1
|
Xie P, Hu H, Cao X, Lan N, Zhang H, Yan R, Yue P, Hu W, Qiao H. Frequency of metastases within the hypothalamic-pituitary area and the associated high-risk factors in patients with brain metastases. Front Neurol 2023; 14:1285662. [PMID: 38099066 PMCID: PMC10720031 DOI: 10.3389/fneur.2023.1285662] [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: 08/30/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Objective Brain radiotherapy often results in impairment of hypothalamic-pituitary (HT-P) function, which in turn causes secretory dysfunction of related hormones. In this paper, the frequency of metastasis in the HT-P area and its high-risk factors in patients with brain metastasis were retrospectively analyzed, and thus provide experimental evidence for protecting HT-P area during whole brain radiotherapy (WBRT). Methods A retrospective analysis was performed on the data of patients with brain metastasis diagnosed by cranial magnetic resonance imaging (MRI) at the First Hospital of Lanzhou University from 2017 to 2020. The anatomical positions of the hypothalamus and pituitary were delineated, followed by their expansion by 5 mm outwards, respectively, in the three-dimensional direction, and the hypothalamus +5 mm and pituitary +5 mm were obtained as the avoidance area, in which the frequency of brain metastasis was evaluated. Univariate and multivariate logistic regression models were used to analyze the high risk factors of brain metastasis in HT-P area. Results A total of 3,375 brain metastatic lesions from 411 patients were included in the analysis. The rates of brain metastasis in the hypothalamus +5 mm and pituitary +5 mm in the whole group of cases were 2.9% (12/411) and 1.5% (6/411) respectively; the frequency of lesions was 0.4% (13/3375) and 0.2% (6/3375) respectively. Univariate and multivariate analyses showed that the number of brain metastases (OR = 14.946; 95% CI = 4.071-54.880; p < 0.001), and the occurrence of brain metastasis in the pituitary (OR = 13.331; 95% CI = 1.511-117.620; p = 0.020) were related to brain metastasis in the hypothalamus, and that the only relevant factor for brain metastasis in the pituitary was the occurrence of that in the hypothalamus (OR = 0.069; 95% CI = 0.010-0.461; p = 0.006). There was no correlation between tumor pathological types, the maximum diameter, the total volume of brain metastatic lesions and the risk of brain metastasis in hypothalamus and pituitary. Conclusion The frequency of brain metastasis in the HT-P area is extremely low. The risk of brain metastases in the hypothalamus is correlated with their number. The larger the number of metastatic lesions, the higher the frequency of brain metastasis. Protection of the HT-P area during WBRT may be unlikely to compromise the tumor recurrence rate for patients with a relatively small number of brain metastases.
Collapse
Affiliation(s)
- Peng Xie
- Department of Radiation Oncology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Huiling Hu
- CT Room, The First People’s Hospital of Lanzhou City, Lanzhou, China
| | - Xiong Cao
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ning Lan
- Department of Radiotherapy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Huanyu Zhang
- Department of Radiation Oncology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ruifeng Yan
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Peng Yue
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, China
| | - Wenteng Hu
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, China
| | - Hui Qiao
- Department of Oncology, The First Hospital of Lanzhou University, Lanzhou, China
- School of Life Sciences, Lanzhou University, Lanzhou, China
| |
Collapse
|
2
|
Muscle Function, Body Composition, Insulin Sensitivity and Physical Activity in Adolescents Born Preterm: Impact of Gestation and Vitamin D Status. Nutrients 2022; 14:nu14235045. [PMID: 36501074 PMCID: PMC9736929 DOI: 10.3390/nu14235045] [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: 10/22/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
Whilst several studies have explored adolescent metabolic and cognitive function after preterm birth, few have explored muscle function and physical activity. We set out to examine the relationship between gestational age and muscle metabolism in a cohort of adolescents who were born preterm. Participants were recruited from the Newcastle preterm birth growth study cohort. They did not have severe neurological disease and were not on daily medication. Participants underwent an assessment of oxidative muscle function using phosphorus magnetic resonance spectroscopy that included the half-time for recovery of equilibrium of phosphocreatine, τ½PCr. In addition, we measured key variables that might affect muscle function including physical activity levels determined by 3-day accelerometry, body composition using air displacement plethysmography, insulin sensitivity using the homeostatic model assessment/Matsuda index and serum vitamin D concentrations. 60 adolescents (35F) median age 15.6 years (range 12.1−18.8) with a median gestation of 31 weeks (range 24 to 34 weeks) underwent a single assessment. Males were more active and spent less time in sedentary mode. Time spent in light activity was associated with insulin sensitivity (IS) (Matsuda Index; p < 0.05) but there were no strong correlations between activity levels and gestational age. Greater fat mass, waist circumference and body mass index were all associated with lower IS. Gestational age was negatively associated with adjusted measures of oxidative muscle function (τ½PCr). In a stepwise multivariate linear regression model, gestational age at birth was the most significant predictor of oxidative muscle function (p = 0.005). Higher serum vitamin D levels were also associated with faster phosphocreatine recovery time (p = 0.045). Oxidative function in the skeletal muscle of adolescents born preterm is associated with gestational age and vitamin D concentrations. Our study suggests that being born preterm may have a long-term impact on muscle metabolism.
