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Adam DP, Grudzinski JJ, Marsh IR, Hill PM, Cho SY, Bradshaw TJ, Longcor J, Burr A, Bruce JY, Harari PM, Bednarz BP. Voxel-Level Dosimetry for Combined Iodine 131 Radiopharmaceutical Therapy and External Beam Radiation Therapy Treatment Paradigms for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2024; 119:1275-1284. [PMID: 38367914 DOI: 10.1016/j.ijrobp.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/20/2023] [Accepted: 02/08/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE Targeted radiopharmaceutical therapy (RPT) in combination with external beam radiation therapy (EBRT) shows promise as a method to increase tumor control and mitigate potential high-grade toxicities associated with re-treatment for patients with recurrent head and neck cancer. This work establishes a patient-specific dosimetry framework that combines Monte Carlo-based dosimetry from the 2 radiation modalities at the voxel level using deformable image registration (DIR) and radiobiological constructs for patients enrolled in a phase 1 clinical trial combining EBRT and RPT. METHODS AND MATERIALS Serial single-photon emission computed tomography (SPECT)/computed tomography (CT) patient scans were performed at approximately 24, 48, 72, and 168 hours postinjection of 577.2 MBq/m2 (15.6 mCi/m2) CLR 131, an iodine 131-containing RPT agent. Using RayStation, clinical EBRT treatment plans were created with a treatment planning CT (TPCT). SPECT/CT images were deformably registered to the TPCT using the Elastix DIR module in 3D Slicer software and assessed by measuring mean activity concentrations and absorbed doses. Monte Carlo EBRT dosimetry was computed using EGSnrc. RPT dosimetry was conducted using RAPID, a GEANT4-based RPT dosimetry platform. Radiobiological metrics (biologically effective dose and equivalent dose in 2-Gy fractions) were used to combine the 2 radiation modalities. RESULTS The DIR method provided good agreement for the activity concentrations and calculated absorbed dose in the tumor volumes for the SPECT/CT and TPCT images, with a maximum mean absorbed dose difference of -11.2%. Based on the RPT absorbed dose calculations, 2 to 4 EBRT fractions were removed from patient EBRT treatments. For the combined treatment, the absorbed dose to target volumes ranged from 57.14 to 75.02 Gy. When partial volume corrections were included, the mean equivalent dose in 2-Gy fractions to the planning target volume from EBRT + RPT differed -3.11% to 1.40% compared with EBRT alone. CONCLUSIONS This work demonstrates the clinical feasibility of performing combined EBRT + RPT dosimetry on TPCT scans. Dosimetry guides treatment decisions for EBRT, and this work provides a bridge for the same paradigm to be implemented within the rapidly emerging clinical RPT space.
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Affiliation(s)
- David P Adam
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joseph J Grudzinski
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ian R Marsh
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patrick M Hill
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Steve Y Cho
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Tyler J Bradshaw
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Adam Burr
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Justine Y Bruce
- University of Wisconsin Carbone Cancer Center, Madison, Wisconsin; Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Paul M Harari
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Bryan P Bednarz
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
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Soror T, Paul J, Melchert C, Idel C, Rades D, Bruchhage KL, Kovács G, Leichtle A. Salvage High-Dose-Rate Interventional Radiotherapy (Brachytherapy) Combined with Surgery for Regionally Relapsed Head and Neck Cancers. Cancers (Basel) 2023; 15:4549. [PMID: 37760518 PMCID: PMC10526533 DOI: 10.3390/cancers15184549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: to report on the use of high-dose-rate (HDR) interventional radiotherapy (brachytherapy, IRT) as a salvage treatment for patients with regionally relapsed head and neck cancers. (2) Methods: A retrospective study of 60 patients treated with HDR-IRT for loco-regionally relapsed head and neck cancers at our institution (2016-2020). Treatment procedure, results, and related toxicities were collected. Local and overall survival outcomes were analyzed. (3) Results: The median follow-up was 22.4 months. Twenty-nine (48.3%) patients had locoregional recurrences with a median time of 28.9 months. The local-recurrence free-survival was 88.1% and 37.3% at 3 years and 5 years. At the last follow-up, 21 patients were alive and the median time to death was 24 months. The overall survival was 39.2% and 16.6% at 3 years and 5 years. Collectively, there were 28 events of grade ≥ 3 late toxicities recorded in 21 patients (35%). (4) Conclusions: Salvage HDR-IRT combined with surgery offers a second-line curative treatment option for regionally relapsed head and neck cancers with acceptable outcomes and toxicities.
