Cerebral Microbleeds Are Associated with Loss of White Matter Integrity

BACKGROUND AND PURPOSE

Previous studies have shown that diffusion tensor imaging suggests a diffuse loss of white matter integrity in people with white matter hyperintensities or lacunes. The purpose of this study was to investigate whether the presence of cerebral microbleeds and their distribution are related to the integrity of white matter microstructures.

MATERIALS AND METHODS

The study comprised 982 participants who underwent brain MR imaging to determine microbleed status. The cross-sectional relation between microbleeds and the microstructural integrity of the white matter was assessed by 2 statistical methods: a multilinear regression model based on the average DTI parameters of normal-appearing white matter and Tract-Based Spatial Statistics analysis, a tract-based voxelwise analysis. Fiber tractography was used to spatially describe the microstructural abnormalities along WM tracts containing a cerebral microbleed.

RESULTS

The presence of cerebral microbleeds was associated with lower mean fractional anisotropy and higher mean diffusivity, axial diffusivity, and radial diffusivity, and the association remained when cardiovascular risk factors and cerebral small-vessel disease markers were further adjusted. Tract-Based Spatial Statistics analysis indicated strictly lobar cerebral microbleeds associated with lower fractional anisotropy, higher mean diffusivity, and higher radial diffusivity in the internal capsule and corpus callosum after adjusting other cerebral small-vessel disease markers, while only a few voxels remained associated with deep cerebral microbleeds. Diffusion abnormalities gradients along WM tracts containing a cerebral microbleed were not found in fiber tractography analysis.

CONCLUSIONS

Cerebral microbleeds are associated with widely distributed changes in white matter, despite their focal appearance on SWI.

[Carcinoembryonic type specific markers and liver cancer immunotherapy]

Hepatocellular carcinoma (HCC) is a chronic inflammation derived from the background of hepatitis B and C virus (HBV and HCV) infection, chemical intoxicants, or non-alcoholic fatty liver disease. Cancerous liver cells can express and secrete a variety of relatively specific markers, such as carcinoembryonic type of alpha-fetoprotein (AFP), phosphatidylinositol-3 (Glypican-3, GPC-3), Wnt/β-Catenin key molecule of signaling pathway Wnt3a and liver cancer specific GGT-II (HS-GGT), etc. Clinical analysis of carcinoembryonic markers not only contributes to diagnosis and prognosis of HCC, but may also be the target of HCC immunotherapy with a promising prospect of development and application. This article reviews the latest valuable advances in carcinoembryonic type specific molecular markers and liver cancer immunotherapy.

Abstract IA20: Radiotherapy plus cetuximab or cisplatin in human papilloma-virus positive oropharyngeal cancer (NRG 1016): A randomized multicenter noninferiority trial*

Background: Patients with HPV-related oropharynx cancer have high survival when treated with radiotherapy plus cisplatin. Whether replacement of cisplatin with cetuximab can preserve high survival and reduce toxicity is unknown. We performed a randomized trial comparing survival and toxicity in 987 patients enrolled at 182 health care centers in the US and Canada between July 2011 and July 2014.

Methods: Eligibility included histologically confirmed HPV positive carcinoma, clinical stage TI-T2, N2-N3 or T3-T4, N0-N3. Zubrod status 0 or 1. All patients received intensity modulated radiotherapy (IMRT) delivered in 35 fractions to 70 gray over 6 weeks using 6 fractions per week. High-dose cisplatin at 100 mg/m² was given every 3 weeks for 2 cycles in arm A (standard of care) versus arm B loading dose cetuximab plus weekly cetuximab. Patients were stratified by T category, N category, Zubord performance status, and smoking history.

Primary analysis was based on modified intention to treat for all patients meeting eligibility criteria. 849 patients were randomly assigned to radiation plus cetuximab (425) or radiotherapy plus cisplatin (424). Median follow-up is 4.5 years.

Results: Radiotherapy plus cetuximab did not meet the non-inferiority criteria for overall survival. Estimated 5-year overall survival was 78% in the cetuximab group versus 85% in the cisplatin group (p=0.016). Progression-free survival was 67% versus 78% (p=0.0002). Local-regional failure was higher in the cetuximab group, 17% versus 10% (p=0.005). High-grade acute toxicity was similar at 77% for both groups. Late toxicity was also similar.

Conclusions: For HPV-positive oropharyngeal carcinoma, radiotherapy plus cetuximab showed inferior overall survival, progression-free survival, and locoregional control compared with radiation plus cisplatin. This study defines radiation using IMRT plus cisplatin as the standard of care for this population.