Collapse
|
3
|
Andrade-Guimarães AL, Aguiar-Oliveira MH, Salvatori R, Carvalho VO, Alvim-Pereira F, Daniel CRA, Brasileiro GAM, Santana-Ribeiro AA, Santos-Carvalho HA, Oliveira CRP, Vieira ER, Gois-Junior MB. Adult individuals with congenital, untreated, severe isolated growth hormone deficiency have satisfactory muscular function. Endocrine 2019; 63:112-119. [PMID: 30251164 DOI: 10.1007/s12020-018-1763-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/11/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE While growth hormone (GH) and the insulin-like growth factor type I (IGF-I) are known to exert synergistic actions on muscle anabolism, the consequences of prolonged GH deficiency (GHD) on muscle function have not been well defined. We have previously described a large cohort of subjects with isolated GHD (IGHD) caused by a mutation in the GH-releasing hormone receptor gene, with low serum levels of GH and IGF-I. The aim of this study was to assess muscular function in these IGHD subjects. METHODS A total of 31 GH-naïve IGHD (16 males) and 40 control (20 males) subjects, matched by age and degree of daily physical activity, were enrolled. Fat free mass was measured by bioelectrical impedance; muscle strength by dynamometry of handgrip, trunk extension, and knee extension; myoelectric activity and muscle fatigue by fractal dimension; conduction velocity in vastus medialis, rectus femoris, and vastus lateralis muscles by surface electromyography. RESULTS The IGHD group showed higher knee extension strength both when corrected for weight and fat free mass, and higher handgrip and trunk extension strength corrected by fat free mass. They also exhibit higher conduction velocity of the muscles vastus medialis, rectus femoris, and vastus lateralis, but lower free fat mass and myoelectric activity of the vastus medialis, rectus femoris and vastus lateralis. There were no differences between the two groups in fractal dimension in all studied muscles. CONCLUSION Individuals with untreated IGHD have better muscle strength parameters adjusted for weight and fat free mass than controls. They also exhibit greater peripheral resistance to fatigue, demonstrating satisfactory muscle function.
Collapse
Affiliation(s)
- Alana L Andrade-Guimarães
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, 21287, USA.
