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1.
Surg Clin North Am ; 103(1): 187-199, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36410350

RESUMO

Radiation treatment is a well-established component of breast cancer treatment, in both breast conservation and also for many patients who have had mastectomy as well as those with metastatic disease. The basis for this was established in multiple large meta-analyses, and multiple modern studies have further defined the role of radiation. The radiation must be delivered to the area at risk, which can include the partial breast, whole breast, chest wall, and/or regional lymph nodes. There are a number of acceptable radiation treatment techniques and dose-fractionation schedules that can be individualized to each patient. Radiation can also play an important role in patients with metastatic cancer.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Mastectomia/métodos , Linfonodos/patologia
2.
Genes Chromosomes Cancer ; 62(1): 39-46, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35716171

RESUMO

Ependymal tumors are the third most common brain tumor under 14 years old. Even though metastatic disease is a rare event, it affects mostly young children and carries an adverse prognosis. The factors associated with dissemination and the best treatment approach have not yet been established and there is limited published data on how to manage metastatic disease, especially in patients under 3 years of age. We provide a review of the literature on clinical characteristics and radiation-sparing treatments for metastatic ependymoma in children under 3 years of age treated. The majority (73%) of the identified cases were above 12 months old and had the PF as the primary site at diagnosis. Chemotherapy-based approaches, in different regimens, were used with radiation reserved for progression or relapse. The prognosis varied among the studies, with an average of 50%-58% overall survival. This study also describes the case of a 7-month-old boy with metastatic posterior fossa (PF) ependymoma, for whom we identified a novel SPECC1L-RAF1 gene fusion using a patient-centric comprehensive molecular profiling protocol. The patient was successfully treated with intensive induction chemotherapy followed by high-dose chemotherapy and autologous hematopoietic progenitor cell rescue (AuHSCR). Currently, the patient is in continuous remission 5 years after his diagnosis, without radiation therapy. The understanding of the available therapeutic approaches may assist physicians in their management of such patients. This report also opens the perspective of newly identified molecular alterations in metastatic ependymomas that might drive more chemo-sensitive tumors.


Assuntos
Neoplasias Encefálicas , Ependimoma , Transplante de Células-Tronco Hematopoéticas , Criança , Masculino , Humanos , Pré-Escolar , Lactente , Adolescente , Recidiva Local de Neoplasia , Ependimoma/tratamento farmacológico , Ependimoma/genética , Ependimoma/radioterapia , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/diagnóstico
3.
Adv Wound Care (New Rochelle) ; 12(2): 68-84, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35951024

RESUMO

Significance: Laser use has become part of the gold standard of treatment as an effective adjuvant in multimodal therapy for pathologic scarring caused by burns, trauma, acne, and surgery, as well as vascular anomalies. Understanding indications and applications for laser therapy is essential for physicians to improve patient outcomes. Recent Advances: Since the 1980s, the medical use of lasers has continuously evolved with improvements in technology. Novel lasers and fractionated technologies are currently being studied in the hopes to improve treatment efficacy, while reducing complications. Recent advancements include acne treatment with novel picosecond lasers, new hypertrophic scar therapies with simultaneous laser and intense pulsed light use, and novel systems such as lasers with intralesional optical fiber delivery devices. In addition, optimizing the timing of laser therapy and its use in multimodal treatments continue to advance the field of photothermolysis. Critical Issues: Selecting the correct laser for a given indication is the fundamental decision when choosing a laser balancing effective treatment with minimal complications. This article covers the principles of laser therapy, the preferred lasers used for the treatment of scarring and vascular anomalies, and discusses the current evidence behind these laser choices. Future Directions: To optimize laser therapy, larger randomized control trials and split scar studies are needed. Continued advancement through better randomized controlled studies will help to improve patient outcomes on a broader scale.


Assuntos
Acne Vulgar , Cicatriz Hipertrófica , Terapia a Laser , Terapia com Luz de Baixa Intensidade , Doenças Vasculares , Malformações Vasculares , Humanos , Cicatriz Hipertrófica/radioterapia , Cicatriz Hipertrófica/cirurgia , Acne Vulgar/complicações , Acne Vulgar/cirurgia , Resultado do Tratamento , Doenças Vasculares/complicações , Doenças Vasculares/cirurgia , Malformações Vasculares/cirurgia , Malformações Vasculares/complicações
4.
Anticancer Res ; 42(4): 2095-2104, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35347033

