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Wei H, Wang CY, Yin YY, Wang Y. [Analysis on morbidity characteristics of occupational diseases in Taian City from 2006 to 2021]. ZHONGHUA LAO DONG WEI SHENG ZHI YE BING ZA ZHI = ZHONGHUA LAODONG WEISHENG ZHIYEBING ZAZHI = CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES 2023; 41:841-845. [PMID: 37935551 DOI: 10.3760/cma.j.cn121094-20220506-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Objective: To analyze the morbidity characteristics of new occupational diseases in Taian City from 2006 to 2021 and provide scientific evidence for local prevention and treatment of occupational diseases. Methods: In March 2022, the data of newly diagnosed occupational diseases in Taian City from 2006 to 2021 were obtained from Information Monitoring System for Occupational Diseases and Health Hazards. A descriptive analysis was performed for the distribution of onset age, working years, types of occupational diseases, region, industries, enterprise scale, enterprise economic type and the epidemic trend of occupational diseases. Results: 1362 cases of occupational diseases in 29 species of 9 categories were reported in Taian City from 2006 to 2021, including 1311 males and 51 females. The M (P(25), P(75)) of onset age and working age were 53 (47, 64) and 24.08 (16.56, 29.25) respectively. The top three categories of occupational diseases were occupational pneumoconiosis and other respiratory diseases (1128 cases, 82.82%), occupational otolaryngology and oral diseases (107 cases, 7.86%), and occupational chemical poisoning (70 cases, 5.14%) in sequence. Coal worker's pneumoconiosis, noise deafness, silicosis, poisoning of manganese and its compounds and cataract were the top five species of occupational diseases, which accounted for 69.60% (948/1362), 7.64% (104/1362), 5.58% (76/1362), 3.38% (46/1362) and 2.94% (40/1362) of the total cases of occupational diseases.There were significant differences among the composition of occupational diseases categories reported annually (P<0.001), but the number of occupational pneumoconiosis and other respiratory diseases was the highest on each year. The number of occupational diseases showed a decreasing trend with the year, and the optimal fitting curve was an growth curve. The number of newly diagnosed occupational diseases was predicted to be 172 cases from 2022 to 2026. Occupational pneumoconiosis and other respiratory diseases was the main disease in 6 counties. The occupational diseases cases were mainly distributed in Feicheng County and Xintai County, with 520 cases and 504 cases respectively, accounting for 75.18% of occupational diseases cases. The coal mining and washing industry had the largest number of occupational diseases cases, accounting for 73.05% of all occupational diseases cases. 91.85% of occupational diseases cases came from large and medium-sized enterprises. The economic type of enterprises with the most occupational diseases was state-owned enterprises, accounting for 74.52% of occupational diseases cases. Conclusion: The predominant occupational diseases in Taian City are occupational pneumoconiosis and other respiratory diseases, occupational otolaryngology and oral diseases, occupational chemical poisoning. And the prevention and control of occupational diseases should be strengthened in key industries such as coal mining and washing industry, key enterprises such as state-owned large and medium-sized enterprises.
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Zabinski B, Zaid E, Zakareishvili T, Zakharchuk N, Zambito S, Zamora Saa JA, Zang J, Zanzi D, Zaplatilek O, Zeitnitz C, Zeng H, Zeng JC, Zenger DT, Zenin O, Ženiš T, Zenz S, Zerradi S, Zerwas D, Zhai M, Zhang B, Zhang DF, Zhang J, Zhang J, Zhang K, Zhang L, Zhang P, Zhang R, Zhang S, Zhang T, Zhang X, Zhang X, Zhang Y, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao P, Zhao T, Zhao Y, Zhao Z, Zhemchugov A, Zheng K, Zheng X, Zheng Z, Zhong D, Zhou B, Zhou H, Zhou N, Zhou Y, Zhu CG, Zhu J, Zhu Y, Zhu Y, Zhuang X, Zhukov K, Zhulanov V, Zimine NI, Zinsser J, Ziolkowski M, Živković L, Zoccoli A, Zoch K, Zorbas TG, Zormpa O, Zou W, Zwalinski L. Measurement of the Sensitivity of Two-Particle Correlations in pp Collisions to the Presence of Hard Scatterings. PHYSICAL REVIEW LETTERS 2023; 131:162301. [PMID: 37925689 DOI: 10.1103/physrevlett.131.162301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/18/2023] [Accepted: 08/09/2023] [Indexed: 11/07/2023]
Abstract
A key open question in the study of multiparticle production in high-energy pp collisions is the relationship between the "ridge"-i.e., the observed azimuthal correlations between particles in the underlying event that extend over all rapidities-and hard or semihard scattering processes. In particular, it is not known whether jets or their soft fragments are correlated with particles in the underlying event. To address this question, two-particle correlations are measured in pp collisions at sqrt[s]=13 TeV using data collected by the ATLAS experiment at the LHC, with an integrated luminosity of 15.8 pb^{-1}, in two different configurations. In the first case, charged particles associated with jets are excluded from the correlation analysis, while in the second case, correlations are measured between particles within jets and charged particles from the underlying event. Second-order flow coefficients, v_{2}, are presented as a function of event multiplicity and transverse momentum. These measurements show that excluding particles associated with jets does not affect the measured correlations. Moreover, particles associated with jets do not exhibit any significant azimuthal correlations with the underlying event, ruling out hard processes contributing to the ridge.
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Wang Y, Gao QY, Wang H, Zhang D, Gao Y, Miao YD, Zhai XH, Hu XX, Rui XL, Zhang WH. [Clinical analysis of long-term survival and influencing factors of chimeric antigen receptor T-cell therapy in relapsed/refractory acute B-cell lymphoblastic leukemia]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:800-804. [PMID: 38049330 PMCID: PMC10694086 DOI: 10.3760/cma.j.issn.0253-2727.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Indexed: 12/06/2023]
Abstract
Objective: To analyze the survival and influencing factors of chimeric antigen receptor (CAR) T-cell therapy in relapsed/refractory acute B-cell lymphoblastic leukemia (R/R B-ALL) . Methods: Clinical information of patients who received CAR-T-cell therapy and achieved complete remission of R/R B-ALL between May 2015 and June 2018 at the Shaanxi Provincial People's Hospital was obtained. Kaplan-Meier analysis was used to evaluate the overall survival (OS) and leukemia-free survival (LFS) times of patients, and Cox regression analysis was performed to analyze the prognostic factors that affect patient survival after CAR-T therapy. Results: Among the 38 patients with R/R B-ALL, 21 were men, with a median age of 25 (6-59) years and a median OS time of 18 (95% CI 3-33) months. Multivariate Cox regression analysis showed that positive MLL-AF4 fusion gene expression was an independent risk factor for OS and LFS (OS: HR=4.888, 95% CI 1.375-17.374, P=0.014; LFS: HR=6.683, 95% CI 1.815-24.608, P=0.004). Maintenance therapy was a protective factor for OS and LFS (OS: HR=0.153, 95% CI 0.054-0.432, P<0.001; LFS: HR=0.138, 95% CI 0.050-0.382, P<0.001). In patients with MRD negative conversion, LFS benefit (HR=0.209, 95% CI 0.055-0.797, P=0.022) and OS difference was statistically insignificant (P=0.111). Moreover, patients with high tumor burden were risk factors for OS and LFS at the level of 0.1 (OS: HR=2.662, 95% CI 0.987-7.184, P=0.053; LFS: HR=2.452, 95% CI 0.949-6.339, P=0.064) . Conclusion: High tumor burden and high-risk genetics may affect the long-term survival rate of patients with R/R B-ALL receiving CAR-T, and lenalidomide-based maintenance therapy may improve their prognosis.
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Ablikim M, Achasov MN, Adlarson P, Aliberti R, Amoroso A, An MR, An Q, Bai Y, Bakina O, Balossino I, Ban Y, Batozskaya V, Begzsuren K, Berger N, Berlowski M, Bertani M, Bettoni D, Bianchi F, Bianco E, Bloms J, Bortone A, Boyko I, Briere RA, Brueggemann A, Cai H, Cai X, Calcaterra A, Cao GF, Cao N, Cetin SA, Chang JF, Chang TT, Chang WL, Che GR, Chelkov G, Chen C, Chen C, Chen G, Chen HS, Chen ML, Chen SJ, Chen SM, Chen T, Chen XR, Chen XT, Chen YB, Chen YQ, Chen ZJ, Cheng WS, Choi SK, Chu X, Cibinetto G, Coen SC, Cossio F, Cui JJ, Dai HL, Dai JP, Dbeyssi A, de Boer RE, Dedovich D, Deng ZY, Denig A, Denysenko I, Destefanis M, De Mori F, Ding B, Ding XX, Ding Y, Ding Y, Dong J, Dong LY, Dong MY, Dong X, Du SX, Duan ZH, Egorov P, Fan YL, Fang J, Fang SS, Fang WX, Fang Y, Farinelli R, Fava L, Feldbauer F, Felici G, Feng CQ, Feng JH, Fischer K, Fritsch M, Fritzsch C, Fu CD, Fu YW, Gao H, Gao YN, Gao Y, Garbolino S, Garzia I, Ge PT, Ge ZW, Geng C, Gersabeck EM, Gilman A, Goetzen K, Gong L, Gong WX, Gradl W, Gramigna S, Greco M, Gu MH, Gu YT, Guan CY, Guan ZL, Guo AQ, Guo LB, Guo RP, Guo YP, Guskov A, Hou XT, Han WY, Hao XQ, Harris FA, He KK, He KL, Heinsius FH, Heinz CH, Heng YK, Herold C, Holtmann T, Hong PC, Hou GY, Hou YR, Hou ZL, Hu HM, Hu JF, Hu T, Hu Y, Huang GS, Huang KX, Huang LQ, Huang XT, Huang YP, Hussain T, Hüsken N, Imoehl W, Irshad M, Jackson J, Jaeger S, Janchiv S, Jeong JH, Ji Q, Ji QP, Ji XB, Ji XL, Ji YY, Jia ZK, Jiang PC, Jiang SS, Jiang TJ, Jiang XS, Jiang Y, Jiao JB, Jiao Z, Jin S, Jin Y, Jing MQ, Johansson T, Kui X, Kabana S, Kalantar-Nayestanaki N, Kang XL, Kang XS, Kappert R, Kavatsyuk M, Ke BC, Khoukaz A, Kiuchi R, Kliemt R, Koch L, Kolcu OB, Kopf B, Kuessner M, Kupsc A, Kühn W, Lane JJ, Lange JS, Larin P, Lavania A, Lavezzi L, Lei TT, Lei ZH, Leithoff H, Lellmann M, Lenz T, Li C, Li C, Li CH, Li C, Li DM, Li F, Li G, Li H, Li HB, Li HJ, Li HN, Li H, Li JR, Li JS, Li JW, Li K, Li LJ, Li LK, Li L, Li MH, Li PR, Li SX, Li T, Li WD, Li WG, Li XH, Li XL, Li X, Li YG, Li ZJ, Li ZX, Li ZY, Liang C, Liang H, Liang H, Liang H, Liang YF, Liang YT, Liao GR, Liao LZ, Libby J, Limphirat A, Lin DX, Lin T, Liu BJ, Liu BX, Liu C, Liu CX, Liu D, Liu FH, Liu F, Liu F, Liu GM, Liu H, Liu HB, Liu HM, Liu H, Liu H, Liu JB, Liu JL, Liu JY, Liu K, Liu KY, Liu K, Liu L, Liu LC, Liu L, Liu MH, Liu PL, Liu Q, Liu SB, Liu T, Liu WK, Liu WM, Liu X, Liu Y, Liu YB, Liu ZA, Liu ZQ, Lou XC, Lu FX, Lu HJ, Lu JG, Lu XL, Lu Y, Lu YP, Lu ZH, Luo CL, Luo MX, Luo T, Luo XL, Lyu XR, Lyu YF, Ma FC, Ma HL, Ma JL, Ma LL, Ma MM, Ma QM, Ma RQ, Ma RT, Ma XY, Ma Y, Maas FE, Maggiora M, Maldaner S, Malde S, Mangoni A, Mao YJ, Mao ZP, Marcello S, Meng ZX, Messchendorp JG, Mezzadri G, Miao H, Min TJ, Mitchell RE, Mo XH, Muchnoi NY, Nefedov Y, Nerling F, Nikolaev IB, Ning Z, Nisar S, Niu Y, Olsen SL, Ouyang Q, Pacetti S, Pan X, Pan Y, Pathak A, Pei YP, Pelizaeus M, Peng HP, Peters K, Ping JL, Ping RG, Plura S, Pogodin S, Prasad V, Qi FZ, Qi H, Qi HR, Qi M, Qi TY, Qian S, Qian WB, Qiao CF, Qin JJ, Qin LQ, Qin XP, Qin XS, Qin ZH, Qiu JF, Qu SQ, Redmer CF, Ren KJ, Rivetti A, Rodin V, Rolo M, Rong G, Rosner C, Ruan SN, Salone N, Sarantsev A, Schelhaas Y, Schoenning K, Scodeggio M, Shan KY, Shan W, Shan XY, Shangguan JF, Shao LG, Shao M, Shen CP, Shen HF, Shen WH, Shen XY, Shi BA, Shi HC, Shi JY, Shi QQ, Shi RS, Shi X, Song JJ, Song TZ, Song WM, Song YX, Sosio S, Spataro S, Stieler F, Su YJ, Sun GB, Sun GX, Sun H, Sun HK, Sun JF, Sun K, Sun L, Sun SS, Sun T, Sun WY, Sun Y, Sun YJ, Sun YZ, Sun ZT, Tan YX, Tang CJ, Tang GY, Tang J, Tang YA, Tao LY, Tao QT, Tat M, Teng JX, Thoren V, Tian WH, Tian WH, Tian Y, Tian ZF, Uman I, Wang B, Wang BL, Wang B, Wang CW, Wang DY, Wang F, Wang HJ, Wang HP, Wang K, Wang LL, Wang M, Wang M, Wang S, Wang T, Wang TJ, Wang W, Wang W, Wang WH, Wang WP, Wang X, Wang XF, Wang XJ, Wang XL, Wang Y, Wang YD, Wang YF, Wang YH, Wang YN, Wang YQ, Wang Y, Wang Y, Wang Z, Wang ZL, Wang ZY, Wang Z, Wei D, Wei DH, Weidner F, Wen SP, Wenzel CW, Wiedner U, Wilkinson G, Wolke M, Wollenberg L, Wu C, Wu JF, Wu LH, Wu LJ, Wu X, Wu XH, Wu Y, Wu YJ, Wu Z, Xia L, Xian XM, Xiang T, Xiao D, Xiao GY, Xiao H, Xiao SY, Xiao YL, Xiao ZJ, Xie C, Xie XH, Xie Y, Xie YG, Xie YH, Xie ZP, Xing TY, Xu CF, Xu CJ, Xu GF, Xu HY, Xu QJ, Xu WL, Xu XP, Xu YC, Xu ZP, Yan F, Yan L, Yan WB, Yan WC, Yan XQ, Yang HJ, Yang HL, Yang HX, Yang T, Yang Y, Yang YF, Yang YX, Yang Y, Ye M, Ye MH, Yin JH, You ZY, Yu BX, Yu CX, Yu G, Yu T, Yu XD, Yuan CZ, Yuan L, Yuan SC, Yuan XQ, Yuan Y, Yuan ZY, Yue CX, Zafar AA, Zeng FR, Zeng X, Zeng Y, Zeng YJ, Zhai XY, Zhan YH, Zhang AQ, Zhang BL, Zhang BX, Zhang DH, Zhang GY, Zhang H, Zhang HH, Zhang HH, Zhang HQ, Zhang HY, Zhang JJ, Zhang JL, Zhang JQ, Zhang JW, Zhang JX, Zhang JY, Zhang JZ, Zhang J, Zhang LM, Zhang LQ, Zhang L, Zhang P, Zhang QY, Zhang S, Zhang S, Zhang XD, Zhang XM, Zhang XY, Zhang XY, Zhang Y, Zhang YT, Zhang YH, Zhang Y, Zhang Y, Zhang ZH, Zhang ZL, Zhang ZY, Zhang ZY, Zhao G, Zhao J, Zhao JY, Zhao JZ, Zhao L, Zhao L, Zhao MG, Zhao SJ, Zhao YB, Zhao YX, Zhao ZG, Zhemchugov A, Zheng B, Zheng JP, Zheng WJ, Zheng YH, Zhong B, Zhong X, Zhou H, Zhou LP, Zhou X, Zhou XK, Zhou XR, Zhou XY, Zhou YZ, Zhu J, Zhu K, Zhu KJ, Zhu L, Zhu LX, Zhu SH, Zhu SQ, Zhu TJ, Zhu WJ, Zhu YC, Zhu ZA, Zou JH, Zu J. Determination of Spin-Parity Quantum Numbers for the Narrow Structure near the pΛ[over ¯] Threshold in e^{+}e^{-}→pK^{-}Λ[over ¯]+c.c. PHYSICAL REVIEW LETTERS 2023; 131:151901. [PMID: 37897776 DOI: 10.1103/physrevlett.131.151901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/22/2023] [Accepted: 09/15/2023] [Indexed: 10/30/2023]
Abstract
A narrow structure in the pΛ[over ¯] system near the mass threshold, named as X(2085), is observed in the process e^{+}e^{-}→pK^{-}Λ[over ¯] with a statistical significance greater than 20σ. Its spin and parity are determined for the first time to be J^{P}=1^{+} in an amplitude analysis, with a statistical significance greater than 5σ over other quantum numbers (0^{-},1^{-} and 2^{+}). The pole positions of X(2085) are measured to be M_{pole}=(2084_{-2}^{+4}±9) MeV and Γ_{pole}=(58_{-3}^{+4}±25) MeV, where the first uncertainties are statistical and the second ones are systematic. The analysis is based on the study of the process e^{+}e^{-}→pK^{-}Λ[over ¯] and uses the data samples collected with the BESIII detector at the center-of-mass energies sqrt[s]=4.008, 4.178, 4.226, 4.258, 4.416, and 4.682 GeV with a total integrated luminosity of 8.35 fb^{-1}.