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Affiliation(s)
- Tamer Soror
- Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany; (C.M.); (D.R.)
- National Cancer Institute (NCI), Radiation Oncology Department, Cairo University, Giza 12613, Egypt
| | - Justina Paul
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
| | - Corinna Melchert
- Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany; (C.M.); (D.R.)
| | - Christian Idel
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
| | - Dirk Rades
- Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany; (C.M.); (D.R.)
| | - Karl-Ludwig Bruchhage
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
| | - György Kovács
- Università Cattolica del Sacro Cuore, Gemelli-INTERACTS, 00168 Rome, Italy;
| | - Anke Leichtle
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
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Adam DP, Grudzinski J, Bormett I, Cox BL, Marsh IR, Bradshaw TJ, Harari PM, Bednarz B. Validation of Monte Carlo 131 I radiopharmaceutical dosimetry workflow using a 3D printed anthropomorphic head and neck phantom. Med Phys 2022; 49:5491-5503. [PMID: 35607296 PMCID: PMC9388595 DOI: 10.1002/mp.15699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose Approximately 50% of head and neck cancer (HNC) patients will experience loco‐regional disease recurrence following initial courses of therapy. Retreatment with external beam radiotherapy (EBRT) is technically challenging and may be associated with a significant risk of irreversible damage to normal tissues. Radiopharmaceutical therapy (RPT) is a potential method to treat recurrent HNC in conjunction with EBRT. Phantoms are used to calibrate and add quantification to nuclear medicine images, and anthropomorphic phantoms can account for both the geometrical and material composition of the head and neck. In this study, we present the creation of an anthropomorphic, head and neck, nuclear medicine phantom, and its characterization for the validation of a Monte Carlo, SPECT image‐based, 131I RPT dosimetry workflow. Methods 3D‐printing techniques were used to create the anthropomorphic phantom from a patient CT dataset. Three 131I SPECT/CT imaging studies were performed using a homogeneous, Jaszczak, and an anthropomorphic phantom to quantify the SPECT images using a GE Optima NM/CT 640 with a high energy general purpose collimator. The impact of collimator detector response (CDR) modeling and volume‐based partial volume corrections (PVCs) upon the absorbed dose was calculated using an image‐based, Geant4 Monte Carlo RPT dosimetry workflow and compared against a ground truth scenario. Finally, uncertainties were quantified in accordance with recent EANM guidelines. Results The 3D‐printed anthropomorphic phantom was an accurate re‐creation of patient anatomy including bone. The extrapolated Jaszczak recovery coefficients were greater than that of the 3D‐printed insert (∼22.8 ml) for both the CDR and non‐CDR cases (with CDR: 0.536 vs. 0.493, non‐CDR: 0.445 vs. 0.426, respectively). Utilizing Jaszczak phantom PVCs, the absorbed dose was underpredicted by 0.7% and 4.9% without and with CDR, respectively. Utilizing anthropomorphic phantom recovery coefficient overpredicted the absorbed dose by 3% both with and without CDR. All dosimetry scenarios that incorporated PVC were within the calculated uncertainty of the activity. The uncertainties in the cumulative activity ranged from 23.6% to 106.4% for Jaszczak spheres ranging in volume from 0.5 to 16 ml. Conclusion The accuracy of Monte Carlo‐based dosimetry for 131I RPT in HNC was validated with an anthropomorphic phantom. In this study, it was found that Jaszczak‐based PVCs were sufficient. Future applications of the phantom could involve 3D printing and characterizing patient‐specific volumes for more personalized RPT dosimetry estimates.