RESUMO

BACKGROUND/AIM: The standard of treatment for esophageal cancer with adjacent organ invasion (T4) has not been established. We retrospectively analyzed the clinical outcomes of radiotherapy (RT) in elderly and younger patients with T4 esophageal cancer. PATIENTS AND METHODS: Sixty-nine patients with T4 esophageal cancer who underwent RT at the Kanagawa Cancer Center between January 2014 and November 2020 were included in this study. Patients aged ≥70 years were defined as the elderly group and those aged <70 years were defined as the younger group. The total dose of RT was set at 60 Gy in 30 fractions. Chemotherapy combined with 5-fluorouracil and cisplatin was administered concurrently with RT in general. The overall survival (OS) rate was estimated using the Kaplan-Meier method. Adverse events were assessed using CTCAE v4.0. RESULTS: The median survival time (MST) of the elderly group (n=35) was 21.5 months, and the OS rates at 1, 3, and 5 years were 63.7%, 31.3%, and 15.6%, respectively. The MST of the younger group (n=34) was 12.5 months, and the OS rates at 1, 3, and 5 years were 52.2%, 29.4%, and 29.4%, respectively. No significant difference in OS was observed between the two groups (p=0.767). Toxicities were not significantly different between the two groups except for thrombocytopenia and esophageal fistula (p=0.012 and p=0.022, respectively). CONCLUSION: The clinical outcomes of RT for T4 esophageal cancer in elderly patients were generally similar to those in the younger group.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Idoso , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/métodos , Cisplatino/efeitos adversos , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Humanos , Estudos Retrospectivos
5.
Anticancer Res ; 42(5): 2657-2663, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35489760

RESUMO

BACKGROUND/AIM: Many head-and-neck cancer patients receive radiotherapy, which may be associated with significant toxicities. Xerostomia is considered one of the most debilitating late adverse events. This study was performed to identify risk factors for xerostomia. PATIENTS AND METHODS: Several characteristics were investigated for associations with late xerostomia in 159 patients irradiated for head-and-neck cancer including age, sex, tumor site and size, underlying pathology, histologic grading, upfront resection, systemic treatment, and type and dose of radiotherapy. RESULTS: Ninety (57%) and 35 (22%) patients experienced grade ≥2 and ≥3 xerostomia, respectively. Grade ≥2 xerostomia was significantly associated with tumor site (nasopharynx/oropharynx/oral cavity/floor of mouth, p=0.049). Grade ≥3 xerostomia was significantly associated with age ≥61 years (p=0.035); trends were found for tumor site (p=0.088), bilateral nodal involvement (p=0.093), definitive treatment (p=0.082), and systemic treatment (p=0.055). CONCLUSION: Risk factors for xerostomia following radiotherapy of head-and-neck cancers were identified including older age, unfavorable tumor site, bilateral involvement of lymph nodes, definitive treatment, and addition of systemic therapies. For patients with risk factors, sparing of the salivary glands is particularly important.


Assuntos
Neoplasias de Cabeça e Pescoço , Xerostomia , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Glândulas Salivares , Xerostomia/epidemiologia , Xerostomia/etiologia
6.
J Vis Exp ; (188)2022 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-36342149

RESUMO

The aim of this study was to explore the use of hyperbaric oxygen to enhance the radiosensitivity of human glioma cells. Sub-cultured U251 human glioma cells were randomly divided into four groups: an untreated control group, cells treated with hyperbaric oxygen (HBO) only, cells treated with X-ray irradiation (X-ray) only, and cells treated with both HBO and X-ray. Cell morphology, cell proliferation activity, cell cycle distribution, and apoptosis were observed in these groups to evaluate the role of HBO in improving the radiosensitivity of glioma cells. With the increase in X-ray doses (0 Gy, 2 Gy, 4 Gy, 6 Gy, 8 Gy), the survival fraction (SF) of glioma cells gradually decreased. Significantly lower SF was observed for the cells treated with the HBO and X-ray together than in the X-ray group for each dose (all P < 0.05). The proliferation inhibition was significantly higher in the HBO combined with X-ray group than in the X-ray group for each dose (all P < 0.05) for the U251 cell line. The percentage of G2/M phase cells was significantly higher in the HBO combined with X-ray (2 Gy) group (26.70% ± 2.46%) and the HBO group (22.36% ± 0.91%) than in the control group (11.56% ± 2.01%) and X-ray (2 Gy) group (10.35% ± 2.69%) (all P < 0.05). U251 cell apoptosis was significantly higher in the HBO combined with X-ray (2 Gy) group than in the HBO group, the X-ray (2 Gy) group, and the control group (all P < 0.05). We conclude that HBO can enhance the proliferation inhibition and apoptosis of glioma U251 cells by blocking glioma cells in the G2/M phase and improve the radiosensitivity of U251 glioma cells.


Assuntos
Glioma , Oxigenoterapia Hiperbárica , Radiossensibilizantes , Humanos , Linhagem Celular Tumoral , Glioma/radioterapia , Glioma/metabolismo , Radiossensibilizantes/farmacologia , Tolerância a Radiação , Apoptose , Oxigênio
7.
Cancer Biol Ther ; 23(1): 1-13, 2022 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-36329030

RESUMO

Radiation resistance poses a major clinical challenge in breast cancer (BC) treatment, but little is known about how long noncoding RNA (lncRNA) may regulate this phenomenon. Here, we reported that DUXAP8 was highly expressed in radioresistant BC tissues, and high expression of DUXAP8 was associated with poor prognosis. We found that the overexpression of DUXAP8 promoted radioresistance, while the knockdown of DUXAP8 expression increased radiosensitivity. Further studies revealed that DUXAP8 enhanced the radioresistance of BC cells by activating the PI3K/AKT/mTOR pathway and by repressing the expression of E-cadherin and RHOB through interaction with EZH2. Together, our work demonstrates that the overexpression of DUXAP8 promotes the resistance of BC cells toward radiation through modulating PI3K/AKT/mTOR pathway and EZH2-E-cadherin/RHOB axis. Targeting DUXAP8 may serve as a potential strategy to overcome radioresistance in BC treatment.