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Aaij R, Abdelmotteleb ASW, Abellan Beteta C, Abudinén F, Ackernley T, Adeva B, Adinolfi M, Adlarson P, Afsharnia H, Agapopoulou C, Aidala CA, Ajaltouni Z, Akar S, Akiba K, Albicocco P, Albrecht J, Alessio F, Alexander M, Alfonso Albero A, Aliouche Z, Alvarez Cartelle P, Amalric R, Amato S, Amey JL, Amhis Y, An L, Anderlini L, Andersson M, Andreianov A, Andreotti M, Andreou D, Ao D, Archilli F, Artamonov A, Artuso M, Aslanides E, Atzeni M, Audurier B, Bachiller Perea I, Bachmann S, Bachmayer M, Back JJ, Bailly-Reyre A, Baladron Rodriguez P, Balagura V, Baldini W, Baptista de Souza Leite J, Barbetti M, Barlow RJ, Barsuk S, Barter W, Bartolini M, Baryshnikov F, Basels JM, Bassi G, Batsukh B, Battig A, Bay A, Beck A, Becker M, Bedeschi F, Bediaga IB, Beiter A, Belin S, Bellee V, Belous K, Belov I, Belyaev I, Benane G, Bencivenni G, Ben-Haim E, Berezhnoy A, Bernet R, Bernet Andres S, Berninghoff D, Bernstein HC, Bertella C, Bertolin A, Betancourt C, Betti F, Bezshyiko I, Bhom J, Bian L, Bieker MS, Biesuz NV, Billoir P, Biolchini A, Birch M, Bishop FCR, Bitadze A, Bizzeti A, Blago MP, Blake T, Blanc F, Blank JE, Blusk S, Bobulska D, Bocharnikov V, Boelhauve JA, Boente Garcia O, Boettcher T, Boldyrev A, Bolognani CS, Bolzonella R, Bondar N, Borgato F, Borghi S, Borsato M, Borsuk JT, Bouchiba SA, Bowcock TJV, Boyer A, Bozzi C, Bradley MJ, Braun S, Brea Rodriguez A, Breer N, Brodzicka J, Brossa Gonzalo A, Brown J, Brundu D, Buonaura A, Buonincontri L, Burke AT, Burr C, Bursche A, Butkevich A, Butter JS, Buytaert J, Byczynski W, Cadeddu S, Cai H, Calabrese R, Calefice L, Cali S, Calvi M, Calvo Gomez M, Campana P, Campora Perez DH, Campoverde Quezada AF, Capelli S, Capriotti L, Carbone A, Cardinale R, Cardini A, Carniti P, Carus L, Casais Vidal A, Caspary R, Casse G, Cattaneo M, Cavallero G, Cavallini V, Celani S, Cerasoli J, Cervenkov D, Chadwick AJ, Chahrour I, Chapman MG, Charles M, Charpentier P, Chavez Barajas CA, Chefdeville M, Chen C, Chen S, Chernov A, Chernyshenko S, Chobanova V, Cholak S, Chrzaszcz M, Chubykin A, Chulikov V, Ciambrone P, Cicala MF, Cid Vidal X, Ciezarek G, Cifra P, Clarke PEL, Clemencic M, Cliff HV, Closier J, Cobbledick JL, Coco V, Cogan J, Cogneras E, Cojocariu L, Collins P, Colombo T, Congedo L, Contu A, Cooke N, Corredoira I, Corti G, Couturier B, Craik DC, Cruz Torres M, Currie R, Da Silva CL, Dadabaev S, Dai L, Dai X, Dall'Occo E, Dalseno J, D'Ambrosio C, Daniel J, Danilina A, d'Argent P, Davies JE, Davis A, De Aguiar Francisco O, de Boer J, De Bruyn K, De Capua S, De Cian M, De Freitas Carneiro Da Graca U, De Lucia E, De Miranda JM, De Paula L, De Serio M, De Simone D, De Simone P, De Vellis F, de Vries JA, Dean CT, Debernardis F, Decamp D, Dedu V, Del Buono L, Delaney B, Dembinski HP, Denysenko V, Deschamps O, Dettori F, Dey B, Di Nezza P, Diachkov I, Didenko S, Dieste Maronas L, Ding S, Dobishuk V, Dolmatov A, Dong C, Donohoe AM, Dordei F, Dos Reis AC, Douglas L, Downes AG, Duda P, Dudek MW, Dufour L, Duk V, Durante P, Duras MM, Durham JM, Dutta D, Dziurda A, Dzyuba A, Easo S, Egede U, Egorychev V, Eirea Orro C, Eisenhardt S, Ejopu E, Ek-In S, Eklund L, Elashri M, Ellbracht J, Ely S, Ene A, Epple E, Escher S, Eschle J, Esen S, Evans T, Fabiano F, Falcao LN, Fan Y, Fang B, Fantini L, Faria M, Farry S, Fazzini D, Felkowski L, Feo M, Fernandez Gomez M, Fernez AD, Ferrari F, Ferreira Lopes L, Ferreira Rodrigues F, Ferreres Sole S, Ferrillo M, Ferro-Luzzi M, Filippov S, Fini RA, Fiorini M, Firlej M, Fischer KM, Fitzgerald DS, Fitzpatrick C, Fiutowski T, Fleuret F, Fontana M, Fontanelli F, Forty R, Foulds-Holt D, Franco Lima V, Franco Sevilla M, Frank M, Franzoso E, Frau G, Frei C, Friday DA, Frontini L, Fu J, Fuehring Q, Fulghesu T, Gabriel E, Galati G, Galati MD, Gallas Torreira A, Galli D, Gambetta S, Gandelman M, Gandini P, Gao H, Gao Y, Gao Y, Garau M, Garcia Martin LM, Garcia Moreno P, García Pardiñas J, Garcia Plana B, Garcia Rosales FA, Garrido L, Gaspar C, Geertsema RE, Gerick D, Gerken LL, Gersabeck E, Gersabeck M, Gershon T, Giambastiani L, Gibson V, Giemza HK, Gilman AL, Giovannetti M, Gioventù A, Gironella Gironell P, Giugliano C, Giza MA, Gizdov K, Gkougkousis EL, Gligorov VV, Göbel C, Golobardes E, Golubkov D, Golutvin A, Gomes A, Gomez Fernandez S, Goncalves Abrantes F, Goncerz M, Gong G, Gorelov IV, Gotti C, Grabowski JP, Grammatico T, Granado Cardoso LA, Graugés E, Graverini E, Graziani G, Grecu AT, Greeven LM, Grieser NA, Grillo L, Gromov S, Gruberg Cazon BR, Gu C, Guarise M, Guittiere M, Günther PA, Gushchin E, Guth A, Guz Y, Gys T, Hadavizadeh T, Hadjivasiliou C, Haefeli G, Haen C, Haimberger J, Haines SC, Halewood-Leagas T, Halvorsen MM, Hamilton PM, Hammerich J, Han Q, Han X, Hansmann-Menzemer S, Hao L, Harnew N, Harrison T, Hasse C, Hatch M, He J, Heijhoff K, Hemmer F, Henderson C, Henderson RDL, Hennequin AM, Hennessy K, Henry L, Herd J, Heuel J, Hicheur A, Hill D, Hilton M, Hollitt SE, Horswill J, Hou R, Hou Y, Hu J, Hu J, Hu W, Hu X, Huang W, Huang X, Hulsbergen W, Hunter RJ, Hushchyn M, Hutchcroft D, Ibis P, Idzik M, Ilin D, Ilten P, Inglessi A, Iniukhin A, Ishteev A, Ivshin K, Jacobsson R, Jage H, Jaimes Elles SJ, Jakobsen S, Jans E, Jashal BK, Jawahery A, Jevtic V, Jiang E, Jiang X, Jiang Y, John M, Johnson D, Jones CR, Jones TP, Joshi S, Jost B, Jurik N, Juszczak I, Kandybei S, Kang Y, Karacson M, Karpenkov D, Karpov M, Kautz JW, Keizer F, Keller DM, Kenzie M, Ketel T, Khanji B, Kharisova A, Kholodenko S, Khreich G, Kirn T, Kirsebom VS, Kitouni O, Klaver S, Kleijne N, Klimaszewski K, Kmiec MR, Koliiev S, Kolk L, Kondybayeva A, Konoplyannikov A, Kopciewicz P, Kopecna R, Koppenburg P, Korolev M, Kostiuk I, Kot O, Kotriakhova S, Kozachuk A, Kravchenko P, Kravchuk L, Kreps M, Kretzschmar S, Krokovny P, Krupa W, Krzemien W, Kubat J, Kubis S, Kucewicz W, Kucharczyk M, Kudryavtsev V, Kulikova E, Kupsc A, Lacarrere D, Lafferty G, Lai A, Lampis A, Lancierini D, Landesa Gomez C, Lane JJ, Lane R, Langenbruch C, Langer J, Lantwin O, Latham T, Lazzari F, Lazzeroni C, Le Gac R, Lee SH, Lefèvre R, Leflat A, Legotin S, Leroy O, Lesiak T, Leverington B, Li A, Li H, Li K, Li P, Li PR, Li S, Li T, Li T, Li Y, Li Z, Liang X, Lin C, Lin T, Lindner R, Lisovskyi V, Litvinov R, Liu G, Liu H, Liu K, Liu Q, Liu S, Lobo Salvia A, Loi A, Lollini R, Lomba Castro J, Longstaff I, Lopes JH, Lopez Huertas A, López Soliño S, Lovell GH, Lu Y, Lucarelli C, Lucchesi D, Luchuk S, Lucio Martinez M, Lukashenko V, Luo Y, Lupato A, Luppi E, Lusiani A, Lynch K, Lyu XR, Ma R, Maccolini S, Machefert F, Maciuc F, Mackay I, Macko V, Madhan Mohan LR, Maevskiy A, Maisuzenko D, Majewski MW, Malczewski JJ, Malde S, Malecki B, Malinin A, Maltsev T, Manca G, Mancinelli G, Mancuso C, Manera Escalero R, Manuzzi D, Manzari CA, Marangotto D, Marchand JF, Marconi U, Mariani S, Marin Benito C, Marks J, Marshall AM, Marshall PJ, Martelli G, Martellotti G, Martinazzoli L, Martinelli M, Martinez Santos D, Martinez Vidal F, Massafferri A, Materok M, Matev R, Mathad A, Matiunin V, Matteuzzi C, Mattioli KR, Mauri A, Maurice E, Mauricio J, Mazurek M, McCann M, Mcconnell L, McGrath TH, McHugh NT, McNab A, McNulty R, Meadows B, Meier G, Melnychuk D, Meloni S, Merk M, Merli A, Meyer Garcia L, Miao D, Miao H, Mikhasenko M, Milanes DA, Millard E, Milovanovic M, Minard MN, Minotti A, Minucci E, Miralles T, Mitchell SE, Mitreska B, Mitzel DS, Modak A, Mödden A, Mohammed RA, Moise RD, Mokhnenko S, Mombächer T, Monk M, Monroy IA, Monteil S, Morello G, Morello MJ, Morgenthaler MP, Moron J, Morris AB, Morris AG, Mountain R, Mu H, Muhammad E, Muheim F, Mulder M, Müller K, Murphy CH, Murray D, Murta R, Muzzetto P, Naik P, Nakada T, Nandakumar R, Nanut T, Nasteva I, Needham M, Neri N, Neubert S, Neufeld N, Neustroev P, Newcombe R, Nicolini J, Nicotra D, Niel EM, Nieswand S, Nikitin N, Nolte NS, Normand C, Novoa Fernandez J, Nowak G, Nunez C, Oblakowska-Mucha A, Obraztsov V, Oeser T, Okamura S, Oldeman R, Oliva F, Onderwater CJG, O'Neil RH, Otalora Goicochea JM, Ovsiannikova T, Owen P, Oyanguren A, Ozcelik O, Padeken KO, Pagare B, Pais PR, Pajero T, Palano A, Palutan M, Panshin G, Paolucci L, Papanestis A, Pappagallo M, Pappalardo LL, Pappenheimer C, Parker W, Parkes C, Passalacqua B, Passaleva G, Pastore A, Patel M, Patrignani C, Pawley CJ, Pellegrino A, Pepe Altarelli M, Perazzini S, Pereima D, Pereiro Castro A, Perret P, Petridis K, Petrolini A, Petrucci S, Petruzzo M, Pham H, Philippov A, Piandani R, Pica L, Piccini M, Pietrzyk B, Pietrzyk G, Pili M, Pinci D, Pisani F, Pizzichemi M, Placinta V, Plews J, Plo Casasus M, Polci F, Poli Lener M, Poluektov A, Polukhina N, Polyakov I, Polycarpo E, Ponce S, Popov D, Poslavskii S, Prasanth K, Promberger L, Prouve C, Pugatch V, Puill V, Punzi G, Qi HR, Qian W, Qin N, Qu S, Quagliani R, Raab NV, Rachwal B, Rademacker JH, Rajagopalan R, Rama M, Ramos Pernas M, Rangel MS, Ratnikov F, Raven G, Rebollo De Miguel M, Redi F, Reich J, Reiss F, Remon Alepuz C, Ren Z, Resmi PK, Ribatti R, Ricci AM, Ricciardi S, Richardson K, Richardson-Slipper M, Rinnert K, Robbe P, Robertson G, Rodrigues E, Rodriguez Fernandez E, Rodriguez Lopez JA, Rodriguez Rodriguez E, Rolf DL, Rollings A, Roloff P, Romanovskiy V, Romero Lamas M, Romero Vidal A, Roth JD, Rotondo M, Rudolph MS, Ruf T, Ruiz Fernandez RA, Ruiz Vidal J, Ryzhikov A, Ryzka J, Saborido Silva JJ, Sagidova N, Sahoo N, Saitta B, Salomoni M, Sanchez Gras C, Sanderswood I, Santacesaria R, Santamarina Rios C, Santimaria M, Santoro L, Santovetti E, Saranin D, Sarpis G, Sarpis M, Sarti A, Satriano C, Satta A, Saur M, Savrina D, Sazak H, Scantlebury Smead LG, Scarabotto A, Schael S, Scherl S, Schertz AM, Schiller M, Schindler H, Schmelling M, Schmidt B, Schmitt S, Schneider O, Schopper A, Schubiger M, Schulte N, Schulte S, Schune MH, Schwemmer R, Sciascia B, Sciuccati A, Sellam S, Semennikov A, Senghi Soares M, Sergi A, Serra N, Sestini L, Seuthe A, Shang Y, Shangase DM, Shapkin M, Shchemerov I, Shchutska L, Shears T, Shekhtman L, Shen Z, Sheng S, Shevchenko V, Shi B, Shields EB, Shimizu Y, Shmanin E, Shorkin R, Shupperd JD, Siddi BG, Silva Coutinho R, Simi G, Simone S, Singla M, Skidmore N, Skuza R, Skwarnicki T, Slater MW, Smallwood JC, Smeaton JG, Smith E, Smith K, Smith M, Snoch A, Soares Lavra L, Sokoloff MD, Soler FJP, Solomin A, Solovev A, Solovyev I, Song R, Souza De Almeida FL, Souza De Paula B, Spaan B, Spadaro Norella E, Spedicato E, Speer JG, Spiridenkov E, Spradlin P, Sriskaran V, Stagni F, Stahl M, Stahl S, Stanislaus S, Stein EN, Steinkamp O, Stenyakin O, Stevens H, Strekalina D, Su Y, Suljik F, Sun J, Sun L, Sun Y, Swallow PN, Swientek K, Szabelski A, Szumlak T, Szymanski M, Tan Y, Taneja S, Tat MD, Terentev A, Teubert F, Thomas E, Thompson DJD, Tilquin H, Tisserand V, T'Jampens S, Tobin M, Tomassetti L, Tonani G, Tong X, Torres Machado D, Tou DY, Trippl C, Tuci G, Tuning N, Ukleja A, Unverzagt DJ, Usachov A, Ustyuzhanin A, Uwer U, Vagnoni V, Valassi A, Valenti G, Valls Canudas N, Van Dijk M, Van Hecke H, van Herwijnen E, Van Hulse CB, van Veghel M, Vazquez Gomez R, Vazquez Regueiro P, Vázquez Sierra C, Vecchi S, Velthuis JJ, Veltri M, Venkateswaran A, Veronesi M, Vesterinen M, Vieira D, Vieites Diaz M, Vilasis-Cardona X, Vilella Figueras E, Villa A, Vincent P, Volle FC, Vom Bruch D, Vorobyev V, Voropaev N, Vos K, Vrahas C, Walsh J, Walton EJ, Wan G, Wang C, Wang G, Wang J, Wang J, Wang J, Wang J, Wang M, Wang R, Wang X, Wang Y, Wang Z, Wang Z, Wang Z, Ward JA, Watson NK, Websdale D, Wei Y, Westhenry BDC, White DJ, Whitehead M, Wiederhold AR, Wiedner D, Wilkinson G, Wilkinson MK, Williams I, Williams M, Williams MRJ, Williams R, Wilson FF, Wislicki W, Witek M, Witola L, Wong CP, Wormser G, Wotton SA, Wu H, Wu J, Wyllie K, Xiang Z, Xie Y, Xu A, Xu J, Xu L, Xu L, Xu M, Xu Q, Xu Z, Xu Z, Yang D, Yang S, Yang X, Yang Y, Yang Z, Yang Z, Yeomans LE, Yeroshenko V, Yeung H, Yin H, Yu J, Yuan X, Zaffaroni E, Zavertyaev M, Zdybal M, Zeng M, Zhang C, Zhang D, Zhang J, Zhang L, Zhang S, Zhang S, Zhang Y, Zhang Y, Zhao Y, Zharkova A, Zhelezov A, Zheng Y, Zhou T, Zhou X, Zhou Y, Zhovkovska V, Zhu X, Zhu X, Zhu Z, Zhukov V, Zou Q, Zucchelli S, Zuliani D, Zunica G. Measurement of the Λ_{b}^{0}→Λ(1520)μ^{+}μ^{-} Differential Branching Fraction. PHYSICAL REVIEW LETTERS 2023; 131:151801. [PMID: 37897753 DOI: 10.1103/physrevlett.131.151801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/11/2023] [Indexed: 10/30/2023]
Abstract
The branching fraction of the rare decay Λ_{b}^{0}→Λ(1520)μ^{+}μ^{-} is measured for the first time, in the squared dimuon mass intervals q^{2}, excluding the J/ψ and ψ(2S) regions. The data sample analyzed was collected by the LHCb experiment at center-of-mass energies of 7, 8, and 13 TeV, corresponding to a total integrated luminosity of 9 fb^{-1}. The result in the highest q^{2} interval, q^{2}>15.0 GeV^{2}/c^{4}, where theoretical predictions have the smallest model dependence, agrees with the predictions.
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K, Younas S, Young CJS, Young C, Yu Y, Yuan M, Yuan R, Yue L, Zaazoua M, Zabinski B, Zaid E, Zakareishvili T, Zakharchuk N, Zambito S, Zamora Saa JA, Zang J, Zanzi D, Zaplatilek O, Zeitnitz C, Zeng H, Zeng JC, Zenger DT, Zenin O, Ženiš T, Zenz S, Zerradi S, Zerwas D, Zhai M, Zhang B, Zhang DF, Zhang J, Zhang J, Zhang K, Zhang L, Zhang P, Zhang R, Zhang S, Zhang T, Zhang X, Zhang X, Zhang Y, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao P, Zhao T, Zhao Y, Zhao Z, Zhemchugov A, Zheng K, Zheng X, Zheng Z, Zhong D, Zhou B, Zhou H, Zhou N, Zhou Y, Zhu CG, Zhu J, Zhu Y, Zhu Y, Zhuang X, Zhukov K, Zhulanov V, Zimine NI, Zinsser J, Ziolkowski M, Živković L, Zoccoli A, Zoch K, Zorbas TG, Zormpa O, Zou W, Zwalinski L. Observation of an Excess of Dicharmonium Events in the Four-Muon Final State with the ATLAS Detector. PHYSICAL REVIEW LETTERS 2023; 131:151902. [PMID: 37897770 DOI: 10.1103/physrevlett.131.151902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/31/2023] [Accepted: 08/11/2023] [Indexed: 10/30/2023]
Abstract
A search is made for potential ccc[over ¯]c[over ¯] tetraquarks decaying into a pair of charmonium states in the four muon final state using proton-proton collision data at sqrt[s]=13 TeV, corresponding to an integrated luminosity of 140 fb^{-1} recorded by the ATLAS experiment at LHC. Two decay channels, J/ψ+J/ψ→4μ and J/ψ+ψ(2S)→4μ, are studied. Backgrounds are estimated based on a hybrid approach involving Monte Carlo simulations and data-driven methods. Statistically significant excesses with respect to backgrounds dominated by the single parton scattering are seen in the di-J/ψ channel consistent with a narrow resonance at 6.9 GeV and a broader structure at lower mass. A statistically significant excess is also seen in the J/ψ+ψ(2S) channel. The fitted masses and decay widths of the structures are reported.