| | - Vitor O Carvalho
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Fabiano Alvim-Pereira
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Carlos R Araújo Daniel
- Department of Statistic and Actuarial Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Giulliani A Moreira Brasileiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Ananda A Santana-Ribeiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Hugo A Santos-Carvalho
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Edgar R Vieira
- Department of Physical Therapy and Neuroscience, Wertheims'College of Nursing and Health Science, Florida International University, Florida, USA
| | - Miburge B Gois-Junior
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
- Department of Physical Therapy and Neuroscience, Wertheims'College of Nursing and Health Science, Florida International University, Florida, USA
| |
Collapse
|
4
|
Simultaneously avoiding the hippocampus and hypothalamic-pituitary axis during whole brain radiotherapy: A planning study. Med Dosim 2019; 44:130-135. [DOI: 10.1016/j.meddos.2018.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/08/2018] [Accepted: 04/09/2018] [Indexed: 01/19/2023]
|
5
|
Pascucci C, De Biase RV, Savi D, Quattrucci S, Isidori AM, Lubrano C, Gnessi L, Lenzi A. Deregulation of the growth hormone/insulin-like growth factor-1 axis in adults with cystic fibrosis. J Endocrinol Invest 2018; 41:591-596. [PMID: 29098662 DOI: 10.1007/s40618-017-0784-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/24/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Patients with cystic fibrosis (CF) present with signs and symptoms that overlap with those of adult growth hormone deficiency (GHD) syndrome: loss of muscle mass, bone fragility and lower stress tolerance. In literature, the prevalence of GHD in pediatric CF patients is higher than general population, but these studies have been performed on children with growth delay. To our knowledge, there are no studies on adult patients. The aim of this paper is to evaluate GH-IGF1 axis in an adult CF population. METHODS Fifty clinically stable adult patients, 30 males; age 36 ± 2 years; BMI 21.39 ± 0.22 kg/m2 and FEV1 67 ± 4% were studied. Data regarding glycometabolic status and results of pituitary, thyroid, parathyroid, gonadal and adrenal function tests were recorded. All patients underwent a GH releasing hormone (GHRH) + Arginine stimulation test to confirm a GHD. RESULTS GHRH + Arginine test revealed the presence of GHD in 16 patients (32%); specifically 7 patients had a severe deficiency and 9 a partial deficiency. CONCLUSIONS Adult patients with CF may show GHD. These patients should be followed over time to assess if the GHD could impact the clinical progression of CF.
Collapse
Affiliation(s)
- C Pascucci
- Section of Medical Pathophysiology, Endocrinology, Department Experimental Medicine, Sapienza University, 00161, Rome, Italy.
| | - R V De Biase
- Pediatrics Department, Cystic Fibrosis Regional Center, Sapienza University of Rome, Rome, Italy
| | - D Savi
- Pediatrics Department, Cystic Fibrosis Regional Center, Sapienza University of Rome, Rome, Italy
- Cystic Fibrosis Unit, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - S Quattrucci
- Pediatrics Department, Cystic Fibrosis Regional Center, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Section of Medical Pathophysiology, Endocrinology, Department Experimental Medicine, Sapienza University, 00161, Rome, Italy
| | - C Lubrano
- Section of Medical Pathophysiology, Endocrinology, Department Experimental Medicine, Sapienza University, 00161, Rome, Italy
| | - L Gnessi
- Section of Medical Pathophysiology, Endocrinology, Department Experimental Medicine, Sapienza University, 00161, Rome, Italy
| | - A Lenzi
- Section of Medical Pathophysiology, Endocrinology, Department Experimental Medicine, Sapienza University, 00161, Rome, Italy
| |
Collapse
|
6
|
Zhu Q, Hu H, Weng DS, Zhang XF, Chen CL, Zhou ZQ, Tang Y, Xia JC. Pooled safety analyses of ALK-TKI inhibitor in ALK-positive NSCLC. BMC Cancer 2017; 17:412. [PMID: 28606126 PMCID: PMC5469041 DOI: 10.1186/s12885-017-3405-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 06/07/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The anaplastic lymphoma kinase tyrosine kinase inhibitors (ALK-TKIs) have been administered to patients with ALK-positive non-small cell lung cancer for a long period of time and show a promising response. However, the differences in the toxicity profiles among these drugs are still unclear. METHODS We performed a comprehensive search of the MEDLINE, EMBASE, WEB OF SCIENCE and COCHRANE databases from the drugs' inception to May 2016 to identify clinical trials. Severe adverse events (AEs) (grade ≥ 3) based on the ALK-TKI type were analysed. RESULTS Seventeen trials published between 2011 and 2016, including a total of 1826 patients, were eligible for analysis. Patients in 10 trials (n = 1000) received crizotinib, patients in 5 trials (n = 601) received ceritinib and patients in 2 trials (n = 225) received alectinib. The overall frequencies of treatment-related death and AEs due to treatment withdrawal were 0.9% (12/1365) and 5.5% (85/1543), respectively. Moreover, the frequency of severe AEs in patients treated with ceritinib was significantly higher than patients treated with crizotinib or alectinib, especially for hepatotoxicity, fatigue and some of gastrointestinal symptoms. Additionally, significant difference in the elevated lipase and amylase levels (grade ≥ 3) were detected between ceritinib and crizotinib/alectinib, whereas neutropenia was less frequent. CONCLUSIONS ALK-TKIs were safe for ALK-positive patients. Moreover, statistically significant differences in some severe AEs among ceritinib, crizotinib and alectinib were detected in present study.