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Affiliation(s)
- David P Adam
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705
| | - Joseph Grudzinski
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, 53705
| | - Ian Bormett
- Morgridge Institute for Research, University of Wisconsin-Madison, Madison, WI, 53705
| | - Benjamin L Cox
- Morgridge Institute for Research, University of Wisconsin-Madison, Madison, WI, 53705
| | - Ian R Marsh
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705
| | - Tyler J Bradshaw
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, 53705
| | - Paul M Harari
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI, 53705
| | - Bryan Bednarz
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705
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Yu J, Tsay C, Sasaki C, Son YH, Decker RH, Mehra S, Burtness B. Brachytherapy and non-cancer mortality in patients with oral cavity and oropharynx SCCs. Oral Oncol 2021; 122:105585. [PMID: 34688055 DOI: 10.1016/j.oraloncology.2021.105585] [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: 05/15/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Oral cavity and oropharyngeal squamous cell cancers (OC-OPSCC) display high cancer-specific mortality and increased non-cancer mortality. We examined cause of death in patients treated for OC-OPSCC with brachytherapy, chemotherapy, external beam radiation, surgery, or combination of modalities. We hypothesized that brachytherapy does not increase non-cancer mortality comparably with external beam radiation. METHODS A database was constructed from institutional tumor registry and electronic medical record data from all patients with first OC-OPSCC diagnosis at our institution between 2000 and 2010, excluding patients with a second primary cancer at diagnosis. The primary outcome was association between treatment modality and non-cancer mortality. RESULTS Of 693 eligible patients, 460 were deceased; 84 from primary malignancy and 96 from a non-primary cancer cause, including 24 with a second primary cancer. 193 patients received brachytherapy. Cox proportional hazards regression was performed on treatment regimen, stratified by AJCC stage, race, and sex. Age, smoking history, and alcohol had HRs for death of 1.05 (p < 0.005), 1.37 (p = 0.106), and 2.24 (p < 0.005), respectively, while brachytherapy had a 0.53 HR (p < 0.005) for death. Non-smoking OPC patients had an 88% 5-year OS, suggesting these were largely HPV-driven cancers. In smoking OPC patients, 5-year OS was 61%. Non-cancer mortality HR of 0.36 for brachytherapy-treated patients. CONCLUSION We report non-cancer mortality from a cohort of curatively treated OC-OPSCC and show a significant correlation between brachytherapy and non-cancer survival, independent of remission status. The impact of brachytherapy in OPC was strongest in smokers.
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Affiliation(s)
- Jovian Yu
- Department of Medicine and Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States.
| | - Cynthia Tsay
- Department of Medicine and Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States
| | - Clarence Sasaki
- Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, United States
| | - Yung H Son
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Roy H Decker
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Saral Mehra
- Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, United States
| | - Barbara Burtness
- Department of Medicine and Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States
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Wang M, Xiao C, Ni P, Yu JJ, Wang XW, Sun H. Correlation of Betel Quid with Oral Cancer from 1998 to 2017: A Study Based on Bibliometric Analysis. Chin Med J (Engl) 2018; 131:1975-1982. [PMID: 30082530 PMCID: PMC6085852 DOI: 10.4103/0366-6999.238140] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Betel quid chewing has been a major risk factor for oral cancer (OC) in southern China. This study aimed to analyze the scientific publications on the relationship between betel quid chewing and OC and construct a model to quantitatively and qualitatively evaluate pertinent publications from 1998 to 2017. Methods: The publications from 1998 to 2017 were retrieved from the Web of Science Core Collection database. Microsoft Excel, Thomson Data Analyzer, VOSviewer, and CiteSpace software were used to analyze the publication outcomes, journals, countries/regions, institutions, authors, research areas, and research frontiers. Results: A total of 788 publications on the relationship between betel quid chewing and OC published until October 25, 2017, were identified. The top 4 related journals were Journal of Oral Pathology Medicine, Oral Oncology, Plos One, and International Journal of Cancer. The top five countries engaged in related research included China, India, the United States, the United Kingdom, and Malaysia. The corresponding disciplines, such as oncology, oral surgery, pathology, environmental and occupational health, and toxicology, were mainly concentrated in three disciplines. The subject terms squamous cell carcinoma, OC, betel quid, expression, oral submucous fibrosis, India, and p53 ranked first among research hotspots. The burst terms squamous cell carcinoma, OC, betel quid, and expression ranked first in research frontiers. Conclusions: Research in this area emphasized hotspots such as squamous cell carcinoma, OC, oral submucosal fibrosis, betel quid, and tobacco. The annual number of publications steadily decreased from 1998 to 2017, with a lack of a systematic study from interdisciplinary perspectives, inadequate pertinent journals, limited regions with the practice of betel quid chewing, and insufficient participation of researchers, which indicate that as the prevalence of OC increases, particularly in China, research in this area warrants further expansion.