Assuntos
Neoplasias da Mama , RNA Longo não Codificante , Humanos , Feminino , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Neoplasias da Mama/genética , Neoplasias da Mama/radioterapia , Transdução de Sinais , Linhagem Celular Tumoral , Apoptose , Serina-Treonina Quinases TOR/metabolismo , Caderinas/genética , Proliferação de Células , Proteína Potenciadora do Homólogo 2 de Zeste/genética , Proteína Potenciadora do Homólogo 2 de Zeste/metabolismo
8.
Sci Rep ; 12(1): 18631, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36329116

RESUMO

Real-time magnetic resonance image guided stereotactic ablative radiotherapy (MRgSBRT) is used to treat abdominal tumors. Longitudinal data is generated from daily setup images. Our study aimed to identify delta radiomic texture features extracted from these images to predict for local control in patients with liver tumors treated with MRgSBRT. Retrospective analysis of an IRB-approved database identified patients treated with MRgSBRT for primary liver and secondary metastasis histologies. Daily low field strength (0.35 T) images were retrieved, and the gross tumor volume was identified on each image. Next, images' gray levels were equalized, and 39 s-order texture features were extracted. Delta-radiomics were calculated as the difference between feature values on the initial scan and after delivered biological effective doses (BED, α/ß = 10) of 20 Gy and 40 Gy. Then, features were ranked by the Gini Index during training of a random forest model. Finally, the area under the receiver operating characteristic curve (AUC) was estimated using a bootstrapped logistic regression with the top two features. We identified 22 patients for analysis. The median dose delivered was 50 Gy in 5 fractions. The top two features identified after delivery of BED 20 Gy were gray level co-occurrence matrix features energy and gray level size zone matrix based large zone emphasis. The model generated an AUC = 0.9011 (0.752-1.0) during bootstrapped logistic regression. The same two features were selected after delivery of a BED 40 Gy, with an AUC = 0.716 (0.600-0.786). Delta-radiomic features after a single fraction of SBRT predicted local control in this exploratory cohort. If confirmed in larger studies, these features may identify patients with radioresistant disease and provide an opportunity for physicians to alter management much sooner than standard restaging after 3 months. Expansion of the patient database is warranted for further analysis of delta-radiomic features.


Assuntos
Neoplasias Hepáticas , Radiocirurgia , Humanos , Radiocirurgia/métodos , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Curva ROC , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/radioterapia , Neoplasias Hepáticas/etiologia
9.
BMC Cancer ; 22(1): 1167, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36368974

RESUMO

BACKGROUND: The goal of research was to investigate the possible relations between serum concentrations of IL-6 and TGF-ß1, individual and clinical characteristics, and adverse effects of radiotherapy in patients with prostate cancer: acute and late genitourinary and gastrointestinal toxicity, and fatigue. METHODS: Thirty-nine patients with localized or locally advanced prostate cancer who were treated with radiotherapy were enrolled in this study. The acute radiotoxicity grades and fatigue levels were assessed during the radiotherapy and 1 month after the radiotherapy. Estimation of the late radiotoxicity was performed every three months in the first year, every four months in the second year, and then every six months. Serum levels of IL-6 and TGF-ß1 were determined before radiotherapy and after the 25th radiotherapy fraction by ELISA. RESULTS: The significant positive association between diabetes mellitus and changes in acute genitourinary toxicity grades during the radiotherapy was observed in prostate cancer patients. In addition, patients who were smokers had significantly higher maximum fatigue levels in comparison with patients who were non-smokers. The circulating IL-6 levels were significantly higher after the 25th radiotherapy fraction in comparison with levels determined before radiotherapy. The significant positive correlations between pretreatment TGF-ß1 levels and maximum genitourinary toxicity grades and between TGF-ß1 levels after the 25th fraction and genitourinary toxicity grades after the 25th fraction, were found. The pretreatment IL-6 concentrations and TGF-ß1 concentrations after the 25th fraction were positively correlated with maximum genitourinary toxicity grades. The IL-6 levels after the 25th fraction were positively associated with genitourinary toxicity grades after this fraction. The pretreatment IL-6 concentrations were significantly positively correlated with maximum fatigue scores. The significant positive correlation between IL-6 concentrations and fatigue scores after the 25th fraction was determined. The positive correlations between IL-6 and TGF-ß1 concentrations measured after the 25th fraction and maximum fatigue scores were observed. CONCLUSIONS: Our results suggest that serum levels of IL-6 and TGF-ß1 might influence the severity of acute genitourinary radiotoxicity and fatigue in patients with prostate cancer. Combining clinical parameters and circulating cytokine levels might be useful for the prediction of adverse reactions to radiotherapy.


