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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, 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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, 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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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L, Papadatos C, Parajuli S, Paramonov A, Paraskevopoulos C, Paredes Hernandez D, Park TH, Parker MA, Parodi F, Parrish EW, Parrish VA, Parsons JA, Parzefall U, Pascual Dias B, Pascual Dominguez L, Pascuzzi VR, Pasquali F, Pasqualucci E, Passaggio S, Pastore F, Pasuwan P, Pater JR, Patton J, Pauly T, Pearkes J, Pedersen M, Pedro R, Peleganchuk SV, Penc O, Peng C, Peng H, Penski KE, Penzin M, Peralva BS, Peixoto APP, Pereira Sanchez L, Perepelitsa DV, Perez Codina E, Perganti M, Perini L, Pernegger H, Perrella S, Perrevoort A, Perrin O, Peters K, Peters RFY, Petersen BA, Petersen TC, Petit E, Petousis V, Petridou C, Petrukhin A, Pettee M, Pettersson NE, Petukhov A, Petukhova K, Peyaud A, Pezoa R, Pezzotti L, Pezzullo G, Pham T, Phillips PW, Phipps MW, Piacquadio G, Pianori E, Piazza F, Piegaia R, Pietreanu D, Pilkington AD, Pinamonti M, Pinfold JL, Pereira BCP, Pitman Donaldson C, Pizzi DA, Pizzimento L, Pizzini A, Pleier MA, Plesanovs V, Pleskot V, Plotnikova E, Poddar G, Poettgen R, 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Rezaei Estabragh M, Rezanova OL, Reznicek P, Ricci E, Richter R, Richter S, Richter-Was E, Ridel M, Rieck P, Riedler P, Rijssenbeek M, Rimoldi A, Rimoldi M, Rinaldi L, Rinn TT, Rinnagel MP, Ripellino G, Riu I, Rivadeneira P, Rivera Vergara JC, Rizatdinova F, Rizvi E, Rizzi C, Roberts BA, Roberts BR, Robertson SH, Robin M, Robinson D, Robles Gajardo CM, Robles Manzano M, Robson A, Rocchi A, Roda C, Rodriguez Bosca S, Rodriguez Garcia Y, Rodriguez Rodriguez A, Rodríguez Vera AM, Roe S, Roemer JT, Roepe-Gier AR, Roggel J, Røhne O, Rojas RA, Roland B, Roland CPA, Roloff J, Romaniouk A, Romano E, Romano M, Romero Hernandez AC, Rompotis N, Roos L, Rosati S, Rosser BJ, Rossi E, Rossi E, Rossi LP, Rossini L, Rosten R, Rotaru M, Rottler B, Rousseau D, Rousso D, Rovelli G, Roy A, Rozanov A, Rozen Y, Ruan X, Rubio Jimenez A, Ruby AJ, Ruelas Rivera VH, Ruggeri TA, Rühr F, Ruiz-Martinez A, Rummler A, Rurikova Z, Rusakovich NA, Russell HL, Rutherfoord JP, Rüttinger EM, Rybacki K, Rybar M, Rye EB, Ryzhov A, Sabater Iglesias JA, Sabatini P, Sabetta L, Sadrozinski HFW, Safai Tehrani F, Safarzadeh Samani B, Safdari M, Saha S, Sahinsoy M, Saimpert M, Saito M, Saito T, Salamani D, Salamanna G, Salnikov A, Salt J, Salvador Salas A, Salvatore D, Salvatore F, Salzburger A, Sammel D, Sampsonidis D, Sampsonidou D, Sánchez J, Sanchez Pineda A, Sanchez Sebastian V, Sandaker H, Sander CO, Sandesara JA, Sandhoff M, Sandoval C, Sankey DPC, Sansoni A, Santi L, Santoni C, Santos H, Santpur SN, Santra A, Saoucha KA, Saraiva JG, Sardain J, Sasaki O, Sato K, Sauer C, Sauerburger F, Sauvan E, Savard P, Sawada R, Sawyer C, Sawyer L, Sayago Galvan I, Sbarra C, Sbrizzi A, Scanlon T, Schaarschmidt J, Schacht P, Schaefer D, Schäfer U, Schaffer AC, Schaile D, Schamberger RD, Schanet E, Scharf C, Schegelsky VA, Scheirich D, Schenck F, Schernau M, Scheulen C, Schiavi C, Schillaci ZM, Schioppa EJ, Schioppa M, Schlag B, Schleicher KE, Schlenker S, Schmieden K, Schmitt C, Schmitt S, Schoeffel L, Schoening A, Scholer PG, Schopf E, Schott M, Schovancova J, Schramm S, Schroeder F, Schultz-Coulon HC, Schumacher M, Schumm BA, Schune P, Schwartzman A, Schwarz TA, Schwemling P, Schwienhorst R, Sciandra A, Sciolla G, Scuri F, Scutti F, Sebastiani CD, Sedlaczek K, Seema P, Seidel SC, Seiden A, Seidlitz BD, Seiss T, Seitz C, Seixas JM, Sekhniaidze G, Sekula SJ, Selem L, Semprini-Cesari N, Sen S, Sengupta D, Senthilkumar V, Serin L, Serkin L, Sessa M, Severini H, Sevova S, Sforza F, Sfyrla A, Shabalina E, Shaheen R, Shahinian JD, Shaikh NW, Shaked Renous D, Shan LY, Shapiro M, Sharma A, Sharma AS, Sharma P, Sharma S, Shatalov PB, Shaw K, Shaw SM, Shen Q, Sherwood P, Shi L, Shimmin CO, Shimogama Y, Shinner JD, Shipsey IPJ, Shirabe S, Shiyakova M, Shlomi J, Shochet MJ, Shojaii J, Shope DR, Shrestha S, Shrif EM, Shroff MJ, Sicho P, Sickles AM, Sideras Haddad E, Sidiropoulou O, Sidoti A, Siegert F, Sijacki D, Sikora R, Sili F, Silva JM, Silva Oliveira MV, Silverstein SB, Simion S, Simoniello R, Simpson EL, Simpson ND, Simsek S, Sindhu S, Sinervo P, Sinetckii V, Singh S, Singh S, Sinha S, Sinha S, Sioli M, Siral I, Sivoklokov SY, Sjölin J, Skaf A, Skorda E, Skubic P, Slawinska M, Smakhtin V, Smart BH, Smiesko J, Smirnov SY, Smirnov Y, Smirnova LN, Smirnova O, Smith AC, Smith EA, Smith HA, Smith JL, Smith R, Smizanska M, Smolek K, Smykiewicz A, Snesarev AA, Snoek HL, Snyder S, Sobie R, Soffer A, Solans Sanchez CA, Soldatov EY, Soldevila U, Solodkov AA, Solomon S, Soloshenko A, Solovieva K, Solovyanov OV, Solovyev V, Sommer P, Sonay A, Song WY, Sopczak A, Sopio AL, Sopkova F, Sothilingam V, Sottocornola S, Soualah R, Soumaimi Z, South D, Spagnolo S, Spalla M, Spanò F, Sperlich D, Spigo G, Spina M, Spinali S, Spiteri DP, Spousta M, Staats EJ, Stabile A, Stamen R, Stamenkovic M, Stampekis A, Standke M, Stanecka E, Stanislaus B, Stanitzki MM, Stankaityte M, Stapf B, Starchenko EA, Stark GH, Stark J, Starko DM, Staroba P, Starovoitov P, Stärz S, Staszewski R, Stavropoulos G, Steentoft J, Steinberg P, Steinhebel AL, Stelzer B, Stelzer HJ, Stelzer-Chilton O, Stenzel H, Stevenson TJ, Stewart GA, Stockton MC, Stoicea G, Stolarski M, Stonjek S, Straessner A, Strandberg J, Strandberg S, Strauss M, Strebler T, Strizenec P, Ströhmer R, Strom DM, Strom LR, Stroynowski R, Strubig A, Stucci SA, Stugu B, Stupak J, Styles NA, Su D, Su S, Su W, Su X, Sugizaki K, Sulin VV, Sullivan MJ, Sultan DMS, Sultanaliyeva L, Sultansoy S, Sumida T, Sun S, Sun S, Gudnadottir OS, Sutton MR, Svatos M, Swiatlowski M, Swirski T, Sykora I, Sykora M, Sykora T, Ta D, Tackmann K, Taffard A, Tafirout R, Tafoya Vargas JS, Taibah RHM, Takashima R, Takeda K, Takeva EP, Takubo Y, Talby M, Talyshev AA, Tam KC, Tamir NM, Tanaka A, Tanaka J, Tanaka R, Tanasini M, Tang J, Tao Z, Tapia Araya S, Tapprogge S, Tarek Abouelfadl Mohamed A, Tarem S, Tariq K, Tarna G, Tartarelli GF, Tas P, Tasevsky M, Tassi E, Tate AC, Tateno G, Tayalati Y, Taylor GN, Taylor W, Teagle H, Tee AS, Teixeira De Lima R, Teixeira-Dias P, Teoh JJ, Terashi K, Terron J, Terzo S, Testa M, Teuscher RJ, Thaler A, Theiner O, Themistokleous