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Mate CM, McClelland GM, Erlandsson R, Chiang S. Atomic-scale friction of a tungsten tip on a graphite surface. PHYSICAL REVIEW LETTERS 1987; 59:1942-1945. [PMID: 10035374 DOI: 10.1103/physrevlett.59.1942] [Citation(s) in RCA: 468] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
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Wöll C, Chiang S, Wilson RJ, Lippel PH. Determination of atom positions at stacking-fault dislocations on Au(111) by scanning tunneling microscopy. PHYSICAL REVIEW. B, CONDENSED MATTER 1989; 39:7988-7991. [PMID: 9947487 DOI: 10.1103/physrevb.39.7988] [Citation(s) in RCA: 304] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Lippel PH, Wilson RJ, Miller MD, Wöll C, Chiang S. High-resolution imaging of copper-phthalocyanine by scanning-tunneling microscopy. PHYSICAL REVIEW LETTERS 1989; 62:171-174. [PMID: 10039941 DOI: 10.1103/physrevlett.62.171] [Citation(s) in RCA: 161] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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161 |
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Chao A, Jost L, Chiang SC, Jiang YH, Chazdon RL. A two-stage probabilistic approach to multiple-community similarity indices. Biometrics 2008; 64:1178-86. [PMID: 18355386 DOI: 10.1111/j.1541-0420.2008.01010.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
SUMMARY A traditional approach for assessing similarity among N (N > 2) communities is to use multiple pairwise comparisons. However, pairwise similarity indices do not completely characterize multiple-community similarity because the information shared by at least three communities is ignored. We propose a new and intuitive two-stage probabilistic approach, which leads to a general framework to simultaneously compare multiple communities based on abundance data. The approach is specifically used to extend the commonly used Morisita index and NESS (normalized expected species shared) index to the case of N communities. For comparing N communities, a profile of N- 1 indices is proposed to characterize similarity of species composition across communities. Based on sample abundance data, nearly unbiased estimators of the proposed indices and their variances are obtained. These generalized NESS and Morisita indices are applied to comparison of three size classes of plant data (seedling, saplings, and trees) within old-growth and secondary rain forest plots in Costa Rica.
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Schwarz MJ, Chiang S, Müller N, Ackenheil M. T-helper-1 and T-helper-2 responses in psychiatric disorders. Brain Behav Immun 2001; 15:340-70. [PMID: 11782103 DOI: 10.1006/brbi.2001.0647] [Citation(s) in RCA: 145] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The expanding field of psychoneuroimmunology has markedly increased knowledge about the interference of the central nervous system and the immune system. Immunological abnormalities in psychiatric patients have been repeatedly described in the last century. Modern concepts of immunology and the growing knowledge of psychoneuroimmunology may help in understanding the distinct immunological mechanisms in psychiatric disorders. One of these concepts regarding the adaptive immune system is the discrimination between Th1-like cell-mediated and Th2-like antibody-related immune responses. This article systematically describes alterations of Th1- or Th2-specific parameters in the major psychiatric disorders schizophrenia, major depression, and Alzheimer's disease. There are several hints of associations of these two distinct arms of immune response with subgroups of schizophrenia and major depression. The immunological research in Alzheimer's disease has already led to a preclinical model of immunotherapy. Categorization of immune parameters may also help to identify a possible immune-related pathophysiology in psychotic and affective disorders, resulting in specific treatment strategies.
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Review |
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Ohtani H, Wilson RJ, Chiang S, Mate CM. Scanning tunneling microscopy observations of benzene molecules on the Rh(111)-(3 x 3) (C6H6+2CO) surface. PHYSICAL REVIEW LETTERS 1988; 60:2398-2401. [PMID: 10038341 DOI: 10.1103/physrevlett.60.2398] [Citation(s) in RCA: 143] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Sprinkle M, Siegel D, Hu Y, Hicks J, Tejeda A, Taleb-Ibrahimi A, Le Fèvre P, Bertran F, Vizzini S, Enriquez H, Chiang S, Soukiassian P, Berger C, de Heer WA, Lanzara A, Conrad EH. First direct observation of a nearly ideal graphene band structure. PHYSICAL REVIEW LETTERS 2009; 103:226803. [PMID: 20366119 DOI: 10.1103/physrevlett.103.226803] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Indexed: 05/29/2023]
Abstract
Angle-resolved photoemission and x-ray diffraction experiments show that multilayer epitaxial graphene grown on the SiC(0001) surface is a new form of carbon that is composed of effectively isolated graphene sheets. The unique rotational stacking of these films causes adjacent graphene layers to electronically decouple leading to a set of nearly independent linearly dispersing bands (Dirac cones) at the graphene K point. Each cone corresponds to an individual macroscale graphene sheet in a multilayer stack where AB-stacked sheets can be considered as low density faults.