Assuntos
Neoplasias da Próstata , Fator de Crescimento Transformador beta1 , Masculino , Humanos , Interleucina-6 , Neoplasias da Próstata/radioterapia , Sistema Urogenital , Fadiga/etiologia
10.
J Transl Med ; 20(1): 524, 2022 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371220

RESUMO

OBJECTIVE: This paper intends to propose a method of using TransResSEUnet2.5D network for accurate automatic segmentation of the Gross Target Volume (GTV) in Radiotherapy for lung cancer. METHODS: A total of 11,370 computed tomograms (CT), deriving from 137 cases, of lung cancer patients under radiotherapy developed by radiotherapists were used as the training set; 1642 CT images in 20 cases were used as the validation set, and 1685 CT images in 20 cases were used as the test set. The proposed network was tuned and trained to obtain the best segmentation model and its performance was measured by the Dice Similarity Coefficient (DSC) and with 95% Hausdorff distance (HD95). Lastly, as to demonstrate the accuracy of the automatic segmentation of the network proposed in this study, all possible mirrors of the input images were put into Unet2D, Unet2.5D, Unet3D, ResSEUnet3D, ResSEUnet2.5D, and TransResUnet2.5D, and their respective segmentation performances were compared and assessed. RESULTS: The segmentation results of the test set showed that TransResSEUnet2.5D performed the best in the DSC (84.08 ± 0.04) %, HD95 (8.11 ± 3.43) mm and time (6.50 ± 1.31) s metrics compared to the other three networks. CONCLUSIONS: The TransResSEUnet 2.5D proposed in this study can automatically segment the GTV of radiotherapy for lung cancer patients with more accuracy.


Assuntos
Neoplasias Pulmonares , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Processamento de Imagem Assistida por Computador/métodos
11.
Radiat Oncol ; 17(1): 178, 2022 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371225

RESUMO

RATIONALE: This systematic review aims to synthesise the outcomes of different strategies of incorporating functional biological markers in the radiation therapy plans of patients with glioblastoma to support clinicians and further research. METHODS: The systematic review protocol was registered on PROSPERO (CRD42021221021). A structured search for publications was performed following PRISMA guidelines. Quality assessment was performed using the Newcastle-Ottawa Scale. Study characteristics, intervention methodology and outcomes were extracted using Covidence. Data analysis focused on radiation therapy target volumes, toxicity, dose distributions, recurrence and survival mapped to functional image-guided radiotherapy interventions. RESULTS: There were 5733 citations screened, with 53 citations (n = 32 studies) meeting review criteria. Studies compared standard radiation therapy planning volumes with functional image-derived volumes (n = 20 studies), treated radiation therapy volumes with recurrences (n = 15 studies), the impact on current standard target delineations (n = 9 studies), treated functional volumes and survival (n = 8 studies), functionally guided dose escalation (n = 8 studies), radiomics (n = 4 studies) and optimal organ at risk sparing (n = 3 studies). The approaches to target outlining and dose escalation were heterogeneous. The analysis indicated an improvement in median overall survival of over two months compared with a historical control group. Simultaneous-integrated-boost dose escalation of 72-76 Gy in 30 fractions appeared to have an acceptable toxicity profile when delivered with inverse planning to a volume smaller than 100 cm[Formula: see text]. CONCLUSION: There was significant heterogeneity between the approaches taken by different study groups when implementing functional image-guided radiotherapy. It is recommended that functional imaging data be incorporated into the gross tumour volume with appropriate technology-specific margins used to create the clinical target volume when designing radiation therapy plans for patients with glioblastoma.


Assuntos
Glioblastoma , Radioterapia de Intensidade Modulada , Humanos , Glioblastoma/diagnóstico por imagem , Glioblastoma/radioterapia , Glioblastoma/tratamento farmacológico , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Neuroimagem Funcional
12.
Zhonghua Zhong Liu Za Zhi ; 44(11): 1175-1185, 2022 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-36380666

