Radiation Oncology Journal最新文献_第6页

Trends in the use of radiation for meningioma across the United States 美国脑膜瘤放射治疗的趋势

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-03-01 DOI: 10.3857/roj.2021.00563

H. Matani, S. Abel, A. Yu, S. Karlovits, R. Wegner

Purpose Meningiomas are tumors originating from arachnoid cap cells on the surface of the brain or spinal cord. Treatment differs by grade but can consist of observation, surgery, radiation therapy or both. We utilized the National Cancer Database (NCDB) to compare trends in the use stereotactic radiosurgery (SRS) and external beam radiation therapy (EBRT) in the management of meningioma. Materials and Methods We queried the NCDB from 2004–2015 for meningioma patients (grade 1–3) treated with radiation therapy, either SRS or EBRT. Multivariable logistic regression was used to identify predictors of each treatment and to generate a propensity score. Propensity adjusted Kaplan-Meier survival curve analysis and multivariable Cox hazards ratios were used to identify predictors of survival. Results We identified 5,406 patients with meningioma meeting above criteria with 45%, 44%, and 11% having World Health Organization (WHO) grade 1, 2, and 3 disease, respectively. Median follow up was 43 months. Predictors for SRS were grade 1 disease, distance from treatment facility, and histology. The only predictor of EBRT was grade 3 disease. Treatment year, histology, race and female sex were associated with improved survival. Five- and 10-year survival rates were 89.2% versus 72.6% (p < 0.0001) and 80.3% versus 61.4% (p = 0.29) for SRS and EBRT respectively. After propensity matching 226 pairs were generated. For SRS, 5-year survival was not significantly improved at 88.2% compared with EBRT (p = 0.056). Conclusion In the present analysis, predictors of SRS utilization in management of meningioma include WHO grade 1 disease, distance from treatment facility and histology whereas conventional EBRT utilization was associated with grade 2 and 3 disease. Future studies need to be performed in order to optimize management of atypical and malignant meningioma.

目的脑膜瘤是起源于脑或脊髓表面蛛网膜帽细胞的肿瘤。治疗因分级而异，但可以包括观察、手术、放射治疗或两者兼而有之。我们利用国家癌症数据库(NCDB)来比较在脑膜瘤治疗中使用立体定向放射手术(SRS)和外束放射治疗(EBRT)的趋势。材料和方法我们查询了2004-2015年接受SRS或EBRT放射治疗的脑膜瘤患者(1-3级)的NCDB。使用多变量逻辑回归来确定每种治疗的预测因子并生成倾向评分。使用倾向校正Kaplan-Meier生存曲线分析和多变量Cox风险比来确定生存预测因子。结果5406例脑膜瘤患者符合上述标准，其中45%、44%和11%分别为世界卫生组织(WHO) 1级、2级和3级疾病。中位随访时间为43个月。SRS的预测因子为1级疾病、与治疗机构的距离和组织学。EBRT的唯一预测因子是3级疾病。治疗时间、组织学、种族和女性与生存率的提高有关。SRS和EBRT的5年和10年生存率分别为89.2%对72.6% (p < 0.0001)和80.3%对61.4% (p = 0.29)。经过倾向匹配，生成226对。对于SRS，与EBRT相比，5年生存率没有显著提高，为88.2% (p = 0.056)。结论:在目前的分析中，脑膜瘤治疗中SRS使用的预测因素包括WHO分级为1级的疾病、与治疗设施的距离和组织学，而常规EBRT使用与分级为2级和3级的疾病相关。未来的研究需要进行，以优化非典型和恶性脑膜瘤的管理。

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引用次数: 3

Long-term outcomes of low-dose radiotherapy in Kasabach-Merritt syndrome 低剂量放疗治疗Kasabach-Merritt综合征的远期疗效

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-03-01 DOI: 10.3857/roj.2021.00983

