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Starace M, Rapparini L, Cedirian S. Skin Malignancies Due to Anti-Cancer Therapies. Cancers (Basel) 2024; 16:1960. [PMID: 38893081 PMCID: PMC11171349 DOI: 10.3390/cancers16111960] [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: 04/09/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Skin cancers involve a significant concern in cancer therapy due to their association with various treatment modalities. This comprehensive review explores the increased risk of skin cancers linked to different anti-cancer treatments, including classic immunosuppressants such as methotrexate (MTX), chemotherapeutic agents such as fludarabine and hydroxyurea (HU), targeted therapies like ibrutinib and Janus Kinase inhibitors (JAKi), mitogen-activated protein kinase pathway (MAPKP) inhibitors, sonic hedgehog pathway (SHHP) inhibitors, and radiotherapy. MTX, a widely used immunosuppressant in different fields, is associated with basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and cutaneous melanoma (CM), particularly at higher dosages. Fludarabine, HU, and other chemotherapeutic agents increase the risk of non-melanoma skin cancers (NMSCs), including cSCC and BCC. Targeted therapies like ibrutinib and JAKi have been linked to an elevated incidence of NMSCs and CM. MAPKP inhibitors, particularly BRAF inhibitors like vemurafenib, are associated with the development of cSCCs and second primary melanomas (SPMs). SHHP inhibitors like vismodegib have been linked to the emergence of cSCCs following treatment for BCC. Additionally, radiotherapy carries carcinogenic risks, especially for BCCs, with increased risks, especially with younger age at the moment of exposure. Understanding these risks and implementing appropriate screening is crucial for effectively managing patients undergoing anti-cancer therapies.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.S.); (S.C.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.S.); (S.C.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.S.); (S.C.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
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Chen G, Yu Z, Zhang Y, Liu S, Chen C, Zhang S. Radiation-induced gastric injury during radiotherapy: molecular mechanisms and clinical treatment. JOURNAL OF RADIATION RESEARCH 2023; 64:870-879. [PMID: 37788485 PMCID: PMC10665304 DOI: 10.1093/jrr/rrad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/08/2023] [Indexed: 10/05/2023]
Abstract
Radiotherapy (RT) has been the standard of care for treating a multitude of cancer types. Radiation-induced gastric injury (RIGI) is a common complication of RT for thoracic and abdominal tumors. It manifests acutely as radiation gastritis or gastric ulcers, and chronically as chronic atrophic gastritis or intestinal metaplasia. In recent years, studies have shown that intracellular signals such as oxidative stress response, p38/MAPK pathway and transforming growth factor-β signaling pathway are involved in the progression of RIGI. This review also summarized the risk factors, diagnosis and treatment of this disease. However, the root of therapeutic challenges lies in the incomplete understanding of the mechanisms. Here, we also highlight the potential mechanistic, diagnostic and therapeutic directions of RIGI.
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Affiliation(s)
- Guangxia Chen
- Department of Gastroenterology, The First People’s Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou 221200, China
| | - Zuxiang Yu
- Laboratory of Radiation Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Yuehua Zhang
- Laboratory of Radiation Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Shiyu Liu
- Department of Gastroenterology, The First People’s Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou 221200, China
| | - Chong Chen
- Department of Gastroenterology, The First People’s Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou 221200, China
| | - Shuyu Zhang
- Laboratory of Radiation Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital , Chengdu 610051, China
- NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital), Mianyang 621099, China
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Lee B, Cho S, Park HC, Kang SW, Kim JS, Chung JB. Assessment of dose perturbations for metal stent in photon and proton radiotherapy plans for hepatocellular carcinoma. Radiat Oncol 2022; 17:125. [PMID: 35842636 PMCID: PMC9288675 DOI: 10.1186/s13014-022-02100-8] [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: 01/10/2022] [Accepted: 07/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to investigate the dosimetric impact of metal stent for photon and proton treatment plans in hepatocellular carcinoma. METHODS With computed tomography data of a water-equivalent solid phantom, dose perturbation caused by a metal stent included in the photon and proton treatment of hepatocellular carcinoma was evaluated by comparing Eclipse and RayStation treatment planning system (TPS) to a Monte Carlo (MC) based dose calculator. Photon and proton plans were created with anterior-posterior/posterior-anterior (AP/PA) fields using a 6 MV beam and AP/PA fields of a wobbling beam using 150 MeV and a 10 cm ridge filter. The difference in dose distributions and dosimetric parameters were compared depending on the stent's positions (the bile duct (GB) and intestinal tract (GI)) and angles (0°, 45°, and 90°). Additionally, the dose variation in the target volume including the stent was comparatively evaluated through dose volume histogram (DVH) analysis. And the comparison of clinical cases was carried out in the same way. RESULTS Percentage differences in the dosimetric parameters calculated by MC ranged from - 7.0 to 3.9% for the photon plan and - 33.7 to 4.3% for the proton plan, depending on the angle at which the GB and GI stents were placed, compared to those without the stent. The maximum difference was observed at the minimum dose (Dmin), which was observed in both photon and proton plans in the GB and GI stents deployed at a 90° incidence angle. The parameter differences were greater in the proton plan than in photon plan. The target volume showed various dose variations depending on positions and angles of stent for both beams. Compared with no-stent, the doses within the target volume containing the GI and GB stents for the photon beam were overestimated in the high-dose area at 0°, nearly equal within 1% at 45°, and underestimated at 90°. These doses to the proton beam were underestimated at all angles, and the amount of underdose to the target volume increased with an increase in the stent angle. However, the difference was significantly greater with the proton plan than the photon plan. CONCLUSIONS Dose perturbations within the target volume due to the presence of the metal stent were not observed in the TPS calculations for photon and proton beams, but MC was used to confirm that there are dose variations within the target volume. The MC results found that delivery of the treatment beam avoiding the stent was the best method to prevent target volume underdose.
