As oncologic therapies continue to advance,the overall survival of cancer patients has markedly increased.Nevertheless,virtually every anticancer treatment modality is accompanied by some degree of cardiotoxicity.Epid...As oncologic therapies continue to advance,the overall survival of cancer patients has markedly increased.Nevertheless,virtually every anticancer treatment modality is accompanied by some degree of cardiotoxicity.Epidemiological data indicate that approximately 30%of cancer survivors ultimately die from cardiovascular disease.Among the cardiotoxic agents,the anthracycline doxorubicin(DOX)is the most widely used.It effectively suppresses a variety of malignant tumors——including breast cancer,lymphoma,and acute leukemia——but its cardiac toxicity limits further escalation of clinical dosing.Literature reports identify a cumulative dose of≥250 mg/m²as the threshold of high risk,with roughly 25%of patients receiving DOX developing varying degrees of myocardial injury;severe cases progress to heart failure.Even at cumulative doses below the traditional safety limit,some patients exhibit cardiac dysfunction after the first administration,suggesting that cardiotoxicity is not solely a linear function of dose.DOX related cardiotoxicity can be classified as acute(hours to days after administration),sub acute(weeks to months),and chronic/late onset(years later).Most patients initially exhibit only mild reductions in left ventricular ejection fraction(LVEF)or subtle abnormalities in global longitudinal strain(GLS),often without symptoms.Recently,cardiac biomarkers(cTn,NT proBNP)combined with high sensitivity echocardiography(speckle tracking)have been recommended for monitoring high risk individuals,enabling detection of subclinical injury before overt LVEF decline.Currently,several preventive and therapeutic approaches are used in clinical practice,which can be summarized into the following four points.(1)Dose limitation and administration strategies:fractionated low dose regimens,liposomal encapsulation,or continuous infusion lower peak plasma concentrations,thereby reducing cardiac exposure.(2)Pharmacologic prophylaxis:βblockers(e.g.,carvedilol)and ACE inhibitors/ARBs have shown protective effects on LVEF in some randomized trials,though results remain inconsistent and require larger confirmatory studies.(3)Metabolic targeted interventions:animal experiments indicate that activation of PPARαor supplementation with L carnitine restores fatty acid oxidation and improves ATP generation,suggesting metabolic modulators as promising cardioprotective candidates.(4)Lifestyle modifications:regular aerobic exercise up regulates mitochondrial biogenesis genes(PGC-1α)and reduces reactive oxygen species(ROS)production;small clinical studies have demonstrated a potential benefit in attenuating cTnT elevation.However,DOX-induced cardiotoxicity has not been effectively controlled,indicating that the core mechanism underlying DOX‑related cardiac toxicity remains unidentified.Cardiomyocytes are high energy demand cells,and metabolic dysregulation is considered a central component of DOX induced cardiotoxicity.DOX disrupts myocardial metabolic balance through several interrelated pathways.(1)Oxidative stress and mitochondrial damage:DOX generates abundant ROS within cells,leading to mitochondrial membrane potential loss,lipid peroxidation,and iron accumulation,which suppress electron transport chain activity and markedly reduce ATP synthesis efficiency.(2)Autophagy dysregulation:DOX interferes with autophagic flux,preventing the clearance of damaged mitochondria and further aggravating apoptosis and inflammatory responses.(3)Inflammation and cytokine release:oxidative stress activates NF‑κB,up-regulating pro inflammatory cytokines such as TNF‑αand IL-6,creating a chronic inflammatory microenvironment that weakens myocardial contractility.(4)Epigenetic modifications:studies have shown that DOX alters DNA methylation and histone acetylation patterns in cardiomyocytes,affecting the expression of key metabolic genes(e.g.,PGC-1α,CPT-1)and further inhibiting fatty acidβoxidation.These mechanisms collectively lead to suppressed fatty acid oxidation and compensatory up regulation of glycolysis,manifested by an elevated lactate/pyruvate ratio,accumulation of medium chain acyl carnitines,and a pronounced decline in ATP production.The resulting energy deficit precipitates left ventricular contractile dysfunction and,ultimately,heart failure.Despite extensive basic and clinical research on DOX cardiotoxicity,a unified risk assessment model and precise interventions targeting metabolic disturbances remain lacking.This review systematically summarizes recent progress on DOX induced cardiotoxicity and highlights that impairment of myocardial energy metabolism is a central mechanism of injury,thereby deepened our understanding of how impaired myocardial energy metabolism drives DOX induced injury,we can move toward safer chemotherapy protocols that achieve“cure cancer without harming the heart”.展开更多
Hospital wastewater contains complex pollutants,including residual organic dyes and antibiotic-resistant pathogens,posing severe risks to ecosystems and human health.Conventional adsorbents,constrained by monopolar fu...Hospital wastewater contains complex pollutants,including residual organic dyes and antibiotic-resistant pathogens,posing severe risks to ecosystems and human health.Conventional adsorbents,constrained by monopolar functional groups and limited surface sites,fail to remove both pollutants simultaneously.Here,we report an intelligent responsive polyurethane microsphere adsorbent doped with diallyl dimethylammonium chloride modified carbon nanotubes,termed as PUCD microspheres.The PUCD integrates bipolar adsorption sites,tunable micrometer-scale pores,and a near-infrared(NIR)-triggered in situ capture mechanism within a single platform,which achieves up to 98.3%dye removal,maintains strong adsorption performance across a wide pH range and retains 83.3%efficiency for rhodamine B after five cycles.Notably,the PUCD employs a temperature-responsive phase transition:under NIR irradiation,the microspheres undergo shrinkage,reducing the pore size to generate a‘polymer trap',enabling in situ capture of bacteria with>99%efficiencies for both Staphylococcus aureus and Escherichia coli.By immobilizing live bacteria,the PUCD microspheres substantially reduces the risk of pathogen desorption and toxin release.This promising platform offers a safe,efficient,and single-stage strategy for hospital wastewater purification,enabling the simultaneous elimination of dyes and pathogenic bacteria.展开更多
Objective Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy(VMAT) has been introduced into clinical practice. The p...Objective Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy(VMAT) has been introduced into clinical practice. The purpose of this study was to investigate the dosimetric effects of different multileaf collimators(MLC) on VMAT radiotherapy plans for treating breast cancer.Methods Fifteen breast cancer patients who were treated using a conventional technique in our department were selected to participate in this retrospective analysis. VMAT plans based on three types of Elekta MLCs [Beam Modulator(BM) with 4-mm leaf width, Agility with 5-mm leaf width and MLCi2 with 10-mm leaf width] were independently generated for each patient. Plan comparisons were performed based on dose-volume histogram(DVH) analysis including dosimetric parameters such as the homogeneity index(HI), conformity index(CI), Dmax, Dmin, and Dmean for the planning treatment volume(PTV), in addition to dose-volume parameters for the organs at risk(OARs). The delivery efficiency of the three types of MLCs was compared in terms of the beam delivery time and the monitor units(MUs) per fraction for each plan. Results Both target uniformity and conformity were improved in plans for Agility and BM MLC compared with the plan using MLCi2. The mean HI decreased from 1.14 for MLCi2 to 1.13 for BM and 1.10 for Agility, while the mean CI increased from 0.68 for MLCi2 to 0.73 for BM and 0.75 for Agility. Furthermore, at both low and high dose levels, smaller volumes of ipsilateral lung, heart, contralateral lung, and breast were irradiated with Agility MLC than with the other two types of MLCs. The delivery time with Agility MLC was reduced by 10.8% and 32.1%, respectively, compared with that for MLCi2 and BM.Conclusion Our results indicate that the Agility MLC exhibits a dosimetric advantage and a significant improvement in delivery efficiency for the treatment of breast cancer using VMAT.展开更多
