Tag: pubmed

Med Dosim. 2022 Oct 29:S0958-3947(22)00070-X. doi: 10.1016/j.meddos.2022.09.003. Online ahead of print.

ABSTRACT

Whole pelvic radiotherapy (WPRT) can sterilize microscopic lymph node metastases in treatment of prostate cancer. WPRT, compared to prostate only radiotherapy (PORT), is associated with increased acute gastrointestinal, and hematological toxicities. To further explore minimizing normal tissue toxicities associated with WPRT in definitive IMRT for prostate cancer, this planning study compared dosimetric differences between static 9-field-IMRT, full arc VMAT, and mixed partial-full arc VMAT techniques. In this retrospective study, 12 prostate cancer patients who met the criteria for WPRT were randomly selected for this study. The initial volume, PTV46, included the prostate, seminal vesicles, and pelvic nodes with margin and was prescribed to 4600 cGy. The cone-down volume, PTV78, included the prostate and proximal seminal vesicles with margin to a total dose of 7800 cGy. For each CT image set, 3 plans were generated for each of the PTVs: an IMRT plan, a full arc (FA) VMAT plan, and a mixed partial-full arc (PFA) VMAT plan, using 6MV photons energy. According to RTOG protocols none of the plans had a major Conformity Index (CI) violation by any of the 3 planning techniques. PFA plan had the best mean CI index of 1.00 and significantly better than IMRT (p = 0.03) and FA (p = 0.007). For equivalent PTV coverage, the average composite gradient index of the PFA plans was better than the IMRT and the FA plans with values 1.92, 2.03, and 2.01 respectively. The defference was statistically significant between PFA/IMRT and PFA/FA, with p- values of < 0.001. The IMRT plans and the PFA plans provided very similar doses to the rectum, bladder, sigmoid colon, and femoral heads, which were lower than the dose in the FA plans. There was a significant decrease in the mean dose to the rectum from 4524 cGy with the FA to 4182 cGy with the PFA and 4091 cGy with IMRT (p < 0.001). The percent of rectum receiving 4000 cGy was also the highest with FA at 66.1% compared to 49.9% (PFA) and 47.5% (IMRT). There was a significant decrease in the mean dose to the bladder from 3922 cGy (FA) to 3551 cGy (PFA) and 3612 cGy (IMRT) (p < 0.001). The percent of bladder receiving 4000 cGy was also the highest with FA at 45.4% compared to 36.6% (PFA) and 37.4% (IMRT). The average mean dose to the sigmoid colon decreased from 4177 cGy (FA) to 3893 cGy (PFA) and 3819 cGy (IMRT). The average mean dose to the femoral heads decreased from 2091 cGy (FA) to 2026 cGy (PFA) and 1987 cGy (IMRT). Considering the improvement in plan quality indices recorded in this study including the dose gradient and the dose to organs at risk, mixed partial-full arc plans may be the preferred VMAT treatment technique over full arc plans for prostate cancer treatments that include nodal volumes.

PMID:36319515 | DOI:10.1016/j.meddos.2022.09.003

Transplant Proc. 2022 Oct 29:S0041-1345(22)00655-8. doi: 10.1016/j.transproceed.2022.10.011. Online ahead of print.

ABSTRACT

BACKGROUND: The role of non-HLA antibody is gaining special attention in solid-organ transplantation and in highly sensitized (HS) patients because of its potential involvement in graft loss (GL) and/or antibody-mediated rejection (ABMR). The identification of non-HLA antibodies while listed may provide deeper information about the increased immunologic risk prior to transplant. We aimed to identify non-HLA antibodies pretransplant that could involve GL in HS patients.

METHODS: Nineteen pretransplant samples from HS patients who underwent transplant at the Marqués de Valdecilla University Hospital were studied for both HLA antibodies and a panel of 39 non-HLA antigens analyzed based on Luminex platform.

RESULTS: Eleven patient (57.9%) maintained the graft (KT group), whereas 8 (42.1%) had a GL within a median of 30 days. The median fluorescent intensity (MFI) of the 39 non-HLA antigens were compared within the groups, obtaining a statistically significant differences in protein tyrosine phosphatase receptor type N (P < .04) with a MFI mean of 1408 vs 4931 for KT and GL groups, respectively. However, no significant differences were observed in non-HLA MFI between ABMR and non-ABMR KT recipients.

CONCLUSIONS: The presence of non-HLA antibodies in HS is high. The levels of anti-protein tyrosine phosphatase receptor type N before transplant could indicate a potential risk of GL, although longitudinal studies with large number of cases are needed to define anti-non-HLA profiles of risk of ABMR.