*Lancet. Vol 393, p 40-50, January 5, 2019

Citation Format: J.A. Ridge, J. Ringash, M. Yao, D.M. Blakaj, M.A. Razaq, A.D. Colevas, J.J. Beitler, C.U. Jones, N.E. Dunlap, S.A. Seaward, S. Spencer, T.J. Galloway, J.J. Dignam, Q.T. Le, M.L. Gillison, E.M. Sturgis, J. Phan, A.M. Trotti, J. Harris, A. Eisbruch, P.M. Harari, D.J. Adelstein, S.A. Koyfman, B. Burtness. Radiotherapy plus cetuximab or cisplatin in human papilloma-virus positive oropharyngeal cancer (NRG 1016): A randomized multicenter noninferiority trial [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr IA20.

AB0126 EXPRESSION CHARACTERISTICS OF ADENOSINE DEAMINASES ACTING ON RNA-1 IN SYSTEMIC LUPUS ERYTHEMATOSUS AND ITS CORRELATION WITH SERUM IFN-Α

Background:

SLE is a multisystem autoimmune disease characterized by the production of multiple autoantibodies and loss of immunity against autoantigens in various tissues. SLE patients have significantly elevated RNA editing levels and the potential to produce new autoantigens.1ADAR1 is an RNA A-I editing enzyme that converts adenine to hypoxanthine and contributes to SLE pathogenesis.2

Objectives:

Dama demonstrated the upregulation of ADAR1p150 expression in SLE T cells, B cells, PBMCs, and NK cells;3however, the following issues were not reported in detail: 1. specific alterations in ADAR1 expression in PBMCs collected from SLE patients with varying degrees of the disease and its correlation with serum IFN-α levels; 2. association between ADAR1 and clinical indicators; and 3. ADAR1 expression in renal tissue of LN patients. Our study therefore aimed to elucidate the abovementioned points.

Methods:

We used qRT-PCR to determine ADAR1 expression levels in PBMCs and renal tissues of controls and SLE patients. We also conducted immunohistochemical studies to detect positive ADAR1 expression rate in renal cells of controls and LN patients.

Results:

ADAR1 expression was higher in PBMCs of SLE patients than in those of controls and was positively correlated with SLEDAI. When serum IFN-α levels in SLE patients decreased <260.0 pg/mL, ADAR1 expression in PBMCs increased with the increase in IFN-α concentration, and serum IFN-α may regulate ADAR1 level in PBMC in SLE patients, which may require the participation of serum IgG antibody and related immune complex. However, there was no significant difference between the expression in renal tissues in all patients.

Conclusion:

There was a certain correlation between ADAR1 expression and serum IFN-α levels in PBMCs of SLE patients.

References:

[1]Roth SH, Danan-Gotthold M, Ben-Izhak M, et al. Increased RNA Editing May Provide a Source for Autoantigens in Systemic Lupus Erythematosus.Cell Rep2018; 23: 50-57.

[2]Hogg M, Paro S, Keegan LP and O’Connell MA. RNA editing by mammalian ADARs.Adv Genet2011; 73: 87-120.

[3]Laxminarayana D, Khan IU, O’Rourke KS and Giri B. Induction of 150-kDa adenosine deaminase that acts on RNA (ADAR)-1 gene expression in normal T lymphocytes by anti-CD3-epsilon and anti-CD28.Immunology2007; 122: 623-633.

Figure 1.

Analysis of ADAR1 expression levels. a. The ADAR1 expression in PBMCs was higher in SLE patients (n=30) than in healthy controls (n = 30) (p<0.05). b. SLE patients were divided into three groups: NSLE (SLEDAI 0–4, n = 6), LSLE (SLEDAI 5–9, n = 12), and SSLE (SLEDAI ≥10, n = 12) according to SLEDAI score. c. Based on the effect of the disease on the kidneys, the patients were divided into the SLE#group (#:SLE patient group without the kidney involved, n = 17) and LN group (lupus nephritis group, n = 13). d. There was no significant difference observed between the renal tissues of controls (n = 5) and LN patients (n = 10) (p>0.05).

Figure 2.

a. Immunohistochemical image of renal tissues from the two groups (200×). b. There was no significant difference in the ADAR1 cell positive rate between controls (n = 5), LN patients(n = 20), and different pathological subgroups (class III, n = 5; class IV, n = 5; class V, n = 5; class III+IV, n = 5) (p>0.05). c. The positive expression rate of ADAR1 in renal tubular cells was higher than that in glomerular cells both in the two groups (p<0.05).