Objective: We aim to quantify the magnitude of setup errors in intensity-modulated radiotherapy (IMRT) treated Head and Neck cancer patients and recommend appropriate PTV margin. Methods: 60 patients with head and nec...Objective: We aim to quantify the magnitude of setup errors in intensity-modulated radiotherapy (IMRT) treated Head and Neck cancer patients and recommend appropriate PTV margin. Methods: 60 patients with head and neck cancer required bilateral neck irradiation were planned and treated by simultaneous integrated boost IMRT technique either treated radically or postoperative. Patients undergoing image-guided radiotherapy (IGRT) each with once weekly scheduled cone beam computed tomography (CBCT). The 3D displacements, systematic and random errors were calculated. The appropriate PTV expansion was determined using Van Herk’s formula. Results: Mean 3D displacement was 0.16 cm in the vertical direction, 0.14 cm in the horizontal direction and 0.16 cm in the longitudinal direction. Conclusion: Use of weekly CBCT allows the planning target volume (PTV) expansion to be reduced according to our setup. The appropriate clinical target volume (CTV)-PTV margin for our institute is 0.30 cm, 0.38 cm, and 0.33 cm in the horizontal, vertical, and longitudinal directions, respectively.展开更多
Polyvinyl alcohol(PVA) is a well-known friendly polymer for paper-making, textiles, and a variety of coatings, biomedical applications such as artificial pancreas, synthetic vitreous body, wound dressing, artificial s...Polyvinyl alcohol(PVA) is a well-known friendly polymer for paper-making, textiles, and a variety of coatings, biomedical applications such as artificial pancreas, synthetic vitreous body, wound dressing, artificial skin,and cardiovascular device. In this paper, ion/electron beam is employed to get insight into the irradiation effect on surface morphology and optical properties of PVA polymer. UV-Vis spectra are recorded to investigate the effect of induced defects on the optical band gap and the formed carbon clusters size. Scanning electron microscopy(SEM) is used to relate and investigate surface morphology and optical properties of the target polymer with different doses(15, 30 and 60 min). Also, PVA polymer is subjected to theoretical studies by using semi-empirical PM7 quantum chemical method.展开更多
This work was undertaken to establish a new experimental model of hepatic fibrosis by gamma irradiation and CCl4 and to study the hepatoprotective effect of Reishi Mushroom (RM) against hepatic fibrosis induced in tha...This work was undertaken to establish a new experimental model of hepatic fibrosis by gamma irradiation and CCl4 and to study the hepatoprotective effect of Reishi Mushroom (RM) against hepatic fibrosis induced in that model. Our results revealed that oral co-administration of 110 mg/kg RM by gavage to fibrotic rats offered an obvious hepatic protection as assured by the significant decrement in ALT and AST, HP content, MDA and NO levels with elevation of the antioxidant enzymes activities. The levels of TGF-β, TNF-α, HO-1 and type-1 collagen and their m-RNA expression were markedly declined as compared with those of fibrotic rats. Microscopical examination revealed that the exposure of rats to radiation aggravated the effect of CCl4 causing extensive collagen deposition and marked pseudolobulation of the hepatic parenchyma indicative of bridging fibrosis. While, oral co-administration of RM obviously improved the state of steatosis and apparently suppressed hepatic fibrogenesis.展开更多
The article provides outcomes of efforts taken by the specialists of radiation safety departments of Ukrainian Nuclear Power Plants （NPPs） to optimize and decrease exposure doses of personnel performing works during...The article provides outcomes of efforts taken by the specialists of radiation safety departments of Ukrainian Nuclear Power Plants （NPPs） to optimize and decrease exposure doses of personnel performing works during outages at NPP units. The article is written based on many years＇ experience and analysis of radiation hazardous works performed during scheduled maintenance of NPP equipment. It highlights significance of planning radiation doses （dose quotas） and organization of pending works during outages based on lessons learned. The results of works allowed to give due consideration to training of NPP maintenance personnel, improvement of labour conditions, workplace setup and enhancement of radiation protection means.展开更多
Background: The risk of carotid vessel stenosis is high after radiotherapy (RT) to neck;however, carotid vessels are unavoidable during supraclavicular (SC-RT) in adjuvant treatment of breast cancer (BC). However, car...Background: The risk of carotid vessel stenosis is high after radiotherapy (RT) to neck;however, carotid vessels are unavoidable during supraclavicular (SC-RT) in adjuvant treatment of breast cancer (BC). However, carotid vessels RT dose is less well-understood. We aimed to determine the carotid vessels doses received by different techniques for SC-RT. Materials and Methods: Thirty consecutive BC patients were planned to receive SC-RT and breast after breast conserving surgery (BCS) after taking 5 mm image slices on computed tomography (CT) simulation. Organs at risk (OAR) including carotid vessels, lungs, spinal cord alongwith clinical target volume (CTV) for primary tumor and lymph nodes were delineated. Comparative analysis was done between two treatment plans;three-field conformal radiation therapy (3F-CRT) and four field conformal RT (4F-CRT) for CTV and carotid vessels doses. Results: The 4F-CRT was found better than 3F-3DCRT regarding coverage and homogeneity of the CTV volume. The 98% of the CTV was covered by 84% dose in 3F-CRT and 95% in 4F-CRT (p 0.001). The carotid vessels maximum dose in the in 3F-CRT was 54.5 ± 1.3 Gy compared to 51.6 ± 1.3 Gy in 4F-CRT (p 0.014), however the mean dose did not differ significantly (p value 0.8). The ipsilateral lung dose did not differ between the two techniques (p Value 0.9). Conclusion: The 4F-CRT plan was found better than 3F-CRT in CTV coverage with minimal dose to the carotid vessel and without significant higher dose to the ipsilateral lung.展开更多
Background and Purpose: The relapsed low grade non-Hodgkin’s lymphoma (LG-NHL) is currently?incurable disease and the optimal treatment regimen has not determined yet. Low dose total body irradiation (LTBI) provides ...Background and Purpose: The relapsed low grade non-Hodgkin’s lymphoma (LG-NHL) is currently?incurable disease and the optimal treatment regimen has not determined yet. Low dose total body irradiation (LTBI) provides an alternative mechanism of action against cancer cells rather than direct cell kill. The mode of action of LTBI is immune-modulatory effect, induction of apoptosis and?hypersensitivity to low radiation doses. The aim of our study is to evaluate the effect of LTBI on relapsed?LG-NHL and reporting our experience at National Cancer Institute, Cairo (NCI, Cairo). Material and Methods: Fifty eight patients with relapsed LG-NHL and received LTBI studied retrospectively.?LTBI dose was 1.6 Gy/8 fractions divided on 2 courses;each course 4 fractions treated over 4 days with 2 weeks rest between the 2 courses. Results: The median age is 54 years;65% of the patients are men. Forty (69%) patients had performance status of 2 or more. Twenty seven patients were stage II/III and 31 patients (53%) had stage IV disease. Twenty six (45%) patients had bulky disease more than 10 cm and 22 (38%) patients had B symptoms at the time of relapse. The?extranodal disease was present in 17 patients (29%) and 78% of the patients received?>3 regimens of chemotherapy before referral to LTBI. Twenty three patients received IFRT (mean dose 32 ± 4 Gy) to initially bulky sites after LTBI. Fourteen patients (24%) achieved complete remission (CR) while 45%, 21% and 10% had partial remission (PR), stable disease (SD) and progressive disease (PD) respectively. The median PFS duration was 14 months and the median OS duration?was 39 months. Stage VI,?>3 regimen of chemotherapy and bad response to LTBI (SD) affected?progression duration adversely (0.03, 0.05 and 0.01 respectively). The response to LTBI is the only factor affected the OS duration significantly. The 3-year PFS was 19% ± 9%, and 3-year OS was 45% ± 8%. Stage IV was the only factor affected the 3-year PFS significantly with p value 0.03. The hematological toxicity was the main side effect of LTBI. Eleven patients developed G3/4 anemia while 8 patients only developed G3/4 thrombocytopenia and 13 patients developed G3/4 leucopenia. Conclusion: The use of LTBI in patients with relapsed low grade NHL is a feasible, effective and tolerable treatment that is worthy of testing in a future with chemotherapy and Rituximab maintenance.展开更多
