Search

Background To investigate the loco-regional progression-free survival (LPFS) of intensity-modulated radiotherapy (IMRT) with different fraction sizes for locally advanced non-small-cell lung cancer (LANSCLC), and to apply a new radiobiological model for tumor control probability (TCP). Methods One hundred and three LANSCLC patients treated with concurrent radiochemotherapy were retrospectively analyzed. Factors potentially predictive of LPFS were assessed in the univariate and multivariate analysis. Patients were divided into group A (2.0 ≤ fraction size Results With a median follow-up of 22.1 months, the median LPFS was 23.8 months. Fraction size was independently prognostic of LPFS. The median LPFS of group A, B and C was 13.8, 35.7 months and not reached, respectively. Using the new LQRG/TCP model, the average absolute and relative fitting errors for LPFS were 6.9 and 19.6% for group A, 5.5 and 8.8% for group B, 6.6 and 9.5% for group C, compared with 9.5 and 29.4% for group A, 16.6 and 36.7% for group B, 24.8 and 39.1% for group C using the conventional LQ/TCP model. Conclusions Hypo-fractionated IMRT could be an effective approach for dose intensification in LANSCLC. Compared with conventional LQ model, the LQRG model showed a better performance in predicting follow-up time dependent LPFS.

Dysregulation of PARP10 has been implicated in various tumor types and plays a vital role in delaying hepatocellular carcinoma (HCC) progression. However, the mechanisms controlling the expression and activity of PARP10 in HCC remain mostly unknown. The crosstalk between PLK1, PARP10, and NF-κB pathway in HCC was determined by performing different in vitro and in vivo assays, including mass spectrometry, kinase, MARylation, chromatin immunoprecipitation, and luciferase reporter measurements. Functional examination was performed by using small chemical drug, cell culture, and mice HCC models. Correlation between PLK1, NF-κB, and PARP10 expression was determined by analyzing clinical samples of HCC patients with using immunohistochemistry. PLK1, an important regulator for cell mitosis, directly interacts with and phosphorylates PARP10 at T601. PARP10 phosphorylation at T601 significantly decreases its binding to NEMO and disrupts its inhibition to NEMO ubiquitination, thereby enhancing the transcription activity of NF-κB toward multiple target genes and promoting HCC development. In turn, NF-κB transcriptionally inhibits the PARP10 promoter activity and leads to its downregulation in HCC. Interestingly, PLK1 is mono-ADP-ribosylated by PARP10 and the MARylation of PLK1 significantly inhibits its kinase activity and oncogenic function in HCC. Clinically, the expression levels of PLK1 and phosphor-p65 show an inverse correlation with PARP10 expression in human HCC tissues. These findings are the first to uncover a PLK1/PARP10/NF-κB signaling circuit that underlies tumorigenesis and validate PLK1 inhibitors, alone or with NF-κB antagonists, as potential effective therapeutics for PARP10-expressing HCC.

Background: Dysregulation of prostate stem cell antigen (PSCA) has been implicated in human cancers. Studies have reported that PSCA expression is generally high in prostate cancer, which correlates with a worse survival. PSCA is also highly expressed in bladder, ovarian, and pancreatic cancers. However, PSCA is expressed at low levels in gastric, gallbladder and oesophageal cancers. At present, the clinical significance, expression pattern and biological function of PSCA in gastric cancer (GC) are still unclear. Methods: Previously, we used cDNA microarray as a screening tool to compare GC tissues with its matched normal gastric mucosa tissues (MNGT), and obtained the differentially expressed genes of the two tissue types. PSCA is one of the genes significantly down-regulated in GC tissues. In this study, we detected the expression of PSCA in GC tissues and MNGT by western-blot experiment and immunohistochemical staining (IHC). Then the relationship between the expression pattern of PSCA and the clinicopathological characteristics and survival in GC was analyzed. In order to further study the function of PSCA in GC, lentivirus was used to construct stable cell lines with knockdown and overexpression of PSCA gene. We used AGS and MKN45 cell lines for plasmid transfection. Colony formation assay, MTS and nude mice xenograft model were performed to investigate the effect of PSCA in GC. Results: Western-blot and IHC assays demonstrated that the expression of PSCA in GC tissues was significantly lower than that in the MNGT. PSCA expression in GC tissues was high in 252 (57.5%) and low in 186 (42.5%) of 438 patients. PSCA expression for MNGT was high in 273 (62.3%) and low in 165 (37.7%) of 438 patients. PSCA expression was significantly associated with T classification (P=0.024), N classification (P=0.018) and TNM stage (P=0.019) using χ2 test. The relationship between PSCA expression level and patient survival was analysed using Kaplan-Meier analysis and the log-rank test. Low levels of PSCA expression were significantly associated with a poorer OS than high expression levels of PSCA (P=0.011). In the COX regression analysis of OS, all 9 variables in the univariate analysis were significantly correlated with OS (P

