth, the RhoA/ROCK signaling pathway, migration, and proliferation of LUAD cells. Moreover, lncRNA NEAT1, which is highly expressed in LUAD, was detected upstream of miR-490-3p. Upregulation of lncRNA NEAT1 exacerbated the behavior of LUAD cells and offset the suppressive influence of miR-490-3p-mediated upregulation on malignant LUAD cell behavior. CONCLUSION: MiR-490-3p sponging by lncRNA NEAT1 could hamper LUAD progression by inhibiting the RhoA/ROCK signaling pathway. These findings provide new insights for LUAD diagnosis and treatment.

Analysis of the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters related to right heart function in detecting acute radiation-induced right heart injury.

BACKGROUND: The aim of the present study was to investigate the value of parameters related to right heart function combined with N-terminal pro-B-type natriuretic peptide (NT-proBNP) in acute radiation-induced right heart injury. METHODS: Seventy patients who received chest radiotherapy (RT) in the RT department of our hospital between September 2015 and March 2019 were included in the study. RESULTS: Of the included 70 patients, 19, 32, 4, and 15 had thoracic esophageal cancer, central lung cancer, thymoma, and left breast cancer, respectively. The Tei index, tricuspid annular displacement, right ventricular ejection fraction, and NT-proBNP of the 70 patients were measured 1 week before RT, at weeks 2 and 4 during RT, and 4 weeks after RT. Differences in the Tei index, the tricuspid annular displacement, and NT-proBNP were significant (P<0.01, P<0.05, and P<0.05, respectively). The Tei index significantly increased in the second week of RT. Tricuspid annular displacement decreased significantly 4 weeks after RT. NT-proBNP reached its peak value in the fourth week of RT. However, there was no significant difference in right ventricular ejection fraction (P>0.05). CONCLUSIONS: The Tei index of the right ventricle can be used as a sensitive indicator for the early detection of right heart injury after RT for thoracic tumors. Additionally, tricuspid annular displacement can be used as an index for the early detection of right ventricular damage after RT for thoracic tumors. However, right ventricular ejection fraction showed no significant change in the early stage of right heart damage after RT. Finally, it is important to consider NT-proBNP for the detection of acute radiation-induced heart injury. In acute radiation-induced right heart injury, the combined application of right ventricular Tei index, tricuspid annular displacement, and NT-proBNP is clinically relevant.

The role of postoperative radiotherapy for radically resected esophageal squamous cell carcinoma: a systemic review and meta-analysis.

BACKGROUND: The role of postoperative radiotherapy (PORT) for radical resected esophageal squamous cell carcinoma (ESCC) remains controversial. This meta-analysis aims to determine whether PORT achieves survival benefit compared with surgery alone (S alone) for radically resected ESCC. METHODS: The PubMed, EMBASE, Web of Science, and Cochrane Library were searched for relevant articles. The primary endpoints were overall survival (OS) and disease-free survival (DFS), reported as hazard ratios (HR) and 95% confidence intervals (CIs). RESULTS: Six randomized trials and 13 retrospective studies that included a total of 8,198 patients were eligible. PORT provided significant OS benefit compared with S alone in retrospective studies (HR =0.75, 95% CI: 0.65-0.85), but not in randomized controlled trials (RCTs) (HR =0.94, 95% CI: 0.81-1.09). PORT was associated with significantly improved DFS and obvious reduction in the risk of locoregional recurrence compared to S alone in either retrospective studies or RCTs. In the subgroup analysis for retrospective studies, PORT gained superior OS in patients with lymph node-positive (pN+), patients with lymph node-negative (pN0) or pT2-3N0, PORT with three-dimensional radiotherapy (3D-RT), PORT with chemotherapy, and patients with R0 resection, respectively. CONCLUSIONS: The present study shows that PORT can improve DFS and decrease risk of locoregional recurrence in patients with radically resected ESCC, and PORT using 3D-RT or in combination with chemotherapy is likely to be more useful. Further well-designed, prospective studies are needed to confirm the effect of PORT on OS.

The risk and predictors for severe radiation pneumonitis in lung cancer patients treated with thoracic reirradiation.

BACKGROUND: Thoracic reirradiation (re-RT) is increasingly administered. However, radiation pneumonitis (RP) remains to be the most common side effect from retreatment. This study aimed to determine the risk and predictors for severe RP in patients receiving thoracic re-RT. METHODS: Sixty seven patients with lung cancer received thoracic re-RT for recurrent or metastatic disease. Three-dimensional conformal radiotherapy (3D-CRT)/intensity modulated radiotherapy (IMRT) was used for 60 patients, and stereotactic body radiation therapy (SBRT) was used in 7 patients. Deformable image registration (DIR) was performed to create a composite plan. Severe (grade ≥ 3) RP was graded according to Common Terminology Criteria for Adverse Events version 4.0. RESULTS: Eighteen patients (26.9%) developed grade ≥ 3 RP (17 of grade 3, and 1 of grade 4). In univariate analyses, V5 and mean lung dose (MLD) of initial RT or re-RT plans, V5 and V20 of composite plans, and the overlap between V5 of initial RT and V5 of re-RT plans/V5 of re-RT plans (overlap-V5/re-V5) were significantly associated with grade ≥ 3 RP (P < 0.05 for each comparison). Multivariate analysis revealed that MLD of the initial RT plans (HR = 14.515, 95%CI:1.778-118.494, P = 0.013), V5 of the composite plans (HR = 7.398, 95%CI:1.319-41.495, P = 0.023), and overlap-V5/re-V5 (P = 0.041) were independent predictors for grade ≥ 3 RP. Out-of-field failures with medium overlap-V5/re-V5 of 0.4-0.8 was associated with higher risk of grade ≥ 3 RP compared with in-field failures (18.3% vs. 50%, P = 0.014). CONCLUSIONS: The risk of grade ≥ 3 RP could be predicted not only by dose-volume variables from re-RT plan, but also by some from initial-RT and composite plans. Out-of-field failures was associated with higher risk of severe RP compared with in-field failures in some cases.