Total Cancer Research Articles

Radiofrequency ablation of the hip: review.

Radiofrequency ablation (RFA) of the articular branches of the femoral and obturator nerves (the innervation of the anterior capsule of the hip) is an emerging treatment for chronic hip pain. Body mass index (BMI) greater than 30, older age, large acetabular/femoral head bone marrow lesions, chronic widespread pain, depression, and female sex increase the risk of developing hip pain. Chronic hip pain is a common condition with a wide range of etiologies, including hip osteoarthritis (OA), labral tears, osteonecrosis, post total hip arthroplasty (THA), post-operative dislocation/fracture, and cancer. The most common and well studied is hip OA. Management of chronic hip pain includes conservative measures (pharmacotherapy and exercise), surgery, and percutaneous procedures such as RFA. While surgery is effective, those whose medical comorbidities preclude surgery, those who do not wish to have surgery, and those whose pain persists after surgery (11-36% of patients) could benefit from RFA. Because of the aforementioned circumstances, hip RFA is often a palliative intervention. Hip RFA is an effective treatment, one recent retrospective study of 138 patients found 69% had >50% pain relief at 6 months. The most frequent adverse event reported for hip RFA is pain from needle placement. No serious bleeding events have been reported, despite the valid concern of the procedure's proximity to vasculature. This descriptive review details the pathophysiology of hip pain, its etiologies, its clinical presentation, conservative management, the anatomy/technique of hip RFA, hip RFA efficacy, and RFA adverse events.

Assessment of Heavy Metal Contamination and Potential Health Risk of Selected Fish Species in Dhaka District

Fish is a rich source of quality protein and fatty acids. Bangladesh's average daily fish consumption is 67.8 grams per people. Fish species are also prone to heavy metal contamination from their surrounding environment. The main objective of this research was to assess the degree of risk associated with the consumption of various fish species in Dhaka, Bangladesh. Three fish species—Tilapia (Oreochromis mossambicus), Shorputi (Systomus sarana), and Mola (Amblypharyngodon mola)—from three local markets in Savar Union, Dhaka, Bangladesh, were selected for analysis. The Kjeldahl technique, Folch method, and several formulae were used to determine the protein, fat, ash, and moisture content for the proximate analysis. The concentration of heavy metals was determined using Atomic Absorption Spectrophotometry (AAS). The estimated daily intake (EDI), target hazard quotient (THQ), total target hazard quotient (TTHQ), hazard index (HI), and cancer risk (CR) were used to evaluate the danger to human health. Tilapia had the highest moisture and lipid content, whereas Shorputi and Mola had the highest protein and ash contents, ranging from 20.77% to 18.16%, respectively. The mean concentration of heavy metals in fish was determined to be Pb>Ni>Cr>Cd in this study. Every fish species had extremely high levels of lead (Pb), with the Shorputi fish having the highest levels. Fish from the Shorputi species had the highest EDI value. Pb>Ni>Cr>Cd was the trace element EDI for adults. Among all species, only Pd had a THQ value higher than 1. The CR value across all species were within E-3 and E-6 range, while the HI value was >1. In conclusion, the highest average Pb concentrations were detected in Shorputi, while the highest amounts of Cd, Cr, and Ni were observed in Tilapia. The findings of this study recommended that the Bangladeshi government regularly assess the levels of dangerous heavy metal and metalloid contamination in the daily meals of its citizens in order to enforce regulatory limits and determine the likelihood of long-term exposure. Bioresearch Commu. 10(2): 1524-1531, 2024 (July)

Progress of Clinical Research on Treatment of Lower Limb Lymphedema after Cervical Cancer Surgery