N, Theveneaux-Pelzer T, Thielmann O, Thomas DW, Thomas JP, Thompson EA, Thompson PD, Thomson E, Thorpe EJ, Tian Y, Tikhomirov V, Tikhonov YA, Timoshenko S, Ting EXL, Tipton P, Tisserant S, Tlou SH, Tnourji A, Todome K, Todorova-Nova S, Todt S, Togawa M, Tojo J, Tokár S, Tokushuku K, Tombs R, Tomoto M, Tompkins L, Topolnicki KW, Tornambe P, Torrence E, Torres H, Torró Pastor E, Toscani M, Tosciri C, Tovey DR, Traeet A, Trandafir IS, Trefzger T, Tricoli A, Trigger IM, Trincaz-Duvoid S, Trischuk DA, Trocmé B, Trofymov A, Troncon C, Truong L, Trzebinski M, Trzupek A, Tsai F, Tsai M, Tsiamis A, Tsiareshka PV, Tsigaridas S, Tsirigotis A, Tsiskaridze V, Tskhadadze EG, Tsopoulou M, Tsujikawa Y, Tsukerman II, Tsulaia V, Tsuno S, Tsur O, Tsybychev D, Tu Y, Tudorache A, Tudorache V, Tuna AN, Turchikhin S, Turk Cakir I, Turra R, Turtuvshin T, Tuts PM, Tzamarias S, Tzanis P, Tzovara E, Uchida K, Ukegawa F, 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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Zhang L, Aierken A, Qiu ZM. [Investigation of diagnostic methods and criteria for gastroesophageal reflux-related cough]. ZHONGHUA JIE HE HE HU XI ZA ZHI = ZHONGHUA JIEHE HE HUXI ZAZHI = CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES 2023; 46:954-957. [PMID: 37752036 DOI: 10.3760/cma.j.cn112147-20230221-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Gastroesophageal reflux-related cough is a multidisciplinary disease that cannot be diagnosed solely based on typical reflux-related symptoms. Its current diagnostic methods and criteria are largely derived from those used for gastroesophageal reflux disease, with slight differences. Esophageal reflux monitoring can provide objective evidence for the diagnosis of gastroesophageal reflux-related cough and is therefore the first-choice of laboratory tests recommended by the guidelines for cough management. Acid exposure time and syndrome association probability have been accepted as the diagnostic criteria, while esophageal motility assessment also has some certain auxiliary diagnostic value. Based on the existing evidence, we have reviewed how to improve the diagnostic methods and criteria for gastroesophageal reflux-related cough, as well as the issues that need to be addressed in the future.
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Zhang MR, Zhang L, Aierken A, Chen Q, Yu L, Xu XH, Qiu ZM. [Esophageal dysmotility detection in patients with gastroesophageal reflux-related cough and its influence on the efficacy of anti-reflux therapy]. ZHONGHUA JIE HE HE HU XI ZA ZHI = ZHONGHUA JIEHE HE HUXI ZAZHI = CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES 2023; 46:985-992. [PMID: 37752040 DOI: 10.3760/cma.j.cn112147-20230223-00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Objective: To investigate the characteristics of esophageal dysmotility in patients with an initial diagnosis of acid/non-acid gastroesophageal reflux-related cough (GERC), and its correlation with the therapeutic response to anti-reflux treatments to search for the useful indicators to screen patients with chronic cough suitable for anti-reflux therapy. Methods: A total of 173 patients with suspicious GERC who attended the Chronic Cough Specialist Clinic of Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University between June 2020 and December 2022 were retrospectively selected for the study. The age of the patients was (45.1±14.6) years old, including 87 males and 86 females. Their demographic characteristics, clinical manifestations, and the results of high-resolution manometry (HRM) and multichannel intraluminal impedance-pH monitoring (MII-pH) were collected. Information on the etiological identification process and final diagnosis was also recorded. The recruited cases were grouped according to therapeutic outcomes and divided into cases with a favourable response to conventional anti-reflux treatment, cases with a favourable response to intensified anti-reflux treatment, and cases with no response to anti-reflux treatment. Factors influencing the efficacy of anti-reflux treatment were investigated. Differences between groups were compared using the χ2 test, Student-Newman-Keuls test, and Kruskal-Wallis H(K) test, where applicable. Logistic regression analysis using forward stepwise regression based on maximum likelihood estimation was used to screen for influence factors. Results: The 175 patients with suspicious GERC included 45 (26.0%) patients who responded to conventional anti-reflux treatment, 54 (31.2%) who responded to intensified anti-reflux treatment and 74 (42.8%) who did not respond to anti-reflux therapies. Esophageal dysmotility was present in 52.0% of patients (90/173), but was less common in patients who responded to conventional anti-reflux treatment (χ2=8.09, P=0.018). Although the majority of reflux episodes were non-acid (136/173, 78.6%), the proportion of acid reflux (χ2=19.49, P<0.001) and acid exposure time (H=11.04, P=0.004) were significantly higher in patients who responded to conventional anti-reflux treatment. The patients with acid and non-acid GERC had comparable proportion of esophageal dysmotility (64.9% vs. 48.5%, χ2=3.11, P=0.078), with a shorter break [2.4 (0.7, 5.6) cm vs. 6.1 (1.4, 10.0) cm, Z=-2.39, P=0.017], longer upper esophageal sphincter [(4.1±0.9) cm vs. (3.7±1.3) cm, t=-2.09, P=0.038], higher percentage of normal esophageal contractions [60.0% (17.8%, 90.0%) vs. 30.0% (0, 80.0%), Z=-2.14, P=0.032], and lower percentage of large break [10.0% (0, 40.0%) vs. 50.0% (0, 100.0%), Z=-2.92, P=0.004] in the patients with non-acid GERC. The mean resting pressure of the lower esophageal sphincter was significantly lower (H=7.49, P=0.024), while the percentage of ineffective esophageal contractions was markedly higher (H=8.60, P=0.014) in the patients who responded to intensified anti-reflux treatment and in the patients who did not respond to the anti-reflux therapies. Multifactorial logistic regression analysis identified the percentage of ineffective contraction as an independent factor predicting the efficacy of conventional anti-reflux treatment, with a cut-off value of≤45% and a moderate predictive value (AUC=0.67, P=0.004). Conclusions: Esophageal dysmotility is common in GERC patients with different characteristics in acid and non-acid GERC. The percentage of ineffective esophageal contraction may be a useful indicator for selecting an anti-reflux strategy and predicting treatment outcomes.
