A model that predicts a real-time tumour surface using intra-treatment skin surface and end-of-expiration and end-of-inhalation planning CT images.

OBJECTIVES: To develop a mapping model between skin surface motion and internal tumour motion and deformation using end-of-exhalation (EOE) and end-of-inhalation (EOI) 3D CT images for tracking lung tumours during respiration. METHODS: Before treatment, skin and tumour surfaces were segmented and reconstructed from the EOE and the EOI 3D CT images. A non-rigid registration algorithm was used to register the EOE skin and tumour surfaces to the EOI, resulting in a displacement vector field that was then used to construct a mapping model. During treatment, the EOE skin surface was registered to the real-time, yielding a real-time skin surface displacement vector field. Using the mapping model generated, the input of a real-time skin surface can be used to calculate the real-time tumour surface. The proposed method was validated with and without simulated noise on 4D CT images from 15 patients at Léon Bérard Cancer Center and the 4D-lung dataset. RESULTS: The average centre position error, dice similarity coefficient (DSC), 95%-Hausdorff distance and mean distance to agreement of the tumour surfaces were 1.29 mm, 0.924, 2.76 mm, and 1.13 mm without simulated noise, respectively. With simulated noise, these values were 1.33 mm, 0.920, 2.79 mm, and 1.15 mm, respectively. CONCLUSIONS: A patient-specific model was proposed and validated that was constructed using only EOE and EOI 3D CT images and real-time skin surface images to predict internal tumour motion and deformation during respiratory motion. ADVANCES IN KNOWLEDGE: The proposed method achieves comparable accuracy to state-of-the-art methods with fewer pre-treatment planning CT images, which holds potential for application in precise image-guided radiation therapy.

Effects of Glutamine Synthetase on Neovascularization in Glioma: In Vivo MR Vessel Size Imaging and Histology.

BACKGROUND: Glutamine Synthetase (GS) could induce vascular sprouting through the improvement of endothelial cell migration in inflammatory diseases. MR vessel-size imaging has been proposed as a valuable approach for visualizing the underlying angiogenic processes in the brain. OBJECTIVE: This study aims to investigate the role of GS in the neovascularization of gliomas through the utilization of MR vessel-size imaging and histopathological techniques. METHODS: In this exploratory animal study, we randomly divided the C6 glioma rat models into a control group and an L-methionine sulfoximine (MSO) treatment group. Daily intraperitoneal injections were administered for three consecutive days, starting from day 10 following the implantation of C6 glioma cells in rats. Subsequently, MR vessel size imaging was conducted using a BRUKER 7 T/200 mm MRI scanner, and the MRI results were validated through histopathological examination. RESULTS: A significant decrease in microvessel density was observed in both the tumor periphery and center areas in the MSO treatment group compared to that in the control group. The mean vessel diameter (mVD) and vessel size index (VSI) did not exhibit significant changes compared to the control group. Moreover, the staining intensity of platelet endothelial cell adhesion molecule-1 (CD31) and GS in the tumor periphery was significantly decreased in the MSO treatment group. Additionally, the MSO treatment demonstrated a substantial inhibition of tumor growth. CONCLUSION: GS inhibitors significantly reduced angiogenesis in the periphery area of C6 glioma, exerting an inhibitory effect on tumor progression. Thus, GS inhibitors could be potential therapeutic agents for treating glioma. Additionally, in vivo MR vessel size imaging detects changes in vascularrelated parameters after tumor treatment, making it a promising method for detecting neovascularization in glioma.

CT radiomics-based model for predicting TMB and immunotherapy response in non-small cell lung cancer.