Accidents involving industrial radiography are the most frequent cause of severe or fatal overexposure to workers and the public. On May 5, 2000, a radiation accident happened at a construction site in a gamma radiogr...Accidents involving industrial radiography are the most frequent cause of severe or fatal overexposure to workers and the public. On May 5, 2000, a radiation accident happened at a construction site in a gamma radiography practice at the village of Meet Halfa-Egypt. The accident was a severe overdose of non-radiation workers due to external exposure of Ir-192. This paper provides a methodology for calculating doses and dose rates from the most commonly used industrial γ-sources: 192Ir, 60Co, 134Cs, 137Cs and 131I. For this purpose, MCNP computer code based on Monte Carlo technique is used. The applied method helps firstly in studying and analyzing the doses from the above mentioned sources. Secondly, it provides a lead container design in a trial to reduce the dose rate within the permissible. Computer models were used to simulate the 192Ir Meet Halfa accident. To verify these models, the calculated doses were compared with a well-known empirical formula to convert source activity into dose rate and then the models were applied at different distances to analyze the factors that affect the deposited dose in the human body to find out the dose received by the victims.展开更多
Background: Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of prim...Background: Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of primary rectal cancer is curative surgical resection;however, a fine balance remains between disease cure and restoration of gastrointestinal continuity. Combined modality has proven efficacy in many malignant tumors with advantage of organ preservation. Methods: Forty nine (49) patients with low rectal carcinoma were included in a prospective study, between Jan 2007 and Jan 2012. Preoperative chemoradiation was administrated to all patients and subjected to different techniques of sphincter saving surgery. Stage I and Stage IV disease at diagnosis were excluded from the study. Results: Forty nine patients were included in the study. 27 (55%) patients were male and 22 (45%) were female;the age ranges from 23 years to 70 years with the median age 46 years. The main presenting symptoms were bleeding per rectum and tenesmus, Stage II 18 patients (36.7%), stage III 31 patients (63.3%). Complete clinical and pathological response in 3 patients (6%), and complete clinical response with only microscopically residual carcinoma in 20 patients (41%), partial response in 18 patients (36.7%), and no significant response in 8 patients (16%) 7 from 8 were mucoid carcinoma. Low anterior resection (LAR) in 22 patients (44.9%), Hartman’s procedure in 4 patients (8.1%), Coloanal pull-through (COP) was done in 19 patients (38.9%) and perineal colostomy in 4 patients (8.1%). For patients with colo-anal pull-through technique complete dehiscent and retraction observed in 2 cases, Major leakage in one case, stenosis in 4 cases. Conclusion: There is tendency of colorectal cancers to affect younger groups. Most patients presented in advanced stage. Neadjuvant chemo radiation is an excellent tool in sphincter saving surgery. Coloanal pull-through technique is not a widely spread technique for low rectal cancer with good oncological safety and acceptable functional outcome.展开更多
Background: Systemic inflammation due to radiation exposure has been identified in a biological system by certain metabolic and behavioral disorders. These anarchies mostly mediated under a regulation of cyclooxygenas...Background: Systemic inflammation due to radiation exposure has been identified in a biological system by certain metabolic and behavioral disorders. These anarchies mostly mediated under a regulation of cyclooxygenase 2 (COX2) induced production of an inflammatory mediator prostaglandin E2 (PGE2). Aim: This study was undertaken to investigate the anti-inflammatory impact of brown sea weed extract (BSWE) against induction of COX2/PGE2 inflammatory pathway in gamma-irradiated rats. Rats were orally administrated with BSWE (27 mg/kg body weight/day) for 7 consecutive days before exposure to 8 Gy fractionated gamma radiation (2 Gy × 4;every 3 days). Treatment with BSWE was extended along with and in-between irradiation doses for another 14 successive days. Our data demonstrated that the administration of BSWE to rats exposed to gamma radiation, following the regimen suggested, significantly neutralize the changes induced in the inflammatory molecules COX2, PGE2, tumor necrosis alpha (TNF-α), and nitric oxide (NO). In addition, it adjusted significantly the cellular redox tone via regulation of changes induced in malondialdehyde (MDA) reduced glutathione (GSH), superoxide dismutase (SOD) catalase (CAT) and xanthine oxidoreductase system (XOR). Credibly, from the results emerged in this study, it could be suggested that BSWE has substantial anti-inflammatory activities and gamma radiation protection capabilities. It is recommended to include BSWE in the treatment strategy of various inflammatory diseases especially cancer as a safe natural anti-inflammatory agent.展开更多
Objective: The current research study aims to calculate entrance surface air kerma for skull, chest, cervical spine, lumbar spine, and pelvic X-ray examinations in interior posterior and posterior interior positions a...Objective: The current research study aims to calculate entrance surface air kerma for skull, chest, cervical spine, lumbar spine, and pelvic X-ray examinations in interior posterior and posterior interior positions and generate a method for chest dose reduction to decrease radiation risk. Materials and Methods: The indirect dose measurement was used in the current research. The X-ray tube output was measured using RAD-CHECK Plus ionization chamber and the indirect entrance surface air kerma was calculated via applying physical acquisition parameters such as a focus on skin distance, tube current times exposure time (mAs), and applied tube voltage (kV), and applying a mathematical model. Results: The main findings were obtained from comparing the radiation doses with the reference levels of International organizations such as the American College of Radiology and the International Atomic Energy Authority. The mean entrance skin dose for the skull (AP), skull (PA), skull (LAT), cervical spine (PA), cervical spine (LAT), lumbar spine (AP), lumbar spine (LAT), pelvis (AP), and pelvis (LAT) of adult X-ray examinations was within the diagnostic reference dose level values obtained by ACR (2018) except for the ESD for chest (AP) which was 0.88 mGy. Conclusions: The results of the study concluded that by adjusting the applied tube voltage, kV, and tube current product time, mAs decreased the radiation dose to the chest X-ray by 58%.展开更多