Cervical cancer is one of the most common gynecological malignant tumors, the early stage often without obvious symptoms and signs, with the development of lesions, clinical will appear to vaginal bleeding and vaginal drainage of the main symptoms, and according to the cancer focus of the scope of frequent urination urgent, constipation, lower limb swelling pain and a series of secondary symptoms. Not only that, according to the survey research shows that China's cervical cancer mortality accounted for the fourth of the total cancer mortality, accounting for the second female cancer, and the average age of cervical cancer patients in China to 40~50 years old. Surgical treatment, radiotherapy, chemotherapy, targeted therapy and immunotherapy are important methods for the treatment of cervical cancer. Complications may also occur during treatment, such as urinary tract infections, urinary retention, deep vein thrombosis and lymphedema of the lower extremities. Among them, lower extremity lymphedema is the most common and tricky, according to a foreign study found that the incidence of lower extremity lymphedema in patients with cervical cancer is as high as 47%, the main clinical manifestations of swelling, heavy, stinging, numbness, coarsedness and hardening, serious joint dysfunction, difficulty in activity, and even more, can cause erysipelas and cellulitis. Because it is incurable for a long time, the quality of life of patients is seriously reduced. In recent years, for the treatment of lower limb lymphedema after cervical cancer surgery, there are no safe and effective drugs in modern clinical medicine. Despite various treatment methods, its efficacy is still controversial. Therefore, most patients with lymphedema cannot receive effective treatment. Traditional Chinese medicine believes that the disease is mainly characterized by "mixed good and evil, deficiency and deficiency", so the treatment advocates the principle of "attack and tonification, specimen treatment", and its treatment methods are diverse and effective. This article discusses the treatment methods of lower limb lymphedema after cervical cancer surgery, and concludes that the combined treatment of traditional Chinese and Western medicine is effective.

Concentrations and Health Risk Valuation of Possibly Toxic Metals in Soil and Sediment in Parts of Ona River, Ibadan, Nigeria

The accumulation of contaminants in the soils and sediments may negatively affects people within the vicinity of Ona River and increase potential of human health risk. This study appraised the concentration status, probable origins and human health risks of some possibly toxic elements (Fe, Cu, Zn, Mn, Pb and Cd) in the riverbank soils (RBK) and riverbed sediments (RBS) of Ona River section bordering residential community in Ibadan, Southwest Nigeria. Therefore, six composite samples of RBK and RBD were analyzed for heavy metals using atomic absorption spectrophotometry (AAS). Enrichment factor (EF) and quantification of contamination (QoC) are used to examine potential origins of tested metals. Furthermore, hazard index (HI) and total cancer risk (TCR) have been utilized to evaluate the extent of non-carcinogenic and cancer risks of studied metals to inhabitants of the study site. The results of metal contamination assessment revealed low concentration <1.0 mg/kg for each analyzed metal in both RBK and RBD while EF and QoC advocate lithogenic origins of assessed metals with little or none anthropogenic inputs in both studied soils and sediments. The computed HI values were lower than 1.0 and thus no adversative health effects on adults and children via ingestion, skin contact and inhalation routes. The CR computation exposed that adults and children are at growing risk of developing cancer over a lifetime when exposed to RBK and RBD via ingestion and dermal pathways. Cadmium contributed largely to TCRs among the assessed metals. The study indicates the inevitability of initiating actions that reduce exposure of residents to nearby soil and sediment and safeguard their health, particularly the children.

Disparities in Cancer Mortality among Disaggregated Asian American Subpopulations, 2018-2021.

Federal, state, and institutional data collection practices and analyses involving Asian Americans as a single, aggregated group obscure critical health disparities among the vast diversity of Asian American subpopulations. Using from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Causes of Death database, we conducted a cross-sectional study using data on disaggregated Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, other Asians) between 2018 and 2021. We examine deaths from 22 cancer types and in situ, benign neoplasms, identified using ICD-10 codes C00-C97 and D00-D48. Overall, our study comprised 327,311 Asian American decedents, with a mean age of death at 70.57years (SD=2.79), wherein females accounted for approximately half of the sample (n=36,596/73,207; 49.99%). Notably, compared to the aggregated Asian American reference group, we found higher proportions of deaths from total cancers among Chinese (25.99% vs. 22.37% [ref]), Korean (25.29% vs. 22.37% [ref]), and Vietnamese (24.98% vs. 22.37% [ref]) subgroups. In contrast, total cancer deaths were less prevalent among Asian Indians (17.49% vs. 22.37% [ref]), Japanese (18.90% vs. 22.37% [ref]), and other Asians (20.37% vs. 22.37% [ref]). We identified further disparities by cancer type, sex, and age. Disaggregated data collection and analyses are imperative to understanding differences in cancer mortality among Asian American subgroups, illustrating at-risk populations with greater granularity. Future studies should aim to describe the association between these trends and social, demographic, and environmental risk factors.

Trends and Patterns of Top Ten Common Cancers in Eastern India from 2014 to 2021: A Retrospective Hospital-based Cancer Registry Data Update.

