Farmergustavsen2255

To evaluate the distribution of metastatic lymph nodes (LN) detected on

Ga-PSMA-positron emission tomography/computed tomography (PET/CT) in treatment-naïve prostate cancer (PC) patients and to analyze the LN coverage rates of the pelvic fields defined in the GETUG trial and RTOG guidelines and a pelvic field extending superiorly from the L4/L5 interspace.

Ga-PSMA-PET/CT images obtained at diagnosis of 138 PC patients were retrospectively analyzed. The number and locations of

Ga-PSMA-positive LNs were co-registered with one single-planning CT. The numbers, locations, and sizes of LNs located outside the three pelvic volumes were investigated for the entire cohort and for patients with LN metastasis in the pelvic area only.

A total of 441 PSMA-PET-positive LN metastases were identified. The most frequent metastatic LNs were internal iliac LNs (25.2%). Para-aortic and presacral LNs outside the three pelvic fields were present in 20 (14.5%) and 22 patients (15.9%), respectively. The LN coverage rates according to the GETUG trial, the RTOG guidelines, and the pelvic field extending superiorly from L4/L5 were 44.2%, 52.2%, and 71, respectively, in the entire cohort and 51.7%, 61 and 83.1%, respectively, in patients with only pelvic LN metastasis. The number of metastatic LNs was a predictive factor for LNs located outside the three pelvic fields.

Extending the cranial margin of the pelvic field from L5/S1 to L4/L5 increases the accuracy of pelvic field irradiation in approximately 20% of patients, highlighting the importance of proximal common iliac irradiation, particularly in patients with multiple LN metastasis.

Extending the cranial margin of the pelvic field from L5/S1 to L4/L5 increases the accuracy of pelvic field irradiation in approximately 20% of patients, highlighting the importance of proximal common iliac irradiation, particularly in patients with multiple LN metastasis.Despite of the predominant role of chemotherapy and surgery in pancreatic ductal adenocarcinoma (PDAC), radiotherapy (RT) still has a place in multimodal management of this disease where local tumour sequelae are fatal in about 40% of the patients. RT (chemoradiotherapy and stereotactic body radiotherapy) is used and investigated in the non-metastatic setting as part of definitive treatment strategies, in (neo)adjuvant settings and for locally recurrent disease. The ACROP committee was delegated by ESTRO to recommend target volume delineation for these clinical situations. The guidelines of this document are a result of a structured evaluation of the best available evidence by a panel of international experts in the field. Guidance for treatment planning including diagnostic imaging is provided. Recommendations are given for GTV delineation. The role and the definition of CTV volumes are critically discussed. Aspects of motion management and patient positioning are taken into account for PTV definition. Furthermore, aspects of delineation of organs at risk and of dose constraints are described in both, standard and hypofractionated, settings. This guideline has the purpose to support standardised and optimised processes of RT treatment planning for both, clinical practice and prospective studies.

To determine the outcomes of oral cavity squamous cell cancer (OSCC) patients treated with non-surgical approach i.e. definitive intensity-modulated radiation therapy (IMRT).

All OSCC patients treated radically with IMRT (without primary surgery) between 2005-2014 were reviewed in a prospectively collected database. OSCC patients treated with definitive RT received concurrent chemotherapy except for early stage patients or those who declined or were unfit for chemotherapy. The 5-year local, and regional, distant control rates, disease-free, overall, and cancer-specific survival, and late toxicity were analyzed.

Among 1316 OSCC patients treated with curative-intent; 108 patients (8%) received non-operative management due to medical inoperability (n=14, 13%), surgical unresectability (n=8, 7%), patient declined surgery (n=15, 14%), attempted preservation of oral structure/function in view of required extensive surgery (n=53, 49%) or extensive oropharyngeal involvement (n=18, 17%). Sixty-eight (63%) were cT3-4, 38 (35%) were cN2-3, and 38 (35%) received concurrent chemotherapy. With a median follow-up of 52months, the 5-year local, regional, distant control rate, disease-free, overall, and cancer-specific survival were 78%, 92%, 90%, 42%, 50%, and 76% respectively. Patients with cN2-3 had higher rate of 5-year distant metastasis (24% vs 3%, p=0.001), with detrimental impact on DFS (p=0.03) and OS (p<0.02) on multivariable analysis. Grade≥3 late toxicity was reported in 9% of patients (most common grade 3 osteoradionecrosis in 6%).

Non-operative management of OSCC resulted in a meaningful rate of locoregional control, and could be an alternative curative approach when primary surgery would be declined, unsuitable or unacceptably delayed.

Non-operative management of OSCC resulted in a meaningful rate of locoregional control, and could be an alternative curative approach when primary surgery would be declined, unsuitable or unacceptably delayed.In this study, the factors affecting lipase adsorption onto SiO2 nanoparticles including SiO2 nanoparticles amounts (8, 19 and 30 mg/mL), lipase concentrations (30, 90 and 150 μg/mL), adsorption temperatures (5, 20 and 35 °C) and adsorption times (1, 12.5 and 24 h) were optimized using central composite design. VPA inhibitor mw The optimal conditions were determined as a SiO2 nanoparticles amount of 8.5-14 mg/ml, a lipase concentration of 106-116 μg/mL, an adsorption temperature of 20 °C and an adsorption time of 12.5 h, which resulted in a specific activity and immobilization efficiency of 20,000 (U/g protein) and 60 %, respectively. The lipase adsorbed under optimal conditions (SiO2-lipase) was entrapped in a PVA/Alg hydrogel, successfully. FESEM and FTIR confirmed the two-step method of lipase immobilization. The entrapped SiO2-lipase retained 76.5 % of its initial activity after 30 days of storage at 4 °C while adsorbed and free lipase retained only 43.4 % and 13.7 %, respectively. SiO2-lipase activity decreased to 34.43 % after 10 cycles of use, while the entrapped SiO2-lipase retained about 64.