Pub Date : 2024-06-01DOI: 10.1016/j.radmp.2024.04.002
Haiying Wang, Jian Tong, Yi Cao
Cellular senescence has emerged as an important contributor to aging and age-related diseases. Non-ionizing radiation (NIR), including ultraviolet radiation and electromagnetic fields, has been increasingly recognized as a key inducer of premature senescence. In this review, we discuss the molecular mechanisms of NIR-induced cellular senescence and its effects on aging and age-related diseases. We also summarize the modulation strategies for NIR-induced cellular senescence. A better understanding of the complex relationship between non-ionizing radiation, cellular senescence and age-related pathology may lead to interventions to ameliorate radiation damage and delay aging. Further research is still needed to elucidate the precise mechanisms, dose-response effects, and to develop protective strategies against radiation-induced senescence.
{"title":"Non-ionizing radiation-induced cellular senescence and age-related diseases","authors":"Haiying Wang, Jian Tong, Yi Cao","doi":"10.1016/j.radmp.2024.04.002","DOIUrl":"10.1016/j.radmp.2024.04.002","url":null,"abstract":"<div><p>Cellular senescence has emerged as an important contributor to aging and age-related diseases. Non-ionizing radiation (NIR), including ultraviolet radiation and electromagnetic fields, has been increasingly recognized as a key inducer of premature senescence. In this review, we discuss the molecular mechanisms of NIR-induced cellular senescence and its effects on aging and age-related diseases. We also summarize the modulation strategies for NIR-induced cellular senescence. A better understanding of the complex relationship between non-ionizing radiation, cellular senescence and age-related pathology may lead to interventions to ameliorate radiation damage and delay aging. Further research is still needed to elucidate the precise mechanisms, dose-response effects, and to develop protective strategies against radiation-induced senescence.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 68-74"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000273/pdfft?md5=9af5ec13cca6dc1bc81b0498a8ccc5db&pid=1-s2.0-S2666555724000273-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To analyze the current status of knowledge and practices among the Moroccan dentists in the region of Rabat-Salé-Kenitra, towards radiation protection.
Methods
This is a cross-sectional study based on a questionnaire related to knowledge and practice regarding radiation protection of patients and dental staff from April to June 2022. The study sample included 325 dentists practicing in the Rabat-Salé-Kénitra region. The target population consisted of all dentists working in public, semi-public and private workplaces.
Results
96.6% of dentists were aware of radiation protection. However, nearly 35% were aware of ALARA (as low as reasonably achievable) principle and 73.9% thought that dental X-rays are harmful. 63.6%of subjects used digital image receptor. Only 16.7% of them used a film holder and more than 60% didn't follow the position and distance rule. The median knowledge score was 7 [5, 9], and there was a statistically significant difference according to dentist qualification (P = 0.007), dental radiation protection continuous training (P < 0.0001), age (P = 0.007) and years of experience (P = 0.039). The median practice score was 5 [4, 6] and there was a statically significance association according to workplace setting (P = 0.001). There was a significant positive relationship between knowledge score and practice score (r = 0.24, P<0.0001). Dentist qualification (OR 0.51, 95%CI: 0.27–0.94, P = 0.03) and continuous training (OR 2.40, 95%CI: 1.47–3.93, P<0.0001) were significant predictors of knowledge, while workplace setting (OR 0.54, 95%CI: 0.32–0.93, P = 0.027) and knowledge score (OR 1.24, 95%CI: 1.12–1.38, P<0.0001) were predictors of practices.
Conclusion
Improving dentists' knowledge of radiation protection measures and tools as well as dose reduction techniques could increase their safe practices in dental radiology.
