1
|
Bourbonne V, Lévy A, Khalifa J, Antoni D, Blais E, Darréon J, Le Péchoux C, Lerouge D, Giraud P, Marguerit A, Pourel N, Riet FG, Thureau S. Radiotherapy in the management of lung oligometastases. Cancer Radiother 2024; 28:36-48. [PMID: 38228422 DOI: 10.1016/j.canrad.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 01/18/2024]
Abstract
In recent years, the development of both medical imaging and new systemic agents (targeted therapy and immunotherapy) have revolutionized the field of oncology, leading to a new entity: oligometastatic disease. Adding local treatment of oligometastases to systemic treatment could lead to prolonged survival with no significant impact on quality of life. Given the high prevalence of lung oligometastases and the new systemic agents coming with increased pulmonary toxicity, this article provides a comprehensive review of the current state-of-art for radiotherapy of lung oligometastases. After reviewing pretreatment workup, the authors define several radiotherapy regimen based on the localization and size of the oligometastases. A comment on the synergistic combination of medical treatment and radiotherapy is also made, projecting on future steps in this specific clinical setting.
Collapse
Affiliation(s)
- V Bourbonne
- Radiation Oncology Department, CHU de Brest, Brest, France; LaTim, Inserm, UMR 1101, université de Bretagne occidentale, Brest, France
| | - A Lévy
- Department of Radiation Oncology, Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - J Khalifa
- Department of Radiation Oncology, institut Claudius-Regaud, institut universitaire du cancer Toulouse-Oncopôle, Toulouse, France
| | - D Antoni
- Department of Radiation Oncology, Institut de cancérologie Strasbourg Europe, Strasbourg, France
| | - E Blais
- Department of Radiation Oncology, polyclinique Marzet, Pau, France
| | - J Darréon
- Department of Radiation Oncology, institut Paoli-Calmettes, Marseille, France
| | - C Le Péchoux
- Department of Radiation Oncology, Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Faculté de médecine, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - D Lerouge
- Department of Radiation Oncology, centre François-Baclesse, Caen, France
| | - P Giraud
- Department of Radiation Oncology, hôpital européen Georges-Pompidou, Paris, France; Université Paris Cité, Paris, France
| | - A Marguerit
- Department of Radiation Oncology, Institut de cancérologie de Montpellier, Montpellier, France
| | - N Pourel
- Department of Radiation Oncology, institut Sainte-Catherine, Avignon, France
| | - F-G Riet
- Department of Radiation Oncology, centre hospitalier privé Saint-Grégoire, 35760 Saint-Grégoire, France
| | - S Thureau
- Radiotherapy Department, centre Henri-Becquerel, Rouen, France; QuantIF-Litis EA4108, université de Rouen, Rouen, France.
| |
Collapse
|
2
|
Shaterabadi D, Zamani Sani M, Rahdan F, Taghizadeh M, Rafiee M, Dorosti N, Dianatinasab A, Taheri-Anganeh M, Asadi P, Khatami SH, Movahedpour A. MicroRNA biosensors in lung cancer. Clin Chim Acta 2024; 552:117676. [PMID: 38007056 DOI: 10.1016/j.cca.2023.117676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Lung cancer has been one of the leading causes of death over the past century. Unfortunately, the reliance on conventional methods to diagnose the phenotypic properties of tumors hinders early-stage cancer diagnosis. However, recent advancements in identifying disease-specific nucleotide biomarkers, particularly microRNAs, have brought us closer to early-stage detection. The roles of miR-155, miR-197, and miR-182 have been established in stage I lung cancer. Recent progress in synthesizing nanomaterials with higher conductivity has enhanced the diagnostic sensitivity of electrochemical biosensors, which can detect low concentrations of targeted biomarkers. Therefore, this review article focuses on exploring electrochemical biosensors based on microRNA in lung cancer.
Collapse
Affiliation(s)
- Donya Shaterabadi
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Zamani Sani
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fereshteh Rahdan
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Taghizadeh
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maedeh Rafiee
- Department of Veterinary Sciences, University of Wyoming, 1174 Snowy Range Road, Laramie, WY 82070, USA
| | - Nafiseh Dorosti
- Department of Medical Nanotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aria Dianatinasab
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mortaza Taheri-Anganeh
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Peyman Asadi
- Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyyed Hossein Khatami
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | |
Collapse
|
3
|
Wu M, Huang Y, Huang X, Wang F, Wei X. Copolymerized carbon nitride nanoparticles for near-infrared II photoacoustic-guided synergistic photothermal/radiotherapy. Front Chem 2023; 11:1124559. [PMID: 36711234 PMCID: PMC9880048 DOI: 10.3389/fchem.2023.1124559] [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: 12/15/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
Nanotheranostic agents that integrate diagnosis and treatment are promising for precision medicine, but they encounter some obstacles such as penetration depth and efficiency. In this study, novel carbon nitride-rose bengal nanoparticles (CN-RB NPs) with a graphite carbon nitride skeleton were synthesized by one-step thermal copolymerization. The enhanced absorption in the near-infrared-II region (NIR-II) endows CN-RB NPs with an excellent photothermal effect under 1064 nm laser irradiation, as well as an obvious photoacoustic signal for imaging in vivo. Interestingly, due to the introduced iodine element, CN-RB NPs exhibit enhanced radiation therapy, indicating that CN-RB NPs can achieve ideal therapeutic outcome through collaborative photothermal/radiation therapy under the guidance of NIR-II photoacoustic imaging. Moreover, CN-RB NPs demonstrate minimal side effects and long-term biological stability after 14 days. Therefore, the proposed new multifunctional nano-platform CN-RB NPs hold great potential in the application of deep therapeutics.
Collapse
Affiliation(s)
- Min Wu
- Department of Plastic and Reconstructive Surgery, School of Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Min Wu, ; Fu Wang, ; Xunbin Wei,
| | - Yuxin Huang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyu Huang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Fu Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Min Wu, ; Fu Wang, ; Xunbin Wei,
| | - Xunbin Wei
- Biomedical Engineering Department, Peking University, Beijing, China,*Correspondence: Min Wu, ; Fu Wang, ; Xunbin Wei,
| |
Collapse
|
4
|
Stereotactic body radiation therapy for metastatic lung metastases. Jpn J Radiol 2022; 40:995-1005. [PMID: 36097233 PMCID: PMC9529709 DOI: 10.1007/s11604-022-01323-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/25/2022] [Indexed: 11/08/2022]
Abstract
Although systemic therapy is standard management for patients with metastatic disease, several recent reports have indicated that an addition of local therapies including stereotactic body radiation therapy (SBRT) for patients with oligometastatic disease (OMD) could improve survival. The lung is the most common site of distant metastasis from many solid tumors, and the strategy of SBRT, such as dose-fraction schedules, timing, etc., would be different depending on the type of primary tumor, location, and patterns of OMD. This review describes the role of SBRT with curative-intent for patients with pulmonary OMD for each of these variables. First, differences according to the type of primary tumor, for which many studies suggest that SBRT-mediated local control (LC) for patients with pulmonary OMD from colorectal cancer (CRC) is less successful than for those from non-CRC tumors. In addition, higher dose-fraction schedules seemed to correlate with higher LC; hence, different SBRT treatment strategies may be needed for patients with pulmonary OMD from CRC relative to other tumors. Second, differences according to location, where the safety of SBRT for peripheral pulmonary tumors has been relatively well established, but safety for central pulmonary tumors including pulmonary OMD is still considered controversial. To determine the optimal dose-fraction schedules, further data from prospective studies are still needed. Third, differences according to the patterns of OMD, the number of metastases and the timing of SBRT whereby 1–5 lesions in most patients and patients with synchronous or metachronous OMD are considered good candidates for SBRT. We conclude that there are still several problems in defining suitable indications for local therapy including SBRT, and that further prospective studies are required to resolve these issues.
Collapse
|
5
|
Nittala MR, Duggar WN, Mundra E, Packianathan S, Smith ML, Woods WC, Otts J, Bhandari R, Allbright R, De Delva PE, Moremen JR, Yang CC, Vijayakumar S. Single Institution Experience of Stereotactic Body Radiation Therapy in Non-small Cell Lung Cancer: Comparison of Two Dose Regimes and a Perspective on Ideal Dose Regimens. Cureus 2021; 13:e18862. [PMID: 34804715 PMCID: PMC8597860 DOI: 10.7759/cureus.18862] [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] [Accepted: 10/18/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Stereotactic body radiation therapy (SBRT) is an effective treatment for early-stage non-small cell lung cancer (NSCLC) patients who are either medically inoperable or who decline surgery. SBRT improves tumor control and overall survival (OS) in medically inoperable, early-stage, NSCLC patients. In this study, we investigated the effectiveness of two different SBRT doses commonly used and present our institutional experience. Purpose To determine the clinical outcomes between two treatment regiments (50 Gray [Gy] vs. 55 Gy in five fractions) among Stage I NSCLC patients treated with SBRT at a state academic medical center. Methods We performed a retrospective analysis of 114 patients with Stage I (T1-2 N0 M0) NSCLC treated at a state academic medical center between October 2009 and April 2019. Survival analyses with treatment regimens of 50 Gy and 55 Gy in five fractions were conducted to detect any improvement in outcomes associated with the higher dose. The primary endpoints of this study included OS, local control (LC), and disease-free survival (DFS). Log-rank test and the Kaplan-Meier method were used to analyze the survival curves of the two treatment doses. The SPSS v.24.0 (IBM Corp., Armonk, NY, USA) was used for statistical analyses. Results The 114 early-stage NSCLC patients (median age, 68 years; range 12 to 87 years) had a median follow-up of 25 months (range two to 86 months). The number of males (n = 72; 63.2 %) exceeded the number of females (n = 42; 36.8 %). The majority of patients in this study were Caucasians (n = 68; 59.6 %) and 46 patients were African Americans (40.4 %). Two-thirds of the patients (n = 76; 66.7 %) were treated with 50 Gy in five fractions, and 38 patients (33.3 %) with 55 Gy in five fractions. The one-, two-, and three-year OS and DFS rates were improved in the patients treated with 55 Gy [OS, 81.7 % vs. 72.8 %; 81.7 % vs. 58.9 %; 81.7 % vs. 46.7 % (p = 0.049)], [DFS, 69.7 % vs. 69.7 %; 61.9 % vs. 55.7 %; 61.9 % vs. 52.0 % (p = 0.842)], compared to those treated with 50 Gy. Adenocarcinoma was the most common histology in both groups (51.3 % and 68.4 %). Failure rates were elevated for the 50 Gy regimen [39 (34.2 %) vs. 12 (8.5 %)]. Three year control rates were (66.3 % vs. 96.6 %; p = 0.002) local control; (63.3 % vs. 94.4 %; p = 0.000) regional control; and (65.7 % vs. 97.1 %; p = 0.000) distant control, compared to those treated with 55 Gy. Conclusion Early-stage NSCLC patients treated with SBRT 55 Gy in five fractions did better in terms of local control, overall survival, and disease-free survival rates compared to the 50 Gy in five fractions group.
Collapse
Affiliation(s)
- Mary R Nittala
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - William N Duggar
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Eswar Mundra
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Satya Packianathan
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Maria L Smith
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - William C Woods
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Jeremy Otts
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Rahul Bhandari
- Radiation Oncology, G.V. (Sonny) Montgomery VA Medical Center, Jackson, USA
| | - Robert Allbright
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | | | - Jacob R Moremen
- Surgery, University of Mississippi Medical Center, Jackson, USA
| | - Claus Chunli Yang
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | | |
Collapse
|
6
|
Gutiérrez E, Sánchez I, Díaz O, Valles A, Balderrama R, Fuentes J, Lara B, Olimón C, Ruiz V, Rodríguez J, Bayardo LH, Chan M, Villafuerte CJ, Padayachee J, Sun A. Current Evidence for Stereotactic Body Radiotherapy in Lung Metastases. ACTA ACUST UNITED AC 2021; 28:2560-2578. [PMID: 34287274 PMCID: PMC8293144 DOI: 10.3390/curroncol28040233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/25/2022]
Abstract
Lung metastases are the second most common malignant neoplasms of the lung. It is estimated that 20–54% of cancer patients have lung metastases at some point during their disease course, and at least 50% of cancer-related deaths occur at this stage. Lung metastases are widely accepted to be oligometastatic when five lesions or less occur separately in up to three organs. Stereotactic body radiation therapy (SBRT) is a noninvasive, safe, and effective treatment for metastatic lung disease in carefully selected patients. There is no current consensus on the ideal dose and fractionation for SBRT in lung metastases, and it is the subject of study in ongoing clinical trials, which examines different locations in the lung (central and peripheral). This review discusses current indications, fractionations, challenges, and technical requirements for lung SBRT.