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Li X, Huang YH, Fan X, Li HL, Zeng RR, Wang HY, Bai P, Wang L, Zhang L, Lin XC. [Efficacy and safety analysis of an improved overlength biliary stent in the treatment of biliary stricture]. ZHONGHUA YI XUE ZA ZHI 2023; 103:2959-2963. [PMID: 37752056 DOI: 10.3760/cma.j.cn112137-20230428-00696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Objective: To evaluate the efficacy and safety of an improved overlength biliary stent in the treatment of bile duct stricture. Methods: Prospective randomized controlled study. Patients with bile duct stricture in Peking University International Hospital from February 2016 to June 2021 were randomly divided into the conventional plastic biliary stents (CPBS) group and the improved overlength biliary stents (IOBS) group by envelope random method. CPBS or IOBS were placed after endoscopic retrograde cholangiopancreatography (ERCP) breast catheterization was successfully conducted and the stenosis length was determined by angiography. The incidence of postoperative complications, median patency time of postoperative stent and reoperation rate within 6 months were compared between the two groups, Kaplan-Meier method was used to draw the survival curve, and log-rank test was conducted to evaluate the safety and efficacy of IOBS in the treatment of bile duct stricture. Results: A total of 90 patients were included. There were 45 patients in IOBS group, including 28 males and 17 females, aged (67.2±11.7) years. There were 45 patients in CPBS group, including 26 males and 19 females, aged (64.6±14.4) years. The patients in the both groups were balanced and comparable. There were no significant differences in success rate of operation, operation time, hospitalization time, operation cost and prospective complication rate between the two groups (all P>0.05). There were no significant differences in the changes of liver function index before and 72 hours after operation between the two groups (both P>0.05). The median patency time of stents in IOBS group was longer than that in CPBS group [M(Q1, Q3), 201(155,246) vs 109(55,167) d, P=0.002].The IOBS group had lower reoperation rate than the CPBS group within 6 months [46.2% (18/39) vs 78.9%(30/38), P=0.003]. Conclusion: IOBS has good safety in the treatment of bile duct stricture and the clinical efficacy is superior to CPBS.
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Du Y, Li S, Wang X, Liu J, Gao Y, Lv W, Liu P, Huang H, Luan J, Zhang L. Meta-analysis of the association between toll-like receptor gene polymorphisms and hepatitis C virus infection. Front Microbiol 2023; 14:1254805. [PMID: 37869679 PMCID: PMC10585147 DOI: 10.3389/fmicb.2023.1254805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Objective The objective of this study is to investigate the association between toll-like receptor (TLR) 3/7 gene polymorphisms and the infection by hepatitis C virus (HCV). Methods PubMed, Embase, Web of Science, Scopus, CNKI, Wanfang Data, and SinoMed were searched to identify studies focusing on the association between the TLR3 rs3775290 or the TLR7 rs179008 single nucleotide polymorphisms (SNPs) and the HCV infection. All the related articles were collected from the inception of each database to 15 January 2023. Our meta-analysis was conducted using the allelic model, the dominant model, and the recessive model. Outcomes were presented by odds ratio (ORs) and 95% confidence interval (95%CI). The heterogeneity across studies was assessed by the I2 test. A subgroup analysis was performed to explore the source of heterogeneity. Funnel plots were drawn to assess the risk of publication bias. Review Manager 5.4 was used for statistical analysis. Results Ten articles were finally included, among which six studies were analyzed for rs3775290 and five studies were analyzed for rs179008. Studies relating to rs3775290 included 801 patients and 1,045 controls, whereas studies relating to rs179008 included 924 patients and 784 controls. The results of the meta-analysis showed that there is no significant association between rs3775290 gene polymorphism and HCV infection (T vs. C: OR = 1.12, 95%CI 0.97-1.30; TT+CT vs. CC: OR = 1.20, 95%CI 0.73-1.96; TT vs. CT+CC: OR = 1.13, 95%CI 0.68-1.89). The recessive model showed that rs179008-T allele homozygotes had an 89% increased risk of infection by HCV compared with rs179008-A allele carriers (TT vs. AT+AA: OR = 1.89, 95%CI 1.13-3.16). The results of the subgroup analysis demonstrated that the characteristics of the control population may serve as an important source of heterogeneity. In the African populations, individuals with homozygous rs179008-T alleles had a higher risk of infection by HCV than rs179008-A allele carriers (OR = 2.14, 95%CI 1.18-3.87). We did not find that this difference existed in the European populations (OR = 1.24, 95%CI 0.43-3.56). Conclusion There is no significant association between rs3775290 single nucleotide polymorphism and the infection by HCV. Individuals with homozygous rs179008-T alleles have a higher risk of an infection by HCV than rs179008-A allele carriers, which is statistically significant in the African populations.
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Dai SZ, Li SS, Zhou MY, Xu Y, Zhang L, Zhang YH, Ye DN, Xu LP, Han SP. [Assessment of risk factors for bronchopulmonary dysplasia with pulmonary hypertension and construction of a prediction nomogram model]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2023; 61:902-909. [PMID: 37803857 DOI: 10.3760/cma.j.cn112140-20230616-00406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Objective: To explore the risk factors of pulmonary hypertension (PH) in premature infants with bronchopulmonary dysplasia (BPD), and to establish a prediction model for early PH. Methods: This was a retrospective cohort study. Data of 777 BPD preterm infants with the gestational age of <32 weeks were collected from 7 collaborative units of the Su Xinyun Neonatal Perinatal Collaboration Network platform in Jiangsu Province from January 2019 to December 2022. The subjects were randomly divided into a training cohort and a validation cohort at a ratio of 8∶2 by computer, and non-parametric test or χ2 test was used to examine the differences between the two retrospective cohorts. Univariate Logistic regression and multivariate logistic regression analyses were used in the training cohort to screen the risk factors affecting the PH associated with BPD. A nomogram model was constructed based on the severity of BPD and its risk factors,which was internally validated by the Bootstrap method. Finally, the differential, calibration and clinical applicability of the prediction model were evaluated using the training and verification queues. Results: A total of 130 among the 777 preterm infants with BPD had PH, with an incidence of 16.7%, and the gestational age was 28.7 (27.7, 30.0) weeks, including 454 males (58.4%) and 323 females (41.6%). There were 622 preterm infants in the training cohort, including 105 preterm infants in the PH group. A total of 155 patients were enrolled in the verification cohort, including 25 patients in the PH group. Multivariate Logistic regression analysis revealed that low 5 min Apgar score (OR=0.87, 95%CI 0.76-0.99), cesarean section (OR=1.97, 95%CI 1.13-3.43), small for gestational age (OR=9.30, 95%CI 4.30-20.13), hemodynamically significant patent ductus arteriosus (hsPDA) (OR=4.49, 95%CI 2.58-7.80), late-onset sepsis (LOS) (OR=3.52, 95%CI 1.94-6.38), and ventilator-associated pneumonia (VAP) (OR=8.67, 95%CI 3.98-18.91) were all independent risk factors for PH (all P<0.05). The independent risk factors and the severity of BPD were combined to construct a nomogram map model. The area under the receiver operating characteristic (ROC) curve of the nomogram model in the training cohort and the validation cohort were 0.83 (95%CI 0.79-0.88) and 0.87 (95%CI 0.79-0.95), respectively, and the calibration curve was close to the ideal diagonal. Conclusions: Risk of PH with BPD increases in preterm infants with low 5 minute Apgar score, cesarean section, small for gestational age, hamodynamically significant patent ductus arteriosus, late-onset sepsis, and ventilator-associated pneumonia. This nomogram model serves as a useful tool for predicting the risk of PH with BPD in premature infants, which may facilitate individualized early intervention.
