Postoperative Radiotherapy Research Articles

Biomimetic Nanosensitizer Potentiates Efficient Glioblastoma Gene-Radiotherapy through Synergistic Hypoxia Mitigation and PLK1 Silencing.

Postoperative radiotherapy currently stands as the cornerstone of glioblastoma (GBM) treatment. Nevertheless, low-dose radiotherapy has been proven ineffective for GBM, due to hypoxia in the GBM microenvironment, which renders the resistance to radiation-induced cell death. Moreover, the overexpression of the PLK1 gene in glioma cells enhances GBM proliferation, invasion, metastasis, and resistance to radiation. This study introduced a hybrid membrane-camouflaged biomimetic lipid nanosensitizer (CNL@miPA), which efficiently encapsulated gold nanoclusters (PA) and miR-593-5p by a chimeric membrane derived from lipids, cancer cells, and natural killer cells. CNL@miPA exhibited exceptional blood-brain barrier and tumor tissue penetration, effectively ameliorating hypoxia and synergizing with radiotherapy. By enabling prolonged miRNA circulation in the bloodstream and achieving high enrichment at the tumor site, CNL@miPA significantly suppressed tumor growth in combination treatment, thereby significantly extending the survival period of treated mice. Overall, the developed biomimetic nanosensitizer represented an efficient and multifunctional targeted delivery system, offering a novel strategy for gene-radiotherapy of GBM.

Unilateral Neck Treatment with either Surgery and/or Radiotherapy for Squamous Cell Carcinoma for the Tonsil

Introduction: Strategies for treatment of tonsil carcinoma are under active investigation. Limiting surgical and radiation treatment volumes to the primary tumor and ipsilateral neck in appropriately selected patients are one such approach. Here, we present our institutional experience with treatment through ipsilateral surgical or radiotherapeutic neck management. Methods: We retrospectively reviewed our institutional database of patients with tonsil carcinoma treated from 2012 to 2020. Patients were included for analysis if they received definitive radiation therapy (RT), definitive surgery (S), or surgery with postoperative radiation therapy (S-PORT) and whose treatment volumes were limited to the primary tumor and involved/elective ipsilateral neck. Patients who received radiation and/or surgery to the contralateral neck (including those with bilateral nodal involvement), as well as patients with metastatic disease, were excluded. Clinical factors including T- and N-stage (AJCC 7th edition), and HPV status (by p16 and/or HPV DNA PCR) were recorded, as were pathologic factors (when applicable) including margin status, extracapsular extension (ECE), lymphovascular invasion (LVSI), and perineural invasion (PNI). Overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) at 2 years were estimated using the Kaplan-Meier method. Results: In total, 71 patients were treated with unilateral neck approaches: S (n = 49), RT (n = 10), and S+PORT (n = 12). Among these patients, 32, 36, and 3 had T1, T2, and T3 disease, respectively. N-stage was N0, N1, N2a, N2b, and N3 in 22, 20, 5, 23, and 1 patient(s), respectively. Concurrent chemotherapy was administered in 12 patients. From those with recorded risk factors, 86% were HPV positive, 20% had LVSI, 7% had PNI, 13% had ECE, and 5% had positive margins. From a median follow-up of 27 months, local, regional, and distant failures occurred in 5, 6, and 5 patients, respectively. No contralateral neck failures were recorded. At 2 years, OS, PFS, and LRC were 92% (95% CI 85–99%), 85% (95% CI 75–95%), and 88% (95% CI 80–98%), respectively. Conclusions: In patients with early T-stage tonsil carcinoma, treatment of the primary tumor and ipsilateral neck is associated with acceptable OS, PFS, and LRC. In this population, the risk of contralateral neck failure is likely very low regardless of primary treatment modality. Additional prospective studies are needed to determine the impact of limiting treatment extent, either surgical or radiotherapeutic, to the unilateral neck.

Efficacy of Stilbene Derivatives in Sensitizing Breast Cancer Cells to Ionizing Radiation.