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Ulloa Poblete PA, Unal G, Unal M, Undrus A, Unel G, Uno K, Urban J, Urquijo P, Usai G, Ushioda R, Usman M, Uysal Z, Vacek V, Vachon B, Vadla KOH, Vafeiadis T, Valderanis C, Valdes Santurio E, Valente M, Valentinetti S, Valero A, Vallier A, Valls Ferrer JA, Van Daalen TR, Van Gemmeren P, Van Rijnbach M, Van Stroud S, Van Vulpen I, Vanadia M, Vandelli W, Vandenbroucke M, Vandewall ER, Vannicola D, Vannoli L, Vari R, Varnes EW, Varni C, Varol T, Varouchas D, Varriale L, Varvell KE, Vasile ME, Vaslin L, Vasquez GA, Vazeille F, Vazquez Schroeder T, Veatch J, Vecchio V, Veen MJ, Veliscek I, Veloce LM, Veloso F, Veneziano S, Ventura A, Verbytskyi A, Verducci M, Vergis C, Verissimo De Araujo M, Verkerke W, Vermeulen JC, Vernieri C, Verschuuren PJ, Vessella M, Vesterbacka ML, Vetterli MC, Vgenopoulos A, Viaux Maira N, Vickey T, Vickey Boeriu OE, Viehhauser GHA, Vigani L, Villa M, Villaplana Perez M, Villhauer EM, Vilucchi E, Vincter MG, Virdee GS, Vishwakarma A, Vittori C, Vivarelli I, Vladimirov V, Voevodina E, Vogel F, Vokac P, Von Ahnen J, Von Toerne E, Vormwald B, Vorobel V, Vorobev K, Vos M, Vossebeld JH, Vozak M, Vozdecky L, Vranjes N, Vranjes Milosavljevic M, Vreeswijk M, Vuillermet R, Vujinovic O, Vukotic I, Wada S, Wagner C, Wagner W, Wahdan S, Wahlberg H, Wakasa R, Wakida M, Walbrecht VM, Walder J, Walker R, Walkowiak W, Wang AM, Wang AZ, Wang C, Wang C, Wang H, Wang J, Wang P, Wang RJ, Wang R, Wang R, Wang SM, Wang S, Wang T, Wang WT, Wang WX, Wang X, Wang X, Wang X, Wang Y, Wang Y, Wang Z, Wang Z, Wang Z, Warburton A, Ward RJ, Warrack N, Watson AT, Watson MF, Watts G, Waugh BM, Webb AF, Weber C, Weber MS, Weber SA, Weber SM, Wei C, Wei Y, Weidberg AR, Weingarten J, Weirich M, Weiser C, Wells CJ, Wenaus T, Wendland B, Wengler T, Wenke NS, Wermes N, Wessels M, Whalen K, Wharton AM, White AS, White A, White MJ, Whiteson D, Wickremasinghe L, Wiedenmann W, Wiel C, Wielers M, Wieseotte N, Wiglesworth C, Wiik-Fuchs LAM, Wilbern DJ, Wilkens HG, Williams DM, Williams HH, Williams S, Willocq S, Windischhofer PJ, Winklmeier F, Winter BT, Wittgen M, Wobisch M, Wolf A, Wölker R, Wollrath J, Wolter MW, Wolters H, Wong VWS, Wongel AF, Worm SD, Wosiek BK, Woźniak KW, Wraight K, Wu J, Wu M, Wu SL, Wu X, Wu Y, Wu Z, Wuerzinger J, Wyatt TR, Wynne BM, Xella S, Xia L, Xia M, Xiang J, Xiao X, Xie M, Xie X, Xiong J, Xiotidis I, Xu D, Xu H, Xu H, Xu L, Xu R, Xu T, Xu W, Xu Y, Xu Z, Xu Z, Yabsley B, Yacoob S, Yamaguchi N, Yamaguchi Y, Yamauchi H, Yamazaki T, Yamazaki Y, Yan J, Yan S, Yan Z, Yang HJ, Yang HT, Yang S, Yang T, Yang X, Yang X, Yang Y, Yang Z, Yao WM, Yap YC, Ye H, Ye J, Ye S, Ye X, Yeh Y, Yeletskikh I, Yexley MR, Yin P, Yorita K, Young CJS, Young C, Yuan M, Yuan R, Yue L, Yue X, Zaazoua M, Zabinski B, Zaid E, Zakareishvili T, Zakharchuk N, Zambito S, Zamora Saa JA, Zang J, Zanzi D, Zaplatilek O, Zeißner SV, Zeitnitz C, Zeng JC, Zenger DT, Zenin O, Ženiš T, Zenz S, Zerradi S, Zerwas D, Zhang B, Zhang DF, Zhang G, Zhang J, Zhang K, Zhang L, Zhang P, Zhang R, Zhang S, Zhang T, Zhang X, Zhang X, Zhang Z, Zhang Z, Zhao H, Zhao P, Zhao T, Zhao Y, Zhao Z, Zhemchugov A, Zheng Z, Zhong D, Zhou B, Zhou C, Zhou H, Zhou N, Zhou Y, Zhu CG, Zhu C, Zhu HL, Zhu H, Zhu J, Zhu Y, Zhu Y, Zhuang X, Zhukov K, Zhulanov V, Zimine NI, Zinsser J, Ziolkowski M, Živković L, Zoccoli A, Zoch K, Zorbas TG, Zormpa O, Zou W, Zwalinski L. Observation of the γγ→ττ Process in Pb+Pb Collisions and Constraints on the τ-Lepton Anomalous Magnetic Moment with the ATLAS Detector. PHYSICAL REVIEW LETTERS 2023; 131:151802. [PMID: 37897746 DOI: 10.1103/physrevlett.131.151802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/07/2022] [Indexed: 10/30/2023]
Abstract
This Letter reports the observation of τ-lepton-pair production in ultraperipheral lead-lead collisions Pb+Pb→Pb(γγ→ττ)Pb and constraints on the τ-lepton anomalous magnetic moment a_{τ}. The dataset corresponds to an integrated luminosity of 1.44 nb^{-1} of LHC Pb+Pb collisions at sqrt[s_{NN}]=5.02 TeV recorded by the ATLAS experiment in 2018. Selected events contain one muon from a τ-lepton decay, an electron or charged-particle track(s) from the other τ-lepton decay, little additional central-detector activity, and no forward neutrons. The γγ→ττ process is observed in Pb+Pb collisions with a significance exceeding 5 standard deviations and a signal strength of μ_{ττ}=1.03_{-0.05}^{+0.06} assuming the standard model value for a_{τ}. To measure a_{τ}, a template fit to the muon transverse-momentum distribution from τ-lepton candidates is performed, using a dimuon (γγ→μμ) control sample to constrain systematic uncertainties. The observed 95% confidence-level interval for a_{τ} is -0.057
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Cao Z, Aharonian F, An Q, Axikegu, Bai YX, Bao YW, Bastieri D, Bi XJ, Bi YJ, Cai JT, Cao Q, Cao WY, Cao Z, Chang J, Chang JF, Chen AM, Chen ES, Chen L, Chen L, Chen L, Chen MJ, Chen ML, Chen QH, Chen SH, Chen SZ, Chen TL, Chen Y, Cheng N, Cheng YD, Cui MY, Cui SW, Cui XH, Cui YD, Dai BZ, Dai HL, Dai ZG, Danzengluobu, Della Volpe D, Dong XQ, Duan KK, Fan JH, Fan YZ, Fang J, Fang K, Feng CF, Feng L, Feng SH, Feng XT, Feng YL, Gabici S, Gao B, Gao CD, Gao LQ, Gao Q, Gao W, Gao WK, Ge MM, Geng LS, Giacinti G, Gong GH, Gou QB, Gu MH, Guo FL, Guo XL, Guo YQ, Guo YY, Han YA, He HH, He HN, He JY, He XB, He Y, Heller M, Hor YK, Hou BW, Hou C, Hou X, Hu HB, Hu Q, Hu SC, Huang DH, Huang TQ, Huang WJ, Huang XT, Huang XY, Huang Y, Huang ZC, Ji XL, Jia HY, Jia K, Jiang K, Jiang XW, Jiang ZJ, Jin M, Kang MM, Ke T, Kuleshov D, Kurinov K, Li BB, Li C, Li C, Li D, Li F, Li HB, Li HC, Li HY, Li J, Li J, Li J, Li K, Li WL, Li WL, Li XR, Li X, Li YZ, Li Z, Li Z, Liang EW, Liang YF, Lin SJ, Liu B, Liu C, Liu D, Liu H, Liu HD, Liu J, Liu JL, Liu JY, Liu MY, Liu RY, Liu SM, Liu W, Liu Y, Liu YN, Lu R, Luo Q, Lv HK, Ma BQ, Ma LL, Ma XH, Mao JR, Min Z, Mitthumsiri W, Mu HJ, Nan YC, Neronov A, Ou ZW, Pang BY, Pattarakijwanich P, Pei ZY, Qi MY, Qi YQ, Qiao BQ, Qin JJ, Ruffolo D, Sáiz A, Semikoz D, Shao CY, Shao L, Shchegolev O, Sheng XD, Shu FW, Song HC, Stenkin YV, Stepanov V, Su Y, Sun QN, Sun XN, Sun ZB, Tam PHT, Tang QW, Tang ZB, Tian WW, Wang C, Wang CB, Wang GW, Wang HG, Wang HH, Wang JC, Wang K, Wang LP, Wang LY, Wang PH, Wang R, Wang W, Wang XG, Wang XY, Wang Y, Wang YD, Wang YJ, Wang ZH, Wang ZX, Wang Z, Wang Z, Wei DM, Wei JJ, Wei YJ, Wen T, Wu CY, Wu HR, Wu S, Wu XF, Wu YS, Xi SQ, Xia J, Xia JJ, Xiang GM, Xiao DX, Xiao G, Xin GG, Xin YL, Xing Y, Xiong Z, Xu DL, Xu RF, Xu RX, Xu WL, Xue L, Yan DH, Yan JZ, Yan T, Yang CW, Yang F, Yang FF, Yang HW, Yang JY, Yang LL, Yang MJ, Yang RZ, Yang SB, Yao YH, Yao ZG, Ye YM, Yin LQ, Yin N, You XH, You ZY, Yu YH, Yuan Q, Yue H, Zeng HD, Zeng TX, Zeng W, Zha M, Zhang BB, Zhang F, Zhang HM, Zhang HY, Zhang JL, Zhang LX, Zhang L, Zhang PF, Zhang PP, Zhang R, Zhang SB, Zhang SR, Zhang SS, Zhang X, Zhang XP, Zhang YF, Zhang Y, Zhang Y, Zhao B, Zhao J, Zhao L, Zhao LZ, Zhao SP, Zheng F, Zhou B, Zhou H, Zhou JN, Zhou M, Zhou P, Zhou R, Zhou XX, Zhu CG, Zhu FR, Zhu H, Zhu KJ, Zuo X. Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A. PHYSICAL REVIEW LETTERS 2023; 131:151001. [PMID: 37897763 DOI: 10.1103/physrevlett.131.151001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/08/2023] [Accepted: 08/18/2023] [Indexed: 10/30/2023]
Abstract
The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10 TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60 TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.
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Ablikim M, Achasov MN, Adlarson P, Ai XC, Aliberti R, Amoroso A, An MR, An Q, Bai Y, Bakina O, Balossino I, Ban Y, Batozskaya V, Begzsuren K, Berger N, Berlowski M, Bertani M, Bettoni D, Bianchi F, Bianco E, Bortone A, Boyko I, Briere RA, Brueggemann A, Cai H, Cai X, Calcaterra A, Cao GF, Cao N, Cetin SA, Chang JF, Chang TT, Chang WL, Che GR, Chelkov G, Chen C, Chen C, Chen G, Chen HS, Chen ML, Chen SJ, Chen SM, Chen T, Chen XR, Chen XT, Chen YB, Chen YQ, Chen ZJ, Cheng WS, Choi SK, Chu X, Cibinetto G, Coen SC, Cossio F, Cui JJ, Dai HL, Dai JP, Dbeyssi A, de Boer RE, Dedovich D, Deng ZY, Denig A, Denysenko I, Destefanis M, De Mori F, Ding B, Ding XX, Ding Y, Ding Y, Dong J, Dong LY, Dong MY, Dong X, Du MC, Du SX, Duan ZH, Egorov P, Fan YL, Fang J, Fang SS, Fang WX, Fang Y, Farinelli R, Fava L, Feldbauer F, Felici G, Feng CQ, Feng JH, Fischer K, Fritsch M, Fritzsch C, Fu CD, Fu JL, Fu YW, Gao H, Gao YN, Gao Y, Garbolino S, Garzia I, Ge PT, Ge ZW, Geng C, Gersabeck EM, Gilman A, Goetzen K, Gong L, Gong WX, Gradl W, Gramigna S, Greco M, Gu MH, Gu YT, Guan CY, Guan ZL, Guo AQ, Guo LB, Guo MJ, Guo RP, Guo YP, Guskov A, Han TT, Han WY, Hao XQ, Harris FA, He KK, He KL, Heinsius FHH, Heinz CH, Heng YK, Herold C, Holtmann T, Hong PC, Hou GY, Hou XT, Hou YR, Hou ZL, Hu HM, Hu JF, Hu T, Hu Y, Huang GS, Huang KX, Huang LQ, Huang XT, Huang YP, Hussain T, Hüsken N, Imoehl W, Irshad M, Jackson J, Jaeger S, Janchiv S, Jeong JH, Ji Q, Ji QP, Ji XB, Ji XL, Ji YY, Jia XQ, Jia ZK, Jiang PC, Jiang SS, Jiang TJ, Jiang XS, Jiang Y, Jiao JB, Jiao Z, Jin S, Jin Y, Jing MQ, Johansson T, X K, Kabana S, Kalantar-Nayestanaki N, Kang XL, Kang XS, Kappert R, Kavatsyuk M, Ke BC, Khoukaz A, Kiuchi R, Kliemt R, Kolcu OB, Kopf B, Kuessner MK, Kupsc A, Kühn W, Lane JJ, Larin P, Lavania A, Lavezzi L, Lei TT, Lei ZH, Leithoff H, Lellmann M, Lenz T, Li C, Li C, Li CH, Li C, Li DM, Li F, Li G, Li H, Li HB, Li HJ, Li HN, Li H, Li JR, Li JS, Li JW, Li KL, Li K, Li LJ, Li LK, Li L, Li MH, Li PR, Li QX, Li SX, Li T, Li WD, Li WG, Li XH, Li XL, Li X, Li YG, Li ZJ, Li ZX, Liang C, Liang H, Liang H, Liang H, Liang YF, Liang YT, Liao GR, Liao LZ, Liao YP, Libby J, Limphirat A, Lin DX, Lin T, Liu BJ, Liu BX, Liu C, Liu CX, Liu FH, Liu F, Liu F, Liu GM, Liu H, Liu HB, Liu HM, Liu H, Liu H, Liu JB, Liu JL, Liu JY, Liu K, Liu KY, Liu K, Liu L, Liu LC, Liu L, Liu MH, Liu PL, Liu Q, Liu SB, Liu T, Liu WK, Liu WM, Liu X, Liu Y, Liu Y, Liu YB, Liu ZA, Liu ZQ, Lou XC, Lu FX, Lu HJ, Lu JG, Lu XL, Lu Y, Lu YP, Lu ZH, Luo CL, Luo MX, Luo T, Luo XL, Lyu XR, Lyu YF, Ma FC, Ma HL, Ma JL, Ma LL, Ma MM, Ma QM, Ma RQ, Ma RT, Ma XY, Ma Y, Ma YM, Maas FE, Maggiora M, Malde S, Malik QA, Mangoni A, Mao YJ, Mao ZP, Marcello S, Meng ZX, Messchendorp JG, Mezzadri G, Miao H, Min TJ, Mitchell RE, Mo XH, Muchnoi NY, Nefedov Y, Nerling F, Nikolaev IB, Ning Z, Nisar S, Niu Y, Olsen SL, Ouyang Q, Pacetti S, Pan X, Pan Y, Pathak A, Patteri P, Pei YP, Pelizaeus M, Peng HP, Peters K, Ping JL, Ping RG, Plura S, Pogodin S, Prasad V, Qi FZ, Qi H, Qi HR, Qi M, Qi TY, Qian S, Qian WB, Qiao CF, Qin JJ, Qin LQ, Qin XP, Qin XS, Qin ZH, Qiu JF, Qu SQ, Redmer CF, Ren KJ, Rivetti A, Rodin V, Rolo M, Rong G, Rosner C, Ruan SN, Salone N, Sarantsev A, Schelhaas Y, Schoenning K, Scodeggio M, Shan KY, Shan W, Shan XY, Shangguan JF, Shao LG, Shao M, Shen CP, Shen HF, Shen WH, Shen XY, Shi BA, Shi HC, Shi JL, Shi JY, Shi QQ, Shi RS, Shi X, Song JJ, Song TZ, Song WM, Song YJ, Song YX, Sosio S, Spataro S, Stieler F, Su YJ, Sun GB, Sun GX, Sun H, Sun HK, Sun JF, Sun K, Sun L, Sun SS, Sun T, Sun WY, Sun Y, Sun YJ, Sun YZ, Sun ZT, Tan YX, Tang CJ, Tang GY, Tang J, Tang YA, Tao LY, Tao QT, Tat M, Teng JX, Thoren V, Tian WH, Tian WH, Tian Y, Tian ZF, Uman I, Wang SJ, Wang B, Wang BL, Wang B, Wang CW, Wang DY, Wang F, Wang HJ, Wang HP, Wang JP, Wang K, Wang LL, Wang M, Wang M, Wang S, Wang S, Wang T, Wang TJ, Wang W, Wang W, Wang WP, Wang X, Wang XF, Wang XJ, Wang XL, Wang Y, Wang YD, Wang YF, Wang YH, Wang YN, Wang YQ, Wang Y, Wang Y, Wang Z, Wang ZL, Wang ZY, Wang Z, Wei D, Wei DH, Weidner F, Wen SP, Wenzel CW, Wiedner UW, Wilkinson G, Wolke M, Wollenberg L, Wu C, Wu JF, Wu LH, Wu LJ, Wu X, Wu XH, Wu Y, Wu YJ, Wu Z, Xia L, Xian XM, Xiang T, Xiao D, Xiao GY, Xiao H, Xiao SY, Xiao YL, Xiao ZJ, Xie C, Xie XH, Xie Y, Xie YG, Xie YH, Xie ZP, Xing TY, Xu CF, Xu CJ, Xu GF, Xu HY, Xu QJ, Xu QN, Xu W, Xu WL, Xu XP, Xu YC, Xu ZP, Xu ZS, Yan F, Yan L, Yan WB, Yan WC, Yan XQ, Yang HJ, Yang HL, Yang HX, Yang T, Yang Y, Yang YF, Yang YX, Yang Y, Yang ZW, Yao ZP, Ye M, Ye MH, Yin JH, You ZY, Yu BX, Yu CX, Yu G, Yu JS, Yu T, Yu XD, Yuan CZ, Yuan L, Yuan SC, Yuan XQ, Yuan Y, Yuan ZY, Yue CX, Zafar AA, Zeng FR, Zeng X, Zeng Y, Zeng YJ, Zhai XY, Zhai YC, Zhan YH, Zhang AQ, Zhang BL, Zhang BX, Zhang DH, Zhang GY, Zhang H, Zhang HH, Zhang HH, Zhang HQ, Zhang HY, Zhang JJ, Zhang JL, Zhang JQ, Zhang JW, Zhang JX, Zhang JY, Zhang JZ, Zhang J, Zhang J, Zhang LM, Zhang LQ, Zhang L, Zhang P, Zhang QY, Zhang S, Zhang S, Zhang XD, Zhang XM, Zhang XY, Zhang XY, Zhang Y, Zhang Y, Zhang YT, Zhang YH, Zhang Y, Zhang Y, Zhang ZH, Zhang ZL, Zhang ZY, Zhang ZY, Zhao G, Zhao J, Zhao JY, Zhao JZ, Zhao L, Zhao L, Zhao MG, Zhao SJ, Zhao YB, Zhao YX, Zhao ZG, Zhemchugov A, Zheng B, Zheng JP, Zheng WJ, Zheng YH, Zhong B, Zhong X, Zhou H, Zhou LP, Zhou X, Zhou XK, Zhou XR, Zhou XY, Zhou YZ, Zhu J, Zhu K, Zhu KJ, Zhu L, Zhu LX, Zhu SH, Zhu SQ, Zhu TJ, Zhu WJ, Zhu YC, Zhu ZA, Zou JH, Zu J. Precise Measurement of the e^{+}e^{-}→D_{s}^{*+}D_{s}^{*-} Cross Sections at Center-of-Mass Energies from Threshold to 4.95 GeV. PHYSICAL REVIEW LETTERS 2023; 131:151903. [PMID: 37897771 DOI: 10.1103/physrevlett.131.151903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 10/30/2023]
Abstract
The process e^{+}e^{-}→D_{s}^{*+}D_{s}^{*-} is studied with a semi-inclusive method using data samples at center-of-mass energies from threshold to 4.95 GeV collected with the BESIII detector operating at the Beijing Electron Positron Collider. The Born cross sections of the process are measured for the first time with high precision in this energy region. Two resonance structures are observed in the energy-dependent cross sections around 4.2 and 4.4 GeV. By fitting the cross sections with a coherent sum of three Breit-Wigner amplitudes and one phase-space amplitude, the two significant structures are assigned masses of (4186.8±8.7±30) and (4414.6±3.4±6.1) MeV/c^{2}, widths of (55±15±53) and (122.5±7.5±8.1) MeV, where the first errors are statistical and the second ones are systematic. The inclusion of a third Breit-Wigner amplitude is necessary to describe a structure around 4.79 GeV.
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Yin MY, Wang Y, Tang Y, Han QH. [Human amniotic membrane plug for recurrent retinal detachment associated with pathologic myopic macular hole]. [ZHONGHUA YAN KE ZA ZHI] CHINESE JOURNAL OF OPHTHALMOLOGY 2023; 59:846-849. [PMID: 37805418 DOI: 10.3760/cma.j.cn112142-20221211-00631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
A 60-year-old woman presented with a history of "pathological myopia combined with macular hole retinal detachment, " for which she underwent vitrectomy, internal limiting membrane tamponade, and silicone oil filling surgery one year ago. Seven months ago, the silicone oil was removed. She now returned to seek medical attention as her visual acuity has declined by 10 diopters. Examination revealed a recurrence of macular hole retinal detachment. The patient was treated with combined amniotic membrane tamponade and silicone oil filling. During the surgery, the frozen amniotic membrane was cut into 2 mm × 2 mm and placed under the macular hole retina after silicone oil filling. Within 6 months after the surgery, her retina repositioned well, the macular hole closed, and her visual function improved from hand motion to 0.05. No severe complications were observed. Therefore, this surgical approach provides a new perspective for treating recurrent pathological myopia combined with macular hole retinal detachment.
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Xue Y, Yang X, Zhang H, Zhang T, Chen W, Chang X, Wang Y. [Protective effect of recombinant Schistosoma japonicum cystatin against acute kidney injury associated with acute liver failure in mice]. ZHONGGUO XUE XI CHONG BING FANG ZHI ZA ZHI = CHINESE JOURNAL OF SCHISTOSOMIASIS CONTROL 2023; 35:331-339. [PMID: 37926467 DOI: 10.16250/j.32.1374.2023067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To evaluate the protective effect of recombinant Schistosoma japonicum cystatin (rSj-Cys) against acute kidney injury induced by acute liver failure and unravel the underlying mechanism, so as to provide insights into the clinical therapy of acute kidney injury. METHODS Twenty-four male C57BL/6J mice at ages of 6 to 8 weeks were randomly divided into the normal control group, rSj-Cys control group, lipopolysaccharide (LPS)/D-galactosamine (D-GaIN) model group and LPS/D-GaIN + rSj-Cys treatment group, of 6 mice each group. Mice in the LPS/D-GaIN group and LPS/D-GaIN + rSj-Cys group were intraperitoneally injected with LPS (10 μg/kg) and D-GaIN (700 mg/kg), and mice in the LPS/D-GaIN + rSj-Cys group were additionally administered with rSj-Cys (1.25 mg/kg) by intraperitoneal injection 30 min post-modeling, while mice in the rSj-Cys group were intraperitoneally injected with rSj-Cys (1.25 mg/kg), and mice in the normal control group were injected with the normal volume of PBS. All mice were sacrificed 6 h post-modeling, and mouse serum and kidney samples were collected. Serum creatinine (Cr) and urea nitrogen (BUN) levels were measured, and the pathological changes of mouse kidney specimens were examined using hematoxylin-eosin (HE) staining. Serum tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were detected using enzyme-linked immunosorbent assay (ELISA), and the expression of inflammatory factors and pyroptosis-related proteins was quantified in mouse kidney specimens using immunohistochemistry. In addition, the expression of pyroptosis-related proteins and nuclear factor-kappa B (NF-κB) signaling pathway-associated proteins was determined in mouse kidney specimens using Western blotting assay. RESULTS HE staining showed no remarkable abnormality in the mouse kidney structure in the normal control group and the rSj-Cys control group, and renal tubular injury was found in LPS/D-GaIN group, while the renal tubular injury was alleviated in LPS/D-GaIN+rSj-Cys treatment group. There were significant differences in serum levels of Cr (F = 46.33, P < 0.001), BUN (F = 128.60, P < 0.001), TNF-α (F = 102.00, P < 0.001) and IL-6 (F = 202.10, P < 0.001) among the four groups, and lower serum Cr [(85.35 ± 32.05) μmol/L], BUN [(11.90 ± 2.76) mmol/L], TNF-α [(158.27 ± 15.83) pg/mL] and IL-6 levels [(56.72 ± 4.37) pg/mL] were detected in the in LPS/D-GaIN + rSj-Cys group than in the LPS/D-GaIN group (all P values < 0.01). Immunohistochemical staining detected significant differences in TNF-α (F = 24.16, P < 0.001) and IL-10 (F = 15.07, P < 0.01) expression among the four groups, and lower TNF-α [(106.50 ± 16.57)%] and higher IL-10 expression [(91.83 ± 5.23)%] was detected in the LPS/D-GaIN + rSj-Cys group than in the LPS/D-GaIN group (both P values < 0.01). Western blotting and immunohistochemistry detected significant differences in the protein expression of pyroptosis-related proteins NOD-like receptor thermal protein domain associated protein 3 (NLRP3) (F = 24.57 and 30.72, both P values < 0.001), IL-1β (F = 19.24 and 22.59, both P values < 0.001) and IL-18 (F = 16.60 and 19.30, both P values < 0.001) in kidney samples among the four groups, and lower NLRP3, IL-1β and IL-18 expression was quantified in the LPS/D-GaIN + rSj-Cys treatment group than in the LPS/D-GaIN group (P values < 0.05). In addition, there were significant differences in the protein expression of NF-κB signaling pathway-associated proteins p-NF-κB p-P65/NF-κB p65 (F = 71.88, P < 0.001), Toll-like receptor (TLR)-4 (F = 45.49, P < 0.001) and p-IκB/IκB (F = 60.87, P < 0.001) in mouse kidney samples among the four groups, and lower expression of three NF-κB signaling pathway-associated proteins was determined in the LPS/D-GaIN + rSj-Cys treatment group than in the LPS/D-GaIN group (all P values < 0.01). CONCLUSIONS rSj-Cys may present a protective effect against acute kidney injury caused by acute liver failure through inhibiting inflammation and pyroptosis and downregulating the NF-κB signaling pathway.