Collapse
Affiliation(s)
- Enrique Gutiérrez
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Irving Sánchez
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Omar Díaz
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Adrián Valles
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Ricardo Balderrama
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Jesús Fuentes
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Brenda Lara
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Cipatli Olimón
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Víctor Ruiz
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - José Rodríguez
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Luis H. Bayardo
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Matthew Chan
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Conrad J. Villafuerte
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Jerusha Padayachee
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Alexander Sun
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
- Correspondence: ; Tel.: +1-41-6946-2853
| |
Collapse
|
7
|
Abdel‐Salam AG, Mollazehi M, Bandyopadhyay D, Malki AM, Shi Z, Zayed H. Assessment of lung cancer risk factors and mortality in Qatar: A case series study. Cancer Rep (Hoboken) 2021; 4:e1302. [PMID: 33026195 PMCID: PMC7941510 DOI: 10.1002/cnr2.1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The global burden of cancer has exponentially increased over the last few years. In 2018 alone, approximately more than half of the 18.1 million individuals who had cancer succumbed to it. Lung cancer cases and fatalities are particularly on the rise. Therefore, exploring the factors surrounding lung cancer mortality is of utmost importance. AIMS We investigate the clinicopathological and epidemiological characteristics of patients with lung cancer undergoing treatments, and their 5-year survival rates from a case series study in Qatar. METHODS AND RESULTS All patients' data (between January 2010 and December 2014) in this case series study were retrieved from Al-Amal Hospital database. Kaplan-Meier survival plots, life tables and Cox regression were utilized for the statistical analysis. A total of 229 lung cancer patients were included in this study; of which 23.6% are Qatari (40 males and 14 females) and 76.4% non-Qatari (133 males and 42 females). Approximately 57.6% of our patients received at least one type of treatment. We observe a 5-year survival rate of 9.4% in our patient cohort. We also observe other predictive factors, such as distant metastasis (adjusted hazards ratio, HR = 2.414, 95% CI: 1.035-5.632), smoking status (adjusted HR = 3.909, 95% CI: 1.664-9.180) and the treatment history (adjusted HR = 0.432, 95% CI: 0.270-0.691), to be significant. CONCLUSION Lung cancer is a prevalent health condition in Qatar, particularly owing to the rising use of tobacco in the country. The survival rate for lung cancer patients in this country is lower, compared to the global average. Moreover, several factors such as distant metastasis, smoking status, and treatment history are associated with lung cancer survival in Qatar.
Collapse
Affiliation(s)
- Abdel‐Salam G. Abdel‐Salam
- Department of Mathematics, Statistics and PhysicsCollege of Arts and Sciences, Qatar UniversityDohaQatar
| | - Mohammad Mollazehi
- Department of Mathematics, Statistics and PhysicsCollege of Arts and Sciences, Qatar UniversityDohaQatar
| | - Dipankar Bandyopadhyay
- Department of Biostatistics, School of MedicineVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Ahmed M. Malki
- Department of Biomedical SciencesCollege of Health Sciences, QU Health, Qatar UniversityDohaQatar
| | - Zumin Shi
- Human Nutrition DepartmentCollege of Health Sciences, QU Health, Qatar UniversityDohaQatar
| | - Hatem Zayed
- Department of Biomedical SciencesCollege of Health Sciences, QU Health, Qatar UniversityDohaQatar
| |
Collapse
|
8
|
Voruganti IS, Donovan E, Walker-Dilks C, Swaminath A. Chest wall toxicity after stereotactic radiation in early lung cancer: a systematic review. Curr Oncol 2020; 27:179-189. [PMID: 32905234 PMCID: PMC7467794 DOI: 10.3747/co.27.5959] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Radiation-induced chest wall pain (cwp) and rib fracture (rf) are late adverse effects after stereotactic body radiation therapy (sbrt) for stage i non-small-cell lung cancer (nsclc); however, the literature about their incidence and risk factors shows variability. We performed a systematic review to determine the pooled incidence of cwp and rf in the relevant population. Methods A literature search using the prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines considered English publications in medline and embase from January 1996 to August 2017. Abstracts were screened, followed by full-text review and data extraction. Results The database searches identified 547 records. Twenty-eight publications comprising 3892 patients met the inclusion criteria. Median reported ages and follow-up durations fell into the ranges 67-82 years and 12-84 months. Prescriptions fell into the range of 40-70 Gy in 3-10 fractions. Despite study heterogeneity, the pooled incidences of cwp and rf were estimated to be 8.94% and 5.27% respectively. Nineteen studies reported cwp grade: 58 of 308 patients (18.8%) experienced grades 3-4 cwp (no grade 5 events reported). Thirteen studies reported rf grade: grades 3-4 rf were observed in 9 of 113 patients (7.96%). A high chest wall V30 was an important predictor of cwp and rf. Conclusions In patients with stage i nsclc, rates of cwp and rf after sbrt are low; however, tumour location, accurate toxicity reporting, and dose-fractionation schemes might alter those rates. Prospective correlation with dosimetry and quality of life assessment will further improve the understanding of cwp and rf after sbrt.
Collapse
Affiliation(s)
- I S Voruganti
- Department of Radiation Oncology, University of Toronto, Toronto
| | - E Donovan
- Department of Radiation Oncology, University of Toronto, Toronto
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto
| | - C Walker-Dilks
- Program in Evidence-Based Care, McMaster University, Hamilton
| | - A Swaminath
- Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton
- Department of Oncology, McMaster University, Hamilton, ON
| |
Collapse
|
9
|
Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group. J Geriatr Oncol 2020; 11:1190-1198. [PMID: 32709495 PMCID: PMC7365054 DOI: 10.1016/j.jgo.2020.07.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/10/2020] [Indexed: 12/25/2022]
Abstract
The COVID-19 pandemic poses a barrier to equal and evidence-based management of cancer in older adults. The International Society of Geriatric Oncology (SIOG) formed a panel of experts to develop consensus recommendations on the implications of the pandemic on several aspects of cancer care in this age group including geriatric assessment (GA), surgery, radiotherapy, systemic treatment, palliative care and research. Age and cancer diagnosis are significant predictors of adverse outcomes of the COVID-19 infection. In this setting, GA is particularly valuable to drive decision-making. GA may aid estimating physiologic reserve and adaptive capability, assessing risk-benefits of either providing or temporarily withholding treatments, and determining patient preferences to help inform treatment decisions. In a resource-constrained setting, geriatric screening tools may be administered remotely to identify patients requiring comprehensive GA. Tele-health is also crucial to ensure adequate continuity of care and minimize the risk of infection exposure. In general, therapeutic decisions should favor the most effective and least invasive approach with the lowest risk of adverse outcomes. In selected cases, this might require deferring or omitting surgery, radiotherapy or systemic treatments especially where benefits are marginal and alternative safe therapeutic options are available. Ongoing research is necessary to expand knowledge of the management of cancer in older adults. However, the pandemic presents a significant barrier and efforts should be made to ensure equitable access to clinical trials and prospective data collection to elucidate the outcomes of COVID-19 in this population.
Collapse
|
10
|
Kowalchuk RO, Waters MR, Richardson M, Spencer K, Larner JM, Kersh CR. Low-dose hilar and mediastinal stereotactic body radiation therapy for non-small cell lung cancer: Analysis of outcomes in patients receiving one or multiple courses of treatment. Thorac Cancer 2020; 11:2005-2013. [PMID: 32469465 PMCID: PMC7327689 DOI: 10.1111/1759-7714.13501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 12/25/2022] Open
Abstract
Background This study reports the outcomes of a single institutional experience treating non‐small cell lung cancer (NSCLC) involving the pulmonary hilum with low‐dose stereotactic body radiation therapy (SBRT). The authors also present a series of repeat hilar SBRT. Methods Inclusion criteria required treatment with SBRT for NSCLC involving regional lymph nodes of the: (i) hilum, (ii) mediastinum, (iii) aortopulmonary window (station 5), or (iv) mainstem bronchus. At least one clinical follow‐up with imaging was required, unless the patient had a prior documented death from cancer. Results A total of 32 patients with 44 treatments were included, and 37 treatments targeted the hilum directly, with seven concerning the mediastinum, AP window, or mainstem bronchus. Median dose was 28 Gy in four fractions with once‐weekly fractionation. At a median clinical follow‐up of 23 months, local control was 64%. Median overall survival was 24 months, and median progression‐free survival was 15 months. A total of 48% of treatments resulted in complete radiographic response on last imaging follow‐up, and no cases of grade ≥ 3 toxicity were reported. For repeat SBRT (after prior hilar SBRT), local control was 92%. Median overall survival was 20 months, and median progression‐free survival was 19 months. Complete radiographic response was noted after 58% of treatments, with 0 instances of progressive response and no reported side effects. Conclusions Low‐dose hilar SBRT was efficacious and well‐tolerated, with impressive overall survival and no grade ≥ 3 toxicity. Repeat treatments with SBRT were feasible and effective, demonstrating overall survival, local control, and toxicity comparable to primary treatments. Key points
Collapse
Affiliation(s)
- Roman O Kowalchuk
- University of Virginia / Riverside, Radiosurgery Center, Newport News, Virginia, USA
| | - Michael R Waters
- University of Virginia / Riverside, Radiosurgery Center, Newport News, Virginia, USA
| | - Martin Richardson
- University of Virginia / Riverside, Radiosurgery Center, Newport News, Virginia, USA
| | - Kelly Spencer
- University of Virginia / Riverside, Radiosurgery Center, Newport News, Virginia, USA
| | - James M Larner
- University of Virginia, Department of Radiation Oncology, Charlottesville, Virginia, USA
| | - Charles R Kersh
- University of Virginia / Riverside, Radiosurgery Center, Newport News, Virginia, USA
| |
Collapse
|
11
|
Liu Z, Ning Z, Lu H, Cao T, Zhou F, Ye X, Chen C. Long non-coding RNA RFPL3S is a novel prognostic biomarker in lung cancer. Oncol Lett 2020; 20:1270-1280. [PMID: 32724368 PMCID: PMC7377115 DOI: 10.3892/ol.2020.11642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/07/2019] [Indexed: 01/10/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) are functional components of the human genome. Recent studies have demonstrated that lncRNAs play essential roles in tumorigenesis, and are involved in cell proliferation, apoptosis, migration and invasion in several types of tumor, including lung cancer. However, the clinical relevance of lncRNA expression in lung cancer remains unknown. The aim of the present study was to investigate the expression pattern of RFPL3 antisense (RFPL3S) and its associations with clinicopathological characteristics in patients with lung cancer. Whether RFPL3S can act as a potential prognostic biomarker for lung cancer was also investigated. RFPL3S expression in tumor samples and cells was assessed using the Oncomine database and the Cancer Cell Line Encyclopedia, respectively. Based on Kaplan-Meier Plotter analyses, the prognostic values of RFPL3S were further evaluated. It was revealed that RFPL3S was highly expressed in lung cancer tissues when compared with normal tissues and was significantly associated with pN factor, pTNM stage and Ki-67 labeling index. In the survival analyses, increased RFPL3S expression was associated with poor survival and was inversely associated with first progression in all patients. These results indicate that RFPL3S may be of clinical significance and may act as a prognostic biomarker in lung cancer.
Collapse
Affiliation(s)
- Zhonghua Liu
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Zhiqiang Ning
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Hailin Lu
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Tinghua Cao
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| | - Feng Zhou
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Xia Ye
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Chao Chen
- Department of Oncology, Suzhou Ninth People's Hospital, Suzhou, Jiangsu 215200, P.R. China.,Department of Oncology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China
| |
Collapse
|
12
|
Ijsseldijk MA, Shoni M, Siegert C, Wiering B, van Engelenburg AKC, Tsai TC, Ten Broek RPG, Lebenthal A. Oncologic Outcomes of Surgery Versus SBRT for Non-Small-Cell Lung Carcinoma: A Systematic Review and Meta-analysis. Clin Lung Cancer 2020; 22:e235-e292. [PMID: 32912754 DOI: 10.1016/j.cllc.2020.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/21/2020] [Accepted: 04/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The optimal treatment of stage I non-small-cell lung carcinoma is subject to debate. The aim of this study was to compare overall survival and oncologic outcomes of lobar resection (LR), sublobar resection (SR), and stereotactic body radiotherapy (SBRT). METHODS A systematic review and meta-analysis of oncologic outcomes of propensity matched comparative and noncomparative cohort studies was performed. Outcomes of interest were overall survival and disease-free survival. The inverse variance method and the random-effects method for meta-analysis were utilized to assess the pooled estimates. RESULTS A total of 100 studies with patients treated for clinical stage I non-small-cell lung carcinoma were included. Long-term overall and disease-free survival after LR was superior over SBRT in all comparisons, and for most comparisons, SR was superior to SBRT. Noncomparative studies showed superior long-term overall and disease-free survival for both LR and SR over SBRT. Although the papers were heterogeneous and of low quality, results remained essentially the same throughout a large number of stratifications and sensitivity analyses. CONCLUSION Results of this systematic review and meta-analysis showed that LR has superior outcomes compared to SBRT for cI non-small-cell lung carcinoma. New trials are underway evaluating long-term results of SBRT in potentially operable patients.