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Affiliation(s)
- Boram Lee
- Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Seongnam, Korea
| | - Sungkoo Cho
- Department of Radiation Oncology, Samsung Medical Center, Seoul, South Korea
| | - Hee Chul Park
- Department of Radiation Oncology, Samsung Medical Center, Seoul, South Korea.,Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang-Won Kang
- Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Seongnam, Korea
| | - Jae-Sung Kim
- Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Seongnam, Korea
| | - Jin-Beom Chung
- Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Seongnam, Korea.
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Kang DJ, Shin YJ, Jeong S, Jung JY, Lee H, Lee B. Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy. Radiat Oncol 2021; 16:108. [PMID: 34118968 PMCID: PMC8199704 DOI: 10.1186/s13014-020-01722-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 12/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study is to develop a clinical application program that automatically calculates the effect for secondary cancer risk (SCR) of individual patient. The program was designed based on accurate dose calculations using patient computed tomography (CT) data and Monte Carlo engine. Automated patient-specific evaluation program was configured to calculate SCR. Methods The application program is designed to re-calculate the beam sequence of treatment plan using the Monte Carlo engine and patient CT data, so it is possible to accurately calculate and evaluate scatter and leakage radiation, difficult to calculate in TPS. The Monte Carlo dose calculation system was performed through stoichiometric calibration using patient CT data. The automatic SCR evaluation program in application program created with a MATLAB was set to analyze the results to calculate SCR. The SCR for organ of patient was calculated based on Biological Effects of Ionizing Radiation (BEIR) VII models. The program is designed to sequentially calculate organ equivalent dose (OED), excess absolute risk (EAR), excess relative risk (ERR), and the lifetime attributable risk (LAR) in consideration of 3D dose distribution analysis. In order to confirm the usefulness of the developed clinical application program, the result values from clinical application program were compared with the manual calculation method used in the previous study. Results The OED values calculated in program were calculated to be at most approximately 13.3% higher than results in TPS. The SCR result calculated by the developed clinical application program showed a maximum difference of 1.24% compared to the result of the conventional manual calculation method. And it was confirmed that EAR, ERR and LAR values can be easily calculated by changing the biological parameters. Conclusions We have developed a patient-specific SCR evaluation program that can be used conveniently in the clinic. The program consists of a Monte Carlo dose calculation system for accurate calculation of scatter and leakage radiation and a patient-specific automatic SCR evaluation program using 3D dose distribution. The clinical application program that improved the disadvantages of the existing process can be used as an index for evaluating a patient treatment plan.
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Affiliation(s)
- Dong-Jin Kang
- Department of Radiation Oncology, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, Korea
| | - Young-Joo Shin
- Department of Radiation Oncology, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, Korea.
| | - Seonghoon Jeong
- Proton Therapy Center, National Cancer Center, Goyang, Korea
| | - Jae-Yong Jung
- Department of Radiation Oncology, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, Korea
| | | | - Boram Lee
- Department of Radiation Oncology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81, Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea.