Dowook Kim, J. Choi, K. Hong, H. Kang, I. Kim, J. Lee

Purpose Reports on results of radiation therapy (RT) for Kasabach-Merritt syndrome (KMS) are limited. We performed a retrospective study to evaluate the response rates and late complications and to determine the adequate RT dose for patients with KMS patients. Materials and Methods We studied 11 patients who received RT between October 1988 and September 2008 for KMS refractory to pharmacologic therapy. All patients had external hemangiomas and received the diagnosis of KMS within 12 months of birth. All 11 patients received steroids as the first-line therapy; eight patients additionally received interferon-α therapy, and one patient underwent surgery. Nine patients underwent single-course RT with a total dose of 4.5–8 Gy (1.5–2 Gy/fraction). Two patients received multiple courses of RT, with a cumulative total dose of 12 Gy (2 Gy/fraction) and 18 Gy (1.5 Gy/fraction), respectively. Results The median follow-up period was 156 months (interquartile range [IQR], 75 to 226 months). The median total dose of RT was 6 Gy, and all patients maintained complete remission until the last follow-up. An additional course of RT was performed for refractory cases or cases of local relapse after initial RT. Rapid platelet count increase after RT was seen in most patients, which returned to normalcy in a median of 20 days (IQR, 5 to 178 days). However, seven patients experienced radiation-related long-term complications. Conclusion Low-dose RT is effective and yields rapid response in patients with KMS. However, given growth-related late complications, RT should be carefully considered.

目的:关于Kasabach-Merritt综合征(KMS)放射治疗(RT)结果的报道有限。我们进行了一项回顾性研究，以评估反应率和晚期并发症，并确定KMS患者的适当放疗剂量。材料与方法我们研究了1988年10月至2008年9月期间11例KMS药物治疗难治性的患者。所有患者均有外血管瘤，并在出生后12个月内被诊断为KMS。所有11例患者均接受类固醇作为一线治疗;8名患者接受了干扰素-α治疗，1名患者接受了手术。9例患者接受单疗程放疗，总剂量为4.5-8 Gy (1.5-2 Gy/次)。2例患者接受多疗程放疗，累计总剂量分别为12 Gy (2 Gy/分)和18 Gy (1.5 Gy/分)。结果中位随访时间为156个月(四分位间距[IQR]， 75 ~ 226个月)。中位总放疗剂量为6 Gy，所有患者在最后一次随访前均保持完全缓解。对于顽固性病例或初次放疗后局部复发的病例，再进行一个疗程的放疗。大多数患者在放疗后血小板计数迅速增加，在中位20天(IQR, 5至178天)内恢复正常。然而，7名患者经历了与放射相关的长期并发症。结论低剂量放疗治疗KMS疗效好，见效快。然而，考虑到生长相关的晚期并发症，RT应该仔细考虑。

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引用次数: 1

Radiation therapy in chronic hidradenitis suppurativa: case report 放射治疗慢性化脓性汗腺炎1例

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-03-01 DOI: 10.3857/roj.2021.00570

P. Sakyanun, Thirada Vongvanichvathana, P. Lertsanguansinchai

A 26-year-old female presented recurrent painful, carbuncles at both axillae for 10 years. It caused offensive odor and scar. Tissue diagnosis was chronic hidradenitis suppurativa. She was treated using antibiotics followed by multiple excisions with drainage but showed no improvement. Isotretinoin provided no benefit. She was socially isolated and experienced lower quality of life. Consequently, she was sent for radiation therapy. Computed tomography simulation was performed revealing an ulcer with deep chronic pus tracts at her axilla. Three-dimensional conformal radiation therapy was provided with 6 MV photon (7.5 Gy in 3 fractions) covering all ulcers and pus tracts. On the last day of radiation therapy, carbuncles and wounds at the left axilla exhibited much improvement without pus. Three months follow-up showed much improvement of the lesions. The skin was smoother without pus or odor. Radiation therapy was confirmed one treatment option for chronic hidradenitis suppurativa.

