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Demizu Y, Imai R, Kiyohara H, Matsunobu A, Okamoto M, Okimoto T, Tsuji H, Ohno T, Shioyama Y, Nemoto K, Nakano T, Kamada T. Carbon ion radiotherapy for sacral chordoma: A retrospective nationwide multicentre study in Japan. Radiother Oncol 2020; 154:1-5. [PMID: 32941958 DOI: 10.1016/j.radonc.2020.09.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 08/16/2020] [Accepted: 09/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Usefulness of carbon ion radiotherapy (CIRT) for sacral chordoma has been reported from single institutions. We conducted a retrospective nationwide multicentre study to evaluate the clinical outcomes of CIRT for sacral chordoma in Japan. MATERIALS AND METHODS A total of 219 patients who underwent CIRT for sacral chordoma at institutions across Japan between December 2003 and July 2014 were included in this study. RESULTS Median patient age was 67 years (range, 26-87 years). Most patients had no history of surgical resection (96%). The most frequent planning target volume (PTV) range was 100-500 mL (65%). The most frequently used dose-fractionation was 67.2 Gy (relative biological effectiveness) in 16 fractions (65%). The median follow-up was 56 months (range, 7-132 months). The 5-year overall survival (OS), progression-free survival, and local control rates were 84%, 48%, and 72%, respectively. Frequent sites of out-of-field recurrence included bone (9%) and lung (9%) metastases. The Cox proportional hazards model revealed that both younger age (P = 0.004) and smaller PTV (P = 0.001) were associated with significantly better OS. Acute toxicities of ≥Grade 3 occurred in eight patients (4%). Late toxicities of ≥Grade 3 occurred in 13 patients (6%): skin disorders in six patients (3%), pain in three (1%), myositis in three (1%), etc. CONCLUSION: Our retrospective nationwide multicentre study showed that CIRT for sacral chordoma was effective and safe, and replicated the previously reported data from a representative CIRT institution in Japan demonstrating high local control and low toxicity rates.
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Affiliation(s)
- Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Reiko Imai
- QST Hospital, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroki Kiyohara
- Department of Radiation Oncology, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | | | | | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Hiroshi Tsuji
- QST Hospital, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Kenji Nemoto
- Department of Radiation Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | - Takashi Nakano
- National Institute of Radiological Sciences, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tadashi Kamada
- Ion-beam Radiation Oncology Center, Kanagawa Cancer Center, Yokohama, Japan.
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Komatsu S, Demizu Y, Sulaiman NS, Terashima K, Suga M, Kido M, Toyama H, Tokumaru S, Okimoto T, Sasaki R, Fukumoto T. Space-making particle therapy for sarcomas derived from the abdominopelvic region. Radiother Oncol 2020; 146:194-199. [PMID: 32220700 DOI: 10.1016/j.radonc.2020.02.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/10/2020] [Accepted: 02/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The primary definitive treatment for abdominopelvic sarcomas (APSs) is resection, although incomplete resection has a negative prognostic impact. Although the effectiveness of particle therapy (PT) as a treatment for APS has already been demonstrated, its application for tumors adjacent to the gastrointestinal tract is frequently restricted, due to extremely low tolerance. Space-making PT, consisting of surgical spacer placement and subsequent PT, has been developed to overcome this limitation. MATERIALS AND METHODS Between June 2006 and June 2018, a total of 75 patients with 12 types of APS underwent space-making PT. RESULTS The 3-year local control rate of all patients was 90.3%. Fourteen surgery-related complications were observed in 12 patients (16%), and complications of Grade 3b or higher were observed in 3 patients. Ninety-five PT-related complications were seen in 66 patients (88.0%), and 13 patients (17.3%) had complications of Grade 3 or higher. The median V95% (volume irradiated with 95% of the treatment planning dose) of the gross tumor volume and clinical target volume were 99.9% and 99.5%, respectively. The median D95% (dose intensity covering 95% of the target volume) of the gross tumor volume/planned dose and clinical target volume/planned dose were 99.4%, and 99.1%, respectively. CONCLUSION The feasibility and effectiveness of space-making PT have been demonstrated via dosimetric evaluation, and our results indicate that this new strategy may potentially provide an effective and innovative treatment option for advanced APS.
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Affiliation(s)
- Shohei Komatsu
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Japan.