{"title":"Radiation protection knowledge and practices among Moroccan dentists: A cross-sectional study","authors":"Naoual Elmorabit , Majdouline Obtel , Mohamed Azougagh , Oumkeltoum Ennibi","doi":"10.1016/j.radmp.2024.03.001","DOIUrl":"10.1016/j.radmp.2024.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the current status of knowledge and practices among the Moroccan dentists in the region of Rabat-Salé-Kenitra, towards radiation protection.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study based on a questionnaire related to knowledge and practice regarding radiation protection of patients and dental staff from April to June 2022. The study sample included 325 dentists practicing in the Rabat-Salé-Kénitra region. The target population consisted of all dentists working in public, semi-public and private workplaces.</p></div><div><h3>Results</h3><p>96.6% of dentists were aware of radiation protection. However, nearly 35% were aware of ALARA (as low as reasonably achievable) principle and 73.9% thought that dental X-rays are harmful. 63.6%of subjects used digital image receptor. Only 16.7% of them used a film holder and more than 60% didn't follow the position and distance rule. The median knowledge score was 7 [5, 9], and there was a statistically significant difference according to dentist qualification (<em>P</em> = 0.007), dental radiation protection continuous training (<em>P</em> < 0.0001), age (<em>P</em> = 0.007) and years of experience (<em>P</em> = 0.039). The median practice score was 5 [4, 6] and there was a statically significance association according to workplace setting (<em>P</em> = 0.001). There was a significant positive relationship between knowledge score and practice score (<em>r</em> = 0.24, <em>P</em><0.0001). Dentist qualification (<em>OR</em> 0.51, 95%<em>CI</em>: 0.27–0.94, <em>P</em> = 0.03) and continuous training (<em>OR</em> 2.40, 95%<em>CI</em>: 1.47–3.93, <em>P</em><0.0001) were significant predictors of knowledge, while workplace setting (<em>OR</em> 0.54, 95%<em>CI</em>: 0.32–0.93, <em>P</em> = 0.027) and knowledge score (<em>OR</em> 1.24, 95%<em>CI</em>: 1.12–1.38, <em>P<</em>0.0001) were predictors of practices.</p></div><div><h3>Conclusion</h3><p>Improving dentists' knowledge of radiation protection measures and tools as well as dose reduction techniques could increase their safe practices in dental radiology.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 131-138"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000212/pdfft?md5=457743697810a3d1f1568879a59f4710&pid=1-s2.0-S2666555724000212-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the performance and advantages of HyperArc for radiotherapy of multiple brain metastases with dosimetric parameters with respect to coplanar volumetric modulated arc radiotherapy (c-VMAT), and characterize implicit correlations between tumor features and dosimetric parameters.
Methods
This retrospective study involved 40 patients with multiple brain metastases (4–16 tumors, 12.8–240.8 cm3) who received simultaneous radiotherapy at the Department of Radiation Oncology, Shenzhen People's Hospital from January 2019 to December 2022. Both HyperArc and c-VMAT plans were designed by the same and qualified physicist using the Eclipse system with Truebeam. A single isocenter and a 6 MV flattening filter-free (6FFF) photon beam were used for radiotherapy of multiple brain metastases in each plan. Dosimetric parameters of tumors and organs at risk (OARs) were compared between HyperArc and c-VMAT plans. Correlations between tumor features (number and volume) and dosimetric parameters were revealed and analyzed. Furthermore, monitor units (MUs) of both plan types were recorded to assess rays utilization and delivery efficiency.
Results
Compared to c-VMAT plans, HyperArc plans achieved higher maximum dose (Dmax) (5.23%, t = 7.87, P < 0.01), but lower minimum dose (Dmin) (3.94%, t = −2.12, P = 0.04) and mean dose (Dmean) (1.05%, t = −3.29, P < 0.01) for planning gross tumor volumes (PGTVs). The conformity index (CI), homogeneity index (HI), gradient index (GI) and R50% of PGTVs with HyperArc were better than those with c-VMAT, with the improvements of 20.78%, 1.68%, 19.83% and 36.20%, respectively (P < 0.01). The dosimetric parameters of OARs were significantly improved in HyperArc plans compared to c-VMAT plans. Specifically, the Dmax and the Dmean to the brainstem decreased by 16.14% and 11.37%, respectively. The Dmax for eye_L decreased by 16.88%, for eye_R decreased by 11.67%, for optical nerve_L decreased by 12.56 %, and for chiasm decreased by 18.12%. Few correlations were observed between the differences of CI/HI/GI/R50% and the number of PGTVs between the two plan types. Whereas, regression analysis indicated that the differences of CI/ GI/ R50% were negatively correlated with the volume of PGTVs, respectively. Moreover, although HyperArc plans reduced the MUs by 4.74 % compared to c-VMAT, no significant difference was observed (P > 0.05).
