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Inheriting the medicinal illustrations in Bencao Tujing(, Illustration of Materia Medica), the two picture books of Zhenghe Bencao(, Pharmacopoeia of the Zhenghe reign) Huiming Sanctum edition and Daguan Bencao(, Pharmacopoeia of the Daguan reign) Liu Jia edition show different styles and characteristics in illustrations. They present different art styles and features in medicinal illustrations of ores, plants and animals because of the regional influences from the south and the north. In the process of carving and printing the illustrations of the two classics, different attitudes lead to similarities in the outline and yet differences in details. Besides, the different artistic levels in carving and printing contribute to different artistic standards. Compared with the paintings created in Song Dynasty, more subtle features are lost in Zhenghe Bencao(Huiming Sanctum edition) than in Daguan Bencao (Liu Jia edition). Therefore, the Zhenglei Bencao (, Collected Classified Materia Medica) Huiming Sanctum edition are much closer to the ones in Bencao Tujing and the real medicinals as well than those in Daguan Bencao (Liu Jia edition).Brain metastases are common in stage IV malignant melanoma, carrying a prognosis traditionally regarded as severe, with a median survival of few months. Recently introduced systemic therapies as targeted therapy or immunotherapy have significantly improved the prognosis of metastatic melanoma. The optimal association of radiotherapy to such novel treatments has to be clarified. We report on a 43-year-old woman with 10 brain metastases. Three of them were treated with stereotactic radiosurgery (SRS) with complete response even of the untreated lesions. As the patient was BRAF-mutated, she was started on dabrafenib/trametinib. After 8 months she developed new brain metastases, which again responded to a new treatment with SRS. As after 7 months additional lesions appeared, she was treated with whole brain radiotherapy and was started on nivolumab. Twenty months after the first diagnosis of brain metastases the patient is fit without significant clinical and radiological signs of toxicity.Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients. Maximum safe resection is performed in most of the cases followed by postoperative radiotherapy in children over 3 years of age. Benefit of temozolomide is unclear in these patients. check details Here, we present the clinicopathological details and outcome of six pGBM patients treated at our institute in 2018-2019.
This study investigated the possible radioprotective effect of Costus afer extract (CAE) on hematological and histopathological parameters of mice.
Fifty-four male mice with mass between 37-43 g, 11-13 weeks old were used for this study. We divided the mice into six different groups containing nine animals, which were then further sub-divided into irradiated groups and un-irradiated groups. Animals received 250 mg/kg body weight extract of CAE by oral gavage for 6 days in addition to feeding and water ad libitum. Animals in the irradiated group were exposed to radiation at the Department of Radiotherapy and Oncology, Grey's Hospital using a linear accelerator. Blood samples were collected at 48-hour post-irradiation for the hematology test followed by histopathology examination of kidney and liver.
Our findings revealed that 3 Gy and 6 Gy dose of X-ray radiation caused a significant reduction in the white blood cell, packed cell volume, hemoglobin, neutrophils, lymphocytes, eosinophils, and platelet counts compared with the control group. However, the administration of CAE before irradiation significantly increased the mentioned parameters. There was no increase in red blood cell and monocyte among treated groups compared with the control. Histopathological changes in the kidney and liver sections revealed that no visible lesion in the pretreated mice. Hepatocytes seem to be within normal histological limits.
This study concludes that CAE offered some protection against radiation-induced hematological alterations, but there was no significant improvement in the histopathological parameters. Thus, further studies are needed to validate its radioprotective effect on histopathological variables.
This study concludes that CAE offered some protection against radiation-induced hematological alterations, but there was no significant improvement in the histopathological parameters. Thus, further studies are needed to validate its radioprotective effect on histopathological variables.
The integration of large-scale gene data and their functional analysis needs the effective application of various computational tools. Here we attempted to unravel the biological processes and cellular pathways in response to ionizing radiation using a systems biology approach.
Analysis of gene ontology shows that 80, 42, 25, and 35 genes have roles in the biological process, molecular function, the cellular process, and immune system pathways, respectively. Therefore, our study emphasizes gene/protein network analysis on various differentially expressed genes (DEGs) to reveal the interactions between those proteins and their functional contribution upon radiation exposure.
A gene/protein interaction network was constructed, which comprises 79 interactors with 718 interactions and TP53, MAPK8, MAPK1, CASP3, MAPK14, ATM, NOTCH1, VEGFA, SIRT1, and PRKDC are the top 10 proteins in the network with high betweenness centrality values. Further, molecular complex detection was used to cluster these associated partners in the network, which produced three effective clusters based on the Molecular Complex Detection (MCODE) score. Interestingly, we found a high functional similarity from the associated genes/proteins in the network with known radiation response genes.