Purpose The purpose of this study was to compare the survival and toxicities in cervical esophageal squamous cell carcinoma (CESCC) treated by concurrent chemoradiothrapy with either three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) techniques. Materials and methods A total of 112 consecutive CESCC patients were retrospectively reviewed. 3D-CRT and IMRT groups had been analyzed by propensity score matching method, with sex, age, Karnofsky performance status, induction chemotherapy, and tumor stage well matched. The Kaplan-Meier method and Cox proportional hazards model were used for overall survival (OS) and progression-free survival (PFS). Toxicities were compared between two groups by Fisher exact test. Results With a median follow-up time of 34.9 months, the 3-year OS (p=0.927) and PFS (p=0.859) rate was 49.6% and 45.8% in 3D-CRT group, compared with 54.4% and 42.8% in IMRT group. The rates of grade ≥ 3 esophagitis, grade ≥ 2 pneumonitis, esophageal stricture, and hemorrhage were comparable between two groups, while the rate of tracheostomy dependence was much higher in IMRT group than 3D-CRT group (14.3% vs.1.8%, p=0.032). Radiotherapy technique (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.01 to 0.79) and pretreatment hoarseness (HR, 0.12; 95% CI 0.02 to 0.70) were independently prognostic of tracheostomy dependence. Conclusion No survival benefits had been observed while comparing IMRT versus 3D-CRT in CESCC patients. IMRT with fraction dose escalation and pretreatment hoarseness were considered to be associated with a higher risk for tracheostomy dependence. Radiation dose escalation beyond 60 Gy should be taken into account carefully when using IMRT with hypofractionated regimen.

Purpose. To determine whether the female gender is a barrier for the access to cataract surgery services in South Asia in the last two decades. Methods. Eligible cross-sectional studies were identified via computer searches and reviewing the reference lists of the obtained articles. The cataract surgical coverage (CSC) by sex based on person and eyes at visual acuity Results. Sixteen studies with 135972 subjects were included in the final analysis. The pooled ORs of CSC by sex on a person basis at visual acuity Conclusions. The female gender remains a significant barrier for the access to cataract surgery in South Asia. Visual impairment, including blindness, from unoperated cataract, could be reduced by approximately 6.28% with the elimination of gender disparities to access. More efforts are needed to increase eye care service utilization by female population.

By using a bi-dentate phosphine oxide ligand L (L = bis(diphenylphosphino)methane dioxide), two mono-nuclear lanthanide complexes [LnL2(DMF)Cl2]Cl (Ln = Sm, 1; Dy, 2) with a D5h equatorial ligand field (LF) are obtained. Ab initio CASSCF calculations suggest that the equatorial LF promotes the magnetic anisotropy of the central SmIII and impair that of DyIII. Alternating current (ac) susceptibility measurements reveal that the samarium complex is the first SmIII mono-nuclear complex with slow magnetic relaxation. The isostructural DyIII compound, in contrast, relaxes much faster. Further magnetic property studies were then performed to probe the origin of magnetic anisotropy and magnetic relaxations.

Aims: Hilar cholangiocarcinoma (HCCA) is a tumour with high malignancy, low surgical resection potential, and a poor prognosis. Ecotropic Viral Integration site 1 (EVI1) is a transcriptional regulator that has been proven to be associated with tumourigenesis and progression in many human solid tumours. However, the expression of EVI1 and its role in HCCA progression remain unclear. The aim of this study was to clarify the association between EVI1 expression and clinical outcomes in patients with HCCA. Methods: The expression of EVI1 in HCCA tissue samples and cell lines was examined by quantitative real-time PCR (qRT-PCR), Western blotting, and immunohistochemistry (IHC). Kaplan-Meier analysis was used for survival analysis. A log-rank test was performed for univariate analysis of survival, and a Cox regression model was utilized for multivariate analysis of survival. Cell proliferation was measured by cell counting kit-8 (CCK-8), colony formation, and 5-ethynyl-2'-deoxyuridine (EdU) assays. The cell cycle was evaluated by flow cytometry. Cell apoptosis was detected by flow cytometry and a terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labelling (TUNEL) assay. In vivo tumour growth was observed for xenografts in nude mice. Results: EVI1 expression was upregulated in HCCA tissue samples and correlated with a poor prognosis. In clinical specimens, the expression of EVI1 correlated with tumour histological grade and tumour size. Knocking down EVI1 expression reduced HCCA cell proliferation, blocked cell cycle progression, and promoted apoptosis in vitro and in vivo. Furthermore, we found that EVI1 could regulate the AKT signalling pathway by regulating PTEN levels in HCCA. Conclusion: Our data revealed that EVI1 played important roles in HCCA tumourigenesis and development. Our findings suggest that EVI1 may be a potentially useful therapeutic target in HCCA.