RESUMO

Objective: To study the effect of circ-WHSC1 on the growth, metastasis and radiosensitivity of nasopharyngeal carcinoma cells and its molecular mechanism. Methods: Cancerous tissues and adjacent tissues were collected from 23 patients with nasopharyngeal carcinoma, and real-time fluorescent quantitative PCR (RT-qPCR) was used to detect the expression levels of circ-WHSC1, miR-338-3p, and ELAVL1 mRNA. Western blot was used to detect the expression of ELAVL1 protein. Nasopharyngeal carcinoma cells 5-8F and SUNE1 were divided into si-NC group, si-circ-WHSC1 group, pCD5-ciR group, circ-WHSC1 group, anti-miR-NC group, anti-miR-338-3p group, miR-NC group, miR-338-3p group, si-circ-WHSC1+ anti-miR-NC group, si-circ-WHSC1+ anti-miR-338-3p group, miR-338-3p+ pcDNA group, miR-338-3p+ ELAVL1 group. Tetramethylazolium salt colorimetric method (MTT) was used to detect cell viability. Clone formation test was used to detect cell clone formation and cell radiosensitivity. Flow cytometry was used to detect cell apoptosis. Transwell was used to detect cell migration and invasion. Dual luciferase assay was used to detect the targeting relationship between circ-WHSC1 and miR-338-3p, miR-338-3p and ELAVL1. The SUNE1 cells stably transfected with sh-circ-WHSC1 were injected into nude mice and irradiated with radiation, and then the tumor volume and weight of mice were detected. Results: The expressions of circ-WHSC1 (1.57±0.94 vs 3.78±1.18, 1.00±0.10 vs 1.64±0.14/2.00±0.21/2.81±0.26/3.36±0.34) and ELAVL1 (1.28±0.74 vs 3.36±0.77, 1.00±0.08 vs 2.51±0.19/3.27±0.27) in nasopharyngeal carcinoma tissues and cells were increased, and the expression of miR-338-3p (3.13±0.96 vs 1.37±0.98, 1.00±0.08 vs 0.48±0.08/0.38±0.07) was decreased (P<0.05). After knockdown of circ-WHSC1, the activity of nasopharyngeal carcinoma cells was decreased [(100.00±8.00)% vs (51.33±8.62)%, (100.00±10.10)% vs (41.02±7.31)%], the number of clone-forming cells was decreased (101.00±8.54 vs 50.33±8.02, 114.00±14.10 vs 42.33±10.01), the rate of apoptosis was increased [(5.37±1.20)% vs (18.3±1.01)%, (6.5±1.18)% vs (22.43±1.40)%], and the numbers of migration (136.00±13.00 vs 72.33±9.50, 154.00±14.10 vs 62.67±11.50) and invasion (113.67±11.59 vs 60.67±9.07, 124.33±15.57 vs 50.33±9.01) were decreased; after different doses of radiation, the cell survival score was decreased (0.23±0.04 vs 0.06±0.01, 0.32±0.07 vs 0.05±0.02) (P<0.05). Circ-WHSC1 targeted and negatively regulated miR-338-3p. Inhibition of miR-338-3p affected the effect of knockdown of circ-WHSC1 on the proliferation, apoptosis, migration, invasion and radiosensitivity of nasopharyngeal carcinoma cells. MiR-338-3p targeted and negatively regulated ELAVL1; ELAVL1 overexpression affected the effects of miR-338-3p on the proliferation, apoptosis, migration, invasion and radiosensitivity of nasopharyngeal carcinoma cells. After the cells stably transfected with sh-circ-WHSC1 were injected into nude mice, the tumor volume [(884.67±95.63)mm(3) vs (487.33±76.51)mm(3)] and weight [(899.01±88.54)mg vs (558.67±75.04) mg] of the nude mice were reduced; after further irradiation, the tumor volume [(395.00±73.50)mm(3) vs 243.13±42.51)mm(3)] and weight[ (452.33±67.30)mg vs (211.09±57.51)mg] of the nude mice were reduced (P<0.05). Circ-WHSC1 regulated the expression of ELAVL1 by targeting miR-382. Conclusion: Knockdown of circ-WHSC1 can inhibit the growth and metastasis of nasopharyngeal carcinoma cells by targeting miR-338-3p/ELAVL1 axis, and enhances the radiosensitivity of nasopharyngeal carcinoma cells.


Assuntos
MicroRNAs , Neoplasias Nasofaríngeas , Camundongos , Animais , Carcinoma Nasofaríngeo/genética , Carcinoma Nasofaríngeo/radioterapia , Camundongos Nus , MicroRNAs/genética , Antagomirs , Linhagem Celular Tumoral , Tolerância a Radiação/genética , Neoplasias Nasofaríngeas/genética , Neoplasias Nasofaríngeas/radioterapia , Neoplasias Nasofaríngeas/patologia , Proliferação de Células/genética , Regulação Neoplásica da Expressão Gênica
13.
Dis Colon Rectum ; 65(12): 1494-1502, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36382840