一位26岁的女性表现为复发性疼痛，双腋窝痈10年。它会产生难闻的气味和疤痕。组织诊断为慢性化脓性汗腺炎。她接受抗生素治疗，随后多次切除并引流，但没有好转。异维甲酸没有提供任何益处。她在社会上被孤立，生活质量较低。因此，她被送去接受放射治疗。计算机断层扫描模拟显示溃疡深慢性脓液束在她的腋窝。三维适形放射治疗提供6 MV光子(3次7.5 Gy)覆盖所有溃疡和脓管。放射治疗的最后一天，左腋窝的红肿和伤口有了很大的改善，没有脓。随访3个月，病变明显好转。皮肤光滑，没有脓液和气味。放射治疗被证实是慢性化脓性汗腺炎的一种治疗选择。

引用次数: 1

Optimal positive lymph node ratio showing the benefit of postoperative radiotherapy in pathologic N2 non-small cell lung cancer: an exploratory study using the Surveillance, Epidemiology, and End Results data 病理N2非小细胞肺癌术后放疗的最佳淋巴结阳性比例:一项使用监测、流行病学和最终结果数据的探索性研究

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-03-01 DOI: 10.3857/roj.2021.00969

Shiho Lee, Kyu Noh

Purpose This study aimed to identify the clinical parameters having the beneficial effect of postoperative radiotherapy (PORT) in pathologic N2 (pN2) non-small cell lung cancer (NSCLC) using the Surveillance, Epidemiology, and End Results (SEER) data. Materials and methods Among non-metastatic NSCLC patients in the SEER data, we included patients who diagnosed after 2002, who confirmed as pN2 after lobectomy or pneumonectomy, and who coded as underwent PORT or observation. Patients who survived less than 4 months of diagnosis were excluded in consideration of the perioperative mortality. After performing propensity score matching (PSM) on the selected patients, we compared PORT group with surgery alone group. We also performed exploratory subgroup analysis to find patients who could benefit from PORT. Results Among the selected 4,456 patients, 1,729 patients received PORT, and 2,727 patients did not. There was no survival benefit of PORT in all patients with pN2 disease (hazard ratio [HR] = 1.03, p = 0.5). In subgroup analyses, the patients with a positive lymph node (LN) ratio of 60%–80% showed the significant benefit of PORT (HR = 0.71, p = 0.002). Conclusion PORT did not show the significant survival benefit in patients with pN2 disease after correcting the confoundedness in the SEER data. However, a specific range of LN ratios can be a potential indicator maximizing the survival benefit of PORT.

目的本研究旨在通过监测、流行病学和最终结果(SEER)数据，确定对病理N2 (pN2)非小细胞肺癌(NSCLC)术后放疗(PORT)有利的临床参数。材料和方法在SEER数据中的非转移性NSCLC患者中，我们纳入了2002年以后诊断的患者，在肺叶切除术或全肺切除术后确诊为pN2的患者，以及编码为接受PORT或观察的患者。生存时间小于4个月的患者排除在围手术期死亡率考虑之外。在对选定的患者进行倾向评分匹配(PSM)后，我们将PORT组与单纯手术组进行比较。我们还进行了探索性亚组分析，以寻找可以从PORT获益的患者。结果4456例患者中，1729例患者接受了PORT治疗，2727例患者未接受PORT治疗。在所有pN2疾病患者中，PORT无生存获益(风险比[HR] = 1.03, p = 0.5)。在亚组分析中，淋巴结(LN)阳性比例为60%-80%的患者显示PORT的显著获益(HR = 0.71, p = 0.002)。结论在纠正了SEER数据中的混淆后，PORT并未显示pN2疾病患者的显著生存获益。然而，LN比率的特定范围可能是PORT生存效益最大化的潜在指标。

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引用次数: 3

Comment on “Abscopal effect in the radio and immunotherapy” “放射与免疫治疗中的抽象化效应”述评

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-03-01 DOI: 10.3857/roj.2022.00017