Resveratrol (RSV) has been confirmed to confer multiple health benefits, and the majority of RSV tends to be metabolized in the gut microbiota after oral administration. In this study, the metabolism of RSV was investigated by using mouse models with distinct gut microbiota compositions: germ-free mice colonized with probiotics, conventional mouse, and DSS-induced colitis mouse models. The results demonstrated that in feces, the metabolites of RSV, including resveratrol sulfate (RES-sulfate), resveratrol glucuronide (RES-glucuronide), and dihydroresveratrol, significantly increased after probiotics colonized in germ-free mice. Furthermore, RES-sulfate and RES-glucuronide were below the detectable limit in the feces of conventional mice, with dihydroresveratrol being the dominant metabolite. Compared to the conventional mice, the ratio of Firmicutes/Bacteroides and the abundance of Lactobacillus genera were found significantly elevated in colitis mice after long-term ingestion of RSV, which shifted the metabolism of RSV in return. Our study provided critical implications in further application of RSV in foods and food supplements.

This study aimed to quantitatively assess [The 60-min dynamic total-body [A total of 30 patients with stage IIIA-IV NSCLC were enrolled. Patients were divided into fast dynamic FDG metabolic group (F-DFM) and slow dynamic FDG metabolic group (S-DFM) by the unsupervised K-means classification of PTs. The F-DFM group showed significantly higher Patlak-Ki (P 0.001) and SUVThe dynamic total-body [

Depth image-based rendering (DIBR) is an important technology in the process of 2D-to-3D conversion. It uses texture images and related depth maps to render virtual views. While there are still some challenging problems in the current DIBR systems, such as disocclusion occurrences. Inpainting methods based on deep learning have recently shown significant improvements and generated plausible images. However, most of these methods may not deal well with the disocclusion holes in the synthesized views, because on the one hand they only treat this issue as generative inpainting after 3D warping, rather than following the full DIBR processing procedures. While on the other hand the distributions of holes on the virtual views are always around the transition regions of foreground and background, which makes them more difficult to distinguish without special constraints. Motivated by these observations, this paper proposes a novel learning-based method for stereoscopic view synthesis, in which the disocclusion regions are restored by a progressive structure reconstruction strategy instead of direct texture inpainting. Additionally, some special cues in the synthesized scenes are further exploited as constraints for the network to alleviate hallucinated structure mixtures among different layers. Extensive empirical evaluations and comparisons validate the strengths of the proposed approach and demonstrate that the model is more suitable for stereoscopic synthesis in the 2D-to-3D conversion applications.

To evaluate the efficacy of thymosin α1 in management of radiation pneumonitis (RP) in patients with locally advanced non-small cell lung cancer (LANSCLC) treated with concurrent chemoradiotherapy (CCRT).This phase 2, single-arm trial enrolled patients with unresectable LANSCLC of 18 to 75 years' old and an Eastern Cooperative Oncology Group performance status of 0 to 1. Eligible patients received definitive CCRT and weekly thymosin α1 from the start of CCRT until 2 months after CCRT. Patients were administered 51 Gy in 17 daily fractions or 40 Gy in 10 daily fractions in the first course followed by a re-evaluation and those patients without disease progression had an adaptive plan of 15 Gy in 5 daily fractions or 24 Gy in 6 daily fractions as a boost. Concurrent chemotherapy consisted of weekly docetaxel (25 mg/mSixty-nine patients were enrolled in the study, and another 69 patients were selected as the control group. The incidence of G≥2 RP was lower in the study group compared with control cases (36.2% vs 53.6%, P = .040). G1 late pulmonary fibrosis occurred in 2 (3.7%) patients of the control group compared with no event in the study group (P = .243). Compared with the control group, the incidence of G3 to G4 lymphopenia (19.1% vs 62.1%, P.001) was lower, and the median TLC nadir (0.51 k/µL vs 0.30 k/µL, P.001) was higher in the study group. The proportion of patients with maximum CRP ≥100 mg/L was lower in the study group (13.8% vs 29.7% P = .029). The diversity and community composition of the gut microbiota were not significantly different between the 2 groups.Administration of thymosin α1 during and after CCRT was associated with significant reductions in G≥2 RP and G3 to G4 lymphopenia in patients with LANSCLC compared with historic controls.