Conclusions
This study demonstrates the promising performance of HyperArc for radiotherapy of multiple brain metastases, including better dose conformity for the tumors, more rapid dose drop and less dose spillage
{"title":"HyperArc performance in radiotherapy and its correlations with number and volume of multiple brain metastases","authors":"Hongtao Chen, Zihuang Li, Guixiang Liao, Lijun Wang, Xiaonian Deng, Heli Zhong","doi":"10.1016/j.radmp.2024.05.004","DOIUrl":"10.1016/j.radmp.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the performance and advantages of HyperArc for radiotherapy of multiple brain metastases with dosimetric parameters with respect to coplanar volumetric modulated arc radiotherapy (c-VMAT), and characterize implicit correlations between tumor features and dosimetric parameters.</p></div><div><h3>Methods</h3><p>This retrospective study involved 40 patients with multiple brain metastases (4–16 tumors, 12.8–240.8 cm<sup>3</sup>) who received simultaneous radiotherapy at the Department of Radiation Oncology, Shenzhen People's Hospital from January 2019 to December 2022. Both HyperArc and c-VMAT plans were designed by the same and qualified physicist using the Eclipse system with Truebeam. A single isocenter and a 6 MV flattening filter-free (6FFF) photon beam were used for radiotherapy of multiple brain metastases in each plan. Dosimetric parameters of tumors and organs at risk (OARs) were compared between HyperArc and c-VMAT plans. Correlations between tumor features (number and volume) and dosimetric parameters were revealed and analyzed. Furthermore, monitor units (MUs) of both plan types were recorded to assess rays utilization and delivery efficiency.</p></div><div><h3>Results</h3><p>Compared to c-VMAT plans, HyperArc plans achieved higher maximum dose (<em>D</em><sub>max</sub>) (5.23%, <em>t</em> = 7.87, <em>P</em> < 0.01), but lower minimum dose (<em>D</em><sub>min</sub>) (3.94%, <em>t</em> = −2.12, <em>P</em> = 0.04) and mean dose (<em>D</em><sub>mean</sub>) (1.05%, <em>t</em> = −3.29, <em>P</em> < 0.01) for planning gross tumor volumes (PGTVs). The conformity index (CI), homogeneity index (HI), gradient index (GI) and R<sub>50</sub><sub>%</sub> of PGTVs with HyperArc were better than those with c-VMAT, with the improvements of 20.78%, 1.68%, 19.83% and 36.20%, respectively (<em>P</em> < 0.01). The dosimetric parameters of OARs were significantly improved in HyperArc plans compared to c-VMAT plans. Specifically, the <em>D</em><sub>max</sub> and the <em>D</em><sub>mean</sub> to the brainstem decreased by 16.14% and 11.37%, respectively. The <em>D</em><sub>max</sub> for eye_L decreased by 16.88%, for eye_R decreased by 11.67%, for optical nerve_L decreased by 12.56 %, and for chiasm decreased by 18.12%. Few correlations were observed between the differences of CI/HI/GI/R<sub>50</sub><sub>%</sub> and the number of PGTVs between the two plan types. Whereas, regression analysis indicated that the differences of CI/ GI/ R<sub>50</sub><sub>%</sub> were negatively correlated with the volume of PGTVs, respectively. Moreover, although HyperArc plans reduced the MUs by 4.74 % compared to c-VMAT, no significant difference was observed (<em>P</em> > 0.05).</p></div><div><h3>Conclusions</h3><p>This study demonstrates the promising performance of HyperArc for radiotherapy of multiple brain metastases, including better dose conformity for the tumors, more rapid dose drop and less dose spillage ","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 139-144"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000327/pdfft?md5=9756f327828bbaf08c3737544fba9530&pid=1-s2.0-S2666555724000327-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the applicability degree of the international guidelines by Moroccan radiotherapists, in order to improve the management of cervical cancer (CC), since CC is the second most common cancer for women in Morocco.
Methods
This cross-sectional study was carried out using a questionnaire sent online to Moroccan radiotherapists. The questionnaire covered participants' characteristics, initial assessment and treatment preparation, techniques and indications for radiotherapy and brachytherapy, dose and indications, as well as on the protocol adopted in the intermediate stages and the location of adjuvant treatments and assessments' follow-up.
Results
74 radiotherapists out of 300 have responded to the survey. Only 27.0% of practitioners reported discussing patient records systematically in a multidisciplinary consultation meeting (MCM). For the initial assessment, 77.0% requested pelvic magnetic resonance imaging (MRI). It is significantly less requested in regional oncology centers (ROCs) than in university hospital centers (UHCs) or the private sector (P < 0.001). Furthermore, Clinicians in ROCs do not have access to new techniques of radiotherapy. In 83.8% of cases, the most prescribed radiotherapy protocols were 45–46 Gy in 1.8–2 Gy per fraction. Three-dimensional gynaecological brachytherapy high-throughput dose guided by dosimetric scanner was available in 75.5% of structures while interstitial gynaecological brachytherapy was only available in 23% of centers. The two most prescribed dose protocols were 4 × 7 Gy and 3 × 7 Gy in 74.4% and 21.6% of cases, respectively. Finally, monitoring during the first two years was based mainly on pelvic MRI (82.2%) while PET/CT was recommended by only less than 10%.
Conclusions
The findings obtained show that our radiotherapists generally comply with international guidelines for the cervical cancer management. However, they should still enhance their practices for the first staging evaluation, the use of systematic MCMs, the doses and treatment techniques used, and the follow-up evaluation.
