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Renal cancer is one of the most common malignancies of the urinary system, and the number of deaths continues to increase. The standardized management of the diagnosis and treatment of renal cancer is challenging due to the great differences in the diagnosis and treatment of renal cancer in different regions. The Renal Cancer Expert Committee of the National Cancer Quality Control Center (NCQCC) identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of renal cancer. The Renal Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization, uniformity, and normalization of renal cancer diagnosis and treatment, which ultimately improved the survival rate and quality of life of renal cancer patients. A panel of experts with renal cancer surgery, renal cancer medicine, medical imaging, pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of renal cancer. The Indices includes 20 items that cover all key areas in the diagnosis and treatment of renal cancer, such as standard diagnosis, surgery treatment, systemic treatment, and prognostic evaluation.

PURPOSEThis survey was conducted to assess the current research practices among the 14 members of the Federation of Asian Organizations for Radiation Oncology (FARO) committee, to inform measures for research capacity building in these nations.MATERIALS AND METHODSA 19-item electronic survey was sent to two research committee members from the 14 representative national radiation oncology organizations (N = 28) that are a part of FARO.RESULTSThirteen of the 14 member organizations (93%) and 20 of 28 members (71.5%) responded to the questionnaire. Only 50% of the members stated that an active research environment existed in their country. Retrospective audits (80%) and observational studies (75%) were the most common type of research conducted in these centers. Lack of time (80%), lack of funding (75%), and limited training in research methodology (40%) were cited as the most common hindrances in conducting research. To promote research initiatives in the collaborative setting, 95% of the members agreed to the creation of site-specific groups, with head and neck (45%) and gynecological cancers (25%) being the most preferred disease sites. Projects focused on advanced external beam radiotherapy implementation (40%), and cost-effectiveness studies (35%) were cited as some of the potential areas for future collaboration. On the basis of the survey results, after result discussion and the FARO officers meeting, an action plan for the research committee has been created.CONCLUSIONThe results from the survey and the initial policy structure may allow facilitation of radiation oncology research in the collaborative setting. Centralization of research activities, funding support, and research-directed training are underway to help foster a successful research environment in the FARO region.

Simple summarySomatic and germline aberrations in homologous recombinant repair (HHR) genes are associated with increased incidence and poor prognosis for prostate cancer. Through next-generation sequencing of prostate cancer patients across all clinical states from north China, here the authors identified a somatic mutational rate of 3% and a germline mutational rate of 3.9% for HRR genes using 200 tumor tissues and 714 blood specimens. Thus, mutational rates in HRR genes were lower compared with previous studies.BackgroundHomologous recombination repair deficiency is associated with higher risk and poorer prognosis for prostate cancer. However, the landscapes of somatic and germline mutations in these genes remain poorly defined in Chinese patients, especially for those with localized disease and those from north part of China. In this study, we explore the genomic profiles of these patients.MethodsWe performed next-generation sequencing with 200 tumor tissues and 714 blood samples from prostate cancer patients at Peking University First Hospital, using a 32 gene panel including 19 homologous recombination repair genes.ResultsTP53, PTEN, KRAS were the most common somatic aberrations; BRCA2, NBN, ATM were the most common germline aberrations. In terms of HRR genes, 3% (6/200) patients harbored somatic aberrations, and 3.8% (28/714) patients harbored germline aberrations. 98.0% (196/200) somatic-tested and 72.7% (519/714) germline tested patients underwent prostatectomy, of which 28.6% and 42.0% had Gleason scores ≥8 respectively. Gleason scores at either biopsy or prostatectomy were predictive for somatic aberrations in general and in TP53; while age of onset

Abstract In recent years, the incidence of prostate cancer in China has shown a trend of continuous growth. Prostate cancer has become a urinary malignant tumor that seriously affects the health of men in China. Radical surgery and precision radiotherapy are the main methods of radical treatment for prostate cancer. Standardized diagnosis and treatment via a multidisciplinary team should be the standard practice to improve cure rate. Rapid development in imaging, pathology and molecular gene diagnosis has significantly changed the management of prostate cancer. In radiation oncology, image‐guided intensity modulated radiotherapy has been widely adopted in the treatment of prostate cancer. The comprehensive approach centered with radiotherapy has achieved excellent curative effect while continuously reducing treatment‐related side effects.