BACKGROUND: Tumor mutational burden (TMB) is one of the most significant predictive biomarkers of immunotherapy efficacy in non-small cell lung cancer (NSCLC). Radiomics allows high-throughput extraction and analysis of advanced and quantitative medical imaging features. This study develops and validates a radiomic model for predicting TMB level and the response to immunotherapy based on CT features in NSCLC. METHOD: Pre-operative chest CT images of 127 patients with NSCLC were retrospectively studied. The 3D-Slicer software was used to outline the region of interest and extract features from the CT images. Radiomics prediction model was constructed by LASSO and multiple logistic regression in a training dataset. The model was validated by receiver operating characteristic (ROC) curves and calibration curves using external datasets. Decision curve analysis was used to assess the value of the model for clinical application. RESULTS: A total of 1037 radiomic features were extracted from the CT images of NSCLC patients from TCGA. LASSO regression selected three radiomics features (Flatness, Autocorrelation and Minimum), which were associated with TMB level in NSCLC. A TMB prediction model consisting of 3 radiomic features was constructed by multiple logistic regression. The area under the curve (AUC) value in the TCGA training dataset was 0.816 (95% CI: 0.7109-0.9203) for predicting TMB level in NSCLC. The AUC value in external validation dataset I was 0.775 (95% CI: 0.5528-0.9972) for predicting TMB level in NSCLC, and the AUC value in external validation dataset II was 0.762 (95% CI: 0.5669-0.9569) for predicting the efficacy of immunotherapy in NSCLC. CONCLUSION: The model based on CT radiomic features helps to achieve cost effective improvement in TMB classification and precise immunotherapy treatment of NSCLC patients.

Dose-dependent early white matter alterations in patients with brain metastases after radiotherapy.

PURPOSE: Previous diffusion tensor imaging (DTI) studies have mainly focused on dose-dependent white matter (WM) alterations 1 month to 1 year after radiation therapy (RT) with a tract-average method. However, WM alterations immediately after RT are subtle, resulting in early WM alterations that cannot be detected by tract-average methods. Therefore, we performed a study with an along-tract method in patients with brain metastases to explore the early dose-response pattern of WM alterations after RT. METHODS: Sixteen patients with brain metastases underwent DTI before and 1-3 days after brain RT. DTI metrics, such as fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were calculated. Along-tract statistics were then used to resample WM fibre streamlines and generate a WM skeleton fibre tract. DTI metric alterations (post_RT-pre_RT DTI metrics) and the planned doses (max or mean doses) were mapped to 18 WM tracts. A linear fixed model was performed to analyse the main effect of dose on DTI metric alterations. RESULTS: AD alterations in the left hemispheric uncinated fasciculus (UNC_L) were associated with max doses, in which decreased AD alterations were associated with higher doses. CONCLUSION: Our findings may provide pathological insight into early dose-dependent WM alterations and may contribute to the development of max dose-constrained RT techniques to protect brain microstructure in the UNC_L.

The radiomic-clinical model using the SHAP method for assessing the treatment response of whole-brain radiotherapy: a multicentric study.

OBJECTIVE: To develop and validate a pretreatment magnetic resonance imaging (MRI)-based radiomic-clinical model to assess the treatment response of whole-brain radiotherapy (WBRT) by using SHapley Additive exPlanations (SHAP), which is derived from game theory, and can explain the output of different machine learning models. METHODS: We retrospectively enrolled 228 patients with brain metastases from two medical centers (184 in the training cohort and 44 in the validation cohort). Treatment responses of patients were categorized as a non-responding group vs. a responding group according to the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) criteria. For each tumor, 960 features were extracted from the MRI sequence. The least absolute shrinkage and selection operator (LASSO) was used for feature selection. A support vector machine (SVM) model incorporating clinical factors and radiomic features wase used to construct the radiomic-clinical model. SHAP method explained the SVM model by prioritizing the importance of features, in terms of assessment contribution. RESULTS: Three radiomic features and three clinical factors were identified to build the model. Radiomic-clinical model yielded AUCs of 0.928 (95%CI 0.901-0.949) and 0.851 (95%CI 0.816-0.886) for assessing the treatment response in the training cohort and validation cohort, respectively. SHAP summary plot illustrated the feature's value affected the feature's impact attributed to model, and SHAP force plot showed the integration of features' impact attributed to individual response. CONCLUSION: The radiomic-clinical model with the SHAP method can be useful for assessing the treatment response of WBRT and may assist clinicians in directing personalized WBRT strategies in an understandable manner. KEY POINTS: • Radiomic-clinical model can be useful for assessing the treatment response of WBRT. • SHAP could explain and visualize radiomic-clinical machine learning model in a clinician-friendly way.