Introduction Mesenchymal stem cells (MSCs) have potential for re-epithelization and recovery in acute respiratory distress syndrome (ARDS). In a previous in vitro study, the results showed that the canonical Wnt/β-catenin pathway promoted the differentiation of MSCs into type II alveolar epithelial cells, conferred resistance to oxidative stress, and promoted their migration, suggesting that the Wnt/β-catenin pathway might be one of the key mechanisms underling the therapeutic effect of mouse MSCs in ARDS. Methods Mouse MSCs stable transfected with β-catenin or green fluorescent protein control were transplanted intratracheally into the ARDS mice induced by lipopolysaccharide. Lung tissue injury and repair assessment were examined using haematoxylin and eosin staining, lung injury scoring, Masson’s trichrome staining and fibrosis scoring. Homing and differentiation of mouse MSCs were assayed by labelling and tracing MSCs using NIR815 dye, immunofluorescent staining, and Western immunoblot analysis. The inflammation and permeability were evaluated by detecting the cytokine and protein measurements in bronchoalveolar lavage fluid using enzyme-linked immunosorbent assay. Results In this study, β-catenin-overexpressing MSC engraftment led to more significant effects than the GFP controls, including the retention of the MSCs in the lung, differentiation into type II alveolar epithelial cells, improvement in alveolar epithelial permeability, and the pathologic impairment of the lung tissue. Conclusion These results suggest that the activation of canonical Wnt/β-catenin pathway by mouse MSCs by overexpressing β-catenin could further improve the protection of mouse MSCs against epithelial impair and the therapeutic effects of mouse MSCs in ARDS mice.

Cholangiocarcinoma (CCA) is a class of malignant tumors originating from bile duct epithelial cells. Due to difficult early diagnosis and limited treatment, the prognosis of CCA is extremely poor. BMI1 is dysregulated in many human malignancies. However, the prognostic significance and oncogenic role of BMI1 in cholangiocarcinoma (CCA) are not well elucidated.In the present study, we investigated its clinical importance and the potential mechanisms in the progression of CCA. We detected BMI1 expression in a large CCA cohort. We demonstrated that BMI1 was substantially upregulated in CCA tissues and was identified as an independent prognostic biomarker of CCA. Moreover, overexpression of BMI1 promoted CCA proliferation, migration, and invasion. And BMI1 knockdown could inhibit proliferation and metastases of CCA in vitro and in vitro/vivo validation. Interestingly, we found that CCA-derived exosomes contain BMI1 proteins, which can transfer BMI1 between CCA cells. The unique BMI1-containing exosomes promote CCA proliferation and metastasis through autocrine/paracrine mechanisms. In addition, we demonstrated that BMI1 inhibits CD8BMI1 is an unfavorable prognostic biomarker of CCA. Our data depict a novel function of BMI1 in CCA tumorigenesis and metastasis mediated by exosomes. Besides, BMI1 inhibition may augment immune checkpoint blockade to inhibit tumor progression by activating cell-intrinsic immunity of CCA.

This prospective phase 2 study aimed to evaluate the efficacy and safety of hypofractionated radiation therapy (HRT) combined with concurrent weekly chemotherapy in patients with unresectable or recurrent thymic epithelial tumors (TETs).Patients with unresectable or recurrent intrathoracic TETs that could be encompassed within the radiation fields were enrolled. HRT using intensity modulated radiation therapy (IMRT) technique was administered with 3 different levels of radiation doses (51 Gy/17 fractions (fx), 48 Gy/12 fx, and 45 Gy/9 fx; biologically effective dose of 66.3-67.5Gy), combined with weekly docetaxel (25 mg/mFifty eligible patients enrolled from August 1, 2018, to July 1, 2020, were analyzed. Most patients (82.0%) had stage IVB tumors. Patients had IMRT-HRT (36-51 Gy in 9-17 fx, median biologically effective dose of 67.2 Gy) and concurrent weekly docetaxel/nedaplatin (2-4 cycles). During a median follow-up of 25.0 months (14.0-40.0), the ORR was 83.7%, the 2-year PFS was 59.1%, and the 2-year OS was 90.0%. There was 1 (2.0%) in-field recurrence while 19 (38.0%) patients developed out-of-field recurrence. Grade 3 pneumonitis was observed in 1 patient (2.0%). The ORR, 2-year PFS, 2-year OS, and toxicity were similar among 3 dose levels. Fourteen (28.0%) patients had 2 to 4 courses of radiation therapy because of recurrent diseases. Only 1 suffered from grade 1 pulmonary fibrosis during follow-up. Most patients (88%) maintained a stable QOL within 1 year after radiation therapy.IMRT-HRT and concurrent weekly docetaxel/nedaplatin was effective and well tolerated in unresectable or recurrent TETs. Considering the common out-of-field recurrence, this combined regimen could be an option for repeated radiation therapy. Thymosin α1 might help lower the incidence of pneumonitis and maintain the QOL.