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Han JB, Luo ZH, Dong J, Wang Y, Hua QQ. [Efficacy of Barbed reposition pharyngoplasty combined with Han-Uvulopalatopharyngoplasty for the treatment of OSAHS patients]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2023; 58:959-965. [PMID: 37840160 DOI: 10.3760/cma.j.cn115330-20221202-00725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Objective: To study the efficacy of Barbed reposition pharyngoplasty (BRP) combined with Han-Uvulopalatopharyngoplasty (H-UPPP) in surgical treatment of OSAHS patients. Methods: OSAHS patients admitted to our department from June 2021 to February 2022 who met the surgical enrollment criteria were divided into two groups by surgical procedure: H-UPPP operation group [Control group, 47 cases, including 42 males and 5 females, aged 18-64 (37.77±11.65)years, and H-UPPP+BRP group [Study group, 48 cases, including 45 males and 3 females, aged 23-60 (39.10±9.86) years]. The surgical efficacy 6 months after operation was retrospectively analyzed. Meanwhile, the relationship between the surgical efficacy and modified Friedman pharyngeal anatomical stages was analyzed. The postoperative pain VAS score at first 3 days and the incidence of foreign body sensation in pharynx after 6 months of operation were compared between the two groups. Statistical analysis was conducted by SPSS 23.0. Results: There were no significant differences in gender, age, BMI, Friedman pharyngeal anatomical stages, ESS score, AHI and LSpO2 between the two groups, preoperatively (P>0.05). There was significant difference between the two groups in ratio of cumulative time of oxygen saturation below 90% to total sleep time(CT90), preoperatively. Surgical efficacy of H-UPPP operation group was 48.9% (23/47), while H-UPPP+BRP operation group was 70.8% (34/48), which was statistically significant (χ2=4.74, P=0.029). H-UPPP+BRP group seemed to have a higher surgical efficacy than H-UPPP group in patients with Friedman Ⅱb (87% vs. 61.9%) and Ⅲ stage (44.4% vs. 15%), but there was no statistically significant difference (P>0.05). H-UPPP+BRP group had a higher pain VAS score in first three days (t=-3.10, P=0.003), also had higher incidence of pharyngeal foreign body sensation after 6 months of operation (χ2=4.727, P=0.030). Conclusions: In the surgical treatment of OSAHS patients, the overall efficacy of BRP combined H-UPPP surgery is higher than that of H-UPPP surgery alone. It may be more suitable for OSAHS patients with modified Friedman type Ⅱb and type Ⅲ stage.
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Hu WQ, Cong H, Fang RH, Yuan WT, Mao CY, Wang JR, Wang Y, Shi XY. [Application of preoperative serum CYFRA 21-1 level in the prognosis of colorectal cancer]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2023; 57:1613-1619. [PMID: 37859379 DOI: 10.3760/cma.j.cn112150-20230611-00457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
To explore the predictive value of preoperative serum CYFRA 21-1 in colorectal cancer (CRC) resection patients. In this retrospective study, 456 patients with CRC who received surgical treatment in the Department of General Surgery, Affiliated Hospital of Nantong University from January 2016 to February 2018 were analyzed. Preoperative CYFRA 21-1, CEA, CA19-9 and pathological data of the study subjects were collected. Determine the cut-off value of CYFRA 21-1 based on the X-tile. Chi-square test or Fisher exact probability test were used to compare clinicopathological features in different CYFRA 21-1 level groups. Univariate and multivariate regression analysis of factors affecting 5-year overall survival (OS) and disease-free survival (DFS). Kaplan-Meier survival curves were used to analyze 5-year differences in OS and DFS in CRC patients with different levels of CYFRA 21-1, CEA and CA19-9. Receiver operating characteristic(ROC) was adopted. ROC curves were used to analyze the prognostic efficacy of CYFRA21-1 for CRC, and nomogram maps were used to predict 1, 3, and 5-year survival rates. The results showed that the optimal cut-off values of serum CYFRA 21-1, CEA and CA19-9 were 4.9 ng/ml, 29.2 ng/ml and 72.8 U/ml, respectively. Different gender, tumor size, location, degree of differentiation, depth of invasion, lymph node metastasis and tumor node metastasis (TNM) classification stage were significantly different between the two groups with high and low CYFRA 21-1, the P-values were 0.018,<0.001,<0.001,<0.001, 0.002, 0.001, 0.003, respectively. CYFRA 21-1 (≥4.9 ng/ml) was an independent risk factor for 5-year OS (HR: 4.008, 95%CI: 2.309-6.958, P<0.001) and DFS (HR: 3.75, 95%CI: 2.227-6.314, P<0.001) in CRC patients. CYFRA 21-1 predicts a 5-year AUC of 0.725 and 0.720 for OS and DFS, respectively, and 0.804 and 0.827 for the combination of CEA and CA19-9. Based on the results of multivariate Cox regression analysis, nomogram graphs of OS and DFS were established, the C-indexes were 0.799 and 0.803, respectively. In conclusion, preoperative serum CYFRA 21-1 level may be an independent risk factor affecting the prognosis of patients with colorectal cancer. The prognostic model established by CYFRA 21-1 combined with CEA, CA19-9 and TNM stages may provide references for the prevention of CRC recurrence and clinical decision-making.
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Ablikim M, Achasov MN, Adlarson P, Aliberti R, Amoroso A, An MR, An Q, Bai Y, Bakina O, Balossino I, Ban Y, Batozskaya V, Begzsuren K, Berger N, Berlowski M, Bertani M, Bettoni D, Bianchi F, Bianco E, Bloms J, Bortone A, Boyko I, Briere RA, Brueggemann A, Cai H, Cai X, Calcaterra A, Cao GF, Cao N, Cetin SA, Chang JF, Chang TT, Chang WL, Che GR, Chelkov G, Chen C, Chen C, Chen G, Chen HS, Chen ML, Chen SJ, Chen SM, Chen T, Chen XR, Chen XT, Chen YB, Chen YQ, Chen ZJ, Cheng WS, Choi SK, Chu X, Cibinetto G, Coen SC, Cossio F, Cui JJ, Dai HL, Dai JP, Dbeyssi A, de Boer RE, Dedovich D, Deng ZY, Denig A, Denysenko I, Destefanis M, De Mori F, Ding B, Ding XX, Ding Y, Ding Y, Dong J, Dong LY, Dong MY, Dong X, Du SX, Duan ZH, Egorov P, Fan YL, Fang J, Fang SS, Fang WX, Fang Y, Farinelli R, Fava L, Feldbauer F, Felici G, Feng CQ, Feng JH, Fischer K, Fritsch M, Fritzsch C, Fu CD, Fu JL, Fu YW, Gao H, Gao YN, Gao Y, Garbolino S, Garzia I, Ge PT, Ge ZW, Geng C, Gersabeck EM, Gilman A, Goetzen K, Gong L, Gong WX, Gradl W, Gramigna S, Greco M, Gu MH, Gu YT, Guan CY, Guan ZL, Guo AQ, Guo LB, Guo RP, Guo YP, Guskov A, Hou XT, Han TT, Han WY, Hao XQ, Harris FA, He KK, He KL, Heinsius FHH, Heinz CH, Heng YK, Herold C, Holtmann T, Hong PC, Hou GY, Hou YR, Hou ZL, Hu HM, Hu JF, Hu T, Hu Y, Huang GS, Huang KX, Huang LQ, Huang XT, Huang YP, Hussain T, Hüsken N, Imoehl W, Irshad M, Jackson J, Jaeger S, Janchiv S, Jeong JH, Ji Q, Ji QP, Ji XB, Ji XL, Ji YY, Jia ZK, Jiang PC, Jiang SS, Jiang TJ, Jiang XS, Jiang Y, Jiao JB, Jiao Z, Jin S, Jin Y, Jing MQ, Johansson T, Kui X, Kabana S, Kalantar-Nayestanaki N, Kang XL, Kang XS, Kappert R, Kavatsyuk M, Ke BC, Khoukaz A, Kiuchi R, Kliemt R, Koch L, Kolcu OB, Kopf B, Kuessner MK, Kupsc A, Kühn W, Lane JJ, Lange JS, Larin P, Lavania A, Lavezzi L, Lei TT, Lei ZH, Leithoff H, Lellmann M, Lenz T, Li C, Li C, Li CH, Li C, Li DM, Li F, Li G, Li H, Li HB, Li HJ, Li HN, Li H, Li JR, Li JS, Li JW, Li K, Li LJ, Li LK, Li L, Li MH, Li PR, Li SX, Li T, Li WD, Li WG, Li XH, Li XL, Li X, Li YG, Li ZJ, Li ZX, Li ZY, Liang C, Liang H, Liang H, Liang H, Liang YF, Liang YT, Liao GR, Liao LZ, Libby J, Limphirat A, Lin DX, Lin T, Liu BJ, Liu BX, Liu C, Liu CX, Liu D, Liu FH, Liu F, Liu F, Liu GM, Liu H, Liu HB, Liu HM, Liu H, Liu H, Liu JB, Liu JL, Liu JY, Liu K, Liu KY, Liu K, Liu L, Liu LC, Liu L, Liu MH, Liu PL, Liu Q, Liu SB, Liu T, Liu WK, Liu WM, Liu X, Liu Y, Liu YB, Liu ZA, Liu ZQ, Lou XC, Lu FX, Lu HJ, Lu JG, Lu XL, Lu Y, Lu YP, Lu ZH, Luo CL, Luo MX, Luo T, Luo XL, Lyu XR, Lyu YF, Ma FC, Ma HL, Ma JL, Ma LL, Ma MM, Ma QM, Ma RQ, Ma RT, Ma XY, Ma Y, Maas FE, Maggiora M, Maldaner S, Malde S, Mangoni A, Mao YJ, Mao ZP, Marcello S, Meng ZX, Messchendorp JG, Mezzadri G, Miao H, Min TJ, Mitchell RE, Mo XH, Muchnoi NY, Nefedov Y, Nerling F, Nikolaev IB, Ning Z, Nisar S, Niu Y, Olsen SL, Ouyang Q, Pacetti S, Pan X, Pan Y, Pathak A, Patteri P, Pei YP, Pelizaeus M, Peng HP, Peters K, Ping JL, Ping RG, Plura S, Pogodin S, Prasad V, Qi FZ, Qi H, Qi HR, Qi M, Qi TY, Qian S, Qian WB, Qiao CF, Qin JJ, Qin LQ, Qin XP, Qin XS, Qin ZH, Qiu JF, Qu SQ, Redmer CF, Ren KJ, Rivetti A, Rodin V, Rolo M, Rong G, Rosner C, Ruan SN, Salone N, Sarantsev A, Schelhaas Y, Schoenning K, Scodeggio M, Shan KY, Shan W, Shan XY, Shangguan JF, Shao LG, Shao M, Shen CP, Shen HF, Shen WH, Shen XY, Shi BA, Shi HC, Shi JL, Shi JY, Shi QQ, Shi RS, Shi X, Song JJ, Song TZ, Song WM, Song YJ, Song YX, Sosio S, Spataro S, Stieler F, Su YJ, Sun GB, Sun GX, Sun H, Sun HK, Sun JF, Sun K, Sun L, Sun SS, Sun T, Sun WY, Sun Y, Sun YJ, Sun YZ, Sun ZT, Tan YX, Tang CJ, Tang GY, Tang J, Tang YA, Tao LY, Tao QT, Tat M, Teng JX, Thoren V, Tian WH, Tian WH, Tian ZF, Uman I, Wang B, Wang BL, Wang B, Wang CW, Wang DY, Wang F, Wang HJ, Wang HP, Wang K, Wang LL, Wang M, Wang M, Wang S, Wang S, Wang T, Wang TJ, Wang W, Wang W, Wang WH, Wang WP, Wang X, Wang XF, Wang XJ, Wang XL, Wang Y, Wang YD, Wang YF, Wang YH, Wang YN, Wang YQ, Wang Y, Wang Y, Wang Z, Wang ZL, Wang ZY, Wang Z, Wei D, Wei DH, Weidner F, Wen SP, Wenzel CW, Wiedner UW, Wilkinson G, Wolke M, Wollenberg L, Wu C, Wu JF, Wu LH, Wu LJ, Wu X, Wu XH, Wu Y, Wu YJ, Wu Z, Xia L, Xian XM, Xiang T, Xiao D, Xiao GY, Xiao H, Xiao SY, Xiao YL, Xiao ZJ, Xie C, Xie XH, Xie Y, Xie YG, Xie YH, Xie ZP, Xing TY, Xu CF, Xu CJ, Xu GF, Xu HY, Xu QJ, Xu QN, Xu W, Xu WL, Xu XP, Xu YC, Xu ZP, Xu ZS, Yan F, Yan L, Yan WB, Yan WC, Yan XQ, Yang HJ, Yang HL, Yang HX, Yang T, Yang Y, Yang YF, Yang YX, Yang Y, Yang ZW, Ye M, Ye MH, Yin JH, You ZY, Yu BX, Yu CX, Yu G, Yu T, Yu XD, Yuan CZ, Yuan L, Yuan SC, Yuan XQ, Yuan Y, Yuan ZY, Yue CX, Zafar AA, Zeng FR, Zeng X, Zeng Y, Zeng YJ, Zhai XY, Zhan YH, Zhang AQ, Zhang BL, Zhang BX, Zhang DH, Zhang GY, Zhang H, Zhang HH, Zhang HH, Zhang HQ, Zhang HY, Zhang JJ, Zhang JL, Zhang JQ, Zhang JW, Zhang JX, Zhang JY, Zhang JZ, Zhang J, Zhang J, Zhang LM, Zhang LQ, Zhang L, Zhang P, Zhang QY, Zhang S, Zhang S, Zhang XD, Zhang XM, Zhang XY, Zhang XY, Zhang Y, Zhang Y, Zhang YT, Zhang YH, Zhang Y, Zhang Y, Zhang ZH, Zhang ZL, Zhang ZY, Zhang ZY, Zhao G, Zhao J, Zhao JY, Zhao JZ, Zhao L, Zhao L, Zhao MG, Zhao SJ, Zhao YB, Zhao YX, Zhao ZG, Zhemchugov A, Zheng B, Zheng JP, Zheng WJ, Zheng YH, Zhong B, Zhong X, Zhou H, Zhou LP, Zhou X, Zhou XK, Zhou XR, Zhou XY, Zhou YZ, Zhu J, Zhu K, Zhu KJ, Zhu L, Zhu LX, Zhu SH, Zhu SQ, Zhu TJ, Zhu WJ, Zhu YC, Zhu ZA, Zou JH, Zu J. First Experimental Study of the Purely Leptonic Decay D_{s}^{*+}→e^{+}ν_{e}. PHYSICAL REVIEW LETTERS 2023; 131:141802. [PMID: 37862669 DOI: 10.1103/physrevlett.131.141802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/25/2023] [Accepted: 09/05/2023] [Indexed: 10/22/2023]
Abstract
Using 7.33 fb^{-1} of e^{+}e^{-} collision data taken with the BESIII detector at the BEPCII collider, we report the first experimental study of the purely leptonic decay D_{s}^{*+}→e^{+}ν_{e}. Our data contain a signal of this decay with a statistical significance of 2.9σ. The branching fraction of D_{s}^{*+}→e^{+}ν_{e} is measured to be (2.1_{-0.9_{stat}}^{+1.2}±0.2_{syst})×10^{-5}, corresponding to an upper limit of 4.0×10^{-5} at the 90% confidence level. Taking the total width of the D_{s}^{*+} [(0.070±0.028) keV] predicted with the radiative D_{s}^{*+} decay from the lattice QCD calculation as input, the decay constant of the D_{s}^{*+} is determined to be f_{D_{s}^{*+}}=(214_{-46_{stat}}^{+61}±44_{syst}) MeV, corresponding to an upper limit of 354 MeV at the 90% confidence level.
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Shang QX, Xu K, Dai QG, Huang HD, Hu JL, Zou X, Chen LL, Wei Y, Li HP, Zhen Q, Cai W, Wang Y, Bao CC. [Analysis on the secondary attack rates of SARS-CoV-2 Omicron variant and the associated factors]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2023; 57:1550-1557. [PMID: 37859370 DOI: 10.3760/cma.j.cn112150-20230227-00162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Objective: To evaluate the secondary attack rates of the SARS-CoV-2 Omicron variant and the associated factors. Methods: A total of 328 primary cases and 40 146 close contacts of the SARS-CoV-2 Omicron variant routinely detected in local areas of Jiangsu Province from February to April 2022 were selected in this study, and those with positive nucleic acid test results during 7 days of centralized isolation medical observation were defined as secondary cases. The demographic information and clinical characteristics were collected, and the secondary attack rate (SAR) and the associated factors were analyzed by using a multivariate logistic regression model. Results: A total of 1 285 secondary cases of close contacts were reported from 328 primary cases, with a SAR of 3.2% (95%CI: 3.0%-3.4%). Among the 328 primary cases, males accounted for 61.9% (203 cases), with the median age (Q1, Q3) of 38.5 (27, 51) years old. Among the 1 285 secondary cases, males accounted for 59.1% (759 cases), with the median age (Q1, Q3) of 34 (17, 52) years old. The multivariate logistic regression model showed that the higher SAR was observed in the primary male cases (OR=1.632, 95%CI: 1.418-1.877), younger than 20 years old (OR=1.766, 95%CI: 1.506-2.072),≥60 years old (OR=1.869, 95%CI: 1.476-2.365), infected with the BA.2 strain branch (OR=2.906, 95%CI: 2.388-3.537), the confirmed common cases (OR=2.572, 95%CI: 2.036-3.249), and confirmed mild cases (OR=1.717, 95%CI: 1.486-1.985). Meanwhile, the higher SAR was observed in the close contacts younger than 20 years old (OR=2.604, 95%CI: 2.250-3.015),≥60 years old (OR=1.287, 95%CI: 1.052-1.573) and exposure for co-residence (OR=27.854, 95%CI: 23.470-33.057). Conclusion: The sex and age of the primary case of the Omicron variant, the branch of the infected strain, case severity of the primary case, as well as the age and contact mode of close contacts are the associated factors of SAR.
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Wen J, Wang Y, Wang B, Jiang B, Lan J, Yang J, Tao J, Shen C, Li Y. Rapid Clearance of Corticosteroid-resistant Targetoid Acute Generalized Exanthematous Pustulosis Using IL-17A Inhibitor: A Case Report. J Investig Allergol Clin Immunol 2023; 34:0. [PMID: 37796637 DOI: 10.18176/jiaci.0946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
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Guo BY, Wang Y, Li J, Li CF, Feng XQ, Zheng MC, Liu SX, Yang LH, Jiang H, Xu HG, He XL, Wen H. [Clinical features and prognosis of core binding factor acute myeloid leukemia children in South China: a multicenter study]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2023; 61:881-888. [PMID: 37803854 DOI: 10.3760/cma.j.cn112140-20230224-00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Objective: To analyze the clinical features, efficacy and prognosis factors of core binding factor (CBF) acute myeloid leukemia (AML) children in South China. Methods: This was a retrospective cohort study. Clinical data of 584 AML patients from 9 hospitals between January 2015 to December 2020 was collected. According to fusion gene results, all patients were divided into two groups: CBF-AML group (189 cases) and non-CBF-AML group (395 cases). CBF-AML group were divided into AML1-ETO subgroup (154 cases) and CBFβ-MYH11 subgroup (35 cases). Patients in CBF-AML group chosen different induction scheme were divided into group A (fludarabine, cytarabine, granulocyte colony stimulating factor and idarubicin (FLAG-IDA) scheme, 134 cases) and group B (daunorubicin, cytarabine and etoposide (DAE) scheme, 55 cases). Age, gender, response rate, recurrence rate, mortality, molecular genetic characteristics and other clinical data were compared between groups. Kaplan-Meier method was used for survival analysis and survival curve was drawn. Cox regression model was used to analyze prognostic factors. Results: A total of 584 AML children were diagnosed, including 346 males and 238 females. And a total of 189 children with CBF-AML were included, including 117 males and 72 females. The age of diagnosis was 7.3 (4.5,10.0)years, and the white blood cell count at initial diagnosis was 21.4 (9.7, 47.7)×109/L.The complete remission rate of the first course (CR1) of induction therapy, relapse rate, and mortality of children with CBF-AML were significantly different from those in the non-CBF-AML group (91.0% (172/189) vs. 78.0% (308/395); 10.1% (19/189) vs. 18.7% (74/395); 13.2% (25/189) vs. 25.6% (101/395), all P<0.05). In children with CBF-AML, the CBFβ-MYH11 subgroup had higher initial white blood cells and lower proportion of extramedullary invasion than the AML1-ETO subgroup, with statistical significance (65.7% (23/35) vs. 14.9% (23/154), 2.9% (1/35) vs. 16.9% (26/154), both P<0.05). AML1-ETO subgroup had more additional chromosome abnormalities (75/154), especially sex chromosome loss (53/154). Compared with group B, group A had more additional chromosome abnormalities and a higher proportion of tumor reduction regimen, with statistical significance (50.0% (67/134) vs. 29.1% (16/55), 34.3% (46/134) vs. 18.2% (10/55), both P<0.05). Significant differences were found in 5-years event free survival (EFS) rate and 5-year overall survival (OS) rate between CBF-AML group and non-CBF-AML group ((77.0±6.4)%vs. (61.9±6.7)%,(83.7±9.0)%vs. (67.3±7.2)%, both P<0.05).EFS and OS rates of AML1-ETO subgroup and CBFβ-MYH11 subgroup in children with CBF-AML were not significantly different (both P>0.05). Multivariate analysis showed in the AML1-ETO subgroup, CR1 rate and high white blood cell count (≥50×109/L) were independent risk factors for EFS (HR=0.24, 95%CI 0.07-0.85,HR=1.01, 95%CI 1.00-1.02, both P<0.05) and OS (HR=0.24, 95%CI 0.06-0.87; HR=1.01, 95%CI 1.00-1.02; both P<0.05). Conclusions: In CBF-AML, AML1-ETO is more common which has a higher extramedullary involvement and additional chromosome abnormalities, especially sex chromosome loss. The prognosis of AML1-ETO was similar to that of CBFβ-MYH11. The selection of induction regimen group FLAG-IDA for high white blood cell count and additional chromosome abnormality can improve the prognosis.