One of the treatments for breast cancer is surgical resection of the tumour and prevention of recurrence with postoperative radiotherapy. Unfortunately, radiotherapy is not always effective enough due to the low sensitivity of cancer cells to ionising radiation. This study aimed to evaluate the radiosensitising properties of resveratrol, piceatannol and polydatin on breast cancer cells, which differ in the presence of hormonal receptors on their surface. The experimental part was carried out on triple-negative breast cancer cells (HCC38) and hormone-dependent cells (MCF7). The study assessed the level of cell death, changes in the expression of genes (BAX, BCL-2) and proteins related to the apoptosis process (CASPASE 3, 8 and P53), changes in the expression of antioxidant enzymes (CATALASE, SOD, GPx1/2) and NRF-2. Additionally, the expression level of RAD51 protein and histone H2AX, which are involved in DNA repair processes, was assessed. Statistical significance was evaluated by a two-way analysis of variance (ANOVA) followed by Tukey's post hoc test (p < 0.05). Ionising radiation in combination with resveratrol or piceatannol activates the apoptosis process by internal and external pathways. Greater sensitivity of MCF7 cells compared to HCC38 cells to ionising radiation in combination with resveratrol is associated with a weaker antioxidant response of cells and reduced intensity of DNA damage repair. DNA repair induced by ionising radiation occurs more effectively in HCC38 cells than in MCF7 cells. Resveratrol has the highest radiosensitising potential among the tested stilbene for cells of both lines. The effectiveness of ionizing radiation in combination with resveratrol (to a lesser extent with piceatannol) is more significant in MCF7 than in HCC38 cells.

Treatment Outcomes after Postoperative Radiotherapy in Triple-Negative Breast Cancer: Multi-Institutional Retrospective Study (KROG 17-05).

We designed a multi-institutional retrospective study to investigate the previously unreported failure pattern, survivals, and prognostic factors after postoperative radiotherapy (PORT) in triple negative breast cancer (TNBC) patients in South Korea. We retrospectively reviewed 699 patients with TNBC who underwent PORT at six institutions between 2008 and 2010. The median follow-up period was 94 months (range: 7-192 months). There were 216, 380, and 100 patients in stages I, II, and III, respectively. After 94 months post-treatment, all patients with pathologic complete remission after neoadjuvant chemotherapy were alive without any failure. Distant metastasis was the main cause of failure. The 5-year overall survival rate was 91.4%, 5-year loco-regional relapse-free survival rate (LRRFS) was 92.3%, 5-year distant metastasis-free survival rate (DMFS) was 89.4%, and 5-year disease-free survival rate (DFS) was 85.2%. On multivariate (Cox) analysis, T and N stages were significant prognostic factors for survival, and lympho-vascular invasion (LVI) was a significant factor for LRRFS and DMFS. Ki-67 expression was significantly associated with LRRFS and DFS. We verified that T and N stages, LVI, and Ki-67 expression were significantly associated with survival outcomes after PORT in TNBC.

Single-Center Experience and Literature Review of Radiotherapy Outcomes for Adult Ependymomas

Objective: To retrospectively determine the long-term outcome of adult intracranial and spinal ependymoma patients treated with postoperative radiation therapy after surgery. Methods: Fourteen adult patients who underwent radiotherapy after surgery at a single center between 1999 and 2022 were included. The endpoints analyzed were overall survival and progression-free survival, together with prognostic factors. Results: The median (range) age was 29.5 (23–58) years. The majority (71.4%) of the tumors were located in the spinal canal and gross total resection was performed in nine (64.3%) patients. Six patients were irradiated after recurrence (spinal n=4, intracranial n=2) of whom three had myxopapillary and two had anaplastic histology. Patients were followed up for a median duration of 106.5 (13-172) months. Overall, 4 patients (intracranial n=3, spinal n=1) had recurrences and died after radiotherapy as a direct result of disease progression during the follow-up period. All of these intracranial tumors exhibited anaplastic histology and the spinal tumor was myxopapillary type. Patients with intracranial lesions had a 5-year survival of 50% and no patient was alive on the 10th year, compared with 5- and 10-year overall survival of 87.5 % for patients with spinal tumors. Patients with spinal tumors had a 5- and 10-year progression-free survival rate of 52.5%, while those with intracranial lesions had a rate of 25%. Conclusion: In low-grade spinal ependymomas radiotherapy appears to control disease, even after recurrence. For myxopapillary ependymoma patients, in subtotally resected intracranial and all high-grade tumors, regardless of the extent of resection, adjuvant radiotherapy should be administered.