Collapse
Affiliation(s)
- Michiel A Ijsseldijk
- Division of Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands; Division of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Melina Shoni
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Charles Siegert
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Thoracic Surgery, West Roxbury Veterans Administration, West Roxbury, MA
| | - Bastiaan Wiering
- Division of Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands
| | | | - Thomas C Tsai
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Richard P G Ten Broek
- Division of Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands; Division of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Abraham Lebenthal
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA; Division of Thoracic Surgery, West Roxbury Veterans Administration, West Roxbury, MA; Harvard Medical School, Boston, MA
| |
Collapse
|
13
|
Cooke R, Camilleri P, Chu KY, O'Cathail SM, Robinson M, Van Den Heuvel F, Hawkins MA. Stereotactic body radiotherapy for moderately central and ultra-central oligometastatic disease: Initial outcomes. Tech Innov Patient Support Radiat Oncol 2020; 13:24-30. [PMID: 32128460 PMCID: PMC7042153 DOI: 10.1016/j.tipsro.2020.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/14/2020] [Accepted: 01/17/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Delivery of SBRT to central thoracic tumours within 2 cm of the proximal bronchial tree (PBT), and especially ultra-central tumours which directly abut the PBT, has been controversial due to concerns about high risk of toxicity and treatment-related death when delivering high doses close to critical mediastinal structures. We present dosimetric and clinical outcomes from a group of oligometastatic patients treated with a risk-adapted SBRT approach. METHODS Between September 2015 and October 2018, 27 patients with 28 central thoracic oligometastases (6 moderately central, 22 ultra-central) were treated with 60 Gy in 8 fractions under online CBCT guidance. PTV dose was compromised where necessary to meet mandatory OAR constraints. Patients were followed up for toxicity and disease status. RESULTS Mandatory OAR constraints were met in all cases; this required PTV coverage compromise in 23 cases, with V100% reduced to <70% in 11 cases. No acute or late toxicities of Grade ≥ 3 were reported. One and 2 year in-field control rates were 95.2% and 85.7% respectively, progression-free survival rates were 42.8% and 23.4% respectively, and overall survival rates were 82.7% and 69.5% respectively. No significant differences were seen in control or survival rates by extent of PTV underdosage or between moderately and ultra-central cases. CONCLUSION It appears that compromising PTV coverage to meet OAR constraints allows safe and effective delivery of SBRT to moderately and ultra-central tumours, with low toxicity rates and high in-field control rates. This treatment can be delivered on standard linear accelerators with widely available imaging technology.
Collapse
Affiliation(s)
- Rosie Cooke
- Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
- Oxford University Hospitals NHS FT, Churchill Hospital, Old Road, Oxford OX3 7LE, United Kingdom
| | - Philip Camilleri
- Oxford University Hospitals NHS FT, Churchill Hospital, Old Road, Oxford OX3 7LE, United Kingdom
| | - Kwun-Ye Chu
- Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
- Oxford University Hospitals NHS FT, Churchill Hospital, Old Road, Oxford OX3 7LE, United Kingdom
| | - Séan M. O'Cathail
- Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
| | - Maxwell Robinson
- Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
- Oxford University Hospitals NHS FT, Churchill Hospital, Old Road, Oxford OX3 7LE, United Kingdom
| | - Frank Van Den Heuvel
- Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
- Oxford University Hospitals NHS FT, Churchill Hospital, Old Road, Oxford OX3 7LE, United Kingdom
| | - Maria A. Hawkins
- Medical Physics and Biomedical Engineering, Malet Place Engineering Building, University College London, Gower Street, London WC1E 6BT, United Kingdom
| |
Collapse
|
14
|
Zubair M, Shafiqullah. Measurement of natural radioactivity in several sandy-loamy soil samples from Sijua, Dhanbad, India. Heliyon 2020; 6:e03430. [PMID: 32154406 PMCID: PMC7056655 DOI: 10.1016/j.heliyon.2020.e03430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/31/2019] [Accepted: 02/13/2020] [Indexed: 11/30/2022] Open
Abstract
The activity concentrations of natural radionuclides 226Ra, 232Th and 40K in soil samples collected from Sijua Dhanbad, India were measured by using a gamma-ray spectrometer with a NaI(Tl) detector. The average activity concentration of 226Ra, 232Th, and 40K was found as 60.3, 64.5 and 481.0 Bq . kg - 1 , respectively. Average radium equivalent activity, absorbed dose rate, outdoor dose, external hazard index and internal hazard index for the area under study is determined as 189.5 Bq . kg - 1 , 87.2nGy h - 1 , 0.4, 0.5 and 0.6 mSv . y - 1 , respectively. The annual effective dose to the general public is found 0.4 mSv . y - 1 . This value lies well below the limit of 1 mSv . y - 1 . Measured values have found safe for the environment and public health of the study area.
Collapse
Affiliation(s)
- M. Zubair
- Applied Science Section, Faculty of Engineering and Technology, Aligarh Muslim University, Aligarh, 202002, India
| | | |
Collapse
|
15
|
Singh R, Ansinelli H, Sharma D, Jenkins J, Davis J, Sharma S, Vargo JA. Stereotactic body radiation therapy (SBRT) for metastatic renal cell carcinoma: A multi-institutional experience. JOURNAL OF RADIOSURGERY AND SBRT 2020; 7:29-37. [PMID: 32802576 PMCID: PMC7406342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Examine local control(LC), overall survival(OS), and toxicity following stereotactic body radiation therapy(SBRT) for patients with metastatic renal cell carcinoma(mRCC). Methods: A multi-institutional registry was queried. Potential predictive factors of LC and OS were evaluated with a Cox-proportional hazards model for multivariate analysis(MVA). Results: We identified 115 mRCC patients with 181 lesions. Median biologically effective dose (BED7) was 72.9 Gy7 (range: 42.9-231.4 Gy7) with a median dose/fraction of 10 Gy (range: 5-24 Gy). Utilizing both Karnofsky Performance Score (KPS) and presence of osseous metastatic disease as prognostic indicators, estimated 2-year OS rates were 67.7% (95% CI: 49.9-89.5%), 31.8% (95% CI: 19.0-45.3%), and 20% (95% CI: 1.4-54.7%; p=0.0012). One- and 2-year LC rates were 88.2% and 82.7%, respectively, with no prognostic factors identified. Roughly 13% of patients reported toxicities with one Grade 3-5 toxicity. Conclusion: SBRT was well-tolerated with promising LC. Both KPS and osseous metastatic disease should be considered in determining which patients with mRCC may preferentially benefit from SBRT.
Collapse
Affiliation(s)
- Raj Singh
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, VA 23298, USA
- Department of Radiation Oncology, University of Arizona, Tucson, AZ 85719, USA
- Department of Radiation Oncology, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
- The Radiosurgery Society, Sunnyvale, CA 94402, USA
- Department of Radiation Oncology, St. Mary's Medical Center, Huntington, WV 25701, USA
- Department of Radiation Oncology, University of Pittsburgh Hillman Cancer Center, Pittsburgh, PA 15232, USA
| | - Hayden Ansinelli
- Department of Radiation Oncology, University of Arizona, Tucson, AZ 85719, USA
| | - Dana Sharma
- Department of Radiation Oncology, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
| | - Jan Jenkins
- The Radiosurgery Society, Sunnyvale, CA 94402, USA
| | - Joanne Davis
- The Radiosurgery Society, Sunnyvale, CA 94402, USA
| | - Sanjeev Sharma
- Department of Radiation Oncology, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
- Department of Radiation Oncology, St. Mary's Medical Center, Huntington, WV 25701, USA
| | - John Austin Vargo
- Department of Radiation Oncology, University of Pittsburgh Hillman Cancer Center, Pittsburgh, PA 15232, USA
| |
Collapse
|
16
|
Jiang Z, Chen Y, Zhang Y, Ge Y, Yin FF, Ren L. Augmentation of CBCT Reconstructed From Under-Sampled Projections Using Deep Learning. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:2705-2715. [PMID: 31021791 PMCID: PMC6812588 DOI: 10.1109/tmi.2019.2912791] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Edges tend to be over-smoothed in total variation (TV) regularized under-sampled images. In this paper, symmetric residual convolutional neural network (SR-CNN), a deep learning based model, was proposed to enhance the sharpness of edges and detailed anatomical structures in under-sampled cone-beam computed tomography (CBCT). For training, CBCT images were reconstructed using TV-based method from limited projections simulated from the ground truth CT, and were fed into SR-CNN, which was trained to learn a restoring pattern from under-sampled images to the ground truth. For testing, under-sampled CBCT was reconstructed using TV regularization and was then augmented by SR-CNN. Performance of SR-CNN was evaluated using phantom and patient images of various disease sites acquired at different institutions both qualitatively and quantitatively using structure similarity (SSIM) and peak signal-to-noise ratio (PSNR). SR-CNN substantially enhanced image details in the TV-based CBCT across all experiments. In the patient study using real projections, SR-CNN augmented CBCT images reconstructed from as low as 120 half-fan projections to image quality comparable to the reference fully-sampled FDK reconstruction using 900 projections. In the tumor localization study, improvements in the tumor localization accuracy were made by the SR-CNN augmented images compared with the conventional FDK and TV-based images. SR-CNN demonstrated robustness against noise levels and projection number reductions and generalization for various disease sites and datasets from different institutions. Overall, the SR-CNN-based image augmentation technique was efficient and effective in considerably enhancing edges and anatomical structures in under-sampled 3D/4D-CBCT, which can be very valuable for image-guided radiotherapy.
Collapse
Affiliation(s)
- Zhuoran Jiang
- Department of Radiation Oncology, Duke University Medical Center, DUMC Box 3295, Durham, North Carolina, 27710, USA
- School of Electronic Science and Engineering, Nanjing University, 163 Xianlin Road, Nanjing, Jiangsu, 210046, China
| | - Yingxuan Chen
- Medical Physics Graduate Program, Duke University, 2424 Erwin Road Suite 101, Durham, NC 27705, USA
| | - Yawei Zhang
- Department of Radiation Oncology, Duke University Medical Center, DUMC Box 3295, Durham, North Carolina, 27710, USA
| | - Yun Ge
- School of Electronic Science and Engineering, Nanjing University, 163 Xianlin Road, Nanjing, Jiangsu, 210046, China
| | - Fang-Fang Yin
- Department of Radiation Oncology, Duke University Medical Center, DUMC Box 3295, Durham, North Carolina, 27710, USA
- Medical Physics Graduate Program, Duke University, 2424 Erwin Road Suite 101, Durham, NC 27705, USA
- Medical Physics Graduate Program, Duke Kunshan University, Kunshan, Jiangsu, 215316, China
| | - Lei Ren
- Department of Radiation Oncology, Duke University Medical Center, DUMC Box 3295, Durham, North Carolina, 27710, USA
- Medical Physics Graduate Program, Duke University, 2424 Erwin Road Suite 101, Durham, NC 27705, USA
| |
Collapse
|
17
|
Ashraf MR, Bruza P, Pogue BW, Nelson N, Williams BB, Jarvis LA, Gladstone DJ. Optical imaging provides rapid verification of static small beams, radiosurgery, and VMAT plans with millimeter resolution. Med Phys 2019; 46:5227-5237. [PMID: 31472093 DOI: 10.1002/mp.13797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/09/2019] [Accepted: 08/10/2019] [Indexed: 11/07/2022] Open
Abstract
PURPOSE We demonstrate the feasibility of optical imaging as a quality assurance tool for static small beamlets, and pretreatment verification tool for radiosurgery and volumetric-modulated arc therapy (VMAT) plans. METHODS Small static beams and clinical VMAT plans were simulated in a treatment planning system (TPS) and delivered to a cylindrical tank filled with water-based liquid scintillator. Emission was imaged using a blue-sensitive, intensified CMOS camera time-gated to the linac pulses. For static beams, percentage depth and cross beam profiles of projected intensity distribution were compared to TPS data. Two-dimensional (2D) gamma analysis was performed on all clinical plans, and the technique was tested for sensitivity against common errors (multileaf collimator position, gantry angle) by inducing deliberate errors in the VMAT plans control points. The technique's detection limits for spatial resolution and the smallest number of control points that could be imaged reliably were also tested. The sensitivity to common delivery errors was also compared against a commercial 2.5D diode array dosimeter. RESULTS A spatial resolution of 1 mm was achieved with our imaging setup. The optical projected percentage depth intensity profiles agreed to within 2% relative to the TPS data for small static square beams (5, 10, and 50 mm2 ). For projected cross beam profiles, a gamma pass rate >99% was achieved for a 3%/1 mm criteria. All clinical plans passed the 3%/3 mm criteria with >95% passing rate. A static 5 mm beam with 20 Monitor Units could be measured with an average percent difference of 5.5 ± 3% relative to the TPS. The technique was sensitive to multileaf collimator errors down to 1 mm and gantry angle errors of 1°. CONCLUSIONS Optical imaging provides ample spatial resolution for imaging small beams. The ability to faithfully image down to 20 MU of 5 mm, 6 MV beamlets prove the ability to perform quality assurance for each control point within dynamic plans. The technique is sensitive to small offset errors in gantry angles and multileaf collimator (MLC) leaf positions, and at certain scenario, it exhibits higher sensitivity than a commercial 2.5D diode array.