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Schrank BR, Wang Y, Antony A, Jiang W. Listeriolysin O Drives Innate and Adaptive Immune Responses to CD47 Immunotherapy. Int J Radiat Oncol Biol Phys 2023; 117:S104. [PMID: 37784275 DOI: 10.1016/j.ijrobp.2023.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radioimmunotherapies that combine radiation with antibodies against the "don't eat me" signal CD47 show increasing promise. One opportunity to synergize RT with anti-CD47 is via the Stimulator of Interferon Genes (STING) pathway which facilitates potent immune responses to cytoplasmic DNA. Anti-CD47 should activate STING by increasing macrophage consumption of tumor DNA. However, tumor contents are destroyed in phagolysosomes. Listeria (L.) monocytogenes escape lysosomes by secreting a pore-forming protein Listeriolysin O (LLO). We recently engineered a protein-antibody conjugate linking anti-CD47 to LLO. Here, we demonstrate that LLO-CD47 enhances macrophage STING signaling, tumor cell phagocytosis, and tumor antigen presentation. At doses compatible with minimal toxicity in mice, LLO-CD47 delays the growth of orthotopic breast tumors. By contrast, anti-CD47 fails to activate STING in macrophages or inhibit tumor growth. We further hypothesize that LLO-CD47 requires innate and adaptive immune cells for antitumor immunity. MATERIALS/METHODS Anti-CD47 was conjugated to LLO using a water-soluble SPDP crosslinker and purified by affinity chromatography. Transmission electron microscopy (TEM) was used to visualize the integrity of macrophage phagolysosomes following treatment. C57B6 mouse bone marrow-derived macrophages (BMDMs) were used to study the impact of LLO-CD47 on M2-to-M1 polarization, tumor cell phagocytosis, STING activation, and antigen presentation. CD8+ T cells or tumor-associated macrophages (TAMs) were depleted from tumor-bearing mice using an anti-CD8 antibody or anti-CSF-1R antibody prior to LLO-CD47 treatment. RESULTS (1) LLO-CD47 skews BMDMs from M2-to-M1 inflammatory phenotypes and enhances the phagocytosis of E0771 tumor cells. (2) BMDMs visualized by TEM show breaches in phagosome membranes following LLO-CD47, but not anti-CD47, treatment. (3) LLO-CD47 increases levels of phosphorylated STING, IFN, and TNFα relative to cells treated with anti-CD47. (4) LLO-CD47 significantly inhibits the growth of orthotopically implanted E0771 murine breast tumors relative to anti-CD47. (5) The elimination of CD8+ T cells or TAMs abrogates the antitumor effect of LLO-CD47. CONCLUSION LLO-CD47 is a de novo protein-antibody conjugate engineered for cGAS-STING pathway activation in innate immune cells. CD8+ T cells and TAMs are required for the antitumor activity LLO-CD47 in orthotopic models of breast cancer. This novel immunotherapy builds on clinical interest in myeloid checkpoint inhibitors and may be studied as a supplemental therapy for patients with metastatic breast cancer.
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Ou X, He X, Wang Y, Hu C. Induction Chemotherapy and Toripalimab for Larynx Preservation in Resectable Locally Advanced Laryngeal/Hypopharyngeal Carcinoma: Preliminary Results of INSIGHT Study. Int J Radiat Oncol Biol Phys 2023; 117:S99. [PMID: 37784619 DOI: 10.1016/j.ijrobp.2023.06.2296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Previous studies have demonstrated excellent pathological response of induction PD-1 inhibitor with chemotherapy for locally advanced head and neck cancer. To our knowledge, there is scarce evidence on induction chemotherapy (ICT) and PD-1 inhibitor in organ preservation for patients (pts) with laryngeal/hypopharyngeal carcinoma. Hence, the aim of this study is to evaluate the efficacy and toxicities of ICT and PD-1inhibitor (Toripalimab) followed by radiotherapy or surgery, for pts with resectable locally advanced laryngeal/hypopharyngeal carcinoma. MATERIALS/METHODS This isa single-arm phase II study. Pts with histopathologic confirmed, resectable locally advanced laryngeal/hypopharyngeal squamous cell carcinoma and ECOG PS 0-1 were eligible. Three cycles of ICT (paclitaxel 175 mg/m d1, cisplatin 25 mg/m d1-3) combined with PD-1 inhibitor (Toripalimab 240 mg d0) were given. Response assessment (RECIST 1.1) was performed post-ICT. Patients with complete response (CR)/partial response (PR) of primary tumor received concurrent chemoradiation, followed by maintenance therapy of Toripalimab for eight cycles. Otherwise, patients were referred to surgery, followed by adjuvant radiation (RT)/chemoradiation (CRT), and then maintenance therapy of Toripalimab. The primary endpoint is larynx-preservation (LP) rate at 3 months post-RT. Forty-two patients were planned. Based on a two-stage Fleming design (one-sided α:10%, power: 80%), if at least 22 patients attained LP of the first 27 patients in stage I or at least thirty-two pts attained LP of the 42 patients at the end of stage II, the null hypothesis would be rejected. The cohort would enroll 15 more pts in stage II if 19-21 pts in stage I observed LP, and the study would be terminated if the number of pts with LP were less than 18 in stage I. RESULTS A total of 27 pts were enrolled. By the cut-off date Feb 8, 2023, all reached at least 3 months of follow-up post-RT. Median age was 63 (53-74) years with 92.6% male. Hypopharyngeal cancer accounted for 66.7%. There were 74.1% who were T3 to T4, and 77.7% were N2 to N3. Six cases had primary invasion of esophagus and five pts underwent pretreatment tracheostomy. ORR of ICT was 85.2%. Afterward, 21 pts were treated with concurrent CRT, while 6 pts received surgery of primary tumor. At 3 months post-RT, 23 pts attained organ preservation and the LP rate was 85.2%. With a median follow-up of 13.5 months, 1-year OS rate, PFS rate and LP survival rate was 83.1%, 79.5% and 79.4%, respectively. During ICT, 22.2% of pts experienced grade 3-4 treatment-related AEs (TRAEs). The most common grade 3-4 TRAEs were nausea and neutrophil count decreased. CONCLUSION The primary endpoint LP rate was met. In this cohort of extensive locally advanced laryngeal/hypopharyngeal carcinoma, ICT and Toripalimab followed by radiotherapy or surgery resulted in satisfactory short-term LP rate and encouraging survival.
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Wang Q, Chen X, Wu L, Wang Y, Peng L, Li T, Han Y. Endoscopic Ultrasonography-Derived Maximum Tumor Thickness and Tumor Shrinkage Rate as Independent Prognostic Factors in Locally Advanced Esophageal Squamous Cell Carcinoma after Neoadjuvant Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e349. [PMID: 37785210 DOI: 10.1016/j.ijrobp.2023.06.2421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Neoadjuvant chemoradiotherapy (NCRT) is increasingly used in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC). Endoscopic ultrasonography (EUS)-derived maximum tumor thickness (MTT) before and after standard NCRT for LA-ESCC indicates treatment response. However, the accuracy of predicting long-term survival remains uncertain. This study aimed to investigate the association between EUS-derived MTT pre- and post-NCRT and tumor shrinkage rate as well as long-term survival in patients with LA-ESCC receiving NCRT. MATERIALS/METHODS We retrospectively enrolled patients with LA-ESCC who underwent EUS examination pre- and post-NCRT from 2017 to 2021. MTT was measured using EUS. Tumor shrinkage rate was the ratio of the difference between pre- and post-MTT to pre-MTT. The most fitted cut-off value defining the EUS response was determined by the receiver operating characteristic curve. Univariate and multivariate Cox regression analyses and Kaplan-Meier (KM) curves were used to calculate overall survival (OS) and progression-free survival (PFS). Data from another center were also used for external validation testing. RESULTS The median follow-up period was 30.6 months.230 patients with LA-ESCC who underwent EUS pre- or post-NCRT were enrolled. Of the patients, 178 completed the first EUS pre-NCRT and obtained pre-MTT, 200 completed the re-examined EUS post-NCRT and obtained post-MTT, and 148 completed both EUS and achieved tumor shrinkage. In the whole group the 1-year and 3-year OS rates were 93.9% and 67.9%, and PFS rates were 77.7% and 54.1%, respectively. Thinner post-MTT (≤8.8 mm) and EUS-responders (tumor shrinkage rate≥52%) were independently associated with better OS. The result of EUS-respond was an independent prognostic factor could be confirmed in the external validation group. Among LA-ESCC patients with initial ultrasonic T2-3 staging and T4 staging, no statistically differences were observed between the responder and non-responder groups (P = 0.082; P = 0.190). CONCLUSION EUS-derived MTT and tumor shrinkage post-NCRT are independent prognostic factors for long-term survival and may be an alternative method for evaluating tumor response in patients with LA-ESCC after NCRT. Initial tumor infiltration beyond esophageal adventitial layer on ultrasound effect could not, however, predict the long-term prognosis.
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Wang Y, Zhang H, Ma K, Zhou Y, Wang Q, Lin T. Comparison of Pathologic Response and Survival Outcomes between Neoadjuvant Immunochemotherapy (nICT) and Neoadjuvant Chemoradiotherapy (nCRT) in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e350. [PMID: 37785214 DOI: 10.1016/j.ijrobp.2023.06.2423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The neoadjuvant immunochemotherapy (nICT) is a novel treatment, which is likely to be safer for locally advanced, surgically resectable Esophageal squamous cell carcinoma (ESCC) that comparing with the traditional neoadjuvant therapy. However, the efficacy of nICT was controversial and the survival benefit remain unknown. MATERIALS/METHODS This study included 313 patients with locally advanced ESCC who underwent surgery following neoadjuvant therapy at Sichuan Cancer Hospital from June 2017 and September 2021. The patients were divided into nICT group and neoadjuvant chemoradiotherapy (nCRT) group according to the neoadjuvant strategy. A 1:2 propensity score matching (PSM) was used to balance potential bias across several covariates between two groups with a caliper 0.05. RESULTS Among the 146 patients after PSM, the baseline factors were comparable between two groups. Compared with the nCRT group, the nICT group shown a lower pathologic complete response(pCR) rate (11.54% vs 35.11%; P = 0.0039) and lymph nodes uninvolved rate (ypN0: 44.23% vs 62.77%; P = 0.0154), but a higher perineural invasion (32.69% vs 12.77%; P = 0.0075) and angioinvasion rate (40.38% vs 10.64%; P = 0.0001). However, the 2-year OS and DFS rates were similar between the nICT group and the nCRT group in overall study cohort, and these data were confirmed in the matched samples (2-year OS, 78.2% vs 77.2% [p = 0.95]; DFS, 56.9% vs 58.0% [p = 0.69]). CONCLUSION Our preliminary findings indicate that, for individuals with locally advanced ESCC, nICT followed by surgery appears to be less effective in pathologic outcomes, while having a comparable survival rate to nRCT. These results imply a complicated and possibly multifaceted link between the kind of neoadjuvant therapy, the pathologic outcomes, and the final survival.
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Zhang J, Wan J, Shen L, Zhang H, Wang Y, Wang Y, Zhu J, Xia F, Zhang Z. Dosimetric Predictors of Acute Diarrhea in Locally Advanced Rectal Cancer Patients Treated with Neoadjuvant Chemoradiation with Capecitabine and Irinotecan: A Discovery and Validation Study. Int J Radiat Oncol Biol Phys 2023; 117:e355-e356. [PMID: 37785227 DOI: 10.1016/j.ijrobp.2023.06.2436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Additional irinotecan can increase the pCR rate from 15% to 30% compared with capecitabine-based neoadjuvant chemoradiotherapy in locally advanced rectal cancer, while more acute diarrhea was induced and predictors of diarrhea have yet to be fully elucidated. In this analysis, we report the incidence of and factors associated with grade 3+ acute diarrhea in LARC patients treated with the CaplriRT regimen in the CinClare trial. MATERIALS/METHODS We identified the dosimetric markers with a lasso-Cox risk scoring model tested on CaplriRT group patients in the CinClare trial at our institution from 2015 to 2017 (CinClare, NCT02605265), and then independently validated according to a predefined protocol in patients treated with neoadjuvant chemoradiation with capecitabine and irinotecan from 2019 to 2022 (NCT05688033). Clinical documentation and patient-reported outcomes were reviewed to determine grade 3+ acute diarrhea events. RESULTS A total of 116 patients from Cinclare trial treated with CaplriRT regimen were used as a training cohort to obtain dosimetric prediction model and 168 patients were used for independent validation. The majority received 50 Gray (Gy) in 25 fractions with concurrent capecitabine and irinotecan. Median number of concurrent chemotherapy cycles received was 4 (IQR: 3-4). Seventeen (23.6%) patients treated with the CaplriRT regimen in the CinClare trial experienced grade 3+ acute diarrhea. Dosimetric predictors of acute diarrhea included peritoneal space volume receiving 25 Gy or greater (V25Gy). The single multivariate Cox regression, and receiver operating characteristic (ROC) curve analysis showed that the model had good predictive ability (p<0.05). It was also validated using the validation cohort. Patients with peritoneal space V25Gy>950 cm3 were associated with a higher risk of 3+ acute diarrhea compared with those without constraints of V25Gy (p = 0.002). CONCLUSION Peritoneal space V25Gy as an important predictor of acute diarrhea during capecitabine and irinotecan neoadjuvant chemoradiation treatment. Peritoneal space V25Gy < 950 cm3 may reduce acute diarrhea toxicity.
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Choi AR, D'Agostino R, Farris M, Abdulhaleem M, Wang Y, Smith M, Ruiz J, Lycan T, Petty W, Cramer CK, Tatter SB, Laxton A, White J, Su J, Whitlow CT, Xing F, Chan MD. Genomic Signature for Oligometastatic Disease in Non-Small Cell Lung Cancer Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:S129. [PMID: 37784331 DOI: 10.1016/j.ijrobp.2023.06.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Biomarkers for oligometastatic disease remain elusive and few studies have attempted to correlate genomic data to the presence of true oligometastatic disease. MATERIALS/METHODS Patients with non-small cell lung cancer (NSCLC) and brain metastases were identified in our departmental database. Electronic medical records were used to identify patients for whom liquid biopsy-based comprehensive genomic profiling (Guardant Health) was available. Oligometastatic disease was defined as patients having ≤5 non-brain metastases without diffuse involvement of a single organ. Widespread disease was any spread beyond oligometastatic. Fisher's exact tests were used to identify mutations statistically associated (p<0.1) with either oligometastatic or widespread extracranial disease. A score of +1 was assigned for every mutation present associated with oligometastatic disease, and -1 was assigned for mutations associated with widespread disease. Scores were summed for each patient to create a risk score for the likelihood of oligometastatic disease, with scores subsequently correlated to the likelihood of having oligometastatic disease vs widespread disease. For oligometastatic patients, a competing risk analysis was done to assess for cumulative incidence of oligometastatic progression accounting for the potential competing risks of widespread progression of extracranial disease or death. Cox regression was used to determine the association between oligometastatic risk score and oligometastatic progression. RESULTS One hundred thirty patients met study criteria and were included in the analysis. 51 patients (39%) had oligometastatic disease. Genetic mutations included in the Guardant panel associated (p<0.1) with the presence of oligometastatic extracranial disease included ATM, JAK2, MAP2K2, and NTRK1; ARID1A and CCNE1 were associated with widespread disease. Patients with a positive, neutral and negative risk score for oligometastatic disease had a 78%, 41% and 11.5% likelihood of having oligometastatic disease, respectively (p<0.0001). Overall survival for patients with positive, neutral and negative risk scores for oligometastatic disease was 86% vs 82% vs 64% at 6 months (p = 0.2). The competing risk analysis found that the oligometastatic risk score was significantly associated with the likelihood of oligometastatic progression based on the Wald Chi-square test. Patients with positive, neutral and negative risk scores for oligometastatic disease had a cumulative incidence of oligometastatic progression of 77% vs 35% vs 33% at 6 months (p = 0.03 from competing risk model). CONCLUSION Elucidation of a genomic signature for oligometastatic disease derived from non-invasive liquid biopsy appears feasible for NSCLC patients. Patients with the oligometastatic signature exhibited higher rates of early oligometastatic progression. Validation of this signature could lead to a biomarker that has the potential to direct local therapies in oligometastatic patients.
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Li S, Luo H, Tan X, Wang Y, Jin F. The Potential Ability of Plan Complexity Metrics on the Dose Calculation and Plans Delivery in Intensity Modulated Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e406-e407. [PMID: 37785351 DOI: 10.1016/j.ijrobp.2023.06.1546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The excessive modulation of treatment plan during radiotherapy (RT) increases the complexity. Evaluation of the multidimensional relationship between program complexity metrics, computation-based patient-specific quality assurance (PSQA), and conventional measurement-based PSQA could assist in enhancing the robustness of treatment planning, guide the allocation of clinical QA resources, and ultimately lessen QA workload. MATERIALS/METHODS The fifty-five metrics affecting RT planning and delivery accuracy were calculated by a house-built program to describe the complexity of 404 dynamic IMRT plans, with sensitivity to the small field, aperture position, MLC edge, low MUs, MLC leaf motion, leaf speed/acceleration, etc. The calculation-based PSQA was performed using Monte Carlo (MC) method and Collapsed Cone Convolution (CCC) algorithm, implemented in SciMoCa and Mobius 3D, respectively. The measurement-based PSQA was performed using 3D diode arrays with different geometries covering "O", "+" and " × " shapes which exist in ArcCheck, Delta4 phantom+ (Delta4) and Delta4PT phantom (Delta4PT), respectively. Gamma passing rates (GPRs) were recorded to measure the results of each QA system. This multidimensional relationship was evaluated using correlation analysis and principal component linear regression (PCR) analysis. RESULTS A total of 4448 GPRs for various QA systems corresponding to two Linacs were counted. The modulation index for speed (MIs) and modulation index for acceleration (MIa) were consistently located at the high points of the radarplots of the Spearman correlation coefficient |rs| between metrics and GPRs of the four QA systems, just except Delta4. Besides, the rs between SciMoCa and ArcCheck were 0.275-0.531 (P ≤ 0.001), SciMoCa and Delta4 were 0.32-0.418 (P ≤ 0.001), and Mobius 3Dand Delta4PT were 0.124-0.226 (P ≤ 0.05). The PCR model's coefficients determination (R2) for SciMoCa were 0.461-0.756 (P ≤ 0.001), ArcCheck were 0.243-0.440 (P ≤ 0.001), Delta4 were 0.268-0.402 (P ≤ 0.001), Mobius 3D were 0.299-0.407 (P ≤ 0.001), and Delta4PT were 0.087-0.141 (P ≤ 0.05). CONCLUSION This study is the first overall assessment of the impact of various complexity metrics on the accuracy of TPS calculation and Linac delivery. Of the metrics studied, MIs and MIa metrics have a standout impact on the ability of the TPS calculation and delivery system, extra attention should be paid during the planning process. It is inappropriate to utilize calculation-based QA to predict the results of measurement-based QA since there is a poor correlation between the two. Furthermore, calculation-based QA outperforms measurement-based QA in identifying highly complex plans, which can further guide clinical QA process optimization and save limited clinical resources.
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Chang CW, Goette M, Kadom N, Wang Y, Wynne JF, Wang T, Liu T, Esiashvili N, Zhou J, Eaton BR, Yang X. Using Longitudinal MRI to Manage Proton Range Uncertainty for Pediatric Proton Craniospinal Irradiation. Int J Radiat Oncol Biol Phys 2023; 117:e505-e506. [PMID: 37785585 DOI: 10.1016/j.ijrobp.2023.06.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Clinical evidence has shown that proton therapy can effectively reduce side effects for pediatric patients undergoing vertebral body-sparing craniospinal irradiation (VBS CSI), compared to conventional photon treatment modalities. However, radiation-induced growth impairment remains challenging for VBS CSI due to proton range uncertainty, compromising vertebral body sparing for growing children. Previous studies have shown that fatty marrow replacement can be observed in vertebral bodies 4-48 weeks after treatment is complete. This study aims to detect and quantify the fatty marrow replacement in vertebral bodies using longitudinal magnetic resonance (MR) to manage proton range uncertainty. MATERIALS/METHODS A prospective clinical trial of proton VBS CSI was designed, and ten pediatric patients were enrolled with prescribed doses of 15-36 Gy. The thecal sac and neural foramina were the clinical target volumes, and a Monte Carlo planning system was used to robustly optimize treatment plans with a 3.5% range margin. We analyzed patients' T1/T2 MR images acquired before, during, and after proton treatment to investigate the hematopoietic marrow transformation induced by irradiation. A metric was defined to calculate the ratio of fatty and hematopoietic marrow based on relative MR intensity histograms. We proposed a machine learning method via Gaussian fitting process (ML-GFP) to explore hidden correlations between marrow transition and radiation dose to 2 cm3 of the bone marrow (D2cc). We also leveraged this method to embed uncertainty to support potential proton range management for VBS enhancement. RESULTS The results indicated that fatty marrow replacement could be observed during inter-fractional treatment. For instance, an individual patient showed that the fatty marrow generation ratios were 0.54, 0.74, and 0.45, corresponding to 11, 18, and 65 days after the treatment started. Using ML-GFP, the fatty marrow transition was found to be quadratically correlated to treatment fractions, and the maximum transformation ranged from 40 to 50 days. Then marrow regeneration was observed due to the decrease in fatty marrow ratios. The fatty marrow ratios were also positively correlated to the D2cc doses ranging from 10 Gy to 36 Gy. Limited by insufficient low-dose data, the ML-GFP model extrapolated the data to predict the marrow transformation below 10 Gy. CONCLUSION We demonstrated the feasibility of using non-invasive longitudinal MR to quantify the fatty marrow transition from inter-fractional treatment. Based on this prospective study, the method can detect early fatty marrow generation in vertebrae caused by proton irradiation due to the conservative range margin used for robust optimization. The proposed method could be used to validate the actual proton range, allowing an accurate range margin to be defined to preserve bone marrow. Future investigation will likely focus on clinical implementation to improve life quality for pediatric CSI patients.