PMID:36319497 | DOI:10.1016/j.transproceed.2022.10.011

Transplant Proc. 2022 Oct 30:S0041-1345(22)00668-6. doi: 10.1016/j.transproceed.2022.10.009. Online ahead of print.

ABSTRACT

BACKGROUND: An organ shortage is the reason why it is necessary to expand the pool of donors, which can be achieved by using elderly donors. The main goal of this study is to analyze the outcomes of liver transplant (LT) when it is performed with donors older than 75 years.

METHODS: We carried out a retrospective case-control study (N = 212) that included LTs with donors older than 75 years (group A, n = 106 cases) that were performed in our center between the years 2010 and 2020. This cohort has been paired off with a similar control group (group B, n = 106) whose donors were significantly younger. A survival analysis using the Kaplan-Meier model was performed.

RESULTS: Average (SD) age of donors in group A was statistically greater than group B (A, 79.1 [3.0] years vs B, 54.4 [15.3], P < .001). There were no differences either in the average age of the recipients or in the Model for End-Stage Liver Disease score of both groups. Indications for LT were distributed equally in both groups: the most common was cellular hepatocarcinoma followed by alcohol-related cirrhosis. Survival rates for group A were 81%, 78%, and 67%, in 1, 3, and 5 years, respectively, while in group B they were 85%, 76%, and 71%, respectively, without differences found between the groups (P = .57).

CONCLUSIONS: Using elderly liver donors is safe, achieving good outcomes in terms of short- and midterm rates of survival.

PMID:36319496 | DOI:10.1016/j.transproceed.2022.10.009

Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1146-1154. doi: 10.3760/cma.j.cn112152-20200818-00751.

ABSTRACT

Objective: To analyze the clinical features and prognosis of patients with cutaneous melanoma. Methods: The clinical data and follow-up data of 125 patients with cutaneous malignant melanoma (CMM) treated in the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between February 2008 and August 2019 were collected. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for impact factor analysis. Results: Among the 125 patients, 12 were stage Ⅰ, 62 were stage Ⅱ, 30 were stage Ⅲ, and 21 were stage Ⅳ; 76 were acral and 49 were non-acral. The median survival time was 44 months, and the 1-, 2-, and 5-year survival rates were 85.4%, 63.2% and 38.7%, respectively. Kaplan-Meier univariate survival analysis showed that Karnofsky performance status score, tumor stage, primary site, vascular infiltration, Ki-67, BRAF, lactate dehydrogenase (LDH), and surgical treatment were related to the prognosis of patients (P<0.05). The median overall survival (OS) time of patients receiving interferon treatment was 53 months, which was better than 40 months of patients not receiving interferon treatment, but the difference was not statistically significant (P=0.448). Among stage Ⅲ patients, the median OS time of patients receiving interferon therapy was 40 months, which was better than 17 months of patients not receiving interferon therapy (P=0.012). Among stage Ⅱ patients, the 1-, 2-, and 5-year survival rates of acral patients were 97.1%, 84.7%, and 65.8%, and the 1-, 2-, and 5-year survival rates of non-acral patients were 93.3%, 70.0% and 17.0%. The prognosis of patients with stage Ⅱ acral type was better than that of non-acral type (P=0.043). The median survival time of stage Ⅲ patients with acral type was 32 months, better than 17 months of non-acral type, but the difference was not statistical significance (P=0.164). The median survival time of acral type and non-acral type was 8 months and 11 months respectively (P=0.458). Cox multivariate analysis showed that tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma. Conclusions: Interferon treatment can improve the prognosis of patients with stage Ⅲ, and stage Ⅱ acral type patients have better prognosis than that of non-acral type patients. Tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma.

PMID:36319462 | DOI:10.3760/cma.j.cn112152-20200818-00751

Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1132-1138. doi: 10.3760/cma.j.cn112152-20210517-00390.

ABSTRACT

Objective: To investigate the incidence and the related risk factors of para-aortic lymph node metastasis in cervical cancer. Methods: The pathological data of 727 patients with cervical cancer who underwent radical hysterectomy and pelvic and para-aortic lymph node dissection were retrospectively analyzed. The relative postoperative pathological parameters of para-aortic lymph node metastasis were statistically analyzed. Results: Among the 727 patients with cervical cancer, 123(16.9%) had para-aortic lymph node metastasis. Univariate analysis showed that the tumor size, the depth of muscular invasion, the vessel invasion, the uterine body invasion, the vaginal invasion, the parametrial invasion, positive surgical margin, the ovary metastasis, the fallopian tubes metastasis, the pelvic lymph node metastasis, and the common iliac lymph node metastasis were associated with para-aortic lymph node metastasis. While the multivariate logistic regression analysis showed that the diameter of primary tumor >4.2 cm, the parametrial invasion, the pelvic lymph node metastasis, and the common iliac lymph node metastasis were the independent risk factors of para-aortic lymph node metastasis. Conclusions: The diameter of primary tumor >4.2 cm, the parametrial invasion, the pelvic lymph node metastasis, and the common iliac lymph node metastasis are the independent risk factors of para-aortic lymph node metastasis in cervical cancer. The tumor size and the common iliac lymph node status should be fully evaluated before the initial operation. Additionally, assessment of the postoperative pelvic lymph node status and the parametrial status will help reduce the rate of misdiagnosis and missed diagnosis, providing a basis for individualized treatment and prognostic judgment.

