Radiation Theraphy Research Articles

The interplay between cancer associated fibroblasts and immune cells in the context of radiation therapy.

Fibroblasts are a key component of the tumor microenvironment (TME) that can serve as a scaffold for tumor cell migration and augment the tumor's ability to withstand harsh conditions. When activated by external or endogenous stimuli, normal fibroblasts become cancer associated fibroblasts (CAFs), a heterogeneous group of stromal cells in the tumor that are phenotypically and epigenetically different from normal fibroblasts. Dynamic crosstalk between cancer cells, immune cells, and CAFs through chemokines and surface signaling makes the TME conducive to tumor growth. When activated, CAFs promote tumorigenesis and metastasis through several phenomena including regulation of tumor immunity, metabolic reprogramming of the TME, extracellular matrixremodeling and contraction, and induction of therapeutic resistance. Ionizing radiation (radiation theraphy [RT]) is a potent immunological stimulant that has been shown to increase cytotoxic Teff infiltration and IFN-I stimulated genes. RT, however, is unable to overcome the infiltration and activation of immunosuppressive cells which can contribute to tumor progression. Another paradox of RT is that, while very effective at killing cancer cells, it can contribute to the formation of CAFs. This review examines how the interplay between CAFs and immune cells during RT contributes to organ fibrosis, immunosuppression, and tumor growth. We focus on targeting mechanistic pathways of CAF formation as a potentially effective strategy not only for preventing organ fibrosis, but also in hampering tumor progression in response to RT.

P06.03 * CASE REPORT OF A METASTASIS OF SQUAMOUS CELL LUNG CARCINOMA INTO AN INTRACRANIAL MENINGIOMA

INTRODUCTION: Rare cases of tumor-to-meningioma metastases have yet been reported before. Cancer metastasis into a meningioma is a rare and often incidential finding. The most commonly reported malignancies are breast and lung cancer. Meningiomas are the most common intracranial lesion to host metastatic tissue and meningiomas seem to provide a favorable environment for metastatic seeding. Several factors responsible for tumor metastasis into meningioma have been proposed :meningiomas are highly vascular and also grow slowly. In addition their high collagen and lipid content seems to be supportive to the seeding and growing of malignant cells. Also, meningeomas express binding proteins which may also play a role in metastatic seeding. CASE REPORT: A 73-year-old woman was admitted because of progression with a 3-week history of her former of left sided arm weakness. She had undergone a right upper lobectomy for poorly differentiated sqamous cell carcinoma of the lung 3 months ago. An MRI scan of the brain revealed a lesion the size of 3.5 cm on the right parietal side. It was adhering to the dura mater, which suggested an extraaxial origin of the tumor and meningeoma was suggested. The lesion showed significant contrast agent uptake and was surrounded by peritumoral edema. A surgical removal of the lesion was performed. Histologic analysis showed a secretory meningioma (WHO grade I) highly infiltrated with metastatic cancer cells of a poor-differentiated squamous cell carcinoma. The focus within the meningeoma stained positive for p16, CK 5/6, p63/HMW-CK, CK AE 1/3 and negative for TTF-1, Ki-67. The patient was treated with postoperative cerebral radiation theraphy. A CT staging of the chest and abdomen was performed and revealed new blastomatoid lesions of the lung, liver and the left adrenal gland. The general condition of the patient deteriorated fast in the following weeks and she died two months after surgery as a result of the reactivation of the malignant squamous cell lung carcinoma. DISCUSSION: The phenomenon of tumor to tumor metastasis is defined by two criteria: The metastatic focus must be encased by a rim of histologically distinct tumor tissue and a proven primary carcinoma that is compatible with the metastasis. In this patient, an intracranial meningeoma was the target for the seeding of a malignant systemic cancer. Given the comparatively large number of patients with meningeoma and even larger number of persons with cancer this coincidence could be seen higher than reported. The practical issue is to identify future factors to identify patients with cancer metastasis into meningioma to improve therapeutic strategies.

P5-14-19: Ipsilateral Breast Tumor Recurrence Prediction with Web-Based Normogram in Korea.