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Hallmark VM, Chiang S, Rabolt JF, Swalen JD, Wilson RJ. Observation of atomic corrugation on Au(111) by scanning tunneling microscopy. PHYSICAL REVIEW LETTERS 1987; 59:2879-2882. [PMID: 10035677 DOI: 10.1103/physrevlett.59.2879] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Chambliss DD, Wilson RJ, Chiang S. Nucleation of ordered Ni island arrays on Au(111) by surface-lattice dislocations. PHYSICAL REVIEW LETTERS 1991; 66:1721-1724. [PMID: 10043290 DOI: 10.1103/physrevlett.66.1721] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Wöll C, Wilson RJ, Chiang S, Zeng HC, Mitchell KA. Oxygen on Cu(100) surface structure studied by scanning tunneling microscopy and by low-energy-electron-diffraction multiple-scattering calculations. PHYSICAL REVIEW. B, CONDENSED MATTER 1990; 42:11926-11929. [PMID: 9995504 DOI: 10.1103/physrevb.42.11926] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Wilson RJ, Chiang S. Structure of the Ag/Si(111) surface by scanning tunneling microscopy. PHYSICAL REVIEW LETTERS 1987; 58:369-372. [PMID: 10034916 DOI: 10.1103/physrevlett.58.369] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Hsu MH, Chiang SC, Ye RD, Prossnitz ER. Phosphorylation of the N-formyl peptide receptor is required for receptor internalization but not chemotaxis. J Biol Chem 1997; 272:29426-9. [PMID: 9367998 DOI: 10.1074/jbc.272.47.29426] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The human N-formyl peptide receptor (FPR) is a member of the family of leukocyte, G protein-coupled, chemoattractant receptors. To determine the role(s) of receptor phosphorylation in FPR processing and formylmethionylleucylphenylalanine (fMLF)-mediated chemotaxis, we utilized U937 cells expressing the recombinant wild type receptor and a mutant form of the FPR. This mutant, which lacks all of the serine and threonine residues in the C terminus of the receptor, DeltaST, has recently been shown to produce a receptor capable of fMLF binding and G protein activation but was demonstrated not to undergo fMLF-dependent phosphorylation or desensitization of the calcium mobilization response upon repeated exposure to agonist (Prossnitz, E. R. (1997) J. Biol. Chem. 272, 15213-15219). In this report, we examined the role of receptor phosphorylation in FPR internalization and leukocyte chemotaxis. Whereas the wild type receptor was rapidly internalized upon stimulation, the phosphorylation-deficient mutant was not, remaining entirely on the cell surface. In addition, contrary to the hypothesis that receptor processing and recycling are required for chemotaxis, we found no defect in the ability of the mutant FPR to migrate up a concentration gradient of fMLF. These results indicate that phosphorylation of the FPR is a necessary step in receptor internalization but that receptor phosphorylation, desensitization, and internalization are not required for chemotaxis.
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Abstract
Angular and rotational profile of the lower limbs of 2,630 normal Chinese children from newborn to age 12 years were compiled using tibiofemoral angle, intercondylar, intermalleolar distance, medial and lateral rotation of the hip, and thigh-foot angle. Children with clinical tibiofemoral angles, intercondylar or intermalleolar distances tended to be bowlegged at birth, maximally knock-kneed at age 3 and to have normal lower limbs by age 8. Medial hip rotation increased steadily from birth to a maximum of 56 degrees at age 9, and lateral hip rotation decreased from birth to a minimum of 30 degrees at age 9. Significant differences between Chinese children and children of other races were highlighted.