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Liu Q, Wu Q, Wang Y, Zheng Y, Wang X, Peng X, Wang X, Wei X, Zhang S, Qiao J, Li L, Yang Y. A Phase 2 Trial of Efficacy and Safety of Intraoperative Radiation Therapy for Locally Advanced Laryngocarcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e600-e601. [PMID: 37785812 DOI: 10.1016/j.ijrobp.2023.06.1962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For locally advanced laryngeal cancer (LAL), the local recurrence rate remains 19-40% after radical surgery with postoperative radiotherapy alone or with concurrent chemoradiotherapy in patients with unfavorable prognostic factors. We evaluate local control and acute toxicity of intraoperative radiation therapy (IORT) as a tumor bed boost for locally advanced laryngeal cancer in this prospective phase 2 trial. MATERIALS/METHODS This phase II clinical study in which a total of 63 LAL patients (T2N1-3/T3N0-3/T4N0-3) were selected and received IORT (T2: 8-10Gy, T3,4:12-15 Gy) as a tumor bed boost during radical surgery, then received external-beam radiation therapy (EBRT) at a total dose of 54-60Gy within 6 weeks after surgery, 5 times per week, 1.8-2Gy per time, 30 times in total. The median follow-up time was 20 months (7 -39 months). The primary outcome was the local control (LC) and 2 - year survival rate determined using the Kaplan-Meier method. This study is registered with ClinicalTrials.gov, NCT04278638. RESULTS A total of 63 patients consented to participate in the study; 59 males and 4 females, median age was 61 years (40-81 years), 14 patients had supraglottic LAL, 44 patients had glottic LAL and 5 patients had subglottic LAL. 10 patients showed high differentiation and 44 patients showed moderate differentiation and 9 patients showed low differentiation with laryngeal squamous cell carcinoma. 3 patients were in T2N1-2 stage, 40 patients in T3N0-2 stage, and 20 patients in T4N0-2 stage, 48 patients received total laryngectomy and 15 patients received hemilaryngectomy; 16 patients were lymph node-positive and 1 patient developed vascular tumor thrombus after surgery. After surgery combined with IORT and EBRT, the 1- and 2- year LC rates were 98.2% and 93.1 %, respectively, 2-year overall survival rate was 97.4%. Pharyngeal fistula was observed in 1 patient (1. 6 %) and wound infection in 3 patients (4.8%). Radiation Therapy Oncology Group (RTOG) grade 3 pain and RTOG grade 4 dyspnea were noted in one patient (1.6%) and 2 patients (3.2 %), respectively. CONCLUSION In summary, our prospective phase II trial proved that the addition of intraoperative radiotherapy as a tumor bed boost to postoperative radiotherapy provided local therapeutic benefit to patients with locally advanced laryngeal cancer. Our data support the safety of this combined therapy. Additional investigation is warranted to determine the role of intraoperative radiotherapy in the local treatment of locally advanced laryngeal cancer.
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Yu Y, Han TT, Zhang YY, Cheng YF, Wang JZ, Mo XD, Wang FR, Yan CH, Chen YY, Han W, Sun YQ, Fu HX, Xu ZL, Wang Y, Tang FF, Liu KY, Zhang XH, Huang XJ, Xu LP. [Safety and survival analysis of haplo-identical hematopoietic stem cell transplantation in patients with severe aplastic anemia who had previous failure to antithymoglobulin treatment]. ZHONGHUA NEI KE ZA ZHI 2023; 62:1209-1214. [PMID: 37766440 DOI: 10.3760/cma.j.cn112138-20221003-00727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Objective: To investigate the safety and efficacy of haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) conditioning with the same dosage form of antithymoglobulin (ATG) in patients with severe aplastic anemia (SAA) failure to ATG. Methods: This was a retrospective cohort study. A total of 65 patients with SAA who failed ATG treatment and received haplo-HSCT conditioning with the same dosage of ATG at the Institute of Hematology, Peking University People's Hospital between July 2008 and October 2020 were included as the ATG treatment failure group. An additional 65 SAA patients who applied ATG for the first time during haplo-HSCT were randomly selected by stratified sampling as the first-line haplo-HSCT group. Baseline clinical data and follow-up data of the two groups were collected. Conditioning-related toxicity within 10 days after ATG application and long-term prognosis were analyzed. The Kaplan-Meier was used to calculate the overall survival rate, and the Log-rank test was applied to compare the rates of the two groups. Results: In the ATG treatment failure group, there were 36 males and 29 females, and the age at the time of transplantation [M (Q1, Q3)] was 16 (8, 25) years. In the first-line haplo-HSCT group, there were 35 males and 30 females, with a median age of 17 (7, 26) years. Within 10 days of ATG application, the incidence of noninfectious fever, noninfectious diarrhea, and liver injury in the ATG treatment failure group was 78% (51 cases), 45% (29 cases), and 28% (18 cases), respectively, and in the first-line haplo-HSCT group was 74% (48 cases), 54% (35 cases), and 25% (16 cases), respectively; the difference between the two groups was not statistically significant for any of these three parameters (all P>0.05). For graft-versus-host disease (GVHD), there was no significant difference between the ATG treatment failure group and the first-line haplo-HSCT group in the development of 100 day Ⅱ to Ⅳ acute GVHD (29.51%±0.35% vs. 25.42%±0.33%), Ⅲ to Ⅳ acute GVHD (6.56%±0.10% vs. 6.78%±0.11%), and 3-year chronic GVHD (26.73%±0.36% vs. 21.15%±0.30%) (all P>0.05). Three-year overall survival (79.6%±5.1% vs. 84.6%±4.5%) and 3-year failure-free survival (79.6%±5.1% vs. 81.5%±4.8%) were also comparable between these two groups (both P>0.05). Conclusions: Compared with no exposure to ATG before HSCT, similar early adverse effects and comparable survival outcomes were achieved in patients with SAA who failed previous ATG treatment and received haplo-HSCT conditioning with the same dosage form of ATG. This might indicate that previous failure of ATG treatment does not significantly impact the efficacy and safety of salvaging haplo-HSCT in patients with SAA.
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Tao D, Sun L, Wang LL, Yang D, Jiang Y, Zhou W, Wang Y, Wu YZ. Early Stereotactic Body Radiotherapy to the Primary Lung Lesion for Patients with Advanced NSCLC Treated with First-Line Systemic Therapy. Int J Radiat Oncol Biol Phys 2023; 117:S128. [PMID: 37784330 DOI: 10.1016/j.ijrobp.2023.06.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Although adding consolidative stereotactic body radiotherapy (SBRT) to systemic therapy improves survival in advanced non-small cell lung cancer (NSCLC), the optimal timing of SBRT remains unclear. This study aimed to explore the clinical outcome of early and delayed SBRT to primary lung lesions of advanced NSCLC patients treated with first-line systemic therapy. MATERIALS/METHODS We identified patients with advanced NSCLC who were suitable to receiveSBRT for the primary lung tumors after first-line systemic therapy. All eligible patients were treated with first-line systemic therapy and SBRT for their primary lung lesions. Early SBRT group was defined as patients who received SBRT for their primary lung tumor at the maximal response of systemic therapy. Delayed SBRT group was defined as patients who received SBRT after the occurrence of oligoprogression in primary lung tumor. The primary endpoints were progression-free survival 1 (PFS1, time from start of first-line systemic therapy to disease progression) and PFS2 (time from start of first-line systemic therapy to disease progression after SBRT). Overall survival (OS) and adverse effects (AEs) were secondary endpoints. A two-sided P value of 0.05 was considered statistically significant. All of the statistical analyses were performed with statistical software. RESULTS A total of184 patients with advanced NSCLC treated with SBRT for primary tumors were screened, and 49 patients were eligible for enrollment in this study. The median age of the entire cohort was 66 years (range, 37-80 years), and 34 (69.4%) patients were male. Thirty-four patients (69.4%) were treated by target therapy and 15 (30.6%) were treated by chemotherapy and immunotherapy. Of the 49 eligible patients, 28(57.1%) received early SBRT to lung primary tumor and 21(42.9%) received delayed SBRT to lung primary tumor. The early SBRT group showed a significantly prolonged PFS1 as compared with the delayed SBRT group (mPFS1: 30 months vs. 8 months, P<0.001). The median PFS2 of the early SBRT group was longer than that of the delayed SBRT group, but the difference between the two groups did not achieve a statistical significance (mPFS2: 42 months vs. 23 months, P = 0.303). Median OS of both groups has not reached. No severe toxicities (≥grade 3) were observed in early SBRT group and only one patient in the delayed SBRT group experienced grade 3 radiation pneumonitis. CONCLUSION Early SBRT to the primary lung lesion significantly improved PFS and is a new potentially effective and tolerable treatment option for patients with advanced NSCLC who had stable disease during first-line systemic therapy.
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Song Y, Kong J, Li N, Liu X, Li X, Zhu L, Wang Y, Fang H, Jing H, Tang Y, Li Y, Wang XH, Zhang J, Wang S. Comparison of Supraclavicular Surgery plus Radiotherapy vs. Radiotherapy Alone in Breast Cancer Patients with Synchronous Ipsilateral Supraclavicular Lymph Node Metastasis: A Multicenter Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e208. [PMID: 37784870 DOI: 10.1016/j.ijrobp.2023.06.1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate and compare the outcomes of supraclavicular lymph node dissection (SLND) plus radiotherapy (RT) and RT alone for patients with synchronous ipsilateral supraclavicular lymph node metastasis (sISLM). MATERIALS/METHODS In all, 293 patients with sISLM across three centers were included. Of these, 85 (29.0%) received SLND plus RT and 208 (71.0%) received RT alone. All patients received preoperative systemic therapy followed by mastectomy or lumpectomy and axillary dissection. Supraclavicular recurrence-free survival (SCRFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated by using the Kaplan-Meier method and multivariate Cox models. Multiple imputation was used for missing data. RESULTS The median follow-up duration of the RT and SLND+RT groups were 53.7 and 63.5 months, respectively. For the RT and SLND+RT groups, the 5-year SCRFS rates were 91.7% vs. 85.5% (P = 0.522), LRRFS rates were 79.1% vs. 73.1% (P = 0.412), DMFS rates were 60.4 vs. 58.8% (P = 0.708), DFS rates were 57.6% vs. 49.7% (P = 0.291), and OS rates were 71.9% vs. 62.2% (P = 0.272), respectively. There was no significant effect on any outcome when comparing SLND+RT versus RT alone in the multivariate analysis. Based on four risk factors of DFS, patients were classified into three risk groups: the intermediate- and high-risk groups had significantly lower survival outcomes than the low-risk group. SLND+RT did not improve outcomes of any risk group compared with RT alone. CONCLUSION Patients with sISLM may not benefit from SLND. Distant metastasis remained the major failure pattern, especially for intermediate- and high-risk groups with sISLM may not benefit from SLND. Distant metastasis remained the major failure pattern, especially for intermediate- and high-risk groups.
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Liu YC, Zhang X, Zhang L, Sui J, Wang Y. Proposals for the Delineation of Neck Clinical Target Volume Specific to Oral Squamous Cell Cancer Based on Lymph Node Distribution. Int J Radiat Oncol Biol Phys 2023; 117:e601. [PMID: 37785814 DOI: 10.1016/j.ijrobp.2023.06.1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To establish the regional lymph node (LN) distribution probability map and draw the neck clinical target volume specific to oral squamous cell cancer (OSCC). MATERIALS/METHODS A total of 293 patients with pathologically proven OSCC were enrolled from Jan 2014 to Jun 2022. The patients were divided into two groups according to the ≤1 cm or>1 cm of minimal distance from the lesion's edge to the midline of body. The center point of the LNs with a minimal axial diameter of ≥10 mm was marked on a single treatment planning computed tomography scan. The neck LN levels I to X were based on 2013 updated international consensus guidelines. LN distribution probability maps were established. The relationships between the LN distribution and consensus guidelines were analyzed to propose modifications for clinical target volume boundaries specific to OSCC. RESULTS A total of 1033 LNs were marked. Compared with the >1 cm group, The ≤1 cm group has following feature tendencies: strong addiction to smoking and drinking, predilection for tongue and oral floor cancer, larger primary lesion with mainly infiltrative growth pattern, more frequent extra-nodal extension with mainly contralateral LNs. For the ≤1cm group, the distribution probability of LNs was: ipsilateral II (42.67%), ipsilateral Ib (17.35%), contralateral II (11.18%), ipsilateral III (8.74%), contralateral Ib (7.46%), Ia (6.43%). The other group was: ipsilateral Ib (43.14%), ipsilateral II (37.64%), contralateral Ib (4.31%), ipsilateral III (3.92%), contralateral II (3.53%), Ia (0.78%). Accordingly, the proposals for the delineation of neck clinical target volume were: 1. the inferior boundary of level Ia extends until the level of the thyroid cartilage plate; 2. the upper boundary of level Ib descends to the level of the mandibular angle, and the inner posterior boundary only includes the lateral and posterior margin of the submandibular gland within 5mm; 3. the upper boundary of level II changes to the transverse process of the second cervical vertebra, and the posterior boundary retracts to the posterior edge of the levator scapula. 4. the anterior inner border of level IVa contains only the internal jugular arteriovenous sheath. CONCLUSION This is the first description of LN topographic spread patterns for OSCC. Optimization of CTV delineation is helpful to improve the treatment outcome and reduce adverse events.
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Dai J, Zhou FX, Xu H, Jiang CQ, Wang WB, Jiang HG, Wang QY, Wang Y, Xia L, Wu H, Peng J, Wei Y, Luo M, Tang F, Yang L, Hu H, Huang TH, Jiang DZ, Wang DJ, Wang XY. Efficacy and Safety of High-Dose Vitamin C Combined with Total Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer (HCCSC R02 Study). Int J Radiat Oncol Biol Phys 2023; 117:e291-e292. [PMID: 37785075 DOI: 10.1016/j.ijrobp.2023.06.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Forpatients with locally advanced rectal cancer (LARC), the standard treatment is fluoropyrimidine (FU) -based neoadjuvant chemoradiotherapy (NCRT) combined with curative surgery. The CAO/ARO/AIO-04 trial and FORWARC trial reported that the addition of oxaliplatin to FU -based NCRT contributed to improve pathologic complete response (pCR), nevertheless, increased the acute therapeutic toxicity. Some studies showed that vitamin C (VitC) had potential benefits on anti-tumor therapy and anti-inflammatory response. Therefore, we conducted this HCCSC R02 study to explore the efficacy and safety of adding a high-dose intravenous VitC to mFOLFOX6/XELOX -based NCRT in LARC. MATERIALS/METHODS HCCSCR02 study was designed as a prospective, single-center phase II trial, which including pts aged 18-75 years with stage II/III rectal adenocarcinoma, distance from anus ≤12cm. The enrollment criteria included: staged with MRI as cT3/cT4 or cN1/2, or mesorectal fascia involvement (MRF+), or difficult to preserve the anus. Patients with glucose-6-phosphate dehydrogenase enzyme(G6PD) deficiency were excluded. Pelvic intensity modulated radiation therapy (IMRT) was given in 45-50.4Gy/25-28 fractions. Concurrently, two cycles of chemotherapy (mFOLFOX6 or XELOX) were administered during IMRT, as well as intravenous VitC (24g) delivered daily after the end of each radiation therapy. Additional 2-3 cycles of mFOLFOX6 / XELOX were adopted between the completion of radiotherapy and surgery. The primary endpoint was pCR rate. The secondary endpoints included radiation-related toxicities, overall survival (OS) and disease-free survival (DFS). This study is still recruiting. RESULTS From May 15, 2021 to Feb 8, 2023, 19 pts were recruited and finished all the scheduled NCRT, of which the proportion of cT4, cT3, cN2, cN1 were 31.6%, 63.2%, 52.6%, 36.8%, respectively. In addition, 10 pts (52.6%) were diagnosed as MRF+ initially, and 8 pts (42.1%) had a lower primary tumor(≤5cm) who were considered difficult for anal preservation before NCRT. All subjects enrolled were confirmed to be proficient mismatch repair (pMMR). As a result, 18 pts underwent a total mesorectal excision (TME) all with R0-resection, and 8 pts were evaluated as pCR (44.4%, 8/18, confidence interval: 0.246-0.663), 11 as major pathological response rate (MPR) (61.6%, 11/18), respectively. The anus preservation rate in patients with lower diseases was 87.5% (7/8). One case accepted a watch-and-wait strategy because of clinical complete response (cCR). Overall, grade 3 toxicities were observed in 4 pts, including 3 leucopenia (15.8%, 3/19), 2 neutropenia (10.5%, 2/19) and 1 diarrhea (5.3%, 1/19). No grade 4 adverse event was observed. CONCLUSION The addition of high-dose VitC to the mFOLFOX6/XELOX-based NCRT in LARC showed a promising pCR, well tolerance, particularly low rate of diarrhea, thus warrants further investigation. CLINICAL TRIAL INFORMATION NCT04801511.
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Zhou Z, Wang Y, Zhao F, Yao G, Yu H, Yu H, Bu L, Lu Z, Yan S. Radiation Induced Lung Injury in Rats after Pre-Oxygenation Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e279-e280. [PMID: 37785046 DOI: 10.1016/j.ijrobp.2023.06.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Deep inspiratory breath holding (DIBH) has been widely used during the radiotherapy of thoracic tumors. The main disadvantage of voluntary DIBH is the short duration of each breath hold. The hypocapnia induced by hyperoxia (oxygen concentration > 50%) pre-oxygenation (PreO2) combined with mechanical hyperventilation has been reported to prolong the duration of single breath hold, but its safety remains controversial, especially the sensitivity of lung tissue to radiation damage under hyperoxia exposure has not been elucidated. In this study, we aim to investigate the changes of radiation induced lung injury in rats after PreO2 radiation. MATERIALS/METHODS We evaluated the lung tissue of rats at different time points (48h, 2w, 4w, 8w, 12w) after thoracic radiation (15Gy single fraction to the right lung), and sequenced the transcriptome of lung tissue at 48 hours after irradiation. Rat cohorts (n = 7/group): 1. Control (Con); 2. Radiation group (RT); 3. Pre-oxygenation (oxygen concentration > 90%) for 8 hours before thoracic radiation (PreO2). RESULTS The inflammatory exudation emerged in the pulmonary interstitium at 48 hours, and reached the most serious alveolitis after four weeks of irradiation (the comparison of alveolitis scores in RT4w vs Con4w and PreO2(4w) vs Con4w, P<0.001) on hematoxylin-eosin staining. While the alveolitis scores in RT group and PreO2 group were not statistically different at each time point. Masson staining showed that the pulmonary fibrosis in the RT group and the PreO2 group reached an obvious pathological change at 12 weeks after irradiation, but the difference between the two groups was not significant. Transcriptome sequencing showed that the number of differential genes in PreO2 vs Con was 559 (302 up-regulated genes and 257 down-regulated genes). The GO enrichment analysis indicated that chromosome segregation was the most significant functional item with P value in the comparative analysis, and the KEGG enrichment analysis suggested that cell division was the most significant enrichment pathway of these differential genes. While there was a small quantity of differential genes in PreO2 vs RT group (3 up-regulated genes and 12 down-regulated genes). Pentose and glucuronate conversions were the most significant enrichment pathway of these differential genes. CONCLUSION This study demonstrated that PreO2 radiotherapy did not increase the severity of radiation induced lung injury in rats compared to conventional radiotherapy. Further study should be conducted to confirm these results and to investigate the regulatory mechanism of pneumonia caused by PreO2 radiotherapy.
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Liu Y, Wang Y, Ma Z, Bao Y, Zhang W, Zhang H, Deng H, Men Y, Zhai Y, Wang X, Liu W, Bi N, Ye F, Men K, Qin J, Xue L, Wang Q, Hui Z. A Machine Learning Method to Predict Pathological Complete Response of Esophageal Cancer after Neoadjuvant Chemoradiotherapy with Clinicohematological Markers and MR Radiomics: A Multi-Center Study. Int J Radiat Oncol Biol Phys 2023; 117:e318. [PMID: 37785139 DOI: 10.1016/j.ijrobp.2023.06.2355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Nearly 30% of patients with local advanced esophageal cancer achieved pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT), who may benefit from organ-preservation strategy under accurate prediction of pCR. We aimed to develop and validate machine learning models based on clinicohematological markers and MR radiomics to accurately predict pCR of esophageal cancer after nCRT. MATERIALS/METHODS In this multi-center study, eligible patients with esophageal cancer who received baseline MR scan (T2-weighted image) and nCRT plus surgery were enrolled between September 2014 and September 2022 at institution 1 (training set) and between December 2017 and August 2021 at institution 2 (testing set). Pre-nCRT and post-nCRT blood test results were collected to calculate hematological markers. Models were constructed by machine learning based on clinicohematological markers and MR radiomics to predict pCR. Area under the curve (AUC) and cut-off analysis were used to evaluate model performances. RESULTS Totally 154 patients (81 in the training set and 73 in the testing set) were enrolled. The combined model integrating pre-nCRT monocyte-to-lymphocyte ratio and 6 radiomics features achieved AUC of 0.800 (95% CI 0.671-0.918) in the testing set, with sensitivity of 79.2% (95% CI 62.5%-95.8%), specificity of 83.7% (95% CI 73.5%-93.9%), positive predictive value of 76.0% (95% CI 62.5%-90.0%), and negative predictive value of 89.6% (95% CI 82.0%-95.8%). CONCLUSION A machine learning model based on clinicohematological markers and MR radiomics to predict pCR after nCRT for patients with esophageal cancer was developed and validated, providing a novel tool for personalized treatment. It is necessary to further validate in more large datasets.