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Romanato M, Zhang L, Sawacha Z, Gutierrez-Farewik EM. Influence of different calibration methods on surface electromyography-informed musculoskeletal models with few input signals. Clin Biomech (Bristol, Avon) 2023; 109:106074. [PMID: 37660576 DOI: 10.1016/j.clinbiomech.2023.106074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/20/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Although model personalization is critical when assessing individuals with morphological or neurological abnormalities, or even non-disabled subjects, its translation into routine clinical settings is hampered by the cumbersomeness of experimental data acquisition and lack of resources, which are linked to high costs and long processing pipelines. Quantifying the impact of neglecting subject-specific information in simulations that aim to estimate muscle forces with surface electromyography informed modeling approaches, can address their potential in relevant clinical questions. The present study investigates how different methods to fine-tune subject-specific neuromuscular parameters, reducing the number of electromyography input data, could affect the estimation of the unmeasured excitations and the musculotendon forces. METHODS Three-dimensional motion analysis was performed on 8 non-disabled adult subjects and 13 electromyographic signals captured. Four neuromusculoskeletal models were created for 8 participants: a reference model driven by a large set of sEMG signals; two models informed by four electromyographic signals but calibrated in different fashions; a model based on static optimization. FINDINGS The electromyography-informed models better predicted experimental excitations, including the unmeasured ones. The model based on static optimization obtained less reliable predictions of the experimental data. When comparing the different reduced models, no major differences were observed, suggesting that the less complex model may suffice for predicting muscle forces with a small set of input in clinical gait analysis tasks. INTERPRETATION Quantitative model performance evaluation in different conditions provides an objective indication of which method yields the most accurate prediction when a small set of electromyographic recordings is available.
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Han HT, Yue P, Meng WB, Zhang L, Zhu KX, Zhu XL, Miao L, Wang ZF, Wang HP, Li X. [The comparison between endoscopic and surgical treatment of delayed iatrogenic bile duct injury by propensity score matching]. ZHONGHUA WAI KE ZA ZHI [CHINESE JOURNAL OF SURGERY] 2023; 61:871-879. [PMID: 37653989 DOI: 10.3760/cma.j.cn112139-20230119-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Objective: To compare the safety and clinical efficacy of endoscopic and surgical treatment of patients with delayed iatrogenic bile duct injury (DBDI) with severity (SG) grade 1 to 2. Methods: The clinical data of 129 patients with SG grade 1 to 2 DBDI who received endoscopic or surgical treatment in the First Hospital of Lanzhou University from November 2007 to November 2021 were retrospectively collected. There were 46 males and 83 females,aged (M(IQR)) 54(22)years(range: 21 to 82 years). The baseline data of the two groups were matched 1∶1 by propensity score matching(caliper value was 0.2). Independent sample t test,rank sum test,χ2 test or Fisher exact probability test were used to analyze the data of the two matched groups. Results: There were 48 patients in each of the endoscopic treatment and surgical groups after matching,and there was no difference in general information between the two groups(both P>0.05). The bile duct injury-repair interval and intraoperative anesthesia complications were not statistically significant between the two groups after matching(all P>0.05). Compared with the surgical group, patients in the endoscopic treatment group had significantly shorter operative time(50 (30) minutes vs. 185 (100) minutes, Z=7.675,P<0.01) and postoperative hospital stay(5 (5) days vs. 12 (7) days, Z=5.848, P<0.01).For safety,there was no statistical difference in the incidence of immediate postoperative complications between the two groups with Clavien-Dindo classification of surgical complications<Ⅲ;the incidence of serious postoperative complications (Clavien-Dindo classification of surgical complications≥Ⅲ) was significantly higher in the surgical group than in the endoscopic treatment group(P=0.012). The incidence of long-term postoperative complications was not statistically different between the two groups(28.1% vs. 20.7%,P=0.562). In terms of efficacy,the postoperative liver function indexes of patients in both groups improved significantly compared with the preoperative period and returned to normal or near normal levels; the postoperative infection indexes of both groups showed an increasing trend,but were within the normal range. Of the 96 patients in both groups,61 obtained follow-up,and the follow-up time was (89.4±48.0)months(range: 3 to 165 months),and there was no statistical difference between the two groups(P=0.079). The probability of excellent long-term follow-up (78.1% vs. 86.2%) was not statistically different between the two groups(P=0.412).In patients with Strasberg-Bismuth type E1,the probability of excellent long-term follow-up was higher in the endoscopic treatment group compared with the surgical group(13/14 vs. 2/5,P=0.037). Conclusions: For DBDI patients with SG grade 1 to 2 and bile duct continuity,endoscopy can be used as the first deterministic treatment. The advantages of endoscopic therapy compared to surgery are the lower incidence of postoperative serious complications,and the shorter duration of surgery and postoperative hospital stay.
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Xu M, Chen R, Xing P, Kong Y, Zhang J, Zhao X, Zhang L. An Innovative Regimen Basing on HFRT/SBRT and RC48-ADC Coactivation for Salvage Therapy in Patients with HER2-Expressing Advanced Solid Tumors. Int J Radiat Oncol Biol Phys 2023; 117:e158. [PMID: 37784749 DOI: 10.1016/j.ijrobp.2023.06.985] [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) It is now widely accepted that radiotherapy, especially hypofractionated radiation therapy (HFRT) or stereotactic radiotherapy (SBRT), can modulate tumor phenotypes, enhance antigen presentation and provoke a systemic immune response which gives a strong rationale for the combination of RT and immunotherapy (iRT). The PRaG therapy is an innovative iRT, when combined with HFRT/SBRT, PD-1/L1 inhibitor and GM-CSF to activate the immune response and modulate the tumor microenvironment to exert the desired in abscopal effect. Previous studies have demonstrated encouraging efficacy of the PRaG regimen in the treatment of advanced refractory tumors. RC48-ADC is a promising anti-HER2 antibody-drug conjugate with inducing immunogenic cell death and widespread release of cancer cell antigens, synergize with immunotherapy by promoting effector T-cell activation. The aim of this study is to explore efficacy and safety of RC48-ADC combined with radiotherapy, PD-1/L1 inhibitor sequential GM-CSF and IL-2(PRaG3.0 regimen) for treatment of HER2-expressing advanced solid tumors. MATERIALS/METHODS Participants with advanced, confirmed HER2-expressing (IHC3+, 2+ or 1+) solid tumors that had progressed after standard treatment, or intolerance were enrolled. In a PRaG3.0 regimen cycle, those received RC48-ADC (2.0 mg/kg d1, every 3 weeks), then HFRT (2-3 doses of 5-8 Gy) was delivered for one metastatic lesion every other day, followed by GM-CSF (200 μg d3-7), sequential IL-2(2million IU d8-12), and PD-1/L1 inhibitor was dosing within one week after completion of HFRT. After RC48-ADC combined with PD-1/L1 inhibitor sequential GM-CSF and IL-2 for at least 6 cycles, then maintenance with PD-1/L1 inhibitor was administered until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR). This trial is registered with ClinicalTrials.gov, number NCT05115500. RESULTS With the cutoff date of 31 December 2022, a total of 30 patients (n = 6 for gynecological cancer, n = 5 for pancreatic cancer, n = 19 for other cancers) were enrolled, in which 21 patients completed at least 1 tumor assessment. The objective response rate (ORR) was 42.9%, and the disease control rate was 71.4% by RECIST1.1. The ORR was 66.7% in gynecological cancer, 25.3% in pancreatic cancer, and 36.4% in other cancers. Median progression-free survival (PFS) for all patients was 7.0 months (95% CI: 3.4, 10.7). The most common treatment-related adverse events (TRAEs) included fatigue, fever, alopecia and anorexia. Grade ≥3 TRAEs occurred in two patients (6.7%). CONCLUSION These preliminary results show that of PRaG3.0 regimen has a manageable safety profile and encouraging antitumor activity in heavily pretreated patients with HER2- expressing cancers. Ultimately the regimen achieved the accurate integration of RT, immunotherapy and targeted therapy.