Abstract Purpose Ipsilateral Breast Tumor Recurrence(IBTR!) 2.0 is web-based tool which predict the ten years risk of local recurrence after breast conserving theraphy. This tool integrates seven prognostic factors (patient age, margin status, lymphovascular invasion, tumor size, tumor grade, use of chemotherapy and hormonal therapy) for local recurrence with or without radiation theraphy. To validate IBTR! 2.0 for Korean breast cancer patients, Samsung Medical Center database was used between 1994 and 2001. Methods The IBTR! 2.0 nomogram was tested against 358 patients who underwent breast conserving surgery with radiation theraphy from Samsung Medical Center between 1994 and 2001. The individual dadabase which was entered into IBTR! 2.0 computer model generate predictive local recurrence rate. The mean predicted and observed 10-year estimates were compared for the entire cohort and for four groups predefined by nomogram-predicted risks: group 1: less than 3%; group 2: 3% to 5%; group 3: 5% to 10%; and group 4: more than 10%. Results IBTR! version 2.0 predicted an overall 10-year IBTR estimate of 5.5% (95% CI, 5.2 to 5.9), while the observed estimate was 7.69% (20 IBTR cases in 358 patients, 95% CI, 1.6 to 9.3; P=0.59). The predicted and observed IBTR estimates were: group 1 ( 2 cases in 67 patients): 2.3% versus 2.9%, P=0.53; group 2 (2 cases in 124 patients)): 3.9% versus 4.1%, P=0.18; group 3 (14 cases in 139 patinets): 7.3% versus 4.8%, P=0.13; and group 4 (2 cases in 28 patients): 12.15% versus 7.1%, P=0.61. Conclusion IBTR! 2.0 is acceptable nomogram for predicting 10 years local recurrence using Samsung medical Center database. This nomogram showed overestimation in group 3, 4, however did not showed statistical differences. This nomogram may assist patient counseling and medical decision making, but prior to using whole Korean patients, this model requires validation with multiple Korean sources.

방사선학과 대학원 교육의 국내외 현황 및 분석

The impotance of Radiological science is greater due to development of Science and technology in Medical and Engineering. people who research specific area thought interdisciplinary approach, convergence is essential to pioneer a new field, receive attention was that interdisciplinary approach was needed. so investigating graduate system of radiological science, advanced country, designed to fit their country, could propose reference. the results show, in the university of offered with Master Degree operated program for Clinical experts(Sonography Specialist, Radiation Theraphy Specialist and Nuclear Medicine Specialist)and offered with Ph.D Degree operated program for Scientist and physicist (Nuclear Scientist, Medical Physicist). Note that by this, advanced graduate school program will enable us to become a reader of academia, play a leading role in the world.

SU-GG-T-71: Dosimetric Comparison of Bone Marrow-Sparing Intensity Modulated Radiation Theraphy Versus Conventional Techniques for the Treatment of Cervical Cancer

Purpose: To compare bone marrow‐sparing intensity modulated pelvic radiation therapy (BMS‐IMRT) to conventional (AP/PA and 4‐field box) techniques in the treatment of cervical cancer.Method and Materials: Seven cervical cancer patients treated with concurrent chemotherapy and IMRT were analyzed. We compared BMS‐IMRT to AP/PA and 4‐field box plans. All plans were normalized to cover PTV with the 99% isodose line. The clinical target volume (CTV) consisted of the pelvic and presacral lymph nodes, uterus and cervix, upper vagina, and parametrial tissue. A 1.0 cm uniform margin was added to create the PTV. Normal tissues included bowel, bladder, and pelvic bone marrow (PBM), which comprised the lumbosacral spine (LSBM), ilium (IBM), and ischium, pubis, and proximal femora (lower pelvis bone marrow — LPBM). Dose volume histograms for PTV and normal tissues were compared for BMS‐IMRT vs. 4‐field box and AP/PA plans. Results: BMS‐IMRT was superior to 4‐field box in reducing the dose to PBM, small bowel, rectum and bladder. Compared to AP/PA, BMS‐IMRT reduced the PBM volume receiving a dose above 16.4 Gy, however, that receiving below this threshold dose was increased. BMS‐IMRT reduced IBM, LPBM and bowel radiation above 27.7 Gy, 18.7 Gy, and 21.1 Gy, respectively, but increased dose below these thresholds, compared to AP/PA plans. BMS‐IMRT reduced the volume of LSBM, rectum, small bowel, and bladder at all dose levels in all 7 patients. Conclusion: BMS‐IMRT reduced irradiation of PBM compared to 4‐field box techniques. Compared to AP/PA, BMS‐IMRT reduced LSBM irradiation and reduced the volume of PBM irradiated to high doses, but increased that irradiated to low doses. BMS‐IMRT may reduce acute HT compared to conventional techniques.

