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Objective: Different perfusion metrics were investigated to determine the accuracy of Perfusion CT (PCT) in differentiating recurrence of brain metastases from radiation necrosis in patients who previously underwent stereotactic radiation therapy (SRT). Patients and Methods: Twenty patients previously treated with SRT underwent PCT examination of the brain. Normalized Cerebral Blood Volume (nCBV) values within the region of interest (ROI) were calculated. Fractional volumes at nCBV values between 1.0 and 2.25, defined as V 1.0-V 2.25, were derived as alternative metrics and compared to the conventional method based on the mean CBV value within the lesion (nCBV mean). The Mann-Whitney test was used to compare the two patient's groups with recurrence and radiation necrosis with respect to the different nCBV metrics. Predictive powers and optimal thresholds for both the nCBV mean and the V 1.0-V 2.25 were evaluated using the Receiver Operating Characteristic Curves. The gold standard was represented either by the histopathological examination or the Magnetic Resonance (MR) imaging follow-up longer than six months. Results and Conclusion: The differences between the patient's group with recurrence and that with radiation necrosis resulted statistically significant for all the metrics, showing the lowest p-value for V 1.75 and V 2. The metrics based on the fractional volumes were found to show higher predictive powers, with the highest value of 0.96 for V 2.0. Quantitative analysis of the CBV map deriving different metrics may potentially improve the diagnostic accuracy of PCT in differentiating brain metastasis recurrence from radiation necrosis. © 2011 Elsevier Ireland Ltd. All rights reserved

Recent studies have suggested an alpha/beta ratio in prostate cancer of 1.5-3 Gy, which is lower than that assumed for late-responsive normal tissues. Therefore the administration of a single, intraoperative dose of irradiation should represent a convenient irradiation modality in prostate cancer. MATERIALS AND METHODS: Between February 2002 and June 2004, 34 patients with localized prostate cancer with only one risk factor (Gleason score > or =7, Clinical Stage [cT] > or =2c, or prostate-specific antigen [PSA] of 11-20 ng/mL) and without clinical evidence of lymph node metastases were treated with radical prostatectomy (RP) and intraoperative radiotherapy on the tumor bed. A dose-finding procedure based on the Fibonacci method was employed. Dose levels of 16, 18, and 20 Gy were selected, which are biologically equivalent to total doses of about 60-80 Gy administered with conventional fractionation, using an alpha/beta ratio value of 3. RESULTS: At a median follow-up of 41 months, 24 (71%) patients were alive with an undetectable PSA value. No patients died from disease, whereas 2 patients died from other malignancies. Locoregional failures were detected in 3 (9%) patients, 2 in the prostate bed and 1 in the common iliac node chain outside the radiation field. A PSA rise without local or distant disease was observed in 7 (21%) cases. The overall 3-year biochemical progression-free survival rate was 77.3%. CONCLUSIONS: Our dose-finding study demonstrated the feasibility of intraoperative radiotherapy in prostate cancer also at the highest administered dose.

The purpose of this work is to introduce a new treatment approach and technique for partial breast irradiation in only one session to patients in prone position by using a dedicated positioning device. The patients were treated on a home-made treatment table top that allows the breast to hang down. A particular immobilization system was introduced in order to assure the reproducibility of patient positioning between the CT acquisition session and the treatment session. The clinical target volume (CTV) was outlined according to surgical clips position and/or tumor location on preoperative mammography. Because of negligible movement due to respiration, only an additional margin of 3 mm was added to obtain the planning target volume (PTV). Based on radiobiological calculations, a dose of 21 Gy was prescribed to PTV. The tumor bed was treated with 3D-CRT technique by using 5 fields and rotating the table while the gantry was approximately 90 or 270 degrees. Thirty patients were enrolled for this study chosen in conformity to an approved clinical protocol. The average percentage of PTV volume enclosed in the 90% and 95% of prescribed dose were 99.9 and 98.6% respectively, while only 3.4% of PTV volume received more than 105% of prescribed dose. Dose to 3% of skin volume was, on average, 15.2 Gy. In 97% of patients, less than 50% of the ipsilateral breast received a dose greater than half the prescribed dose. Mean doses to lungs, heart and contralateral breast were negligible. With a median follow-up of 9 months, no important early toxicity was observed both for skin and breast tissue. The treatment of breast tumor bed in prone position in only one session by using the 3D-CRT is technically feasible and seems to be a promising alternative to other accelerated partial breast irradiation techniques.