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Shi W, Zhang L, Yu X. Skin Microbiome Composition is Associated with Radiation Dermatitis in Breast Cancer Patients Undergoing Radiation after Reconstructive Surgery: A Prospective, Longitudinal Study. Int J Radiat Oncol Biol Phys 2023; 117:e207. [PMID: 37784866 DOI: 10.1016/j.ijrobp.2023.06.1091] [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) Approximately 95% of breast cancer (BC) patients receiving radiotherapy (RT) develop varying degrees of radiation dermatitis (RD), which can greatly affect the patient's quality of life and aesthetics. Severe acute RD can lead to interruption or delay of RT. Currently, there is no consensus on the prevention and management of RD. The skin microbiota (SM), which are mainly composed of bacteria and fungi, are essential for skin homeostasis and microbial dysbiosis is correlated with the onset and progression of many common skin diseases. However, to date, research on the role of the SM in RD remains scarce. This prospective, longitudinal study aims to analyze the association of SM with RD. MATERIALS/METHODS We collected 200 SM samples both before and after RT from the region in the irradiated chest wall of 100 BC patients receiving RT after reconstructive surgery and samples from the corresponding region in the contralateral breast for bacterial 16S and fungal ITS (internal transcribed spacer) rRNA sequencing. Acute RD was graded according to the Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG). Patients were divided into no or mild dermatitis (N/MD, RTOG grade 0 or 1) and severe dermatitis (SD, RTOG grade 2 and above). The compositional differences across groups were compared using STAMP and high-dimensional class comparisons by linear discriminant analysis of effect size (LEfSe). Differences in metabolic function between groups were predicted by the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) method. RESULTS Significant differences were observed in the diversity and composition of the SM between N/MD and SD both before and after RT. Analysis of bacterial 16S sequencing (n = 89, 63 N/MD, 26 SD) showed significantly higher relative abundance of particular taxa such as Ralstonia, Truepera, Methyloversatilis genera and lower abundance of particular taxa including Staphylococcus, Corynebacterium genera in N/MD patients. Besides, analysis of fungal ITS sequencing (n = 71, 53 N/MD, 18 SD) showed significantly higher relative abundance of particular taxa such as Hypocreaceae family and lower abundance of particular taxa such as Sporidiobolus genus in N/MD patients. Pathways including fatty acid synthesis were predicted to be enriched in N/MD patients. CONCLUSION The SM and pathway markers were identified in this study to be associated with the severity of acute RD in BC patients undergoing RT after reconstructive surgery. More patient data is needed to verify the current findings and the results of metagenomic, metatranscriptomic, and metabolomic analyses will further mine key biomarkers at the compositional and functional level.
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Peng Y, Xu M, Kong Y, Xing P, Zhang L. Impact of PRaG Therapy on Immune Microenvironment of Bilateral Subcutaneous Tumor Model of Colon Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e270. [PMID: 37785023 DOI: 10.1016/j.ijrobp.2023.06.1235] [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) Immune microenvironment is closely related to the efficacy of PD-1 inhibitors. The immune microenvironment contains a variety of immune cells, including effector T cells (cytotoxic CD8+T cells and effector CD4+T cells), dendritic cells (DC), and Myeloid-derived suppressor cells (MDSCs). The antitumor effects of PRaG therapy have been confirmed in bilateral subcutaneous transplantation tumor model of colon cancer. But the impact of PRaG therapy on immune microenvironment of such model is unclear. Therefore, the study continued to reveal the changes of immune microenvironment in mice. MATERIALS/METHODS 80 male Balb/c mice aged 6-8 weeks were divided into five groups: control group, PD-1 inhibitor group, radiation group, radiation + PD-1 inhibitor group, and radiation + PD-1 inhibitor +GM-CSF (PRaG therapy) group. Bilateral subcutaneous tumor model of colon cancer in mice was constructed. 3×105 CT26.WT cells were inoculated subcutaneously in the right thigh root, and then the left thigh root 3 days later. Right subcutaneous tumor was selected for radiotherapy of 8 Gy×3. GM-CSF (100ng, i.p.) was given on the 1st day and PD-1 inhibitor (0.25mg/kg, i.p.) was given on the 2nd day after radiotherapy with one cycle every 3 days. On day 15, the spleen, left inguinal lymph node and left subcutaneous tumor of mice were collected. The proportion of immune cells was detected by flow cytometry. RESULTS Compared with other groups, PRaG therapy decreased the proportion of cDC1 in left inguinal lymph node, increased the proportion of cDC2 in left subcutaneous tumor and left inguinal lymph node. Moreover, PRaG therapy increased the proportion of CD8+ effector memory T cells and CD226+CD8+T cells in left inguinal lymph nodes. Finally, PRaG therapy increased the proportion of CD4+, CD8+ central memory T cells and CD69+CD8+T cells and reduced the proportion of M-MDSCs in spleen. CONCLUSION PRaG therapy can improve the immune microenvironment of spleen, unirradiated tumors and inguinal draining lymph nodes of bilateral subcutaneous tumor model of colon cancer in mice.
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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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Salunkhe RR, O'Sullivan B, Huang SH, Su J, Xu W, Hosni A, Waldron J, Irish J, de Almeida J, Witterick I, Montero E, Gilbert RW, Razak AA, Zhang L, Brown D, Goldstein D, Gullane P, Tong L, Hahn E. Dawn of Staging for Head and Neck Soft Tissue Sarcoma: Validation of the Novel 8 th Edition AJCC T Classification and Proposed Stage Groupings. Int J Radiat Oncol Biol Phys 2023; 117:S149. [PMID: 37784378 DOI: 10.1016/j.ijrobp.2023.06.567] [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) After decades of stagnation, the 8th edition TNM (TNM8) introduced a new T classification for head and neck (HN) soft tissue sarcomas (STS). New size cutoffs of 2 and 4 cm define T1-3, and a novel T4 category is defined by local invasion of adjoining structures. These size cutoffs had been chosen arbitrarily to advance data collection in this unique disease site since literature showed approximately 70% of HN STS did not reach the previous size threshold (5 cm) for the existing T1 category. The definition of the TNM8 T categories also align with mucosal HN cancers. No stage grouping for HN STS was defined since this new classification required more data collection to derive stage groups. This study aims to validate the TNM8 T classification and to propose stage groupings. MATERIALS/METHODS Clinical data of all adult (>16 years) HN STS patients treated from 1988 - 2019 with curative intent in our tertiary cancer center were retrieved from a prospective database, and supplemented with chart review. As per TNM8, cutaneous angiosarcoma, embryonal and alveolar rhabdomyosarcoma, Kaposi sarcoma, and dermatofibrosarcoma protuberans were excluded due to their different behavior. Multivariate analysis (MVA) identified prognostic factors for overall survival (OS). Adjusted hazard ratios (AHR) and recursive partitioning analysis (RPA) were used to derive stage groupings. Stage grouping performance for OS was assessed and also compared against the existing TNM8 groups for non-HN STS. RESULTS A total of 221 patients (N1: 2; M1: 2) were included. Of the 219 M0 patients, 63% were males; median tumor size was 3.0 cm (range: 0.3-14.0); the proportion of TNM8 T1-T4 were 35%, 34%, 26%, and 5%, respectively. Median follow up was 5.9 years. Five-year OS was 79%. MVA confirmed the prognostic value of T category (T4 HR 7.73, 95% CI 3.62-16.5) and grade (G2/3 vs G1 HR 3.7, 95% CI 1.82-7.53), in addition to age (HR 1.03, 95% CI 1.01-1.04) (all p<0.001) for OS. AHR model derived T1-3_Grade 1 as stage 1; T1-3_Grade 2/3 as stage II; and T4_any Grade or any T_N1 as stage III (Table 1); the corresponding 5-year OS was 93%, 73%, and 38%, respectively. Both patients with M1 died within 1.5 years after diagnosis and M1 disease was designated stage IV. The AHR-grouping outperformed the RPA and non-HN TNM8 stage grouping for hazard consistency, hazard discrimination, percent variance explained, hazard difference, and sample size balance. CONCLUSION The novel T4 category introduced in TNM8 is associated with a >7 fold increased risk of death. Grade continues to be a critical prognostic factor in HN STS. The TNM8 HN STS T classifications have been validated, and the proposed new stage groupings with TNM8 incorporating grade have excellent performance for OS.