Collapse
Affiliation(s)
| | - Petr Bruza
- Thayer School of Engineering, Dartmouth College Hanover, Hanover, NH, 03755, USA
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College Hanover, Hanover, NH, 03755, USA.,Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - Nathan Nelson
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - Benjamin B Williams
- Thayer School of Engineering, Dartmouth College Hanover, Hanover, NH, 03755, USA.,Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA.,Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover, Hanover, NH, 03755, USA
| | - Lesley A Jarvis
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA.,Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover, Hanover, NH, 03755, USA
| | - David J Gladstone
- Thayer School of Engineering, Dartmouth College Hanover, Hanover, NH, 03755, USA.,Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA.,Department of Medicine, Geisel School of Medicine, Dartmouth College Hanover, Hanover, NH, 03755, USA
| |
Collapse
|
18
|
Sui C, Song Z, Yu H, Wang H. Prognostic significance of TPX2 and NIBP in esophageal cancer. Oncol Lett 2019; 18:4221-4229. [PMID: 31516617 PMCID: PMC6732995 DOI: 10.3892/ol.2019.10747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/10/2019] [Indexed: 12/17/2022] Open
Abstract
The expression of targeting protein for Xenopus kinesin-like protein 2 (TPX2) and NIK-IKK-β binding protein (NIBP) in patients with esophageal cancer were investigated. A total of 250 samples of cancer tissue and 250 samples of adjacent normal tissue were collected from 250 patients who underwent radical resection of esophageal cancer in Weihai Central Hospital from March 2011 to February 2014. RT-qPCR was used to detect the relative expression of TPX2 and NIBP. The relative expression of TPX2 and NIBP in esophageal cancer tissues was statistically higher than those in adjacent normal tissues (P<0.05). TPX2 and NIBP levels in tumor tissues with lymph node metastasis were significantly higher than those in tissues without lymph node metastasis (P<0.05). There was a significant difference in the relative expression of TPX2 and NIBP in different degrees of infiltration (P<0.05). Tissues with a TPX2 level equal to or higher than the average TPX2 level (1.465) were divided into TPX2 high expression group, while tissues with a TPX2 level below the average were divided into TPX2 low expression group. The 5-year overall survival rate of TPX2 high expression group was significantly lower than that of TPX2 low expression group (P<0.05). Tissues with a NIBP level equal to or higher than the average NIBP level (0.498) were included in the NIBP high expression group, while tissues with a NIBP level below the average were included in the NIBP low expression group. The 5-year overall survival rate of NIBP high expression group was significantly lower than that of NIBP low expression group (P<0.05). TPX2, NIBP, TNM staging, lymph node metastasis, and degree of infiltration were independent prognostic factors affecting overall survival (P<0.05). In conclusion, owing to their high expression in esophageal cancer tissues, TPX2 and NIBP are potentially important biomarkers for the evaluation of TNM stage, metastasis, and prognosis of esophageal cancer.
Collapse
Affiliation(s)
- Chao Sui
- Department of Medical Oncology, Weihai Central Hospital, Weihai, Shandong 264400, P.R. China
| | - Zhifang Song
- Department of Oncology, Weihai Central Hospital, Weihai, Shandong 264400, P.R. China
| | - Huimin Yu
- Department of Medical Oncology, Weihai Central Hospital, Weihai, Shandong 264400, P.R. China
| | - Haiwen Wang
- Department of Thoracic Surgery, Weihai Central Hospital, Weihai, Shandong 264400, P.R. China
| |
Collapse
|
19
|
Khanmohammadi A, Aghaie A, Vahedi E, Qazvini A, Ghanei M, Afkhami A, Hajian A, Bagheri H. Electrochemical biosensors for the detection of lung cancer biomarkers: A review. Talanta 2019; 206:120251. [PMID: 31514848 DOI: 10.1016/j.talanta.2019.120251] [Citation(s) in RCA: 177] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 01/05/2023]
Abstract
Cancer is one of the most widespread challenges and important diseases, which has the highest mortality rate. Lung cancer is the most common type of cancer, so that about 25% of all cancer deaths are related to the lung cancer. The lung cancer is classified as two different types with different treatment methodology: the small cell lung carcinoma and nonsmall cell lung carcinoma are two categories of the lung cancer. Since the lung cancer is often in the latent period in its early stages, therefore, early diagnosis of lung cancer has many challenges. Hence, there is a need for sensitive and reliable tools for preclinical diagnosis of lung cancer. Therefore, many detection methods have been employed for early detection of lung cancer. As lung cancer tumors growth in the body, the cancerous cells release numerous DNA, proteins, and metabolites as special biomarkers of the lung cancer. The levels of these biomarkers show the stages of the lung cancer. Therefore, detection of the biomarkers can be used for screening and clinical diagnosis of the lung cancer. There are numerous biomarkers for the lung cancer such as EGFR, CEA, CYFRA 21-1, ENO1, NSE, CA 19-9, CA 125 and VEGF. Nowadays, electrochemical methods are very attractive and useful in the lung cancer detections. So, in this paper, the recent advances and improvements (2010-2018) in the electrochemical detection of the lung cancer biomarkers have been reviewed.
Collapse
Affiliation(s)
- Akbar Khanmohammadi
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Aghaie
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ensieh Vahedi
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Qazvini
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Afkhami
- Faculty of Chemistry, Bu-Ali Sina University, Hamedan, Iran
| | - Ali Hajian
- Institute of Sensor and Actuator Systems, TU Wien, Vienna, Austria
| | - Hasan Bagheri
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
20
|
Gao K, Tu W, Yu X, Ahmad F, Zhang X, Wu W, An X, Chen X, Li W. W-doped TiO 2 nanoparticles with strong absorption in the NIR-II window for photoacoustic/CT dual-modal imaging and synergistic thermoradiotherapy of tumors. Theranostics 2019; 9:5214-5226. [PMID: 31410211 PMCID: PMC6691582 DOI: 10.7150/thno.33574] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/04/2019] [Indexed: 02/03/2023] Open
Abstract
Multifunctional nanomaterials that have integrated diagnostic and therapeutic functions and low toxicity, and can enhance treatment efficacy through combination therapy have drawn tremendous amounts of attention. Herein, a newly developed multifunctional theranostic agent is reported, which is PEGylated W-doped TiO2 (WTO) nanoparticles (NPs) synthesized via a facile organic route, and the results demonstrated strong absorbance of these WTO NPs in the second near-infrared (NIR-II) window due to successful doping with W. These PEGylated WTO NPs can absorb both NIR-II laser and ionizing radiation, rendering them well suited for dual-modal computed tomography/NIR-II photoacoustic imaging and synergistic NIR-II photothermal/radiotherapy of tumors. In addition, the long-term in vivo studies indicated that these PEGylated WTO NPs had no obvious toxicity on mice in vivo, and they can be cleared after a 30-day period. In summary, this multifunctional theranostic agent can absorb both NIR-II laser and ionizing radiation with negligible toxicity and rapid clearance, therefore it has great promise for applications in imaging and therapeutics in biomedicine.
Collapse
Affiliation(s)
- Ke Gao
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Wenzhi Tu
- The Comprehensive Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Xujiang Yu
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Farooq Ahmad
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Xiannan Zhang
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Weijie Wu
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Xiao An
- The Comprehensive Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Xiaoyuan Chen
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda, Maryland 20892, United States
| | - Wanwan Li
- State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| |
Collapse
|
21
|
Clinical Outcomes Following Stereotactic Body Radiation Therapy (SBRT) for Stage I Medically Inoperable Small Cell Lung Carcinoma. Am J Clin Oncol 2019; 42:602-606. [DOI: 10.1097/coc.0000000000000561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
22
|
Zhang J, Gao Y, Ma C, Wang Y. Murrayanine Induces Cell Cycle Arrest, Oxidative Stress, and Inhibition of Phosphorylated p38 Expression in A549 Lung Adenocarcinoma Cells. Med Sci Monit 2019; 25:2002-2008. [PMID: 30879017 PMCID: PMC6436240 DOI: 10.12659/msm.913873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Murrayanine is a carbazole alkaloid derived from Murraya koenigii, which has been used in traditional Chinese medicine in the treatment of cancer. This study aimed to investigate the effects of murrayanine on human lung adenocarcinoma cells in vitro and to investigate the mechanisms of its action. Material/Methods A549 human lung adenocarcinoma cells and MRC-5 human lung fibroblasts were grown in culture, and an MTT assay determined cell viability. Cells were treated for 24 h with increasing doses of murrayanine (0, 9, 18, and 36 μM). Fluorescence, using 4′, 6-diamidino-2-phenylindole (DAPI), acridine orange, ethidium bromide, and propidium iodide (PI), were used for the detection of apoptosis. The cell cycle was studied with fluorescence-activated cell sorting (FACS), and Western blot evaluated protein expression. Results Murrayanine treatment resulted in significant dose-dependent inhibition of the growth of A549 cells (p<0.05), with an IC50 of 9 μM, and arrested the cells at the G2/M phase of the cell cycle, reduced the expression of cyclin D and E, CDK2, 4, and 6, and increased the expression of p21 and p27. Murrayanine treatment increased apoptosis of the A549 cells and increased cleaved of caspase-3 and caspase-9, and the Bax/Bcl-2 ratio. Murrayanine treatment increased levels of reactive oxygen species (ROS), disrupted the mitochondrial membrane potential, inhibited invasion, and inhibited phosphorylation of p38 mitogen-activated protein kinase (MAPK) of the A549 cells. Conclusions Murrayanine induced cell cycle arrest, oxidative stress, and inhibited the expression of phosphorylated p38 in A549 adenocarcinoma cells.
Collapse
Affiliation(s)
- Jingbao Zhang
- Department of Oncology, Jiaozhou Peoples' Hospital, Qingdao, Shandong, China (mainland)
| | - Yanfei Gao
- Department of Oncology, Jiaozhou Peoples' Hospital, Qingdao, Shandong, China (mainland)
| | - Changbo Ma
- Department of Oncology, Jiaozhou Peoples' Hospital, Qingdao, Shandong, China (mainland)
| | - Yi Wang
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, Shandong, China (mainland)
| |
Collapse
|
23
|
Tabasso AFS, Jones DJL, Jones GDD, Macip S. Radiotherapy-Induced Senescence and its Effects on Responses to Treatment. Clin Oncol (R Coll Radiol) 2019; 31:283-289. [PMID: 30826201 DOI: 10.1016/j.clon.2019.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 12/24/2022]
Abstract
Radiotherapy is still a treatment of choice for many malignancies, often in combination with other strategies. However, its efficacy is limited by the dose that can be safely administered without eliciting serious side-effects, as well as the fact that recurrence is common, particularly in large tumours. Combining radiotherapy with drugs that could sensitise cells to radiation and/or reduce the factors that promote the recovery of the surviving cancer cells is a promising approach. Ionising radiation has been shown to induce senescence and the accumulation of senescent cells creates a microenvironment that facilitates neoplastic growth. This provides a rationale to test the addition of anti-senescent drugs, some of which are already available in the clinic, to radiotherapy protocols. Here, we discuss the relevance of radiotherapy-induced senescent cell accumulation and the potential interventions to minimise its negative effects.