PMID:36319460 | DOI:10.3760/cma.j.cn112152-20210517-00390

Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1112-1118. doi: 10.3760/cma.j.cn112152-20201114-00986.

ABSTRACT

Objective: To investigate the prevalence and risk factors of coronary artery calcification (CAC) on lung cancer screening with low-dose computed tomography (LDCT). Methods: A total of 4 989 asymptomatic subjects (2 542 males and 2 447 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The visual scoring method was used to assess coronary artery calcification score. χ(2) test or independent t-test was used to compare the difference of CAC positive rate among different groups. Multivariate logistic regression was used to analyze risk factors associated with CAC in the study. Results: Of the 4 989 asymptomatic subjects, CAC occurred in 1 018 cases. The positive rate was 20.4%, of which mild, moderate and severe calcification accounted for 86.3%, 11.4% and 2.3%, respectively. Gender, age, BMI, education level, occupation, smoking history, diabetes, hypertension and hyperlipidemia had statistically significant differences in CAC positive rates among groups. Multivariate logistic regression analysis showed that gender, age, diabetes, hypertension, hyperlipidemia and smoking history were risk factors for CAC. Age, diabetes, hypertension and smoking history were statistically significant risk factors between the mild and moderate CAC group. A total of 1 730 coronary arteries in 1 018 CAC positive cases had calcification, CAC positive rate of left anterior descending was the highest(51.3%); 568 cases (55.8%) were single vessel calcification, 450 cases (44.2%) were multiple vessel calcification. Conclusions: LDCT can be used for the ‘one-stop’ early detection of lung cancer and coronary atherosclerosis. Gender, age, diabetes, hypertension, hyperlipidemia and smoking are related risk factors for coronary atherosclerosis.

PMID:36319457 | DOI:10.3760/cma.j.cn112152-20201114-00986

Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1096-1101. doi: 10.3760/cma.j.cn112152-20200225-00125.

ABSTRACT

Objective: To describe the epidemic characteristics of esophageal cancer mortality in Qidong from 1972 to 2016, and to provide baseline for making control measures and strategies for prevention. Methods: The cancer registry data were collected and analyzed on mortality of oesophagus cancer during 1972-2016 in Qidong in different sex, age and time. Indices of statistics included crude mortality rate (CR), China age-standardized rate (CASR), world age-standardized rate (WASR), 35-64 years truncated rate, 0-74 years cumulative rate, cumulative risk, average annual percentage change (AAPC), mortality by period and mortality in the birth cohort. Results: A total of 4 795 esophageal cancer cases (male: 3 315, female: 1 480) died during the 45 years, accounting for 4.85% of all cancer deaths. The crude mortality was 9.48/10(5) (CASR: 3.62/10(5,) WASR: 6.30/10(5)) from 1972 to 2016. The crude mortality was significantly increased with age. In 2016, the crude mortality was 11.61/10(5) (CASR: 2.64/10(5,) WASR: 4.89/10(5)), respectively. The average annual percentage change (AAPC) were 0.99%、-2.03%、-1.72%. The mortalities of esophageal cancer in all age groups from 35 to 74 have been decreasing since the 1980s. The age-birth cohort analysis showed a decline in mortality rates in age groups from 40 to 79. Conclusions: The crude mortality rate of esophageal cancer increases slightly in Qidong, while the China age-standardized rate and world age-standardized rate decrease significantly. However, esophageal cancer is still one of the malignant tumors that affects the health of residents and seriously threatens the people’s lives and health. The situation of cancer prevention and control is still serious in Qidong.

PMID:36319455 | DOI:10.3760/cma.j.cn112152-20200225-00125

Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1091-1095. doi: 10.3760/cma.j.cn112152-20220307-00156.

