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Rieu R, Prestwich RJ, Paterson C, Vohra S, Swan A, Noble D, Srinivasan D, Dixon L, Chiu K, Scott A, Mendes R, Khan S, Pilar A, Thompson A, Nutting CM, McPartlin A. A Multicenter Study of Clinician and Patient Reported Acute and Late Toxicity after Radical (Chemo)Radiotherapy for Non-Endemic Nasopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e619. [PMID: 37785855 DOI: 10.1016/j.ijrobp.2023.06.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Curative (chemo)radiotherapy ((CT)RT) for Nasopharyngeal cancers (NPC) achieves excellent disease control but is associated with significant late toxicities despite modern treatment delivery. Contemporary late toxicity data, including patient reported outcomes (PROs), is limited in the non-endemic population; we present a large contemporary series of toxicity outcomes and late PROs following treatment of non-endemic NPC. MATERIALS/METHODS Adult patients completing radical (CT)RT for primary NPC between February 2016 and 2020 at 7 large UK cancer centers were identified on institutional databases. Patients were excluded if they had prior head and neck cancer or prior therapeutic head and neck surgery (except neck dissection). Patients with an active other cancer were excluded from PRO assessment. Demographic, treatment, acute toxicity and outcome data were collected retrospectively from patient records. Disease-free patients were invited to complete an M.D. Anderson Dysphagia Index (MDADI) and University of Washington (UoW) Quality of Life (QoL) PROs questionnaires. RESULTS A total of 180 eligible patients were identified: 68% male, median age 54 years, 11% ≥70 years. EBV status was positive in 61% (unknown 12%). Patients had stage I (5%), II (22%), III (37%), IV (36%) disease; 95% were performance status ≤1 at baseline. Median follow-up was 31.2 months (range 0-68). A total of 54% received 70Gy in 33-35# and 43% received 65-66 Gy in 30-33#. 66% received induction and 65% received concurrent chemotherapy. 9.5% had residual disease at the first follow-up scan. Subsequent locoregional or distant recurrence occurred in 5% and 12% respectively. At last assessment, 84% patients were alive, 16% had died (of which 70% had active disease). Acute treatment toxicity included: 63% of patients required enteral support (median duration 98 days) with 9% a feeding tube at 1 year post treatment. 18% G3 dermatitis, 53% G3 mucositis. 82% requiring opioids and 40% admitted for symptom management. 90 patients completed the PROs (76% response rate) at a median of 37.8 months post treatment (Table 1). These demonstrate significant QoL detriment: 28% report significant pain, 24% require regular analgesia, and 59% report significant impact on daily activity. This was found to persist at different timepoints (not shown). CONCLUSION Excellent cancer survival outcomes are seen in a non-selected, non-endemic NPC population. However significant acute and late toxicity following radical treatment is identified which can profoundly negatively impact QoL in a relatively young cohort. This highlights the importance of ongoing efforts to reduce toxicity and supports the prospective evaluation of potential toxicity sparing technologies, such as proton beam radiotherapy.
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Affiliation(s)
- R Rieu
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - R J Prestwich
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - C Paterson
- Beatson West of Scotland Cancer Centre, Radiation Oncology Department, Glasgow, United Kingdom
| | - S Vohra
- Beaton West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - A Swan
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road South, Edinburgh, United Kingdom
| | - D Noble
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road South, Edinburgh, United Kingdom
| | - D Srinivasan
- Western General Hospital, Edinburgh, United Kingdom
| | - L Dixon
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, Sheffield, United Kingdom
| | - K Chiu
- Mount Vernon Cancer Centre, Department of Clinical Oncology, Northwood, United Kingdom
| | - A Scott
- Mount Vernon Hospital, Department of Clinical Oncology, Northwood, United Kingdom
| | - R Mendes
- University College London Hospital, London, United Kingdom
| | - S Khan
- University College London Hospital, London, United Kingdom
| | - A Pilar
- University College London Hospital, London, United Kingdom
| | - A Thompson
- North Middlesex University Hospital, Cambridge CB2 8AP, United Kingdom
| | - C M Nutting
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A McPartlin
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
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Pilar A, Saunders D, Pan S, Gaito S, Charlwood F, Lowe M, Smith E, Mcpartlin A, Thorp N. PD-0167 Acute, late toxicities & early outcomes in children after proton therapy for head & neck malignancy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cady NC, Tokranova N, Minor A, Nikvand N, Strle K, Lee WT, Page W, Guignon E, Pilar A, Gibson GN. Multiplexed detection and quantification of human antibody response to COVID-19 infection using a plasmon enhanced biosensor platform. Biosens Bioelectron 2021; 171:112679. [PMID: 33069957 PMCID: PMC7545244 DOI: 10.1016/j.bios.2020.112679] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 12/18/2022]
