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Danieli R, Milano A, Gallo S, Veronese I, Lascialfari A, Indovina L, Botta F, Ferrari M, Cicchetti A, Raspanti D, Cremonesi M. Personalized Dosimetry in Targeted Radiation Therapy: A Look to Methods, Tools and Critical Aspects. J Pers Med 2022; 12:205. [PMID: 35207693 PMCID: PMC8874397 DOI: 10.3390/jpm12020205] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 12/10/2022] Open
Abstract
Targeted radiation therapy (TRT) is a strategy increasingly adopted for the treatment of different types of cancer. The urge for optimization, as stated by the European Council Directive (2013/59/EURATOM), requires the implementation of a personalized dosimetric approach, similar to what already happens in external beam radiation therapy (EBRT). The purpose of this paper is to provide a thorough introduction to the field of personalized dosimetry in TRT, explaining its rationale in the context of optimization and describing the currently available methodologies. After listing the main therapies currently employed, the clinical workflow for the absorbed dose calculation is described, based on works of the most experienced authors in the literature and recent guidelines. Moreover, the widespread software packages for internal dosimetry are presented and critical aspects discussed. Overall, a selection of the most important and recent articles about this topic is provided.
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Affiliation(s)
- Rachele Danieli
- Dipartimento di Fisica, Università degli Studi di Pavia, Via Bassi 6, 27100 Pavia, Italy;
| | - Alessia Milano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito 1, 00168 Roma, Italy;
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Roma, Italy
| | - Salvatore Gallo
- Dipartimento di Fisica “Aldo Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (S.G.); (I.V.)
- INFN Sezione di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Ivan Veronese
- Dipartimento di Fisica “Aldo Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (S.G.); (I.V.)
- INFN Sezione di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Alessandro Lascialfari
- INFN-Pavia Unit, Department of Physics, University of Pavia, Via Bassi 6, 27100 Pavia, Italy;
| | - Luca Indovina
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito 1, 00168 Roma, Italy;
| | - Francesca Botta
- Medical Physics Unit, European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milano, Italy; (F.B.); (M.F.)
| | - Mahila Ferrari
- Medical Physics Unit, European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milano, Italy; (F.B.); (M.F.)
| | - Alessandro Cicchetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy;
| | - Davide Raspanti
- Temasinergie S.p.A., Via Marcello Malpighi 120, 48018 Faenza, Italy;
| | - Marta Cremonesi
- Radiation Research Unit, European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milano, Italy;
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Raghavapudi H, Singroul P, Kohila V. Brain Tumor Causes, Symptoms, Diagnosis and Radiotherapy Treatment. Curr Med Imaging 2021; 17:931-942. [PMID: 33573575 DOI: 10.2174/1573405617666210126160206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022]
Abstract
The strategy used for the treatment of given brain cancer is critical in determining the post effects and survival. An oncological diagnosis of tumor evaluates a range of parameters such as shape, size, volume, location and neurological complexity that define the symptomatic severity. The evaluation determines a suitable treatment approach chosen from a range of options such as surgery, chemotherapy, hormone therapy, radiation therapy and other targeted therapies. Often, a combination of such therapies is applied to achieve superior results. Radiotherapy serves as a better treatment strategy because of a higher survival rate. It offers the flexibility of synergy with other treatment strategies and fewer side effects on organs at risk. This review presents a radiobiological perspective in the treatment of brain tumor. The cause, symptoms, diagnosis, treatment, post-treatment effects and the framework involved in its elimination are summarized.