ABSTRACT

Objective: To analyze the survival of esophageal cancer cases in Qidong, Jiangsu Province from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention of esophageal cancer patients. Methods: The data of esophageal cancer were obtained from the Qidong Cancer Registration and Reporting System, and the follow-up date ended December 31, 2021. Observed survival rate (OSR) and relative survival rate (RSR) were calculated by SURV 3.01 software, and Hakulinen’s likelihood ratio test was used for statistical difference comparison. Joinpoint regression model was used to conduct the average annual percentage change (AAPC) in esophageal cancer survival rate, and the ARIMA model was used to predict the trend of esophageal cancer survival rate. Results: During 1972 to 2016, there were 5 112 new cases of esophageal cancer in Qidong. The OSR of esophageal cancer at 1, 5 and 10 years were 24.43%, 6.93% and 4.43%, and the RSR at 1, 5 and 10 years were 25.88%, 9.35% and 8.34%, respectively. Dividing 1972-2016 into 9 periods, compared with 1972-1976, the 5-year RSR from 2012-2016 increased from 4.47% to 17.85%, and the RSR trend of the 9 periods was statistically significant (χ(2)=263.43, P<0.001). The survival rate of female with esophageal cancer was slightly higher than that of male, however, there was no significant difference in RSR between male and female (χ(2)=9.40, P=0.401). The 5-OSR and 5-RSR for male were 6.73% and 9.11%, and for female were 7.37% and 9.87%, respectively. The 5-RSR for the age groups of 45-54, 55-64, 65-74, and over 75 years old were 11.99%, 11.21%, 8.17% and 7.08%, respectively. There was a statistically significant difference in RSR among different age groups (χ(2)=98.19, P<0.001). The time trend results showed that the overall AAPC of the 5-RSR of esophageal cancer in Qidong from 1972 to 2016 was 3.89% (t=11.98, P<0.001). The 5-RSR uptrend was consistent among different genders, and the uptrend was greater in female (AAPC=4.25% for male, and AAPC=5.72% for female, P<0.05). Furthermore, the 5-RSR of esophageal cancer in all age groups showed an upward trend, and the upward trend was statistically significant in the 55-64-year-old group (AAPC=4.23%, P<0.05) and the 65-74-year-old group (AAPC=6.82%, P<0.05), there was no statistical significance in the 45-54-year-old group (AAPC=2.17%, P>0.05) and more than 75 years old group (AAPC=1.82%, P>0.05). Survival rate prediction of esophageal cancer showed that by 2026, 5-RSR will increase to 24.79%. Conclusions: During 1972 to 2016, the overall survival rate of esophageal cancer in the whole population of Qidong has improved to a certain extent, but there is still a large room for improvement. More emphasis should be continued to strengthen on the early diagnosis and early treatment of esophageal cancer.

PMID:36319454 | DOI:10.3760/cma.j.cn112152-20220307-00156

Rev Sci Instrum. 2022 Oct 1;93(10):103535. doi: 10.1063/5.0101806.

ABSTRACT

Two newly developed, eight-channel, integrated Beam Emission Spectroscopy (BES) detectors have been installed at Huan-Liuqi-2A tokamak, which extends the existing 16 single-channel modular BES system with additional 16 spatial channels. The BES collects the Doppler-shifted Balmer D_α emission with a spatial resolution of 1 cm (radial) × 1.5 cm (poloidal) and a temporal resolution of 0.5 µs to measure long-wavelength (k_⊥ρ_i < 1) density fluctuations. Compared to the modular BES, the dark noise of the integrated BES is reduced by 50%-60% on average. The signal-to-noise ratio of the integrated BES system is optimized by the high light throughput front-end optics, high quantum efficiency photodiodes, high-gain, low-noise preamplifiers, and sufficient cooling capacity provided by the thermoelectric cooling (TEC) units that maintain the detectors at -20 °C. Crosstalk between channels that share the same optical system is found to be negligible. High-quality density fluctuation data enables 2D (radial-poloidal) imaging of turbulence, which allows for multi-channel spectral analysis, multi-channel cross-correlation analysis and velocimetry analysis. Preliminary results show that BES successfully captures the spatiotemporal features of the local turbulence and obtains statistically consistent turbulence characterization results.

PMID:36319390 | DOI:10.1063/5.0101806

Rev Sci Instrum. 2022 Oct 1;93(10):103527. doi: 10.1063/5.0101853.

ABSTRACT

A high-resolution x-ray spectrometer was coupled with an ultrafast x-ray streak camera to produce time-resolved line shape spectra measured from hot, solid-density plasmas. A Bragg crystal was placed near laser-produced plasma to maximize throughput; alignment tolerances were established by ray tracing. The streak camera produced single-shot, time-resolved spectra, heavily sloped due to photon time-of-flight differences, with sufficient reproducibility to accumulate photon statistics. The images are time-calibrated by the slope of streaked spectra and dewarped to generate spectra emitted at different times defined at the source. The streaked spectra demonstrate the evolution of spectral shoulders and other features on ps timescales, showing the feasibility of plasma parameter measurements on the rapid timescales necessary to study high-energy-density plasmas.

PMID:36319349 | DOI:10.1063/5.0101853