23-year review of spheno-orbital meningioma: clinical, radiological, and pathological insights from 100 cases

BackgroundSpheno-orbital meningioma (SOM) represents a unique variant of sphenoid wing meningiomas, distinguished by its propensity for bone infiltration and cranio-orbital involvement. SOM exhibits a considerable incidence of misdiagnosis and recurrence.PurposesTo elucidate the clinical, radiological, and pathological characteristics of SOM.MethodsReview of electronic medical records, histopathology, radiological images and follow-up information of 100 SOM patients.ResultsOf the 100 patients (28 males, 72 females) with SOM, mean age was 46.8 ± 12.6 years and prevalent symptoms were proptosis (99%). All the CT scans showed hyperostosis with 89.3% of the hyperostosis having an irregular edge. In MRI scans, dural tail sign was observed across all patients and the cranio-orbital tumors often penetrated temporal muscle (74.1%), extraocular muscle (74.1%) and lacrimal gland (63%). All the 100 patients underwent surgical intervention, and among them, 62 individuals received postoperative radiotherapy. Grade I resections had a lower recurrence rate(16.7%), which further decreased with the addition of radiotherapy(13.9%). In contrast, all patients with grade II or higher grade resections without radiotherapy experienced recurrence, indicating a higher risk associated with less complete tumor removal. The pathological examination revealed that intraorbital sections exhibited comparable tumor density to intraorbital SOM tumors, along with increased fibrous density but decreased vascular distribution.ConclusionsRadiological characteristics of SOM included cranio-orbital tumors, hyperostosis of the sphenoid wing with an irregular edge, and dural tail sign. Combination of gross total resection and adjuvant radiotherapy was recommended to minimize recurrence rate. Intracranial SOM tumors tended to be softer and more bleed-prone than intraorbital sections, necessitating surgical precision.

Postoperative radiotherapy for thymic epithelial tumors: a narrative review.

Thymic epithelial tumors (TETs), including thymomas and thymic carcinomas, are rare mediastinal tumors. Surgical resection is the treatment strategy for resectable TETs, and postoperative radiotherapy (PORT) is administered to improve local control in patients with a high risk of recurrence. The rarity of TETs has led to a lack of randomized controlled trials, and the current indications for PORT rely largely on retrospective studies. This review analyzes the literature on TETs, highlighting PORT, to guide current research and future investigations. Studies that focused on TETs, addressed topics on PORT, and had English abstracts accessible online were eligible for inclusion in our review. We excluded case reports or review articles, articles written in languages other than English, articles published >30 years ago, and articles concerning thymic neuroendocrine tumors. Masaoka or Masaoka-Koga staging, World Health Organization (WHO) histological subtype, and resection status indicate PORT in resected TETs. Current literature suggests that PORT does not improve overall survival in stage I-IIA TETs, with inconsistent results for stage IIB-III TETs. Patients with a higher risk, such as carcinomas or WHO type B, might benefit from PORT if they do not develop distant metastasis. Determining which patients will benefit most from PORT requires further investigation. For recurrent TETs, the significance of applying PORT is unclear because available data are limited. Given the long-term survival of TETs, late toxicities, including radiation pneumonitis, radiation-induced cardiotoxicities, and secondary malignancies, must be addressed. Proton beam radiotherapy might reduce toxicities by sparing organs at risk compared to conventional photon beam radiotherapy. The use of high-precision radiation therapy, along with emerging immunotherapy, targeted therapy, and minimally invasive surgery, could improve TET outcomes. This review consolidates the literature on PORT for TETs, factoring in the Masaoka-Koga staging, WHO histological subtypes, and resection status. Varying results regarding PORT efficacy have led to an undefined strategy for stage IIB-III TETs. Although advanced radiotherapy techniques promise to reduce radiation-induced toxicities, further research is needed to investigate the efficacy of PORT and combination therapy.

Impact of Microsurgery and Postoperative Radiotherapy on Neurological Function in Intramedullary Spinal Cord Gliomas.