Collapse
Affiliation(s)
- A F S Tabasso
- Leicester Cancer Research Centre, Leicester Royal Infirmary, University of Leicester, Leicester, UK; Mechanisms of Cancer and Ageing Laboratory, Department of Molecular and Cell Biology, University of Leicester, Leicester, UK
| | - D J L Jones
- Leicester Cancer Research Centre, Leicester Royal Infirmary, University of Leicester, Leicester, UK
| | - G D D Jones
- Leicester Cancer Research Centre, Leicester Royal Infirmary, University of Leicester, Leicester, UK
| | - S Macip
- Mechanisms of Cancer and Ageing Laboratory, Department of Molecular and Cell Biology, University of Leicester, Leicester, UK.
| |
Collapse
|
24
|
Sarvizadeh M, Ghasemi F, Tavakoli F, Sadat Khatami S, Razi E, Sharifi H, Biouki NM, Taghizadeh M. Vaccines for colorectal cancer: an update. J Cell Biochem 2018; 120:8815-8828. [PMID: 30536960 DOI: 10.1002/jcb.28179] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 11/12/2018] [Indexed: 12/29/2022]
Abstract
Colorectal cancer (CRC) is known as the third most common and fourth leading cancer associated death worldwide. The occurrence of metastasis has remained as a critical challenge in CRC, so that distant metastasis (mostly to the liver) has been manifested in about 20%-25% of patients. Several screening approaches have introduced for detecting CRC in different stages particularly in early stages. The standard treatments for CRC are surgery, chemotherapy and radiotherapy, in alone or combination. Immunotherapy is a set of novel approaches with the aim of remodeling the immune system battle with metastatic cancer cells, such as immunomodulatory monoclonal antibodies (immune checkpoint inhibitors), adoptive cell transfer (ACT) and cancer vaccine. Cancer vaccines are designed to trigger the intense response of immune system to tumor-specific antigens. In two last decades, introduction of new cancer vaccines and designing several clinical trials with vaccine therapy, have been taken into consideration in colon cancer patients. This review will describe the treatment approaches with the special attention to vaccines applied to treat colorectal cancer.
Collapse
Affiliation(s)
- Mostafa Sarvizadeh
- The Advocate Center for Clinical Research, Ayatollah Yasrebi Hospital, Kashan, Iran
| | - Faezeh Ghasemi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Fatemeh Tavakoli
- Department of Biotechnology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sara Sadat Khatami
- Department of Biotechnology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Ebrahim Razi
- The Advocate Center for Clinical Research, Ayatollah Yasrebi Hospital, Kashan, Iran
| | - Hossein Sharifi
- The Advocate Center for Clinical Research, Ayatollah Yasrebi Hospital, Kashan, Iran
| | - Nousin Moussavi Biouki
- Department of Surgery, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
25
|
Talib WH, Al-Hadid SA, Ali MBW, Al-Yasari IH, Ali MRA. Role of curcumin in regulating p53 in breast cancer: an overview of the mechanism of action. BREAST CANCER (DOVE MEDICAL PRESS) 2018; 10:207-217. [PMID: 30568488 PMCID: PMC6276637 DOI: 10.2147/bctt.s167812] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
p53 is a tumor suppressor gene involved in various cellular mechanisms including DNA repair, apoptosis, and cell cycle arrest. More than 50% of human cancers have a mutated nonfunctional p53. Breast cancer (BC) is one of the main causes of cancer-related deaths among females. p53 mutations in BC are associated with low survival rates and more resistance to the conventional therapies. Thus, targeting p53 activity was suggested as an important strategy in cancer therapy. During the past decades, cancer research was focused on the development of monotargeted anticancer therapies. However, the development of drug resistance by modulation of genes, proteins, and pathways was the main hindrance to the success of such therapies. Curcumin is a natural product, extracted from the roots of Curcuma longa, and possesses various biological effects including anticancer activity. Previous studies proved the ability of curcumin to modulate several signaling pathways and biomolecules in cancer. Safety and cost-effectiveness are additional inevitable advantages of curcumin. This review summarizes the effects of curcumin as a regulator of p53 in BC and the key molecular mechanisms of this regulation.
Collapse
Affiliation(s)
- Wamidh H Talib
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan,
| | - Sonia A Al-Hadid
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan,
| | - Mai B Wild Ali
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan,
| | - Intisar Hadi Al-Yasari
- Food Technology Department, Faculty of Food Science, AL-Qasim Green University, Babylon, Iraq
| | | |
Collapse
|
26
|
Schick P, Gottschlag H, Fielitz O, Budach W, Simiantonakis I. Performance evaluation and first clinical experience with the Varian RGSC module for breath detection of 15 lung cancer patients. Z Med Phys 2018; 29:229-238. [PMID: 30309715 DOI: 10.1016/j.zemedi.2018.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 12/25/2022]
Abstract
The University Hospital of Düsseldorf, Germany (UKD) recently installed the Respiratory Gating for Scanners module (RGSC) (Varian Medical Systems, Palo Alto, USA). The aim of this article is to report on the commissioning and clinical implementation of the RGSC system. The steps encompassed the validation of the manufacturer's specifications including functionality tests using a commercial and in-house developed breathing phantom, to establish calibration procedures, and clinical workflow analysis involving breath acquisition and patient data evaluation. In this context also the RGSC signal without motion was performed to assess the calibration procedure. Reproducibility test were conducted as well with breathing phantoms. Fifteen clinical breath curves were examined in order to assess the impact of treatment related uncertainties such as noises of the CT, patient positioning, movement of the CT table, unintended patient motion. Finally, different binning approaches were assessed and the effect on the CT reconstructions and methodic advantages were investigated. All technical specifications of the manufacturer were confirmed. A baseline drift of 1.83mm of the measured breath curve occurred during longitudinal movement of the CT table. This drift is smaller if the direction of table motion coincides precisely with the level of calibration. If the calibration is carried out on extensions for patient positioning we measured a baseline drift up to 6mm. It was found that especially for a combination of a ceiling mounted IR-camera and amplitude based 4D-CT reconstructions, precise calibration is prerequisite. The evaluations of patient breath curves and corresponding CT reconstructions revealed patient specific aspects and variations, respectively. Consequently patient selection criteria need to be established in parallel with the technical implementation and validation phase of respiratory gating.
Collapse
Affiliation(s)
- Phillip Schick
- Faculty of Physics/Medical Physics, Heinrich-Heine-University Düsseldorf, Germany; Department of Radiotherapy and Radiation Oncology, University Hospital of Düsseldorf, Germany.
| | - Holger Gottschlag
- Department of Radiotherapy and Radiation Oncology, University Hospital of Düsseldorf, Germany.
| | - Oliver Fielitz
- Faculty of Physics/Medical Physics, Heinrich-Heine-University Düsseldorf, Germany; Department of Radiotherapy and Radiation Oncology, University Hospital of Düsseldorf, Germany.
| | - Wilfried Budach
- Department of Radiotherapy and Radiation Oncology, University Hospital of Düsseldorf, Germany.
| | - Ioannis Simiantonakis
- Department of Radiotherapy and Radiation Oncology, University Hospital of Düsseldorf, Germany.
| |
Collapse
|
27
|
Treatment-Related Adverse Effects in Lung Cancer Patients after Stereotactic Ablative Radiation Therapy. JOURNAL OF ONCOLOGY 2018; 2018:6483626. [PMID: 30402100 PMCID: PMC6193322 DOI: 10.1155/2018/6483626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/04/2018] [Indexed: 12/25/2022]
Abstract
Introduction Lung cancer is a disease which, despite the advancements in treatment, still has a very poor 5-year survival rate. Stereotactic ablative radiation therapy (SABR) is a highly advanced, sophisticated, and safe treatment which allows patients with early stage lung cancer to be treated effectively without invasive procedures and with excellent clinical outcomes. Avoiding surgery minimises morbidity and recovery time, bettering patients' quality of life. Furthermore, SABR allows patients unsuitable for surgery to still undergo curative treatment. Methods We aimed to review SABR-related normal tissue toxicities reported in the literature. While many studies assess safety, clinical efficacy, and disease control of SABR for lung cancer, the number of comprehensive reviews that analyse SABR-related side-effects is scarce. This integrative review summarises the toxicities reported in literature based on published clinical trials and tumour location (central or peripheral tumours) for available SABR techniques. Given that the majority of the clinical studies did not report on the statistical significance (e.g., p-values and confidence intervals) of the toxicities experienced by patients, statistical analyses cannot be performed. As a result, adverse events are compiled from clinical reports; however, due to various techniques and nonstandard toxicity reports, no meta-analysis is possible at the current stage of reported data. Results When comparing lobectomy and SABR in phase III trials, surgery resulted in increased procedure-related morbidity. In phase II trials, very few studies showed high grade toxicities/fatalities as a result of SABR for lung cancer. Gross target volume size was a significant predictor of toxicity. An ipsilateral mean lung dose larger than 9 Gy was significantly associated with radiation pneumonitis. Conclusions Based on the studies reviewed SABR is a safe treatment technique for lung cancer; however, further well-designed phase III randomised clinical trials are required to produce timely conclusive results and to enable their comparison and statistical analysis.
Collapse
|
28
|
Chan MKH, Lee VWY, Kadoya N, Chiang CL, Wong MYP, Leung RWK, Cheung S, Blanck O. Single fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors? J Contemp Brachytherapy 2018; 10:446-453. [PMID: 30479622 PMCID: PMC6251454 DOI: 10.5114/jcb.2018.79335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/27/2018] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To provide a pilot dosimetric study of computed tomography (CT)-guided high-dose-rate (HDR) brachytherapy (BRT) and stereotactic body radiotherapy (SBRT) for primary and metastatic lung lesions. MATERIAL AND METHODS For nine lung primary and metastasis patients, 3D image-based BRT plan using a single virtual catheter was planned for 34 Gy in single fraction to the gross tumor volume (GTV) + 3 mm margin to account for tumor deformation. These plans were compared to margin-based (MB-) and robustness optimized (RO-) SBRT, assuming the same tumor deformation under real-time tumor tracking. Consistent dose calculation was ensured for both BRT and SBRT plans using the same class of collapsed cone convolution superposition algorithm. Plan quality metrics were compared by Friedman tests and Wilcoxon t-tests. RESULTS AND CONCLUSIONS Brachytherapy plans showed significant higher GTV mean dose compared to MB- and RO-SBRT (122.2 Gy vs. 50.4 and 44.7 Gy, p < 0.05), and better dose gradient index (R50) = 2.9 vs. 4.3 and 8.4 for MB- and RO-SBRT, respectively. Dose constraints per the RTOG 0915 protocol were achieved for all critical organs except chest wall in BRT. All other dose-volume histograms (DVH) metrics are comparable between BRT and SBRT. Treatment delivery time of BRT and SBRT plans significantly increased and decreased with increasing GTV size, respectively. SBRT using advanced MLC tracking technique and non-coplanar VMAT can achieve comparable dosimetric quality to HDR BRT. Whether or not, the significantly higher GTV dose can increase killing of radioresistant tumor cells and offset the effect of tumor reoxygenation in single fraction BRT, requires further clinical investigation.
Collapse
Affiliation(s)
- Mark KH Chan
- Department of Radiation Oncology, University Schleswig-Holstein, Kiel Campus, Germany
| | - Venus WY Lee
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong (S.A.R)
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Chi-Leung Chiang
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong (S.A.R)
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Hong Kong (S.A.R)
| | - Matthew YP Wong
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong (S.A.R)
| | - Ronnie WK Leung
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong (S.A.R)
| | - Steven Cheung
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong (S.A.R)
| | - Oliver Blanck
- Department of Radiation Oncology, University Schleswig-Holstein, Kiel Campus, Germany
| |
Collapse
|
29
|
Stereotactic Body Radiation Therapy for Central Early-Stage NSCLC: Results of a Prospective Phase I/II Trial. J Thorac Oncol 2018; 13:1727-1732. [PMID: 30056162 DOI: 10.1016/j.jtho.2018.07.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/15/2018] [Accepted: 07/19/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We report results from a prospective phase I/II trial for patients with centrally located, early-stage NSCLC receiving stereotactic body radiation therapy. METHODS Eligible patients were medically inoperable with biopsy-proven NSCLC within 2 cm of the proximal bronchial tree or 5 mm of the mediastinal pleura or parietal pericardium. Phase I had four dose levels using 5 fractions: 9, 10, 11, and 12 Gy per fraction. The primary phase II objective was to determine if the maximum tolerated dose in phase I achieved local control greater than 80% at 2 years. RESULTS Seventy-four patients were enrolled; 23 to phase I and 51 to phase II. Two phase I patients treated with 10 Gy × 5 fractions developed unrelated acute grade 3 lung toxicities which resolved. The phase II dose level selected was 11 Gy × 5 fractions. The median follow-up for living phase II patients was 27 months (range, 9 to 58 months). Two-year local control using 11 Gy × 5 fractions was 85% (95% confidence interval [CI]: 62%-95%). Two-year overall survival was 43% (95% CI: 28%-57%). Three patients (6%, 95% CI: 1%-17%) experienced acute grade 3 and 4 cardiac or pulmonary toxicities. Of the 41 patients evaluable for late cardiac and pulmonary toxicity, 11 (27%, 95% CI: 14%-43%) developed grade 3, 5 (12%, 95% CI: 4%-26%) developed grade 4, and 1 (4%, 95% CI: 0%-13%) died of grade 5 toxicity. CONCLUSION Stereotactic body radiation therapy for central NSCLC using 11 Gy × 5 fractions is tolerable and has excellent local control, but is associated severe late toxicity in some patients.