Association of the tissue infiltrated and peripheral blood immune cell subsets with response to radiotherapy for rectal cancer.

BACKGROUND: Tumor microenvironment plays pivotal roles in carcinogenesis, cancer development and metastasis. Composition of cancer immune cell subsets can be inferred by deconvolution of gene expression profile accurately. Compositions of the cell types in cancer microenvironment including cancer infiltrating immune and stromal cells have been reported to be associated with the cancer outcomes markers for cancer prognosis. However, rare studies have been reported on their association with the response to preoperative radiotherapy for rectal cancer. METHODS: In this paper, we deconvoluted the immune/stromal cell composition from the gene expression profiles. We compared the composition of immune/stromal cell types in the RT responsive versus nonresponsive for rectal cancer. We also compared the peripheral blood immune cell subset composition in the stable diseases versus progressive diseases of rectal cancer patients with fluorescence-activated cell sorting from our institution. RESULTS: Compared with the non-responsive group, the responsive group showed higher proportions of CD4+ T cell (0.1378 ± 0.0368 vs. 0.1071 ± 0.0373, p = 0.0215), adipocytes, T cells CD4 memory resting, and lower proportions of CD8+ T cell (0.1798 ± 0.0217 vs. 0.2104 ± 0.0415, p = 0.0239), macrophages M2, and preadipocytes in their cancer tissue. The responsive patients showed a higher ratio of CD4+/CD8+ T cell proportions (mean 0.7869 vs. 0.5564, p = 0.0210). Consistently, the peripheral blood dataset showed higher proportion of CD4+ T cells and higher ratio of CD4+/CD8+ T cells, and lower proportion of CD8+ T cells for favorable prognosis. We validated these results with a pooled dataset of GSE3493 and GSE35452, and more peripheral blood data, respectively. Finally, we imported these eight cell features including eosinophils and macrophage M1 to Support Vector Machines and could predict the pre-radiotherapy responsive versus non-responsive with an accuracy of 76%, ROC AUC 0.77, 95% confidential interval of 0.632-0.857, better than the gene signatures. CONCLUSIONS: Our results showed that the proportions of tumor-infiltrating subsets and peripheral blood immune cell subsets can be important immune cell markers and treatment targets for outcomes of radiotherapy for rectal cancer.

Early-Onset Micromorphological Changes of Neuronal Fiber Bundles During Radiotherapy.

BACKGROUND: Patients receiving cranial radiation face the risk of delayed brain dysfunction. However, an early medical imaging marker is not available until irreversible morphological changes emerge. PURPOSE: To explore the micromorphological white matter changes during the radiotherapy session by utilizing an along-tract analysis framework. STUDY TYPE: Prospective. POPULATION: Eighteen nasopharyngeal carcinoma (two female) patients receiving cranial radiation. FIELD STRENGTH/SEQUENCE: 3.0 T; Diffusion tensor imaging (DTI) and T1- and T2-weighted images (T1W, T2W); computed tomography (CT). ASSESSMENT: Patients received three DTI imaging scans during the radiotherapy (RT), namely the baseline scan (1-2 days before RT began), the middle scan (the middle of the RT session), and the end scan (1-2 days after RT ended). Twelve fibers were segmented after whole-brain tractography. Then, the fractional anisotropy (FA) values and the cumulative radiation dose received for each fiber streamline were resampled and projected into their center fiber. STATISTICAL TESTS: The contrast among the three scans (P1: middle scan-baseline scan; P2: end scan-middle scan; P3: end scan-baseline scan) were compared using the linear mixed model for each of the 12 center fibers. Then, a dose-responsiveness relationship was performed using Pearson correlation. P < 0.05 was considered statistically significant. RESULTS: Six of the 12 center fibers showed significant changes of FA values during the RT but with heterogeneous patterns. The significant changes along a specific center fiber were associated with their cumulative dose received (Genu: P1 r = -0.6182, P2 r = -0.5907; Splenium: P1 r = 0.4055, P = 0.1063, P2 r = 0.6742; right uncinate fasciculus: P1 r = -0.3865, P2 r = -0.4912, P = 0.0533; right corticospinal tract: P1 r = 0.4273, P = 0.1122, P2 r = -0.6885). DATA CONCLUSION: The along-tract analysis might provide sensitive measures on the early-onset micromorphological changes. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.