To assess the clinical efficacy of combined microsurgery and postoperative radiotherapy for the treatment of intramedullary spinal gliomas and its impact on neurological function. An observational study. Place and Duration of the Study: Department of Neurosurgery, Baoding No.1 Central Hospital, Hebei, China, between January 2020 and 2023. Sixty patients diagnosed with spinal cord intramedullary gliomas were divided equally into an experimental and control group. The control group received microsurgical treatment, and the experimental group received microsurgical treatment combined with postoperative radiotherapy. The treatment effectiveness, neurological function, and follow-up results of the two groups were compared. After treatment, the clinical efficacy of the experimental group treatment was significantly better than that of the control group (p <0.05). The National Institutes of Health Stroke Scale (NIHSS) scores were significantly lower, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) scores were significantly higher in the experimental group than in the control group (p <0.05). The 1-3-year survival rate and median survival time of the experimental group were significantly higher than those of the control group (p <0.05). The incidence of complications was 3.33% in the experimental group and 6.67% in the control group, but the difference was not statistically significant (p >0.05). The postoperative recurrence rate was significantly lower in the experimental (0%) than in the control group (13.33%, p <0.05). Combined microsurgery and postoperative radiotherapy was found to be more effective than microsurgery alone. It was also more conducive to the recovery of neurological function and improved the patient's quality of life. Intramedullary spinal cord glioma, Microsurgery, Neurological function, Radiotherapy.

442. POSTOPERATIVE ADJUVANT RADIOTHERAPY REDUCES LOCOREGIONAL RECURRENCE IN PATIENTS WITH BORDERLINE RESECTABLE ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract Background borderline resectable esophageal squamous cell carcinoma (Br-ESCC) patients who underwent R0 resection had a significantly improved prognosis. However, local recurrence cannot be ignored. We sought to investigate the efficacy of postoperative adjuvant radiotherapy in reducing locoregional recurrence in patients with Br-ESCC. Methods we established a new resection status, Rbr+, which was defined as no clear boundary between the mass/scar and the outer aortic/tracheal membrane, no visible cancer remaining on the outer aortic/tracheal membrane, and a pathologically negative circumferential margin. patients with Br-ESCC who underwent curative esophagectomy at our center from January 2018 to December 2021 were eligible for this study. Patient characteristics, and perioperative variables were included in this study. univariable and multivariable analyses were performed to compare locoregional recurrence based on the logistic regression model. The Kaplan-Meier method and Cox proportional hazard model were used to compare overall and cause-specific survival. Results A total of 99 patients were included, among whom 27 (27.3%) had a locoregional recurrence. 71.7% (71/99) were classified as Rbr+ resection, and 28.3% (28/99) were classified as Rbr- resection. With a median postoperative follow-up of 55.3 months (range, 24.3-70.8 months), 25 patients out of 71 with Rbr+ resection suffered from local recurrence. However, 2 patients out of 28 with Rbr- resection suffered from locally recurrence. The locoregional recurrence was 25%(7/28) and 41.9%(18/43) in Rbr+ resection with and without postoperative adjuvant radiotherapy. While, the locoregional recurrence was 8.33%(1/12) and 6.25%(1/16) in Rbr- resection patients with and without postoperative adjuvant radiotherapy. Conclusion Rbr+ resection was independently associated with locoregional recurrence in patients with Br-ESCC. postoperative adjuvant radiotherapy was independently associated with overall and cause-specific survival in patients with Br-ESCC.

Fat Necrosis in Single Perforator Deep Inferior Epigastric Artery and Superficial Epigastric Artery Perforator Free Flaps: A Prospective Randomized Study.

