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OBJECTIVE: This study aimed to assess the efficacy and tolerability of stereotactic body radiation therapy (SBRT) for the treatment of liver metastases. METHODS: Patients with up to 5 liver metastases were enrolled in this prospective multicenter study and underwent SBRT. Efficacy outcomes included in-field local control (LC), progression-free survival (PFS), and overall survival (OS). Acute and late toxicities were evaluated using CTCAE v.4.0. RESULTS: A total of 52 patients with 105 liver metastases were treated between 2015 and 2018. The most common primary tumor was colorectal cancer (72% of cases). Liver metastases were synchronous with the primary tumor diagnosis in 24 patients (46.2%), and 21 patients (40.4%) presented with other extrahepatic oligometastases. All patients underwent intensity-modulated radiation therapy (IMRT)/volumetric-modulated arc therapy (VMAT) with image-guided radiation therapy (IGRT) and respiratory gating, and a minimum biologically effective dose (BED10Gy) of 100 Gy was delivered to all lesions. With a median follow-up of 23.1 months (range: 13.4-30.9 months) since liver SBRT, the median actuarial local progression-free survival (local-PFS) was not reached. The actuarial in-field LC rates were 84.9% and 78.4% at 24 and 48 months, respectively. The median actuarial liver-PFS and distant-PFS were 11 and 10.8 months, respectively. The actuarial median overall survival (OS) was 27.7 months from SBRT and 52.5 months from metastases diagnosis. Patients with lesion diameter ≤ 5 cm had significantly better median liver-PFS (p = 0.006) and OS (p = 0.018). No acute or late toxicities of grade ≥ 3 were observed. CONCLUSIONS: This prospective multicenter study confirms that liver SBRT is an effective alternative for the treatment of liver metastases, demonstrating high rates of local control and survival while maintaining a low toxicity profile.
Asunto(s)
Neoplasias Hepáticas , Radiocirugia , Radioterapia de Intensidad Modulada , Humanos , Radiocirugia/métodos , Radiocirugia/efectos adversos , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/radioterapia , Neoplasias Hepáticas/mortalidad , Masculino , Estudios Prospectivos , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto , Radioterapia de Intensidad Modulada/métodos , Supervivencia sin Progresión , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/radioterapia , Neoplasias Colorrectales/mortalidad , Radioterapia Guiada por Imagen , Tasa de SupervivenciaRESUMEN
This review focuses on the combination of metal-organic frameworks (MOFs) and ionic liquids (ILs) to obtain composite materials to be used as solid electrolytes in metal-ion battery applications. Benefiting from the controllable chemical composition, tunable pore structure and surface functionality, MOFs offer great opportunities for synthesizing high-performance electrolytes. Moreover, the encapsulation of ILs into porous materials can provide environmentally benign solid-state electrolytes for electrochemical devices. Due to the versatility of MOF-based materials, in this review we also explore their use as anodes and cathodes in Li- and Na-ion batteries. Finally, solid IL@MOF electrolytes and their implementation into Li and Na batteries have been analyzed, as well as the design and advanced manufacturing of solid IL@MOF electrolytes embedded on polymeric matrices.
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BACKGROUND AND AIM: Radiotherapy (RT) plays a key role in the control of locally advanced non-small cell lung cancer (LA-NSCLC). Throughout the years, different doses and fractionations of RT have been used in an attempt to optimize the results. Recently, special interest has been given to hypofractionation (hypoRT) and stereotactic body radiation therapy (SBRT). HypoRT is a relatively widespread treatment, although the accompanying level of evidence is limited. For its part, SBRT has been used specially to overdose specific areas of the disease as a boost after radiochemotherapy. In both cases, the study of how to integrate these RT tools with chemotherapy and immunotherapy is fundamental. In addition, the 2020 COVID-19 pandemic situation has sparked increased interest in hypofractionated treatments. In this review, we analyze the role of SBRT and hypoRT in the management of LA-NSCLC in accordance with current scientific evidence. RELEVANCE FOR PATIENTS: The objective of this article is to introduce professionals to the role that hypoRT and SBRT can play in the treatment of LA-NSCLC to offer the best treatment to their patients.