The aim of the study was to report the clinical results in patients with high-risk prostate cancer treated with pelvic intensity-modulated radiation therapy (IMRT) and simultaneous integrated boost (SIB) to the prostate area. A total of 110 patients entered our study, 37 patients presented with localized prostate cancer and radiological evidence of node metastases or ≥15% estimated risk of lymph node (LN) involvement, while 73 patients underwent postoperative adjuvant or salvage irradiation for biochemical or residual/recurrent disease, LN metastases, or high risk of harboring nodal metastases. All patients received androgen deprivation therapy (ADT) for 2 years. The median follow-up was 56.5 months. For the whole patient group, the 3- and 5-year freedom from biochemical failure were 82.6% and 74.6%, respectively, with a better outcome in patients treated with radical approach. The 3- and 5-year freedom from local failure were 94.4% and 90.2%, respectively, while the 3- and 5-year distant metastasis-free survival were 87.8% and 81.7%, respectively. For all study patients, the rate of freedom from G2 acute rectal, intestinal, and urinary toxicities was 60%, 77%, and 61%, respectively. There was no G3 acute toxicity, ≥G2 late intestinal toxicity, or G3 late urinary or rectal toxicity. The 3- and 5-year ≥G2 freedom from late rectal toxicity rate were 98% and 95%, respectively, while the 3- and 5-year ≥G2 freedom from late urinary toxicity rate were 95% and 88%, respectively. The study concludes that pelvic IMRT and SIB to the prostatic area in association with 2-year ADT was a well-tolerated technique, providing high disease control in patients with prostate cancer requiring LN treatment.

PURPOSE: To compare the toxicity and efficacy of hypofractionated (62 Gy/20 fractions/5 weeks, 4 fractions per week) vs. conventional fractionation radiotherapy (80 Gy/40 fractions/8 weeks) in patients with high-risk prostate cancer. METHODS AND MATERIALS: From January 2003 to December 2007, 168 patients were randomized to receive either hypofractionated or conventional fractionated schedules of three-dimensional conformal radiotherapy to the prostate and seminal vesicles. All patients received a 9-month course of total androgen deprivation (TAD), and radiotherapy started 2 months thereafter. RESULTS: The median (range) follow-up was 32 (8-66) and 35 (7-64) months in the hypofractionation and conventional fractionation arms, respectively. No difference was found for late toxicity between the two treatment groups, with 3-year Grade 2 rates of 17% and 16% for gastrointestinal and 14% and 11% for genitourinary in the hypofractionation and conventional fractionation groups, respectively. The 3-year freedom from biochemical failure (FFBF) rates were 87% and 79% in the hypofractionation and conventional fractionation groups, respectively (p = 0.035). The 3-year FFBF rates in patients at a very high risk (i.e., pretreatment prostate-specific antigen (iPSA) >20 ng/mL, Gleason score >or=8, or T >or=2c), were 88% and 76% (p = 0.014) in the former and latter arm, respectively. The multivariate Cox analysis confirmed fractionation, iPSA, and Gleason score as significant prognostic factors. CONCLUSIONS: Our findings suggest that late toxicity is equivalent between the two treatment groups and that the hypofractionated schedule used in this trial is superior to the conventional fractionation in terms of FFBF.

PURPOSE: The aim of this work is to report a retrospective study of radiobiological indicators based on Dose-Volume Histograms analysis obtained by stereotactic radiotherapy treatments. METHODS AND MATERIALS: Fifty-five patients for a total of sixty-seven brain metastases with a mean target volume of 8.49 cc were treated by Dynamic Conformal Arc Therapy (DCAT) and Intensity-Modulated Stereotactic Radiotherapy (IMRST). The Delivered prescription dose was chosen on the basis of tumor size and location so as to ensure a 100% isodose coverage to the target volume. RESULTS: The treatment plans reported a mean value of 10% and 2.19% for the inhomogeneity and conformal index, respectively. The F factor showed we overdosed sixty-three patients delivering an additional 7% dose more than calculated values. The radiobiological parameters: TCP and NTCP showed a complete tumor control limiting the organs at risk damage. CONCLUSION: One goal of stereotactic radiotherapy is to design a treatment plan in which the steep dose gradient achievable minimizes the amount of radiation delivered outside the tumor region. This technique allows to deliver a much larger dose to the target without exceeding the radiation-related tolerance of normal tissues and improving patients' quality of life

Background and purpose: To report the treatment-related morbidity in patients with prostate cancer treated with an optimized pelvic intensity-modulated radiation therapy (IMRT) and simultaneous integrated dose escalation to prostate/prostate bed. Materials and methods: Between November 2003 and May 2006, 55 patients with localized prostate cancer and >15% risk of lymph node involvement were treated with pelvic IMRT and simultaneous dose escalation to prostate area. Twenty-four patients received a radical radiation therapy program, and the remaining thirty-one patients received a postoperative irradiation as adjuvant treatment or after biochemical or macroscopic local/regional relapse. After a customized immobilization all patients underwent contrast-enhanced CT. On the CT slices CTV1 and CTV2 were delineated. CTV1 included the prostate and seminal vesicles or prostate bed. CTV2 consisted of CTV1 plus pelvic nodes. CTV1 and CTV2 were then expanded by 0.5 and 1 cm, respectively, to generate the planning target volumes. IMRT treatment plans were generated using commercial inverse planning software. Total doses of 66-80 Gy and 50-59 Gy in 33-40 fractions were prescribed to the prostate area and pelvis, respectively. The worst acute and late rectal, intestinal and GU toxicities during and after treatment were scored according to the EORTC/RTOG scales. Results: The IMRT dose distribution provided excellent PTV coverage and satisfying sparing of all the organs at risk, with no patient experiencing >grade 2 acute or late toxicities. Patients without acute grade 2 intestinal, rectal, and GU toxicity were 91%, 71%, and 63%, respectively. After a median follow-up of 19 months (interquartile range of 9 to 28 months), late grade 2 toxicity was detected only for rectum, with an actuarial 2-year rate of freedom from G2 rectal bleeding of 92%. (CI 95% 0.83-0.99.). Conclusions: Pelvic IMRT and simultaneous dose escalation to prostate area is a well-tolerated technique in patients wi