{"title":"Survey of current practices in the management of cervical cancer by Moroccan radiotherapists","authors":"Bouchra Amaoui , Slimane Semghouli , Hanane El Kacemi , Issam Lalya , Nadia Benchekroune , Fatima Safini , Sanae Abbaoui","doi":"10.1016/j.radmp.2024.04.001","DOIUrl":"10.1016/j.radmp.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the applicability degree of the international guidelines by Moroccan radiotherapists, in order to improve the management of cervical cancer (CC), since CC is the second most common cancer for women in Morocco.</p></div><div><h3>Methods</h3><p>This cross-sectional study was carried out using a questionnaire sent online to Moroccan radiotherapists. The questionnaire covered participants' characteristics, initial assessment and treatment preparation, techniques and indications for radiotherapy and brachytherapy, dose and indications, as well as on the protocol adopted in the intermediate stages and the location of adjuvant treatments and assessments' follow-up.</p></div><div><h3>Results</h3><p>74 radiotherapists out of 300 have responded to the survey. Only 27.0% of practitioners reported discussing patient records systematically in a multidisciplinary consultation meeting (MCM). For the initial assessment, 77.0% requested pelvic magnetic resonance imaging (MRI). It is significantly less requested in regional oncology centers (ROCs) than in university hospital centers (UHCs) or the private sector (<em>P</em> < 0.001). Furthermore, Clinicians in ROCs do not have access to new techniques of radiotherapy. In 83.8% of cases, the most prescribed radiotherapy protocols were 45–46 Gy in 1.8–2 Gy per fraction. Three-dimensional gynaecological brachytherapy high-throughput dose guided by dosimetric scanner was available in 75.5% of structures while interstitial gynaecological brachytherapy was only available in 23% of centers. The two most prescribed dose protocols were 4 × 7 Gy and 3 × 7 Gy in 74.4% and 21.6% of cases, respectively. Finally, monitoring during the first two years was based mainly on pelvic MRI (82.2%) while PET/CT was recommended by only less than 10%.</p></div><div><h3>Conclusions</h3><p>The findings obtained show that our radiotherapists generally comply with international guidelines for the cervical cancer management. However, they should still enhance their practices for the first staging evaluation, the use of systematic MCMs, the doses and treatment techniques used, and the follow-up evaluation.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 124-130"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000261/pdfft?md5=d2f54fba9abae3e69e924c78e371b1b3&pid=1-s2.0-S2666555724000261-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.radmp.2024.05.003
Qin Ding , Wei Liu , Junping Pan , Lihua Wang , Wenquan Hong , Sunqin Cai , Xin Chen , Duanyu Lin , Sufang Qiu
Objective
To explore the correlation between mitophagy and the tumor microenvironment (TME) in patients with head and neck squamous cell carcinoma (HNSCC), with an aim to enhance therapeutic efficacy for HNSCC.
Methods
A machine learning-based multigene prognostic signature was developed based on mitophagy-related differentially expressed genes (MRGs) identified in The Cancer Genome Atlas cohort. This signature was correlated with the TME using gene set enrichment analysis. The association between this prognostic signature and various immunological features of the TME was explored, including status of tumor-infiltrating immune cells, expression of immune checkpoint molecules, and the immunoscore. Immunohistochemistry validated the expression of hub gene CSNK2A2 and assessed its relationship with immunomarker expression. Quantitative PCR validated CSNK2A2 knockdown in HNSCC cell lines. Functional experiments including Transwell assays to determine cell migration and invasion, Cell Counting Kit 8 assay, and 5-ethynyl-2-deoxyuridine assay were performed to confirm the role of CSNK2A2 in HNSCC. Finally, a subcutaneous xenograft model was generated in C3H mice to validate our findings.
Results
The MRG-based prognostic signature showed excellent predictive performance. High-risk patients had significantly shorter progression-free and overall survival (P < 0.0001) than low-risk patients. CD8+ T cell infiltration was lower in high-risk groups, whereas low-risk groups showed higher immunological marker expression. Thus, the low-risk HNSCC subtype may benefit from immune therapy, while high-risk subtypes may benefit from chemotherapy (P < 0.001). CSNK2A2 was highly expressed and strongly correlated with CD8 and PD-L1 based on immunohistochemistry of the HNSCC tissue microarray. CSNK2A2 knockdown reduced cell migration, invasion, and proliferation, and arrested cells in G1 phase. In vivo, it led to slower tumor growth and smaller tumor volumes.
Conclusion
We established a potential prognostic signature that could improve HNSCC management in the future. CSNK2A2 may be a new biomarker to predict immunotherapy efficacy in HNSCC.