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Affiliation(s)
- Mu Wang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Chang Xiao
- Department of Health Policy, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Ping Ni
- Department of Health Policy, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Jian-Jun Yu
- Department of Head and Neck Surgery, Hunan Cancer Hospital, Central South University, Changsha, Hunan 410008, China
| | - Xiao-Wan Wang
- Department of Health Policy, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Hong Sun
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
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Kourou K, Exarchos KP, Papaloukas C, Fotiadis DI. A Bayesian Network-based approach for discovering oral cancer candidate biomarkers. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:7663-6. [PMID: 26738067 DOI: 10.1109/embc.2015.7320167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Oral cancer can arise in the head and neck region. Due to the aggressive nature of the disease, which often leads to poor prognosis, Oral Squamous Cell Carcinoma (OSCC) constitutes the 8(th) most common neoplasms in humans. In the present work we formulate gene interaction network from oral cancer genomic data using Dynamic Bayesian Networks (DBNs). Four modules were extracted after applying a clustering technique to the network. We consequently explore them by applying topological and functional analysis methods in order to identify significant network nodes. Our analysis revealed that these important nodes may correspond to candidate biomarkers of the disease.
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Morris ZS, Weichert JP, Saker J, Armstrong EA, Besemer A, Bednarz B, Kimple RJ, Harari PM. Therapeutic combination of radiolabeled CLR1404 with external beam radiation in head and neck cancer model systems. Radiother Oncol 2015; 116:504-9. [PMID: 26123834 PMCID: PMC4609259 DOI: 10.1016/j.radonc.2015.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/10/2015] [Accepted: 06/13/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND PURPOSE CLR1404 is a phospholipid ether that exhibits selective uptake and retention in malignant tissues. Radiolabeled CLR1404 enables tumor-specific positron-emission tomography (PET) imaging ((124)I) and targeted delivery of ionizing radiation ((131)I). Here we describe the first preclinical studies of this diapeutic molecule in head and neck cancer (HNC) models. MATERIAL AND METHODS Tumor-selective distribution of (124)I-CLR1404 and therapeutic efficacy of (131)I-CLR1404 were tested in HNC cell lines and patient-derived xenograft tumor models. Monte Carlo dose calculations and (124)I-CLR1404 PET/CT imaging were used to examine (131)I-CLR1404 dosimetry in preclinical HNC tumor models. RESULTS HNC tumor xenograft studies including patient-derived xenografts demonstrate tumor-selective uptake and retention of (124)I-CLR1404 resulting in a model of highly conformal dose distribution for (131)I-CLR1404. We observe dose-dependent response to (131)I-CLR1404 with respect to HNC tumor xenograft growth inhibition and this effect is maintained together with external beam radiation. CONCLUSIONS We confirm the utility of CLR1404 for tumor imaging and treatment of HNC. This promising agent warrants further investigation in a developing phase I trial combining (131)I-CLR1404 with reduced-dose external beam radiation in patients with loco-regionally recurrent HNC.
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Affiliation(s)
- Zachary S Morris
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Jamey P Weichert
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Jarob Saker
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Eric A Armstrong
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Abigail Besemer
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Bryan Bednarz
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Randall J Kimple
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Paul M Harari
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States.