RESUMO

BACKGROUND: Despite short-course radiation and chemotherapy gaining popularity because of similar or better oncological outcomes, functional outcomes relative to long-course radiation have not been evaluated. OBJECTIVE: To compare bowel function outcomes after long-course or short-course radiation and delayed operation for advanced rectal cancers. DESIGN: Propensity-matched analysis. SETTINGS: This study was conducted at a single tertiary cancer center. Patients were operated on between 2014 and 2020. PATIENTS: The study included patients with locally advanced, nonmetastatic, mid, and low rectal cancers who underwent low anterior resection with stapled anastomosis and diverting ostomy. Extended or beyond total mesorectal excisions and lateral node dissections were excluded. INTERVENTIONS: Long-course radiation delivered as a radiation dose of 50 Gy in 25 fractions or short-course radiation (5 Gy in 5 fractions) and delayed surgery after 4 to 6 weeks with or without chemotherapy. MAIN OUTCOME MEASURES: One-time assessment of low anterior resections syndrome and Wexner incontinence scores at least 6 months after stoma reversal. RESULTS: After matching 124 patients in the 1:2 ratio between short- and long-course radiations, 93 patients were included for analysis. Any low anterior resection syndrome was found in 90.3% of short-course patients compared to 54.8% after long-course radiation (p < 0.001). Major incontinence was detected in 6.5% after short-course radiation as opposed to 8.1% of patients after long-course radiation (p = 0.781). On multivariate logistic regression, short-course radiation predicted the development of any low anterior resection syndrome with an OR of 4.4. LIMITATIONS: Selection and misclassification biases from retrospective recruitment. CONCLUSIONS: For patients with locally advanced, nonmetastatic, mid, and low rectal cancers who underwent preoperative radiation followed by stapled low anterior resection, short-course radiation had higher probability of developing low anterior resection syndrome than long-course radiation. See Video Abstract at http://links.lww.com/DCR/C37. RESULTADOS DE LA FUNCIN INTESTINAL DESPUS DE LA RADIACIN DE CICLO LARGO O CORTO EN CNCER DE RECTO AVANZADO UN ANLISIS EMPAREJADO DE PROPENSIN: ANTECEDENTES:A pesar de que la radiación de corta duración y la quimioterapia están ganando popularidad debido a resultados oncológicos similares o mejores, los resultados funcionales en relación con la radiación de larga duración no han sido evaluado.OBJETIVO:Comparar resultados de la función intestinal después de la radiación de ciclo largo o corto y cirugía diferida para los en cáncer de recto avanzado.DISEÑO:Análisis emparejado de propensión.ENTORNO CLINICO:Centro único de cáncer terciario. Pacientes operados entre 2014 y 2020.PACIENTES:Cánceres de recto medio y bajo localmente avanzados, no metastásicos, que se sometieron a resección anterior baja con anastomosis grapada y ostomía de derivación. Se excluyeron las escisiones total de mesorecto extendidas o más allá del plano y las disecciones de los ganglios laterales.INTERVENCIONES:Radiación de ciclo largo administrada como 50 Gy en 25 fracciones o radiación de ciclo corto (5 Gy en 5 fracciones) y cirugía diferida después de 4 a 6 semanas con o sin quimioterapia.PRINCIPALES MEDIDAS DE RESULTADO:Evaluación única del síndrome de reseccion anterior baja y escala de Wexner de incontinencia al menos seis meses después de la restitución del tránsito intestinal.RESULTADOS:Después de emparejar 124 pacientes en la proporción 1:2 entre radiación de ciclo corto y largo, se incluyeron 93 pacientes para el análisis. Se encontró cualquier síndrome de resección anterior baja en el 90,3% de los pacientes de ciclo corto en comparación con el 54,8% después de la radiación de ciclo largo (p < 0,001). Se detectó incontinencia grave en el 6,5% después de un tratamiento de corta duración frente al 8,1% de los pacientes que recibieron un tratamiento de radiación de larga duración (p = 0,781). En la regresión logística multivariable, la radiación de corta duración predijo el desarrollo de cualquier síndrome de resección anterior baja con una probabilidad de 4,4.LIMITACIONES:Sesgos de selección y clasificación errónea de reclutamiento retrospectivo.CONCLUSIONES:Para los cánceres de recto medio e inferior localmente avanzados, no metastásicos, que se sometieron a radiación preoperatoria seguida de resección anterior baja con grapas, curso corto tuvo una mayor probabilidad de desarrollar síndrome de resección anterior baja en comparación con radiación de curso largo. Consulte Video Resumen en http://links.lww.com/DCR/C37. (Traducción- Dr. Francisco M. Abarca-Rendon).


Assuntos
Protectomia , Neoplasias Retais , Humanos , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Neoplasias Retais/patologia , Estudos Retrospectivos , Complicações Pós-Operatórias , Síndrome
14.
Rev Med Suisse ; 18(804): 2134-2142, 2022 Nov 16.
Artigo em Francês | MEDLINE | ID: mdl-36382973

RESUMO

Despite technical improvements concerning lung irradiation modalities, radiation-induced pneumonitis remains a usual complication, notably in the field of lung cancer treatment. This complication may remain asymptomatic but can also lead to respiratory distress. Thus, a low degree of suspicion and a comprehensive work-up is mandatory to evaluate the indication for specific treatment. In this article, we discuss the hypothesized pathophysiologic pathways, risk factors, clinical/radiological presentation and management.


Malgré les améliorations des techniques d'irradiation à l'étage thoracique, la pneumopathie radique (PpR) reste une complication fréquente, en particulier dans le cadre du traitement du cancer pulmonaire. Cette complication, qu'elle soit précoce ou tardive, peut demeurer silencieuse ou causer une détresse respiratoire potentiellement fatale. C'est pourquoi un faible degré de suspicion est nécessaire, de manière à débuter précocement un bilan d'investigation et décider de l'indication à un traitement spécifique. Dans cet article, nous discutons des hypothèses pathophysiologiques qui sous-tendent la PpR, des facteurs de risque de survenue, de la présentation clinique et radiologique, ainsi que de sa prise en charge.