Advance directives and end-of-life care: knowledge and preferences of patients with brain Tumours from Anhui, China.

BACKGROUND: In Mainland China, advance directives (ADs) and end-of-life care for patients with tumours, especially patients with brain tumours who may have lost consciousness or the ability to speak at the early stage of their illness, have been poorly acknowledged. Thus, this study aimed to clarify the knowledge and preferences of ADs and end-of-life care in patients with brain tumours and to investigate predictors of patient preferences. METHODS: This was a population-based cross-sectional survey that was conducted via face-to-face interviews. Information on sociodemographic factors, brain tumour illness, knowledge and preferences of the advanced decisions and end-of-life care of the patients was collected. RESULTS: A total of 88.61% of participants had never heard of ADs, but 65.18% reported that they would like to make ADs. Knowledge of ADs, receiving surgical treatment or radiotherapy, being younger than 70 years old, being male, having educational qualifications of college or beyond, being childless, having medical insurance for nonworking or working urban residents and self-paying medical expenses were predictors of preference for making ADs. A total of 79.43% of participants wanted to discuss end-of-life arrangements with medical staff, and 63.29% of participants were willing to receive end-of-life care, even though it would not delay death. A total of 65.82% of patients with brain tumours wanted resuscitation, and as many as 45.45% of the patients thought that they did not need life support if they were in a persistent vegetative state. Brain primary tumours, being younger than 70 years old, male sex, educational qualification of junior middle school or below, having children, having new rural cooperative medical insurance and having medical expenses paid by children or spouses were predictors of choosing appropriate palliative care. CONCLUSIONS: ADs and end-of-life care have been poorly acknowledged among patients with brain tumours in mainland China. Additional efforts should be encouraged amongst patients with primary brain tumours, those who are undergoing surgery and radiotherapy and those who have low socioeconomic status. A longitudinal and comprehensive study is encouraged to promote disease-specific ADs among Chinese patients with brain tumours.

Association between clinicopathological features and prognosis significance of PD-L1 expression in small cell lung cancer patients: a systemic review and meta-analysis.

BACKGROUND: Programmed death ligand-1 (PD-L1) has been identified as an established biomarker for predicting response to immunotherapy in a variety types of cancer. However, the clinicopathological and prognostic significance of this protein in small cell lung cancer (SCLC) patients remains controversial. METHODS: Eligible studies extracted from the databases of PubMed, MEDLINE, Embase, and CNKI databases were evaluated. Statistical analysis was performed using STATA 11.2 software. RESULTS: A total of 483 PD-L1+ cases and 570 controls from 11 publications were extracted. Either overall analysis or subcategory analysis showed that no significant association between higher PD-L1 expression and gender (n=8, OR 1.08, 95% CI: 0.73-1.61, P=0.704, I2=0.0%), tumor stage (n=5, OR 0.71, 95% CI: 0.20-2.56, P=0.599, I2=86.5%), smoking status (n=4, OR 0.85, 95% CI: 0.41-1.73, P=0.646, I2=0.0%), and the level of serum lactate dehydrogenase (LDH) (n=4, OR 0.76, 95% CI: 0.48-1.20, P=0.241, I2= 21.6%). PD-L1 expression had no positive correlation with overall survival (OS) (n=11, HR 0.97, 95% CI: 0.61-1.56, P=0.904, I2= 83.2%) in overall analysis. However, the stratified analysis showed that increased expression of PD-L1 predicted a significantly better OS in monoclonal antibody (mAb) subgroup and Food and Drug Administration (FDA) approved antibody clone specification (22C3/28-8/SP142/SP263) subgroup without significant heterogeneity. CONCLUSIONS: PD-L1 is not an important predictor of most clinicopathological features of SCLC patients, but it can predict an improved survival when using mAb or FDA approved clone specifications in IHC assays.