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Wang Q, Yue H, Zhou X, Wu L, Wang Y, Li T, Wang J. Develop a Deep Radiomics Model for Predicting the Response to Neoadjuvant Chemoradiotherapy (nCRT) in Patients with Locally Advanced Esophageal Cancer Using Three-Stage Longitudinal CT Images. Int J Radiat Oncol Biol Phys 2023; 117:e491. [PMID: 37785550 DOI: 10.1016/j.ijrobp.2023.06.1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To develop a deep radiomics model for predicting the response to neoadjuvant chemoradiotherapy (nCRT) of patients with locally advanced esophageal cancer using three stage longitudinal CT images. MATERIALS/METHODS In this study, 189 patients were used to train our model, 80 patients were used to test the performance of the trained model. All patients enrolled in this study underwent nCRT followed by esophagectomy, and all patients underwent three stage longitudinal CT scans (before nCRT, after nCRT and before esophagectomy). The number of radiomics features for each CT images was 2153, the number of longitudinal radiomic features for each patient was 6459. Then, we used the least absolute shrinkage and selection operator regression for feature importance analysis. After this, the selected features of each stage were feed to the disentangled representation network to explore the relationship between the dynamic changes of tumors before and after nCRT and the pathological complete response (pCR). In addition, in order to further evaluate the effect of the time interval between nCRT and esophagectomy on the response to nCRT, we conducted subgroup analysis on different time frames. The performance of our model was evaluated by area under curve (AUC), accuracy, sensitivity and specificity. RESULTS Compared with only using single-stage CT images (the AUC of only using before nCRT CT images, after nCRT CT images, before esophagectomy CT images were 73.27%, 74.21%, and 74.95%, respectively), effectively exploring the dynamic changes of the tumor can achieve better performance in predicting the response to nCRT in the testing cohort (the AUC was 84.29%, 95% CI, 81.14%-87.44%). In addition, the performance of our proposed method outperforms any combinations of two stage CT images (the AUC using the CT images of before nCRT and after nCRT was 77.92%, the AUC using the CT images of before nCRT and before esophagectomy was 79.31%, the AUC using the CT images of after nCRT and before esophagectomy was 80.01%). Finally, the results showed that exploring the dynamic changes of the tumor using the three-stage CT images outperformed using single-stage CT images and any combinations of two-stage CT images in predicting the response to nCRT. The study also found that the time interval between nCRT and esophagectomy had some influence on the accuracy of pCR prediction, with the prediction accuracy tending to increase from 1 to 6 weeks and stabilizing after 6 weeks. CONCLUSION By exploring the dynamic changes of tumors, the designed disentangled representation network can effectively predict the response to nCRT of patients with esophageal cancer. In addition, the time interval between nCRT and esophagectomy also has a certain impact on the response to nCRT.
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Ren G, Wang Y, Wang Y, Chen Y, Chen Q, Wang S. Development and Validation of a Deep Learning-Based Auto-Delineation of Target Volume and Organs at Risk in Pancreatic Cancer Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e482-e483. [PMID: 37785527 DOI: 10.1016/j.ijrobp.2023.06.1706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The delineation of the clinical target volume (CTV), gross target volume (GTV) and organs at risk (OARs) is a crucial and laborious in pancreatic cancer radiotherapy. In this work, we propose and evaluate a three-dimensional (3D) novel convolutional neural network (CNN) for automatic and accurate CTV, GTV and OARs in pancreatic cancer. MATERIALS/METHODS A total of 120 computed tomography (CT) scans patients with pancreatic cancer were collected. A novel 3D CNN network, called ResUNet3D, was developed to achieve auto-delineation. 96 patients chosen randomly were used for training, 12 patients for validation, and 12 patients for testing. Meanwhile, the Dice similarity coefficient (DSC) and 95th percentile Hausdorff distance (HD95%) were used to assess the performance. RESULTS The DSC values for the test data were 80.9±8.6%, 77.5±5.6%, 94.5±1.3%, 66.2±13.4%, 73.6±7.6%, 79.0±8.7%, 94.1±1.9%, 94.6±1.4%, 87.3±5.8% for CTV, GTV, liver, duodenum, spinal cord, bowel, kidney left, kidney right, stomach. The corresponding HD95% values were 10.7±6.9mm, 7.8±5.7mm, 11.6±5.6mm, 18.6±5.6mm, 2.7±0.7mm, 17.7±8.6mm, 3.9±1.4mm, 3.7±1.9mm, 13.4±5.7mm, respectively. The average delineation time for one patient's CT images was within 5 seconds. CONCLUSION The experimental results demonstrate that the CTV, GTV and OARs delineated for pancreatic cancer by ResUNet3D achieved a close agreement with the ground truth. ResUNet3D could significantly reduce the radiation oncologists' contouring time.
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Li W, Wang Y, Li K, Ma L, Li F, Ren H, Song B, Duan Y, Chen J, Fu K, Zhou L, Zhang S, Yin R. Evaluating the Effects of Bone Marrow Sparing Radiotherapy on Acute Hematologic Toxicity for Patients with Locoregionally Advanced Cervical Cancer: A Prospective Phase II Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2023; 117:S40-S41. [PMID: 37784492 DOI: 10.1016/j.ijrobp.2023.06.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Bone marrow sparing intensity modulated radiotherapy (BMS-IMRT) can reduce the incidence of acute hematologic toxicity (HT) for locoregionally advanced cervical cancer (LACC) patients receiving concurrent chemoradiotherapy (CCRT), but the norm has been controversial. The purpose of the study was to evaluate the effects of bone marrow (BM) V40 <25% on decreasing the incidence of acute HT in a prospective clinical trial. MATERIALS/METHODS A total of 242 LACC patients were recruited from May 2021 to May 2022, who were evenly randomized into BMS-IMRT group and standard IMRT group according to a computer-generated random number list. All patients received pelvic irradiation with concurrent cisplatin (40 mg/m2 weekly), followed by brachytherapy. For patients in BMS-IMRT group, the outer contour of pelvic bone, lumbar spine and left and right femur heads were additionally delineated as a surrogate for BM, and V40 <25% was prescribed. Blood counts were tested weekly, of which nadirs during external beam radiotherapy (EBRT) were graded to assess acute HT as primary observation index. Second observation index were dosimetric parameters of EBRT plan from the dose volume histograms (DVHs). Binary logistic regression model and receiver operating characteristic (ROC) curve were used for predictive value analysis. RESULTS Baseline demographic, disease and treatment characteristics were all balanced between BMS-IMRT group and standard IMRT group. BMS-IMRT was associated with a lower incidence of grade ≥2 and grade ≥3 acute HT, leukopenia and neutropenia (72.70% vs 90.90%, P <0.001*; 16.50% vs 65.30%, P <0.001*; 66.10% vs 85.10%, P = 0.001*; 13.20% vs 54.50%, P <0.001*; 37.20% vs 66.10%, P <0.001*; 10.70% vs 43.80%, P <0.001*). Plan target volume (PTV) for all patients satisfied the clinical requirement of V(100%) ≥95%, and conformity and homogeneity were both comparable between 2 groups. BMS also decreased dose delivered to the organs at risk (OARs) including rectum, bladder and left and right femur head. Univariate and multivariate analyses showed that BM V40 was an independent risk factor for grade ≥3 acute HT (odds ratio [OR] = 2.734, 95% confidence interval [CI] = 1.959-3.815, P <0.001*). Cutoff value was 25.036% and area under the curve (AUC) was 0.786. The nomogram was constructed, which was rigorously evaluated and internally cross-validated, showing good predictive performance. CONCLUSION BM V40 <25% can reduce the risks of acute HT for LACC patients receiving CCRT while the dose delivery of target volume and other normal tissues were not compromised. With great practicality and applicability, BM V40 <25% is a promising strategy, making BMS-IMRT widespread especially in the area where application of image guided radiotherapy (IGRT) such as 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET)/CT is not popularized. Chinese clinical trial registry (ChiCTR2200066485).
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Saifi O, Lester SC, Rule WG, Breen W, Stish BJ, Rosenthal A, Munoz J, Lin Y, Johnston P, Ansell SM, Paludo J, Khurana A, Bisneto JV, Wang Y, Iqbal M, Moustafa MA, Murthy HS, Kharfan-Dabaja M, Peterson JL, Hoppe BS. Consolidative Radiotherapy for Residual PET-Avid Disease on Day +30 Post CAR T-Cell Therapy in Non-Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:S52. [PMID: 37784518 DOI: 10.1016/j.ijrobp.2023.06.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Up to30% of non-Hodgkin lymphoma (NHL) patients achieve a partial response (PR) to anti-CD19 Chimeric Antigen Receptor T-cell Therapy (CART) on day +30. Most PR patients relapse and only 30% achieve spontaneous complete response (CR) without additional therapies. This study is the first to report on the role of consolidative radiotherapy (cRT) for PR PET-avid disease on day +30 post-CART in NHL. MATERIALS/METHODS Aretrospective review across 3 institutions from 2018 to 2022 identified 60 patients with B-cell NHL who received CART and achieved PR (Deauville 4-5) with <5 PET-avid disease sites on day +30. Progression-free survival (PFS) was defined from CART infusion to any disease progression. Overall survival (OS) was defined from CART infusion to death. Local relapse-free survival (LRFS), calculated based on the total number of PR sites, was defined from CART infusion to local relapse (LR) in the PR site identified on day +30. cRT was defined as comprehensive (compRT) - treated all PR PET-avid sites - or focal (focRT). RESULTS Followingday +30 PET scan, 45 PR patients were observed and 15 received cRT. Only one patient received consolidative systemic therapy and belonged to the cRT group. Prior to CART, bridging RT was given to 13 patients (9 in observation group and 4 in cRT group). There were no significant differences in the pre-CART and day +30 baseline characteristics, including the median size and SUVmax of the PR sites, between the two groups. However, the median number of PR sites on day +30 was higher in the cRT group (2 [range 1-3] vs 1 [range 1-3], p = 0.003). The median equivalent 2 Gy dose was 39.1 (Interquartile range 36.8-41) Gy, and the most common cRT regimen was 37.5 Gy in 15 fractions. The median follow-up was 21 months. Among the observed patients, 15 (33%) achieved spontaneous CR, and 27 (60%) experienced disease progression with all relapses involving the initial PR sites. Among patients who received cRT, 10 (67%) achieved CR, and 3 (20%) had disease progression with no relapses in the radiated PR sites. None of the 10 cRT patients achieving CR relapsed or required subsequent therapies. The 2-year PFS was 80% and 37% (p = 0.012) and the 2-year OS was 78% and 43% (p = 0.12) in the cRT and observation groups, respectively. Patients consolidated with compRT (n = 12) had superior 2-year PFS (92% vs 37%, p = 0.003) and 2-year OS (86% vs 43%, p = 0.048) compared to observed or focRT patients (n = 48). There were no grade 3+ RT-related toxicities. A total of 90 PR sites were identified; 64 were observed and 26 received cRT. Fourteen (22%) observed PR sites achieved spontaneous sustained CR and 42 (66%) experienced LR. Twenty-four (92%) PR sites consolidated with cRT achieved sustained CR and none experienced LR. The 2-year LRFS was 100% in the cRT sites and 31% in the observed sites (p<0.001). CONCLUSION NHL patients who achieve PR by PET to CART are at high risk of local progression. cRT for residual PET-avid disease on day +30 post-CART appears to alter the pattern of relapse and improve LRFS and PFS.
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Chang CW, Bohannon D, Tian Z, Wang Y, McDonald MW, Yu DS, Liu T, Zhou J, Yang X. Estimating Potential Benefits of Online Adaptive Proton Therapy for Head-and-Neck Cancer: A Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e649. [PMID: 37785928 DOI: 10.1016/j.ijrobp.2023.06.2069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Proton therapy is highly sensitive to anatomical changes and setup variations in head-and-neck (HN) treatments. To address this issue, proton centers often acquire patient CT images weekly to monitor patient anatomical changes during the treatment course and perform offline plan adaptation when needed. However, offline adaptation cannot fully account for daily setup variations or the anatomical changes occurring with high frequency. There are a few groups endeavoring to develop advanced technologies to enable online adaptive proton therapy (APT). However, the necessity of online APT remains controversial, as it is unknown that whether online APT will significantly improve treatment quality and outcomes compared to offline APT. The purpose of this study is to estimate the clinical potential of online APT in the management of HN cancers in relation to the current offline APT. MATERIALS/METHODS Our retrospective study was conducted with four HN patients (35 fractions per patient), who had been treated with intensity modulated proton therapy and had offline adaptation once or twice during their treatment courses. Synthetic CT (sCT) images were generated from 140 daily CBCT images for us to recalculate the dose of the treatment plan in patient's actual treatment anatomy for each treatment fraction and adapt the plan when warranted. These adaptations were assumed to be performed online before treatment delivery to mimic an online APT course. Accumulative doses were calculated for both courses using the CBCT-based sCT images of every fraction for us to compare the target coverage, organ at risk (OAR) sparing, tumor control probability (TCP) and normal tissue complication probability (NTCP). An in-house script was developed to semi-automate this process in a commercial treatment planning system to facilitate our study. RESULTS All patients would benefit from online APT to different extents. For the first patient, with OAR doses comparable to the actual offline course, the retrospective online APT course improved dose coverages of the three CTVs from 95.2%, 98.64% and 89.53% to 98.88%, 99.81%, 98.97%, which would lead to a 4.52% improvement in TCP. Similarly, online APT would yield a 2.66% improvement in TCP for the second patient. For the third patient, with comparable CTV dose coverages, the mean doses of right parotid and oral cavity were decreased from 29.52 Gy relative biological effectiveness (RBE) and 41.89 Gy RBE to 22.16 Gy RBE and 34.61 Gy RBE, leading to a reduce of 1.67% and 3.40% in NTCP. The mean dose of right parotid was decreased from 21.71 Gy RBE to 19.37 Gy RBE for the last patient, leading to a reduce of 0.73% in NTCP. CONCLUSION Our results showed that online APT could better maintain the treatment plan quality than offline APT for all the four patients, despite their significant anatomical changes. Future investigation will focus on collecting more patient data to obtain statistically significant results and help identify the patients to whom the online APT will be of most benefit.
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Li X, Lin FY, Jia LC, Liu T, He SM, Zhang W, Zhang M, Wang Y. Preserving Structural Consistency in the Generation of Synthetic CT in Pelvic MR-Only Radiation Treatment Planning. Int J Radiat Oncol Biol Phys 2023; 117:e686. [PMID: 37786017 DOI: 10.1016/j.ijrobp.2023.06.2154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) MR-based synthetic CT (sCT) generation is necessary for MR-only radiotherapy to assist in radiation dose calculation, owing to no electronic density information in MR images. This study investigated the feasibility of synthesizing CT images from magnetic resonance (MR) images using generation antagonism networks (GANs) for MR radiotherapy of rectal cancer. Meanwhile, the transformer module and the contrast learning loss were introduced to improve the sCT. MATERIALS/METHODS The data set used in this study was the T2-weighted MR and CT image data of 108 patients with rectal cancer. Three-fold cross-validation was performed on all data sets. The transformer module was introduced into the plain CycleGAN, and the improved Patch Noise Contrastive Estimation (PatchNCE) loss was used as the loss function. The improved PatchNCE loss maintained the structural consistency of the MR and the synthetic CT by ensuring the consistency of the distribution of image patches on the MR-sCT image pair. The 2.5D images were taken as the input of our model, which refers to taking two consecutive adjacent layers in a specific layer. The CT-to-sCT image similarity was evaluated by metrics of mean absolute error (MAE), peak signal-to-noise ratio (PSNR), and Structure Similarity Index Measure (SSIM). The sCT dosimetric accuracy was verified against CT-based dose distributions for the photon plan. Relative dose differences in the planning target volume and organs at risk were computed. RESULTS The evaluation indicators of sCT images generated by our model were superior to the plain CycleGAN in the results of the three-fold cross-validation. MAE, PSNR and SSIM of our model were 42.850HU, 26.486 and 0.988, respectively, which were superior to 47.129HU, 25.167 and 0.978 of the plain CycleGAN. In addition, sCT generated by our model exhibited good continuity in the axial direction compared with plain CycleGAN. Furthermore, most of the relative differences in the DVH indicators were less than 1%. CONCLUSION The accuracy of sCT can be effectively improved by introducing a transformer module and comparative learning loss function. Moreover, all dosimetric differences were within clinically acceptable criteria for photon radiotherapy, demonstrating the feasibility of the MRI-only workflow for patients with rectal cancer.
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Li W, Li C, Liu T, Wang Y, Ma X, Xiao X, Zhang Q, Qu J. Self-reported sleep disorders and the risk of all cancer types: evidence from the Kailuan Cohort study. Public Health 2023; 223:209-216. [PMID: 37677850 DOI: 10.1016/j.puhe.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Previous studies that focussed on sleep disturbance have primarily examined specific aspects of sleep disorders rather than considering overall sleep quality. We aimed to investigate different sleep disorders and their combination as risk factors for different types of cancer. STUDY DESIGN Prospective cohort study. METHODS In this prospective cohort study, we included 78,232 participants. A self-reported questionnaire was used to address insomnia, daytime sleepiness, snoring, and sleep duration. Overall sleep quality was evaluated by summarising these four sleep parameters. Cox proportional hazards analysis was used to estimate the hazard ratios and their 95% confidence intervals for determining the effect of the overall sleep-quality score and its components on the risk of incident cancer. RESULTS During a median follow-up of 5.67 years, 1266 participants were diagnosed with incident cancer. Compared to participants in the best sleep-quality score group, participants in the worst sleep-quality score group had a higher subsequent risk of overall cancer, and colorectal, breast, uterine or uterine cervical, prostatic, kidney, and bladder cancer. Participants with insomnia and snoring status had an elevated risk of head and neck, breast, uterine or uterine cervical, prostatic, kidney, bladder cancer, and lymphoma. CONCLUSIONS Poor overall sleep-quality scores as well as poor scores for the scale's components, including insomnia and snoring status, elevated the risk of overall and several specific-site cancers. TRIAL REGISTRATION Kailuan Study, ChiCTR2000029767. Registered 12 February, 2020-Retrospectively registered, https://www.chictr.org.cn/showprojEN.html?proj=48316.
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Bi N, Deng L, Hu X, Shayan G, Zhao L, Zhang L, Jiang W, Zhang J, Zhu X, Wang Y, Ge H, Cao J, Lin Q, Chen M, Wang L. 30 Gy vs. 45 Gy Consolidative Thoracic Radiation (cTRT) for Extensive Stage Small Cell Lung Cancer (ES-SCLC): A Multicenter, Randomized, Phase 3 Trial. Int J Radiat Oncol Biol Phys 2023; 117:S56-S57. [PMID: 37784527 DOI: 10.1016/j.ijrobp.2023.06.350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Consolidative thoracic radiotherapy (cTRT) showed potential benefit to extensive stage small cell lung cancer (ES-SCLC). However, the optimum dose of cTRT is unknown. The purpose of this randomized trial was to compare the effect of 45 Gy in 15 fractions with 30 Gy in 10 fractions cTRT in ES-SCLC. MATERIALS/METHODS This phase III, randomized trial was conducted in 12 public hospitals in China. Eligible patients with pathologically confirmed ES-SCLC who responded to 4-6 cycles of etoposide plus cisplatin (EP) or carboplatin (EC) chemotherapy were randomized 1:1 to receive either 30 Gy in 10 fractions or 45 Gy in 15 fractions cTRT. The primary outcome was 2-year overall survival (OS). Secondary outcomes included 2-year progression-free survival (PFS), 2-year local control (LC) and radiation treatment related toxicity. The primary objective was to detect an OS improvement in 45 Gy cTRT group at 2 years from 13% to 26% assuming a two-sided a = 0.05 and power of 85%, with a planned sample size of 186 patients. This trial was registered with Clinical Trials.gov, number NCT02675088. RESULTS Between January 15, 2016, and September 20, 2022, 90 patients were randomly assigned either 30 Gy in 10 fractions (n = 50) or 45 Gy in 15 fractions (n = 40) cTRT group. Recruitment to the trial closed early due to slow accrual since first-line chemoimmunotherapy has become the new standard of care for ES-SCLC. The median age of patients was 58 years, 87.8% were male, 76.7% had a smoking history, 95.6% received IMRT, and 58.9% received prophylactic cranial irradiation. At a median follow-up of 39.9 months (IQR 27.2-59.2), there was no significant difference in the 2-year OS between the 45 Gy group and the 30 Gy group, at 43.4% (95% CI 29.3%-64.3%) and 40.0% (95% CI 27.9%-59.1%), respectively (log-rank p = 0.62; HR 1.13 [95% CI 0.69-1.84]). The 2-year PFS was 12.1% (95% CI 4.3%-33.8%) in the 45 Gy group and 9.0% (95% CI 3.2%-25.2%) in the 30 Gy group (log-rank p = 0.25, HR 0.76(95% CI [0.478-1.22]). There were also no significant differences in locoregional recurrence free survival (log-rank p = 0.75; HR 0.888 [95% CI 0.423-1.863]) and distant metastasis free survival (log-rank p = 0.95; HR 1.015 [95% CI 0.624-1.651]) between two groups. No grade 5 toxicity was observed in both groups. Patients treated with higher cTRT dose presented with increased incidence of grade 3+ radiation pneumonitis (10% vs 2%) and hematological toxicity (20% vs 12.5%). CONCLUSION This randomized trial did not find a higher probability of survival improvement in patients with ES-SCLC receiving cTRT of 45 Gy in 15 fractions compared with 30 Gy in 10 fractions. In contrast, there was an increase in toxicity, especially radiation pneumonitis. Additional randomized studies investigating the role of cTRT in ES-SCLC after a response to chemoimmunotherapy are warranted.