The deep inferior epigastric perforator (DIEP) flap is the standard of care in autologous breast reconstruction. The superficial inferior epigastric artery perforator flap (SIEA) is an alternative reconstructive option, with the compromise of less donor-site morbidity but variable perfusion to subscarpal fat zones. Fat necrosis is a known complication from marginal perfusion variability. Volumetric analysis of fat necrosis has not been performed between the two reconstructive options, nor has the amount of flap necrosis following radiation. Our objective was to compare rates and volume of fat necrosis between single-perforator DIEP and SIEA flap techniques. A single-center, blinded, prospective cohort study of patients randomized between SIEA and DIEP breast reconstruction was conducted over 2 years (June 2011-July 2013). Inclusion criteria were women undergoing immediate reconstruction following mastectomy. Randomization protocols were strictly followed. Fat necrosis volumetric analysis was determined by an ultrasound-trained attending surgeon at 12 months postoperatively. Patient demographics and adjuvant/neoadjuvant cancer treatment were analyzed. Statistical analyses included Mann-Whitney U tests, chi square, and/or Fisher exact tests. P values of 0.05 or less were considered significant. Fat necrosis was detected in 11 of 46 flaps (23.9%), with a median area of 17.9 cm2. There was no significant difference in prevalence of fat necrosis between the two flap types (P = 0.19). Postoperative radiation did not increase the prevalence (P = 0.30) or extent (P = 0.92) of fat necrosis. Single-perforator DIEP and SIEA flaps have comparable rates of fat necrosis. Postoperative radiation did not result in increased prevalence or extent of fat necrosis.

398. DYSPHAGIA OR REGURGITATION AND ITS CORRELATES AMONG UP TO 10-YEAR ESOPHAGEAL SQUAMOUS CELL CARCINOMA SURVIVORS

Abstract Background Dysphagia and regurgitation significantly impair the quality of life among survivors of esophageal squamous cell carcinoma (ESCC). Notably, the prevalence and associated factors of these symptoms in long-term survivors, particularly within Asian populations, remain underexplored. This study endeavors to bridge these critical knowledge gaps. Methods We evaluated the severity of dysphagia and regurgitation (mild, moderate, and severe), and their associations with clinical features and lifestyle factors among 512 10-year ESCC survivors who underwent ESCC radical surgery. Demographic, clinical, and lifestyle information was collected at study enrollment, which occurred 6 months post-surgery, and dysphagia and regurgitation was assessed at the 10-year post-surgery follow-up survey. Results In this study, 13.3% and 27.0% of participants reported dysphagia and regurgitation, respectively. Multivariable polytomous regression analysis revealed a significant association of dysphagia with upper thoracic esophageal carcinoma (mild dysphagia OR: 2.371, 95% CI: 1.051, 5.347) and postoperative radiotherapy and chemotherapy (mild dysphagia OR: 4.352, 95% CI: 2.168, 8.732; moderate/severe dysphagia OR: 3.651, 95% CI: 1.046, 12.745). An inverse relationship was observed between dysphagia and dietary quality as measured by the CHFP-2007 score (mild dysphagia OR: 0.458, 95% CI: 0.341, 0.615; moderate/severe dysphagia OR: 0.168, 95% CI: 0.089, 0.316). For regurgitation, positive associations were found with higher income level (mild regurgitation OR: 2.074, 95% CI: 1.020, 4.216), insomnia (moderate/severe regurgitation OR: 3.523, 95% CI: 1.127, 11.010), and use of Chinese patent medicine (mild regurgitation OR: 2.264, 95% CI: 1.279, 4.007). Conversely, age at surgery (moderate/severe dysphagia OR: 0.907, 95% CI: 0.848, 0.970) and higher dietary quality (mild dysphagia OR: 0.744, 95% CI: 0.606, 0.914; moderate/severe dysphagia OR: 0.406, 95% CI: 0.259, 0.634) showed protective effects against regurgitation. Conclusions The prevalence of dysphagia and regurgitation among long-term survivors of ESCC in China is high, underscoring a significant health concern. This study identifies critical correlates such as the tumor's anatomical site, the nature of postoperative interventions, dietary quality, socioeconomic standing, and concurrent health issues. These findings advocate for the integration of postoperative management approaches, including tailored dietary and lifestyle adjustments, aimed at mitigating these symptoms in long-term ESCC survivors.

Impact of Radiation Therapy on Serum Humanin and MOTS-c Levels in Patients with Lung or Breast Cancer.