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Jain NS, Dürr UH, Ramamoorthy A. Bioanalytical methods for metabolomic profiling: Detection of head and neck cancer, including oral cancer. CHINESE CHEM LETT 2015. [DOI: 10.1016/j.cclet.2015.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mims J, Bansal N, Bharadwaj MS, Chen X, Molina AJ, Tsang AW, Furdui CM. Energy metabolism in a matched model of radiation resistance for head and neck squamous cell cancer. Radiat Res 2015; 183:291-304. [PMID: 25738895 DOI: 10.1667/rr13828.1] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
While radiation therapy is commonly used for treating cancer, radiation resistance can limit long-term control of the disease. In this study, we investigated the reprogramming of the energy metabolism in radiosensitive and radioresistant head and neck squamous cell carcinomas (HNSCC) using a preclinical matched model of radiation resistance. Our investigation found that radioresistant rSCC-61 cells: 1. They display increased glucose uptake and decreased fatty acid uptake; 2. They deviate from the classical Warburg effect by diverting the glycolytic flux into the pentose phosphate pathway; 3. They are more dependent on glucose than glutamine metabolism to support growth; 4. They have decreased mitochondrial oxidative phosphorylation; 5. They have enhanced fatty acid biosynthesis by increasing the expression of fatty acid synthase; and 6. They utilize endogenous fatty acids to meet the energy demands for proliferation. Inhibition of fatty acid synthase with orlistat or FASN siRNA resulted in increased cytotoxicity and sensitivity to radiation in rSCC-61 cells. These results demonstrate the potential of combination therapy using radiation and orlistat or other inhibitors of lipid and energy metabolism for treating radiation resistance in HNSCC.
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Affiliation(s)
- Jade Mims
- Sections on a Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
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Tanshinone IIA induces apoptosis in human oral cancer KB cells through a mitochondria-dependent pathway. BIOMED RESEARCH INTERNATIONAL 2014; 2014:540516. [PMID: 24900970 PMCID: PMC4036409 DOI: 10.1155/2014/540516] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/12/2014] [Indexed: 02/08/2023]
Abstract
Tanshinone IIA (Tan IIA), an active phytochemical in the dried root of Salvia miltiorrhiza Bunge, has shown an antiproliferative activity on various human cancer cell lines including nasopharyngeal carcinoma cells. However, the effects of Tan IIA on human oral cancer cells are still unknown. This study aimed to investigate the antiproliferative effects of Tan IIA on human oral cancer KB cells and explored the possible underlying mechanism. Treatment of KB cells with Tan IIA suppressed cell proliferation/viability and induced cell death in a dose-dependent manner through sulforhodamine B colorimetric assay. Observation of cell morphology revealed the involvement of apoptosis in the Tan IIA-induced growth inhibition on KB cells. Cell cycle analysis showed a cell cycle arrest in G2/M phase on Tan IIA-treated cells. The dissipation of mitochondrial membrane potential observed by flow cytometry and the expression of activated caspases with the cleaved poly (ADP-ribose) polymerase under immunoblotting analysis indicated that Tan IIA-induced apoptosis in KB cells was mediated through the mitochondria-dependent caspase pathway. These observations suggested that Tan IIA could be a potential anticancer agent for oral cancer.