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Kalki K, Chambliss DD, Johnson KE, Wilson RJ, Chiang S. Evidence for martensitic fcc-bcc transition of thin Fe films on Cu(100). PHYSICAL REVIEW. B, CONDENSED MATTER 1993; 48:18344-18347. [PMID: 10008491 DOI: 10.1103/physrevb.48.18344] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Chen HS, Hwu CM, Kuo BI, Chiang SC, Kwok CF, Lee SH, Lee YS, Weih MJ, Hsiao LC, Lin SH, Ho LT. Abnormal cardiovascular reflex tests are predictors of mortality in Type 2 diabetes mellitus. Diabet Med 2001; 18:268-273. [PMID: 11437856 DOI: 10.1046/j.1464-5491.2001.00442.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS To determine whether diabetic autonomic neuropathy is an important factor contributing to mortality in Type 2 diabetes mellitus. METHODS Between 1989 and 1993, 431 men and 181 women with Type 2 diabetes were given diabetic autonomic neuropathy cardiovascular reflex (CVR) tests. These subjects were followed for the subsequent 5--9 years to assess mortality rates. RESULTS The prevalence rate of abnormal CVR tests was 46.1% in patients with the history of diabetes less than 5 years and up to 69.4% when the history of diabetes exceeded 20 years. During the follow-up period from 1 January 1989 to 31 December 1997 (mean 7.7 years), a total of 135 participants died. The 8-year survival rate for patients with abnormal CVR tests was 63.6% in males and 76.4% in females, compared with 80.9 and 93.3% for patients with normal CVR tests. The results were grouped as: group 1, normal CVR tests without postural hypotension (PHT); group 2, normal CVR tests with PHT; group 3, abnormal CVR tests without PHT; and group 4, abnormal CVR tests with PHT. The 8-year survival rate was 85.4% in group 1, 80.9% in group 2, 74.5% in group 3 and 61.1% in group 4. CONCLUSION Type 2 diabetic patients with abnormal CVR tests may have increased mortality, and those combined with postural hypotension have higher mortality than those without. Abnormal CVR tests may be important predictors of mortality in Type 2 diabetes mellitus.
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Rifkind JM, Lauer LD, Chiang SC, Li NC. Copper and the oxidation of hemoglobin: a comparison of horse and human hemoglobins. Biochemistry 1976; 15:5337-43. [PMID: 187214 DOI: 10.1021/bi00669a021] [Citation(s) in RCA: 45] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Oxidation studies of hemoglobin by Cu(II) indicate that for horse hemoglobin, up to a Cu(II)/heme molar ratio of 0.5, all of the Cu(II) added is used to rapidly oxidize the heme. On the other hand, most of the Cu(II) added to human hemoglobin at low Cu(II)/heme molar ratios is unable to oxidize the heme. Only at Cu(II)/heme molar ratios greater than 0.5 does the amount of oxidation per added Cu(II) approach that of horse hemoglobin. At the same time, binding studies indicate that human hemoglobin has an additional binding site involving one copper for every two hemes, which has a higher copper affinity than the single horse hemoglobin binding site. The Cu(II) oxidation of human hemoglobin is explained utilizing this additional binding site by a mechanism where a transfer of electrons cannot occur between the heme and the Cu(II) bound to the high affinity human binding site. The electron transfer must involve the Cu(II) bound to the lower affinity human hemoglobin binding site, which is similar to the only horse hemoglobin site. The involvement of beta-2 histidine in the binding of this additional copper is indicated by a comparison of the amino acid sequences of various hemoglobins which possess the additional site, with the amino acid sequences of hemoglobins which do not possess the additional site. Zn(II), Hg(II), and N-ethylmaleimide (NEM) are found to decrease the Cu(II) oxidation of hemoglobin. The sulfhydryl reagents, Hg(II) and NEM, produce a very dramatic decrease in the rate of oxidation, which can only be explained by an effect on the rate for the actual transfer of electrons between the Cu(II) and the Fe(II). The effect of Zn(II) is much smaller and can, for the most part, be explained by the increased oxygen affinity, which affects the ligand dissociation process that must precede the electron transfer process.
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Comparative Study |
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Wilson RJ, Chiang S, Salvan F. Examination of the Cu/Si(111) 5 x 5 structure by scanning tunneling microscopy. PHYSICAL REVIEW. B, CONDENSED MATTER 1988; 38:12696-12699. [PMID: 9946226 DOI: 10.1103/physrevb.38.12696] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Chiang S, Dar AM, Goyal SM, Sheikh MA, Pedersen JC, Panigrahy B, Senne D, Halvorson DA, Nagaraja KV, Kapur V. A modified enzyme-linked immunosorbent assay for the detection of avian pneumovirus antibodies. J Vet Diagn Invest 2000; 12:381-4. [PMID: 10907873 DOI: 10.1177/104063870001200417] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Avian pneumovirus (APV) infection of turkeys in Minnesota was first confirmed in March 1997. Serum samples (n = 5,194) from 539 submissions to Minnesota Veterinary Diagnostic Laboratory were tested by a modified enzyme-linked immunosorbent assay (ELISA). Of these, 2,528 (48.7%) samples from 269 submissions were positive and 2,666 (51.3%) samples from 270 submissions were negative for APV antibodies. Most positive samples were from Kandiyohi, Stearns, Morrison, and Meeker counties in Minnesota. In addition, 10 samples from South Dakota were positive. The sensitivity and specificity of the ELISA test with anti-chicken and anti-turkey conjugates were compared by testing field and experimental sera. The ELISA test with anti-turkey conjugate was more sensitive than that with anti-chicken conjugate. The ELISA tests with antigens prepared with APV strains isolated from Colorado and Minnesota were also compared. No difference was detectable. Currently, the Minnesota Veterinary Diagnostic Laboratory uses an antigen prepared from the Colorado isolate of APV and a goat anti-turkey conjugate in the ELISA test.