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Ye J, Wang Y, Wang Y, Hong L, Kang J, Jia Y, Li M, Chen Y, Wu Z, Wang H. Improvement of soil acidification and ammonium nitrogen content in tea plantations by long-term use of organic fertilizer. PLANT BIOLOGY (STUTTGART, GERMANY) 2023; 25:994-1008. [PMID: 37345615 DOI: 10.1111/plb.13554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/07/2023] [Indexed: 06/23/2023]
Abstract
Soil acidification is common in some Chinese tea plantations, which seriously affected growth of tea trees. Hence, it is essential to explore soil remediation in acidified tea plantations for sustainable development of the tea industry. We sought to determine how different fertilizers affect acidified soil and their N transformation in tea plantations. Different fertilizers were used on acidified tea plantation soils for 4 years (2017-2021), and changes in soil pH, indices related to soil N transformation and tea yield were analysed to construct interaction networks of these indices and find which had the largest influence on fertilization. Long-term use of sheep manure reduced soil acidification, increased soil pH, enhanced the number and intensity of N-fixing and ammonifying bacteria, urease, protease, asparaginase and N-acetamide glucose ribosidase activity and nifH gene expression. This treatment reduced the number and intensity of soil nitrifying and denitrifying bacteria, nitrate reductase and nitrite reductase activity, while the expression of amoA-AOA, nirK, nirS, narG and nosZ in turn increased ammonium N content of the soil, reduced nitrate N content, and enhanced tea yield. Topsis index weight analysis showed that ammonium N content in the soil had the largest impact among fertilization effects. Long-term use of sheep manure was beneficial in restoring the balance of the micro-ecosystem in acidified soil. This study provides an important practical basis for soil remediation and fertilizer management in acidified tea plantation soils.
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Li Y, Zhang J, Cai W, Wang C, Yu Z, Jiang Z, Lai K, Wang Y, Yang G. CREB3L2 Regulates Hemidesmosome Formation during Epithelial Sealing. J Dent Res 2023; 102:1199-1209. [PMID: 37555472 DOI: 10.1177/00220345231176520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
The long-term success rate of dental implants can be improved by establishing a favorable biological sealing with a high-quality epithelial attachment. The application of mesenchymal stem cells (MSCs) holds promise for facilitating the soft tissue integration around implants, but the molecular mechanism is still unclear and the general application of MSC sheet for soft tissue integration is also relatively unexplored. We found that gingival tissue-derived MSC (GMSC) sheet treatment significantly promoted the expression of hemidesmosome (HD)-related genes and proteins in gingival epithelial cells (GECs). The formation of HDs played a key role in strengthening peri-implant epithelium (PIE) sealing. Further, high-throughput transcriptome sequencing showed that GMSC sheet significantly upregulated the PI3K/AKT pathway, confirming that cell adhesion and HD expression in GECs were regulated by GMSC sheet. We observed that the expression of transcription factor CREB3L2 in GECs was downregulated. After treatment with PI3K pathway inhibitor LY294002, CREB3L2 messenger RNA and protein expression levels were upregulated. Further experiments showed that overexpression or knockdown of CREB3L2 could significantly inhibit or promote HD-related genes and proteins, respectively. We confirmed that CREB3L2 was a transcription factor downstream of the PI3K/AKT pathway and participated in the formation of HDs regulated by GMSC sheet. Finally, through the establishment of early implant placement model in rats, we clarified the molecular function of CREB3L2 in PIE sealing as a mechanical transmission molecule in GECs. The application of GMSC sheet-implant complex could enhance the formation of HDs at the implant-PIE interface and decrease the penetration distance of horseradish peroxidase between the implant and PIE. Meanwhile, GMSC sheet reduced the length of CREB3L2 protein expression on PIE. These findings elucidate the potential function and molecular mechanism of MSC sheet regulating the epithelial sealing around implants, providing new insights and ideas for the application of stem cell therapy in regenerative medicine.
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Kong Y, Ji Y, Qiu G, Wang Y, Fang J, Chen M, Chen Q, Jiang Y, Yang Y. Radiotherapy for Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Neoadjuvant Immunotherapy Combined with Chemotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e309-e310. [PMID: 37785119 DOI: 10.1016/j.ijrobp.2023.06.2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) With the success of immunotherapy in advanced esophageal cancer, neoadjuvant chemo-immunotherapy (CIT) is being increasingly used for local staged esophageal cancer, especially in the context of clinical trials, which brings similar pCR with neoadjuvant chemoradiotherapy and shows promising results. However, there is still a part of potentially operable patients can't undergo surgery after neoadjuvant chemo-immunotherapy. The follow-up treatment and prognosis of this population remain unclear. MATERIALS/METHODS Patients pathologically diagnosed with ESCC, clinical stage T1-3N+M0 or T3-4aNanyM0(AJCC 8th), PS 0-1 were retrospectively enrolled from 1/2020 to 6/2021 in Zhejiang Cancer Hospital. All patients firstly received PD-1 inhibitors (Camrelizumab, Sintilimab or Tislelizumab) plus chemotherapy (albumin paclitaxel,260 mg/m²on day 1 plus carboplatin AUC = 5 on day 1) every 3 weeks for 2-4 cycles. For those patients who did not receive surgery, definitive radiotherapy with 50.4Gy/28F or 50Gy/25F was adopted using VMAT, concurrent with chemotherapy or alone. The concurrent chemotherapy regimens included weekly TC (paclitaxel 50 mg/m 2, d1, carboplatin AUC = 2, d1) or S1 (60mg bid d1-14,29-42). The survival outcomes and treatment toxicity were recorded and analyzed. RESULTS A total of 56 eligible patients were finally identified from 558 patients who were treated in department of thoracic surgery, 31 patients showed no response to neoadjuvant CIT (6 with PD and 25 with SD), 25 patients achieved PR but did not receive surgery due to poor performance status or refuse to operation. Median age was 66(IQR 56-72) and 55(98.2%) were males. 12(19.6%) were stage II and 44(80.4%) were stage III. Among all the patients,25 (44.6%) received radiotherapy alone, and 31 (55.4%) received chemoradiotherapy after neoadjuvant CIT. The median follow-up was 11.8 months (IQR 8.6-20.1). The median PFS and OS were 16.5 months (95CI 12.9-21.4) and 18.6 months (95CI 11.2-NA), respectively. In the subgroup analysis, the median PFS for patients with PR to CIT was 20.2 moths (95CI:17.23-NA), and 12.9 moths (95CI: 0.68-20.4) for patients with SD or PD, HR was 0.45 (95CI:0.22- 0.93, P = 0.027). No significant difference was observed for patients received radiotherapy alone or chemoradiotherapy with HR = 1.36(95CI:0.69-2.71, P = 0.37). The most common AEs observed during this study were anemia (98.2%), Leukopenia (83.9%), Thrombocytopenia (53.6%). Adverse events of grade≥3 radiation-induced pneumonitis and esophagitis were 12.5% and 32.1%, especially, 6 patients (10.7%) died from esophageal fistula and 2 patients (3.6%) died from grade 5 pneumonitis. CONCLUSION For local advanced ESCC patients after neoadjuvant CIT who did not receive surgery, definitive radiotherapy was an optional treatment strategy. However, those patients with no response to CIT also showed poor response to radiotherapy, and particular attention should be paid to treatment related toxicity, especially esophageal fistula.
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Chen S, Wang XM, Wu F, Huang C, Gao TT, Zhang ZW, Chen JQ, Zheng B, Wang Y, Xu Y, Zhao L, Yang Y. Primary Small Cell Carcinoma of the Esophagus in a Large Multicenter Cohort: Prognostic Factors and Treatment Strategies in the Modern Era. Int J Radiat Oncol Biol Phys 2023; 117:e286-e287. [PMID: 37785063 DOI: 10.1016/j.ijrobp.2023.06.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Primary small cell carcinoma of esophageal (PSCCE) is a rare malignancy with aggressive behavior associated with a perceived poor prognosis. Due to its rarity, the clinical characteristics and the optimal clinical management have not yet been defined, therefore, we designed a multicenter retrospective study to analyze the prognostic factors and the impact of treatment on the prognosis of PSCCE patients. MATERIALS/METHODS We retrospectively evaluated 704 consecutive patients with PSCCE from five participating centers between April 2008 and July 2021. The PSCCE was diagnosed based on the World Health Organization classification. Treatment strategies included surgery, radiotherapy (RT), or chemotherapy only, and combination of 2-3 treatment modalities (surgery, RT and chemotherapy). The estimated hazard rates provide the trajectory of progression and death overtime. Univariate survival analysis was conducted by using Kaplan-Meier plots, and the log-rank test was used to compare survival differences. Cox regression analysis was used to determine the independent prognostic factors in multivariate analysis. RESULTS Overall, 69.0% (486/704) of the patients were male, with a median age of 63 years (range 38-96). Most of the patients were regional lymph node positive (N+, 64.0%), and nearly half with advanced stage (M+, 47.2%). With a median follow-up time of 16 months, 472 patients (67.0%) exhibited disease progression and 429 patients (60.9%) died. Following initial treatment, 85.1% (402/472) of progression/death and 80.1% (344/429) of mortalities occurred within 24 months. Consistently, the maximum annual death and progression/death hazards are highest in the 15.6 months and 9.6 months. The overall survival (OS) rates at 1, 3 and 5 years for all patients were 65.1%, 26.5% and 18.3%, respectively. Univariate survival analysis showed that ECOG score, alcohol abuse, TNM stage, N stage, and M stage were correlated with OS (P <0.05). Multivariate analysis showed that the N stage (HR: 1.378, P = 0.018) and M stage (HR: 1.945, P <0.001) carried independent prognostic factors for OS. In the term of treatment, the OS rates for M- patients treated with combined modality therapy (CMT, surgery±radiotherapy/chemotherapy) were better than those treated with surgery alone or radiotherapy/chemotherapy (3-year OS: 36.7% VS 25.6% VS 32.2%; P = 0.045). The OS rates for M+ patients treated with chemotherapy alone, radiotherapy alone, or radiotherapy combined with chemotherapy were no significant differences (3-year OS: 12.2% VS 19.4% VS 11.1%; P = 0.400). CONCLUSION PSCCE is characterized by a high degree of malignancy with high risks of lymphatic and distant metastasis, N and M stages are the most important prognostic factor. In terms of treatment, comprehensive treatment is most likely to benefit patients without distant metastasis.
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Wang Y, Xu H, Shen W, Chen M. The Clinical Practice and Dosimetric Outcome of the Manual Adaptive Planning during Definitive Radiotherapy Treatment for Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e554. [PMID: 37785702 DOI: 10.1016/j.ijrobp.2023.06.1863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Organ motion is challenging during primary definitive external beam radiotherapy in locally advanced cervical cancer (LACC). Our study evaluated the manual adaptive planning approach three weeks after the treatment started, compared the dosimetric consequences of the manual adaptive plans to the scheduled plans, and explored the clinical factors predicting patients suitable for this replanning strategy. MATERIALS/METHODS We analyzed 82 patients receiving primary definitive external beam radiotherapy with weekly online cone-beam computed tomography (CBCT)-based monitoring. The re-CT simulation was performed during treatment to develop a new plan (manual adaptive plan) due to a significant deviation of the clinical target volume (CTV). To evaluate the dosimetric benefit, D98, homogeneity index (HI) and conformity index (CI) for the planning target volume (PTV), as well as D2cc of the bowel, bladder, sigmoid and rectum were compared between the manual adaptive plans and the scheduled ones. The clinical factors influencing target motion throughout treatment were analyzed by chi-square test and logistic regression analysis. RESULTS The re-CT simulation was performed after 15 fractions during treatment to develop the manual adaptive plan in 41 patients. The median CI and HI of the manual adaptive plan were significantly superior to the scheduled one (P = 0.001, 0.003, respectively), demonstrating a better dose coverage of the target volume. Compared to the scheduled plans, D98 of the manual adaptive plans increased by 3.3% (P = 0.0002), the average of D2cc to the rectum, bladder decreased 0.267Gy (P = 0.0049) and 0.321Gy (P = 0.0146), respectively. In addition, the chi-square test demonstrated that age (P = 0.024), primary tumor volume (P = 0.015), and parametrial infiltration (P = 0.022) were the clinical factors influencing target motion throughout treatment. Multivariate analysis further identified the large tumor volume (≥50cm3, OR = 3.254, P = 0.039) and parametrial infiltration (OR = 3.376, P = 0.018) as the independent risk factors. CONCLUSION We found the most significant organ motion happened after 15 fractions during treatment. The manual adaptive planning of definitive radiotherapy improved the dose coverage and decreased the volume of organs at risk of receiving clinically significant doses of RT in patients with LACC. Patients with bulky mass or with parametrial infiltration were highly suggested to receive manual adaptive planning after 15 fractions during definitive radiotherapy, a timesaving strategy compared to the daily online adaptive radiotherapy without compromising the target dose coverage.
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Luo H, Li S, Tan X, Jin F, Li C, Li Q, Deng W, Li B, Wang Y. Prediction Analysis of Dose Verification Based on Plan Complexity Metrics during Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e692. [PMID: 37786032 DOI: 10.1016/j.ijrobp.2023.06.2166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Plan validation in radiotherapy includes pre-treatment and in-treatment validation. It is feasible to leverage plan complexity to optimize validation processes, because some research reports that the consistency between planning and measurement or execution decreases as plan complexity increases. Therefore, starting from the plan complexity, this study comprehensively and systematically explores these factors affecting whether the plan verification is passed or not and the strength of their correlations, so as to establish a regression model and optimize the verification process. MATERIALS/METHODS The IMRT and model-based validation information were retrospectively collected for patients who received tumor radiotherapy at our institution from January 2020 to May 2022. The seventy-eight metrics characterizing the plan complexity were calculated and checked for each plan by an in-house developed computing platform. The comparisons of plan verification results under different tumor species and different verification methods were carried out, and the plan complexity metrics was also compared. Subsequently, Spearman correlation analysis between plan complexity and plan validation under different tumor species, different verification methods and different evaluation indexes was analyzed to provide the basis for regression analysis. RESULTS One thousand two hundred twenty-six patients were enrolled in the study. The plans in Eclipse TPS were performed by Varian Edge and iX linear accelerators and their verification were executed by EPID, Delat4, and ArcCheck. The gamma index under evaluation index of 3%/3mm, 3%/2mm, 2%/2mm, 1%/1mm were respectively 97.4% (7.1%), 94.8% (10.9%), 86.1% (20.1%), 50.7% (22.6%). The γ and DD of EPID and Detla4 decreased with the increase of TH, and the change of DD was the most significant, while the DTA of Detla4 did not change significantly with TH, and the passing rate of DTA and γ in thoracic and abdominal was the highest in ArcCheck group. Contrast and Variance were the most different between tumor types. The pelvic MIs and MIa were larger than those planned for the other three sites. Except for head and neck CLS and MD, other metrics did not vary significantly among tumor species. The correlation between the metrics characterizing the static characteristics of leaves was more significant for head and neck tumors; the correlation between metrics characterizing the flux complexity were significantly different in pelvic. There was a correlation between plan complexity and γ indicators, and the overall strength was ArcCheck > EPID > Delta4 for head and neck, Delta4 > EPID and ArcCheck for thorax-abdomen, Delta4 and EPID > ArcCheck for pelvic, Delta4 > ArcCheck > EPID for arms and legs. CONCLUSION There was a correlation between different plan complexity metrics. Based on this study, it is feasible to predict the verification results based on these complexity metrics, but the regression models were respectively established according to tumor types and validation methods.
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Li X, Jia LC, Lin FY, Liu T, He SM, Zhang W, Zhang M, Wang Y. Small Samples and Low-Cost Auto-Segmentation Method for Pelvic Organ-at-Risk Segmentation in Magnetic Resonance Images Using Deep-Learning. Int J Radiat Oncol Biol Phys 2023; 117:e685-e686. [PMID: 37786015 DOI: 10.1016/j.ijrobp.2023.06.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In radiotherapy, magnetic resonance (MR) imaging has higher contrast of soft tissue, and no radiation compared with computed tomography (CT) scanning. Due to the high-cost of manual annotation, the deep-learning based automatic organ-at-risk (OAR) and target delineation algorithms are in high-demand, but the collecting of large amounts of high-quality annotated datasets remains difficulty. In this paper, we proposed a low-cost OAR segmentation method with semi-supervised annotation using small annotation samples of pelvic MR images. MATERIALS/METHODS This study consisted of 94 patients diagnosed with rectal cancer from April 2018 to March 2021 at Peking University People's Hospital. We used 17 slices of MR images with annotation and 78 slices without annotation to train a deep-learning based segmentation model. The bladder, femoral heads, rectum and small intestine were selected as OAR. Semi-supervised method and ensemble learning were used for generating training set using small sample with annotation. Post-processing algorithm was used to correct the self-annotation data. Two of 14 annotation samples were set as test set. As for un-labeled images, 40 of them were set as semi-supervised annotation train set, the rest were test set. Besides, both 2D and 3D auto-segmentation networks were evaluated. RESULTS The dice of bladder, femoral head left and right, rectum and small intestine between segmentation results and reference masks is 0.947, 0.983, 0.981, 0.900, 0.845 only using self-annotation and post-processing method of 2D segmentation model. And the dice of corresponding OAR is 0.871, 0.975, 0.975, 0.783, 0.724 using 3D segmentation network, 0.885,0.982, 0.982, 0.882, 0,814 using 2D segmentation network with supervised method (nnUNet). The 2D model outperformed 3D model with better segmentation performance, shorter inference time and fewer parameters. CONCLUSION The results proved that we can train a multi-OAR segmentation model only using small annotation samples and other unlabeled samples. Ensemble learning and post-processing methods are necessary for semi-supervised data annotation. For anisotropy data, 2D model shows better performance than 3D models.
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Eaton BR, Zhou J, Wang Y, Langen KM, Esiashvili N. Prospective Feasibility Trial of Vertebral Body Sparing Pencil Beam Scanning Proton Craniospinal Irradiation in Growing Children. Int J Radiat Oncol Biol Phys 2023; 117:e510-e511. [PMID: 37785599 DOI: 10.1016/j.ijrobp.2023.06.1767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Advanced proton therapy techniques now allow for delivery of craniospinal irradiation (CSI) to the entire brain and thecal sac while sparing many of the anterior vertebral bodies from doses expected to inhibit growth, though this technique has not been prospectively studied. The purpose of this trial is to test the feasibility and robustness of vertebral body sparing (VBS) CSI in children with standard image guidance, to assess the dosimetric and toxicity benefits of this approach, and to report early clinical outcomes. MATERIALS/METHODS Children 3-18 years old requiring CSI treatment were eligible for this IRB approved prospective clinical trial. The CSI clinical target volume (CTV) included the brain, entire thecal sac and neural foramina with no expansion. Select anterior vertebral bodies (AVB) could be included at the physician's discretion. The spinal portion of the CTV was treated with PA beam(s) with robust optimization (+/-3.5% range, 5mm positional uncertainty). Daily image guidance included kV/kV imaging. Cone beam CT (CBCT) was acquired weekly after final positioning and a virtual CT (vCT) was created for quality assurance (QA) analysis. Acute toxicity was prospectively assessed weekly during treatment and 1 month after per CTCAE v5.0. RESULTS Ten children with a median patient age and CSI dose of 9 years (range 3-16) and 36 Gy (RBE) (range 15-36 Gy (RBE)) were enrolled. Common diagnoses were medulloblastoma (n = 4) and non-germinomatous germ cell tumor (n = 3). Seven patients received prior chemotherapy; 2 patients were treated with palliative intent. Dose statistics for the anterior vertebral body varied according to age, CSI dose and portion of the spine, with the greatest sparing in the lower thoracic and lumbar vertebrae for all patients. Nine patients completed all QA CTs; one patient required a replan due to weight gain. For all remaining patients the treatment was highly robust: CTV V95 reduction at the C-spine, T-spine, and L-spine was 0.0±0.1%, 0.6±1.3%, and 0.8±1.1%, respectively. The highest grade non-hematologic acute toxicity was grade 2 alopecia (n = 9) and grade 2 nausea/vomiting (n = 5). One patient reported transient grade 1 esophagitis during treatment. Hematologic toxicity included >/ = grade 3 lymphopenia in 7 patients, >/ = grade 3 leukopenia in 1 patient, >/ = grade 2 anemia in 6 patients, and >/ = grade 1 thrombocytopenia in 3 patients. Median follow-up is 16.6 months (range 10-36 months). Three patients experience intracranial disease progression: 2 local and 1 distant intracranial failure. There were no failures within the spine. CONCLUSION Proton vertebral body sparing CSI targeting the thecal sac only is a highly robust treatment technique and is well tolerated. Weekly CBCT to assess changes in soft tissue posterior to the spine is recommended. Further follow-up is required to assess long-term growth outcomes.
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Ma Y, Ma M, Ye S, Liu Y, Zhao X, Wang Y. Association of IL-17 and IL-27 polymorphisms with susceptibility to recurrent pregnancy loss and pre-eclampsia: A systematic review and meta-analysis. Immun Inflamm Dis 2023; 11:e1057. [PMID: 37904702 PMCID: PMC10599280 DOI: 10.1002/iid3.1057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVE Recurrent pregnancy loss (RPL) and pre-eclampsia (PE) are immune-related pregnancy complications that have been linked to CD4+ T cells and their cytokines, which can be influenced by genetic polymorphisms. This meta-analysis aimed to investigate the relationship between interleukin (IL)-17 and -27 polymorphisms and the susceptibility to RPL and PE. METHODS All eligible case-control studies published up to February 2023 were identified by searching PubMed, EMBASE, Cochrane, Web of Science, and Google Scholar. The risk of recurrent pregnancy loss and PE associated with the IL-17 rs2275913, IL-17 rs763780, IL-27 rs153109, and IL-27 rs17855750 polymorphisms were estimated for each study. RESULTS The meta-analysis incorporated a total of 13 studies. The overall analysis indicated that IL-17 rs2275913, IL-17 rs763780, IL-27 rs153109, and IL-27 rs17855750 polymorphisms were not significantly associated with immune-related pregnancy complications, including RPL and PE. However, when the analysis was stratified by disease type, the IL-17 rs2275913 polymorphism was found to be associated with an increased risk of RPL (recessive model AA/GA + GG: OR = 1.68, 95% confidence interval [CI]: 1.13-2.49, p = .01). CONCLUSIONS The IL-17 rs763780, IL-27 rs153109, and IL-27 rs17855750 polymorphisms were not significantly associated with RPL and PE, whereas the IL-17 rs2275913 polymorphism was associated with the susceptibility to recurrent miscarriage.
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