Aim of the study: To identify all clinico-pathological data, different treatment modalities and the different prognostic factors which affected the locoregional control (LC), disease-free survival (DFS), and overall s...Aim of the study: To identify all clinico-pathological data, different treatment modalities and the different prognostic factors which affected the locoregional control (LC), disease-free survival (DFS), and overall survival (OS) of Type II endometrial cancer patients. Patients and methods: Data of Type II endometrial carcinoma patients who presented to the Radiation Oncology department, National Cancer Institute, Cairo University during the period from (2000-2012) were retrospectively reviewed. Results: Multivariate analysis identified stage as an independent prognostic factor for OS & DFS, and age was an independent prognostic factor for DFS and LC. Low pretreatment hemoglobin levels significantly affected OS. Conclusion: Large and multicentric clinical trials are required to further study this group of patients and define optimum treatment modalities.展开更多
Background:Vasculogenic mimicry refers to a specialized tumor microvasculature independently formed by tumor cells,which facilitates the recurrence,metastasis,and therapeutic resistance in esophageal cancer.Within the...Background:Vasculogenic mimicry refers to a specialized tumor microvasculature independently formed by tumor cells,which facilitates the recurrence,metastasis,and therapeutic resistance in esophageal cancer.Within the framework of traditional Chinese medicine(TCM)theory,there is currently no clear conceptual classification or diagnostic-therapeutic principles for this phenomenon.Objective:To explore traditional Chinese medicine(TCM)herbs and syndrome factors related to the treatment of vasculogenic mimicry in esophageal cancer,and to provide a reference for clarifying the TCM clinical syndromes of vasculogenic mimicry in esophageal cancer.Methods:Based on public databases such as TCMSP,CNKI,and PubMed,TCM herbs related to esophageal cancer,clinical medications,and herbs inhibiting vasculogenic mimicry were retrieved.The herbs collected from multiple databases were standardized,collated,and cross-analyzed,and core herbs were screened for further analysis.Results:Among the public databases,herbs inhibiting vasculogenic mimicry and commonly used clinical herbs for esophageal cancer were mainly of the blood-activating and stasis-resolving type(Huoxue Huayu).In contrast,esophageal cancer-related herbs in the TCMSP database were mainly of the heat-clearing and toxin-resolving type(Qingre Jiedu).A total of 22 TCM herbs related to vasculogenic mimicry in esophageal cancer were identified,mainly blood-activating and stasis-resolving herbs,involving three syndrome factors:“blood stasis(Xueyu),Qi deficiency(Qixu),and Qi stagnation(Qizhi).”Conclusion:Vasculogenic mimicry can promote the progression of esophageal cancer,and blood-activating and stasis-resolving herbs may improve the prognosis of patients with esophageal cancer.展开更多
AIM: To investigate the expression of miR-210 and the role it plays in the cell cycle to regulate radioresistance in oesophageal squamous cell carcinoma(ESCC). METHODS: Mi R-210 expression was evaluated in 37 pairs of...AIM: To investigate the expression of miR-210 and the role it plays in the cell cycle to regulate radioresistance in oesophageal squamous cell carcinoma(ESCC). METHODS: Mi R-210 expression was evaluated in 37 pairs of ESCC tissues and matched para-tumorous normal oesophageal tissues from surgical patients who had not received neoadjuvant therapy, and in the cells of two novel radioresistant cell lines, TE-1R and Eca-109 R, using quantitative reverse transcription-polymerase chain reaction(q RT-PCR). The transient up-regulation of mi R-210 expression in TE-1R and Eca-109 R cells was studied using liposomes and was confirmed using qR T-PCR. The rate of cell survival after a series of radio-treatment doses was evaluated using the cloneformation assay. Flow cytometry was used to detect the changes to the cell cycle patterns due to radiation treatment. RT-PCR and Western blot were used to detect the expression of ataxia telangiectasia mutated(ATM) and DNA dependent protein kinase(DNA-PKcs) after irradiation, and the cell sphere formation assay was used to evaluate the proliferative ability of the cancer stem-like cells.RESULTS: The level of mi R-210 expression was significantly decreased, by 21.3% to 97.2%, with the average being 39.2% ± 16.1%, in the ESCC tissues of most patients(81.1%, 30 of 37 vs patients with high mi R-210 expression, P < 0.05). A low level of expression of miR-210 was correlated with a poorly differentiated pathological type(P < 0.01) but was not correlated with the T-stage or lymph node infiltration(both P > 0.05). Early local recurrences(< 18 mo, n = 19) after radiotherapy were significantly related with low miR-210 expression(n = 13, P < 0.05). The level of mi R-210 was decreased by approximately 73%(vs TE-1, 0.27 ± 0.10, P < 0.01) in the established radioresistant TE-IR cell line and by 52%(vs Eca-109, 0.48 ± 0.17, P < 0.05) in the corresponding Eca-109 R line. Transient transfection with a mi R-210 precursor increased the level of mi R-210 expression, leading to a significant increase in cell survival after radiotherapy(P < 0.05). Twenty-four hours after radiation, the proportion of pmiR-210 cells in S phase was increased(vs control cells, 30.4% ± 0.4%, and vs untreated TE-1R cells, 23.3% ± 0.7%, P < 0.05 for both). The levels of DNA-PKcs(0.21 ± 0.07) and ATM(0.12 ± 0.03, P < 0.05) proteins were significantly lower in the PmiR-210 cells than in control cells, but no differences were found in the levels of the corresponding mR NAs in the two cell types(P > 0.05 for all). Exogenous mi R-210 expression decreased the diameter of pmi R-210 cell spheres(vs control cells, 0.60 ± 0.14, P < 0.05).CONCLUSION: Mi R-210 expression is negatively correlated with the pathological type and the local survivalrate after radiotherapy, and high expression of miR-210 may reverse the radioresistance of ESCC stem-like cells.展开更多
Human tumors tend to activate the immune system regulatory checkpoints as a means of escaping immunosurveillance. For instance, interaction between program death-1(PD-1) and program death-ligand 1(PD-L1) will lead the...Human tumors tend to activate the immune system regulatory checkpoints as a means of escaping immunosurveillance. For instance, interaction between program death-1(PD-1) and program death-ligand 1(PD-L1) will lead the activated T cell to a state of anergy. PD-L1 is upregulated on a wide range of cancer cells. Anti-PD-1 and anti-PD-L1 monoclonal antibodies(m Abs), called immune checkpoint inhibitors(ICIs), have consequently been designed to restore T cell activity. Accumulating data are in favor of an association between PD-L1 expression in tumors and response to treatment. A PD-L1 expression is present in 30% to 50% of digestive cancers. Multiple anti-PD-1(nivolumab, pembrolizumab) and anti-PD-L1 m Abs(MPDL3280A, Medi4736) are under evaluation in digestive cancers. Preliminary results in metastatic gastric cancer with pembrolizumab are highly promising and phase Ⅱ will start soon. In metastatic colorectal cancer(CRC), a phase Ⅲ trial of MPDL3280 A as maintenance therapy will shortly be initiated. Trials are also ongoing in metastatic CRC with high immune T cell infiltration(i.e., microsatellite instability). Major challenges are ahead in order to determine how, when and for which patients we should use these ICIs. New radiologic criteria to evaluate tumor response to ICIs are awaiting prospective validation. The optimal therapeutic sequence and association with cytotoxic chemotherapy needs to be established. Finally, biomarker identification will be crucial to selection ofpatients likely to benefit from ICIs.展开更多
Radiation dose escalation and acceleration improves local control but also increases toxicity.Proton radiation is an emerging therapy for localized cancers that is being sought with increasing frequency by patients.Co...Radiation dose escalation and acceleration improves local control but also increases toxicity.Proton radiation is an emerging therapy for localized cancers that is being sought with increasing frequency by patients.Compared with photon therapy,proton therapy spares more critical structures due to its unique physics.The physical properties of a proton beam make it ideal for clinical applications.By modulating the Bragg peak of protons in energy and time,a conformal radiation dose with or without intensity modulation can be delivered to the target while sparing the surrounding normal tissues.Thus,proton therapy is ideal when organ preservation is a priority.However,protons are more sensitive to organ motion and anatomy changes compared with photons.In this article,we review practical issues of proton therapy,describe its image-guided treatment planning and delivery,discuss clinical outcome for cancer patients,and suggest challenges and the future development of proton therapy.展开更多