India is a vast and diverse country with existing variations in the frequency and distribution of cancers across its various parts. In regions lacking population-based cancer registries (PBCRs) in a vast country like India, hospital-based cancer registry (HBCR) data become an important source of information on the trends and patterns of a region. To determine the numerical trends of cases of the top ten cancer sites reporting to HBCR of a tertiary care cancer center in Bihar from 2014 to 2021. The details of all histopathologically confirmed cancer cases registered in the HBCR department of radiation oncology, State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Patna, India between January 2014 and December 2021 were included in this retrospective observational study. All these cases were grouped site-wise and listed in descending order of the total number of cases reported in each group. Cross-tabulation with age and sex distribution was done. The frequency distribution of the top ten leading cancers for every consecutive calendar year was plotted in line diagrams for time trend analysis. Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.). was used for analysis. Annual percent change (APC) was determined for the number of cases of all ten cancer sites using joinpoint regression analysis (Joinpoint Regression Software, Version 4.0.4-May 2013; Statistical Methodology and Applications Branch, Surveillance Research Program of the US National Cancer Institute; Bethesda, MD, USA). Out of 32,057 total cancer cases registered between Jan 2014 and Dec 2021, 21,848 patients (68.2%) cases constituted the top ten cancers. The top ten cancers among both sexes were cancer gallbladder (n = 4204, 13.1%), head and neck (n = 3395, 10.6%), breast (n = 3392, 10.6%), lung (n = 2069, 6.5%), cervix (n = 2039, 6.4%), hematolymphoid (n = 1930, 6.0%), liver (n = 1572, 4.9%), stomach (n = 1116, 3.5%), ovary (n = 1103, 3.4%), and colon-rectum (n = 1028, 3.2%). Except for cervical and hematolymphoid cancers, the rest all showed a rising trend over consecutive years. Cancer of the gallbladder continues to be among the most common cancers in the region. Focused research in all aspects of this deadly disease is needed. Strengthening of prevention and screening programs for common cancers and upliftment of the existing infrastructure for diagnosis and treatment of cancer in the region are necessitated.

Occupational and human health risks of exposure to potentially toxic elements (PTEs) in top soils from steel fabrication workshops

IntroductionEnvironmental pollution caused by potentially toxic elements (PTEs) from anthropogenic sources has become a global concern due to its deleterious effect on humans and ecosystem health. Therefore, this study evaluated the concentrations of PTEs, pollution level and human health risk in topsoil from ten (10) steel fabrication workshops in Abeokuta, Ogun State, Nigeria. Materials and methodsTen (10) composite soil samples were collected in November 2023, from 10 different steel fabrication workshops in proximity to residence in Abeokuta, Ogun State, Nigeria. One (1) gram of processed sample was digested using aqua regia and PTE concentration estimated using atomic absorption spectrophotometer (AAS). Pollution index assessment was determined using enrichment factor (EF) and geo-accumulation index (I-geo) while descriptive statistics and correlation were subjected to statistical package for social sciences (SPSS). ResultsThe result showed that Iron (Fe) (11,500 – 42,100 mg kg−1), Lead (Pb) (10.7 – 583 mg kg−1), Chromium (Cr) (16.3 - 49.7 mg kg−1), Zinc (Zn) (34.6 – 343 mg kg−1), Manganese (Mn) (109 – 840 mg kg−1), Nickel (Ni) (2.23 - 25.3 mg kg−1), Copper (Cu) (16.6 -107 mg kg−1) and Cadmium (Cd) (2.23 - 25.3 mg kg−1) were present. Mean concentration for Pb (179±202 mg kg−1) is higher than the Canada soil guideline value (CSGV) (140 mg kg−1) while other PTEs are within the recommended limit. Pollution indices revealed EF (Cd and Pb) and I-geo (Cd) as the primary pollutants in the soil while the strong significant correlation between Cr, Cu and Mn p < 0.05. Cr, Ni, Pb and that of Cu, Mn, Ni, Pb, Zn p < 0.01 suggest an emanation from both geogenic and anthropogenic sources. Human health risk assessment revealed Fe as the most dosed PTE and ingestion as the major pathways of exposure especially to children being the most susceptible. Hazard index (HI) and total cancer risk (TCR) values for PTEs were <1 and within the acceptable threshold (1 × 10−6 – 1 × 10−4) except for Pb (3.93E+01; 1.16E-03) in adults respectively. ConclusionThe study showed that the topsoil from the steel fabrication workshop is polluted with Pb and Cu toxicity and the adult (residents and workers) population exposed to the soil is potentially at a non-cancer and cancer risk.