Abstract
The 2019 SARS CoV-2 (COVID-19) pandemic has illustrated the need for rapid and accurate diagnostic tests. In this work, a multiplexed grating-coupled fluorescent plasmonics (GC-FP) biosensor platform was used to rapidly and accurately measure antibodies against COVID-19 in human blood serum and dried blood spot samples. The GC-FP platform measures antibody-antigen binding interactions for multiple targets in a single sample, and has 100% selectivity and sensitivity (n = 23) when measuring serum IgG levels against three COVID-19 antigens (spike S1, spike S1S2, and the nucleocapsid protein). The GC-FP platform yielded a quantitative, linear response for serum samples diluted to as low as 1:1600 dilution. Test results were highly correlated with two commercial COVID-19 antibody tests, including an enzyme linked immunosorbent assay (ELISA) and a Luminex-based microsphere immunoassay. To demonstrate test efficacy with other sample matrices, dried blood spot samples (n = 63) were obtained and evaluated with GC-FP, yielding 100% selectivity and 86.7% sensitivity for diagnosing prior COVID-19 infection. The test was also evaluated for detection of multiple immunoglobulin isotypes, with successful detection of IgM, IgG and IgA antibody-antigen interactions. Last, a machine learning approach was developed to accurately score patient samples for prior COVID-19 infection, using antibody binding data for all three COVID-19 antigens used in the test.
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Affiliation(s)
- Nathaniel C Cady
- College of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, NY, USA.
| | - Natalya Tokranova
- College of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, NY, USA
| | - Armond Minor
- College of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, NY, USA
| | - Nima Nikvand
- College of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, NY, USA
| | - Klemen Strle
- Wadsworth Center, New York State Department of Health, Albany, NY, USA and School of Public Health, University at Albany, Albany, NY, USA
| | - William T Lee
- Wadsworth Center, New York State Department of Health, Albany, NY, USA and School of Public Health, University at Albany, Albany, NY, USA
| | | | | | | | - George N Gibson
- Ciencia, Inc., East Hartford, CT, USA; University of Connecticut, Storrs, CT, USA
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Pilar A, Yu E, Su J, Bartlett E, O’Sullivan B, Waldron J, Spreafico A, de Almeida J, Bayley A, Bratman S, Cho J, Giuliani M, Hope A, Hosni A, Kim J, Ringash J, Perez-Ordonez B, Tong L, Xu W, Huang S. Validating and Refining the 8th Edition TNM N-Classification for HPV Negative Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wang Y, Aravind I, Cai Z, Shen L, Gibson GN, Chen J, Wang B, Shi H, Song B, Guignon E, Cady NC, Page WD, Pilar A, Cronin SB. Hot Electron Driven Photocatalysis on Plasmon-Resonant Grating Nanostructures. ACS Appl Mater Interfaces 2020; 12:17459-17465. [PMID: 32212673 DOI: 10.1021/acsami.0c00066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We demonstrate the hot electron injection of photoexcited carriers in an Ag-based plasmon resonant grating structure. By varying the incident angle of irradiation, sharp dips are observed in the reflectance with p-polarized light (electric field perpendicular to grating lines) when there is wavevector matching between the incident light and the plasmon resonant modes of the grating and no angle dependence is observed with s-polarized light. This configuration enables us to compare photoelectrochemical current produced by plasmon resonant excitation with that of bulk metal interband absorption simply by rotating the polarization of the incident light while keeping all other parameters of the measurement fixed. With 633 nm light, we observed a 12-fold enhancement in the photocurrent (i.e., reaction rate) between resonant and nonresonant polarizations at incident angles of ±7.6° from normal. At 785 nm irradiation, we observed similar resonant profiles to those obtained with 633 nm wavelength light but with a 44-fold enhancement factor. Using 532 nm light, we observed two resonant peaks (with approximately 10× enhancement) in the photocurrent at 19.4° and 28.0° incident angles, each corresponding to higher order modes in the grating with more nodes per period. The lower enhancement factors observed at shorter wavelengths are attributed to interband transitions, which provide a damping mechanism for the plasmon resonance. Finite difference time domain (FDTD) simulations of these grating structures confirm the resonant profiles observed in the angle-dependent spectra of these gratings and provide a detailed picture of the electric field profiles on and off resonance.