Lung and breast cancer are the most frequent causes of death from cancer globally. The objectives of this research were to evaluate the serum mitochondrial open reading frame of the 12S rRNA-c (MOTS-c) and humanin levels in lung or breast cancer patients, and investigate the impacts of radiation therapy on the circulating levels of these peptides. 35 lung cancer patients, 34 breast cancer patients, and healthy volunteers as a control group were recruited in this prospective observatory research. Lung cancer patients with stage IIIA/IIIB were treated with paclitaxel-based chemotherapy plus radiotherapy (2 Gy per day, 30 times, 60 Gy total dose). Breast cancer stage IIA/IIB patients were treated with postoperative locoregional radiation therapy (2 Gy per day, 25 times, 50 Gy total dose). The ELISA method was used to detect serum humanin and MOTS-c levels during, before, and after radiotherapy. We observed marked elevations in circulating MOTS-c, but not humanin levels in patients with lung cancer (P < 0.001). Radiation therapy led to a marked augmentation in MOTS-c levels in these patients (P < 0.001). On the other hand, there was a marked decline in humanin, but not MOTS-c, levels in breast cancer patients (P < 0.001). Our research has shown, for the first time, that increased MOTS-c and decreased humanin levels play a role in lung cancer and breast cancer, respectively. Additionally, radiotherapy modifies MOTS-c levels in patients with lung, but not breast cancer.

Neurološki simptom kao prvi znak kolorektalnog karcinoma

Aim: To present a rare case of a patient with an isolated brain metastasis from colorectal carcinoma in whom an extensive diagnostic workup failed to identify the primary tumour. Case report: A 73-year-old female patient was admitted to the Neurology Department due to weakness in the right side of her body. Imaging with multislice computed tomography (MSCT) and brain magnetic resonance (MR) confirmed an expansive lesion in the left frontal region with surrounding oedema. Radiological findings suggested either a metastasis or a high-grade primary glioma. As the diagnostic workup did not reveal the primary tumour, the patient was transferred to Clinical Hospital Dubrava for surgical treatment. An intracranial tumour resection was performed with a histopathological confirmation of colon carcinoma metastasis. Postoperative brain irradiation was administered. A positron emission tomography scan (PET) showed focal accumulation of radioisotopes without clear pathological substrate in the appendix and cecoascedent junction area. Repeated colonoscopy did not find any pathological mucosal changes. The patient declined systemic treatment. Overall survival was 11 months, in line with literature data. Conclusion: The diagnosis of brain metastases from colorectal carcinoma is very rare, and even rarer is the diagnosis of isolated brain metastases without extracranial progression, counting for &amp;lt;0.5%. Therapeutic options for brain metastases from colorectal carcinoma include surgery, radio-neurosurgery, stereotactic radiotherapy, and brain irradiation. In our opinion, diagnostic evaluation of the central nervous system in patients with colorectal carcinoma should be considered if the patient has neurological symptoms or if there is an increase in carcinoembryonic antigen (CEA) levels without signs of extracranial disease progression.

150 Outcomes and Characteristics of Patients Receiving Pre-Operative Versus Post-Operative Radiation Therapy for Sinonasal Squamous Cell Carcinoma

150 Outcomes and Characteristics of Patients Receiving Pre-Operative Versus Post-Operative Radiation Therapy for Sinonasal Squamous Cell Carcinoma

Immediate Implants in Fibulas: Does the Implant to Fibula Osteotomy Distance Impact Early Implant Failure?