Abstract Purpose The identification of the clinical target volume (CTV) is particularly important in the precise radiotherapy of lung cancer. The purpose of this study was to determine the extension margin from gross tumor volume (GTV) to CTV in primary small cell lung cancer (SCLC) and lung adenocarcinoma (ADC) by microscopic extension (ME). Material and Methods The data of 25 cases of SCLC and 29 cases of ADC from August 2015 to August 2020 were analyzed. The measurement of tumor size between preoperative thoracic computed tomography (CT) and postoperative macroscopic specimens was compared, and the ME range of tumor cells was measured under a microscope to determine its correlation with clinical features and pathological manifestations. Results A total of 217 slides were examined, corresponding to 103 slides for SCLC and 114 slides for ADC. The radiologic sizes of the tumors in SCLC and ADC were 12.8 and 7.9 mm, respectively (p = 0.09), and the macroscopic sizes were 12.5 and 8.5 mm, respectively (p = 0.07). There was a significant correlation between the radiologic and macroscopic size of the same tumor sample (r = 0.886). Compared with ADC, more SCLC tumor cells infiltrated through vascular or lymphatic dissemination (16% vs. 9%, p = 0.047). The mean ME value was 2.81 mm for SCLC and 2.02 mm for ADC (p = 0.012). To take into account 95% of the ME, a margin of 8 and 7.7 mm must be expanded for SCLC and ADC, respectively. The ME value of the tumor was related to the presence of atelectasis, the location of the tumor, and the Ki‐67 cell proliferation index. Conclusion The GTV of the tumor was contoured according to CT images, which was basically consistent with the actual tumor size. The GTVs of SCLC and ADC should be expanded by 8 and 7.7 mm, respectively, to fully cover the subclinical lesions in 95% of cases.

Abstract Purpose To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies. Methods Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC). Results Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI 0.32–0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI 0.45–0.83, P = 0.005) but the DSC of GTV-T and CTV remained constant in most cases. Conclusion Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.

Background: Prostate cancer is a significant clinical issue, particularly for high Gleason score (GS) malignancy patients. Our study aimed to engineer and validate a risk model based on the profiles of high-GS PCa patients for early identification and the prediction of prognosis. Methods: We conducted differential gene expression analysis on patient samples from The Cancer Genome Atlas (TCGA) and enriched our understanding of gene functions. Using the least absolute selection and shrinkage operator (LASSO) regression, we established a risk model and validated it using an independent dataset from the International Cancer Genome Consortium (ICGC). Clinical variables were incorporated into a nomogram to predict overall survival (OS), and machine learning was used to explore the risk factor characteristics’ impact on PCa prognosis. Our prognostic model was confirmed using various databases, including single-cell RNA-sequencing datasets (scRNA-seq), the Cancer Cell Line Encyclopedia (CCLE), PCa cell lines, and tumor tissues. Results: We identified 83 differentially expressed genes (DEGs). Furthermore, WASIR1, KRTAP5-1, TLX1, KIF4A, and IQGAP3 were determined to be significant risk factors for OS and progression-free survival (PFS). Based on these five risk factors, we developed a risk model and nomogram for predicting OS and PFS, with a C-index of 0.823 (95% CI, 0.766–0.881) and a 10-year area under the curve (AUC) value of 0.788 (95% CI, 0.633–0.943). Additionally, the 3-year AUC was 0.759 when validating using ICGC. KRTAP5-1 and WASIR1 were found to be the most influential prognosis factors when using the optimized machine learning model. Finally, the established model was interrelated with immune cell infiltration, and the signals were found to be differentially expressed in PCa cells when using scRNA-seq datasets and tissues. Conclusions: We engineered an original and novel prognostic model based on five gene signatures through TCGA and machine learning, providing new insights into the risk of scarification and survival prediction for PCa patients in clinical practice.