Figure 3.

a. Correlation between ADAR1 and serum IFN-α levels in PBMCs of SLE patients. b. Correlation between ADAR1p150 and serum IFN-α levels in PBMCs of SLE patients.

Figure 4.

In vitroPBMCs assay. a. Western blot (WB) analysis of ADAR1p150 and ADAR1p110 in PBMCs using different concentrations of IFN-α, combined with 1.5 mg/mL IgG purified from the serum of SLE patients or without it, and cultured for 24 hours. b. The line graph depicts the trend of ADAR1, ADAR1p150, and ADAR1p110 expression with increase in IFN-α concentrationin vitroPBMCs co-cultured with serum IgG from SLE patients.

Disclosure of Interests:

None declared

THU0243 HSA_CIRC_0123190 FUNCTIONS AS A COMPETITIVE ENDOGENOUS RNA TO REGULATE APLNR EXPRESSION BY SPONGING HSA-MIR-483-3P IN LUPUS NEPHRITIS

Background:

Lupus nephritis (LN) is one of the most severe complications of systemic lupus erythematosus (SLE). Circular RNAs(circRNAs) can act as competitive endogenous RNAs (ceRNAs) to regulate gene transcription, which is involved in mechanism of many diseases, such as, autoimmunity diseases. However, the role of circRNA in lupus nephritis has been rarely reported.

Objectives:

In this study, we aim to investigate the clinical value of circRNAs and explore the mechanism of circRNA involvement in the pathogenesis of LN.

Methods:

Renal tissues from three untreated LN patients and three normal controls (NCs) were used to identify differently expressed circRNAs by RNA sequencing (RNA-seq). Validated assays were used by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Correlation analysis and receiver operating characteristic (ROC) curve were used to reveal the clinical value of selected circRNA, miRNA and mRNA. The interactions between circRNA and miRNA, or miRNA and mRNA were further determined by luciferase reporter assay. The degrees of renal fibrosis between the two groups were compared by Masson-trichome staining and immunohistochemistry staining.

Results:

159 circRNAs were significantly dysregulated in LN patients compared with NC group. The expression of hsa_circ_0123190 was significantly decreased in renal tissues of patients with LN (p=0.014), as same as the sequencing results. The area under the ROC curve of hsa_circ_0123190 in renal tissues was 0.820. Bio-informatic analysis and luciferase reporter assay illustrated that hsa_circ_0123190 can act as a sponge for hsa-miR-483-3p which was also validated to interact with APLNR mRNA. APLNR mRNA expression was positively related with chronicity index (CI) of LN (R2=0.452,p=0.033). Finally, the factors of renal fibrosis, especially TGF-β (p=0.018), were more pronounced in the LN group.

Conclusion:

Hsa_circ_0123190 could function as a ceRNA to regulate APLNR expression involved in renal fibrosis by sponging hsa-miR-483-3p in LN

References:

[1]Aljaberi N, Bennett M, Brunner HI, Devarajan P. Proteomic profiling of urine: implications for lupus nephritis. Expert review of proteomics. 2019;16(4):303-13.

[2]Zheng ZH, Zhang LJ, Liu WX, Lei YS, Xing GL, Zhang JJ, et al. Predictors of survival in Chinese patients with lupus nephritis. Lupus. 2012;21(10):1049-56.

[3]Chen LL. The biogenesis and emerging roles of circular RNAs. Nature reviews Molecular cell biology. 2016;17(4):205-11.

[4]Mahmoudi E, Cairns MJ. Circular RNAs are temporospatially regulated throughout development and ageing in the rat. Scientific reports. 2019;9(1):2564.

[5]Liang D, Wilusz JE. Short intronic repeat sequences facilitate circular RNA production. Genes & development. 2014;28(20):2233-47.

[6]Tan WL, Lim BT, Anene-Nzelu CG, Ackers-Johnson M, Dashi A, See K, et al. A landscape of circular RNA expression in the human heart. Cardiovascular research. 2017;113(3):298-309.

[7]Zhao Z, Li X, Jian D, Hao P, Rao L, Li M. Hsa_circ_0054633 in peripheral blood can be used as a diagnostic biomarker of pre-diabetes and type 2 diabetes mellitus. Acta diabetologica. 2017;54(3):237-45.

[8]Ouyang Q, Huang Q, Jiang Z, Zhao J, Shi GP, Yang M. Using plasma circRNA_002453 as a novel biomarker in the diagnosis of lupus nephritis. Molecular immunology. 2018;101(undefined):531-8.