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Ade N, du Plessis FCP. Out-of-field scattering from the Integral Quality Monitor® in megavolt photon beams. Appl Radiat Isot 2020; 168:109449. [PMID: 33317891 DOI: 10.1016/j.apradiso.2020.109449] [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: 08/20/2020] [Accepted: 09/24/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate out-of-field scattered doses from the Integral Quality Monitor (IQM) transmission detector in megavoltage photon beams. MATERIALS AND METHODS We measured out-of-field point doses for 20 × 20 cm2 6-15 MV photon beams using 10 × 2 cm2 Gafchromic EBT3 film strips placed across the surfaces of 5-cm thick water-equivalent RW3 slabs. The films were placed at 10 cm intervals from the central axis (CAX) of each beam, up to 1.0 m away on opposite sides of the CAX. The measurements were conducted at 80 cm and 100 cm source-to-surface distances (SSD) without the IQM, and were repeated with the IQM in the paths of the beams. Measurements were also performed at 90 cm SSD for 20 × 20 and 30 × 30 cm2 15 MV fields. Surface dose profiles were then constructed from the measurements for each beam setup with and without the IQM to examine the differences in scattered dose off-axis. The dose profile for each beam setup was normalised to dose maximum measured on the CAX. RESULTS Overall, surface dose profiles acquired with the IQM in the paths of the beams were higher than the corresponding profiles without the IQM. The out-of-field dose increased with increase in photon energy, field size, and shorter SSDs, and decreased with off-axis distance. At 80 cm SSD for the 20 × 20 cm2 field, the IQM-induced surface dose ranged from -0.6% ÷ 1.9%, -0.3% ÷ 3.0%, and 0.3% ÷ 6.8% for 6, 10, and 15 MV beams, respectively. CONCLUSION The higher surface dose profiles measured with the IQM attached to the linac compared to the profiles without the IQM indicates that the device is acting as an additional source of scattered radiation.
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Affiliation(s)
- Nicholas Ade
- Medical Physics Department, University of the Free State, Bloemfontein, 9300, South Africa.
| | - F C P du Plessis
- Medical Physics Department, University of the Free State, Bloemfontein, 9300, South Africa
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Selmansberger M, Michna A, Braselmann H, Höfig I, Schorpp K, Weber P, Anastasov N, Zitzelsberger H, Hess J, Unger K. Transcriptome network of the papillary thyroid carcinoma radiation marker CLIP2. Radiat Oncol 2020; 15:182. [PMID: 32727620 PMCID: PMC7392692 DOI: 10.1186/s13014-020-01620-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/15/2020] [Indexed: 11/29/2022] Open
Abstract
Background We present a functional gene association network of the CLIP2 gene, generated by de-novo reconstruction from transcriptomic microarray data. CLIP2 was previously identified as a potential marker for radiation induced papillary thyroid carcinoma (PTC) of young patients in the aftermath of the Chernobyl reactor accident. Considering the rising thyroid cancer incidence rates in western societies, potentially related to medical radiation exposure, the functional characterization of CLIP2 is of relevance and contributes to the knowledge about radiation-induced thyroid malignancies. Methods We generated a transcriptomic mRNA expression data set from a CLIP2-perturbed thyroid cancer cell line (TPC-1) with induced CLIP2 mRNA overexpression and siRNA knockdown, respectively, followed by gene-association network reconstruction using the partial correlation-based approach GeneNet. Furthermore, we investigated different approaches for prioritizing differentially expressed genes for network reconstruction and compared the resulting networks with existing functional interaction networks from the Reactome, Biogrid and STRING databases. The derived CLIP2 interaction partners were validated on transcript and protein level. Results The best reconstructed network with regard to selection parameters contained a set of 20 genes in the 1st neighborhood of CLIP2 and suggests involvement of CLIP2 in the biological processes DNA repair/maintenance, chromosomal instability, promotion of proliferation and metastasis. Peptidylprolyl Isomerase Like 3 (PPIL3), previously identified as a potential direct interaction partner of CLIP2, was confirmed in this study by co-expression at the transcript and protein level. Conclusion In our study we present an optimized preselection approach for genes subjected to gene-association network reconstruction, which was applied to CLIP2 perturbation transcriptome data of a thyroid cancer cell culture model. Our data support the potential carcinogenic role of CLIP2 overexpression in radiation-induced PTC and further suggest potential interaction partners of the gene.
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Affiliation(s)
- Martin Selmansberger
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Agata Michna
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Herbert Braselmann
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Ines Höfig
- Institute of Radiation Biology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Kenji Schorpp
- Institute for Molecular Toxicology and Pharmacology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Peter Weber
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Natasa Anastasov
- Institute of Radiation Biology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Horst Zitzelsberger
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany.,Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer', Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Julia Hess
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany.,Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer', Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Kristian Unger
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany. .,Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany. .,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer', Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany.