Radiomics is changing the world of medicine and more specifically the world of oncology.Early diagnosis and treatment improve the prognosis of patients with cancer.After treatment,the evaluation of the response will d...Radiomics is changing the world of medicine and more specifically the world of oncology.Early diagnosis and treatment improve the prognosis of patients with cancer.After treatment,the evaluation of the response will determine future treatments.In oncology,every change in treatment means a loss of therapeutic options and this is key in pancreatic cancer.Radiomics has been developed in oncology in the early diagnosis and differential diagnosis of benign and malignant lesions,in the evaluation of response,in the prediction of possible side effects,marking the risk of recurrence,survival and prognosis of the disease.Some studies have validated its use to differentiate normal tissues from tumor tissues with high sensitivity and specificity,and to differentiate cystic lesions and pancreatic neuroendocrine tumor grades with texture parameters.In addition,these parameters have been related to survival in patients with pancreatic cancer and to response to radiotherapy and chemotherapy.This review aimed to establish the current status of the use of radiomics in pancreatic cancer and future perspectives.展开更多
基金supported by grants from the Applied Basic Research Foundation of Yunnan Province(202301AT070095)the Candidate Talents Training Fund of Yunnan Province(H-2024069)。
文摘As oncologic therapies continue to advance,the overall survival of cancer patients has markedly increased.Nevertheless,virtually every anticancer treatment modality is accompanied by some degree of cardiotoxicity.Epidemiological data indicate that approximately 30%of cancer survivors ultimately die from cardiovascular disease.Among the cardiotoxic agents,the anthracycline doxorubicin(DOX)is the most widely used.It effectively suppresses a variety of malignant tumors——including breast cancer,lymphoma,and acute leukemia——but its cardiac toxicity limits further escalation of clinical dosing.Literature reports identify a cumulative dose of≥250 mg/m²as the threshold of high risk,with roughly 25%of patients receiving DOX developing varying degrees of myocardial injury;severe cases progress to heart failure.Even at cumulative doses below the traditional safety limit,some patients exhibit cardiac dysfunction after the first administration,suggesting that cardiotoxicity is not solely a linear function of dose.DOX related cardiotoxicity can be classified as acute(hours to days after administration),sub acute(weeks to months),and chronic/late onset(years later).Most patients initially exhibit only mild reductions in left ventricular ejection fraction(LVEF)or subtle abnormalities in global longitudinal strain(GLS),often without symptoms.Recently,cardiac biomarkers(cTn,NT proBNP)combined with high sensitivity echocardiography(speckle tracking)have been recommended for monitoring high risk individuals,enabling detection of subclinical injury before overt LVEF decline.Currently,several preventive and therapeutic approaches are used in clinical practice,which can be summarized into the following four points.(1)Dose limitation and administration strategies:fractionated low dose regimens,liposomal encapsulation,or continuous infusion lower peak plasma concentrations,thereby reducing cardiac exposure.(2)Pharmacologic prophylaxis:βblockers(e.g.,carvedilol)and ACE inhibitors/ARBs have shown protective effects on LVEF in some randomized trials,though results remain inconsistent and require larger confirmatory studies.(3)Metabolic targeted interventions:animal experiments indicate that activation of PPARαor supplementation with L carnitine restores fatty acid oxidation and improves ATP generation,suggesting metabolic modulators as promising cardioprotective candidates.(4)Lifestyle modifications:regular aerobic exercise up regulates mitochondrial biogenesis genes(PGC-1α)and reduces reactive oxygen species(ROS)production;small clinical studies have demonstrated a potential benefit in attenuating cTnT elevation.However,DOX-induced cardiotoxicity has not been effectively controlled,indicating that the core mechanism underlying DOX‑related cardiac toxicity remains unidentified.Cardiomyocytes are high energy demand cells,and metabolic dysregulation is considered a central component of DOX induced cardiotoxicity.DOX disrupts myocardial metabolic balance through several interrelated pathways.(1)Oxidative stress and mitochondrial damage:DOX generates abundant ROS within cells,leading to mitochondrial membrane potential loss,lipid peroxidation,and iron accumulation,which suppress electron transport chain activity and markedly reduce ATP synthesis efficiency.(2)Autophagy dysregulation:DOX interferes with autophagic flux,preventing the clearance of damaged mitochondria and further aggravating apoptosis and inflammatory responses.(3)Inflammation and cytokine release:oxidative stress activates NF‑κB,up-regulating pro inflammatory cytokines such as TNF‑αand IL-6,creating a chronic inflammatory microenvironment that weakens myocardial contractility.(4)Epigenetic modifications:studies have shown that DOX alters DNA methylation and histone acetylation patterns in cardiomyocytes,affecting the expression of key metabolic genes(e.g.,PGC-1α,CPT-1)and further inhibiting fatty acidβoxidation.These mechanisms collectively lead to suppressed fatty acid oxidation and compensatory up regulation of glycolysis,manifested by an elevated lactate/pyruvate ratio,accumulation of medium chain acyl carnitines,and a pronounced decline in ATP production.The resulting energy deficit precipitates left ventricular contractile dysfunction and,ultimately,heart failure.Despite extensive basic and clinical research on DOX cardiotoxicity,a unified risk assessment model and precise interventions targeting metabolic disturbances remain lacking.This review systematically summarizes recent progress on DOX induced cardiotoxicity and highlights that impairment of myocardial energy metabolism is a central mechanism of injury,thereby deepened our understanding of how impaired myocardial energy metabolism drives DOX induced injury,we can move toward safer chemotherapy protocols that achieve“cure cancer without harming the heart”.
基金financially supported by the National Natural Science Foundation of China(Nos.52473139 and U21A2098)。
文摘Hospital wastewater contains complex pollutants,including residual organic dyes and antibiotic-resistant pathogens,posing severe risks to ecosystems and human health.Conventional adsorbents,constrained by monopolar functional groups and limited surface sites,fail to remove both pollutants simultaneously.Here,we report an intelligent responsive polyurethane microsphere adsorbent doped with diallyl dimethylammonium chloride modified carbon nanotubes,termed as PUCD microspheres.The PUCD integrates bipolar adsorption sites,tunable micrometer-scale pores,and a near-infrared(NIR)-triggered in situ capture mechanism within a single platform,which achieves up to 98.3%dye removal,maintains strong adsorption performance across a wide pH range and retains 83.3%efficiency for rhodamine B after five cycles.Notably,the PUCD employs a temperature-responsive phase transition:under NIR irradiation,the microspheres undergo shrinkage,reducing the pore size to generate a‘polymer trap',enabling in situ capture of bacteria with>99%efficiencies for both Staphylococcus aureus and Escherichia coli.By immobilizing live bacteria,the PUCD microspheres substantially reduces the risk of pathogen desorption and toxin release.This promising platform offers a safe,efficient,and single-stage strategy for hospital wastewater purification,enabling the simultaneous elimination of dyes and pathogenic bacteria.