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Murthy V, Narang K, Ghosh-Laskar S, Gupta T, Budrukkar A, Agrawal JP. Hypothyroidism after 3-dimensional conformal radiotherapy and intensity-modulated radiotherapy for head and neck cancers: Prospective data from 2 randomized controlled trials. Head Neck 2014; 36:1573-80. [DOI: 10.1002/hed.23482] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/06/2013] [Accepted: 08/23/2013] [Indexed: 12/17/2022] Open
Affiliation(s)
- Vedang Murthy
- Department of Radiation Oncology; Tata Memorial Centre; Mumbai India
| | - Kushal Narang
- Department of Radiation Oncology; Tata Memorial Centre; Mumbai India
| | | | - Tejpal Gupta
- Department of Radiation Oncology; Tata Memorial Centre; Mumbai India
| | - Ashwini Budrukkar
- Department of Radiation Oncology; Tata Memorial Centre; Mumbai India
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Straetmans J, Vent J, Lacko M, Speel EJ, Huebbers C, Semrau R, Hoebers F, Mujagic Z, Klussmann JP, Preuss SF, Kremer B. Management of neck metastases of unknown primary origin united in two European centers. Eur Arch Otorhinolaryngol 2014; 272:195-205. [DOI: 10.1007/s00405-014-2934-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 02/04/2014] [Indexed: 10/25/2022]
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Current attitudes of head and neck oncologists in the United Kingdom to induction chemotherapy for locally advanced head and neck cancer: A survey of centres participating in a national randomised controlled trial. Oral Oncol 2014; 50:141-6. [DOI: 10.1016/j.oraloncology.2013.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 11/22/2022]
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Knauer SK, Unruhe B, Karczewski S, Hecht R, Fetz V, Bier C, Friedl S, Wollenberg B, Pries R, Habtemichael N, Heinrich UR, Stauber RH. Functional characterization of novel mutations affecting survivin (BIRC5)-mediated therapy resistance in head and neck cancer patients. Hum Mutat 2012; 34:395-404. [PMID: 23161837 DOI: 10.1002/humu.22249] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Accepted: 10/31/2012] [Indexed: 01/25/2023]
Abstract
Survivin (BIRC5) is an acknowledged cancer therapy-resistance factor and overexpressed in head and neck squamous cell carcinomas (HNSCC). Driven by its nuclear export signal (NES), Survivin shuttles between the nucleus and the cytoplasm, and is detectable in both cellular compartments in tumor biopsies. Although predominantly nuclear Survivin is considered a favorable prognostic disease marker for HNSCC patients, the underlying molecular mechanisms are not resolved. Hence, we performed immunohistochemical and mutational analyses using laser capture microdissection on HNSCC biopsies from patients displaying high levels of nuclear Survivin. We found somatic BIRC5 mutations, c.278T>C (p.Phe93Ser), c.292C>T (p.Leu98Phe), and c.288A>G (silent), in tumor cells, but not in corresponding normal tissues. Comprehensive functional characterization of the Survivin mutants by ectopic expression and microinjection experiments revealed that p.Phe93Ser, but not p.Leu98Phe inactivated Survivin's NES, resulted in a predominantly nuclear protein, and attenuated Survivin's dual cytoprotective activity against chemoradiation-induced apoptosis. Notably, in xenotransplantation studies, HNSCC cells containing the p.Phe93Ser mutation responded significantly better to cisplatin-based chemotherapy. Collectively, our results underline the disease relevance of Survivin's nucleocytoplasmic transport, and provide first evidence that genetic inactivation of Survivin's NES may account for predominantly nuclear Survivin and increased therapy response in cancer patients.
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Affiliation(s)
- Shirley K Knauer
- Institute for Molecular Biology, Centre for Medical Biotechnology, ZMB, University of Duisburg-Essen, Germany.
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Exarchos KP, Goletsis Y, Fotiadis DI. A multiscale and multiparametric approach for modeling the progression of oral cancer. BMC Med Inform Decis Mak 2012; 12:136. [PMID: 23173873 PMCID: PMC3560119 DOI: 10.1186/1472-6947-12-136] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 11/01/2012] [Indexed: 04/12/2023] Open
Abstract
Background In this work, we propose a multilevel and multiparametric approach in order to model the growth and progression of oral squamous cell carcinoma (OSCC) after remission. OSCC constitutes the major neoplasm of the head and neck region, exhibiting a quite aggressive nature, often leading to unfavorable prognosis. Methods We formulate a Decision Support System assembling a multitude of heterogeneous data sources (clinical, imaging tissue and blood genomic), aiming to capture all manifestations of the disease. Our primary aim is to identify the factors that dictate OSCC progression and subsequently predict potential relapses of the disease. The discrimination potential of each source of data is initially explored separately, and afterwards the individual predictions are combined to yield a consensus decision achieving complete discrimination between patients with and without a disease relapse. Moreover, we collect and analyze gene expression data from circulating blood cells throughout the follow-up period in consecutive time-slices, in order to model the temporal dimension of the disease. For this purpose a Dynamic Bayesian Network (DBN) is employed which is able to capture in a transparent manner the underlying mechanism dictating the disease evolvement, and employ it for monitoring the status and prognosis of the patients after remission. Results By feeding as input to the DBN data from the baseline visit we achieve accuracy of 86%, which is further improved to complete discrimination when data from the first follow-up visit are also employed. Conclusions Knowing in advance the progression of the disease, i.e. identifying groups of patients with higher/lower risk of reoccurrence, we are able to determine the subsequent treatment protocol in a more personalized manner.