Measurement of Natural Radioactivity in Fly Ash from a Lignite-Fired Thermal Power Plant and Radiological Risk Assessment Using RESRAD Code

In this study, the activity concentrations of natural primordial radionuclides in fly ash (FA) samples collected from the landfill area of Afşin-Elbistan A lignite-fired thermal power plant (AE-A LFTPP) located in Kahramanmaraş province of Türkiye were measured using a gamma-ray spectrometer. Also, the radiological risk was assessed using the Residual Radioactivity Onsite 7.2 code. The average activity concentrations of 226Ra, 232Th and 40K in FA samples varied from 291 ± 10 to 853 ± 25 Bq/kg, 23 ± 1 to 125 ± 4 Bq/kg and 112 ± 10 to 315 ± 18 Bq/kg, respectively. The predicted maximum total annual effective dose rate due to the natural radionuclides and their progenies is 4.7, 4.4, and 4.0 mSv/y at t = 1000 y for 0.5-m, 1.25-m, and 2.0-m cover scenarios, respectively. While the predicted maximum total cancer risk is 4.56 × 10−3 (3.95 × 10−3 for 226Ra, 5.18 × 10−4 for 232Th and 6.14 × 10−15 for 40K), 4.00 × 10−3(3.80 × 10−3 for 226Ra, 1.90 × 10−4 for 232Th and 7.69 × 10−15 for 40K) and 3.71 × 10−3 (3.71 × 10−3 for 226Ra, 1.820 × 10−8 for 232Th and 7.66 × 10−15 for 40K) at t = 1000 y for 0.5-m, 1.25-m and 2.0-m cover scenario, respectively. Results also revealed that the total doses and cancer risks are less in thicker cover scenarios throughout the 1000 y time span and that 226Ra is the major contributor to the risk in all the scenarios owing to its higher activity concentration than 232Th and 40K.

Swimming benefits outweigh risks of exposure to disinfection byproducts in pools

Disinfection of swimming pool water is critical to ensure the safety of the recreational activity for swimmers. However, swimming pools have a constant loading of organic matter from input water and anthropogenic contamination, leading to elevated levels of disinfection byproducts (DBPs). Epidemiological studies have associated increased risks of adverse health effects with frequent exposure to DBPs in swimming pools. Zhang et al. (2023b) investigated the occurrence of trihalomethanes (THMs), haloacetic acids (HAAs), haloacetonitriles (HANs), and haloacetaldehydes (HALs) in eight swimming pools and the corresponding input water in a city in Eastern China. The concentrations of THMs, HAAs, HANs, and HALs in swimming pools were 1–2 orders of magnitude higher than those detected in the input water. The total lifetime cancer and non-cancer health risks of swimmers through oral, dermal, inhalation, buccal, and aural exposure pathways were assessed using the United States Environmental Protection Agency's (USEPA) standard model and Swimmer Exposure Assessment Model (SWIMODEL). The results showed that dermal and inhalation pathways were the most significant for the associated cancer and non-cancer risks. This article provides an overview and perspectives of DBPs in swimming pools, the benefits of swimming, the need to improve the monitoring of DBPs, and the importance of swimmers’ hygiene practices to keep swimming pools clean. The benefits of swimming outweigh the risks from DBP exposure for the promotion of public health.

Long-term endoscopic gastric mucosal changes up to 20 years after Helicobacter pylori eradication therapy

Helicobacter pylori eradication therapy reduces the risk of gastric cancer. However, it is unclear whether the severity of risk factors for gastric cancer such as atrophy and intestinal metaplasia are reduced after eradication in the long term. We aimed to study long-term changes in endoscopic risk factors for gastric cancer up to 20 years post-eradication. The endoscopic severity of gastritis according to the Kyoto Classification of Gastritis in 167 patients was retrospectively evaluated over an average follow-up 15.7 years. A significant improvement in mean total gastric cancer risk score (4.36 ± 1.66 to 2.69 ± 1.07, p < 0.001), atrophy (1.73 ± 0.44 to 1.61 ± 0.49, p = 0.004), and diffuse redness (1.22 ± 0.79 to 0.02 ± 0.13, p < 0.001) was observed compared to baseline in the Eradication group. However, there was no change in the never infection and current infection groups. The frequency of map-like redness increased over time until 15 years (3.6% to 18.7%, p = 0.03). The Cancer group had significantly higher risk scores at all time points. Endoscopic atrophy significantly improved in eradicated patients over long-term, suggested that eradication is one of the key elements in gastric cancer prevention. Individualized surveillance strategies based on endoscopic gastritis severity before eradication may be important for those at risk of gastric cancer.