Assuntos
Neoplasias Pulmonares , Pneumonia , Pneumonite por Radiação , Humanos , Pneumonite por Radiação/diagnóstico , Pneumonite por Radiação/epidemiologia , Pneumonite por Radiação/etiologia , Neoplasias Pulmonares/radioterapia , Pulmão , Fatores de Risco , Pneumonia/diagnóstico , Pneumonia/epidemiologia , Pneumonia/etiologia
15.
Braz Oral Res ; 36: e132, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36383838

RESUMO

There are divergences among studies regarding features associated to increased risk of osteoradionecrosis (ORN). Our objective was to identify factors that predispose to the development of ORN of the jaw. This was a retrospective, hospital-based, case-control study involving patients with head and neck cancer who had been treated with ≥ 60 Gy external radiotherapy (RT) to the jaw. A total of 19 cases of ORN and 43 controls were included. The patients' demographic data, tumor type, staging, treatment and outcome information, and pre-treatment oral status were collected. Univariate analysis showed that the oral cavity/oropharynx sites were associated with 9.77-fold increased risk of ORN development compared to other sites (p = 0.005). Being an active smoker was associated with 3.95-fold increased risk of ORN development (p = 0.01). A tendency towards increased risk of ORN was observed particularly when tooth extraction occurred after RT (odds ratio (OR): 3.04; p = 0.08). Multivariable analysis showed that tumor site was the only significant risk factor (OR: 21.03, p = 0.01). The oral and oropharyngeal primary site is an important risk factor for ORN. Dental extraction, which did not occur in 28% of the sample, was not an essential event for ORN development.


Assuntos
Neoplasias de Cabeça e Pescoço , Osteorradionecrose , Humanos , Osteorradionecrose/epidemiologia , Osteorradionecrose/etiologia , Estudos de Casos e Controles , Estudos Retrospectivos , Neoplasias de Cabeça e Pescoço/radioterapia , Fatores de Risco
16.
Sci Rep ; 12(1): 19730, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36396802

RESUMO

This retrospective, single-institutional study investigated long-term outcome, toxicity and health-related quality of life (HRQoL) in meningioma patients after radiotherapy. We analyzed the data of 119 patients who received radiotherapy at our department from 1997 to 2014 for intracranial WHO grade I-III meningioma. Fractionated stereotactic radiotherapy (FSRT), intensity modulated radiotherapy (IMRT) or radiosurgery radiation was applied. The EORTC QLQ-C30 and QLQ-BN20 questionnaires were completed for assessment of HRQoL. Overall survival (OS) for the entire study group was 89.6% at 5 years and 75.9% at 10 years. Local control (LC) at 5 and 10 years was 82.4% and 73.4%, respectively. Local recurrence was observed in 22 patients (18.5%). Higher grade acute and chronic toxicities were observed in seven patients (5.9%) and five patients (4.2%), respectively. Global health status was rated with a mean of 59.9 points (SD 22.3) on QLQ-C30. In conclusion, radiotherapy resulted in very good long-term survival and tumor control rates with low rates of severe toxicities but with a deterioration of long-term HRQoL.


Assuntos
Neoplasias Meníngeas , Meningioma , Humanos , Meningioma/radioterapia , Meningioma/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários , Neoplasias Meníngeas/radioterapia , Neoplasias Meníngeas/cirurgia
17.
Radiat Oncol ; 17(1): 188, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397060

RESUMO

BACKGROUND: This study was designed to establish radiation pneumonitis (RP) prediction models using dosiomics and/or deep learning-based radiomics (DLR) features based on 3D dose distribution. METHODS: A total of 140 patients with non-small cell lung cancer who received stereotactic body radiation therapy (SBRT) were retrospectively included in this study. These patients were randomly divided into the training (n = 112) and test (n = 28) sets. Besides, 107 dosiomics features were extracted by Pyradiomics, and 1316 DLR features were extracted by ResNet50. Feature visualization was performed based on Spearman's correlation coefficients, and feature selection was performed based on the least absolute shrinkage and selection operator. Three different models were constructed based on random forest, including (1) a dosiomics model (a model constructed based on dosiomics features), (2) a DLR model (a model constructed based on DLR features), and (3) a hybrid model (a model constructed based on dosiomics and DLR features). Subsequently, the performance of these three models was compared with receiver operating characteristic curves. Finally, these dosiomics and DLR features were analyzed with Spearman's correlation coefficients. RESULTS: In the training set, the area under the curve (AUC) of the dosiomics, DLR, and hybrid models was 0.9986, 0.9992, and 0.9993, respectively; the accuracy of these three models was 0.9643, 0.9464, and 0.9642, respectively. In the test set, the AUC of these three models was 0.8462, 0.8750, and 0.9000, respectively; the accuracy of these three models was 0.8214, 0.7857, and 0.8571, respectively. The hybrid model based on dosiomics and DLR features outperformed other two models. Correlation analysis between dosiomics features and DLR features showed weak correlations. The dosiomics features that correlated DLR features with the Spearman's rho |ρ| ≥ 0.8 were all first-order features. CONCLUSION: The hybrid features based on dosiomics and DLR features from 3D dose distribution could improve the performance of RP prediction after SBRT.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Aprendizado Profundo , Neoplasias Pulmonares , Pneumonite por Radiação , Radiocirurgia , Humanos , Pneumonite por Radiação/etiologia , Radiocirurgia/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Estudos Retrospectivos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia
19.
Biochem Biophys Res Commun ; 636(Pt 2): 24-30, 2022 Dec 25.
Artigo em Inglês | MEDLINE | ID: mdl-36343487