Short-term efficacy and safety of apatinib combined with chemoradiotherapy in treatment of NSCLC patients with brain metastases / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To observe the short-term efficacy and safety of Apatinib combined with radiotherapy and concurrent docetaxel and cisplatin chemotherapy in driver-gene-negative non-small cell lung cancer (NSCLC) patients with brain metastases. Methods: A total of 72 NSCLC patients with brain metastases, who were treated in our hospital from June 2018 to June 2019, were enrolled in this study. The driver gene was proved to be negative by next generation sequencing (NGS). The patients were divided into control group (36 cases) and treatment group (36 cases) by Digital random grouping method.The control group received 2 cycles of chemotherapy with docetaxel and cisplatin and concurrent radiotherapy for brain metastases, and the treatment group was given Apatinib anti-angiogenic treatment based on the regimen in control group. Primary study endpoints: confirmed objective response rate (cORR) and disease control rate (DCR); Secondary study endpoints: progression-free survival (PFS), quality of life (QOL) score, serum carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), and incidence of adverse drug events (AE). Results: Compared with the control group, cORR and DCR in treatment group were significantly improved [41.67% (15/36) vs 33.33% (12/36), 80.56% (29/36) vs 69.44% (25/36), all P<0.05], the median PFS was significantly prolonged (5.9 vs 4.6 months, P<0.05), and serum CEA and VEGF levels were significantly reduced [(16.5±2.3) vs (22.9±3.7) ng/ml, (291.6±42.6) vs (479.3±50.2) ng/L, all P<0.05], while the QOL score was slightly increased, but the difference was not statistically significant [(69.5±8.5) points vs (64.1±7.3) points, P>0.05]. There was no statistically significant difference in the incidence of acute brain edema, gastrointestinal reaction, bone marrow suppression, and liver dysfunction between the two groups of patients (all P>0.05); however, the incidences of oral mucositis, hand-foot syndrome, hypertension and proteinuria in the treatment group were significantly higher than those in the control group (all P<0.05). Conclusion: The efficacy of Apatinib combined with radiochemotherapy in driver-negative NSCLC patients with brain metastases is significantly better than that of radiochemotherapy alone, and the adverse reactions can be controlled. It is worthy of clinical recommendation.

Paeoniflorin exerts protective effect on radiation-induced hepatic fibrosis in rats via TGF-ß1/Smads signaling pathway.

AIM: This study aimed to investigate the protective effects of paeoniflorin (PAE) on radiation-induced hepatic fibrosis in a rat model. METHODS: Fifty healthy male Sprague-Dawley rats were randomly assigned to normal control group, hepatic fibrosis group, and PAE treatment groups. X-ray exposure was employed to establish radiation-induced hepatic fibrosis model. PAE was administered once daily, and rats were sacrificed at week 26 after irradiation. The liver histopathology was evaluated under a light microscope after HE staining and Masson staining. Meanwhile, the protein expression of transforming growth factor-beta 1 (TGF-ß1), Smad3/4 and Smad7 was detected by immunohistochemistry. RESULTS: Radiation-induced liver damage and collagen deposition were observed in the model group as compared to normal control group, but PAE treatment significantly attenuated the liver injury and reduce collagen deposition (P<0.05 or 0.01). The hepatic hydroxyproline content and serum levels of TGF-ß1, hyaluronic acid, ro-collagen type III and laminin markedly increased in model group as compared to control group (P<0.01), but they decreased dramatically after PAE treatment. The expression of TGF-ß1, Smad3/4 and Smad7 in the liver increased significantly in model group as compared to control group (P<0.01), and PAE could down-regulate the expression of Smad3/4 and up-regulate Smad7 expression (P<0.05 or 0.01). The activities of serum amino-transferase and aspartate aminotransferase were significantly higher in hepatic fibrosis group than in normal control group, but PAE treatment markedly reduced them (P<0.05). CONCLUSION: PAE can inhibit the radiation induced hepatic fibrosis via regulating TGF-ß1/Smads signaling pathway.