文摘Objective Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy(VMAT) has been introduced into clinical practice. The purpose of this study was to investigate the dosimetric effects of different multileaf collimators(MLC) on VMAT radiotherapy plans for treating breast cancer.Methods Fifteen breast cancer patients who were treated using a conventional technique in our department were selected to participate in this retrospective analysis. VMAT plans based on three types of Elekta MLCs [Beam Modulator(BM) with 4-mm leaf width, Agility with 5-mm leaf width and MLCi2 with 10-mm leaf width] were independently generated for each patient. Plan comparisons were performed based on dose-volume histogram(DVH) analysis including dosimetric parameters such as the homogeneity index(HI), conformity index(CI), Dmax, Dmin, and Dmean for the planning treatment volume(PTV), in addition to dose-volume parameters for the organs at risk(OARs). The delivery efficiency of the three types of MLCs was compared in terms of the beam delivery time and the monitor units(MUs) per fraction for each plan. Results Both target uniformity and conformity were improved in plans for Agility and BM MLC compared with the plan using MLCi2. The mean HI decreased from 1.14 for MLCi2 to 1.13 for BM and 1.10 for Agility, while the mean CI increased from 0.68 for MLCi2 to 0.73 for BM and 0.75 for Agility. Furthermore, at both low and high dose levels, smaller volumes of ipsilateral lung, heart, contralateral lung, and breast were irradiated with Agility MLC than with the other two types of MLCs. The delivery time with Agility MLC was reduced by 10.8% and 32.1%, respectively, compared with that for MLCi2 and BM.Conclusion Our results indicate that the Agility MLC exhibits a dosimetric advantage and a significant improvement in delivery efficiency for the treatment of breast cancer using VMAT.
文摘Objective: We aim to quantify the magnitude of setup errors in intensity-modulated radiotherapy (IMRT) treated Head and Neck cancer patients and recommend appropriate PTV margin. Methods: 60 patients with head and neck cancer required bilateral neck irradiation were planned and treated by simultaneous integrated boost IMRT technique either treated radically or postoperative. Patients undergoing image-guided radiotherapy (IGRT) each with once weekly scheduled cone beam computed tomography (CBCT). The 3D displacements, systematic and random errors were calculated. The appropriate PTV expansion was determined using Van Herk’s formula. Results: Mean 3D displacement was 0.16 cm in the vertical direction, 0.14 cm in the horizontal direction and 0.16 cm in the longitudinal direction. Conclusion: Use of weekly CBCT allows the planning target volume (PTV) expansion to be reduced according to our setup. The appropriate clinical target volume (CTV)-PTV margin for our institute is 0.30 cm, 0.38 cm, and 0.33 cm in the horizontal, vertical, and longitudinal directions, respectively.
文摘Polyvinyl alcohol(PVA) is a well-known friendly polymer for paper-making, textiles, and a variety of coatings, biomedical applications such as artificial pancreas, synthetic vitreous body, wound dressing, artificial skin,and cardiovascular device. In this paper, ion/electron beam is employed to get insight into the irradiation effect on surface morphology and optical properties of PVA polymer. UV-Vis spectra are recorded to investigate the effect of induced defects on the optical band gap and the formed carbon clusters size. Scanning electron microscopy(SEM) is used to relate and investigate surface morphology and optical properties of the target polymer with different doses(15, 30 and 60 min). Also, PVA polymer is subjected to theoretical studies by using semi-empirical PM7 quantum chemical method.
文摘This work was undertaken to establish a new experimental model of hepatic fibrosis by gamma irradiation and CCl4 and to study the hepatoprotective effect of Reishi Mushroom (RM) against hepatic fibrosis induced in that model. Our results revealed that oral co-administration of 110 mg/kg RM by gavage to fibrotic rats offered an obvious hepatic protection as assured by the significant decrement in ALT and AST, HP content, MDA and NO levels with elevation of the antioxidant enzymes activities. The levels of TGF-β, TNF-α, HO-1 and type-1 collagen and their m-RNA expression were markedly declined as compared with those of fibrotic rats. Microscopical examination revealed that the exposure of rats to radiation aggravated the effect of CCl4 causing extensive collagen deposition and marked pseudolobulation of the hepatic parenchyma indicative of bridging fibrosis. While, oral co-administration of RM obviously improved the state of steatosis and apparently suppressed hepatic fibrogenesis.
文摘The article provides outcomes of efforts taken by the specialists of radiation safety departments of Ukrainian Nuclear Power Plants （NPPs） to optimize and decrease exposure doses of personnel performing works during outages at NPP units. The article is written based on many years＇ experience and analysis of radiation hazardous works performed during scheduled maintenance of NPP equipment. It highlights significance of planning radiation doses （dose quotas） and organization of pending works during outages based on lessons learned. The results of works allowed to give due consideration to training of NPP maintenance personnel, improvement of labour conditions, workplace setup and enhancement of radiation protection means.
文摘Background: The risk of carotid vessel stenosis is high after radiotherapy (RT) to neck;however, carotid vessels are unavoidable during supraclavicular (SC-RT) in adjuvant treatment of breast cancer (BC). However, carotid vessels RT dose is less well-understood. We aimed to determine the carotid vessels doses received by different techniques for SC-RT. Materials and Methods: Thirty consecutive BC patients were planned to receive SC-RT and breast after breast conserving surgery (BCS) after taking 5 mm image slices on computed tomography (CT) simulation. Organs at risk (OAR) including carotid vessels, lungs, spinal cord alongwith clinical target volume (CTV) for primary tumor and lymph nodes were delineated. Comparative analysis was done between two treatment plans;three-field conformal radiation therapy (3F-CRT) and four field conformal RT (4F-CRT) for CTV and carotid vessels doses. Results: The 4F-CRT was found better than 3F-3DCRT regarding coverage and homogeneity of the CTV volume. The 98% of the CTV was covered by 84% dose in 3F-CRT and 95% in 4F-CRT (p 0.001). The carotid vessels maximum dose in the in 3F-CRT was 54.5 ± 1.3 Gy compared to 51.6 ± 1.3 Gy in 4F-CRT (p 0.014), however the mean dose did not differ significantly (p value 0.8). The ipsilateral lung dose did not differ between the two techniques (p Value 0.9). Conclusion: The 4F-CRT plan was found better than 3F-CRT in CTV coverage with minimal dose to the carotid vessel and without significant higher dose to the ipsilateral lung.
文摘Background and Purpose: The relapsed low grade non-Hodgkin’s lymphoma (LG-NHL) is currently?incurable disease and the optimal treatment regimen has not determined yet. Low dose total body irradiation (LTBI) provides an alternative mechanism of action against cancer cells rather than direct cell kill. The mode of action of LTBI is immune-modulatory effect, induction of apoptosis and?hypersensitivity to low radiation doses. The aim of our study is to evaluate the effect of LTBI on relapsed?LG-NHL and reporting our experience at National Cancer Institute, Cairo (NCI, Cairo). Material and Methods: Fifty eight patients with relapsed LG-NHL and received LTBI studied retrospectively.?LTBI dose was 1.6 Gy/8 fractions divided on 2 courses;each course 4 fractions treated over 4 days with 2 weeks rest between the 2 courses. Results: The median age is 54 years;65% of the patients are men. Forty (69%) patients had performance status of 2 or more. Twenty seven patients were stage II/III and 31 patients (53%) had stage IV disease. Twenty six (45%) patients had bulky disease more than 10 cm and 22 (38%) patients had B symptoms at the time of relapse. The?extranodal disease was present in 17 patients (29%) and 78% of the patients received?>3 regimens of chemotherapy before referral to LTBI. Twenty three patients received IFRT (mean dose 32 ± 4 Gy) to initially bulky sites after LTBI. Fourteen patients (24%) achieved complete remission (CR) while 45%, 21% and 10% had partial remission (PR), stable disease (SD) and progressive disease (PD) respectively. The median PFS duration was 14 months and the median OS duration?was 39 months. Stage VI,?>3 regimen of chemotherapy and bad response to LTBI (SD) affected?progression duration adversely (0.03, 0.05 and 0.01 respectively). The response to LTBI is the only factor affected the OS duration significantly. The 3-year PFS was 19% ± 9%, and 3-year OS was 45% ± 8%. Stage IV was the only factor affected the 3-year PFS significantly with p value 0.03. The hematological toxicity was the main side effect of LTBI. Eleven patients developed G3/4 anemia while 8 patients only developed G3/4 thrombocytopenia and 13 patients developed G3/4 leucopenia. Conclusion: The use of LTBI in patients with relapsed low grade NHL is a feasible, effective and tolerable treatment that is worthy of testing in a future with chemotherapy and Rituximab maintenance.