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan; Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Japan
| | | | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Masaki Suga
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Masahiro Kido
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Japan
| | - Hirochika Toyama
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Japan
| | - Sunao Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Japan
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Japan
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Tsugawa D, Komatsu S, Demizu Y, Sulaiman NS, Suga M, Kido M, Toyama H, Okimoto T, Sasaki R, Fukumoto T. Space-Making Particle Therapy with Surgical Spacer Placement in Patients with Sacral Chordoma. J Am Coll Surg 2019; 230:207-215. [PMID: 31765694 DOI: 10.1016/j.jamcollsurg.2019.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/15/2019] [Accepted: 11/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sacral chordomas are rare malignant bone tumors and are often very large for complete resection. Particle therapy for these tumors, which are adjacent to the gastrointestinal tract, is restricted because the tolerance dose of the intestine is low. This study aimed to demonstrate the technical aspects and treatment results of space-making particle therapy with surgical spacer placement for sacral chordoma. We aimed to investigate the dosimetric change in the particle therapy before and after spacer placement and the safety, efficacy, and long-term outcomes of space-making particle therapy. STUDY DESIGN Twenty-one patients with sacral chordomas who were excluded from typical particle therapy were enrolled between 2007 and 2015. Gore-Tex sheets (WL Gore & Assoc) were folded and placed between the sacral and rectum. Particle therapy with 70.4 Gy (relative biologic effectiveness) was then performed. RESULTS The mean volume that allows 95% of the treatment plan dose of the gross tumor volume and clinical tumor volume after spacer placement was improved to 97.7% and 96.4% from preoperative values of 91.0% and 89.5%, respectively. The recurrence rate within the gross tumor volume was only 4.8%. The 4-year local progression-free survival rate was 68.4%. The 5-year overall survival rate was 100% and the adverse events were acceptable. CONCLUSIONS Considering improvements in the dose-volume histogram after spacer placement, low recurrence rates within the gross tumor volume, good survival rates, and low incidences of side effects, treatment of sacral chordoma with space-making particle therapy shows promise.
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Affiliation(s)
- Daisuke Tsugawa
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Shohei Komatsu
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center, Hyoga, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Hyoga, Japan
| | | | - Masaki Suga
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Hyoga, Japan
| | - Masahiro Kido
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirochika Toyama
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyoga, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Fukumoto
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Yamada M, Sato H, Ieko Y, Miyasaka Y, Kanai T, Yano N, Ono T, Akamatsu H, Harada M, Ichikawa M, Teranishi Y, Kikuchi Y, Nemoto K. In silico comparison of the dosimetric impacts of a greater omentum spacer for abdominal and pelvic tumors in carbon-ion, proton and photon radiotherapy. Radiat Oncol 2019; 14:207. [PMID: 31752932 PMCID: PMC6868713 DOI: 10.1186/s13014-019-1411-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/30/2019] [Indexed: 02/06/2023] Open
Abstract
Purpose The purpose of this study was to compare carbon-ion (C-ion), proton and photon radiotherapy (RT) plans with regard to dose reduction of the gastrointestinal (GI) tract by using a greater omentum spacer (GO spacer). Methods We retrospectively retrieved data for ten patients who received the GO spacer as surgical spacer placement for abdominal and pelvic tumors. Simulation plans were created on pre-spacer Computed Tomography (CT) and post-spacer CT for C-ion RT, proton RT and photon RT to compare the dose of the GI tract. The plans were normalized so that at least 95% of the planning target volume (PTV) received 70 Gy (relative biological effectiveness equivalent) delivered in 35 fractions. All plans were created with the lowest possible dose to the GI tract under conditions that meet the dose constraints for the PTV and spinal cord (maximum dose < 45 Gy). The part of the GI tract to be evaluated was defined as that most adjacent to the PTV. C-ion RT plans and proton RT plans were calculated by a spot scanning technique, and photon RT plans were calculated employing by fixed-field intensity-modulated radiation therapy. Results D2 cc and V10–70 of the GI tract were significantly lower on post-spacer plans than on pre-spacer plans for all three RT modalities. Regarding post-spacer plans, D2 cc of the GI tract was significantly lower on C-ion RT plans and proton RT plans than on photon RT plans (C-ion vs photon p = 0.001, proton vs photon p = 0.002). However, there was no significant difference between C-ion RT plans and proton RT plans for D2 cc of the GI tract (C-ion vs proton p = 0.992). In the photon RT plan for one patient, D2 cc of the GI tract did not meet < 50 Gy. Conclusions The GO spacer shows a significant dose reduction effect on the GI tract.