Comparative Analysis of Patterns of Care Study of Radiotherapy for Esophageal Cancer among Three Countries: South Korea, Japan and the United States

†‡ † Purpose: For the first time, a nationwide survey of the Patterns of Care Study (PCS) for the various radiotherapy treatments of esophageal cancer was carried out in Sout h Korea. In order to observe the different parameters, as well as offer a solid cooperative system, we compared the Korean results with those observed in the United States (US) and Japan. Materials and Methods: Two hundreds forty-six esophageal cancer patients from 21 institutions were enrolled in the South Korean study. The patients received radiation ther aphy (RT) from 1998 to 1999. In order to compare these results with those from the United States, a published study by Suntharalingam, which included 414 patients [treated by Radiotherapy (RT)] from 59 institutions between 1996 and 1999 was chosen. In order to compare the South Korean with the Japanese data, we choose two different studies. The results published by Gomi were selected as the surgery group, in which 220 esophageal cancer patients were analyzed from 76 facilities. The patients underwent surgery and received RT with or without chemotherapy between 1998 and 2001. The non-surgery group originated from a study by Murakami, in which 385 patients were treated either by RT alone or RT with chemotherapy, but no surgery, between 1999 and 2001. Results : The median age of enrolled patients was highest in the Japanese non-surgery group (71 years old). The gender ratio was approximately 9：1 (male：female) in both the Korean and Japanese studies, whereas females made up 23.1% of the study population in the US study. Adenocarcinoma outnumbered squamous cell carcinoma in the US study, whereas squamous cell carcinoma was more prevalent both the Korean and Japanese studies (Korea 96.3%, Japan 98%). An esophagogram, endoscopy, and chest CT scan were the main modalities of diagnostic evaluation used in all three countries. The US and Japan used the abdominal CT scan more frequently than the abdominal ultrasonography. Radiotherapy alone treatment was most rarely used in the US study (9.5%), compared to the Korean (23.2%) and Japanese (39%) studies. The combination of the three modalities (Surgery+RT+Chemotherapy) was performed least often in Korea (11.8%) compared to the Japanese (49.5%) and US (32.8%) studies. Chemotherapy (89%) and chemotherapy with concurrent chemoradiotherapy (97%) was most frequently used in the US study. Fluorouracil (5-FU) and Cisplatin were the most preferred drug treatments used in all three countries. The median radiation dose was 50.4 Gy in the US study, as compared to 55.8 Gy in the Korean study regardless of whether an operation was performed. However, in Japan, different median doses were delivered for the surgery (48 Gy) and non-surgery groups (60 Gy). Conclusion : Although some aspects of the evaluation of esophageal cancer and its various treatment modalities were heterogeneous among the three countries surveyed, we found no remarkable differences in the RT dose or technique, which includes the number of portals and energy beams.

Computer assisted radiation theraphy

Computer assisted radiation theraphy

Temporal bone Manifestations of Eosinophilic Granuloma

Eosinophilic granuloma is one of the triad of conditions collectively known as Histiocytosis-X. It is an uncommon granulomatous diseas which can affect the temporal bone(1) Allthough initially quiescent the disease may erode the mastoid cortex, destroy tegmen and extend into the cranial as well as erode the semicircular canals, cochlea or facial canal, giving rise to facial palsy. These lesions almost always become infected and can confused with chronic otomastoiditis. When diagnosed, theraphy consists of conservative surgery, radiation theraphy, steroids and chemotherapy(2).

35 Salvage whole abdominal radiation theraphy for ovarian cancer: A twelve year experience

35 Salvage whole abdominal radiation theraphy for ovarian cancer: A twelve year experience

104.放射線治療時の頭頸部の固定と治療範囲認識装置の開発

104.放射線治療時の頭頸部の固定と治療範囲認識装置の開発

Radiation theraphy treatment planning: an [formula omitted]2 approach

We formulate the radiation theraphy treatment planning (RTTP) problem as constrained optimization in L 2. This is accomplished by first describing the dose operator as a bounded operator from “Treatment Space” into “Patient Space”—both suitable L 2 spaces. Within this context we examine two problems of interest in RTTP. First, we take the case where the sources of radiation are fixed a priori and provide algorithms which lead to the optimal choices of beam profiles for these sources. Secondly, we look at the problem of simultaneously choosing the sources and beam profiles and also suggest an algorithm for this case.

Radiation enhances tumor necrosis factor α production by murine brain cells

Astrocytes and microglial cells cultured from murine brain were stimulated to produce tumor necrosis α (TNF) by exposure to lipopolysaccharide (LPS). TNF α production began within 2 h with maximum production between 4 and 8 h after atimulation. Clinically relevant low (2 Gy), but not high (8 Gy), doses of radiation significantly increased TNF production by astrocytes and microglial cells in response to LPS. The radiation effect was even more marked with multiple 2 Gy doses. TNF is cytotoxic for oligodendrocytes and for certain tumor cells. It increases vascular permeability and enhances immune responses as well as having biological effects. It is conceivable that production of TNF by astrocytes and microglial cells during clinical radiation theraphy might influence the responses of tumor and/or normal CNS tissues.