Collapse
|
30
|
Wan Y, Huang J, Xu F. [Stereotactic Body Radiotherapy for Centrally Located Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:413-418. [PMID: 29764593 PMCID: PMC5999925 DOI: 10.3779/j.issn.1009-3419.2018.05.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A few study has proven that about 90% of local control rates might be benefit from stereotactic body radiotherapy (SBRT) for patients with medically inoperable stage I non-small cell lung cancer (NSCLC), it is reported SBRT associated overall survival and tumor specific survival is comparable with those treated with surgery. SBRT has been accepted as the first line treatment for inoperable patients with peripheral located stage I NSCLC. However, the role of SBRT in centrally located lesions is controversial for potential toxic effects from the adjacent anatomical structure. This paper will review the definition, indication, dose regimens, dose-volume constraints for organs at risk, radiation technology, treatment side effect of centrally located NSCLC treated with SBRT and stereotactic body proton therapy.
Collapse
Affiliation(s)
- Yuming Wan
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jing Huang
- Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Feng Xu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
31
|
Donovan EK, Swaminath A. Stereotactic body radiation therapy (SBRT) in the management of non-small-cell lung cancer: Clinical impact and patient perspectives. LUNG CANCER-TARGETS AND THERAPY 2018; 9:13-23. [PMID: 29588624 PMCID: PMC5859907 DOI: 10.2147/lctt.s129833] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Stereotactic body radiation therapy (SBRT) has emerged as a new technology in radiotherapy delivery, allowing for potentially curative treatment in many patients previously felt not to be candidates for radical surgical resection of stage I non-small-cell lung cancer (NSCLC). Several studies have demonstrated very high local control rates using SBRT, and more recent data have suggested overall survival may approach that of surgery in operable patients. However, SBRT is not without unique toxicities, and the balance of toxicity, and effect on patient-reported quality of life need to be considered with respect to oncologic outcomes. We therefore aim to review SBRT in the context of important patient-related factors, including quality of life in several domains (and in comparison to other therapies such as conventional radiation, surgery, or no treatment). We will also describe scenarios in which SBRT may be reasonably offered (i.e. elderly patients and those with severe COPD), and where it may need to be approached with some caution due to increased risks of toxicity (i.e. tumor location, patients with interstitial lung disease). In total, we hope to characterize the physical, emotional, and functional consequences of SBRT, in relation to other management strategies, in order to aid the clinician in deciding whether SBRT is the optimal treatment choice for each patient with early stage NSCLC.
Collapse
Affiliation(s)
- Elysia K Donovan
- Department of Oncology, McMaster University, Hamilton, ON, Canada.,Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, ON, Canada
| | - Anand Swaminath
- Department of Oncology, McMaster University, Hamilton, ON, Canada.,Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, ON, Canada
| |
Collapse
|
32
|
Seides BJ, Egan JP, French KD, Kovitz KL, Desai NR. Fiducial marker placement for stereotactic body radiation therapy via convex probe endobronchial ultrasound: a case series and review of literature. J Thorac Dis 2018; 10:1972-1983. [PMID: 29707354 DOI: 10.21037/jtd.2018.03.49] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Convex probe endobronchial ultrasound (CP-EBUS) and stereotactic body radiotherapy (SBRT) are valuable tools in the diagnosis, staging, and treatment of thoracic malignancies. With widespread clinical adoption, novel uses of CP-EBUS beyond mediastinal diagnosis and staging continue to be discovered. SBRT is an attractive treatment strategy in early-stage lung cancer and oligo-metastatic disease of the chest when a surgical approach is either not feasible or desirable. Accurate application of SBRT is aided by the placement of radio-opaque fiducial markers (FM) to compensate for respiratory cycle movements. We describe eight patients with central thoracic lesions, either known or suspected to be malignant, who underwent EBUS bronchoscopy with lesion sampling and successful intralesional placement of modified FM via our technique, review the existing literature on this topic, and discuss the nuances of coding and billing aspects of FM placement.
Collapse
Affiliation(s)
- Benjamin J Seides
- Division of Pulmonary, Critical Care, and Allergy, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - John P Egan
- Chicago Chest Center, Chicago, IL, USA.,Suburban Lung Associates, Chicago, IL, USA.,Section of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL, USA
| | - Kim D French
- Chicago Chest Center, Chicago, IL, USA.,Suburban Lung Associates, Chicago, IL, USA
| | - Kevin L Kovitz
- Chicago Chest Center, Chicago, IL, USA.,Suburban Lung Associates, Chicago, IL, USA.,Section of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL, USA
| | - Neeraj R Desai
- Chicago Chest Center, Chicago, IL, USA.,Suburban Lung Associates, Chicago, IL, USA.,Section of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
33
|
Stereotactic Body Radiotherapy (SBRT) for liver metastasis - clinical outcomes from the international multi-institutional RSSearch® Patient Registry. Radiat Oncol 2018; 13:26. [PMID: 29439707 PMCID: PMC5811977 DOI: 10.1186/s13014-018-0969-2] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/02/2018] [Indexed: 02/07/2023] Open
Abstract
Background Stereotactic body radiotherapy (SBRT) is an emerging treatment option for liver metastases in patients unsuitable for surgery. We investigated factors associated with clinical outcomes for liver metastases treated with SBRT from a multi-center, international patient registry. Methods Patients with liver metastases treated with SBRT were identified in the RSSearch® Patient Registry. Patient, tumor and treatment characteristics associated with treatment outcomes were assessed. Dose fractionations were normalized to BED10. Overall survival (OS) and local control (LC) were evaluated using Kaplan Meier analysis and log-rank test. Results The study included 427 patients with 568 liver metastases from 25 academic and community-based centers. Median age was 67 years (31–91 years). Colorectal adenocarcinoma (CRC) was the most common primary cancer. 73% of patients received prior chemotherapy. Median tumor volume was 40 cm3 (1.6–877 cm3), median SBRT dose was 45 Gy (12–60 Gy) delivered in a median of 3 fractions [1–5]. At a median follow-up of 14 months (1–91 months) the median overall survival (OS) was 22 months. Median OS was greater for patients with CRC (27 mo), breast (21 mo) and gynecological (25 mo) metastases compared to lung (10 mo), other gastro-intestinal (GI) (18 mo) and pancreatic (6 mo) primaries (p < 0.0001). Smaller tumor volumes (< 40 cm3) correlated with improved OS (25 months vs 15 months p = 0.0014). BED10 ≥ 100 Gy was also associated with improved OS (27 months vs 15 months p < 0.0001). Local control (LC) was evaluable in 430 liver metastases from 324 patients. Two-year LC rates was better for BED10 ≥ 100 Gy (77.2% vs 59.6%) and the median LC was better for tumors < 40 cm3 (52 vs 39 months). There was no difference in LC based on histology of the primary tumor. Conclusions In a large, multi-institutional series of patients with liver metastasis treated with SBRT, reasonable LC and OS was observed. OS and LC depended on dose and tumor volume, while OS varied by primary tumor. Future prospective trials on the role of SBRT for liver metastasis from different primaries in the setting of multidisciplinary management including systemic therapy, is warranted. Trial registration Clinicaltrials.gov: NCT01885299.
Collapse
|
34
|
Tandberg DJ, Tong BC, Ackerson BG, Kelsey CR. Surgery versus stereotactic body radiation therapy for stage I non-small cell lung cancer: A comprehensive review. Cancer 2017; 124:667-678. [PMID: 29266226 DOI: 10.1002/cncr.31196] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/10/2017] [Accepted: 11/18/2017] [Indexed: 12/14/2022]
Abstract
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in the United States. With the implementation of lung cancer screening, the number and proportion of patients diagnosed with early-stage disease are anticipated to increase. Surgery is currently the standard of care for patients with operable stage I NSCLC. However, promising outcomes with stereotactic body radiation therapy (SBRT) in patients with inoperable disease has led to interest in directly comparing SBRT and surgery in operable patients. Unfortunately, early randomized trials comparing surgery and SBRT closed early because of poor accrual. In this article, the nuances of surgery and SBRT for early-stage NSCLC are reviewed. Furthermore, retrospective and prospective analyses of SBRT in early-stage NSCLC are discussed, and active randomized trials comparing these 2 approaches are described. Cancer 2018;124:667-78. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Daniel J Tandberg
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Betty C Tong
- Division of Cardiothoracic Surgery, Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Bradley G Ackerson
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Chris R Kelsey
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| |
Collapse
|
35
|
Dosimetric comparison of CT-guided iodine-125 seed stereotactic brachytherapy and stereotactic body radiation therapy in the treatment of NSCLC. PLoS One 2017; 12:e0187390. [PMID: 29121047 PMCID: PMC5679513 DOI: 10.1371/journal.pone.0187390] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 10/19/2017] [Indexed: 12/25/2022] Open
Abstract
This study aimed to assess the dosimetric differences between iodine-125 seed stereotactic brachytherapy (SBT) and stereotactic body radiation therapy (SBRT) in the treatment of non-small cell lung cancer (NSCLC). An SBT plan and an SBRT plan were generated for eleven patients with T1-2 NSCLC. Prescription of the dose and fractionation (fr) for SBRT was 48Gy/4fr. The planning aim for SBT was D90 (dose delivered to 90% of the target volume)≥120Gy. Student’s paired t test was used to compare the dosimetric parameters. The SBT and SBRT plans had comparable PTV D90 (104.73±2.10Gyvs.107.64±2.29Gy), and similar mean volume receiving 100% of the prescription dose (V100%) (91.65% vs.92.44%, p = 0.410). The mean volume receiving 150% of the prescribed dose (V150%) for SBT was 64.71%, whereas it was 0% for SBRT. Mean heterogeneity index (HI) deviation for SBT vs. SBRT was 0.73 vs. 0.19 (p<0.0001), and the mean conformity index (CI) for SBT vs. SBRT was 0.77 vs. 0.81 (p = 0.031). The mean lung doses (MLD) in SBT were significantly lower than those in SBRT (1.952±0.713 vs. 5.618±2.009, p<0.0001). In conclusion, compared with SBRT, SBT can generate a comparable dose within PTV, while the organs at risk (OARs) only receive a very low dose. But the HI and CI in SBT were lower than in SBRT.
Collapse
|
36
|
Wong OY, Yau V, Kang J, Glick D, Lindsay P, Le LW, Sun A, Bezjak A, Cho BCJ, Hope A, Giuliani M. Survival Impact of Cardiac Dose Following Lung Stereotactic Body Radiotherapy. Clin Lung Cancer 2017; 19:e241-e246. [PMID: 28941961 DOI: 10.1016/j.cllc.2017.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/09/2017] [Accepted: 08/18/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the impact of radiation dose to substructures of the heart in lung stereotactic body radiotherapy (SBRT) patients on non-cancer-related deaths. METHODS Patients treated with lung SBRT at a single institution from 2005 to 2013 were included. The heart and its substructures were contoured, and dose was calculated including mean, max, and max 10 cc dose. Clinical variables including stage, histology, age, gender, Charlson comorbidity index (CCI), preexisting cardiac disease, pulmonary function (forced expiratory volume in 1 second, diffusion capacity), and smoking status were explored for association with non-cancer-related deaths in univariable (UVA) and multivariable (MVA) analyses. Heart dosimetric parameters were correlated with the risk of radiation pneumonitis (RP) using UVA and MVA. RESULTS A total of 189 patients were included with median age of 76 years (range, 48-93 years). Of these patients, 45.5% were female, 27.5% were T2, 16.9% were current smokers, 64% had preexisting cardiac risk factors, and 34.5% had CCI score of ≥ 3. Mean lung dose ± SD was 456 ± 231 cGy. Heart max, mean, and 10 cc doses were 1867 ± 1712 cGy, 265 ± 269 cGy, and 1150 ± 1075 cGy, respectively. There were 14 (7.4%) ≥ Grade 2 RP and 3 (1.6%) were ≥ Grade 3. The median overall survival was 37.3 months (95% confidence interval, 29.8-45.3 months). On UVA, female gender (P < .01), higher Eastern Cooperative Oncology Group (P = .01), cardiac risk (P < .01), CCI (P < .01), and bilateral ventricles max dose (P = .02) were associated with non-cancer-related deaths; on MVA, bilateral ventricles max dose was significant (P = .05). No heart parameters were associated with RP. CONCLUSIONS Higher bilateral ventricles max dose is associated with poorer survival. Heart dose parameters should be considered when planning patients for SBRT.
Collapse
Affiliation(s)
- Olive Y Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Vivian Yau
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Julie Kang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Daniel Glick
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Patricia Lindsay
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Lisa W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Alexander Sun
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Bezjak
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - B C John Cho
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Hope
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Meredith Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
37
|
Patrini D, Panagiotopoulos N, Lawrence D, Scarci M. Surgical management of lung metastases. Br J Hosp Med (Lond) 2017; 78:192-198. [PMID: 28398890 DOI: 10.12968/hmed.2017.78.4.192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Management of pulmonary metastases has evolved considerably over the last few decades but is still controversial. The surgical management of lung metastases is outlined, discussing the preoperative management, indications for surgery, the surgical approach and outcomes according to the primary histology.