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Affiliation(s)
- Masayoshi Yamada
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan.
| | - Hiraku Sato
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Yoshiro Ieko
- Department of Heavy Particle Medical Science, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Yuya Miyasaka
- Department of Heavy Particle Medical Science, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Takayuki Kanai
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Natsuko Yano
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Takashi Ono
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima, Japan
| | - Hiroko Akamatsu
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Mayumi Harada
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Mayumi Ichikawa
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
| | - Yasushi Teranishi
- Department of General Surgery, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima, Japan
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata, Japan
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Ropero Álvarez AM, Pérez-Vilar S, Pacis-Tirso C, Contreras M, El Omeiri N, Ruiz-Matus C, Velandia-González M. Progress in vaccination towards hepatitis B control and elimination in the Region of the Americas. BMC Public Health 2017; 17:325. [PMID: 28415981 PMCID: PMC5392937 DOI: 10.1186/s12889-017-4227-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 04/05/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Over recent decades, the Region of the Americas has made significant progress towards hepatitis B elimination. We summarize the countries/territories' efforts in introducing and implementing hepatitis B (HB) vaccination and in evaluating its impact on HB virus seroprevalence. METHODS We collected information about HB vaccination schedules, coverage estimates, and year of vaccine introduction from countries/territories reporting to the Pan American Health Organization/World Health Organization (PAHO/WHO) through the WHO/UNICEF Joint Reporting Form on Immunization. We obtained additional information regarding countries/territories vaccination recommendations and strategies through communications with Expanded Program on Immunization (EPI) managers and national immunization survey reports. We identified vaccine impact studies conducted and published in the Americas. RESULTS As of October 2016, all 51 countries/territories have included infant HB vaccination in their official immunization schedule. Twenty countries, whose populations represent over 90% of the Region's births, have included nationwide newborn HB vaccination. We estimated at 89% and 75%, the regional three-dose series and the birth dose HB vaccination coverage, respectively, for 2015. The impact evaluations of infant HB immunization programs in the Region have shown substantial reductions in HB surface antigen (HBsAg) seroprevalence. CONCLUSION The achievements of vaccination programs in the Americas suggest that the elimination of perinatal and early childhood HB transmission could be feasible in the short-term. Moreover, the data gathered indicate that the Region may have already achieved the 2020 WHO goal for HB control.
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Affiliation(s)
- Alba Maria Ropero Álvarez
- Unit of Comprehensive Family Immunization. Department of Family, Gender and Life Course, Pan American Health Organization (PAHO/WHO), 525 23rd St. Nw, Washington DC, 20037 USA
| | - Silvia Pérez-Vilar
- Current address: U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD 20993 USA
| | - Carmelita Pacis-Tirso
- Unit of Comprehensive Family Immunization. Department of Family, Gender and Life Course, Pan American Health Organization (PAHO/WHO), 525 23rd St. Nw, Washington DC, 20037 USA
| | - Marcela Contreras
- Unit of Comprehensive Family Immunization. Department of Family, Gender and Life Course, Pan American Health Organization (PAHO/WHO), 525 23rd St. Nw, Washington DC, 20037 USA
| | - Nathalie El Omeiri
- Unit of Comprehensive Family Immunization. Department of Family, Gender and Life Course, Pan American Health Organization (PAHO/WHO), 525 23rd St. Nw, Washington DC, 20037 USA
| | - Cuauhtémoc Ruiz-Matus
- Unit of Comprehensive Family Immunization. Department of Family, Gender and Life Course, Pan American Health Organization (PAHO/WHO), 525 23rd St. Nw, Washington DC, 20037 USA
| | - Martha Velandia-González
- Unit of Comprehensive Family Immunization. Department of Family, Gender and Life Course, Pan American Health Organization (PAHO/WHO), 525 23rd St. Nw, Washington DC, 20037 USA
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6
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Bailey HH, Chuang LT, duPont NC, Eng C, Foxhall LE, Merrill JK, Wollins DS, Blanke CD. American Society of Clinical Oncology Statement: Human Papillomavirus Vaccination for Cancer Prevention. J Clin Oncol 2016; 34:1803-12. [PMID: 27069078 DOI: 10.1200/jco.2016.67.2014] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
American Society of Clinical Oncology (ASCO), the leading medical professional oncology society, is committed to lessening the burden of cancer and as such will promote underused interventions that have the potential to save millions of lives through cancer prevention. As the main providers of cancer care worldwide, our patients, their families, and our communities look to us for guidance regarding all things cancer related, including cancer prevention. Through this statement and accompanying recommendations, ASCO hopes to increase awareness of the tremendous global impact of human papillomavirus (HPV) -caused cancers, refocus the discussion of HPV vaccination on its likely ability to prevent millions of cancer deaths, and increase HPV vaccination uptake via greater involvement of oncology professionals in ensuring accurate public discourse about HPV vaccination and calling for the implementation of concrete strategies to address barriers to vaccine access and acceptance.