Influence of agro-wastes derived biochar and their composite on reducing the mobility of toxic heavy metals and their bioavailability in industrial contaminated soils

The agro-waste derived valuable products are prime interest for effective management of toxic heavy metals (THMs). The present study investigated the efficacy of biochars (BCs) on immobilization of THMs (Cr, Zn, Pb, Cu, Ni and Cd), bioaccumulation and health risk. Agro-wastes derived BCs including wheat straw biochar (WSB), orange peel biochar (OPB), rice husk biochar (RHB) and their composite biochar (CB) were applied in industrial contaminated soil (ICS) at 1% and 3% amendments rates. All the BCs significantly decreased the bioavailable THMs and significantly (p < 0.001) reduced bioaccumulation at 3% application with highest efficiency for CB followed by OPB, WSB and RHB as compared to control treatment. The bioaccumulation factor (BAF), concentration index (CI) and ecological risk were decreased with all BCs. The hazard quotient (HQ) and hazard index (HI) of all THMs were <1, except Cd, while carcer risk (CR) and total cancer risk index (TCRI) were decreased through all BCs. The overall results depicted that CB at 3% application rate showed higher efficacy to reduce significantly (p < 0.001) the THMs uptake and reduced health risk. Hence, the present study suggests that the composite of BCs prepared from agro-wastes is eco-friendly amendment to reduce THMs in ICS and minimize its subsequent uptake in vegetables.

Epidemiology, risk factors and molecular subtypes of Breast Carcinoma

Breast cancer (BC) is the leading cause of cancer-related death among women and the most commonly diagnosed cancer worldwide. The 5-year overall survival (OS) from BC has increased steadily in most of the developed countries. The incidence rates of BC vary worldwide, with high rates in North America, Northern and Western Europe, intermediate rates in South America and Southern Europe, and low rates in Africa and Asia. In Egypt, BC represents about 37.7% of total cancer cases among women. Gene amplification is a frequent device leading to the overexpression of oncogenes in human cancers. At present, the prognosis, classification, and treatment of BC are dependent on tumor histological grading, tumor stage, as well as 3 major protein markers: Estrogen receptor (ER), Progesterone receptor (PR) and Human epidermal growth factor receptor type 2 (HER2). Despite the efforts to improve the effectiveness of the combination of surgical approach, radio-chemotherapy, endocrine-therapy, and human epidermal growth factor receptor-2 (HER-2)-based targeted therapy, there is an immense clinical need for new therapeutic strategies and molecular targets.

Breast cancer polygenic risk score and patient survival outcomes in the Pathways study.

10502 Background: Many common, low-penetrance variants have been identified for breast cancer risk through genome-wide association studies, leading to the development of polygenic scores (PGS) to aggregate the effects of individual variants for risk prediction. Much less is known about genetic determinants of breast cancer-related outcomes. We hypothesized that breast cancer patients with high breast cancer PGS are at risk of a second breast-related adverse event, such as recurrence, contralateral breast cancer, or death. Methods: The Pathways Study is a prospective cohort study of breast cancer survivors enrolled shortly after diagnosis in 2006-2013 at Kaiser Permanente Northern California, with ongoing follow-up. Genome-wide genotype data were available from 3,995 patients for calculation of 4 PGS, including PGS313, PGS4k, PGS5k, and PGS6m. Scores were categorized into tertiles to investigate their associations with 7 survival outcomes including recurrence, contralateral second primary breast cancer, other second primary cancer, and death. Hazard ratios (HR) and 95% confidence intervals (CI) were derived from multivariable Cox proportional hazards regression models. Results: The median age at diagnosis was 60 (23.6-94.8) years, and most (68%) self-identified as White. Many women had estrogen receptor (ER)+ (83.4%), stage I and II tumors (89%), with 13.3% HER2+ tumors. The majority (60%) received lumpectomy and some type of adjuvant therapy (44.3% radiotherapy, 47.0% chemotherapy, and 74.6% received hormonal therapy). By December 31, 2021, the median follow-up time was 10.5 (0.2-14.2) years, with 504 recurrences, 419 total second primary cancers, 146 contralateral second primary breast cancers, 237 non-breast second primary cancers, and 762 deaths (352 breast cancer-specific deaths) observed. In Table 1, patients with medium (T2) and high (T3) PGS313 had higher risk of recurrence, but not contralateral breast cancer or other second primary cancer. They also had higher risk of all-cause death, breast cancer-specific death, total breast cancer event, and invasive disease. The other 3 PGS were not associated with survival outcomes examined. Conclusions: Our study reveals that breast cancer patients with higher PGS313 had higher risk of recurrence, total breast cancer and invasive breast cancer events, and death. These findings highlight a potential role of breast cancer PGS for prognosis, warranting further exploration. [Table: see text]