Short term efficacy and toxicity of apatinib and docetaxel combined with cisplatin chemotherapy for advanced gastric cancer / 中国肿瘤生物治疗杂志

@# Objective: : To observe the short-term efficacy and toxicity of apatinib monotherapy as well as docetaxel plus cisplatin in advanced gastric cancer. Method: : According to inclusion and exclusion criteria, 108 patients with advanced gastric cancer in the 105th Hospital of PLA were selected. According to random table grouping method, there were 54 cases in group A and 54 cases in group B. Patients in group A received continuous oral administration of apatinib alone, while group B received docetaxel plus cisplatin chemotherapy, with 3 weeks as a cycle and 4 cycles for a course. The efficacy and side effects were evaluated 3 months later. Results: : In groupA, there were 4 cases of CR, 25 cases of PR, 18 cases of SD and 7 cases of PD; the ORR was 53.7% and DCR was 87%. In group B, there were 2 cases of CR, 19 cases of PR, 21 cases of SD and 12 cases of PD; the ORR was 38.9% and DCR was 77.8%. The ORR and DCR in group A were significantly better than those in group B (P<0.05). The main adverse reactions were gastrointestinal reaction, myelosuppression, hypertension and hand-foot syndrome, all of which were grade 1 to 2; The incidence of bone marrow suppression and gastrointestinal reaction in group A was lower than that in group B (P<0.05), while the incidence of hand-foot syndrome and hypertension in group B was lower than that in group A (P<0.01). Conclusion： ：The short-term efficacy of targeted therapy of apatinib alone was better than that of docetaxel combined with cisplatin chemotherapy, and the toxicity and side effects of both regimens were controllable;Apatinib can be used as the primary regimen for the treatment of advanced gastric cancer.

[Clinical efficacy and mechanism of total glucosides from white paeony for radioactive liver damage].

To discuss the effects of total glucosides from white paeony on preventing and treating radioactive liver damage, and explore its possible mechanisms. Thirty-six patients with primary hepatic carcinoma from 105th Hospital of Chinese PLA were treated with 3-dimensional conformal radiotherapy and randomly divided into simple irradiation group, total glucosides from white paeony group, and control group. The levels of AST, ALT, HA, LN, PCⅢ, CIV and TGF-ß1 in serum of various groups were determined by using ELISA method. As compared with the simple irradiation group and control group, total glucosides from white paeony could obviously decrease the levels of AST, ALT, HA, LN, PCⅢ, CIV and TGF-ß1(P<0.05, P<0.01). The results showed that the total glucosides from white paeony could effectively prevent and treat radioactive liver damage, and its mechanism might be associated with decreasing the levels of TGF-ß1, and inhibiting the synthesis of collagen synthesis.

Nestin Expression Is Associated with Poor Clinicopathological Features and Prognosis in Glioma Patients: an Association Study and Meta-analysis.

Nestin has been identified as a molecular marker of neural progenitor cells and putative glioma stem cells (GSCs). Various studies examining the relationship between nestin expression with the clinical outcome in glioma patients have yielded inconclusive results. Thus, we conducted a systematic review to evaluate the association of nestin with prognosis and clinicopathological features of glioma patients. The electronic searches were performed through the database of PubMed, MEDLINE, Embase, and CNKI. In total, this meta-analysis included 14 studies covering 897 nestin + cases and 704 controls. The correlation between nestin expression and clinicopathological or prognostic parameters was evaluated by Stata 11.0 software. Our results showed that nestin protein abundance was significantly correlated with the histological grade [odds ratio (OR) = 4.36, 95 % confidence interval (CI) = 2.14-8.88, P = 0.003] of glioma. With respect to prognosis, nestin expression was positively correlated with overall survival (OS) [hazard ratio (HR) = 1.98, 95 % CI = 1.30-3.02, P = 0.000] and progression-free survival (PFS) (HR = 1.90, 95 % CI = 1.18-3.07, P = 0.040). The further stratified analysis not only defined the predictive function of nestin in different ages but also revealed that different antibodies did not alter the positive outcomes and higher standard cutoff values were more suitable for the accurate assay of nestin. Taken together, our results indicate that nestin may play an important role in the prediction of the clinicopathology and poor prognosis of glioma patients. This study should be taken into consideration in the development of new diagnostic and therapeutic programs.

Three-dimensional cell culture: A powerful tool in tumor research and drug discovery.