{"title":"Role of mitophagy in head and neck squamous cell carcinoma: Prognosis and immune insights","authors":"Qin Ding , Wei Liu , Junping Pan , Lihua Wang , Wenquan Hong , Sunqin Cai , Xin Chen , Duanyu Lin , Sufang Qiu","doi":"10.1016/j.radmp.2024.05.003","DOIUrl":"10.1016/j.radmp.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the correlation between mitophagy and the tumor microenvironment (TME) in patients with head and neck squamous cell carcinoma (HNSCC), with an aim to enhance therapeutic efficacy for HNSCC.</p></div><div><h3>Methods</h3><p>A machine learning-based multigene prognostic signature was developed based on mitophagy-related differentially expressed genes (MRGs) identified in The Cancer Genome Atlas cohort. This signature was correlated with the TME using gene set enrichment analysis. The association between this prognostic signature and various immunological features of the TME was explored, including status of tumor-infiltrating immune cells, expression of immune checkpoint molecules, and the immunoscore. Immunohistochemistry validated the expression of hub gene CSNK2A2 and assessed its relationship with immunomarker expression. Quantitative PCR validated CSNK2A2 knockdown in HNSCC cell lines. Functional experiments including Transwell assays to determine cell migration and invasion, Cell Counting Kit 8 assay, and 5-ethynyl-2-deoxyuridine assay were performed to confirm the role of CSNK2A2 in HNSCC. Finally, a subcutaneous xenograft model was generated in C3H mice to validate our findings.</p></div><div><h3>Results</h3><p>The MRG-based prognostic signature showed excellent predictive performance. High-risk patients had significantly shorter progression-free and overall survival (<em>P</em> < 0.0001) than low-risk patients. CD8+ T cell infiltration was lower in high-risk groups, whereas low-risk groups showed higher immunological marker expression. Thus, the low-risk HNSCC subtype may benefit from immune therapy, while high-risk subtypes may benefit from chemotherapy (<em>P</em> < 0.001). CSNK2A2 was highly expressed and strongly correlated with CD8 and PD-L1 based on immunohistochemistry of the HNSCC tissue microarray. CSNK2A2 knockdown reduced cell migration, invasion, and proliferation, and arrested cells in G<sub>1</sub> phase. <em>In vivo</em>, it led to slower tumor growth and smaller tumor volumes.</p></div><div><h3>Conclusion</h3><p>We established a potential prognostic signature that could improve HNSCC management in the future. CSNK2A2 may be a new biomarker to predict immunotherapy efficacy in HNSCC.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 100-112"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000315/pdfft?md5=dfb195821f34983da2220f71027b923b&pid=1-s2.0-S2666555724000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.radmp.2024.05.002
Han Wu , Miaomiao Liu , Huangang Jiang , Hui Xu , Jin Peng , Jing Dai , Fuxiang Zhou
Objective
To explore the new treatment strategies for radiation proctitis, which is the most common complication of pelvic tumor malignancies.
Methods
Four cases of patients with severe radiation proctitis were treated with high-dosage vitamin C (VC, 12–24 g/d, iv) combined with cyclooxygenase-2 (cyclooxygenase-2, COX-2) inhibitors.
Results
For these four cases, the diarrhea, hematochezia, tenesmus, pain, and other symptoms were significantly improved. The edema of the rectal wall is also significantly improved in the imaging review.
Conclusion
The high-dosage VC combined with the treatment of severe radiation proctitis is safe and effective.
{"title":"Treatment of severe radiation proctitis with high dosage of vitamin C in combination with cyclooxygenase-2 inhibitor","authors":"Han Wu , Miaomiao Liu , Huangang Jiang , Hui Xu , Jin Peng , Jing Dai , Fuxiang Zhou","doi":"10.1016/j.radmp.2024.05.002","DOIUrl":"10.1016/j.radmp.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the new treatment strategies for radiation proctitis, which is the most common complication of pelvic tumor malignancies.</p></div><div><h3>Methods</h3><p>Four cases of patients with severe radiation proctitis were treated with high-dosage vitamin C (V<sub>C</sub>, 12–24 g/d, iv) combined with cyclooxygenase-2 (cyclooxygenase-2, COX-2) inhibitors.</p></div><div><h3>Results</h3><p>For these four cases, the diarrhea, hematochezia, tenesmus, pain, and other symptoms were significantly improved. The edema of the rectal wall is also significantly improved in the imaging review.</p></div><div><h3>Conclusion</h3><p>The high-dosage V<sub>C</sub> combined with the treatment of severe radiation proctitis is safe and effective.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 113-117"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000303/pdfft?md5=75df23389406a12728d33973385ae015&pid=1-s2.0-S2666555724000303-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.radmp.2024.02.003
Professional Committee of Radiation Oncology, China Anti-Cancer Association , Branch of Radiation Oncology, Chinese Medical Association, Branch of Radiation Oncology Treatment Physician, Chinese Medical Doctor Association
Radiotherapy represents an essential treatment approach for esophageal cancer. Over recent years, immunotherapy combined with chemotherapy has become the first-line standard treatment for patients with advanced esophageal cancer. Several phase III studies on immunotherapy combined with radiotherapy for locally advanced esophageal cancer are currently underway. Sufficient evidence-based medical data are urgently needed to support the integration of immunotherapy and chemoradiotherapy as a new treatment strategy for patients with locally advanced esophageal cancer. This consensus, formulated based on the latest study results, in-depth research, and thorough discussions, provides a comprehensive set of recommendations. The document extensively covers treatment strategies and evaluation methods for radiotherapy combined with immunotherapy across patients with operable esophageal cancer, inoperable locally advanced esophageal cancer, and advanced esophageal cancer. Moreover, common complications and radiation-related issues associated with radiotherapy combined with immunotherapy are discussed, serving as clinical guidance. Our expert group comprised members from the Professional Committee of Radiation Oncology, China Anti-Cancer Association, the Branch of Radiation Oncology, Chinese Medical Association, and the Branch of Radiation Oncology Treatment Physician, Chinese Medical Doctor Association.