The aim of this study was to evaluate the impact of genetic polymorphisms in the pharmacokinetics of metabolism and transportation of lenvatinib in the Chinese population.Sixty-three healthy Chinese individuals were recruited and administered with a single dose of 4 mg lenvatinib. Allelic discriminations for 10 SNPs of

Background It is well known that obstructive jaundice could affect the pharmacodynamics of some anesthetics, and the sensitivity of some anesthetics would increase among icteric patients. Remimazolam is a new ultra-short-acting intravenous benzodiazepine sedative/anesthetic, which is a high-selective and affinity ligand for the benzodiazepine site on the GABAA receptor. However, no study has reported the pharmacodynamics of remimazolam in patients with obstructive jaundice. We hypothesize that obstructive jaundice affects the pharmacodynamics of remimazolam, and the sensitivity of remimazolam increases among icteric patients. Methods/design The study will be performed as a prospective, controlled, multicenter trial. The study design is a comparison of remimazolam requirements to reach a bispectral index of 50 in patients with obstructive jaundice versus non-jaundiced patients with chronic cholecystitisor intrahepatic bile duct stones. Remimazolam was infused at 6 mg/kg/h until this endpoint was reached. Discussion Remimazolam could be suitable for anesthesia of patients with obstructive jaundice, because remimazolam is not biotransformed in the liver. Hyperbilirubinemia has been well-described to have toxic effects on the brain, which causes the increasing of sensitivity to some anesthetics, such as desflurane, isoflurane, and etomidate. Furthermore, remimazolam and etomidate have the same mechanism of action when exerting an anesthetic effect. We aim to demonstrate that obstructive jaundice affects the pharmacodynamics of remimazolam, and the dose of remimazolam when administered to patients with obstructive jaundice should be modified. Trial registration Chinese Clinical Trial Registry ChiCTR2100043585. Registered on 23 February 2021

Surface solar radiation (SSR), as a primary component of heat budget between land and atmosphere, controls both water and energy exchanges. However, the sub‐grid terrain radiative effect (STRE) which exerts critical influences on SSR simulation is usually extremely simplified or even ignored in most current land surface models (LSMs) due to the heavy computational burden. In this study, we developed a physically realistic and computationally efficient three dimensional (3D) STRE scheme and implemented it into the Common Land Model (CoLM) to indicate its quantitative influences on surface energy budget, land surface temperature (LST), soil temperature, and moisture simulations over the Heihe River Basin, Tibetan Plateau. Results show that the CoLM coupled with 3D‐STRE scheme shows more realistic description of SSR and improves the simulation of soil thermal and moist features at both single‐point and regional scales. Compared to the results without 3D‐STRE, the inclusion of 3D‐STRE scheme efficiently diminishes the overestimation of SSR, which leads to the root mean square error (RMSE) of LST simulation reduced by 17.1% due to significant improvements in valley areas. Adopting 3D‐STRE scheme also improves the pattern and amplitude of temporal variability of simulated soil temperature (moisture) at 37 sites with the mean Taylor score increased by 3.6–3.7% (14.0–14.3%). These results emphasize the importance of considering the 3D‐STRE scheme in LSMs and are significantly helpful to deepen our understanding of surface heat exchanges and improve the representations of land surface processes over complex terrain.

Second-line treatment options for advanced/metastatic non-small cell lung cancer (NSCLC) patients are limited. We aimed to evaluate the efficacy and safety of docetaxel/sodium cantharidinate combination vs. either agent alone as second-line treatment for advanced/metastatic NSCLC patients with wild-type or unknown EGFR status. A randomized, open-label, phase III study was performed at 12 institutions. Patients with failure of first-line platinum regimens were randomized to receive either single-agent sodium cantharivsdinate (SCA) or single-agent docetaxel (DOX) or docetaxel/sodium cantharidinate combination (CON). The primary endpoints were centrally confirmed progression-free survival (PFS) and overall survival (OS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), quality of life (QoL) and toxicity. A total of 148 patients were enrolled in our study between October 2016 and March 2020. After a median follow-up time of 8.02 months, no significant difference was observed among the three groups in ORR (SCA vs. DOX vs. CON: 6.00% vs. 8.33% vs. 10.00%, respectively; p=0.814) and DCR (74.00% vs. 52.00% vs. 62.50%, respectively; p=0.080). In additional, the mOS was significantly higher in the CON group, compared with the single-agent groups (7.27 vs. 5.03 vs. 9.83 months, respectively; p=0.035), while no significant differences were observed in terms of PFS (2.7 vs. 2.9 vs. 3.1 months, respectively; p=0.740). There was no significant difference in the baseline QoL scores between the three groups (p>0.05); after treatment, life quality in SCA and CON group was significantly better than that in the DOX group (pvs. 79.17 vs. 25.00%, respectively; p=0.038) and the incidence of grade ≥3 AEs was also significantly lower in the SCA group compared with the DOX and CON groups (10.00 vs. 82.00 vs. 30.00%, respectively; p=0.042). Single-agent SCA and single-agent DOX has similar therapeutic efficacy in the second-line treatment of advanced/metastatic NSCLC with wild-type or unknown EGFR status, but single-agent SCA has fewer AEs and better QoL. Also, SCA plus DOX can significantly improve OS and exerted a significant synergistic effect, with good safety and tolerance profile.