François Fabi

general understanding of the abscopal effect. As mentioned by the authors, while this phenomenon has been described for decades, the underlying molecular mechanisms allowing localized radiation to exert a disseminated anti-tumoral effect remains profoundly opaque. Although a multiplicity of pathways, effectors and mediators have been described, little work yielded results which could allow the clinical instrumentalization of this effect. In this review, the authors report the proposed unifying mechanism allowing distant effect of localized radiation therapy, which hinges on the activation of local CD T lymphocytes. These effector cells are exposed and primed to tumoral antigens and then exported to distant lesion sites, where they operate their cytolytic effect. The authors also mention that the generation of a large amount of de novo tumor antigens is responsible for robust immunogenicity, which is required to achieve potent activation of local leukocytes, as confirmed by others [2]. We do agree that tumor mutational burden (TMB) is usually considered as the primary predictor of neoantigen load, which is itself ontologically associated with tumoral immunoreactivity [3]. However, as underlined in pancreatic cancer [4] as well as other organ systems, distinct orthogonal signatures, like chemokine expression, can be used as robust, complementary proxies of the degree of tumoral T-cell infiltration and activation, even in the absence of high TMB or neoantigens. Alternatively, a variety of molecular signatures characteristic of T cell-inflamed phenotypes have been identified, with high T-cell infiltration generally predictive of good immunotherapeutic response. This, in turn, provides a plausibly robust prognosticator of response to immune checkpoint inhibitors [5]. In essence, it is suggested that tumoral immunogenicity, and response to immunotherapy, are not solely contingent on neoantigens and, by extension, TMB. Indeed, recent analysis of the phase 2 pan-cancer study (CA209-538) demonstrated no predictive value of TMB to response to combined PD-1/CTLA-4 (programmed cell death protein-1/cytotoxic T lymphocyte antigen-4) checkpoint inhibition [6]. Rather, tumor infiltration by competent lymphocytes, which appears to be associated with different immunobiologically relevant signatures, could be a complementary, powerful metric of predicted therapeutic sensitivity to both radio and immunotherapies. We agree with the authors that identifying lesions most likely to generate systemic response to loComment on “Abscopal effect in the radio and immunotherapy”

对抽象效应的一般认识。正如作者所提到的，虽然这种现象已经被描述了几十年，但允许局部辐射发挥弥散性抗肿瘤作用的潜在分子机制仍然非常不清楚。虽然已经描述了多种途径，效应剂和介质，但很少有工作产生的结果可以允许这种作用的临床仪器化。在这篇综述中，作者报告了允许局部放射治疗的远程效果的统一机制，这取决于局部CD T淋巴细胞的激活。这些效应细胞暴露于肿瘤抗原，然后输出到远处病变部位，在那里它们发挥细胞溶解作用。作者还提到，大量新生肿瘤抗原的产生是强大的免疫原性的原因，正如其他人所证实的那样，这是实现局部白细胞有效激活所必需的。我们确实同意肿瘤突变负荷(TMB)通常被认为是新抗原负荷的主要预测因子，其本身在本体论上与肿瘤免疫反应性[3]相关。然而，正如在胰腺癌[4]和其他器官系统中所强调的那样，即使在没有高TMB或新抗原的情况下，不同的正交特征，如趋化因子表达，也可以作为肿瘤t细胞浸润和激活程度的稳健、互补的替代指标。另外，已经确定了T细胞炎症表型的各种分子特征，高T细胞浸润通常预示着良好的免疫治疗反应。这反过来又提供了对免疫检查点抑制剂[5]反应的可靠预测。本质上，这表明肿瘤的免疫原性和对免疫治疗的反应并不仅仅取决于新抗原，进而取决于TMB。事实上，最近对2期泛癌症研究(CA209-538)的分析表明，TMB对PD-1/CTLA-4(程序性细胞死亡蛋白-1/细胞毒性T淋巴细胞抗原-4)检查点抑制[6]的反应没有预测价值。相反，似乎与不同免疫生物学相关特征相关的活性淋巴细胞的肿瘤浸润可能是预测放射治疗和免疫治疗敏感性的补充、有力指标。我们同意作者的观点，即识别最可能产生系统性反应的病变。