RESUMO

Although radiotherapy (RT) increases the extra centrosomes of cancer cells compared to normal cells, centrosome clustering of cancer cells with amplified centrosomes ensures bipolar mitosis for cell proliferation in response to RT. Recent evidence suggests that centrosome clustering is a tumor-selective target for improving RT in breast cancer cells. However, whether centrosome de-clustering is involved in the activation of innate immunity in response to RT remains unknown. In this study, we showed that centrosome de-clustering of irradiated cancer cells modulates cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING)-mediated innate immunity in monocytes and macrophages after co-culture. Centrosome de-clustering intensifies mitotic abnormalities and cytosolic dsDNA in breast cancer cells in response to irradiation. Unexpectedly, centrosome de-clustering did not modulate the cGAS-STING signaling pathway in irradiated breast cancer cells. Importantly, centrosome de-clustering activated the cGAS-STING signaling pathway in human monocytes and mouse macrophages after co-culture with irradiated breast cancer cells. Thus, our data provide the first evidence that centrosome de-clustering of irradiated breast cancer cells induces innate immunity in tumor-associated immune cells.


Assuntos
Neoplasias da Mama , Centrossomo , Imunidade Inata , Proteínas de Membrana , Animais , Feminino , Humanos , Camundongos , Neoplasias da Mama/radioterapia , Centrossomo/metabolismo , Proteínas de Membrana/metabolismo , Nucleotidiltransferases/metabolismo
20.
J Hematol Oncol ; 15(1): 165, 2022 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371226

RESUMO

BACKGROUND: The prognosis for metastatic and recurrent tumors of the central nervous system (CNS) remains dismal, and the need for newer therapeutic targets and modalities is critical. The cell surface glycoprotein B7H3 is expressed on a range of solid tumors with a restricted expression on normal tissues. We hypothesized that compartmental radioimmunotherapy (cRIT) with the anti-B7H3 murine monoclonal antibody omburtamab injected intraventricularly could safely target CNS malignancies. PATIENTS AND METHODS: We conducted a phase I trial of intraventricular 131I-omburtamab using a standard 3 + 3 design. Eligibility criteria included adequate cerebrospinal fluid (CSF) flow, no major organ toxicity, and for patients > dose level 6, availability of autologous stem cells. Patients initially received 74 MBq radioiodinated omburtamab to evaluate dosimetry and biodistribution followed by therapeutic 131I-omburtamab dose-escalated from 370 to 2960 MBq. Patients were monitored clinically and biochemically for toxicity graded using CTCAEv 3.0. Dosimetry was evaluated using serial CSF and blood sampling, and serial PET or gamma-camera scans. Patients could receive a second cycle in the absence of grade 3/4 non-hematologic toxicity or progressive disease. RESULTS: Thirty-eight patients received 100 radioiodinated omburtamab injections. Diagnoses included metastatic neuroblastoma (n = 16) and other B7H3-expressing solid tumors (n = 22). Thirty-five patients received at least 1 cycle of treatment with both dosimetry and therapy doses. Acute toxicities included < grade 4 self-limited headache, vomiting or fever, and biochemical abnormalities. Grade 3/4 thrombocytopenia was the most common hematologic toxicity. Recommended phase 2 dose was 1850 MBq/injection. The median radiation dose to the CSF and blood by sampling was 1.01 and 0.04 mGy/MBq, respectively, showing a consistently high therapeutic advantage for CSF. Major organ exposure was well below maximum tolerated levels. In patients developing antidrug antibodies, blood clearance, and therefore therapeutic index, was significantly increased. In patients receiving cRIT for neuroblastoma, survival was markedly increased (median PFS 7.5 years) compared to historical data. CONCLUSIONS: cRIT with 131I-omburtamab is safe, has favorable dosimetry and may have a therapeutic benefit as adjuvant therapy for B7-H3-expressing leptomeningeal metastases. TRIAL REGISTRATION: clinicaltrials.gov NCT00089245, August 5, 2004.


Assuntos
Neoplasias do Sistema Nervoso Central , Neuroblastoma , Humanos , Animais , Camundongos , Distribuição Tecidual , Recidiva Local de Neoplasia/tratamento farmacológico , Anticorpos Monoclonais/efeitos adversos , Neoplasias do Sistema Nervoso Central/radioterapia , Neuroblastoma/radioterapia , Antígenos B7
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