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Chao PJ, Tsai IH, Huang CC, Lin CH, Shieh CS, Hsieh YW, Yang PY, Lee HF, Lee TF. Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment. Front Bioeng Biotechnol 2020; 8:306. [PMID: 32457880 PMCID: PMC7223476 DOI: 10.3389/fbioe.2020.00306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/20/2020] [Indexed: 12/21/2022] Open
Abstract
Background To evaluate the lifetime secondary cancer risk (SCR) of stereotactic body radiotherapy (SBRT) using the CyberKnife (CK) M6 system with a lung-optimized treatment (LOT) module for lung cancer patients. Methods We retrospectively enrolled 11 lung cancer patients curatively treated with SBRT using the CK M6 robotic radiosurgery system. The planning treatment volume (PTV) and common organs at risk (OARs) for SCR analysis included the spinal cord, total lung, and healthy normal lung tissue (total lung volume - PTV). Schneider’s full model was used to calculate SCR according to the concept of organ equivalent dose (OED). Results CK-LOT-SBRT delivers precisely targeted radiation doses to lung cancers and achieves good PTV coverage and conformal dose distribution, thus posing limited SCR to surrounding tissues. The three OARs had similar risk equivalent dose (RED) values among four different models. However, for the PTV, differences in RED values were observed among the models. The cumulative excess absolute risk (EAR) value for the normal lung, spinal cord, and PTV was 70.47 (per 10,000 person-years). Schneider’s Lnt model seemed to overestimate the EAR/lifetime attributable risk (LAR). Conclusion For lung cancer patients treated with CK-LOT optimized with the Monte Carlo algorithm, the SCR might be lower. Younger patients had a greater SCR, although the dose–response relationship seemed be non-linear for the investigated organs, especially with respect to the PTV. Despite the etiological association, the SCR after CK-LOT-SBRT for carcinoma and sarcoma, is low, but not equal to zero. Further research is required to understand and to show the lung SBRT SCR comparisons and differences across different modalities with motion management strategies.
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Affiliation(s)
- Pei-Ju Chao
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - I-Hsing Tsai
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan
| | - Chun-Chieh Huang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Hsueh Lin
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan
| | - Chin-Shiuh Shieh
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan
| | - Yang-Wei Hsieh
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Ying Yang
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiao-Fei Lee
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsair-Fwu Lee
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Biomedical Engineering, Kaohsiung Medical University, Kaohsiung, Taiwan
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Koll TT, Magnuson A, Dale W, LaBarge MA, Leach CR, Mohile S, Muss H, Sedenquist M, Klepin HD. Developing a clinical and biological measures of aging core: Cancer and Aging Research Group infrastructure. J Geriatr Oncol 2020; 11:343-346. [PMID: 31537478 PMCID: PMC7054170 DOI: 10.1016/j.jgo.2019.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/08/2019] [Accepted: 09/05/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Thuy T Koll
- Division of Geriatrics, Gerontology, Palliative Care Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America.
| | - Allison Magnuson
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States of America; James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, United States of America
| | - William Dale
- Department of Supportive Care Medicine, City of Hope, Duarte, CA, United States of America
| | - Mark A LaBarge
- Department of Population Sciences, Beckman Research Institute at City of Hope, Duarte, CA, United States of America
| | - Corinne R Leach
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, United States of America
| | - Supriya Mohile
- Department of Hematology and Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States of America; James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Hyman Muss
- Division of Hematology and Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Geriatric Oncology Program, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Margaret Sedenquist
- SCOREboard Advisory Group, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Heidi D Klepin
- Section of Hematology and Oncology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
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Yuasa Y, Shiinoki T, Onizuka R, Fujimoto K. Estimation of effective imaging dose and excess absolute risk of secondary cancer incidence for four-dimensional cone-beam computed tomography acquisition. J Appl Clin Med Phys 2019; 20:57-68. [PMID: 31593377 PMCID: PMC6839364 DOI: 10.1002/acm2.12741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 09/02/2019] [Accepted: 09/15/2019] [Indexed: 12/25/2022] Open
Abstract
This study was conducted to estimate the organ equivalent dose and effective imaging dose for four-dimensional cone-beam computed tomography (4D-CBCT) using a Monte Carlo simulation, and to evaluate the excess absolute risk (EAR) of secondary cancer incidence. The EGSnrc/BEAMnrc were used to simulate the on-board imager (OBI) from the TrueBeam linear accelerator. Specifically, the OBI was modeled based on the percent depth dose and the off-center ratio was measured using a three-dimensional (3D) water phantom. For clinical cases, 15 lung and liver cancer patients were simulated using the EGSnrc/DOSXYZnrc. The mean absorbed doses to the lung, stomach, bone marrow, esophagus, liver, thyroid, bone surface, skin, adrenal glands, gallbladder, heart, intestine, kidney, pancreas and spleen, were quantified using a treatment planning system, and the equivalent doses to each organ were calculated. Subsequently, the effective dose was calculated as the weighted sum of the equivalent dose, and the EAR of the secondary cancer incidence was determined for each organ with the use of the biologic effects of ionizing radiation (BEIR) VII model. The effective doses were 3.9 ± 0.5, 15.7 ± 2.0, and 7.3 ± 0.9 mSv, for the lung, and 4.2 ± 0.6, 16.7 ± 2.4, and 7.8 ± 1.1 mSv, for the liver in the respective cases of the 3D-CBCT (thorax, pelvis) and 4D-CBCT modes. The lung EARs for males and females were 7.3 and 10.7 cases per million person-years, whereas the liver EARs were 9.9 and 4.5 cases per million person-years. The EAR increased with increasing time since radiation exposure. In clinical studies, we should use 4D-CBCT based on consideration of the effective dose and EAR of secondary cancer incidence.