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Affiliation(s)
- Haarika Raghavapudi
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
| | - Pankaj Singroul
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
| | - V Kohila
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
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Vijayan M, Joseph S, James E, Dutta D. A review on radiation induced nausea and vomiting: "Current management strategies and prominence of radio sensitizers". J Oncol Pharm Pract 2021; 27:1061-1072. [PMID: 33947288 DOI: 10.1177/10781552211011539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Radiations dissipated are high energy waves used mostly as treatment intervention in controlling the unwanted multiplication of cell. About 60%-65% of cancer treatment requires radiation therapy and 40%-80% of radiation therapy causes RINV which are true troublemakers. Radiation therapy (RT) is targeted therapy mostly used to treat early stages of tumour and prevent their reoccurrence. They mainly destroy the genetic material (DNA) of cancerous cells to avoid their unwanted growth and division. The RINV affects the management and quality of life of patients which further reduces the patient outcome. RINV depends on RT related factors (dose, fractionation, irradiation volume, RT techniques) and patient related factors like (gender, health conditions, age, concurrent chemotherapy, psychological state, and tumour stage). RT is an active area of research and there is only limited progress in tackling the RINV crisis. Advanced technological methods are adopted that led to better understanding of total lethal doses. Radiation therapy also affects the immunity system that leads to radiation induced immune responses and inflammation. Radio sensitizers are used to sensitize the tumour cells to radiations that further prevent the normal cell damage from radiation exposure. There is a need for future studies and researches to re-evaluate the data available from previous trials in RINV to make better effective antiemetic regimen. The article focuses on radiation therapy induced nausea and vomiting along with their mechanism of action and treatment strategies in order to have a remarkable patient care.
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Affiliation(s)
- Meenu Vijayan
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Sherin Joseph
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Emmanuel James
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Debnarayan Dutta
- Department of Radiation Oncology, Amrita Vishwa Vidyapeetham, Kochi, India
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Murray I, Flux G. Applying radiobiology to clinical molecular radiotherapy. Nucl Med Biol 2021; 100-101:1-3. [PMID: 34091132 DOI: 10.1016/j.nucmedbio.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Iain Murray
- Joint Department of Physics, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom.
| | - Glenn Flux
- Joint Department of Physics, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey SM2 5PT, United Kingdom
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Kouhkan E, Chegeni N, Hussain A. The Effect of Nucleus Size on the Cell Dose in Targeted Radionuclide Therapy - A Monte Carlo Study. JOURNAL OF MEDICAL SIGNALS & SENSORS 2020; 10:113-118. [PMID: 32676447 PMCID: PMC7359958 DOI: 10.4103/jmss.jmss_21_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/04/2019] [Accepted: 12/25/2019] [Indexed: 11/04/2022]
Abstract
Background: Nowadays, the use of radiopharmaceuticals in medicine is unavoidable. Depending on the distribution of the radiopharmaceutical in the cells, the nucleus absorbed dose changes by the variations in their geometry size. Therefore, this study aims to investigate the S-value by the variation of nucleus size using Geant4 toolkit. Methods: Two spherical cells with a variety of nucleus size have been considered as the cancerous cell. Monoenergetic electrons ranging from 5 to 300 keV are distributed uniformly. The S-value for four target-source components (including Nucleus←Cytoplasm, Nucleus←Cell surface, Nucleus←Nucleus, and Nucleus←Nucleus surface) is computed and plotted. Then, the obtained data are compared with analytical Medical Internal Radiation Dose (MIRD) data. Results: In Nucleus←Cytoplasm compartment for electrons below 10 keV, obtained S-values show a slight decrease for the nucleus in the radii of around half of the cell radius and then S-values increase with the increase in the nucleus radii. In the S-value of Nucleus←Cell surface, for all electron energy levels, a slight decrease observed with the increase of nucleus radii. For Nucleus←Nucleus and Nucleus←Nucleus surface cases, with an increase in the size of the cell nucleus, a sharp reduction in the S-values is detected. Conclusion: It can be concluded that for the beta emitters with low-energy radiation (<40 keV), the S-value is heavily dependent on the nucleus size which may affect the treatment of small tumors. While for the beta emitters with higher-energy radiation (>100 keV), the size of the nucleus is not very noticeable in the induced S-value.