Collapse
Affiliation(s)
- Davide Patrini
- Senior Registrar in Thoracic Surgery, Thoracic Surgery Department, University College London Hospitals, London W1G 8PH
| | - Nikolaos Panagiotopoulos
- Consultant Thoracic Surgeon, Thoracic Surgery Department, University College London Hospitals, London
| | - David Lawrence
- Consultant Cardiothoracic Surgeon, Thoracic Surgery Department, University College London Hospitals, London
| | - Marco Scarci
- Consultant Thoracic Surgeon, Thoracic Surgery Department, University College London Hospitals, London
| |
Collapse
|
38
|
Jumeau R, Filion É, Bahig H, Vu T, Lambert L, Roberge D, Doucet R, Campeau MP. A dosimetric parameter to limit chest wall toxicity in SABR of NSCLC. Br J Radiol 2017; 90:20170196. [PMID: 28590814 DOI: 10.1259/bjr.20170196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Chest wall (CW) toxicity (rib fracture and/or pain) is a recognized complication of stereotactic ablative radiotherapy (SABR) for non-small-cell lung cancer. The aim of this study was to evaluate the frequency of CW toxicity following SABR and to propose a new dosimetric parameter. METHODS We reviewed the charts and SABR plans from patients treated for T1-T2N0 peripheral non-small-cell lung cancer between 2009 and 2015. The CW structure was created through a 3-cm expansion of the lung. The median dose delivered to the planning target volume was 60 Gy. SABR was delivered in three fractions for patients with CW V30 < 30 cm3. If the CW V30 exceeded 30 cm3, five fractions were used, and the plan was optimized based on CW V37 (biologically equivalent to the V30 of three-fraction plans). RESULTS In 6 years, 361 lesions from 356 patients were treated (3 fractions: 297; 5 fractions: 64). The median follow-up was 16 months. 23 patients (6.5%) developed CW toxicity after a median time of 10 months following treatment. The mean CW V30/V37 was 21 cm3 for patients with CW toxicity and 17 cm3 for patients without toxicity (p < 0.05). The 2-year local control and the CW toxicity rates were similar, whether patients received three or five fractions (97% vs 96% and 7% vs 5%). CONCLUSION When the CW V30 is >30 cm3, altered fractionation combined with V37 optimization can limit CW toxicity. Advances in knowledge: The CW V37 is a suggested dosimetric parameter adapted to fractionation that may potentially limit CW toxicity after lung SABR.
Collapse
Affiliation(s)
- Raphaël Jumeau
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Édith Filion
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Houda Bahig
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Toni Vu
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Louise Lambert
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - David Roberge
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Robert Doucet
- 2 Department of Radiation Physics, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Campeau
- 1 Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
39
|
Singh R, Ansinelli H, Sharma S. Clinical outcomes following stereotactic body radiation therapy (SBRT) for non-resectable pancreatic adenocarcinoma. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s13566-017-0313-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
40
|
Iwata H, Ishikura S, Murai T, Iwabuchi M, Inoue M, Tatewaki K, Ohta S, Yokota N, Shibamoto Y. A phase I/II study on stereotactic body radiotherapy with real-time tumor tracking using CyberKnife based on the Monte Carlo algorithm for lung tumors. Int J Clin Oncol 2017; 22:706-714. [DOI: 10.1007/s10147-017-1123-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/05/2017] [Indexed: 12/25/2022]
|
41
|
Klement RJ. Radiobiological parameters of liver and lung metastases derived from tumor control data of 3719 metastases. Radiother Oncol 2017; 123:218-226. [PMID: 28363484 DOI: 10.1016/j.radonc.2017.03.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/13/2017] [Accepted: 03/13/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE The radiobiological parameters for liver and lung metastases treated with stereotactic body radiation therapy (SBRT) are poorly defined. This project aimed at estimating these parameters from published tumor control probability (TCP) data, and separately for metastases with colorectal cancer (CRC) and non-CRC histology. MATERIALS AND METHODS A total of 62 studies with 89 different treatment prescriptions for a total of 3719 metastases were analyzed in a Bayesian framework using four different radiobiological models: The LQ, mLQ, LQ-L and the regrowth model which accounts for tumor regrowth after SBRT. RESULTS Depending on the particular model, α/β ratios in the range 13-23Gy for pulmonary metastases and 16-28Gy for hepatic metastases were estimated. For CRC metastases the estimated α/β ratio was 43.1±4.7Gy compared to 21.6±7.8Gy for non-CRC metastases. Typical isocenter dose prescriptions of 3×12Gy, 3×14.5Gy and 3×17Gy applied within 5days were predicted sufficient to control 90% of lung, liver and CRC metastases after 1yr, respectively. CONCLUSIONS α/β ratios for liver and lung metastases are higher than the usually assumed 10Gy. Differences between CRC and non-CRC histology were found. Future studies confirming these findings in individual patient data are needed.
Collapse
Affiliation(s)
- Rainer J Klement
- Department of Radiotherapy and Radiation Oncology, Leopoldina Hospital, Schweinfurt, Germany.
| |
Collapse
|
42
|
Siva S, Slotman BJ. Stereotactic Ablative Body Radiotherapy for Lung Metastases: Where is the Evidence and What are We Doing With It? Semin Radiat Oncol 2017; 27:229-239. [PMID: 28577830 DOI: 10.1016/j.semradonc.2017.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review provides an overview of the use of stereotactic ablative body radiotherapy (SABR) for pulmonary metastases. The local control rates after SABR are generally >90%. Whether this also translates into a significant improvement in overall survival is the subject of ongoing studies. New exciting opportunities including the integration of SABR with targeted and immune therapies as well as some competing treatment strategies are discussed.
Collapse
Affiliation(s)
- Shankar Siva
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - Ben J Slotman
- Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|
43
|
Ricco A, Davis J, Rate W, Yang J, Perry D, Pablo J, D'Ambrosio D, Sharma S, Sundararaman S, Kolker J, Creach KM, Lanciano R. Lung metastases treated with stereotactic body radiotherapy: the RSSearch® patient Registry's experience. Radiat Oncol 2017; 12:35. [PMID: 28143558 PMCID: PMC5286804 DOI: 10.1186/s13014-017-0773-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 01/24/2017] [Indexed: 01/07/2023] Open
Abstract
Objectives To report overall survival and local control for patients identified in the RSSearch® Patient Registry with metastatic cancer to the lung treated with SBRT. Methods Seven hundred two patients were identified with lung metastases in the RSSearch® Registry. Of these patients, 577 patients had SBRT dose and fractionation information available. Patients were excluded if they received prior surgery, radiation, or radiofrequency ablation to the SBRT treated area. Between April 2004-July 2015, 447 patients treated with SBRT at 30 academic and community-based centers were evaluable for overall survival (OS). Three hundred four patients with 327 lesions were evaluable for local control (LC). All doses were converted to Monte Carlo equivalents and subsequent BED Gy10 for dose response analysis. Results Median age was 69 years (range, 18–93 years). Median Karnofsky performance status (KPS) was 90 (range 25/75% 80–100). 49.2% of patients had prior systemic therapy. Median metastasis volume was 10.58 cc (range 25/75% 3.7–25.54 cc). Site of primary tumor included colorectal (25.7%), lung (16.6%), head and neck (11.4%), breast (9.2%), kidney (8.1%), skin (6.5%) and other (22.1%). Median dose was 50 Gy (range 25/75% 48–54) delivered in 3 fractions (range 25/75% 3–5) with a median BED of 100Gy10 (range 25/75% 81–136). Median OS for the entire group was 26 months, with actuarial 1-, 3-, and 5-year OS of 74.1%, 33.3, and 21.8%, respectively. Patients with head and neck and breast cancers had longer median OS of 37 and 32 months respectively, compared to colorectal (30 months) and lung (26 months) which corresponded to 3-year actuarial OS of 51.8 and 47.9% for head and neck and breast respectively, compared to 35.8% for colorectal and 31.2% for lung. The median LC for all patients was 53 months, with actuarial 1-, 3-, and 5-year LC rates of 80.4, 58.9, and 46.3%, respectively. There was no difference in LC by primary histologic type (p = 0.49). Improved LC was observed for lung metastases that received SBRT doses of BED ≥100Gy10 with 3-year LC rate of 77.1% compared to 45% for lung metastases treated with BED < 100Gy10 (p = 0.01). Smaller tumor volumes (<11 cc) had improved LC compared to tumor volumes > 11 cc. (p = 0.005) Two-year LC rates for tumor volumes < 11 cc, 11–27 cc and > 27 cc were 72.9, 64.2 and 45.6%, respectively. This correlated with improved OS with 2-year OS rates of 62.4, 60.9 and 46.2% for tumor volumes < 11 cc, 11–27 cc and > 27 cc, respectively (p = 0.0023). In a subset of patients who received BED ≥100Gy10, 2-year LC rates for tumor volumes < 11 cc, 11–27 cc and > 27 cc were 82.8, 58.9 and 68.6%, respectively (p = 0.0244), and 2-year OS rates were 66.0, 58.8 and 28.5%, respectively (p = 0.0081). Conclusion Excellent OS and LC is achievable with SBRT utilizing BED ≥100Gy10 for lung metastases according to the RSSearch® Registry data. Patients with small lung metastases (volumes < 11 cc) had better LC and OS when using SBRT doses of BED ≥100Gy10. Further studies to evaluate a difference, if any, between various tumor types will require a larger number of patients.
Collapse
Affiliation(s)
- Anthony Ricco
- Crozer-Keystone Health System, Philadelphia CyberKnife, Havertown, PA, USA
| | | | - William Rate
- Crozer-Keystone Health System, Philadelphia CyberKnife, Havertown, PA, USA
| | - Jun Yang
- Crozer-Keystone Health System, Philadelphia CyberKnife, Havertown, PA, USA
| | - David Perry
- MedStar Franklin Square Medical Center, Baltimore, MD, USA
| | - John Pablo
- St. Joseph's/Chandler Savannah Hospital, Savannah, GA, USA
| | | | | | | | - James Kolker
- Pennsylvania Hospital of University of Pennsylvania, Philadelphia, PA, USA
| | | | - Rachelle Lanciano
- Crozer-Keystone Health System, Philadelphia CyberKnife, Havertown, PA, USA.
| |
Collapse
|
44
|
Song JH, Kang KM, Choi HS, Jeong H, Ha IB, Lee JD, Kim HC, Jeong YY, Cho YJ, Lee SJ, Kim SH, Jang IS, Jeong BK. Comparing the clinical outcomes in stereotactic body radiotherapy for lung tumors between Ray-Tracing and Monte-Carlo algorithms. Oncotarget 2017; 7:19045-53. [PMID: 26544622 PMCID: PMC4951350 DOI: 10.18632/oncotarget.5992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 10/13/2015] [Indexed: 12/25/2022] Open
Abstract
Purpose The purpose of this study was to compare the clinical outcomes between the groups using Ray-Tracing (RAT) and Monte-Carlo (MC) calculation algorithms for stereotactic body radiotherapy (SBRT) of lung tumors. Materials and Methods Thirty-five patients received SBRT with CyberKnife for 47 primary or metastatic lung tumors. RAT was used for 22 targets in 12 patients, and MC for 25 targets in 23 patients. Total dose of 48 to 60 Gy was prescribed in 3 to 5 fractions on median 80% isodose line. The response rate, local control rate, and toxicities were compared between RAT and MC groups. Results The response rate was lower in the RAT group (77.3%) compared to the MC group (100%) (p = 0.008). The response rates showed an association with the mean dose to the gross tumor volume, which the doses were re-calculated with MC algorithm in both groups. However, the local control rate and toxicities did not differ between the groups. Conclusions The clinical outcome and toxicity of lung SBRT between the RAT and MC groups were similar except for the response rate when the same apparent doses were prescribed. The lower response rate in the RAT group, however, did not compromise the local control rates. As such, reducing the prescription dose for MC algorithm may be performed but done with caution.