BackgroundWhen placing dental implants in the free fibula flap, the osteotomy cut edge poses a unique challenge in that an optimal distance has not yet been established. PurposeThe study aimed to measure the association between implant-to-fibula osteotomy edge distance and early implant failure in patients who received free fibula flap reconstruction with immediate implants. Study DesignA retrospective cohort study was designed and implemented. The study population was composed of patients who underwent free fibula flap transfer with immediate dental implant placement for the treatment of benign or malignant conditions of the head and neck from 2015 to 2022 at John Peter Smith Hospital. Subjects were excluded if the implant was in the middle of the free flap bordered by adjacent implants, was >10mm from the osteotomy edge, or had insertional torque values of ≤30 Ncm. Predictor VariablePrimary predictor variable was the implant distance in millimeters from the fibula osteotomy edge. Outcome VariablePrimary outcome variable was early implant failure, defined as implant exfoliation noted by the patient or failure due to implant movement or pain necessitating explantation within 6 months of placement. CovariatesThe covariates were age, sex, diabetes diagnosis, American Society of Anesthesiologists classification, smoking status, history of head and neck radiation, pathology treated, and if postoperative radiation treatment was received. AnalysesA generalized estimating equations (GEE) model was used to assess the relation between the primary predictor and outcome. A p-value of <0.05 was considered statistically significant. ResultsThe sample was composed of 48 subjects who had 130 implants placed, with early failures occurring in 5 implants (3.9%) in 3 subjects. The mean age of the sample was 49 years (SD 20) and 29 (60%) were male. The mean implant distances for early failures and non-failures were 3.5 mm (SD 1.04) and 4.3 mm (SD 1.5), respectively. There was a statistically significant relation between implant distance and early implant failure (P = .005, OR 0.6, 95% CI 0.39 to 0.85). ConclusionsThis study found that shorter distances between the implant and the edge of the fibula osteotomy are associated with early implant failure.

Adjuvant modern radiotherapy in resected pN2 NSCLC patients: results from a multicentre retrospective analysis on acute and late toxicity on behalf of AIRO thoracic oncology study group: the RAC-TAC study.

Recently, the PORT-C and LUNG-ART trials, which evaluated the role of postoperative radiation therapy (PORT), have significantly altered the treatment landscape for NSCLC pN2 patients who previously underwent surgery. In response, the Italian Association of Radiotherapy and Oncology Thoracic Oncology study group has initiated an observational multicenter trial to assess both acute and late toxicities of PORT in pN2 NSCLC patients treated with modern techniques. Data on NSCLC patients submitted to PORT after radical surgery treated between 2015 and 2020 in six Italian Centers were collected. Heart, lung, and esophageal acute and late toxicities have been retrospectively analyzed and related to radiation therapy dosimetric parameters. Furthermore, loco-regional control, distant metastasis and overall survival have been analyzed. A total of 212 patients with a median age of 68years from six different centers were included in this analysis (142 males and 70 females). Prior to undergoing PORT, 96 patients (45.8%) had a history of heart disease, 110 patients (51.9%) had hypertension, and 51 patients (24%) had COPD. Acute toxicity was observed in 147 patients (69.3%), with lung toxicity occurring in 93 patients (G1 in 70 patients, G2 in 17 patients, and G3 in 4 patients), esophageal toxicity in 114 patients (G1 in 89 patients, G2 in 23 patients, and G3 in 1 patient), and cardiac toxicity in 4 patients (G1 in 2 patients and G3 in 2 patients). Late side effects were found in 60 patients (28.3%), predominantly involving the lungs (51 patients: 32 G1, 11 G2, and 1 G3) and the esophagus (11 patients: 8 G1 and 3 G2), with no reported late cardiac side effects. Various clinical and dosimetric parameters were found to correlate with both acute and chronic toxicities. Over a median follow-up period of 54months, 48 patients (22.6%) showed locoregional disease relapse, 106 patients (50%) developed distant metastases, and 66 patients (31.1%) died. RAC-TAC retrospective multicentric study showed the low toxicity of PORT when advanced technology is used. At the same time, it's noteworthy to underline that 50% of the patients develop distant recurrences in the follow up.

Comparing long-term prognosis following different surgical methods in patients with early stage breast cancer and obesity: a retrospective cohort study in China

ObjectiveBreast-conserving therapy (BCT) includes breast-conserving surgery (BCS) combined with radiation therapy (RT). RT plays a crucial role in improving the prognosis of patients who undergo BCS. However, obesity is a...

2527: Evaluation of prognostic factors in patients with oral tongue cancer treated with postoperative RT

2527: Evaluation of prognostic factors in patients with oral tongue cancer treated with postoperative RT

1823: Post-operative keloids irradiation (POKER): surgery/high-dose brachytherapy is a winning hand?

1823: Post-operative keloids irradiation (POKER): surgery/high-dose brachytherapy is a winning hand?

591: Intra- or postoperative radiotherapy for brain metastases: impact on time to next treatment

591: Intra- or postoperative radiotherapy for brain metastases: impact on time to next treatment