In previous years, three-dimensional (3D) cell culture technology has become a focus of research in tumor cell biology, using a variety of methods and materials to mimic the in vivo microenvironment of cultured tumor cells ex vivo. These 3D tumor cells have demonstrated numerous different characteristics compared with traditional two-dimensional (2D) culture. 3D cell culture provides a useful platform for further identifying the biological characteristics of tumor cells, particularly in the drug sensitivity area of the key points of translational medicine. It promises to be a bridge between traditional 2D culture and animal experiments, and is of great importance for further research in the field of tumor biology. In the present review, previous 3D cell culture applications, focusing on anti-tumor drug susceptibility testing, are summarized.

Exhaled gases online measurements for esophageal cancer patients and healthy people by proton transfer reaction mass spectrometry.

BACKGROUND: Esophageal cancer is a prevalent malignancy. There is a considerable demand for developing a fast and noninvasive method to screen out the suspect esophageal cancer patients who may undergo further clinical diagnosis. METHODS: The exhaled breathes from 29 esophageal cancer patients and 57 healthy people were directly measured using our home-made proton transfer reaction mass spectrometer (PTR-MS). Mann-Whitney U test and stepwise discriminant analysis were applied to identify the ions in the breath mass spectral data which can distinguish cancer cohort from healthy group. Receiver operating characteristics (ROC) analysis was also performed. RESULTS: Seven kinds of ions in the breath mass spectrum, viz., m/z 136, m/z 34, m/z 63, m/z 27, m/z 95, m/z 107 and m/z 45, have been found to distinguish between the esophageal cancer patients and healthy people with a sensitivity of 86.2% and a specificity of 89.5%, respectively. Compared with that from the healthy people, the breath mass spectra from esophageal cancer patients show that the mediant intensities of five kinds of ions were decrease and the rest two kinds of ions were increase. ROC analysis gave the area under the curve (AUC) of 0.943. CONCLUSIONS: This pilot study shows that the ionic characteristics of exhaled VOCs detected by PTR-MS may be used to differentiate between the esophageal cancer patients and the healthy people. Although the breath tests for more patients are needed to confirm such results, the present work indicates that the PTR-MS may be a promising method in the esophageal cancer screening.

Iris metastasis from esophageal squamous cell carcinoma: A case report.

Carcinoma metastatic to the eye is a rare condition, typically associated with a poor prognosis. Breast and lung cancers are the most common sources of intraocular metastases, and the majority of metastatic lesions involve the posterior uvea, with <8% of reported cases arising in the iris. Intraocular metastasis as the presenting form of esophageal carcinoma is highly uncommon. In the present report, a rare case of metastatic iris tumor resulting from esophageal squamous cell carcinoma is discussed. A 64-year-old patient presented with a progressively distending pain in the right eye, with associated blurred vision. Local and systemic evaluation was performed, followed by treatment. Multiple examinations identified a neoplasm in the right iris and postoperative pathology revealed that the iris lesion was a metastasis of esophageal squamous cell cancer origin. The patient was treated with adjuvant radiation. To the best of our knowledge, this was only the second reported case of esophageal squamous cell carcinoma metastasizing to the iris.

[Clinical control of different sequential order of three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for portal vein tumor thrombus in patients with hepatocellular carcinoma].

OBJECTIVE: To study the influence of the sequence of three-dimensional conformal radiotherapy (3DCRT) and transcatheter arterial chemoembolization (TACE) on the efficacy and toxicity of treatment in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). METHODS: A total of 65 patients who were diagnosed with primary HCC with PVTT were enrolled in the study from November 2008 to March 2012 and were randomly divided into the following two groups:group A,32 patients treated with 3DCRT followed by TACE; group B,33 patients treated with TACE followed by 3DCRT. RESULTS: The total efficacy rates of groups A and B were 68.8% and 69.7% (x² =0.232, P < 0.793). The survival rates,effective percentage of PVTT and AFP remission rates were not significantly different between group A and group B.The exacerbation rate of liver function was significantly higher for group B than for group A (P < 0.05). No serious complication was found in the follow-up period for either group. CONCLUSION: The combination of 3DCRT and TACE is a relatively effective local treatment for patients with primary HCC and PVTT.Compared with TACE followed by 3DCRT, 3DCRT followed by TACE may have a negative influence on liver function.