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Hallmark VM, Chiang S, Meinhardt K, Hafner K. Observation and calculation of internal structure in scanning tunneling microscopy images of related molecules. PHYSICAL REVIEW LETTERS 1993; 70:3740-3743. [PMID: 10053950 DOI: 10.1103/physrevlett.70.3740] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Hallmark VM, Chiang S, Brown JK, Wöll C. Real-space imaging of the molecular organization of naphthalene on Pt(111). PHYSICAL REVIEW LETTERS 1991; 66:48-51. [PMID: 10043139 DOI: 10.1103/physrevlett.66.48] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Wilson RJ, Chiang S. Registration and nucleation of the Ag/Si(111)( sqrt 3 x sqrt 3)R30 degrees structure by scanning tunneling microscopy. PHYSICAL REVIEW LETTERS 1987; 59:2329-2332. [PMID: 10035515 DOI: 10.1103/physrevlett.59.2329] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Liu ST, Li SN, Wang DC, Chang SF, Chiang SC, Ho WC, Chang YS, Lai SS. Rapid detection of hog cholera virus in tissues by the polymerase chain reaction. J Virol Methods 1991; 35:227-36. [PMID: 1816255 DOI: 10.1016/0166-0934(91)90138-p] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A rapid method for the detection of hog cholera virus (HCV) in infected tissues, using polymerase chain reaction (PCR) was developed. Total RNA isolated from HCV-infected tissues was reverse transcribed with AMV reverse transcriptase and the resulting complementary DNA was amplified by Taq DNA polymerase in the presence of two HCV-specific primers. The amplified DNA fragment was detected by agarose gel electrophoresis. The sensitivity of this method was at 10(4) TCID50 of HCV. The sensitivity increased approximately 1000-fold when the DNA was reamplified with a set of nested primers. DNA sequencing analysis of the PCR products revealed that the HCV sequence amplified from a local field isolate was highly homologous to the HCV Alfort strain. This method may be useful for pathological and epidemiological studies of HCV in pigs.
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Prossnitz ER, Gilbert TL, Chiang S, Campbell JJ, Qin S, Newman W, Sklar LA, Ye RD. Multiple activation steps of the N-formyl peptide receptor. Biochemistry 1999; 38:2240-7. [PMID: 10029516 DOI: 10.1021/bi982274t] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The human N-formyl peptide receptor (FPR) is representative of a growing family of G protein-coupled receptors (GPCR) that respond to chemokines and chemoattractants. Despite the importance of this receptor class to immune function, relatively little is known about the molecular mechanisms involved in their activation. To reveal steps required for the activation of GPCR receptors, we utilized mutants of the FPR which have previously been shown to be incapable of binding and activating G proteins. For this study, the FPR mutants were expressed in human myeloid U937 cells and characterized for functions in addition to G protein coupling, such as receptor phosphorylation and ligand-induced receptor internalization. The results demonstrated that one of the mutants, R123G, though being unable to activate G protein, was capable of undergoing ligand-induced phosphorylation as well as internalization. Receptor internalization was monitored by following the fate of the ligand as well as by directly monitoring the fate of the receptor. The results with the R123G mutant were in contrast to those obtained for mutants D71A and R309G/E310A/R311G which, though being expressed at the cell surface and binding ligand, were incapable of being phosphorylated or internalized upon agonist stimulation. These results suggest that following ligand binding at least two "steps" are required for full activation of the wild-type FPR. That these observations may be of more general importance in GPCR-mediated signaling is suggested by the highly conserved nature of the mutants studied: D71, R123, and the site represented by amino acids 309-311 are very highly conserved throughout the entire superfamily of G protein-coupled receptors. Models of receptor activation based on the observed results are discussed.