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Affiliation(s)
- Ebrahim Kouhkan
- Department of Medical Physics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Chegeni
- Department of Medical Physics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amjad Hussain
- Department of Medical Physics, Cancer Care Manitoba, Winnipeg, MB, Canada
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Chen H, Zhao L, Fu K, Lin Q, Wen X, Jacobson O, Sun L, Wu H, Zhang X, Guo Z, Lin Q, Chen X. Integrin α vβ 3-targeted radionuclide therapy combined with immune checkpoint blockade immunotherapy synergistically enhances anti-tumor efficacy. Am J Cancer Res 2019; 9:7948-7960. [PMID: 31695808 PMCID: PMC6831469 DOI: 10.7150/thno.39203] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/03/2019] [Indexed: 12/26/2022] Open
Abstract
Rationale: Radiotherapy combined with immunotherapy has revealed promising outcomes in both preclinical studies and ongoing clinical trials. Targeted radionuclide therapy (TRT) is a branch of radiotherapy concerned with the use of radioisotopes, radiolabeled molecules or nanoparticles that deliver particulate radiation to cancer cells. TRT is a promising approach in cases of metastatic disease where conventional treatments are no longer effective. The increasing use of TRT raises the question of how to best integrate TRT with immunotherapy. In this study, we proposed a novel therapeutic regimen that combined programmed death ligand 1 (PD-L1)-based immunotherapy with peptide-based TRT (177Lu as the radionuclide) in the murine colon cancer model. Methods: To explore the most appropriate timing of immunotherapy after radionuclide therapy, the anti-PD-L1 antibody (αPD-L1 mAb) was delivered in a concurrent or sequential manner when 177Lu TRT was given. Results: The results demonstrated that TRT led to an acute increase in PD-L1 expression on T cells, and TRT in combination with αPD-L1 mAb stimulated the infiltration of CD8+ T cells, which improved local tumor control, overall survival and protection against tumor rechallenge. Moreover, our data revealed that the time window for this combination therapy may be critical to outcome. Conclusions: This therapeutic combination may be a promising approach to treating metastatic tumors in which TRT can be used. Clinical translation of the result would suggest that concurrent rather than sequential blockade of the PD-1/PD-L1 axis combined with TRT improves overall survival and long-term tumor control.
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A Mathematical Model for the Effect of Low-Dose Radiation on the G2/M Transition. Bull Math Biol 2019; 81:3998-4021. [PMID: 31392576 DOI: 10.1007/s11538-019-00645-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
We develop a mathematical model to study the immediate effect of low-dose radiation on the G2 checkpoint and the G2/M transition of the cell cycle via a radiation pathway (the ATM-Chk2 pathway) of an individual mammalian cell. The model consists of a system of nonlinear differential equations describing the dynamics of a network of regulatory proteins that play key roles in the G2/M transition, cell cycle oscillations, and the radiation pathway. We simulate the application of a single pulse of low-dose radiation at different intensities ([Formula: see text] 0-0.4 Gy) and times during the latter part of the G2-phase. We use bifurcation analysis to characterize the effect of radiation on the G2/M transition via the ATM-Chk2 pathway. We show that radiation between 0.1 and 0.3 Gy can delay the G2/M transition, and radiation higher than 0.3 Gy can fully activate the G2 checkpoint. Also, our results show that radiation can be low enough to neither delay the G2/M transition nor activate the G2 checkpoint ([Formula: see text] 0.1 Gy). Our model supports the idea that the cell response to radiation during G2-phase explains hyper-radiosensitivity and increased radioresistance (HRS/IRR) observed at low dose.