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引用次数: 1

Immunomodulatory effect of splenectomy in lung cancer mouse xenograft models receiving radiation therapy 脾切除对放射治疗肺癌小鼠异种移植模型的免疫调节作用

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-02-23 DOI: 10.3857/roj.2021.00885

Yeeun Kim, Changhoon Choi, Jee Hyun Park, Wongyun Ahn, S. Shin, Shin-Yeong Kim, J. Noh

Purpose This study aims to investigate the effect of splenectomy on radiation-mediated growth inhibition and immune modulation in lung cancer xenograft models. Materials and Methods Human non-small cell lung cancer H1299 cells and murine Lewis lung carcinoma LL/2-luc cells were injected into the right hind leg of BALB/c-nude mice and C57BL/6 mice, respectively. Splenectomy or sham operation was performed prior to tumor cell injection or before and after irradiation during tumor growth. Irradiation was delivered with 2–3 fractions of 6 Gy X-ray using a linear accelerator. Flow cytometry analysis was performed for immune cell profiling. Results Splenectomy prior to tumor injection or at early stage inhibited growth of LL/2-luc tumors but not that of H1299 tumors; however, it did not enhance the antitumor effect of radiation regardless of intervention timing. Flow cytometry analysis showed monocytic myeloid-derived suppressor cells (MDSCs) and activated CD8+ T cells increased after irradiation in the tumors of splenectomized mice, compared to those of sham-operated mice. Administration of anti-PD-1 (programmed death-1) antibodies improved the ability of splenectomy to attenuate the growth of irradiated tumors. Conclusion Splenectomy has paradoxical effects on radiation-induced tumor growth inhibition, depending on tumor types and intervention timing, but it has an immune-modulating effect when combined with radiation.

目的探讨脾切除术对肺癌异种移植瘤模型辐射介导的生长抑制和免疫调节的影响。材料与方法将人非小细胞肺癌H1299细胞和小鼠Lewis肺癌LL/2-luc细胞分别注射到BALB/c裸小鼠和C57BL/6小鼠右后腿。在肿瘤细胞注射前或肿瘤生长期间辐照前后分别行脾切除术或假手术。使用直线加速器以2-3次6 Gy x射线照射。流式细胞术分析免疫细胞谱。结果肿瘤注射前或早期行脾切除术对LL/2-luc肿瘤生长有抑制作用，但对H1299肿瘤无抑制作用;然而，无论干预时间如何，它都没有增强放疗的抗肿瘤作用。流式细胞术分析显示，与假手术小鼠相比，脾切除小鼠肿瘤中单核细胞髓源性抑制细胞(MDSCs)和活化的CD8+ T细胞在照射后增加。给予抗pd -1(程序性死亡-1)抗体可提高脾切除术减弱放射肿瘤生长的能力。结论脾切除术对肿瘤生长的抑制作用因肿瘤类型和干预时间不同而存在矛盾，但与放疗联合使用时具有免疫调节作用。

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引用次数: 2

Reviewing the potential role of radiation therapy in gallbladder cancer: an update 回顾放射治疗在胆囊癌中的潜在作用:最新进展

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2022-01-25 DOI: 10.3857/roj.2021.00717

Divyesh Kumar, N. Kiran, D. Khosla

Gallbladder cancer is a highly malignant disease with a poor prognosis. It is the most common cancer of the biliary tract pathway. Although surgery remains the treatment of choice for early-stage disease, majority of the patients presents in locally advanced, unresectable and metastatic stage of the disease. Radiotherapy and chemotherapy thus form an integral part of management for these locally advanced staged patients. The role of radiation though has been advocated in gallbladder cancer, majorly in the adjuvant setting, its role in neoadjuvant and palliative settings remains in an evolving phase. The article thus aims to review and update the existing literature regarding the role of radiation therapy in gallbladder cancer.