Advancing team science and health equity in clinical oncology using the All of Us Research Program dataset.

e13741 Background: The All of Us Research Program ( All of Us) is one of the largest, most diverse health databases developed to expedite medical breakthroughs and is a resource for cancer researchers. The size and diversity of participants along with data types within the program, coupled with the program’s cloud based data analytics platform, encourage both team science and equitable health research outcomes. All of Us is dedicated to advancing the science of health equity with a focus on populations underrepresented in biomedical research and workforce, and embedding health equity across all aspects of the program. Methods: All of Us uses a centralized protocol where participants may elect to 1) enroll, consent, and authorize EHR, 2) answer surveys, 3) provide physical measurements, 4) provide biosamples, and 5) share data from wearables. High levels of participant diversity was achieved through an Engagement Ecosystem of outreach leaders, participants, and engagement awardees. Outreach, engagement, enrollment, and retention efforts are strategically directed by a Community and Participant Engagement Framework and a Health Equity Strategic Plan. Results: As of January 2024, health data from 413,450+ participants is available, including eight survey types from 337,500+ participants, electronic health records (EHR) from 287,000+ participants, wearable data from 15,600+ participants and whole genome sequencing from 245,350+ participants. Over 75% of participants self-identify as underrepresented in biomedical research, and about 45% self-identify as racial and ethnic minority groups. Cancer data includes history at enrollment as well as incident ascertainment via EHR (N = 26,323 total cancers and 13,067 incident cancers, from 7,544 participants assigned female at birth and 5,264 participants assigned male at birth). As of February 2024, All of Us data has been used in more than 221 publications. Of these, 35% (78) discuss cancer or oncology. More than 10% of active workspaces (921 out of 8000+ as of January 2024) include “cancer” in workspace descriptions. Commonly studied cancer types include breast, prostate, lung, ovarian, and colorectal. Conclusions: All of Us has established itself as a resource for cancer researchers. This database has the potential to provide insights into the development of treatment guidelines and emerging indicators for screening and early detection guided by health equity built on participant engagement, diversity, and broad data availability. Finally, the breadth of All of Us data also offers potential insight into cancer etiology and opportunities for prevention.

Estimating the indirect economic burden of cancer in Jordan: a retrospective observational study

ObjectiveThe aim of this study is to estimate the indirect economic burden of 22 cancer types in Jordan using both the human capital approach (HCA) and the value of a...

Degradation of estrogen receptor α induced by ionizing radiation contributes to senescence of ER+ breast cancer cells.