BackgroundTo explore the efficacy and toxicity of simultaneous modulated accelerated radiotherapy (SMART) concurrently with cisplatin (CDDP) and S1 (tegafur/gimeracil/oteracil) in elderly patients with esophageal squamous cell carcinoma (ESCC).MethodsThis single-arm, phase II study enrolled pathologically confirmed, stage II–IVa ESCC of 70–80 years old and Eastern Cooperative Oncology Group performance status (ECOG PS) 0–2. Patients received SMART (64 Gy to gross tumor volume and 48 Gy to clinical target volume in 30 fractions) with concurrent CDDP (day 1 of each week) and S1 (days 1–14, 22–35). The primary endpoint was objective response rate (ORR). The secondary endpoints included progression-free survival (PFS), overall survival (OS) and toxicities.ResultsThirty-seven eligible patients were analyzed with median follow-up of 25.7 months for all and 46.1 months for survivors. The ORR was 88.9%. Patients with baseline weight loss ConclusionSMART concurrently with CDDP/S1 yielded satisfactory response rate, survival outcome and tolerable treatment-related toxicities in elderly patients with ESCC. Further studies are warranted to validate the results.

The MYC family of proto-oncogenes is activated in a variety of cancers, including multiple high-risk pediatric malignancies. c-MYC (MYC) is ubiquitously expressed in human tissues, while MYCN (MYCN) has tissue and developmentally restricted expression patterns. In both neuroblastoma and medulloblastoma, enhanced activity of either MYCN or c-MYC drives high-risk disease. As transcription factors, MYC proteins exert oncogenic functions through protein-protein interaction networks that alter gene expression, but also mediate a growing list of target-gene independent nuclear functions (transcriptional elongation, chromatin changes throughout the cell cycle, etc…). While c-MYC and MYCN share many functions, they also regulate distinct cellular processes, and within medulloblastoma, they are activated in distinct molecular sub-groups (i.e. MYCN amplification is found in aggressive sonic hedge hog (SHH) subgroup tumors, while MYC amplification is found in aggressive group 3 and group 4 tumors). Here, we present an approach to identify oncogenic functions of c-MYC and MYCN in medulloblastoma and neuroblastoma using human induced pluripotent stem cell (iPSCO based orthotopic model systems. We hypothesize that the protein interaction networks and oncogenic functions of c-MYC and MYCN are impacted by cellular context, which are recapitulated in our orthotopic models (cell transcriptional and epigenetic landscape, tumor microenvironment). This premise is supported by recent single cell sequencing efforts in medulloblastoma and neuroblastoma, where primary human tumor cells are found to recapitulate specific transcriptional cell states found in normal hindbrain and sympathetic nervous system development, respectively. Through proximity labeling and quantitative mass spectrometry, we aim to identify tumor and oncogene specific protein interaction networks. This information will guide functional screening approaches to identify tumor-specific vulnerabilities. * Note MYC(N) refers to c-MYC and MYCN.

Purpose Incidental exposure of heart to ionizing irradiation is associated with an increased risk of ischemic heart disease (IHD) in breast cancer patients after radiotherapy. Intensity-modulated proton radiation therapy (IMPT) offers a promise in limiting the mean heart dose (MHD) in breast irradiation to a negligible level. However, the uncertainty in cost-effectiveness hinders its use. This cost-effectiveness analysis aims to identify patients in appropriate risk groups as targets for IMPT. Methods A Markov decision model was designed to evaluate the cost-effectiveness of IMPT versus intensity-modulated photon-radiation therapy (IMRT) in reducing the irradiation-related IHD risk. Baseline evaluation was performed on 50-year-old women patient without preexisting cardiac risk factor (CRF). Stratified for preexisting cardiac risk and photon MHD, cost-effective scenarios under different proton cost and willingness-to-pay (WTP) were identified for 40-, 50- and 60-year-old patients. Results With baseline set-ups, incremental effectiveness (IE) ranged from 0.025 quality-adjusted life-year (QALY) to 0.135 QALY when photon MHD varied from 3 to 16 Gy; IE increased from 0.043 QALY to 0.964 QALY when preexisting cardiac risk increased from the baseline level to its 10 times. IMPT was not cost-effective to patients without preexisting CRF. At the WTP of China, once proton cost reduced to $20,000, IMPT would be cost-effective to ≤ 50-year-old women patients having preexisting cardiac risk of general-population level. Conclusion Patient’s preexisting cardiac risk level should be a main consideration for the clinical decision of using protons; protons may become cost-effective to general-level patients if a substantial decrease in proton cost occurs in the future.