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Affiliation(s)
- Yuki Yuasa
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
| | - Takehiro Shiinoki
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
| | - Ryota Onizuka
- Department of Radiological TechnologyYamaguchi University HospitalUbeYamaguchiJapan
| | - Koya Fujimoto
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
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Takahashi W, Nawa K, Haga A, Yamashita H, Imae T, Ogita M, Okuma K, Abe O, Nakagawa K. Acceptable fetal dose using flattening filter-free volumetric arc therapy (FFF VMAT) in postoperative chemoradiotherapy of tongue cancer during pregnancy. Clin Transl Radiat Oncol 2019; 20:9-12. [PMID: 31709307 PMCID: PMC6833340 DOI: 10.1016/j.ctro.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
Optimizing irradiation protocols for pregnant women is challenging, because there are few cases and a dearth of fetal dosimetry data. We cared for a 36-year-old pregnant woman with tongue cancer. Prior to treatment, we compared three intensity-modulated radiation therapy (IMRT) techniques, including helical tomotherapy, volumetric arc therapy (VMAT), and flattening-filter free VMAT (FFF-VMAT) using treatment planning software. FFF-VMAT achieved the minimum fetal exposure and was selected as the optimal modality. We prescribed 66 Gy to the involved nodes, 60 Gy to the tumor bed and ipsilateral neck, and 54 Gy to the contralateral neck over 33 fractions. To confirm the out-of-field exposure per fraction, surface doses and the rectal dose were measured during FFF-VMAT delivery. Postoperative chemoradiotherapy was delivered using IMRT and a cisplatin regimen. Without any shielding, the total fetal dose was 0.03 Gy, within the limits established by the ICRP. A healthy girl was born vaginally at 37 weeks' gestation.
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Affiliation(s)
- Wataru Takahashi
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
- Corresponding author at: Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Kanabu Nawa
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Akihiro Haga
- Department of Medical Image Informatics, Tokushima University, Tokushima, Japan
| | - Hideomi Yamashita
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshikazu Imae
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Mami Ogita
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Kae Okuma
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiichi Nakagawa
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
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11
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Li Y, Ge C, Feng G, Xiao H, Dong J, Zhu C, Jiang M, Cui M, Fan S. Low dose irradiation facilitates hepatocellular carcinoma genesis involving HULC. Mol Carcinog 2018; 57:926-935. [PMID: 29573465 DOI: 10.1002/mc.22813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 12/27/2022]
Abstract
Irradiation exposure positive correlates with tumor formation, such as breast cancer and lung cancer. However, whether low dose irradiation induces hepatocarcinogenesis and the underlying mechanism remain poorly defined. In the present study, we reported that low dose irradiation facilitated the proliferation of hepatocyte through up-regulating HULC in vitro and in vivo. Low dose irradiation exposure elevated HULC expression level in hepatocyte. Deletion of heightened HULC erased the cells growth accelerated following low dose irradiation exposure. CDKN1, the neighbor gene of HULC, was down-regulated by overexpression of HULC following low dose irradiation exposure via complementary base pairing, resulting in promoting cell cycle process. Thus, our findings provide new insights into the mechanism of low dose irradiation-induced hepatocarcinogenesis through HULC/CDKN1 signaling, and shed light on the potential risk of low dose irradiation for the development of hepatocellular carcinoma in pre-clinical settings.
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Affiliation(s)
- Yuan Li
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Chang Ge
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Guoxing Feng
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Huiwen Xiao
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Jiali Dong
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Changchun Zhu
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Mian Jiang
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Ming Cui
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Saijun Fan
- Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
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12
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Lee HF, Lan JH, Chao PJ, Ting HM, Chen HC, Hsu HC, Lee TF. Radiation-induced secondary malignancies for nasopharyngeal carcinoma: a pilot study of patients treated via IMRT or VMAT. Cancer Manag Res 2018; 10:131-141. [PMID: 29403311 PMCID: PMC5783017 DOI: 10.2147/cmar.s145713] [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: 11/23/2022] Open
Abstract
Background Patients treated with radiotherapy are at risk of developing a second cancer during their lifetime, which can directly impact treatment decision-making and patient management. The aim of this study was to qualify and compare the secondary cancer risk (SCR) after intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in nasopharyngeal carcinoma (NPC) patients. Patients and methods We analyzed the treatment plans of a cohort of 10 NPC patients originally treated with IMRT or VMAT. Dose distributions in these plans were used to calculate the organ equivalent dose (OED) with Schneider’s full model. Analyses were applied to the brain stem, spinal cord, oral cavity, pharynx, parotid glands, lung, mandible, healthy tissue, and planning target volume. Results We observed that the OED-based risks of SCR were slightly higher for the oral cavity and mandible when VMAT was used. No significant difference was found in terms of the doses to other organs, including the brain stem, parotids, pharynx, submandibular gland, lung, spinal cord, and healthy tissue. In the NPC cohort, the lungs were the organs that were most sensitive to radiation-induced cancer. Conclusion VMAT afforded superior results in terms of organ-at-risk-sparing compared with IMRT. Most OED-based second cancer risks for various organs were similar when VMAT and IMRT were employed, but the risks for the oral cavity and mandible were slightly higher when VMAT was used.