e12544 Background: According to the clinical and pathological characteristics, breast cancer is usually classified into estrogen receptor positive (ER+), human epidermal growth factor receptor 2 positive and triple negative. Among them, ER+ breast cancer accounts for more than two-thirds of total breast cancer. Nowadays, both ionizing radiation and endocrine therapy are used for the treatment of ER+ breast cancer. In our previous studies, it was found that significant cellular senescence and reduction of endogenous estradiol (E2) were induced by carbon ion or X-ray exposure in ER+ breast cancer cells. However, the underlying mechanism remains unclear. Methods: Two human ER+ breast cancer cell lines, MCF7 and T47D, were chosen to investigate the senescence-associated indications after 1-10 Gy of X-ray exposure. Since the elevated estrogen receptor α (ERα) is the most significant characteristic of ER+ breast cancer, the levels of ERα were detected by qRT-PCR and West Blotting analysis. In addition, MCF7 tumors were established in BALB/C nude mice and discerned using immunohistochemistry after local exposure of tumors to 2 Gy of X-rays. Results: It was confirmed that the cell survival decreased in a dose-dependent manner after 1-10 Gy of X-ray exposure in both cell lines. Increased p21 protein expression which was considered as a senescence biomarker and enhanced senescence-associated β-galactosidase activity were also observed after X-ray exposure. Meanwhile, distinct cell cycle arrest was induced by 2 Gy of X-rays in T47D cells or by 8 Gy of X-rays in MCF7 cells, implying that T47D cells were prone to enter senescence. Furthermore, both the mRNA levels and protein levels of ERα were significantly decreased at 24 hours in the two cell lines when the exposure dose was up to 4 Gy of X-rays. Reduction of glucocorticoid-regulated kinase 3 (SGK3), a transcriptional target for ERα, was also observed in both cell lines, in according with the reported SGK3-dependent survival mediated by ERα/E2 dimer in ER+ breast cancer cells. In vitro experiments, the results verified the ERα degradation and the proliferating inhibition indicated by suppression of Ki67 protein in MCF7 tumor after 2 Gy exposure. Conclusions: These findings reveal that the degradation of estrogen receptor α induced by ionizing radiation contributes to the senescence of ER+ breast cancer cells and thereby inhibits the tumor growth. The results provide a potential therapeutic strategy to enhance the radiosensitivity of ER+ breast cancer cells through regulations of ERα or ERα-regulated kinase SGK3 in radiotherapy.

The global burden of primary liver cancer and underlying etiologies from 1990 to 2021.

10573 Background: Liver cancer is a leading cause of global health burden, and was the seventh leading cause of cancer death in 2021. The most common type of liver cancer in adults is hepatocellular carcinoma, which can be due to alcohol, hepatitis B, hepatitis C, non-alcoholic steatohepatitis (NASH), or other causes. In children the most common type of liver cancer is hepatoblastoma. Comprehensive and comparative estimation of liver cancer burden can inform policy decisions and public health interventions to reduce incidence, morbidity, and mortality. This study provides updated liver cancer estimates from 1990 to 2021, and for the first time includes hepatoblastoma. Methods: Using estimation methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) we comprehensively estimated total liver cancer incidence, mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability adjusted life-years (DALYs). Etiologic proportions from meta-analyses of literature review data were applied to the total. Liver cancers under age 10 were attributed to hepatoblastoma. YLLs were calculated using life expectancy estimates. Prevalence and YLDs were calculated from expected survival, disease sequelae, and disability weights. DALYs were the sum of YLLs and YLDs. Results are presented with 95% Uncertainty Intervals (95% UI). Results: Globally, there were an estimated 529,000 (95% UI 480,000 – 594,000) liver cancer cases and 484,000 (437,000 – 538,000) deaths in 2021, contributing to 12,900,000 (11,600,000 – 14,400,000) DALYs. Since 1990, these represented increases of 114.3% (87.0 – 145.3%) in cases, 102.5% (76.4 – 132.0%) in deaths, and 70.6% (48.7 – 96.8%) in DALYs. For liver cancer etiologies (excluding hepatoblastoma), 37.4% (32.6 – 42.6%) of deaths were due to hepatitis B, 30.3% (26.3 – 34.8%) hepatitis C, 19.1% (15.8 – 22.8%) alcohol, 8.5% (6.9 – 10.3%) NASH, and 4.3% (3.6 – 5.1%) other causes in 2021. Conclusions: These GBD 2021 estimates provide comprehensive estimates of the substantial health burden of liver cancer, highlighting a continued need for public health efforts targeting prevention, vaccination, treatment, or behavioral change.[Table: see text]

Male breast cancer survival in Mexico between 2007 and 2016: A retrospective cohort.