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Affiliation(s)
- Howard H Bailey
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR.
| | - Linus T Chuang
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Nefertiti C duPont
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Cathy Eng
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Lewis E Foxhall
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Janette K Merrill
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Dana S Wollins
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Charles D Blanke
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
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Desie N, Van Raemdonck DE, Ceulemans LJ, Nevens F, Verslype C, Vansteenbergen W, Pirenne J, Monbaliu D, Roskams T, Verbeken EK, Neyrinck AP, Dupont LJ, Yserbyt J, Verleden GM, Vos R. Combined or Serial Liver and Lung Transplantation for Epithelioid Hemangioendothelioma: A Case Series. Am J Transplant 2015; 15:3247-54. [PMID: 26288367 DOI: 10.1111/ajt.13430] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/29/2015] [Accepted: 06/21/2015] [Indexed: 01/25/2023]
Abstract
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with variable biological and clinical behavior. There is increasing experience with liver transplantation (LiTx) for hepatic EHE, even in cases of extrahepatic disease localization. Until now, no cases of lung transplantation (LuTx) had been reported for pulmonary EHE. This report describes three cases of EHE with multifocal disease in patients who underwent either serial or combined LiTx and LuTx.
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Affiliation(s)
- N Desie
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - D E Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - L J Ceulemans
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Abdominal Transplant Surgery and Transplant Coordination, University Hospitals Leuven, Leuven, Belgium
| | - F Nevens
- Department of Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - C Verslype
- Department of Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - W Vansteenbergen
- Department of Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - J Pirenne
- Department of Abdominal Transplant Surgery and Transplant Coordination, University Hospitals Leuven, Leuven, Belgium
| | - D Monbaliu
- Department of Abdominal Transplant Surgery and Transplant Coordination, University Hospitals Leuven, Leuven, Belgium
| | - T Roskams
- Department of Histopathology, University Hospitals Leuven, Leuven, Belgium
| | - E K Verbeken
- Department of Histopathology, University Hospitals Leuven, Leuven, Belgium
| | - A P Neyrinck
- Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - L J Dupont
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,KULeuven, Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, and Department of Respiratory Diseases, Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium
| | - J Yserbyt
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - G M Verleden
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,KULeuven, Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, and Department of Respiratory Diseases, Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium
| | - R Vos
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,KULeuven, Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, and Department of Respiratory Diseases, Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium
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8
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CRISPR/Cas9-based tools for targeted genome editing and replication control of HBV. Virol Sin 2015; 30:317-25. [PMID: 26511989 DOI: 10.1007/s12250-015-3660-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/14/2015] [Indexed: 12/25/2022] Open
Abstract
Hepatitis B virus (HBV) infection remains a major global health problem because current therapies rarely eliminate HBV infections to achieve a complete cure. A different treatment paradigm to effectively clear HBV infection and eradicate latent viral reservoirs is urgently required. In recent years, the development of a new RNA-guided gene-editing tool, the CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9) system, has greatly facilitated site-specific mutagenesis and represents a very promising potential therapeutic tool for diseases, including for eradication of invasive pathogens such as HBV. Here, we review recent advances in the use of CRISPR/Cas9, which is designed to target HBV specific DNA sequences to inhibit HBV replication and to induce viral genome mutation, in cell lines or animal models. Advantages, limitations and possible solutions, and proposed directions for future research are discussed to highlight the opportunities and challenges of CRISPR/Cas9 as a new, potentially curative therapy for chronic hepatitis B infection.
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9
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Let It "B"? The role of Hepatitis B universal vaccination among italian problematic drug users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3979-92. [PMID: 25872013 PMCID: PMC4410228 DOI: 10.3390/ijerph120403979] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 02/07/2023]
Abstract
Hepatitis B virus (HBV) hepatitis is extremely common among problematic drug users (DUs). As of 2012, 47 of the 53 European countries had implemented a universal hepatitis B vaccination programme, a scenario that could radically change its spread. Even so, drug users are still one of the main groups at risk of being infected by HBV, exposing the fact that universal vaccination still has not managed to reach an optimal level of contagion protection. In order to evaluate the role of universal HBV vaccination in protecting against risk behaviour related to the use of illicit drugs, a group of 748 DUs, 511 male and 237 female, was tested for HBV markers, at their first access to public addiction clinics in the metropolitan area of Bologna, Italy. 487 were born after 1981, so they were eligible to have received HBV vaccination in adolescence or at birth; in these subjects antibodies against HBV core antigen had the significant prevalence of 6.2%. Universal HBV vaccination has shown evidence of protecting against infection in the general population. These results, amongst the first to evaluate actual protection in DUs vaccinated at birth or during adolescence, show that compulsory universal vaccination does not solve the problem of HBV transmission in the most at risk groups and that additional strategies must be studied and implemented to address this issue.
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