胆囊癌是一种预后不良的高度恶性疾病。它是胆道最常见的肿瘤。虽然手术仍然是早期疾病的治疗选择，但大多数患者表现为局部晚期，不可切除和转移期的疾病。因此，放疗和化疗是这些局部晚期患者治疗的重要组成部分。虽然放疗在胆囊癌中的作用一直被提倡，主要是在辅助治疗中，但其在新辅助治疗和姑息治疗中的作用仍处于不断发展的阶段。因此，本文旨在回顾和更新有关放射治疗在胆囊癌中的作用的现有文献。

引用次数: 1

Impact of somatic mutations on clinical and pathologic outcomes in borderline resectable and locally advanced pancreatic cancer treated with neoadjuvant chemotherapy and stereotactic body radiotherapy followed by surgical resection. 体细胞突变对接受新辅助化疗和立体定向体放射治疗并随后进行手术切除的边缘可切除和局部晚期胰腺癌的临床和病理结果的影响。

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2021-12-01 Epub Date: 2021-12-17 DOI: 10.3857/roj.2021.00815

Abhinav V Reddy, Colin S Hill, Shuchi Sehgal, Ding Ding, Amy Hacker-Prietz, Jin He, Lei Zheng, Joseph M Herman, Jeffrey Meyer, Amol K Narang

Purpose: The purpose of this study was to determine if somatic mutations are associated with clinical and pathologic outcomes in patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) who were treated with neoadjuvant chemotherapy and stereotactic body radiotherapy (SBRT).

Materials and methods: Patients treated with neoadjuvant chemotherapy and SBRT followed by surgical resection from August 2016 to January 2019 and who underwent next generation sequencing of their primary tumor were included in the study. Next-generation sequencing was performed either in-house with a Solid Tumor Panel or with FoundationOne CDx. Univariate (UVA) and multivariable analyses (MVA) were performed to determine associations between somatic mutations and pathologic and clinical outcomes.

Results: Thirty-five patients were included in the study. Chemotherapy consisted of modified FOLFIRINOX, gemcitabine and nab-paclitaxel, or gemcitabine and capecitabine. Patients were treated with SBRT in 33 Gy in 5 fractions. On UVA and MVA, tumors with KRAS G12V mutation demonstrated better pathologic tumor regression grade (TRG) to neoadjuvant therapy when compared to tumors with other KRAS mutations (odds ratio = 0.087; 95% confidence interval [CI], 0.009-0.860; p = 0.036). On UVA and MVA, mutations in NOTCH1/2 were associated with worse overall survival (hazard ratio [HR] = 4.15; 95% CI, 1.57-10.95; p = 0.004) and progression-free survival (HR = 3.61; 95% CI, 1.41-9.28; p = 0.008). On UVA, only mutations in NOTCH1/2 were associated with inferior distant metastasis-free survival (HR = 3.38; 95% CI, 1.25-9.16; p = 0.017).

Conclusion: In BRPC and LAPC, the KRAS G12V mutation was associated with better TRG following chemotherapy and SBRT. Additionally, NOTCH1/2 mutations were associated with worse overall survival, distant metastasis-free survival, and progression-free survival.