BOOK REVIEWS

Journal Article BOOK REVIEWS Get access Radiation Oncology: Radiobiological and Physiological Perspectives . Hassan K. Awwad . Dordrecht, The Netherlands : Kluwer Academic Publishers , 1990 , 682 pp. $175. THEODORE S. LAWRENCE THEODORE S. LAWRENCE Department of Radiation Theraphy University of Michigan Medical CenterDr UH-Rm B2C490/0010 Ann Arbor, MI 48109 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 83, Issue 7, 3 April 1991, Pages 507–508, https://doi.org/10.1093/jnci/83.7.507-a Published: 03 April 1991

132. 紫外線を用いた頭頚部治療用マーキングシステム(装置・器具)

132. 紫外線を用いた頭頚部治療用マーキングシステム(装置・器具)

The Ocular Effects of Intracarotid Bromodeoxyuridine and Radiation Theraphy in the Treatment of Malignant Glioma

Since July 1985, 23 patients have been entered into a phase I/II clinical trial using intraarterial 5-bromodeoxyuridine (BUdR) (400–600 mg/m2 daily for 8.5 weeks) and focal external beam radiotherapy (59.4 Gy at 1.8 Gy daily in 6.5 weeks) in the treatment of malignant gliomas (Kernohan grades 3 and 4). The side effects in all patients have included varying degrees of anorexia, fatigue, ipsilateral forehead dermatitis, blepharitis, and conjunctivitis. Mucopurulent conjunctivitis and exposure keratitis developed in several patients and spontaneous corneal perforation developed in one. Eyes from two individuals examined at autopsy showed significant changes. Animal studies that predated clinical trials using rhesus monkeys did not predict the ophthalmologic complications seen in human subjects.

132. 紫外線を用いた頭頚部治療用マーキングシステム

132. 紫外線を用いた頭頚部治療用マーキングシステム

Tumor oxygenation and reoxygenation during radiation theraphy: Their importance in predicting tumor response

The degree of oxygenation of a tumor is a major determinant of the effectiveness of radiotherapy. From animal experiments, it is known that hypoxia is common in tumors, that there can be marked heterogeneity in cellular oxygenation within a given tumor, and that the hypoxic fraction is influenced by tumor size and site. The three methods used in obtaining such information are discussed. They are not applicable to tumors in man, but other kinds of evidence suggest qualitatively that the patterns of oxygenation in human tumors are not dissimilar to those in animals. Reoxygenation of animal tumors appears to proceed rapidly after single conditioning radiation doses, but its rate and extent depend upon the size and scheduling of the conditioning dose(s). The importance of reoxygenation in determining the outcome of fractionated radiotherapy may be inferred from the results of recent tumor growth delay experiments wherein we have found that reoxygenation in the RIF-I sarcoma is nearly complete by 24 hr. after the completion of 5 daily 5 Gy fractional doses.

T lymphocyte subsets and NK cells in patients with malignant head and neck tumors--analysis using the FACS

Peripheral blood lymphocytes (PBL) on T lymphocyte subsets and NK cells in 46 patients with head and neck malignant tumors were examined. These PBL were determined in Fluores-cence Activated Cell Sorter (FACS) using fluorescein-conjugated monoclonal antibodies (anti-Leu 2a, anti-Leu 3a, anti-Leu 11a). Granulocytes, which are also known to be Leu 11a positive, were preeliminated by 90-size scattering procedure.The results obtained. were as follow:1. Leu 3a/Leu 2a ratio in patients with head and neck malignant tumor wass significantly reduced compared with healthy controls. (p<0.005)2. Patient in the stage differences(UICC), Leu 3a/Leu 2a ratio in stage III, IV groups was also reduced compared with stage I, II groups, (P<0.05)3. Leu 3a/Leu 2a ratio in chemotheraphy patients was also reduced compared with radiation theraphy patients. (p<0.05) The ratio of about 50% chemotheraphy patients were lower than one.4. Leu 11a positive cells in patients was markedly increased than healthy controls. (p<0.005)

High fractional dose radiation theraphy of stage III and IV carcinoma of the head and neck

High fractional dose radiation theraphy of stage III and IV carcinoma of the head and neck

Clinical Radation TheraphyClinical Radiation Theraphy. By KaplanIra I., M.D., F.A.C.R., Clinical Professor of Radiology, New York University Medical College; Attending Radiation Therapist, Beth-David Hospital, New York; Director, Radiation Therapy Department, Bellevue Hospital, New York. Second Edition. A volume of 844 pages, with 614 illustrations. Published by Paul B. Hoeber, Inc., New York, 1949. Price $15.00.

Clinical Radation Theraphy<scp>Clinical Radiation Theraphy</scp>. By KaplanIra I., M.D., F.A.C.R., Clinical Professor of Radiology, New York University Medical College; Attending Radiation Therapist, Beth-David Hospital, New York; Director, Radiation Therapy Department, Bellevue Hospital, New York. Second Edition. A volume of 844 pages, with 614 illustrations. Published by Paul B. Hoeber, Inc., New York, 1949. Price $15.00.