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Ding S, Liu H, Zhang L, Chen M, Li Y, Wang B, Liu B, Li R, Huang X. Influence of Eyes Movement on Lens Dose during MR-Guided Radiotherapy for Brain Tumor. Int J Radiat Oncol Biol Phys 2023; 117:e100. [PMID: 37784625 DOI: 10.1016/j.ijrobp.2023.06.868] [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) Modern radiotherapy techniques achieve highly conformal target doses while avoiding organs at risk such as lens. The magnitude of eyes movement and its influence on lens dose is unclear. The lens dose is relevant for cataract formation. This study aims to evaluate the movement-range of lens and its influence on dose distribution during MR-guided radiotherapy for brain cancer patients. MATERIALS/METHODS Fifty patients with brain cancer who were treated with MR-guided radiotherapy on 1.5 T MR-Linac were included in this study. All patients underwent a pre-treatment MRI and post-treatment MRI for each fraction. The eyes and lens were delineated on each MR image by a radiation oncologist. The reference treatment plans based original CT were recalculated on each MRI by "adapt to position" workflow. Then, we created planning risk volume (PRV) for lens by adding population margin and reoptimized the reference plans to evaluate the dose changes for lens. Inter-fraction and intrafraction variability for eyes and lens were evaluated with the Dice similarity coefficient (DSC), the Hausdorff distance (HD) and mean distance to agreement (MDA). Differences in daily dose (Dmax and Dmean) for eyes and lens were assessed. RESULTS A total of 300 MR images were analyzed in this study. The eyes motion was observed (minimum DSC: 0.57; maximum HD: 10.53; maximum MDA: 3.13). And the obvious lens motion also was found (minimum DSC: 0.01; maximum HD: 10.78; maximum MDA: 5.68). The maximum dose changes for eyes were up to 34.1% and the mean dose changes were up to 18.1%. The maximum dose changes for lens were up to 97.9% and the mean dose changes for eyes were up to 89%. When the reoptimized plans were generated by PRV lens, the dose changes were decreased nearly to 0. CONCLUSION Eyes movements in all radiotherapy fractions result in higher lens doses and potentially increase cataract formation rate. Adding margin expansions in treatment planning, to account for eyes motion, is the feasible approach to limit lens dose.
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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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Xu T, Zhang L. Rising prevalence of mpox in China, Japan, and Republic of Korea. J Infect 2023; 87:e73-e74. [PMID: 37532030 DOI: 10.1016/j.jinf.2023.07.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
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Zhang W, Zhang L, Dong Q, Wang X, Li Z, Wang Q. Hsa_circ_0003928 regulates the progression of diabetic nephropathy through miR-136-5p/PAQR3 axis. J Endocrinol Invest 2023; 46:2103-2114. [PMID: 37017919 DOI: 10.1007/s40618-023-02061-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/06/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Diabetic nephropathy (DN) is one of the complications of diabetes and has a high mortality, but its specific pathogenesis is not clear. In recent years, researches on the mechanism of circRNAs in DN have been proved a lot, whereas the functional mechanism of circ_0003928 in DN remains open and it must be investigated to value its important role in DN prevention. METHODS HK-2 cells were treated with high glucose (HG), normal glucose (NG) or Mannitol. Cell counting kit-8 (CCK8) and 5-ethynyl-2'-deoxyuridine (EdU) assays were performed to detect cell proliferation. Enzyme-linked immunosorbent assay (ELISA) was applied to analyze malondialdehyde (MDA) and superoxide dismutase 1 (SOD) levels. Flow cytometry and western blot were preformed to measure cell apoptosis. Real-time quantitative PCR (RT-qPCR) was used to test the levels of circ_0003928, miR-136-5p and progestin and adipoQ receptor family member 3 (PAQR3) mRNA. Western blot was executed to detect Bcl2 associated X (Bax), B cell leukemia/lymphoma 2 (Bcl2), smooth muscle (αSMA), apolipoprotein (C-IV) and PAQR3 levels. Luciferase reporter assay and RNA pull-down assay were used to analyze the target relationship between miR-136-5p and circ_0003928 or PAQR3. RESULTS Circ_0003928 and PAQR3 expression were up-regulated, whereas miR-136-5p was decreased in DN serum and HG-induced HK-2 cells. Circ_0003928 knockdown promoted cell proliferation, and inhibit cell apoptosis, oxidative stress, and fibrosis in HK-2 cells under HG condition. MiR-136-5p silencing overturned the protective effects of si-circ_0003928 on HG-induced HK-2 cells. MiR-136-5p was targeted by circ_0003928 and directly targeted PAQR3. Overexpression of PAQR3 counteracted the inhibitory functions of circ_0003928 knockdown or miR-136-5p overexpression on HG-induced HK-2 cell injury. CONCLUSION Circ_0003928 acted as a sponge of miR-136-5p to up-regulating PAQR3 expression, and then regulate the proliferation, oxidative stress, fibrosis and apoptosis in HG-induced HK-2 cells.
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Xing P, Yang J, Xu M, Kong Y, Zhang J, Zhao X, Zhang L. A Prospective Clinical Trial of Radiotherapy Combined with PD-1 Inhibitors and GM-CSF, Sequentially Followed by IL-2 (PRaG 2.0) Regimen in Advanced Refractory Solid Tumors. Int J Radiat Oncol Biol Phys 2023; 117:e157-e158. [PMID: 37784748 DOI: 10.1016/j.ijrobp.2023.06.984] [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) Radiotherapy could stimulate the immune response and might synergize with PD-1/PD-L1 inhibitors in the clinical treatment of malignancies. Our previous PRaG trial also demonstrated that SBRT/HFRT in combination with PD-1 inhibitors and granulocyte macrophage-colony stimulating factor (GM-CSF) could improve clinical response in patients with advanced refractory solid tumors (ChiCTR1900026175). To further improve the efficacy of immunotherapy combined with radiotherapy, we conducted the PRaG 2.0 trial (ClinicalTrials.gov: NCT04892498) and optimized the PRaG regimen by adding interleukin-2 (IL-2). Preliminary results of PRaG 2.0 had been reported in the 64th ASTRO. Now we report an updated result. MATERIALS/METHODS The PRaG 2.0 regimen was administered to patients with advanced refractory solid tumors who lacked or were unable to tolerate standard-of-care treatments. A treatment cycle consisted of SBRT or HFRT (5 or 8 Gy×2-3f) delivered for one metastatic lesion, PD-1 inhibitor dosing within one week after completion of radiotherapy, GM-CSF 200μg subcutaneous (SC) injection once daily for 7 days, and then sequentially followed by IL-2 2million IU SC once daily for 7 days. PRaG 2.0 regimen was repeated every 21 days for at least 2 cycles until no appropriate lesions for irradiation or reached the tolerance dose of normal tissues. Patients who could not continue radiotherapy and had not yet developed progression disease (PD) allowed PD-1 inhibitors to be continued as maintenance therapy until PD or unacceptable toxicity but no more than one year. The primary endpoint was Progression-Free Survival (PFS). RESULTS As of 31st October 2022, 51 patients were enrolled in the study, and 42 completed at least one tumor assessment. The median Progression-Free Survival (PFS) was 5.8 months, and the median overall survival (OS) was 13.5 months. The objective response rate (ORR) was 21.4%, and the disease control rate (DCR) was 61.9% according to RECIST version 1.1. Lower plasma levels of Interleukin (IL)-6 and IL-17 at baseline were found to be associated with improved PFS. Treatment-related adverse events (TRAE) occurred in 34 of 42 (78.6%) patients, Grade ≥ 3 TRAEs occurred in 4 patients (9.5%). TRAEs leading to discontinuation of all study treatments occurred in three patients (7.1%). CONCLUSION The PRaG 2.0 trial demonstrates that PD-1 inhibitors in combination with SBRT/HFRT, GM-CSF, and IL-2 could be a potential treatment regimen for patients with advanced refractory solid tumors, with an acceptable benefit/risk profile.