Background: Several cardiovascular risk factors have been suggested to be associated with anthracycline-induced cardiotoxicity, but their quantitative effects have not reached a consensus.Methods: We searched PubMed, EMBASE, and Cochrane Library databases for manuscripts published from inception to February 2021, which reported the results of cardiotoxicity due to anthracycline chemotherapy without trastuzumab. Cardiotoxicity defined by any reduction of left ventricular eject fraction (LVEF) to below 50% or a >10% reduction from baseline was defined as the primary endpoint. Odd ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model meta-analysis.Results: A total of 7,488 patients receiving anthracycline chemotherapy without trastuzumab were included, who had at least one risk factor at baseline. Hypertension (OR: 1.99; 95% CI: 1.43–2.76), diabetes mellitus (OR: 1.74; 95% CI: 1.11–2.74), and obesity (OR: 1.72; 95% CI: 1.13–2.61) were associated with increased risk of cardiotoxicity. In addition, the relative reduction of global longitudinal strain (GLS) from baseline after anthracycline treatment could significantly improve the detection ability of cardiotoxicity (28.5%, 95% CI: 22.1–35.8% vs. 16.4%, 95% CI: 13.4–19.9%) compared with LVEF. The early detection rate of anthracycline-induced cardiotoxicity (3 months after chemotherapy) by GLS was 30.2% (95% CI: 24.9–36.1%), which is similar with the overall result of GLS.Conclusions: Hypertension, diabetes mellitus, and obesity are associated with increased risk of anthracycline-induced cardiotoxicity, which indicates that corresponding protective strategies should be used during and after anthracycline treatment. The findings of higher detection rate and better early detection ability for cardiotoxicity than LVEF added new proofs for the advantages of GLS in detection of AIC.

Background: Increasing numbers of Gastric cancer(GC) patients were diagnosed at younger age with aggressive behavior including early disease recurrence, more frequent peritoneal metastasis and poor overall survival. To investigate the driver genes and mechanisms of the early-onset and more aggressive nature of the GC.Methods: Gastric adenocarcinoma and matched germline samples were obtained from patients in Sun Yat-sen University Cancer Center between 2007 and 2013. Exome sequencing were performed for 198 pairs of primary gastric adenocarcinoma fresh tissue and blood samples from young or elder patients. Besides, matched tumor / blood exome sequencing was performed in 80 patients with peritoneal seeding and 51 patients without. Then bioinformatics analysis was performed to find genomic variants and their clinical meanings.Results: Early-onset gastric cancers (EOGCs) have fewer somatic mutations but some deleterious germline variates in FAT genes, patients carried none, one, two, three of the 4 Single nucleotide polymorphisms (SNPs), the mean ages of diagnosis are 60, 50, 40 and 35 respectively. Somatic mutations in CDH1, TGFBR1 and CTNNB1 are related to early-onset cancers. These variants are all linked to WNT pathways. Somatic mutations in genes involved in cancer aggressiveness like MAP2K7, CDH1 and RhoA are related to cancer progression and metastasis. Patients carrying RhoA, ITGAV, TGFBR1, CDH1, CTNNB1, MYO9B, VAV1, SALL1, CDX4 somatic mutations or simultaneously carrying three FAT germline SNPs have been diagnosed at younger age than those have only TP53 mutations.Conclusions: The molecular characterization gives us a novel insight into the carcinogenesis and tumor progression mechanisms and may provide a guide to developing novel targeted therapy in GC.

Encountering of energetic ocean eddies and atmosphere storms makes the winter Kuroshio extension a hotspot for air-sea interactions. This second part investigates the regulation of vertical eddy heat transport QT in the winter Kuroshio extension mixed layer by different types of air-sea interactions, including the atmosphere synoptic forcing, eddy thermal feedback resulting from eddy-induced surface heat flux anomalies, and eddy current feedback from eddy current’s imprint on wind stress.Atmosphere synoptic forcing modulates intra-seasonal variation of QT by boosting its component contributed by the turbulent thermal wind balance during strong cooling events associated with intense winds. In addition, the magnitude of QT is influenced by the direction of synoptic wind stress primarily via , with the latter exhibiting enhancement both in the downfront- and upfront-wind forcing. Enhanced by the downfront-wind forcing is attributed to increased turbulent vertical viscosity and front intensity caused by the destabilizing wind-driven Ekman buoyancy flux, whereas interaction of uniform wind stress with smaller turbulent vertical viscosity at the front center than periphery (a so-called internal Ekman pumping) accounts for the increased in the upfront-wind forcing. The eddy thermal feedback reduces QT significantly through weakening the fronts. In contrast, the eddy current feedback exerts negligible influences on QT, although it weakens eddy kinetic energy (EKE) evidently. This is due to the much reduced effect of eddy current feedback in damping the fronts compared to EKE and also due to the compensation from Ekman pumping induced by the eddy current feedback.