文摘Accidents involving industrial radiography are the most frequent cause of severe or fatal overexposure to workers and the public. On May 5, 2000, a radiation accident happened at a construction site in a gamma radiography practice at the village of Meet Halfa-Egypt. The accident was a severe overdose of non-radiation workers due to external exposure of Ir-192. This paper provides a methodology for calculating doses and dose rates from the most commonly used industrial γ-sources: 192Ir, 60Co, 134Cs, 137Cs and 131I. For this purpose, MCNP computer code based on Monte Carlo technique is used. The applied method helps firstly in studying and analyzing the doses from the above mentioned sources. Secondly, it provides a lead container design in a trial to reduce the dose rate within the permissible. Computer models were used to simulate the 192Ir Meet Halfa accident. To verify these models, the calculated doses were compared with a well-known empirical formula to convert source activity into dose rate and then the models were applied at different distances to analyze the factors that affect the deposited dose in the human body to find out the dose received by the victims.
文摘Background: Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of primary rectal cancer is curative surgical resection;however, a fine balance remains between disease cure and restoration of gastrointestinal continuity. Combined modality has proven efficacy in many malignant tumors with advantage of organ preservation. Methods: Forty nine (49) patients with low rectal carcinoma were included in a prospective study, between Jan 2007 and Jan 2012. Preoperative chemoradiation was administrated to all patients and subjected to different techniques of sphincter saving surgery. Stage I and Stage IV disease at diagnosis were excluded from the study. Results: Forty nine patients were included in the study. 27 (55%) patients were male and 22 (45%) were female;the age ranges from 23 years to 70 years with the median age 46 years. The main presenting symptoms were bleeding per rectum and tenesmus, Stage II 18 patients (36.7%), stage III 31 patients (63.3%). Complete clinical and pathological response in 3 patients (6%), and complete clinical response with only microscopically residual carcinoma in 20 patients (41%), partial response in 18 patients (36.7%), and no significant response in 8 patients (16%) 7 from 8 were mucoid carcinoma. Low anterior resection (LAR) in 22 patients (44.9%), Hartman’s procedure in 4 patients (8.1%), Coloanal pull-through (COP) was done in 19 patients (38.9%) and perineal colostomy in 4 patients (8.1%). For patients with colo-anal pull-through technique complete dehiscent and retraction observed in 2 cases, Major leakage in one case, stenosis in 4 cases. Conclusion: There is tendency of colorectal cancers to affect younger groups. Most patients presented in advanced stage. Neadjuvant chemo radiation is an excellent tool in sphincter saving surgery. Coloanal pull-through technique is not a widely spread technique for low rectal cancer with good oncological safety and acceptable functional outcome.
文摘Background: Systemic inflammation due to radiation exposure has been identified in a biological system by certain metabolic and behavioral disorders. These anarchies mostly mediated under a regulation of cyclooxygenase 2 (COX2) induced production of an inflammatory mediator prostaglandin E2 (PGE2). Aim: This study was undertaken to investigate the anti-inflammatory impact of brown sea weed extract (BSWE) against induction of COX2/PGE2 inflammatory pathway in gamma-irradiated rats. Rats were orally administrated with BSWE (27 mg/kg body weight/day) for 7 consecutive days before exposure to 8 Gy fractionated gamma radiation (2 Gy × 4;every 3 days). Treatment with BSWE was extended along with and in-between irradiation doses for another 14 successive days. Our data demonstrated that the administration of BSWE to rats exposed to gamma radiation, following the regimen suggested, significantly neutralize the changes induced in the inflammatory molecules COX2, PGE2, tumor necrosis alpha (TNF-α), and nitric oxide (NO). In addition, it adjusted significantly the cellular redox tone via regulation of changes induced in malondialdehyde (MDA) reduced glutathione (GSH), superoxide dismutase (SOD) catalase (CAT) and xanthine oxidoreductase system (XOR). Credibly, from the results emerged in this study, it could be suggested that BSWE has substantial anti-inflammatory activities and gamma radiation protection capabilities. It is recommended to include BSWE in the treatment strategy of various inflammatory diseases especially cancer as a safe natural anti-inflammatory agent.
文摘Objective: The current research study aims to calculate entrance surface air kerma for skull, chest, cervical spine, lumbar spine, and pelvic X-ray examinations in interior posterior and posterior interior positions and generate a method for chest dose reduction to decrease radiation risk. Materials and Methods: The indirect dose measurement was used in the current research. The X-ray tube output was measured using RAD-CHECK Plus ionization chamber and the indirect entrance surface air kerma was calculated via applying physical acquisition parameters such as a focus on skin distance, tube current times exposure time (mAs), and applied tube voltage (kV), and applying a mathematical model. Results: The main findings were obtained from comparing the radiation doses with the reference levels of International organizations such as the American College of Radiology and the International Atomic Energy Authority. The mean entrance skin dose for the skull (AP), skull (PA), skull (LAT), cervical spine (PA), cervical spine (LAT), lumbar spine (AP), lumbar spine (LAT), pelvis (AP), and pelvis (LAT) of adult X-ray examinations was within the diagnostic reference dose level values obtained by ACR (2018) except for the ESD for chest (AP) which was 0.88 mGy. Conclusions: The results of the study concluded that by adjusting the applied tube voltage, kV, and tube current product time, mAs decreased the radiation dose to the chest X-ray by 58%.
文摘Aim of the study: To identify all clinico-pathological data, different treatment modalities and the different prognostic factors which affected the locoregional control (LC), disease-free survival (DFS), and overall survival (OS) of Type II endometrial cancer patients. Patients and methods: Data of Type II endometrial carcinoma patients who presented to the Radiation Oncology department, National Cancer Institute, Cairo University during the period from (2000-2012) were retrospectively reviewed. Results: Multivariate analysis identified stage as an independent prognostic factor for OS & DFS, and age was an independent prognostic factor for DFS and LC. Low pretreatment hemoglobin levels significantly affected OS. Conclusion: Large and multicentric clinical trials are required to further study this group of patients and define optimum treatment modalities.