Collapse
Affiliation(s)
- Qian Zhu
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| | - Hao Hu
- Department of Thoracic Surgery, Medical College of Nanchang University, Nanchang, 330006 People’s Republic of China
| | - De-Sheng Weng
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| | - Xiao-Fei Zhang
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| | - Chang-Long Chen
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| | - Zi-Qi Zhou
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| | - Yan Tang
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| | - Jian-Chuan Xia
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
- Department of Biotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060 People’s Republic of China
| |
Collapse
|
7
|
Kemp GJ, Ahmad RE, Nicolay K, Prompers JJ. Quantification of skeletal muscle mitochondrial function by 31P magnetic resonance spectroscopy techniques: a quantitative review. Acta Physiol (Oxf) 2015; 213:107-44. [PMID: 24773619 DOI: 10.1111/apha.12307] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 12/30/2013] [Accepted: 04/23/2014] [Indexed: 12/16/2022]
Abstract
Magnetic resonance spectroscopy (MRS) can give information about cellular metabolism in vivo which is difficult to obtain in other ways. In skeletal muscle, non-invasive (31) P MRS measurements of the post-exercise recovery kinetics of pH, [PCr], [Pi] and [ADP] contain valuable information about muscle mitochondrial function and cellular pH homeostasis in vivo, but quantitative interpretation depends on understanding the underlying physiology. Here, by giving examples of the analysis of (31) P MRS recovery data, by some simple computational simulation, and by extensively comparing data from published studies using both (31) P MRS and invasive direct measurements of muscle O2 consumption in a common analytical framework, we consider what can be learnt quantitatively about mitochondrial metabolism in skeletal muscle using MRS-based methodology. We explore some technical and conceptual limitations of current methods, and point out some aspects of the physiology which are still incompletely understood.
Collapse
Affiliation(s)
- G. J. Kemp
- Department of Musculoskeletal Biology, and Magnetic Resonance and Image Analysis Research Centre; University of Liverpool; Liverpool UK
| | - R. E. Ahmad
- Department of Musculoskeletal Biology, and Magnetic Resonance and Image Analysis Research Centre; University of Liverpool; Liverpool UK
| | - K. Nicolay
- Biomedical NMR; Department of Biomedical Engineering; Eindhoven University of Technology; Eindhoven the Netherlands
| | - J. J. Prompers
- Biomedical NMR; Department of Biomedical Engineering; Eindhoven University of Technology; Eindhoven the Netherlands
| |
Collapse
|
8
|
Zhao R, Cai Y, Shao X, Ma B. Improving the activity of Lycium barbarum polysaccharide on sub-health mice. Food Funct 2015; 6:2033-40. [DOI: 10.1039/c4fo01108b] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Anti-fatigue activity of Lycium barbarum polysaccharide on sub-health mice: LBP-4a exhibited anti-fatigue activity on sub-health mice, and the mechanism was closely correlated with the reduction of lipid peroxidation levels and an increase of antioxidant enzyme activities in skeletal muscle tissue, in addition to the improvement in intracellular calcium homeostasis imbalance of skeletal muscle and an increase in mitochondrial membrane potential.
Collapse
Affiliation(s)
- Rui Zhao
- Department of Pharmaceutical Engineering
- College of Life Science & Biotechnology
- Heilongjiang Bayi Agricultural University
- P. R. China
| | - Yaping Cai
- Department of Pharmaceutical Engineering
- College of Life Science & Biotechnology
- Heilongjiang Bayi Agricultural University
- P. R. China
| | - Xingyue Shao
- Department of gynaecology and obstetrics
- Daqing Oilfield Hospital
- Daqing 163311
- P. R China
| | - Baoling Ma
- Department of physical education
- Hebei Normal University of Science and Technology
- Qinhuangdao 066004
- P. R. China
| |
Collapse
|