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Kemeny N, Kurilova I, Li J, Camacho JC, Sofocleous CT. Liver-Directed and Systemic Therapies for Colorectal Cancer Liver Metastases. Cardiovasc Intervent Radiol 2019; 42:1240-1254. [DOI: 10.1007/s00270-019-02284-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
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Kurilova I, Beets-Tan RGH, Flynn J, Gönen M, Ulaner G, Petre EN, Edward Boas F, Ziv E, Yarmohammadi H, Klompenhouwer EG, Cercek A, Kemeny NA, Sofocleous CT. Factors Affecting Oncologic Outcomes of 90Y Radioembolization of Heavily Pre-Treated Patients With Colon Cancer Liver Metastases. Clin Colorectal Cancer 2018; 18:8-18. [PMID: 30297264 DOI: 10.1016/j.clcc.2018.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The purpose of this study was to identify predictors of overall (OS) and liver progression-free survival (LPFS) following Yttrium-90 radioembolization (RAE) of heavily pretreated patients with colorectal cancer liver metastases (CLM), as well as to create and validate a predictive nomogram for OS. MATERIALS AND METHODS Metabolic, anatomic, laboratory, pathologic, genetic, primary disease, and procedure-related factors, as well as pre- and post-RAE therapies in 103 patients with CLM treated with RAE from September 15, 2009 to March 21, 2017 were analyzed. LPFS was defined by Response Evaluation Criteria In Solid Tumors 1.1 and European Organization for Research and Treatment of Cancer criteria. Prognosticators of OS and LPFS were selected using univariate Cox regression, adjusted for clustering and competing risk analysis (for LPFS), and subsequently tested in multivariate analysis (MVA). The nomogram was built using R statistical software and internally validated using bootstrap resampling. RESULTS Patients received RAE at a median of 30.9 months (range, 3.4-161.7 months) after detection of CLM. The median OS and LPFS were 11.3 months (95% confidence interval, 7.9-15.1 months) and 4 months (95% confidence interval, 3.3-4.8 months), respectively. Of the 40 parameters tested, 6 were independently associated with OS in MVA. These baseline parameters included number of extrahepatic disease sites (P < .001), carcinoembryonic antigen (P < .001), albumin (P = .005), alanine aminotransferase level (P < .001), tumor differentiation level (P < .001), and the sum of the 2 largest tumor diameters (P < .001). The 1-year OS of patients with total points of < 25 versus > 80 was 90% and 10%, respectively. Bootstrap resampling showed good discrimination (optimism corrected c-index = 0.745) and calibration (mean absolute prediction error = 0.299) of the nomogram. Only baseline maximum standardized uptake value was significant in MVA for LPFS prediction (P < .001; SHR = 1.06). CONCLUSION The developed nomogram included 6 pre-RAE parameters and provided good prediction of survival post-RAE in heavily pretreated patients. Baseline maximum standardized uptake value was the single significant predictor of LPFS.
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Affiliation(s)
- Ieva Kurilova
- Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Jessica Flynn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mithat Gönen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gary Ulaner
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Elena N Petre
- Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - F Edward Boas
- Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Etay Ziv
- Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Hooman Yarmohammadi
- Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Andrea Cercek
- Department of Gastrointestinal Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nancy A Kemeny
- Department of Gastrointestinal Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Constantinos T Sofocleous
- Department of Interventional Oncology/Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.
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Gill MR, Falzone N, Du Y, Vallis KA. Targeted radionuclide therapy in combined-modality regimens. Lancet Oncol 2017; 18:e414-e423. [PMID: 28677577 DOI: 10.1016/s1470-2045(17)30379-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 03/27/2017] [Accepted: 04/10/2017] [Indexed: 12/12/2022]
Abstract
Targeted radionuclide therapy (TRT) is a branch of cancer medicine concerned with the use of radioisotopes, radiolabelled molecules, nanoparticles, or microparticles that either naturally accumulate in or are designed to target tumours. TRT combines the specificity of molecular and sometimes physical targeting with the potent cytotoxicity of ionising radiation. Targeting vectors for TRT include antibodies, antibody fragments, proteins, peptides, and small molecules. The diversity of available carrier molecules, together with the large panel of suitable radioisotopes with unique physicochemical properties, allows vector-radionuclide pairings to be matched to the molecular, pathological, and physical characteristics of a tumour. Some pairings are designed for dual therapeutic and diagnostic applications. Use of TRT is increasing with the adoption into practice of radium-223 dichloride for the treatment of bone metastases and with the ongoing clinical development of, among others, 177Lu-dodecanetetraacetic acid tyrosine-3-octreotate (DOTATATE) for the treatment of neuroendocrine tumours and 90Y-microspheres for the treatment of hepatic tumours. The increasing use of TRT raises the question of how best to integrate TRT into multimodality protocols. Achievements in this area and the future prospects of TRT are evaluated in this Review.