[9]Luan J, Jiao C, Kong W, Fu J, Qu W, Chen Y, et al. CircHLA-C Plays an Important Role in Lupus Nephritis by Sponging miR-150. Molecular therapy Nucleic acids. 2018;10(undefined):245-53.

[10]Kuschnerus K, Straessler ET, Müller MF, Lüscher TF, Landmesser U, Kränkel N. Increased Expression of miR-483-3p Impairs the Vascular Response to Injury in Type 2 Diabetes. Diabetes. 2019;68(2):349-60.

[11]Huang Z, Wu L and Chen L. Apelin/APJ system: A novel potential therapy target for kidney disease. Journal of cellular physiology. 2018;233(5): 3892-900.

Disclosure of Interests:

None declared

Recommendations for the COVID-19 Response at the National Level Based on Lessons Learned from the Ebola Virus Disease Outbreak in the Democratic Republic of the Congo

The tenth outbreak of Ebola virus disease (EVD) in North Kivu, the Democratic Republic of the Congo (DRC), was declared 8 days after the end of the ninth EVD outbreak, in the Equateur Province on August 1, 2018. With a total of 3,461 confirmed and probable cases, the North Kivu outbreak was the second largest outbreak after that in West Africa in 2014–2016, and the largest observed in the DRC. This outbreak was difficult to control because of multiple challenges, including armed conflict, population displacement, movement of contacts, community mistrust, and high population density. It took more than 21 months to control the outbreak, with critical innovations and systems put into place. We describe systems that were put into place during the EVD response in the DRC that can be leveraged for the response to the current COVID-19 global pandemic.

The potential effects of widespread community transmission of SARS-CoV-2 infection in the World Health Organization African Region: a predictive model

The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been unprecedented in its speed and effects. Interruption of its transmission to prevent widespread community transmission is critical because its effects go beyond the number of COVID-19 cases and deaths and affect the health system capacity to provide other essential services. Highlighting the implications of such a situation, the predictions presented here are derived using a Markov chain model, with the transition states and country specific probabilities derived based on currently available knowledge. A risk of exposure, and vulnerability index are used to make the probabilities country specific. The results predict a high risk of exposure in states of small size, together with Algeria, South Africa and Cameroon. Nigeria will have the largest number of infections, followed by Algeria and South Africa. Mauritania would have the fewest cases, followed by Seychelles and Eritrea. Per capita, Mauritius, Seychelles and Equatorial Guinea would have the highest proportion of their population affected, while Niger, Mauritania and Chad would have the lowest. Of the World Health Organization's 1 billion population in Africa, 22% (16%-26%) will be infected in the first year, with 37 (29 - 44) million symptomatic cases and 150 078 (82 735-189 579) deaths. There will be an estimated 4.6 (3.6-5.5) million COVID-19 hospitalisations, of which 139 521 (81 876-167 044) would be severe cases requiring oxygen, and 89 043 (52 253-106 599) critical cases requiring breathing support. The needed mitigation measures would significantly strain health system capacities, particularly for secondary and tertiary services, while many cases may pass undetected in primary care facilities due to weak diagnostic capacity and non-specific symptoms. The effect of avoiding widespread and sustained community transmission of SARS-CoV-2 is significant, and most likely outweighs any costs of preventing such a scenario. Effective containment measures should be promoted in all countries to best manage the COVID-19 pandemic.

A longitudinal study on α-synuclein in plasma neuronal exosomes as a biomarker for Parkinson's disease development and progression

BACKGROUND AND PURPOSE

The identification of reliable diagnostic and prognostic biomarkers for Parkinson's disease (PD) is urgently needed. Here, we explored the potential use of α-synuclein (α-syn) in plasma neuronal exosomes as a biomarker for early PD diagnosis and disease progression.

METHODS

This study included both cross-sectional and longitudinal designs. The subjects included 36 patients with early-stage PD, 17 patients with advanced PD, 20 patients with idiopathic rapid eye movement sleep behavior disorder and 21 healthy controls (HCs). α-syn levels were measured by electrochemiluminescence immunoassay. A subgroup of patients with early-stage PD (n = 18) participated in a follow-up examination with repeated blood collection and clinical assessments after an average of 22 months.