This network-based approach on DEGs of human lymphocytes upon response to ionizing radiation provides clues for an opportunity to improve therapeutic efficacy.
This network-based approach on DEGs of human lymphocytes upon response to ionizing radiation provides clues for an opportunity to improve therapeutic efficacy.
The aim of this study is to evaluate the treatment responses of Kaposi sarcoma patients treated with radiotherapy (RT).
The data of 18 patients (40 different regions) who were treated for Kaposi sarcoma in OOOO between March 23, 2010 to February 13, 2018 were evaluated retrospectively. The primary endpoint of the study was the clinical-subjective response after RT, and the secondary endpoint was the visual response assessment after RT.
In evaluating the patients' reported response of the lesions 25 (62.5%) of complete response (CR), 12 (30%) of partial response (PR), and stable response was seen in 3 patients (7.5%). Patient reported response after RT was significantly higher in male sex (p = 0.002; odds ratio [OR] = 13.8, 95% confidence interval [CI], 2.7-70.0). Physician reported response rates were available for 28 lesions and CR was detected in 12 lesions (30%); PR was observed in 16 (40%). The relationship between physician reported outcome and RT techniques (electron, bolus, or water bolus) is close to the limit of statically significance (p = 0.052). Fewer lesions disappeared in patients with photon preference than electrons (p = 0.036; OR = 0.093; 95% CI, 0.009-0.950). Patients' reported complete response rates were significantly higher in the 20 Gy per 5 fractions treatment arm (p = 0.042; OR = 1.75; 95% CI, 1.1-2.7).
RT is an effective local treatment with high response rates in the treatment of Kaposi sarcoma. The subjective-clinical response rate was higher in male sex and the visual response was higher in the 20 Gy per 5 fractions arm. Additional studies are needed to standardize RT dose and techniques.
RT is an effective local treatment with high response rates in the treatment of Kaposi sarcoma. The subjective-clinical response rate was higher in male sex and the visual response was higher in the 20 Gy per 5 fractions arm. Additional studies are needed to standardize RT dose and techniques.
We aimed to present our initial clinical experience on the implementation of a stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic disease.
Twenty-one patients (24 lesions) with liver metastasis treated with SMART were included in this retrospective study. Step-and-shoot intensity-modulated radiotherapy technique was used with daily plan adaptation. During delivery, real-time imaging was used by acquiring planar magnetic resonance images in sagittal plane for monitoring and gating. Acute and late toxicities were recorded both during treatment and follow-up visits.
The median follow-up time was 11.6 months (range, 2.2 to 24.6 months). The median delivered total dose was 50 Gy (range, 40 to 60 Gy); with a median fraction number of 5 (range, 3 to 8 fractions) and the median fraction dose was 10 Gy (range, 7.5 to 18 Gy). Ninety-three fractions (83.7%) among 111 fractions were re-optimized. No patients were lost to follow-up and all patients were alive except one at the time of analysis. All of the patients had either complete (80.9%) or partial (19.1%) response at irradiated sites. Estimated 1-year overall survival was 93.3%. Intrahepatic and extrahepatic progression-free survival was 89.7% and 73.5% at 1 year, respectively. There was no grade 3 or higher acute or late toxicities experienced during the treatment and follow-up course.
SMART represents a new, noninvasive and effective alternative to current ablative radiotherapy methods for treatment of liver metastases in oligometastatic disease with the advantages of better visualization of soft tissue, real-time tumor tracking and potentially reduced toxicity to organs at risk.
SMART represents a new, noninvasive and effective alternative to current ablative radiotherapy methods for treatment of liver metastases in oligometastatic disease with the advantages of better visualization of soft tissue, real-time tumor tracking and potentially reduced toxicity to organs at risk.
This study aimed to evaluate the clinical outcomes and toxicities of salvage proton beam therapy (PBT) in patients with locoregional recurrent non-small cell lung cancer (NSCLC).
We retrospectively reviewed 53 patients who received salvage PBT for locoregionally recurrent NSCLC between January 2016 and December 2019. The median clinical target volume (CTV) was 71.2 cm3 (range, 13.3 to 1,200.7 cm3). The median prescribed dose was 64.0 cobalt gray equivalent (CGE) (range, 45.0 to 70.0 CGE). One-third of the patients (32.1%) received concurrent chemoradiotherapy (CCRT).
The patients' median age was 67 years (range, 44 to 86 years). The initial treatments were surgery in 31 (58.5%), definitive CCRT in 12 (22.6%), and definitive radiotherapy in 10 (18.9%) patients. The median disease-free interval (DFI) was 14 months (range, 3 to 112 months). Thirty-seven patients (69.8%) had a previous radiotherapy history. Among them, 18 patients (48.7%) had in-field recurrence. The median follow-up time after salvage PBT was 15.