目的：本研究旨在确定体细胞突变是否与接受新辅助化疗和立体定向体放射治疗（SBRT）的边界可切除胰腺癌（BRPC）或局部晚期胰腺癌（LAPC）患者的临床和病理结果相关：研究纳入了2016年8月至2019年1月期间接受新辅助化疗和SBRT治疗后进行手术切除的患者，这些患者均接受了原发肿瘤新一代测序。下一代测序由公司内部的实体瘤专家小组或FoundationOne CDx进行。研究人员进行了单变量（UVA）和多变量分析（MVA），以确定体细胞突变与病理和临床结果之间的关联：研究共纳入35名患者。化疗包括改良FOLFIRINOX、吉西他滨和纳布紫杉醇，或吉西他滨和卡培他滨。患者接受了分 5 次、每次 33 Gy 的 SBRT 治疗。在UVA和MVA治疗中，与其他KRAS突变的肿瘤相比，KRAS G12V突变的肿瘤在新辅助治疗中表现出更好的病理肿瘤消退等级（TRG）（几率比=0.087；95%置信区间[CI]，0.009-0.860；P=0.036）。在 UVA 和 MVA 中，NOTCH1/2 突变与较差的总生存期（危险比 [HR] = 4.15；95% CI，1.57-10.95；p = 0.004）和无进展生存期（HR = 3.61；95% CI，1.41-9.28；p = 0.008）相关。在UVA中，只有NOTCH1/2的突变与较差的无远处转移生存率相关（HR = 3.38; 95% CI, 1.25-9.16; p = 0.017）：结论：在BRPC和LAPC中，KRAS G12V突变与化疗和SBRT后较好的TRG相关。此外，NOTCH1/2突变与较差的总生存期、无远处转移生存期和无进展生存期有关。

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引用次数: 0

Clinical factors affecting the determination of radiotherapy-induced skin toxicity in breast cancer. 影响乳腺癌放射治疗皮肤毒性测定的临床因素。

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2021-12-01 Epub Date: 2021-12-24 DOI: 10.3857/roj.2020.00395

Elisa Eugenia Córdoba, Ezequiel Lacunza, Alba Mabel Güerci

Purpose: Radiotherapy is essential for the treatment of breast cancer (BC). However, adverse effects may occur in healthy tissue, during treatment and even after several months. Although it is known that this clinical radiosensitivity is multifactorial, the factors involved are unknown yet. In this study, we evaluated the effect of these factors on the development of radiodermatitis in patients undergoing radiotherapy.

Materials and methods: Demographic and lifestyle data collected during face-to-face interviews of 122 BC patients and data from clinical records were investigated. Most patients underwent conventional three-dimensional radiotherapy treatment. A total dose of 50 Gy was administered (2 Gy/day), followed by a boost in a tumor bed with a total dose of 18 Gy (2 Gy/day). Radiotoxicity was evaluated weekly using the Radiation Therapy Oncology Group classification system (range, 0 to 4, according to the severity).

Results: In the present study, 75.4% of patients presented acute skin toxic effects with different degrees of severity. In 25% of cases, these effects manifested at the end of the fourth week at a cumulative dose of 40 Gy. The association of grade ≥2 acute skin reactions with body mass index (BMI) and breast size and between grade 3-4 and age was positive compared with controls. However, the role of the other factors could not be confirmed.

Conclusion: Analysis of the factors related to individual radiosensitivity suggests that age, BMI and breast size play an important role in the development of acute skin toxicity during treatment. Particular attention to patients who present these characteristics would help to control treatment effectiveness and therefore optimize their quality of life.

目的:放疗是乳腺癌(BC)治疗的必要手段。然而，在治疗过程中，甚至几个月后，健康组织可能出现不良反应。虽然已知这种临床放射敏感性是多因素的，但涉及的因素尚不清楚。在这项研究中，我们评估了这些因素对放疗患者放射性皮炎发展的影响。材料和方法:对122例BC患者面对面访谈收集的人口学和生活方式数据以及临床记录数据进行调查。大多数患者接受常规三维放射治疗。给药总剂量为50 Gy (2 Gy/天)，随后在肿瘤床上增加总剂量为18 Gy (2 Gy/天)。每周使用放射治疗肿瘤组分类系统评估放射毒性(根据严重程度，范围从0到4)。结果:本研究中，75.4%的患者出现不同程度的急性皮肤毒性作用。在25%的病例中，这些效应在第四周结束时表现出来，累积剂量为40戈瑞。与对照组相比，≥2级急性皮肤反应与体重指数(BMI)和乳房大小、3-4级与年龄呈正相关。然而，其他因素的作用无法得到证实。结论:对个体放射敏感性相关因素的分析表明，年龄、BMI和乳房大小在治疗期间急性皮肤毒性的发生中起重要作用。特别关注那些表现出这些特征的患者将有助于控制治疗效果，从而优化他们的生活质量。