放疗是食道癌的重要治疗方法。近年来，免疫疗法联合化疗已成为晚期食道癌患者的一线标准治疗方法。目前正在进行多项关于免疫疗法联合放疗治疗局部晚期食道癌的 III 期研究。目前迫切需要足够的循证医学数据来支持将免疫疗法与化疗放疗相结合，作为局部晚期食管癌患者的一种新的治疗策略。本共识是在最新研究成果、深入研究和充分讨论的基础上形成的，提供了一套全面的建议。文件广泛涵盖了可手术食管癌、不可手术局部晚期食管癌和晚期食管癌患者放疗联合免疫疗法的治疗策略和评估方法。此外，还讨论了放疗联合免疫疗法的常见并发症和放射相关问题，为临床提供指导。专家组由中国抗癌协会放射肿瘤学专业委员会、中华医学会放射肿瘤学分会、中国医师协会放射肿瘤治疗医师分会的委员组成。
{"title":"Expert consensus on radiotherapy combined with immunotherapy for esophageal cancer (2024 edition)","authors":"Professional Committee of Radiation Oncology, China Anti-Cancer Association , Branch of Radiation Oncology, Chinese Medical Association, Branch of Radiation Oncology Treatment Physician, Chinese Medical Doctor Association","doi":"10.1016/j.radmp.2024.02.003","DOIUrl":"10.1016/j.radmp.2024.02.003","url":null,"abstract":"<div><p>Radiotherapy represents an essential treatment approach for esophageal cancer. Over recent years, immunotherapy combined with chemotherapy has become the first-line standard treatment for patients with advanced esophageal cancer. Several phase III studies on immunotherapy combined with radiotherapy for locally advanced esophageal cancer are currently underway. Sufficient evidence-based medical data are urgently needed to support the integration of immunotherapy and chemoradiotherapy as a new treatment strategy for patients with locally advanced esophageal cancer. This consensus, formulated based on the latest study results, in-depth research, and thorough discussions, provides a comprehensive set of recommendations. The document extensively covers treatment strategies and evaluation methods for radiotherapy combined with immunotherapy across patients with operable esophageal cancer, inoperable locally advanced esophageal cancer, and advanced esophageal cancer. Moreover, common complications and radiation-related issues associated with radiotherapy combined with immunotherapy are discussed, serving as clinical guidance. Our expert group comprised members from the Professional Committee of Radiation Oncology, China Anti-Cancer Association, the Branch of Radiation Oncology, Chinese Medical Association, and the Branch of Radiation Oncology Treatment Physician, Chinese Medical Doctor Association.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 59-67"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000054/pdfft?md5=519fb604d3aac6fbeed74aa6d1620ac0&pid=1-s2.0-S2666555724000054-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.radmp.2024.04.003
Kaixuan Wang , Cong Ye , Lan Luo , Chen Yan
Over the past decades, the survival rates of patients with cancer have significantly increased owing to advancements in cancer treatment strategies. Radiotherapy has become an indispensable treatment modality for thoracic tumors. While it offers benefits in treating or even potentially curing cancer, thoracic radiotherapy exposes neighboring heart tissues to ionizing radiation, elevating the risk of radiation-induced heart disease (RIHD). Despite improvements in radiotherapy techniques that have reduced the incidence of RIHD, complete avoidance of heart radiation exposure remains a challenge. Cohort studies involving atomic bomb survivors and individuals with occupational radiation exposure, even at relatively low doses, have reported a significant increase in RIHD risks. The pathological mechanisms underlying RIHD have been extensively reviewed. At present, imaging techniques and traditional cardiac biomarkers are the primary methods to diagnose RIHD, with ongoing efforts to explore additional promising markers for predicting and monitoring RIHD. Moreover, traditional and novel therapeutic strategies are being actively explored to prevent or alleviate RIHD. Insights gained from therapeutic advancements in other organ systems or heart diseases caused by different factors can provide valuable ideas for RIHD management. This review discusses the recent advancements in the diagnosis and treatment of RIHD.