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Affiliation(s)
- Hsiao-Fei Lee
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, Republic of China.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Jen-Hong Lan
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, Republic of China.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Pei-Ju Chao
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, Republic of China.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Hui-Min Ting
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, Republic of China.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Hui-Chun Chen
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Hsuan-Chih Hsu
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Tsair-Fwu Lee
- Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, Republic of China.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.,Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.,Department of Radiation Oncology, Kaohsiung Yuan's General Hospital, Kaohsiung, Taiwan, Republic of China
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13
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Hodes RJ, Sierra F, Austad SN, Epel E, Neigh GN, Erlandson KM, Schafer MJ, LeBrasseur NK, Wiley C, Campisi J, Sehl ME, Scalia R, Eguchi S, Kasinath BS, Halter JB, Cohen HJ, Demark-Wahnefried W, Ahles TA, Barzilai N, Hurria A, Hunt PW. Disease drivers of aging. Ann N Y Acad Sci 2017; 1386:45-68. [PMID: 27943360 DOI: 10.1111/nyas.13299] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 10/25/2016] [Indexed: 12/14/2022]
Abstract
It has long been known that aging, at both the cellular and organismal levels, contributes to the development and progression of the pathology of many chronic diseases. However, much less research has examined the inverse relationship-the contribution of chronic diseases and their treatments to the progression of aging-related phenotypes. Here, we discuss the impact of three chronic diseases (cancer, HIV/AIDS, and diabetes) and their treatments on aging, putative mechanisms by which these effects are mediated, and the open questions and future research directions required to understand the relationships between these diseases and aging.
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Affiliation(s)
| | | | - Steven N Austad
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | | | | | - Marissa J Schafer
- Robert and Arlene Kogod Center on Aging and Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Nathan K LeBrasseur
- Robert and Arlene Kogod Center on Aging and Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, Minnesota
| | | | - Judith Campisi
- Buck Institute for Research on Aging, Novato, California
| | - Mary E Sehl
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Rosario Scalia
- Department of Physiology and Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Satoru Eguchi
- Department of Physiology and Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Balakuntalam S Kasinath
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center, South Texas Veterans Health Care System, San Antonio, Texas
| | - Jeffrey B Halter
- Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan
| | | | | | - Tim A Ahles
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nir Barzilai
- Institute for Aging Research, Albert Einstein College of Medicine, New York, New York
| | - Arti Hurria
- City of Hope National Medical Center, Duarte, California
| | - Peter W Hunt
- University of California, San Francisco, School of Medicine, San Francisco, California
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14
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Zhang S, Jiang S, Zhang Q, Lin S, Wang R, Zhou X, Zhang G, Lei H, Yu H. Reduction in stray radiation dose using a body-shielding device during external radiation therapy. J Appl Clin Med Phys 2017; 18:206-213. [PMID: 28300368 PMCID: PMC5689945 DOI: 10.1002/acm2.12035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 12/01/2016] [Indexed: 11/08/2022] Open
Abstract
With the purpose of reducing stray radiation dose (SRD) in out-of-field region (OFR) during radiotherapy with 6 MV intensity-modulated radiation therapy (IMRT), a body-shielding device (BSD) was prepared according to the measurements obtained in experimental testing. In experimental testing, optimal shielding conditions, such as 1 mm lead, 2 mm lead, and 1 mm lead plus 10 mm bolus, were investigated along the medial axis of a phantom using thermoluminescent dosimeters (TLDs). The SRDs at distances from field edge were then measured and analyzed for a clinical IMRT treatment plan for nasopharyngeal carcinoma before and after shielding using the BSD. In addition, SRDs in anterior, posterior, left and right directions of phantom were investigated with and without shielding, respectively. Also, the SRD at the bottom of treatment couch was measured. SRD decreased exponentially to a constant value with increasing distance from field edge. The shielding rate was 50%-80%; however, there were no significant differences in SRDs when shielded by 1 mm lead, 2 mm lead, or 1 mm lead plus 10 mm bolus (P>0.05). Importantly, the 10 mm bolus absorbed back-scattering radiation due to the interaction between photons and lead. As a result, 1 mm lead plus 10 mm bolus was selected to prepare the BSD. After shielding with BSD, total SRDs in the OFR decreased to almost 50% of those without shielding when irradiated with IMRT beams. Due to the effects of treatment couch and gantry angle, SRDs at distances were not identical in anterior, posterior, left and right direction of phantom without BSD. As higher dose in anterior and lower dose in posterior, SRDs were substantial similarities after shielding. There was no significant difference in SRDs for left and right directions with or without shielding. Interestingly, SRDs in the four directions were similar after shielding. From these results, the BSD developed in this study may significantly reduce SRD in the OFR during radiotherapy, thus decreasing the risk of secondary cancers.