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Affiliation(s)
- Konstantinos P Exarchos
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR45110 Ioannina, Greece.
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Somashekar BS, Kamarajan P, Danciu T, Kapila YL, Chinnaiyan AM, Rajendiran TM, Ramamoorthy A. Magic angle spinning NMR-based metabolic profiling of head and neck squamous cell carcinoma tissues. J Proteome Res 2011; 10:5232-41. [PMID: 21961579 DOI: 10.1021/pr200800w] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
High-resolution magic-angle spinning (HR-MAS) proton NMR spectroscopy is used to explore the metabolic signatures of head and neck squamous cell carcinoma (HNSCC) which included matched normal adjacent tissue (NAT) and tumor originating from tongue, lip, larynx and oral cavity, and associated lymph-node metastatic (LN-Met) tissues. A total of 43 tissues (18 NAT, 18 Tumor and 7 LN-Met) from 22 HNSCC patients were analyzed. Principal Component Analysis of NMR data showed a clear classification between NAT and tumor tissues, however, LN-Met tissues were classified among tumor. A partial least-squares discriminant analysis model generated from NMR metabolic profiles was used to differentiate normal from tumor samples (Q(2) > 0.80, Receiver Operator Characteristic area under the curve >0.86, using 7-fold cross validation). HNSCC and LN-Met tissues showed elevated levels of lactate, amino acids including leucine, isoleucine, valine, alanine, glutamine, glutamate, aspartate, glycine, phenylalanine and tyrosine, choline containing compounds, creatine, taurine, glutathione, and decreased levels of triglycerides. These elevated metabolites were associated with highly active glycolysis, increased amino acids influx (anaplerosis) into the TCA cycle, altered energy metabolism, membrane choline phospholipid metabolism, and oxidative and osmotic defense mechanisms. Moreover, decreased levels of triglycerides may indicate lipolysis followed by β-oxidation of fatty acids that may exist to deliver bioenergy for rapid tumor cell proliferation and growth.
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Ding ZL, Shi RH, Zhu H, Ling TS, Hao B. RNA interference-mediated down-regulation of Akt attenuates cell proliferation and migration in human esophageal squamous cell carcinoma cell line Eca109. Shijie Huaren Xiaohua Zazhi 2011; 19:451-456. [DOI: 10.11569/wcjd.v19.i5.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of RNA interference-mediated down-regulation of Akt on cell proliferation, migration, and vasculogenic mimicry formation in human esophageal squamous cell carcinoma cell line Eca109.
METHODS: Plasmids harboring small interfering RNA targeting the Akt gene were introduced into Eca109 cells by liposome-mediated transfection. The expression of Akt protein was measured by Western blot. The proliferation of Eca109 cells was determined by methyl thiazolyl tetrazolium (MTT) assay. The migration of Eca109 cells was evaluated by Transwell migration assay. Vasculogenic mimicry was evaluated by counting the number of capillary structures.
RESULTS: Akt expression was markedly down-regulated in Eca109/8 cell clone (transfected with the plasmid harboring small interfering RNA targeting the Akt gene). The expression of Akt protein in Eca109/8 cells could not be detected by Western blot. The proliferation of Eca109/8 cells decreased significantly compared with untransfected Eca109 cells (P < 0.05). Transwell migration assay showed that less Eca109/8 cells could move through the Transwell membrane when compared with untransfected Eca109 cells (59.33 ± 2.87 vs 130.5 ± 2.22, P < 0.05). Eca109 cells were capable of forming vasculogenic mimicry patterns in vitro. Silencing of the Akt gene could significantly suppress vasculogenic mimicry formation in Eca109 cells.