RESULTS

The α-syn levels in plasma neuronal exosomes were significantly higher in patients with early-stage PD compared with HCs (P = 0.007). Differences in α-syn levels between patients with idiopathic rapid eye movement sleep behavior disorder and HCs did not reach statistical significance (P = 0.08). In addition, Spearman correlation analysis revealed that neuronal exosomal α-syn concentrations were correlated with Movement Disorders Society Unified Parkinson's Disease Rating Scale III/(I + II + III) scores, Non-Motor Symptom Questionnaire scores and Sniffin' Sticks 16-item test scores of patients with PD (P < 0.05). After a mean follow-up of 22 months in patients with early-stage PD, a Cox regression analysis adjusted for age and gender showed that longitudinally increased α-syn rather than baseline α-syn levels were associated with higher risk for motor symptom progression in PD (P = 0.039).

CONCLUSIONS

Our results suggested that α-syn in plasma neuronal exosomes may serve as a biomarker to aid early diagnosis of PD and also as a prognostic marker for PD progression.

What are the drivers of recurrent cholera transmission in Nigeria? Evidence from a scoping review

Background

The 2018 cholera outbreak in Nigeria affected over half of the states in the country, and was characterised by high attack and case fatality rates. The country continues to record cholera cases and related deaths to date. However, there is a dearth of evidence on context-specific drivers and their operational mechanisms in mediating recurrent cholera transmission in Nigeria. This study therefore aimed to fill this important research gap, with a view to informing the design and implementation of appropriate preventive and control measures.

Methods

Four bibliographic literature sources (CINAHL (Plus with full text), Web of Science, Google Scholar and PubMed), and one journal (African Journals Online) were searched to retrieve documents relating to cholera transmission in Nigeria. Titles and abstracts of the identified documents were screened according to a predefined study protocol. Data extraction and bibliometric analysis of all eligible documents were conducted, which was followed by thematic and systematic analyses.

Results

Forty-five documents met the inclusion criteria and were included in the final analysis. The majority of the documents were peer-reviewed journal articles (89%) and conducted predominantly in the context of cholera epidemics (64%). The narrative analysis indicates that social, biological, environmental and climatic, health systems, and a combination of two or more factors appear to drive cholera transmission in Nigeria. Regarding operational dynamics, a substantial number of the identified drivers appear to be functionally interdependent of each other.

Conclusion

The drivers of recurring cholera transmission in Nigeria are diverse but functionally interdependent; thus, underlining the importance of adopting a multi-sectoral approach for cholera prevention and control.

[Hepatocellular carcinoma-derived exosomal miRNA expression and its clinical value]

The early diagnosis and effective treatment of hepatocellular carcinoma (HCC) still remains a difficult problem that plagues the medical community. Exosomes are microvesicles with a diameter of 40~100 nm, and contains proteins, lipids and nucleic acids (mRNAs, lncRNAs, circRNAs, and microRNAs). They serve as an information exchange carrier, and play an important role in regulating and controlling the biomolecular function to maintain the stability of the intracellular environment. The function of exosomes in HCC includes intercellular communication, neoangiogenesis, cancer cell metastasis and multidrug resistance, which mediates the transformation of microRNAs (miRNA) and regulate the microenvironment of tumor progression, and then affect the pathophysiological behavior of cancer cells. Exosome-derived miRNA can be used for HCC monitoring or potential specific markers of early diagnosis. In addition, with the development and application prospects it could be a therapeutic goal for HCC. This paper summarizes the recent progress in the study of HCC-derived exosomal miRNA.

[Abnormal expression of Wnt3a and inhibiting role of its molecular-targeted intervening in hepatocellular carcinoma]

Objective: To investigate the Wnt3a expression in tissues of HCC and its gene knockout on effects of HepG2 cell proliferation or xenograft tumor growth. Methods: Hepatic Wnt3a expressions in 87 HCC and their matched surrounding tissues were observed by tissue microarray and immunohistochemistry for analyzing its clinicopathological characteristics; Wnt3a-knockout HepG2 cell lines were established by Crispr/cas9-sgRNA system and genomic cleavage efficiency was verified at gene level by surveyor assay. The relative proteins were confirmed by Western blotting; Cell Counting Kit-8 assay was used to examine cell proliferation after knocking-out Wnt3a successfully, and the nude mice HepG2 cell xenograft tumors delete that the relationship between Wnt3a and HCC growth. Results: The positive Wnt3a with brown staining particles was mainly distributed in cytosol and membrane of hepatocytes. The incidence of hepatic Wnt3a expression in cancerous tissues (95.4%) was significantly higher (χ (2) = 47.754, P < 0.001) than that in their surrounding tissues (49.4%). The high Wnt3a expression was 70.1% in the HCC and only 14.9% in the surrounding tissues. High Wnt3a expression was associated with poorly-differentiated grade, liver cirrhosis, HBV infection, portal vein invasion, TNM stage and 5-year survival rate. After knocked-out by Crispr/cas9-sgRNA system successfully, Wnt3a expression was down-regulated significantly at gene or protein level. Key molecule β-catenin in cytoplasma was obviously inhibited. HepG2 cell lines proliferation was suppressed in time-dependent manner. The nude mice HepG2 cell xenograft tumors confirmed that the knock-out of Wnt3a could significantly supressed HCC growth with slower speed (t = 6.418, P < 0.001), smaller volume(869.4 ± 222.5 mm(3) vs 355.0 ± 99.9 mm(3), t = 5.168, P < 0.001), and lighter weight (0.88 ± 0.20 g vs 0.35 ± 0.11 g, t = 5.628, P < 0.001)compared with the control group. Conclusion: Abnormal expression of Wnt3a could be expected as a promising target for HCC gene therapy.