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Affiliation(s)
- Shuxu Zhang
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Shaohui Jiang
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Quanbin Zhang
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Shengqu Lin
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Ruihao Wang
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Xiang Zhou
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Guoqian Zhang
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Huaiyu Lei
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
| | - Hui Yu
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China
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15
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Hegemann NS, Schlesinger-Raab A, Ganswindt U, Hörl C, Combs SE, Hölzel D, Gschwend JE, Stief C, Belka C, Engel J. Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis. Radiat Oncol 2017; 12:2. [PMID: 28049538 PMCID: PMC5209816 DOI: 10.1186/s13014-016-0738-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 12/06/2016] [Indexed: 12/04/2022] Open
Abstract
Background To investigate the risk of second cancer and radiation induced second cancer following prostate cancer radiotherapy. Methods We compared men with radiotherapy only with those treated with radical prostatectomy only and those with radiotherapy after radical prostatectomy. Cumulative incidences of second cancers were calculated. Cox analyses were performed to identify determinants influencing second cancer incidence. Results Nineteen thousand five hundred thirty eight patients were analyzed. Age and median follow-up differed significantly with radiotherapy only patients having the highest median age (70.3 years) and radical prostatectomy only patients the longest median follow-up (10.2 years). Ten-year cumulative incidence of second cancer was 15.9%, 13.2% and 10.5% for patients with radiotherapy only, radiotherapy after radical prostatectomy and radical prostatectomy only (p <0.0001). Increasing age and belonging to the radiotherapy only group were associated with a higher risk of second cancer—no significant increase was seen in radiotherapy after radical prostatectomy patients. A significantly higher rate of smoking related malignancies, like lung, bladder and non-melanoma skin cancer, was seen in radiotherapy only patients. Conclusions No clear increase in radiation induced second cancer was found in patients after radiotherapy for prostate cancer. Whereas the rate of second cancer was increased in radiotherapy only patients, no such increase was seen in patients with radiotherapy after radical prostatectomy. The increase of second cancer following radiotherapy only is highly likely to reflect advanced age and lifestyle habits and comorbidities.
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Affiliation(s)
- Nina-Sophie Hegemann
- Department of Radiation Oncology, Klinikum der Universität, Ludwig-Maximilians-University, LMU Munich, Marchioninistr 15, 81377, Munich, Germany.
| | - Anne Schlesinger-Raab
- Munich Cancer Registry (MCR) of the Munich Cancer Centre (MCC) at the Department of Medical Informatics, Biometry and Epidemiology (IBE), University of Munich, Marchioninistr 15, 81377, Munich, Germany
| | - Ute Ganswindt
- Department of Radiation Oncology, Klinikum der Universität, Ludwig-Maximilians-University, LMU Munich, Marchioninistr 15, 81377, Munich, Germany
| | - Claudia Hörl
- Department of Radiotherapy, Klinikum Schwabing, Kölner Pl 1, 80804, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technical University (TU), Ismaningerstr 22, 81675, Munich, Germany.,Institute of Innovative Radiotherapy (iRT), Helmholtz Centre, Munich, Germany
| | - Dieter Hölzel
- Munich Cancer Registry (MCR) of the Munich Cancer Centre (MCC) at the Department of Medical Informatics, Biometry and Epidemiology (IBE), University of Munich, Marchioninistr 15, 81377, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum Rechts der Isar, Technical University (TU), Ismaningerstr 22, 81675, Munich, Germany
| | - Christian Stief
- Department of Urology, Klinikum der Universität, Ludwig-Maximilians-University, LMU Munich, Marchioninistr 15, 81377, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, Klinikum der Universität, Ludwig-Maximilians-University, LMU Munich, Marchioninistr 15, 81377, Munich, Germany
| | - Jutta Engel
- Munich Cancer Registry (MCR) of the Munich Cancer Centre (MCC) at the Department of Medical Informatics, Biometry and Epidemiology (IBE), University of Munich, Marchioninistr 15, 81377, Munich, Germany
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16
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Han EY, Paudel N, Sung J, Yoon M, Chung WK, Kim DW. Estimation of the risk of secondary malignancy arising from whole-breast irradiation: comparison of five radiotherapy modalities, including TomoHDA. Oncotarget 2016; 7:22960-9. [PMID: 27027239 PMCID: PMC5008415 DOI: 10.18632/oncotarget.8392] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/18/2016] [Indexed: 12/25/2022] Open
Abstract