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Affiliation(s)
- Martin R Gill
- CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK
| | - Nadia Falzone
- CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK
| | - Yong Du
- The Royal Marsden Hospital NHS Foundation Trust, Sutton, Surrey, UK
| | - Katherine A Vallis
- CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK.
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Selective neck dissection for neck residue of nasopharyngeal carcinoma: A prospective study. J Craniomaxillofac Surg 2015; 43:1571-6. [DOI: 10.1016/j.jcms.2015.06.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 06/05/2015] [Accepted: 06/29/2015] [Indexed: 11/17/2022] Open
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Lo WC, Wang CP, Ko JY, Lou PJ, Yang TL, Wang CW, Hu YL, Chen TC. Salvage treatment for isolated regional failure of nasopharyngeal carcinoma after primary radiotherapy. Ann Surg Oncol 2011; 19:1001-8. [PMID: 21913020 DOI: 10.1245/s10434-011-2018-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Isolated regional failure of nasopharyngeal carcinoma (NPC) after primary treatment is traditionally treated with radical neck dissection (RND). The roles of modified radical neck dissection (MRND) and postoperative radiotherapy after salvage surgery currently remain unclear. METHODS Medical records from our facility of all NPC patients with isolated regional failure after complete primary radiotherapy and receipt of radical surgery as a part of salvage treatment between January 1985 and December 2004 were retrospectively reviewed. RESULTS Forty-five patients were enrolled onto the study. On univariate analyses, the 5-year regional-free, disease-free, and overall survival rates were 67.7%, 47.8%, and 65.7% for patients who underwent salvage surgery alone and were 66.0%, 34.7%, and 61.3% for patients who received salvage surgery plus postoperative radiotherapy (P = 0.74, P = 0.39 and P = 0.7, respectively). The 5-year regional-free, disease-free, and overall survival rates were 87.4%, 53.5%, and 87.1% for patients undergoing RND and were 54.3%, 34.2%, and 50.5% for patients undergoing MRND (P = 0.01, P = 0.02 and P = 0.05, respectively). On multivariate analyses, recurrent N3 disease was the only adverse prognostic factor for disease-free and overall survival (P = 0.05 and P = 0.03, respectively). CONCLUSIONS RND or MRND alone may be the superior treatment for NPC patients with isolated regional failure after primary radiotherapy. Compared to MRND, radical neck dissection could provide better regional control. Postoperative radiotherapy seems to have no benefit on disease-free or overall survival. Distant metastasis is the major cause of death in these patients.