Final results of a multi-institutional phase II trial of reirradiation with concurrent weekly cisplatin and cetuximab for recurrent or second primary squamous cell carcinoma of the head and neck

Background

The optimal regimen of chemotherapy and reirradiation (re-XRT) for recurrent head and neck squamous cell carcinoma (HNSCC) is controversial. We report the final outcomes of a multicenter phase II trial evaluating cetuximab and cisplatin-based chemotherapy concurrent with re-XRT for patients with recurrent HNSCC.

Materials and methods

Patients with unresectable recurrent disease or positive margins after salvage surgery arising within a previously irradiated field with KPS ≥ 70 were eligible for this trial. Cetuximab 400 mg/m2 was delivered as a loading dose in week 1 followed by weekly cetuximab 250 mg/m2 and cisplatin 30 mg/m2 concurrent with 6 weeks of intensity-modulated radiotherapy to a dose of 60-66 Gy in 30 daily fractions. Patients who previously received both concurrent cetuximab and cisplatin with radiation or who received radiotherapy less than 6 months prior were ineligible.

Results

From 2009 to 2013, 48 patients enrolled on this trial, 2 did not receive any protocol treatment. Of the remaining 46 patients, 34 were male and 12 female, with a median age of 62 years (range 36-85). Treatment was feasible and only 1 patient did not complete the treatment course. Common grade 3 or higher acute toxicities were lymphopenia (46%), pain (22%), dysphagia (13%), radiation dermatitis (13%), mucositis (11%) and anorexia (11%). There were no grade 5 acute toxicities. Eight grade 3 late toxicities were observed, four of which were swallowing related. With a median follow-up of 1.38 years, the 1-year overall survival (OS) was 60.4% and 1-year recurrence-free survival was 34.1%. On univariate analysis, OS was significantly improved with young age (P = 0.01). OS was not associated with radiation dose, surgery before re-XRT or interval from prior XRT.

Conclusions

Concurrent cisplatin and cetuximab with re-XRT is feasible and offers good treatment outcomes for patients with high-risk features. Younger patients had significantly improved OS.

ClinicalTrials.Gov Identifier

NCT00833261.

[Study of tumor necrosis factor receptor superfamily 1B gene polymorphism in relation to the outcomes of HCV infection]

Objective: To investigate the tumor necrosis factor receptor superfamily 1B gene (TNFRSF1B) polymorphism in relation to the outcomes of hepatitis C virus (HCV) infection. Methods: One thousand six hundred and forty-five cases without HCV infection, 545 cases with HCV clearance, and 783 cases with chronic HCV infection were enrolled. TaqMan probe method was used to investigate genotype rs1061622 (T > G) and rs1061624 (G > A). Two single nucleotide polymorphisms (SNPs) sites were genotyped and haplotypes were constructed to evaluate their relation with the outcome of HCV infection. Results: Logistic regression analysis showed that there was no relation to the two SNPs with HCV infection susceptibility and chronicity (P > 0.05). Haplotype analysis showed that carrier TA had an increased susceptibility to HCV infection [adjusted odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.01 to 1.30, P = 0.038)]. Carrier TA and GG haplotypes were conducive to chronic HCV infection (adjusted OR = 1.28, 95% CI: 1.08 to 1.53, P = 0.006; OR = 1.31, 95% CI: 1.03 to 1.66, P = 0.026). Conclusion: The combinational effects of rs1061622 and rs1061624 in TNFRSF1B gene may increase the risk of HCV chronicity and infection.