基金National Natural Science Foundation of China(Project No.:82474597)Key Project of Jiangsu Traditional Chinese Medicine Science and Technology Development(Project No.:ZD202330)+1 种基金Major Project of Natural Science Research in Jiangsu Universities(Project No.:22KJA360009)Graduate Innovation Project of Jiangsu Province(Project No.:KYCX25-4103)。
文摘Background:Vasculogenic mimicry refers to a specialized tumor microvasculature independently formed by tumor cells,which facilitates the recurrence,metastasis,and therapeutic resistance in esophageal cancer.Within the framework of traditional Chinese medicine(TCM)theory,there is currently no clear conceptual classification or diagnostic-therapeutic principles for this phenomenon.Objective:To explore traditional Chinese medicine(TCM)herbs and syndrome factors related to the treatment of vasculogenic mimicry in esophageal cancer,and to provide a reference for clarifying the TCM clinical syndromes of vasculogenic mimicry in esophageal cancer.Methods:Based on public databases such as TCMSP,CNKI,and PubMed,TCM herbs related to esophageal cancer,clinical medications,and herbs inhibiting vasculogenic mimicry were retrieved.The herbs collected from multiple databases were standardized,collated,and cross-analyzed,and core herbs were screened for further analysis.Results:Among the public databases,herbs inhibiting vasculogenic mimicry and commonly used clinical herbs for esophageal cancer were mainly of the blood-activating and stasis-resolving type(Huoxue Huayu).In contrast,esophageal cancer-related herbs in the TCMSP database were mainly of the heat-clearing and toxin-resolving type(Qingre Jiedu).A total of 22 TCM herbs related to vasculogenic mimicry in esophageal cancer were identified,mainly blood-activating and stasis-resolving herbs,involving three syndrome factors:“blood stasis(Xueyu),Qi deficiency(Qixu),and Qi stagnation(Qizhi).”Conclusion:Vasculogenic mimicry can promote the progression of esophageal cancer,and blood-activating and stasis-resolving herbs may improve the prognosis of patients with esophageal cancer.
基金Supported by National Natural Science Foundation of China,No.30972962
文摘AIM: To investigate the expression of miR-210 and the role it plays in the cell cycle to regulate radioresistance in oesophageal squamous cell carcinoma(ESCC). METHODS: Mi R-210 expression was evaluated in 37 pairs of ESCC tissues and matched para-tumorous normal oesophageal tissues from surgical patients who had not received neoadjuvant therapy, and in the cells of two novel radioresistant cell lines, TE-1R and Eca-109 R, using quantitative reverse transcription-polymerase chain reaction(q RT-PCR). The transient up-regulation of mi R-210 expression in TE-1R and Eca-109 R cells was studied using liposomes and was confirmed using qR T-PCR. The rate of cell survival after a series of radio-treatment doses was evaluated using the cloneformation assay. Flow cytometry was used to detect the changes to the cell cycle patterns due to radiation treatment. RT-PCR and Western blot were used to detect the expression of ataxia telangiectasia mutated(ATM) and DNA dependent protein kinase(DNA-PKcs) after irradiation, and the cell sphere formation assay was used to evaluate the proliferative ability of the cancer stem-like cells.RESULTS: The level of mi R-210 expression was significantly decreased, by 21.3% to 97.2%, with the average being 39.2% ± 16.1%, in the ESCC tissues of most patients(81.1%, 30 of 37 vs patients with high mi R-210 expression, P < 0.05). A low level of expression of miR-210 was correlated with a poorly differentiated pathological type(P < 0.01) but was not correlated with the T-stage or lymph node infiltration(both P > 0.05). Early local recurrences(< 18 mo, n = 19) after radiotherapy were significantly related with low miR-210 expression(n = 13, P < 0.05). The level of mi R-210 was decreased by approximately 73%(vs TE-1, 0.27 ± 0.10, P < 0.01) in the established radioresistant TE-IR cell line and by 52%(vs Eca-109, 0.48 ± 0.17, P < 0.05) in the corresponding Eca-109 R line. Transient transfection with a mi R-210 precursor increased the level of mi R-210 expression, leading to a significant increase in cell survival after radiotherapy(P < 0.05). Twenty-four hours after radiation, the proportion of pmiR-210 cells in S phase was increased(vs control cells, 30.4% ± 0.4%, and vs untreated TE-1R cells, 23.3% ± 0.7%, P < 0.05 for both). The levels of DNA-PKcs(0.21 ± 0.07) and ATM(0.12 ± 0.03, P < 0.05) proteins were significantly lower in the PmiR-210 cells than in control cells, but no differences were found in the levels of the corresponding mR NAs in the two cell types(P > 0.05 for all). Exogenous mi R-210 expression decreased the diameter of pmi R-210 cell spheres(vs control cells, 0.60 ± 0.14, P < 0.05).CONCLUSION: Mi R-210 expression is negatively correlated with the pathological type and the local survivalrate after radiotherapy, and high expression of miR-210 may reverse the radioresistance of ESCC stem-like cells.
文摘Human tumors tend to activate the immune system regulatory checkpoints as a means of escaping immunosurveillance. For instance, interaction between program death-1(PD-1) and program death-ligand 1(PD-L1) will lead the activated T cell to a state of anergy. PD-L1 is upregulated on a wide range of cancer cells. Anti-PD-1 and anti-PD-L1 monoclonal antibodies(m Abs), called immune checkpoint inhibitors(ICIs), have consequently been designed to restore T cell activity. Accumulating data are in favor of an association between PD-L1 expression in tumors and response to treatment. A PD-L1 expression is present in 30% to 50% of digestive cancers. Multiple anti-PD-1(nivolumab, pembrolizumab) and anti-PD-L1 m Abs(MPDL3280A, Medi4736) are under evaluation in digestive cancers. Preliminary results in metastatic gastric cancer with pembrolizumab are highly promising and phase Ⅱ will start soon. In metastatic colorectal cancer(CRC), a phase Ⅲ trial of MPDL3280 A as maintenance therapy will shortly be initiated. Trials are also ongoing in metastatic CRC with high immune T cell infiltration(i.e., microsatellite instability). Major challenges are ahead in order to determine how, when and for which patients we should use these ICIs. New radiologic criteria to evaluate tumor response to ICIs are awaiting prospective validation. The optimal therapeutic sequence and association with cytotoxic chemotherapy needs to be established. Finally, biomarker identification will be crucial to selection ofpatients likely to benefit from ICIs.
文摘Radiation dose escalation and acceleration improves local control but also increases toxicity.Proton radiation is an emerging therapy for localized cancers that is being sought with increasing frequency by patients.Compared with photon therapy,proton therapy spares more critical structures due to its unique physics.The physical properties of a proton beam make it ideal for clinical applications.By modulating the Bragg peak of protons in energy and time,a conformal radiation dose with or without intensity modulation can be delivered to the target while sparing the surrounding normal tissues.Thus,proton therapy is ideal when organ preservation is a priority.However,protons are more sensitive to organ motion and anatomy changes compared with photons.In this article,we review practical issues of proton therapy,describe its image-guided treatment planning and delivery,discuss clinical outcome for cancer patients,and suggest challenges and the future development of proton therapy.
文摘Radiomics is changing the world of medicine and more specifically the world of oncology.Early diagnosis and treatment improve the prognosis of patients with cancer.After treatment,the evaluation of the response will determine future treatments.In oncology,every change in treatment means a loss of therapeutic options and this is key in pancreatic cancer.Radiomics has been developed in oncology in the early diagnosis and differential diagnosis of benign and malignant lesions,in the evaluation of response,in the prediction of possible side effects,marking the risk of recurrence,survival and prognosis of the disease.Some studies have validated its use to differentiate normal tissues from tumor tissues with high sensitivity and specificity,and to differentiate cystic lesions and pancreatic neuroendocrine tumor grades with texture parameters.In addition,these parameters have been related to survival in patients with pancreatic cancer and to response to radiotherapy and chemotherapy.This review aimed to establish the current status of the use of radiomics in pancreatic cancer and future perspectives.