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Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
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Wang Z, Huang CM, Deng Q, Zeng H, Wang X, Zhang S, Bi F, Tang QL, Zhong RM, Li AJ, He YB, Chen N, Li ZP, Wang W. Effects of the proapoptotic regulator Bcl2/adenovirus EIB 19 kDa-interacting protein 3 on radiosensitivity of cervical cancer. Cancer Biother Radiopharm 2011; 26:279-86. [PMID: 21711117 DOI: 10.1089/cbr.2010.0898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Bcl2/adenovirus EIB 19 kDa-interacting protein 3 (BNIP3) is a proapoptotic member of the Bcl-2 family. To address its potential as a therapeutic target for radiosensitization, this study investigated the effect of Bnip3 expression on radiosensitivity of cervical cancer in vitro and in vivo. MATERIALS AND METHODS In vitro: A plasmid expressing the BNIP3 gene was transfected into human cervical cancer HeLa cells using Lipofectamine(2000), and western blot and immunohistochemistry analysis were performed to evaluate the expression of BNIP3 in transfected cells. The effects on radiation-induced apoptosis were investigated using a clone formation assay and flow cytometry. In vivo: A total of 6 × 10⁶ HeLa cells were subcutaneously inoculated into the dorsal flank of nude mice, and plasmids expressing the BNIP3 gene were injected into the mice via the tail vein. Tumor volume was calculated, and immunohistochemistry was used to detect the expression of BNIP3 in tumor cells. TUNEL assays were performed to determine the apoptosis rates in tumor tissues. RESULTS Transfection with the recombinant BNIP3 plasmid increased expression of the Bnip3 protein in tumor cells. This apoptosis regulator significantly decreased the viability of cells (p < 0.01) and increased the apoptosis rates (p < 0.01) both in vitro and in vivo. The antitumor effect of radiotherapy was enhanced by overexpression of BNIP3, as revealed by tumor growth curve analysis. CONCLUSIONS Radiosensitization in human cervical cancer cells was observed after treatment with the recombinant BNIP3 plasmid in vitro and in vivo. Results suggested that BNIP3 may play a role in enhancement of radiotherapy efficiency, and its expression may have a synergistic effect on radiation treatments.
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Affiliation(s)
- Zi Wang
- Department of Radiation Oncology, Cancer Center of West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Practicality of the cyclotron production of radiolanthanide 142Pr: a potential for therapeutic applications and biodistribution studies. J Radioanal Nucl Chem 2011. [DOI: 10.1007/s10967-011-1033-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Steffen AC, Göstring L, Tolmachev V, Palm S, Stenerlöw B, Carlsson J. Differences in radiosensitivity between three HER2 overexpressing cell lines. Eur J Nucl Med Mol Imaging 2008; 35:1179-91. [PMID: 18193218 DOI: 10.1007/s00259-007-0713-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Accepted: 12/26/2007] [Indexed: 01/11/2023]
Abstract
PURPOSE HER2 is a potential target for radionuclide therapy, especially when HER2 overexpressing breast cancer cells are resistant to Herceptin(R) treatment. Therefore, it is of interest to analyse whether HER2 overexpressing tumour cells have different inherent radiosensitivity. METHODS The radiosensitivity of three often used HER2 overexpressing cell lines, SKOV-3, SKBR-3 and BT-474, was analysed. The cells were exposed to conventional photon irradiation, low linear energy transfer (LET), to characterise their inherent radiosensitivity. The analysis was made with clonogenic survival and growth extrapolation assays. The cells were also exposed to alpha particles, high LET, from (211)At decays using the HER2-binding affibody molecule (211)At-(Z(HER2:4))(2) as targeting agent. Assays for studies of internalisation of the affibody molecule were applied. RESULTS SKOV-3 cells were most radioresistant, SKBR-3 cells were intermediate and BT-474 cells were most sensitive as measured with the clonogenic and growth extrapolation assays after photon irradiation. The HER2 dependent cellular uptake of (211)At was qualitatively similar for all three cell lines. However, the sensitivity to the alpha particles from (211)At differed; SKOV-3 was most resistant, SKBR-3 intermediate and BT-474 most sensitive. These differences were unexpected because it is assumed that all types of cells should have similar sensitivity to high-LET radiation. The sensitivity to alpha particle exposure correlated with internalisation of the affibody molecule and with size of the cell nucleus. CONCLUSION There can be differences in radiosensitivity, which, if they also exist between patient breast cancer cells, are important to consider for both conventional radiotherapy and for HER2-targeted radionuclide therapy.
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Affiliation(s)
- Ann-Charlott Steffen
- Department of Oncology, Radiology and Clinical Immunology, Rudbeck Laboratory, Uppsala University, Uppsala, 751 85, Sweden
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