Quasi-brittle behaviors of cement-based material can be reinforced through diverse methods due to its unique multiscale features. Among them, reinforcing agents are the most direct and effective means, such as slag, metakaolin, and fly ash. These materials can improve the performance of cement stone to a certain extent, but their chemical composition is still mainly silica, which does not in essence change the defects of cement. Therefore, in this experiment, magnesium borate whisker (Mg2B2O5) was used as reinforcer of 90°C class G oil well cement and magnesium borate whisker reinforced cement-based material (MBWRC) was prepared. On the one hand, the performance of mechanical strength was controlled, and the resistance to compression, traction, and bending was included. Furthermore, static stress-strain behaviors analysis and toughness behaviors analysis (dynamic multicycle loading test) were further conducted. Second, mercury intrusion porosimetry (MIP) and scanning electron microscope (SEM) were used to test the characteristics of pores and interfaces of cement-based materials. Through multiscale microstructure analysis, MBWRC was found to have excellent 90°C mechanical performances when compared to control sample’s, for which tensile strength increased to 235% of controlled sample’s, and flexural strength increased to 130%, plus a healthy developed compressive performance, and MBWRC showed much denser pore structure, in which harmless micropore increased from 13.3% to 14.40%, porosity decreased from 17.01% to 16.20%, and permeability decreased from 0.2533% to 0.0205%. Furthermore, MBWRC showed resistance capability to mechanical loading, which can be attributed to the formation of denser pore structure and more excellent mechanical performance.

BACKGROUND: Laboratory studies have shown the anti-tumor effect of metformin on prostate cancer. However, recent epidemiological studies have yielded inconclusive results. METHODS: We searched PubMed database from the inception to May 30 2014 for studies which assessed the effect of metformin use on cancer risk of prostate cancer, biochemical recurrence (BCR) and all-cause mortality of patients with prostate cancer. The pooled results and 95% confidence intervals (CIs) were estimated by random-effect model. RESULTS: Twenty-one studies were eligible according to the inclusion criteria. Based on the pooled results of available observational studies, metformin use was significantly associated with a decreased cancer risk (14 datasets, 963991 male subjects, odds ratio: 0.91, 95% CI: 0.85-0.97) and BCR (6 datasets, 2953 patients, hazard ratio: 0.81, 95% CI: 0.68-0.98) of prostate cancer. However, the association of metformin use with all-cause mortality of patients with prostate cancer was not significant (5 datasets, 9241 patients, hazard ratio: 0.86, 95% CI: 0.64-1.14). CONCLUSION: Results suggest that metformin use appears to be associated with a significant reduction in the cancer risk and BCR of prostate cancer, but not in all-cause mortality of patients with prostate cancer.

With the aim to elucidate the etiology of radioresistance, we explored the genetic alterations in non-radioresistant vs. resistant esophageal cancer cells acquired by long-term fractionated radiation. We found AKR1C3, an aldo-keto reductase expressed seldom in most human tissues, expressed higher in radioresistance-acquired cells. Suppression of AKR1C3 via RNAi or its chemical inhibitors restored the sensitivity of the acquired tumor cells and xenograft BALB/c nude mice to ionizing radiation (IR). Cellular monitoring of the oxidative stress in the AKR1C3-elevated cells indicated that IR-induced ROS accumulation and the concomitant DNA damage was significantly alleviated, and such protective consequence disappeared upon AKR1C3 knockdown. These findings uncover the potential involvement of AKR1C3 in removal of cellular ROS and explain, at least partially, the acquired radioresistance by AKR1C3 overexpression. A retrospective analysis of esophageal carcinomas also indicated a significant expression of AKR1C3 in radio-resistant but not radio-sensitive surgical samples. Our study may provide a potential biomarker for predicting prognosis of radiotherapy and even direct a targeted therapy for esophageal cancer and other tumors.