Background: The aim of this study was to examine the human riboflavin transporter (RFVT) gene polymorphism in Hakka esophageal cancer patients in Guangdong Province and to explore its relationship with esophageal cancer. Methods: We used matrix-assisted laser desorption ionization flight time mass spectrometry to genotype RFVT1 rs346821 and RFVT2 rs13042395 in 211 Hakka esophageal cancer patients and 216 healthy controls in Meizhou. Results: There were polymorphisms in the rs346821 and rs13042395 in the two groups of Hakka; G/A polymorphism in the RFVT1 gene rs346821; three genotypes GG, AG, and AA of RFVT rs346821 were found in the Meizhou Hakka population, with distribution frequencies in the esophageal cancer group at 61.61, 36.02, and 2.37% respectively; the frequencies of allele G and A were 79.62 and 20.38%. The distribution frequencies of the three genotypes in the control subjects were 54.17, 40.28, and 5.55% respectively; the frequencies of allele G and A were 74.31 and 25.69%. There was a significant difference observed in the binary logistic analysis; the occurence of AG and AA genotypes in the Hakka population were 2.424 times and 1.922 times higher than that of the GG genotype. Bioinformatics analysis revealed that RFVT1 rs346821 had a missense mutation, and the corresponding amino acid was changed from alanine to valine, resulting in a change in its protein structure. Conclusions: The study concluded that RFVT1 rs346821 polymorphism might be associated with the genetic susceptibility of the Hakka population to esophageal cancer. The variation in the protein structure resulting from the variation of RFVT1 rs346821 might have a significant influence on the occurrence and development of esophageal cancer in the Hakka population.

This study aimed to explore the role of a modified criteria for assessing tumor response to concurrent chemoradiotherapy (CCRT) in locally advanced non-small cell lung cancer (LA-NSCLC), using the combined modalities of anatomical and functional MRI and CT.One hundred and fifty-three patients with LA-NSCLC who underwent CCRT with continuous chest MRI and CT follow-up were analyzed. The tumor response to CCRT was evaluated two months after the completion of CCRT. The RECIST criteria (CT imaging) and modified criteria (combined chest MRI and CT imaging) were compared and validated on follow-up imaging. The chest MRI scan analysis included T1C, T2fs, DWI imaging and the apparent diffusion coefficient values. Progression free survival (PFS) ≥ 18 months was used as a surrogate endpoint of complete response to analyze the accuracy of tumor response assessment.Eight (5.2%) patients were considered to have complete response (CR) by the RECIST criteria while fifty-five (35.9%) were considered to have CR (CT + MRI) by the modified criteria. Using PFS ≥ 18 months as a surrogate for CR, the sensitivity and specificity of the modified criteria were 71.2% and 90.8% (AUC = 0.810, 95%CI 0.735-0.885), but were 9.1% and 97.7%, respectively, for the RECIST criteria (AUC = 0.534, 95%CI 0.441-0.627). The median PFS was 58.4 months for patients with CR (CT + MRI) and 9.7 months for those with non-CR (P 0.001). Multivariate analysis showed that the tumor response evaluated by the modified criteria [CR (CT + MRI) vs. non-CR] was an independent factor for both PFS (HR 0.182, 95%CI 0.088-0.373, P 0.001) and overall survival (HR 0.134, 95%CI 0.044-0.410, P 0.001).Combined multi-parameter MRI and CT imaging could improve the accuracy of tumor response assessment in LA-NSCLC patients after definitive CCRT, therefore contributed to the risk stratification and survival prediction for clinical practice.

ObjectiveTo analyze changes in volume and position of target regions and organs at risk (OARs) during radiotherapy for esophageal cancer patients.MethodsOverall, 16 esophageal cancer patients who underwent radiotherapy, including 10 cases of intensity-modulated radiation therapy (IMRT) and six of three-dimensional conformal radiotherapy (3D-CRT), were enrolled. The prescription doses for the planning target volumes (PTVs) were as follows: PTV1, 64 Gy/32 fractions; and PTV2, 46 Gy/23 fractions. Repeat computed tomography (CT) was performed for patients after the 5th, 10th, 15th, 20th, and 25th fractions. Delineation of the gross tumor volume (GTV) and OAR volume was determined using five repeat CTs performed by the same physician. The target and OAR volumes and centroid positions were recorded and used to analyze volume change ratio (VCR), center displacement (ΔD), and changes in the distance from the OAR centroid positions to the planned radiotherapy isocenter (distance to isocenter, DTI) during treatment.ResultsNo patient showed significant changes in target volume (TV) after the first week of radiotherapy (five fractions). However, TV gradually decreased over the following weeks, with the rate slowing after the fourth week (40 Gy). The comparison of TV from baseline to 40 Gy (20 fractions) showed that average GTVs decreased from 130.7 ± 63.1 cc to 92.1 ± 47.2 cc, with a VCR of −29.21 ± 13.96% (ppConclusionDuring radiotherapy for esophageal cancer, Targets and OARs change significantly in volume and position during the 2nd–4th weeks. Image-guidance and evaluation of dosimetric changes are recommended for these fractions of treatment to appropriate adjust treatment plans.