CONCLUSION: RNA interference-mediated down-regulation of Akt can attenuate the proliferation, migration, and vasculogenic mimicry formation of Eca109 cells. Blockade of the Akt pathway may provide a new approach to the treatment of human esophagus squamous cell carcinoma.
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Sandulache VC, Myers JN. Altered metabolism in head and neck squamous cell carcinoma: an opportunity for identification of novel biomarkers and drug targets. Head Neck 2011; 34:282-90. [PMID: 21322078 DOI: 10.1002/hed.21664] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/09/2010] [Accepted: 10/04/2010] [Indexed: 01/05/2023] Open
Abstract
Tumor cells were first shown to exhibit a distinct metabolic phenotype over 80 years ago. Since then, it has become clear that multiple oncogenic events contribute to the development of a metabolic phenotype that supports rapid proliferation. Because this phenotype represents an essential component of tumorigenesis and disease progression, it also represents a potential source of biomarkers associated with aggressive disease. In addition, the addiction of tumor cells to specific nutrients and the up-regulation of key metabolic enzymes provide unique opportunities for pharmacologic manipulation. Despite the use of multimodality treatment, survival rates for patients with advanced head and neck squamous cell carcinoma (HNSCC) remain low, partially attributed to the development of drug resistance. In this review, we evaluate the role of altered HNSCC metabolism as both a source of novel biomarkers and a means to bypass resistance mechanisms to conventional forms of therapy.
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Affiliation(s)
- Vlad C Sandulache
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
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Schweitzer A, Knauer SK, Stauber RH. Nuclear receptors in head and neck cancer: current knowledge and perspectives. Int J Cancer 2010; 126:801-9. [PMID: 19839054 DOI: 10.1002/ijc.24968] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Disease management of head and neck cancer has improved significantly. However, a high rate of early recurrences and metastasis still counteract improvement of long-term survival. Hence, the quest for molecular mechanisms and key regulatory factors exploitable by targeted therapies is still ongoing. Such potential candidates may include also nuclear receptors, belonging to a superfamily of transcription factors implicated in a broad spectrum of physiological and pathophysiological processes. As dysfunction of nuclear receptor signaling contributes to a variety of proliferative diseases, they are major targets for drug discovery and hold promising potential for the development of improved anticancer treatment strategies. Several nuclear receptors have also been associated with head and neck cancer, and strategies targeting these molecules are currently tested in clinical trials. However, reports and molecular knowledge on the pathobiological relevance of nuclear receptors for cancers of the head and neck is currently rather fragmented. Hence, this review provides a general overview of nuclear receptors' molecular functions and summarizes their potential prognostic and therapeutic relevance for this tumor entity.
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Affiliation(s)
- Andrea Schweitzer
- ENT Department, Molecular and Cellular Oncology, University Hospital of Mainz, Mainz, Germany
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Knauer SK. Prognostic and therapeutic potential of nuclear receptors in head and neck squamous cell carcinomas. JOURNAL OF ONCOLOGY 2009; 2009:349205. [PMID: 19794826 PMCID: PMC2753797 DOI: 10.1155/2009/349205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 07/13/2009] [Indexed: 01/12/2023]
Abstract
Head and neck squamous cell carcinomas are among the most common neoplasms worldwide and characterized by local tumor aggressiveness, high rate of early recurrences, development of metastasis, and second primary cancers. Despite modern therapeutic strategies and sophisticated surgical management, overall survival-rates remained largely unchanged over the last decades. Thus, the need for novel treatment options for this tumor entity is undeniable. A key event in carcinogenesis is the uncontrolled modulation of genetic programs. Nuclear receptors belong to a large superfamily of transcription factors implicated in a broad spectrum of physiological and pathophysiological processes, including cancer. Several nuclear receptors have also been associated with head and neck cancer. This review will summarize their mode of action, prognostic/therapeutic relevance, as well as preclinical and clinical studies currently targeting nuclear receptors in this tumor entity.
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Affiliation(s)
- Shirley K. Knauer
- Department of Otorhinolaryngology, University of Mainz, Langenbeckstrasse 1, 55101 Mainz, Germany
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