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引用次数: 8

Gamma-ray irradiation modulates PGRMC1 expression and the number of CD56+ and FoxP3+ cells in the tumor microenvironment of endometrial endometrioid adenocarcinoma. γ射线照射对子宫内膜样腺癌肿瘤微环境中PGRMC1表达及CD56+、FoxP3+细胞数量的调节作用。

IF 2.3 Q3 ONCOLOGY

Radiation Oncology Journal

Pub Date : 2021-12-01 Epub Date: 2021-08-17 DOI: 10.3857/roj.2021.00472

Dmitry Aleksandrovich Zinovkin, Yulia Anatolievna Lyzikova, Eldar Arkadievich Nadyrov, Daniil Rudolfovich Petrenyov, Jale Yuzugulen, Md Zahidul Islam Pranjol

Purpose: Although the conventional gamma ray brachytherapy has been successful in treating endometrioid endometrial adenocarcinoma (EC), the molecular and cellular mechanisms of this anti-tumorigenic response remain unclear. Therefore, we investigated whether gamma ray irradiation induces changes in the number of FoxP3+ T-regulatory lymphocytes (Tregs), CD56+ natural killer cells (NK), and the expression of progesterone receptor membrane component 1 (PGRMC1) in the tumor microenvironment (TME).

Materials and methods: According to the inclusion criteria, 127 cases were selected and grouped into irradiation-treated (Rad+) and control (underwent surgery) groups and analyzed using immunohistochemistry. Predictive prognostic values were analyzed using Mann-Whitney U test, ROC analysis, relative risk, log-rank, Spearman rank tests and multivariate Cox's regression.

Results: We observed significant differences (p < 0.001) between the radiation-treated patients and the control groups in FoxP3+ Tregs numbers, CD56+ NK cells and PGRMC1 expression. Gamma ray induced a 3.71- and 3.39-fold increase in the infiltration of FoxP3+ cells, CD56+ NK cells, respectively and 0.0034-fold change in PGRMC1 expression. Univariate and multivariate analyses revealed predictive role of the parameters. In the irradiated patients' group, inverted correlations between clinical unfavorable outcome, FoxP3+ Tregs and CD56+ NK cells were observed.

Conclusion: Our results suggest an immune-modulating role, specifically by increasing immune cell infiltration, of gamma radiation in the TME which may potentially be utilized as biomarkers in prognostic values.

目的:虽然传统的伽玛射线近距离治疗已成功治疗子宫内膜样子宫内膜腺癌(EC)，但这种抗肿瘤反应的分子和细胞机制尚不清楚。因此，我们研究了伽马射线照射是否会诱导肿瘤微环境(TME)中FoxP3+ t调节性淋巴细胞(Tregs)、CD56+自然杀伤细胞(NK)数量的变化，以及孕激素受体膜组分1 (PGRMC1)表达的变化。材料和方法:根据纳入标准，选取127例患者分为放射治疗组(Rad+)和对照组(手术组)，采用免疫组织化学方法进行分析。采用Mann-Whitney U检验、ROC分析、相对危险度检验、log-rank检验、Spearman秩检验和多变量Cox回归分析预测预后价值。结果:放疗组与对照组FoxP3+ Tregs、CD56+ NK细胞、PGRMC1表达差异有统计学意义(p < 0.001)。γ射线诱导FoxP3+细胞和CD56+ NK细胞的浸润量分别增加3.71倍和3.39倍，PGRMC1表达变化0.0034倍。单因素和多因素分析揭示了参数的预测作用。在放疗患者组，观察到临床不良预后、FoxP3+ Tregs和CD56+ NK细胞之间呈负相关。结论:我们的研究结果表明，伽马辐射在TME中的免疫调节作用，特别是通过增加免疫细胞浸润，可能被用作预后价值的生物标志物。

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引用次数: 0