The risk of secondary cancer from radiation treatment remains a concern for long-term breast cancer survivors, especially those treated with radiation at the age younger than 45 years. Treatment modalities optimally maximize the dose delivery to the tumor while minimizing radiation doses to neighboring organs, which can lead to secondary cancers. A new TomoTherapy treatment machine, TomoHDATM, can treat an entire breast with two static but intensity-modulated beams in a slice-by-slice fashion. This feature could reduce scattered and leakage radiation doses. We compared the plan quality and lifetime attributable risk (LAR) of a second malignancy among five treatment modalities: three-dimensional conformal radiation therapy, field-in-field forward-planned intensity-modulated radiation therapy, inverse-planned intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy, and TomoDirect mode on the TomoHDA system. Ten breast cancer patients were selected for retrospective analysis. Organ equivalent doses, plan characteristics, and LARs were compared. Out-of-field organ doses were measured with radio-photoluminescence glass dosimeters. Although the IMRT plan provided overall better plan quality, including the lowest probability of pneumonitis, it caused the second highest LAR. The TomoTherapy plan provided plan quality comparable to the IMRT plan and posed the lowest total LAR to neighboring organs. Therefore, it can be a better treatment modality for younger patients who have a longer life expectancy.
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Affiliation(s)
- Eun Young Han
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nava Paudel
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jiwon Sung
- Department of Bio-Convergence Engineering, Korea University, Seoul, Korea
| | - Myonggeun Yoon
- Department of Bio-Convergence Engineering, Korea University, Seoul, Korea
| | - Weon Kuu Chung
- Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dong Wook Kim
- Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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17
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Schneider U, Walsh L. Age at exposure and attained age variations of cancer risk in the Japanese A-bomb and radiotherapy cohorts. Med Phys 2015; 42:4755-61. [DOI: 10.1118/1.4927062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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18
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Zhang H, Patel N, Xiong J, Ding S. Targeting and noninvasive treatment of hepatocellular carcinoma in situ by ZnO nanorod-mediated concurrent chemoradiotherapy. RSC Adv 2015. [DOI: 10.1039/c5ra16880e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
TfR Ab/Dox/ZnO nanocomposites, in which transferrin receptor antibody (TfR Ab) functionalized ZnO nanorods, loaded with doxorubicin (Dox), were prepared to mediate concurrent chemoradiotherapy for the treatment of hepatocellular carcinoma.
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Affiliation(s)
- Haijun Zhang
- Department of Oncology
- Zhongda Hospital
- Medical School
- Southeast University
- Nanjing
| | - Nishant Patel
- Department of Oncology
- Zhongda Hospital
- Medical School
- Southeast University
- Nanjing
| | - Jian Xiong
- Department of Oncology
- Zhongda Hospital
- Medical School
- Southeast University
- Nanjing
| | - Shuang Ding
- Department of Oncology
- Zhongda Hospital
- Medical School
- Southeast University
- Nanjing
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19
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IL-17 induces radiation resistance of B lymphoma cells by suppressing p53 expression and thereby inhibiting irradiation-triggered apoptosis. Cell Mol Immunol 2014; 12:366-72. [PMID: 25544504 DOI: 10.1038/cmi.2014.122] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 11/16/2014] [Accepted: 11/16/2014] [Indexed: 01/12/2023] Open
Abstract
p53 is a well-known tumor suppressor. However, the regulatory mechanism(s) for p53 expression in B lymphoma cells, and the possible role of p53 in the development of the radioresistance in tumor cells are largely unknown. A human B lymphoma cell line, Karpas1106 (k1106), was used as a model of radioresistance. Apoptosis of k1106 cells was determined using flow cytometry. Expression of p53 was assessed using real time RT-PCR and western blotting. The results showed that irradiation at 8 Gy induced apoptosis in up to 40% of k1106 cells. At the same time, the irradiation markedly increased IL-6 production of the k1106 cells. When k1106 cells were cocultured with regulatory T cells (Tregs) and irradiated, the rate of apoptotic k1106 cells was significantly reduced, indicating an acquired resistance to irradiation. IL-6 derived from the irradiation-treated k1106 cells induced IL-17 expression in Tregs. The IL-17(+)Foxp3(+) T cells suppressed p53 expression in k1106 cells. Collectively, irradiated k1106 cells induce the expression of IL-17 in Tregs, which interferes with the expression of p53 protein in k1106 cells and thereby represses irradiation-triggered apoptosis in k1106 cells.
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