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Affiliation(s)
| | | | | | | | - George N Gibson
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269, United States
- Ciencia Inc., East Hartford, Connecticut 06108, United States
| | | | | | | | | | - Ernest Guignon
- Ciencia Inc., East Hartford, Connecticut 06108, United States
| | - Nathaniel C Cady
- Colleges of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, New York 12203, United States
| | - William D Page
- Ciencia Inc., East Hartford, Connecticut 06108, United States
| | - Arturo Pilar
- Ciencia Inc., East Hartford, Connecticut 06108, United States
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Chou E, Lasek-Nesselquist E, Taubner B, Pilar A, Guignon E, Page W, Lin YP, Cady NC. A fluorescent plasmonic biochip assay for multiplex screening of diagnostic serum antibody targets in human Lyme disease. PLoS One 2020; 15:e0228772. [PMID: 32040491 PMCID: PMC7010292 DOI: 10.1371/journal.pone.0228772] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/22/2020] [Indexed: 12/22/2022] Open
Abstract
Lyme disease (LD) diagnosis using the current two-tier algorithm is constrained by low sensitivity for early-stage infection and ambiguity in determining treatment response. We recently developed a protein microarray biochip that measures diagnostic serum antibody targets using grating-coupled fluorescent plasmonics (GC-FP) technology. This strategy requires microliters of blood serum to enable multiplexed biomarker screening on a compact surface and generates quantitative results that can be further processed for diagnostic scoring. The GC-FP biochip was used to detect serum antibodies in patients with active and convalescent LD, as well as various negative controls. We hypothesized that the quantitative, high-sensitivity attributes of the GC-FP approach permit: 1) screening of antibody targets predictive for LD status, and 2) development a diagnostic algorithm that is more sensitive, specific, and informative than the standard ELISA and Western blot assays. Notably, our findings led to a diagnostic algorithm that may be more sensitive than the current standard for detecting early LD, while maintaining 100% specificity. We further show that analysis of relative antibody levels to predict disease status, such as in acute and convalescent stages of infection, is possible with a highly sensitive and quantitative platform like GC-FP. The results from this study add to the urgent conversation regarding better diagnostic strategies and more effective treatment for patients affected by tick-borne disease.
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Affiliation(s)
- Eunice Chou
- College of Nanoscale Science & Engineering, State University of New York Polytechnic Institute, Albany, New York, United States of America
- College of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, United States of America
| | - Erica Lasek-Nesselquist
- Bioinformatics Core, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Benjamin Taubner
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
- Department of Biomedical Engineering, Mercer University, Macon, Georgia, United States of American
| | - Arturo Pilar
- Ciencia, Inc., East Hartford, Connecticut, United States of America
| | - Ernest Guignon
- Ciencia, Inc., East Hartford, Connecticut, United States of America
| | - William Page
- Ciencia, Inc., East Hartford, Connecticut, United States of America
| | - Yi-Pin Lin
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
- Department of Biomedical Science, State University of New York at Albany, Albany, New York, United States of America
| | - Nathaniel C. Cady
- College of Nanoscale Science & Engineering, State University of New York Polytechnic Institute, Albany, New York, United States of America
- * E-mail:
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Wang Y, Shen L, Wang Y, Hou B, Gibson G, Poudel N, Chen J, Shi H, Guignon E, Cady NC, Page WD, Pilar A, Dawlaty J, Cronin SB. Hot electron-driven photocatalysis and transient absorption spectroscopy in plasmon resonant grating structures. Faraday Discuss 2019; 214:325-339. [DOI: 10.1039/c8fd00141c] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We have developed a method to measure photocurrents produced by photoexcited hot electrons and holes in bulk metal films.
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Laskar S, Pilar A, Khanna N, Gupta M, Puri A, Yadav P, Gulia A, Quereshi S, Nayak P, Juvekar S, Rekhi B, Chinnaswamy G, Medhi S, Bajpai J, Vora T, Desai S. Perioperative Interstitial Brachytherapy and Flap Morbidity in Soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pilar A, Laskar S, Rangarajan V, Purandare N, Budrukkar A, Gupta T, Murthy V, Pai P, Deshmukh A, Chaukar D, D'Cruz A, Agarwal J. Positron Emission Tomography/Computed Tomography Based Prognostication in Nasopharyngeal Cancers Treated With Definitive Chemoradiation Therapy: A Step Beyond TNM? Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ghosh Laskar S, Pilar A, Purandare N, Rangarajan V, Budrukkar A, Gupta T, Murthy V. PO-120: Clinical impact of metabolic and anatomic imaging in nasopharyngeal carcinoma treated with chemo-radiotherapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34880-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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