Compelling evidence indicates that radiotherapy (RT) has a systemic inhibitory effect on nonirradiated lesions (abscopal effect) in addition to the ablation of irradiated tumors. However, this effect occurs only in rare circumstances in clinical practice, and mechanisms underlying the abscopal effect of RT are neither fully understood nor therapeutically utilized. Here we identified that intercellular adhesion molecule-1 (ICAM-1), an inducible glycoprotein of the immunoglobulin superfamily, is up-regulated in nonirradiated tumors responsive to RT. ICAM-1 expression in preclinical animal models can be noninvasively detected by optical imaging and positron emission tomography (PET) using near-infrared fluorescence dye- and 64Cu-labeled imaging probes that we synthesized, respectively. Importantly, the expression levels of ICAM-1 determined by quantitative PET imaging showed a strong negative linear correlation with the growth of nonirradiated tumors. Moreover, genetic or pharmacologic up-regulation of ICAM-1 expression by either an intratumoral injection of engineered recombinant adenovirus or systemic administration of a Toll-like receptor 7 agonist-capsulated nanodrug could induce markedly increased abscopal responses to local RT in animal models. Mechanistic investigation revealed that ICAM-1 expression can enhance both the activation and tumor infiltration of CD8+ T cells to improve the responses of the nonirradiated tumors to RT. Together, our findings suggest that noninvasive PET imaging of ICAM-1 expression could be a powerful means to predict the responses of nonirradiated tumors to RT, which could facilitate the exploration of new combination RT strategies for effective ablation of primary and disseminated lesions. [ABSTRACT FROM AUTHOR]

The dynamic mechanical properties and fracture mechanism of three types of oil well cement with different formulations were investigated using a U50mm split Hopkinson pressure bar (SHPB) and quasi-static mechanical tests were conducted with a hydraulic universal testing machine. The stress-strain diagram, time-stress diagram, total energy absorption diagram, and the dynamic growth factor (DIF) under different strain rates were obtained. The crack propagation process of the oil well cement under dynamic loading is evaluated using high-speed photography to determine the fracture mechanism. The test results show that the strength of the cement increases under a dynamic impact. The compressive strength of the pure cement increases from 37MPa to 184.80MPa under static loading. However, the peak stress of the cement stone strengthened with cellulose fiber is lower under a dynamic load than a static load. Under dynamic loading, the absorption energy is higher for the pure cement stone than for the cement stone reinforced with whiskers and cellulose. Furthermore, the crack initiation, crack propagation, and fracture characteristics of the oil well cement are different under dynamic and static loads. Under a static load, the rupture of the cement is the result of the propagation of the tensile cracks. Under dynamic loading, there are fewer micro cracks on the cement surface and a composite fracture results from tensile and shear cracks. [ABSTRACT FROM AUTHOR]

Whether the addition of induction chemotherapy (IC) or adjuvant chemotherapy (AC) to concurrent chemoradiotherapy (CCRT) is superior to CCRT alone for locally advanced nasopharyngeal cancer is unknown. A Bayesian network meta-analysis was performed to investigate the efficacy of CCRT, IC + CCRT, and CCRT + AC on locally advanced nasopharyngeal cancer. The overall survival (OS) with hazard ratios (HRs) and locoregional recurrence rates (LRRs) and distant metastasis rates (DMRs) with risk ratios (RRs) were investigated. After a comprehensive database search, eleven studies involving 2,626 assigned patients were included in this network meta-analysis. Compared with CCRT alone, IC + CCRT resulted in no significant improvement in OS or LRR and a marginal improvement in DMR (OS: HR =0.67, 95% credible interval (CrI) 0.32-1.18; LRR: RR =1.79, 95% CrI 0.80-3.51; DMR: RR =1.79, 95% CrI 0.24-1.04) and CCRT + AC exhibited no beneficial effects on any of the endpoints of OS, LRR, or DMR (OS: HR =0.99, 95% CrI 0.64-1.43; LRR: RR =0.78, 95% CrI 0.43-1.32; DMR: RR =0.85, 95% CrI 0.57-1.24). As a conclusion, for locally advanced nasopharyngeal cancer, no significant differences in the treatment efficacies of CCRT, IC + CCRT, and CCRT + AC were found, with the exception of a marginally significant improvement in distant control observed following IC + CCRT compared with CCRT alone. [ABSTRACT FROM AUTHOR]