{"title":"Advances in radiation-induced heart disease diagnosis and treatment","authors":"Kaixuan Wang , Cong Ye , Lan Luo , Chen Yan","doi":"10.1016/j.radmp.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.radmp.2024.04.003","url":null,"abstract":"<div><p>Over the past decades, the survival rates of patients with cancer have significantly increased owing to advancements in cancer treatment strategies. Radiotherapy has become an indispensable treatment modality for thoracic tumors. While it offers benefits in treating or even potentially curing cancer, thoracic radiotherapy exposes neighboring heart tissues to ionizing radiation, elevating the risk of radiation-induced heart disease (RIHD). Despite improvements in radiotherapy techniques that have reduced the incidence of RIHD, complete avoidance of heart radiation exposure remains a challenge. Cohort studies involving atomic bomb survivors and individuals with occupational radiation exposure, even at relatively low doses, have reported a significant increase in RIHD risks. The pathological mechanisms underlying RIHD have been extensively reviewed. At present, imaging techniques and traditional cardiac biomarkers are the primary methods to diagnose RIHD, with ongoing efforts to explore additional promising markers for predicting and monitoring RIHD. Moreover, traditional and novel therapeutic strategies are being actively explored to prevent or alleviate RIHD. Insights gained from therapeutic advancements in other organ systems or heart diseases caused by different factors can provide valuable ideas for RIHD management. This review discusses the recent advancements in the diagnosis and treatment of RIHD.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 83-89"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000285/pdfft?md5=17a3a783a1fa002a96c4a0fcc391e1cf&pid=1-s2.0-S2666555724000285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the diagnosis value of a low dose, dual-energy cardiac computed tomography angiography (CTA) with non-electrocardiography-gated (non-ECG-gated) in detecting left atrial appendage (IAA) thrombus.
Methods
Consecutive patients with atrial fibrillation who underwent cardiac CTA protocol (dual-energy scan for arterial phase and conventional scan for delayed phase) were prospectively enrolled. LAA lesions were proved by clinical comprehensive diagnosis, the final study included 18 cases with LAA thrombus and 48 cases with circulatory stasis. Quantitative parameters derived from dual-energy images were measured for the LAA lesions, including the conventional CT attenuation value (CT value), iodine concentration (IC), normalized iodine concentration (NIC), effective atomic number values (Zeff) and energy spectrum curve slope (Slope). The differences between LAA thrombus group and circulatory stasis group were compared by independent sample t-test or Wilcoxon rank sum test regarding to the normality test. The diagnosis performance of the dual-energy parameters was assessed using receiver operating characteristic (ROC) curve analysis and area under curve (AUC).
Results
All the dual-energy parameters were demonstrated significantly difference between LAA thrombus and circulatory stasis group (P＜0.05), and showed better diagnostic performance than the conventional CT value. ROC analysis revealed IC was the most predictive parameter with AUC equal to 0.836. The radiation dose in the arterial phase was (2.64 ± 0.66) mSv.
Conclusion
Dual-energy CTA scanning shows convincing diagnostic performance in detecting left atrial appendage thrombus with lower radiation dose, and may help reduce the need for delayed phase scan.
{"title":"Non-electrocardiography-gated dual-energy cardiac CT angiography for assessment of left atrial appendage thrombus","authors":"Feifei Zhang, Tian Jiang, Ruigang Xie, Jiliang Zhang, Minghua Sun, Yinghui Ge","doi":"10.1016/j.radmp.2024.03.004","DOIUrl":"10.1016/j.radmp.2024.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the diagnosis value of a low dose, dual-energy cardiac computed tomography angiography (CTA) with non-electrocardiography-gated (non-ECG-gated) in detecting left atrial appendage (IAA) thrombus.</p></div><div><h3>Methods</h3><p>Consecutive patients with atrial fibrillation who underwent cardiac CTA protocol (dual-energy scan for arterial phase and conventional scan for delayed phase) were prospectively enrolled. LAA lesions were proved by clinical comprehensive diagnosis, the final study included 18 cases with LAA thrombus and 48 cases with circulatory stasis. Quantitative parameters derived from dual-energy images were measured for the LAA lesions, including the conventional CT attenuation value (CT value), iodine concentration (IC), normalized iodine concentration (NIC), effective atomic number values (Zeff) and energy spectrum curve slope (Slope). The differences between LAA thrombus group and circulatory stasis group were compared by independent sample <em>t</em>-test or Wilcoxon rank sum test regarding to the normality test. The diagnosis performance of the dual-energy parameters was assessed using receiver operating characteristic (ROC) curve analysis and area under curve (AUC).</p></div><div><h3>Results</h3><p>All the dual-energy parameters were demonstrated significantly difference between LAA thrombus and circulatory stasis group (<em>P</em>＜0.05), and showed better diagnostic performance than the conventional CT value. ROC analysis revealed IC was the most predictive parameter with AUC equal to 0.836. The radiation dose in the arterial phase was (2.64 ± 0.66) mSv.</p></div><div><h3>Conclusion</h3><p>Dual-energy CTA scanning shows convincing diagnostic performance in detecting left atrial appendage thrombus with lower radiation dose, and may help reduce the need for delayed phase scan.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 118-123"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266655572400025X/pdfft?md5=667b6e15636487605f5f1aa325113235&pid=1-s2.0-S266655572400025X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.radmp.2024.03.003
Jing Han , Ruru Wang , Bin Chen , Feng Xu , Liangchen Wei , An Xu , Lijun Wu , Guoping Zhao
Objective
To investigate the role and the molecular mechanisms of apoptotic signaling in ferroptosis to regulate tumor radiosensitivity.