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Liang WR, Kang R, Zhao X, Zhang L, Jing LP, Yang WR, Li Y, Ye L, Zhou K, Li JP, Fan HH, Yang Y, Xiong YZ, Zhang FK. [Clinical characteristics of aplastic anemia patients with abnormal autoantibodies and the impact of autoantibodies on immunosuppressive therapy response]. ZHONGHUA NEI KE ZA ZHI 2023; 62:1200-1208. [PMID: 37766439 DOI: 10.3760/cma.j.cn112138-20230201-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Objective: To investigate the clinical characteristics of patients with acquired aplastic anemia (AA) accompanied by abnormal antinuclear antibody (ANA) and autoantibodies and their effects on the efficacy of immunosuppressive therapy (IST). Method: A retrospective case-control study was conducted, analyzing the clinical data of 291 patients with AA who underwent IST and were screened for autoantibodies at initial diagnosis between January 2018 and December 2019 at Blood Diseases Hospital, Chinese Academy of Medical Sciences. According to the titer of ANA at the initial diagnosis, extracted nuclear antigen antibodies (ENAs) abnormality and the change of ANA titer after treatment, the treatment responses of 3 months and 6 months after IST were compared. The correlation between clinical features and ANA abnormality was analyzed by univariate and multivariate logistic regression analysis. The parameters of univariate analysis P<0.1 were included in multivariate analysis, stepwise regression analysis and subgroup analysis. Results: A total of 291 patients were included in the study, of which 145 (49.83%) were male. Among all patients, 147 (50.52%) tested positive for ANA at initial diagnosis, with titers of 1∶100, 1∶320, and 1∶1 000 observed in 94, 47, and 6 cases, respectively. Female gender, older age, presence of paroxysmal nocturnal hemoglobinuria (PNH) clone, and higher levels of IgG, IgA, and thyroid hormone were significantly associated with ANA positivity at initial diagnosis, while white cell counts, reticulocytes, and free triiodothyronine were significantly lower than that of ANA-negatively patients (all P<0.05). Furthermore, logistic regression analyses revealed that female gender (OR=1.980, 95%CI 1.206-3.277), older age (OR=1.017, 95%CI 1.003-1.032), and presence of PNH clone (OR=1.875, 95%CI 1.049-3.408) were independent risk factors for ANA positivity at initial diagnosis. Subgroup analysis indicated that the risk of ANA positivity at initial diagnosis was even higher in PNH clone-positive patients in the subgroups of females (OR=1.24, 95%CI 1.02-1.51), severe AA (OR=1.26, 95%CI 1.07-1.47), and age≥40 years (OR=1.26, 95%CI 1.05-1.52) (all P<0.05). However, ANA titers at initial diagnosis, presence of other abnormal ENAs, and changes in ANA titers after treatment with IST were not correlated with treatment response (all P>0.05). Conclusions: Approximately 50% of patients with AA had abnormal ANA, and their presence was significantly associated with female gender, older age, and presence of PNH clone at initial diagnosis. However, the presence of abnormal ANA and changes in ANA titers after treatment did not affect the efficacy of IST in patients with AA.
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Peng J, Zhang L, Wang L, Feng H, Yao D, Meng R, Liu X, Li X, Liu N, Tan B, Huang Z, Li S, Meng X. PD-L1 Inhibitors Combined with Thoracic Radiotherapy in First-Line Treatment of Extensive Stage Small Cell Lung Cancer: A Propensity Score-Matched, Real-World Study. Int J Radiat Oncol Biol Phys 2023; 117:S127-S128. [PMID: 37784327 DOI: 10.1016/j.ijrobp.2023.06.472] [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 CREST study showed that the addition of thoracic radiotherapy (TRT) could improve the survival of extensive stage small cell lung cancer (ES-SCLC), but whether TRT can bring survival benefit in the era of immunotherapy is controversial. This study aims to explore the efficacy and safety of adding TRT to the combination of PD-L1 inhibitors and chemotherapy. MATERIALS/METHODS Thepatients who received PD-L1 inhibitors combined with platinum-based chemotherapy as the first-line treatment of ES-SCLC from January 2019 to December 2021 were retrospectively collected. According to whether they received TRT, they were divided into two groups, and the follow-up analysis was performed. Propensity score matching (PSM) in with a 1:1 ratio was performed to balance the baseline characteristics of the two cohorts. The endpoints were progression-free survival (PFS) and OS. RESULTS A total of 211 patients with ES-SCLC were enrolled, of whom 70 (33.2%) patients received standard therapy plus TRT as first-line treatment, and 141 (66.8%) patients in the control group received PD-L1 inhibitors plus chemotherapy. After PSM, a total of 65 pairs of patients were enrolled in the analysis. There were no significant differences in baseline characteristics between the two groups of patients who received TRT and those who did not. In all patients, the median PFS (mPFS) in the TRT group and the non-TRT groupwere 9.5 months and 7.2 months, respectively, with HR = 0.60 (95% CI 0.41-0.87, p = 0.007). The median OS (mOS) in the TRT group was also significantly longer than that in the non-TRT group (24.1 months vs. 18.5 months, HR = 0.53, 95% CI 0.32-0.85, p = 0.009). Multivariable analysis showed that baseline liver metastasis and bone metastasis were independent prognostic factors for OS. In terms of safety, immunotherapy combined with thoracic radiotherapy increased the incidence of treatment-related pneumonia (p<0.001), most of which were grade 1-2. CONCLUSION This real-world study shows that adding TRT to durvalumab or atezolizumab plus chemotherapy significantly improves survival in ES-SCLC. It leads to more treatment-related pneumonia, but most of them can be relieved after symptomatic treatment. This treatment model deserves to be explored in prospective clinical trials.
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Edwards DM, Hopkins A, Scott A, Mannan R, Cao X, Zhang L, Andren A, Heth JA, Muraszko K, Sagher O, Orringer D, Hollon T, Hervey-Jumper S, Venneti S, Camelo-Piragua S, Al-Holou W, Chinnaiyan A, Lyssiotis CA, Wahl DR. Identification of Excellent Prognosis IDH Wildtype Glioblastomas Using Genomic and Metabolic Profiling. Int J Radiat Oncol Biol Phys 2023; 117:e101. [PMID: 37784627 DOI: 10.1016/j.ijrobp.2023.06.870] [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) High grade gliomas (HGGs) are aggressive brain tumors with altered cellular metabolism. HGGs can carry mutations in the tricarboxylic acid (TCA) cycle enzyme isocitrate dehydrogenase 1 (IDH1), conferring distinct biology and improved patient prognosis compared to IDH wildtype (wt) tumors. Using metabolomic analyses of tumor tissue, we previously showed that IDH wt and IDH mutant (IDH mut) tumors have unique metabolomic signatures that correlate with different survival outcomes. Among this cohort of 69 HGG samples, we identified two unique patient tumors that metabolically clustered with IDH mut tumors, but lacked both the IDH mutation and its product 2-hydroxyglutarate. We aimed to discover unique mutations in these two tumors that may impart an IDH mutant-like phenotype in the absence of an IDH1 or IDH2 mutation. MATERIALS/METHODS Whole exome sequencing (WES) was performed on frozen tumor samples from two patients diagnosed as glioblastoma (GBM), IDH wt via Agilent v5 + IncRNA platform. Alignment to the hg38 genome and variant calling were completed using an accelerated implementation of GATK's BWA and MuTect2 algorithms from Sentieon. Variants were filtered based on supporting reads and variant allele thresholds, with synonymous variants and common SNPs removed. High-confidence variants were further filtered by membership in the four KEGG pathways associated with IDH1 and IDH2. Identified variants were corroborated with metabolomics data from the two unique IDH wt tumors compared with classical GBM IDH wt, oligodendrogliomas IDH mut and astrocytomas IDH mut to identify putative drivers of an IDH mutant-like metabolomic phenotype in these unique IDH wt tumors. RESULTS Despite the lack of an IDH mutation, one patient survived 45.6 months and the other patient remains alive at last follow up 64 months post diagnosis, much longer than the 16-18-month median survival typical of patients with GBM IDH wt. WES of outlier IDH wt tumor samples revealed 65 unique mutations in the queried KEGG pathways, of which 34 had a variant allele frequency > = 0.15. These variants were processed in Gprofiler, confirming expected enrichment of the carboxylic acid metabolic biologic process, a functional gene set consisting of TCA genes, among these variants (p = 0.002, 3.6-fold enrichment). Accordingly, metabolite levels of intermediates of the TCA cycle, including malate and isocitrate were decreased in the outlier tumor samples compared to classic GBMs IDH wt (p<0.001). Presence of genetic alterations in key variants of the carboxylic acid metabolic biologic process (including ME1, GYP4F3, PTGIS, PFKL, PSPH, AKR1A1, HK2, NOS1) correlated with improved overall survival among GBM patients in the TCGA (p = 0.04). Laboratory validation of these findings in preclinical GBM models is ongoing. CONCLUSION Disruption of the TCA cycle independent of an IDH mutation is associated with favorable survival in GBM. Pharmacologic inhibition of these pathways may be a promising strategy to improve GBM outcomes.