Collapse
Affiliation(s)
- Jin Ho Song
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Hoon-Sik Choi
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hojin Jeong
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - In Bong Ha
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Jong Deog Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ho Cheol Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Yi Yeong Jeong
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Yu Ji Cho
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Seung Jun Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Sung Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - In-Seok Jang
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Bae Kwon Jeong
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| |
Collapse
|
45
|
Application of stereotactic body radiation therapy to cancer liver metastasis. Cancer Lett 2016; 379:225-9. [PMID: 26704306 DOI: 10.1016/j.canlet.2015.10.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/24/2015] [Accepted: 10/27/2015] [Indexed: 12/29/2022]
Abstract
As an accurate external beam irradiation method, stereotactic body radiotherapy (SBRT) has been increasingly used to deliver high dose in less fractions. The liver is one of the most common organs for cancer metastasis. Recently, there have been several trials applying SBRT to cancer liver metastasis and have proved to be effective and safe with local control (LC) rates ranging from 70% to 100% within one or two years and 2-year overall survival (OS) rates ranging from 30% to 38%. Many published studies indicate that SBRT for cancer liver metastasis results in good outcomes without severe toxicities. However, the validated contribution of SBRT to an improved progression-free survival is still missing and more randomized trials should be conducted.
Collapse
|
46
|
Abstract
Pulmonary metastases are common in patients with cancer for which surgery is considered a standard approach in appropriately selected patients. A number of patients are not candidates for surgery due to a medical comorbidities or the extent of surgery required. For these patients, noninvasive or minimally invasive approaches to ablate pulmonary metastases are potential treatment strategies. This article summarizes the rationale and outcomes for non-surgical treatment approaches, including radiotherapy, radiofrequency and microwave ablation, for pulmonary metastases.
Collapse
Affiliation(s)
- Matthew J Boyer
- Department of Radiation Oncology, Duke University, Box 3085 DUMC, Durham, NC 27710, USA
| | - Umberto Ricardi
- Department of Oncology, University of Turin, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - David Ball
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, 2 St Andrews Pl, Melbourne, Victoria 3002, Australia; The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Joseph K Salama
- Department of Radiation Oncology, Duke University, Box 3085 DUMC, Durham, NC 27710, USA.
| |
Collapse
|
47
|
Ma L, Xiang J. Clinical outcomes of video-assisted thoracic surgery and stereotactic body radiation therapy for early-stage non-small cell lung cancer: A meta-analysis. Thorac Cancer 2016; 7:442-51. [PMID: 27385987 PMCID: PMC4930964 DOI: 10.1111/1759-7714.12352] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 02/17/2016] [Indexed: 01/16/2023] Open
Abstract
Background We compared video‐assisted thoracoscopic surgery (VATS) lobectomy and stereotactic body radiation therapy (SABR) to explore clinical outcomes in the treatment of patients with early stage NSCLC. Methods Major medical databases were systematically searched to identify studies on VATS and SBRT published between January 2010 and October 2015. English publications of stage I and II NSCLC with adequate patients and SBRT doses were included. A multivariate random effects model was used to perform meta‐analysis to compare overall survival (OS) and disease‐free survival (DFS) between VATS and SBRT, adjusting for median age and operable patient numbers. Results Thirteen VATS (3436 patients) and 24 SBRT (4433) studies were eligible. The median age and follow‐up duration was 68 years and 42 months for VATS and 74 years and 29.4 months for SBRT patients. After adjusting for the proportion of operable patients and median age, the estimated OS rates at one, two, three, and five years with VATS were 94%, 89%, 84%, and 69% compared with 96%, 94%, 89%, and 82% for SBRT. The estimated DFS rates at one, two, three, and five years with VATS were 97%, 93%, 87%, and 77% compared with 86%, 80%, 73%, and 58% for SBRT. Conclusion Before adjustment, patients treated with SBRT had poorer clinical outcomes compared to those treated with VATS. A substantial difference between median age and operability exists between patients treated with SBRT and VATS. After adjusting for these differences, OS and DFS did not differ significantly between the two techniques.
Collapse
Affiliation(s)
- Longfei Ma
- Department of Thoracic Surgery Fudan University Shanghai Cancer Center Shanghai China; Department of Oncology Shanghai Medical College, Fudan University Shanghai China
| | - Jiaqing Xiang
- Department of Thoracic Surgery Fudan University Shanghai Cancer Center Shanghai China; Department of Oncology Shanghai Medical College, Fudan University Shanghai China
| |
Collapse
|
48
|
王 建, 左 占, 张 洪, 李 伟, 王 坤. [Comparison of Clinical Outcomes of VATS and SBRT in the Treatment of NSCLC]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2016; 19:136-46. [PMID: 27009818 PMCID: PMC5999824 DOI: 10.3779/j.issn.1009-3419.2016.03.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/16/2016] [Accepted: 01/20/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE More and more chest physicians chose video-assisted thoracoscopic surgery (VATS) to treat early stage non-small cell lung cancer (NSCLC). In recent years, there is still lack of a random trial comparing the clinical outcomes of VATS and stereotactic body radiotherapy (SBRT) in treating NSCLC. To provide a reference for the choice between VATS and SBRT, in the current meta-analysis, we compared the clinical outcomes of these two therapies in treating NSCLC. METHODS Five major medical databases, CNKI, CPVIP (http://www.cqvip.com/), PubMed, Embase, and ISI web of science were systematically searched to identify all studies from January 2010 to February 2016 on VATS and SBRT therapies. Finally, original English or Chinese publications of stage I and II NSCLC with adequate patients and adequate SBRT doses were enrolled. A multivariate random effects model was used to perform a meta-analysis to compare overall survival and disease free survival between VATS and SBRT while adjusting for median age and operable patient numbers. RESULTS Fourteen VATS studies (included 3,482 patients) and nineteen SBRT studies (included 3,997 patients) published in the same period were eligible. The median age and follow-up duration were 64 years and 43.4 months for VATS patients and 74 years and 29.5 months for SBRT patients, respectively. The mean unadjusted overall survival rates at 1, 2, 3, and 5 years with VATS were 93.5%, 84.9%, 77.0% and 76.3% compared to 89.0% 73.3% 59.0% and 36.7% with SBRT. The mean unadjusted disease free survival rates at 1, 2, 3, and 5 years with VATS were 93.6%, 88.6%, 85.6% and 75.6% compared to 79.3%, 72.1%, 64.9% and 58.9% with SBRT. While, after adjusted for proportion of operable patients and median age, the estimate overall survival rates at 1, 2, 3, and 5 years with VATS were 94%, 92%, 84% and 71% compared to 98%, 95%, 87% and 83% with SBRT. And the estimate disease free survival rates at 1, 2, 3, and 5 years with VATS were 97%, 94%, 85% and 75% compared to 88%, 81%, 74% and 63% with SBRT. CONCLUSION Before adjustment, the SBRT group showed worse clinical outcomes (overall survival and disease free survival) than VATS group. When take consider of median age and operability, the patients with SBRT differ substantially from patients treated with VATS. After adjustment of median age and operability, there are no significant differences between these two therapy in treating NSCLC.
Collapse
Affiliation(s)
- 建东 王
- />100027 北京,武警北京总队医院胸部肿瘤治疗中心Thoracic Cancer Treatment Center, Armed police Beijing Corps Hospital, Beijing 100027, China
| | - 占杰 左
- />100027 北京,武警北京总队医院胸部肿瘤治疗中心Thoracic Cancer Treatment Center, Armed police Beijing Corps Hospital, Beijing 100027, China
| | - 洪波 张
- />100027 北京,武警北京总队医院胸部肿瘤治疗中心Thoracic Cancer Treatment Center, Armed police Beijing Corps Hospital, Beijing 100027, China
| | - 伟 李
- />100027 北京,武警北京总队医院胸部肿瘤治疗中心Thoracic Cancer Treatment Center, Armed police Beijing Corps Hospital, Beijing 100027, China
| | - 坤峰 王
- />100027 北京,武警北京总队医院胸部肿瘤治疗中心Thoracic Cancer Treatment Center, Armed police Beijing Corps Hospital, Beijing 100027, China
| |
Collapse
|
49
|
Lischalk JW, Malik RM, Collins SP, Collins BT, Matus IA, Anderson ED. Stereotactic body radiotherapy (SBRT) for high-risk central pulmonary metastases. Radiat Oncol 2016; 11:28. [PMID: 26920142 PMCID: PMC4769488 DOI: 10.1186/s13014-016-0608-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background and purpose Radiotherapy of central lung tumors carries a higher risk of treatment-related toxicity and local failure. In the era of aggressive oligometastic management the exploration of the proper dose-fractionation for metastatic central lung tumors is essential. Materials and methods Patients diagnosed with high-risk metastatic lesions of the central pulmonary tree comprised this single-institutional retrospective analysis. “High-risk” central pulmonary lesions were defined as those with abutment and/or invasion of the mainstem bronchus. All patients were treated using the CyberKnife SBRT system in 5 fractions to a total dose of 35 or 40 Gy. Results Twenty patients were treated from 2008 to 2011 at Georgetown University Hospital. At a median follow up of 19 months, 1-year Kaplan-Meier local control and overall survival was 70 and 75 %, respectively. Late grade 2 or higher atelectasis was the most common treatment-related toxicity and was significantly associated with maximum dose to the mainstem bronchus. Gross endobronchial involvement was associated with significantly lower overall survival. Conclusions Five-fraction SBRT to a total dose of 35 or 40 Gy appears to be a safe and effective management strategy for high-risk central pulmonary metastatic lesions, though care should be taken to limit the maximum point dose to the mainstem bronchus.
Collapse
Affiliation(s)
- Jonathan W Lischalk
- Department of Radiation Medicine, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Lower Level Bles, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
| | - Ryan M Malik
- Department of Radiation Medicine, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Lower Level Bles, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
| | - Sean P Collins
- Department of Radiation Medicine, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Lower Level Bles, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
| | - Brian T Collins
- Department of Radiation Medicine, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Lower Level Bles, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
| | - Ismael A Matus
- Division of Pulmonary, Critical Care, and Sleep Medicine, Pasquerilla Healthcare Center, Georgetown University Hospital, 5th floor, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
| | - Eric D Anderson
- Division of Pulmonary, Critical Care, and Sleep Medicine, Pasquerilla Healthcare Center, Georgetown University Hospital, 5th floor, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.
| |
Collapse
|
50
|
Lambrecht M, Melidis C, Sonke JJ, Adebahr S, Boellaard R, Verheij M, Guckenberger M, Nestle U, Hurkmans C. Lungtech, a phase II EORTC trial of SBRT for centrally located lung tumours - a clinical physics perspective. Radiat Oncol 2016; 11:7. [PMID: 26791788 PMCID: PMC4721147 DOI: 10.1186/s13014-015-0567-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/10/2015] [Indexed: 01/31/2023] Open
Abstract
Background The EORTC has launched a phase II trial to assess safety and efficacy of SBRT for centrally located NSCLC: The EORTC 22113-08113—Lungtech trial. Due to neighbouring critical structures, these tumours remain challenging to treat. To guarantee accordance to protocol and treatment safety, an RTQA procedure has been implemented within the frame of the EORTC RTQA levels. These levels are here expanded to include innovative tools beyond protocol compliance verification: the actual dose delivered to each patient will be estimated and linked to trial outcomes to enable better understanding of dose related response and toxicity. Method For trial participation, institutions must provide a completed facility questionnaire and beam output audit results. To insure ability to comply with protocol specifications a benchmark case is sent to all centres. After approval, institutions are allowed to recruit patients. Nonetheless, each treatment plan will be prospectively reviewed insuring trial compliance consistency over time. As new features, patient’s CBCT images and applied positioning corrections will be saved for dose recalculation on patient’s daily geometry. To assess RTQA along the treatment chain, institutions will be visited once during the time of the trial. Over the course of this visit, end-to-end tests will be performed using the 008ACIRS-breathing platform with two separate bodies. The first body carries EBT3 films and an ionization chamber. The other body newly developed for PET- CT evaluation is fillable with a solution of high activity. 3D or 4D PET-CT and 4D-CT scanning techniques will be evaluated to assess the impact of motion artefacts on target volume accuracy. Finally, a dosimetric evaluation in static and dynamic conditions will be performed. Discussion Previous data on mediastinal toxicity are scarce and source of cautiousness for setting-up SBRT treatments for centrally located NSCLC. Thanks to the combination of documented patient related outcomes and CBCT based dose recalculation we expect to provide improved models for dose response and dose related toxicity. Conclusion We have developed a comprehensive RTQA model for trials involving modern radiotherapy. These procedures could also serve as examples of extended RTQA for future radiotherapy trials involving quantitative use of PET and tumour motion.
Collapse
Affiliation(s)
- Marie Lambrecht
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands.
| | | | - Jan-Jakob Sonke
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Sonja Adebahr
- Department of Radiation Oncology, University Medical Center, Freiburg, Germany. .,German Cancer Consortium (DKTK), partner site Freiburg, Germany.
| | - Ronald Boellaard
- Department of Nuclear Medicine VUmc, Amsterdam, The Netherlands.
| | - Marcel Verheij
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | | | - Ursula Nestle
- Department of Radiation Oncology, University Medical Center, Freiburg, Germany. .,German Cancer Consortium (DKTK), partner site Freiburg, Germany.
| | - Coen Hurkmans
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands.
| |
Collapse
|