© 2016, Pleiades Publishing, Inc.Staphylococcus aureus is a major opportunistic and versatile pathogen. Because the bacteria rapidly evolve multi-resistances towards antibiotics, there is an urgent need to find novel targets and alternative strategies to cure bacterial infections. Here, we provide a brief overview on the knowledge acquired on S. aureus ribosomes, which is one of the major antibiotic targets. We will show that subtle differences exist between the translation at the initiation step of Gram-negative and Gram-positive bacteria although their ribosomes display a remarkable degree of resemblance. In addition, we will illustrate using specific examples the diversity of mechanisms controlling translation initiation in S. aureus that contribute to shape the expression of the virulence factors in a temporal and dynamic manner.

© The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.The authors wish to correct their Funding statement as follows: FUNDING. 'Centre National de la Recherche Scientifique' (CNRS) and the 'Agence Nationale de la Recherche' as part of the 'Investissements d'Avenir' program [LabEx: ANR-10-LABX-0036-NETRNA to P.R., Y.H.; ANR-15-CE11-0021-01 to G.Y.]; 'Fondation pour la Recherche Médicale en France' [FDT20140930867 to I.K; 'European Research Council advanced grant' [294312 to M.Y.]; the 'Russian Science Foundation' [Project No. 16-14-10014 to I.K., M.Y.]. Funding for open access charge: Centre National de la Recherche Scientifique (CNRS). In addition, Marat Yusupov is associated with both affiliations1 and 2. The authors apologise to the readers for this error.

© 2016 The Author(s).Comparative structural studies of ribosomes from various organisms keep offering exciting insights on how species-specific or environment-related structural features of ribosomes may impact translation specificity and its regulation. Although the importance of such features may be less obvious within more closely related organisms, their existence could account for vital yet species-specific mechanisms of translation regulation that would involve stalling, cell survival and antibiotic resistance. Here, we present the first full 70S ribosome structure from Staphylococcus aureus, a Gram-positive pathogenic bacterium, solved by cryo-electron microscopy. Comparative analysis with other known bacterial ribosomes pinpoints several unique features specific to S. aureus around a conserved core, at both the protein and the RNA levels. Our work provides the structural basis for the many studies aiming at understanding translation regulation in S. aureus and for designing drugs against this often multi-resistant pathogen.

© 2016 The Author(s).Comparative structural studies of ribosomes from various organisms keep offering exciting insights on how species-specific or environment-related structural features of ribosomes may impact translation specificity and its regulation. Although the importance of such features may be less obvious within more closely related organisms, their existence could account for vital yet species-specific mechanisms of translation regulation that would involve stalling, cell survival and antibiotic resistance. Here, we present the first full 70S ribosome structure from Staphylococcus aureus, a Gram-positive pathogenic bacterium, solved by cryo-electron microscopy. Comparative analysis with other known bacterial ribosomes pinpoints several unique features specific to S. aureus around a conserved core, at both the protein and the RNA levels. Our work provides the structural basis for the many studies aiming at understanding translation regulation in S. aureus and for designing drugs against this often multi-resistant pathogen.

© The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.The authors wish to correct their Funding statement as follows: FUNDING. 'Centre National de la Recherche Scientifique' (CNRS) and the 'Agence Nationale de la Recherche' as part of the 'Investissements d'Avenir' program [LabEx: ANR-10-LABX-0036-NETRNA to P.R., Y.H.; ANR-15-CE11-0021-01 to G.Y.]; 'Fondation pour la Recherche Médicale en France' [FDT20140930867 to I.K; 'European Research Council advanced grant' [294312 to M.Y.]; the 'Russian Science Foundation' [Project No. 16-14-10014 to I.K., M.Y.]. Funding for open access charge: Centre National de la Recherche Scientifique (CNRS). In addition, Marat Yusupov is associated with both affiliations1 and 2. The authors apologise to the readers for this error.

© 2016, Pleiades Publishing, Inc.Staphylococcus aureus is a major opportunistic and versatile pathogen. Because the bacteria rapidly evolve multi-resistances towards antibiotics, there is an urgent need to find novel targets and alternative strategies to cure bacterial infections. Here, we provide a brief overview on the knowledge acquired on S. aureus ribosomes, which is one of the major antibiotic targets. We will show that subtle differences exist between the translation at the initiation step of Gram-negative and Gram-positive bacteria although their ribosomes display a remarkable degree of resemblance. In addition, we will illustrate using specific examples the diversity of mechanisms controlling translation initiation in S. aureus that contribute to shape the expression of the virulence factors in a temporal and dynamic manner.