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Yang Z, Meng J, Mei X, Xiao Q, Mo M, Zhang L, Shi W, Chen X, Ma J, Zhang Z, Shao Z, Guo X, Yu X. Stereotactic Radiotherapy or Whole Brain Radiotherapy Combined with Pyrotinib and Capecitabine in HER2-Positive Advanced Breast Cancer Patients with Brain Metastases (BROPTIMA): A Prospective, Phase Ib/II Single-Arm Clinical Study. Int J Radiat Oncol Biol Phys 2023; 117:S173-S174. [PMID: 37784431 DOI: 10.1016/j.ijrobp.2023.06.641] [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) Approximately half of patients with advanced HER2-positive breast cancer (BC) will develop brain metastases (BM) over time. Local therapy including stereotactic radiotherapy (SRT) and whole brain radiotherapy (WBRT) is the main initial treatment in malignant tumor patients with BM. However, more than 50% patients after radiotherapy in one year suffered intracranial recurrence. Pyrotinib, a small molecule, irreversible, pan-ErbB receptor tyrosine kinase inhibitor (TKI), has a high potency for controlling BM and reducing the occurrence of brain metastases in advanced HER2-positive BC patients. We hypothesized that SRT or WBRT combined with pyrotinib and capecitabine could decrease intracranial progression in HER2 positive BC with newly diagnosed BM. MATERIALS/METHODS In this prospective single-arm phase Ib/II trial (NCT04582968), eligible patients were assigned to either fractionated stereotactic radiotherapy (FSRT) or whole-brain radiation therapy (WBRT), combined with pyrotinib and capecitabine. The primary endpoint was one-year CNS progression-free survival (PFS) rate. Secondary endpoints included intracranial objective response rate (IC-ORR) according to RANO-BM criteria, progression-free survival (PFS), overall survival (OS) and evaluation of safety and neurocognitive function. RESULTS From January 2020 to August 2022, 40 patients were enrolled. Twenty-nine patients were treated with FSRT in 8 Gy per fraction with 3 to 5 fractions and 11 were treated with WBRT in 3 Gy per fraction with 10 fractions, and then received chemotherapy in a time frame starting from 0 to 7 days after radiotherapy. At a median follow-up of 17.3 months, 1-year CNS-PFS rate was 74.9% (95% CI 61.9-90.7%) and median CNS-PFS was 18 months (95% CI, 15.5 to NA months). One-year PFS rate was 66.9% (53.1-84.2%) and median PFS time was 17.6 months (95% CI 12.8-34.1 months). The best intracranial response rate (IC-ORR: complete response and partial response) was 92.5% (37/40). The most common grade 3 or worse toxicity was diarrhea (7.5%) and asymptomatic radiation necrosis was detected in 4 of 67(6.0%) lesions treated with FSRT. No differences of neurocognitive function evaluated by MMSE (Mini-Mental State Exam) were observed between different groups at any time point. CONCLUSION Radiotherapy combined with pyrotinib and capecitabine resulted in a promising efficacy that crossed the pre-specified boundary in patients with HER2-positive advanced breast cancer with brain metastases. This is the first prospective study showing the efficacy and safety of CNS radiotherapy concurrent with pyrotinib and capecitabine in patients with BM from HER2-positive breast cancer. Further investigation in a randomized controlled study is warranted.
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AlDohan M, Zhang E, Karam I, Bayley A, Galapin M, Eskander A, Higgins K, Zhang L, Chin L, Poon I. An Update of Stereotactic Body Radiotherapy (SBRT) for the Palliation of Unirradiated Mucosal Head and Neck Squamous Cell Carcinoma (SCC). Int J Radiat Oncol Biol Phys 2023; 117:e560-e561. [PMID: 37785720 DOI: 10.1016/j.ijrobp.2023.06.1879] [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) We report the treatment outcomes of palliative Stereotactic Body Radiation Therapy (SBRT) in patients with primary mucosal head and neck cancer (HNC) who were not eligible to receive conventional radiation therapy (RT). MATERIALS/METHODS This is a retrospective study that reviewed the medical records of patients with primary SCC mucosal HNC who were treated with SBRT between 2011 and 2022. Patients with other histologies, skin cancer, parotid tumors, or recurrent previously irradiated tumors were excluded from the study. RESULTS A total of 74 patients and 77 tumors were treated with SBRT in this cohort. The median age in the study was 81 (52-97) years and the median follow-up was 7.2 months. The most common site of HNC was the oral cavity (62%), followed by the oropharynx (18%), hypopharynx (8%), larynx (5%), nasal cavity/sinonasal cancer (3%), and unknown primary (1%). T3-4 lesions were found in most patients (76%). SBRT doses ranged from 35-50 Gy in 5 fractions, and the most common prescription dose was ≥45 Gy in 5 fractions (60%) for the GTV prescription. An elective nodal volume of 25 Gy in 5 fractions was infrequently (17%) used. Most patients (81%) who were treated twice a week completed in ≤14 days. The predominant symptoms at presentation were: pain (41%), mass effect (39%), dysphagia/odynophagia (14%), headache/nasal obstruction (1.4%), bleeding (1.4%), stridor (1.4%), asymptomatic (1.4%), and unknown (1.4%). 84% of patients had symptomatic response to treatment with 24% of them having complete symptom response. Cumulative incidence of local failure (LF) was 6.7% and at 6 months and 17.9% at 12 months, respectively. Cumulative incidence of distant metastasis was 7.3% and 10.5% at 6 and 12 months. Cancer was the most common cause of death in 29 patients (51%). The median overall survival (OS) was 8 months with 6 and 12-month OS rates of 67% and 36%, respectively. 39% of patients developed acute G3 toxicity, including 30% with G3 mucositis, 5% with G3 dysphagia, and 4% with G3 dermatitis. A crude rate of late G ≥3 toxicity was observed in 11% of patients including (5%, n = 4) with osteoradionecrosis, and a single case of dysphagia, soft tissue necrosis, supraglottic ulceration, and mucosal necrosis. CONCLUSION This study highlights the feasibility of SBRT as a treatment option for primary mucosal head and neck cancer patients who are not eligible for conventional radiation therapy. The results indicate that SBRT was effective in achieving local control and symptom relief, but larger prospective studies are needed to confirm the findings. The Canadian Cancer Trials Group has endorsed HN-13, a randomized control trial comparing HN SBRT to palliative RT.
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