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MESH Headings
- Animals
- Calcium Signaling
- Cell Line
- Fibroblasts
- Flow Cytometry
- GTP-Binding Proteins/metabolism
- Humans
- Ligands
- Mice
- Mice, Inbred C57BL
- Models, Biological
- Models, Molecular
- Mutagenesis, Site-Directed
- N-Formylmethionine Leucyl-Phenylalanine/metabolism
- Phosphorylation
- Receptors, Formyl Peptide
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
- Receptors, Immunologic/physiology
- Receptors, Peptide/genetics
- Receptors, Peptide/metabolism
- Receptors, Peptide/physiology
- U937 Cells
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Abstract
BACKGROUND/PURPOSE Angiogenesis plays an integral role in wound healing and tissue remodeling. The authors hypothesized that inhibition of angiogenesis would reduce intraabdominal adhesion formation. METHODS In 98 C57BL6/J mice, a 2-cm midline laparotomy was performed and a 5 mm2 SILASTIC (Dow Corning, Midland, MI) patch fixed to the right side of the peritoneum. Mice were injected with normal saline (n = 54) or TNP-470, an inhibitor of angiogenesis (n = 44; 30 mg/kg every other day over 6 days before surgery until 10 days after surgery). Animals were killed on postoperative days 10, 15, 35, and 55. Adhesions to the SILASTIC (Dow Corning) patch were scored based on their extent, type, and tenacity. Angiogenesis was quantified digitally as the area of vascularized peritoneum over the patch. RESULTS At day 10, when TNP-470 was stopped, the percentage of vascularized peritoneum over the patch was less in treatment animals than in controls (P = .004). At day 35, the patch in treatment animals was completely covered by vascularized peritoneum, similar to controls. Adhesions in TNP-470 animals were reduced at day 10 compared with controls (P<.05) and remained reduced off treatment at day 55. CONCLUSIONS Angiogenesis appears to play an important role in the development of intraabdominal adhesions, because the extent of early neovascularization correlates with adhesion formation. Perioperative treatment with TNP-470, a potent endothelial cell inhibitor, reduced vessel ingrowth over the patch and was associated with a sustained reduction in adhesion formation.
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Teh BS, Bloch C, Galli-Guevara M, Doh L, Richardson S, Chiang S, Yeh P, Gonzalez M, Lunn W, Marco R, Jac J, Paulino AC, Lu HH, Butler EB, Amato RJ. The treatment of primary and metastatic renal cell carcinoma (RCC) with image-guided stereotactic body radiation therapy (SBRT). Biomed Imaging Interv J 2007; 3:e6. [PMID: 21614267 PMCID: PMC3097653 DOI: 10.2349/biij.3.1.e6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2007] [Revised: 02/11/2007] [Accepted: 02/13/2007] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Brain metastases from renal cell carcinoma (RCC) have been successfully treated with stereotactic radiosurgery (SRS). Metastases to extra-cranial sites may be treated with similar success using stereotactic body radiation therapy (SBRT), where image-guidance allows for the delivery of precise high-dose radiation in a few fractions. This paper reports the authors' initial experience with image-guided SBRT in treating primary and metastatic RCC. MATERIALS AND METHODS The image-guided Brainlab Novalis stereotactic system was used. Fourteen patients with 23 extra-cranial metastatic RCC lesions (orbits, head and neck, lung, mediastinum, sternum, clavicle, scapula, humerus, rib, spine and abdominal wall) and two patients with biopsy-proven primary RCC (not surgical candidates) were treated with SBRT (24-40 Gy in 3-6 fractions over 1-2 weeks). All patients were immobilised in body cast or head and neck mask. Image-guidance was used for all fractions. PET/CT images were fused with simulation CT images to assist in target delineation and dose determination. SMART (simultaneous modulated accelerated radiation therapy) boost approach was adopted. 4D-CT was utilised to assess tumour/organ motion and assist in determining planning target volume margins. RESULTS Median follow-up was nine months. Thirteen patients (93%) who received SBRT to extra-cranial metastases achieved symptomatic relief. Two patients had local progression, yielding a local control rate of 87%. In the two patients with primary RCC, tumour size remained unchanged but their pain improved, and their renal function was unchanged post SBRT. There were no significant treatment-related side effects. CONCLUSION Image-guided SBRT provides excellent symptom palliation and local control without any significant toxicity. SBRT may represent a novel, non-invasive, nephron-sparing option for the treatment of primary RCC as well as extra-cranial metastatic RCC.
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