Methods
Reactive oxygen species (ROS) and lipid peroxide levels were detected in Mouse embryonic fibroblasts(MEFs) with Bcl-xL or Mcl-1 deficiency induced by erastin. Colony formation, ROS, lipid peroxidation and the transcription/translation levels of PTGS2 were measured in Bcl-xL knockdown tumor cells induced by 5 Gy γ-rays or co-treated with ferrostatin-1 (Ferr-1). The protein levels of LPCAT3, ACSL4 and PEBP1 in Bcl-xL knockout MEF cells were evaluated in Bcl-xL knockout MEF cells post-radiation. Moreover, the interaction of heat shock protein 90 (HSP90) with Bcl-xL, GPX4, or LAMP2A was detected by protein mass spectrometry and immunoprecipitation assays.
Results
Manipulating Bcl-xL levels facilitated radiation-induced ferroptosis by augmenting the enzymatic oxidation of polyunsaturated fatty acids (PUFAs) and enhancing chaperone-mediated autophagy (CMA) of glutathione peroxidase 4 (GPX4) (MEF cell line: t=4.540, P＜0.01; A549 cell line: t=56.16, P＜0.0001; t=4.885, P＜0.01; HCT116 cell line: t=14.75, P＜0.01; t=7.363, P＜0.05). Downregulating Bcl-xL expression promoted the activity of acyl-CoA synthetase long-chain family member 4 (ACSL4), thus increasing the enzymatic oxidation of PUFAs (t=4.258, P＜0.01). Moreover, depletion of Bcl-xL expedited the CMA process targeting GPX4 by facilitating the association of GPX4 with heat shock protein 90 (HSP90) and LAMP2A following radiation exposure. Subsequent degradation of GPX4 led to the accumulation of lipid peroxides, ultimately triggering ferroptosis.
Conclusions
Our study provides initial insights into the regulatory role of Bcl-xL in ferroptosis and underscores the potential of targeting Bcl-xL as a promising therapeutic strategy for cancer by modulating both apoptotic and ferroptotic pathways.
{"title":"Bcl-xL regulates radiation-induced ferroptosis through chaperone-mediated autophagy of GPX4 in tumor cells","authors":"Jing Han , Ruru Wang , Bin Chen , Feng Xu , Liangchen Wei , An Xu , Lijun Wu , Guoping Zhao","doi":"10.1016/j.radmp.2024.03.003","DOIUrl":"10.1016/j.radmp.2024.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the role and the molecular mechanisms of apoptotic signaling in ferroptosis to regulate tumor radiosensitivity.</p></div><div><h3>Methods</h3><p>Reactive oxygen species (ROS) and lipid peroxide levels were detected in Mouse embryonic fibroblasts(MEFs) with Bcl-xL or Mcl-1 deficiency induced by erastin. Colony formation, ROS, lipid peroxidation and the transcription/translation levels of PTGS2 were measured in Bcl-xL knockdown tumor cells induced by 5 Gy γ-rays or co-treated with ferrostatin-1 (Ferr-1). The protein levels of LPCAT3, ACSL4 and PEBP1 in Bcl-xL knockout MEF cells were evaluated in Bcl-xL knockout MEF cells post-radiation. Moreover, the interaction of heat shock protein 90 (HSP90) with Bcl-xL, GPX4, or LAMP2A was detected by protein mass spectrometry and immunoprecipitation assays.</p></div><div><h3>Results</h3><p>Manipulating Bcl-xL levels facilitated radiation-induced ferroptosis by augmenting the enzymatic oxidation of polyunsaturated fatty acids (PUFAs) and enhancing chaperone-mediated autophagy (CMA) of glutathione peroxidase 4 (GPX4) (MEF cell line: <em>t</em>=4.540, <em>P</em>＜0.01; A549 cell line: <em>t</em>=56.16, <em>P</em>＜0.0001; <em>t</em>=4.885, <em>P</em>＜0.01; HCT116 cell line: <em>t</em>=14.75, <em>P</em>＜0.01; <em>t</em>=7.363, <em>P</em>＜0.05). Downregulating Bcl-xL expression promoted the activity of acyl-CoA synthetase long-chain family member 4 (ACSL4), thus increasing the enzymatic oxidation of PUFAs (<em>t</em>=4.258, <em>P</em>＜0.01). Moreover, depletion of Bcl-xL expedited the CMA process targeting GPX4 by facilitating the association of GPX4 with heat shock protein 90 (HSP90) and LAMP2A following radiation exposure. Subsequent degradation of GPX4 led to the accumulation of lipid peroxides, ultimately triggering ferroptosis.</p></div><div><h3>Conclusions</h3><p>Our study provides initial insights into the regulatory role of Bcl-xL in ferroptosis and underscores the potential of targeting Bcl-xL as a promising therapeutic strategy for cancer by modulating both apoptotic and ferroptotic pathways.</p></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"5 2","pages":"Pages 90-99"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666555724000248/pdfft?md5=9e4fe81d7fc078e70bbb93ae8eeb68cb&pid=1-s2.0-S2666555724000248-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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