1116 Background: Male breast cancer represents around 1% of all breast cancers worldwide. Due to its rarity, it is more likely to be diagnosed at advanced stages than in women, and survival rates tend to be lower than in female patients. Information about survival in male breast cancer in low- and middle-income countries (LMIC) is scarce. Methods: We conducted a retrospective cohort study cross-linking nationwide reimbursement claims for breast cancer cases between 2007 and 2016 treated within the Seguro Popular health financing scheme to a national mortality registry in Mexico. Age, municipality of residence, clinical stage, and year of treatment initiation were described. Facilities were classified according to location, total breast cancer patient volume, and type of funding. We estimated 5-year overall survival (OS) with 95% confidence intervals (95% CI) through the Kaplan Meier method and used the log-rank test to compare differences between patient groups. Patients with in situ disease and missing data for clinical stage were excluded from survival analyses. Results: We identified 268,703 claims representing 60,846 patients, from which 328 were male (0.53%). Median age was 56 years (IQR 48-67). At treatment initiation, 20.7% of patients had early disease, 46.3% had locally advanced (LA) disease and 15.5% metastatic disease; clinical stage information was missing in 16% of patients Most patients (86.6%) were treated at public facilities, and 40.5% were treated at high volume facilities. With a median follow-up of 4.1 years, five-year OS in the whole cohort was 64.3% (CI 95% 58.1-71.2). In patients with early-stage disease, 5-year OS was 78.7% (95% CI 67.0-92.4), in LA disease 66.3% (95% CI 58.4-75.3) and in metastatic disease 39.7% (95% CI 27.5-57.5) (p &lt;0.001). Patients with LA disease treated at a private facility had improved 5-year OS (88.9%) compared to those who were treated at a public facility (62.8%) (p=0.033). We did not find any other significant differences in survival according to patient or facility characteristics, including patient volume. Conclusions: These results represent the largest cohort to describe survival in men with breast cancer in Latin America. We found a larger proportion of men diagnosed with metastatic disease than described in women in Mexico, and lower than expected survival in patients with early-stage and LA disease.

Patient’s perception of cancer treatment outcomes in geriatric age groups: A retrospective analysis from a tertiary care centre in India.

e13774 Background: Geriatric population forms a significant part of the total cancer patients in any given country and their expectations, their needs and challenges are different from younger patients. Patients may perceive their “chances” differently from what is expected with cancer treatment. In our analysis we aimed to look at such perceived intent of therapy in geriatric patients and factors that might influence these perceptions. Methods: We retrospectively looked at data of comprehensive geriatric assessment (CGA) which is maintained by the geriatric clinic at our institute. Patients are referred to our geriatric clinic after their joint clinic meetings and after their meetings with their primary oncologists. We identified 2962 patients who underwent CGA and collected data of age, gender, social support, marital status, education level, actual intent of therapy, patients’ perception of intent, their desire of disclosure of disease status. We also collected objective scores of GDS, GAD 7, TUG and ECOG performance status. Descriptive statistics were performed to find out the factors significantly affecting patient’s perception of intent of therapy. Results: The median age of our cohort was 68 years (Interquartile range- 64-72 years). Results are shown (Table). 70.6% wanted full disclosure of disease. Out of 1404 patients who were in palliative setting, 40.2 percent patient had misperception of treatment. Conclusions: Our data highlights the significant impact of patient’s general wellbeing both physical and mental on the perception of their treatment goals. It brings forth the need to address these issues along with cancer therapy in an already vulnerable geriatric population. Our data also highlights the desire to know about the disease status in majority which may empower terminal patients to spend their time and energy on things they value. A nearly 41% misperception in palliative patients is indicative of an urgent need for better communication practices to help patients be more aware of outcomes and thus may be able to put more quality in the limited time they have. [Table: see text]

A Population-Based Tumor-Volume Model for Head and Neck Cancer During Radiation Therapy With a Dynamic Oxygenated Compartment

PurposeWith the coming era of digital wisdom medical technology, mathematical modelling of tumor becomes a key step to optimize and realize precision radiotherapy. The purpose of this study is to develop a mathematical model for simulating the change of head-and-neck tumor (HN) volume during radiotherapy. Methods and MaterialsA formula is developed to describe the dynamic change of oxygenated compartment within a tumor, which is combined with the LPL model to describe various cell processes during radiotherapy, including potentially lethal lesion repair and misrepair, cell proliferation/loss, and tumor reoxygenation. Parameter sensitivity analysis is performed to evaluate the impacts of the lesion-related and repair-related biological factors on radiotherapy outcome. ResultsWe tested our model on 14 available HN cancer patients and compared the performance with three other models. The mean error of our model for the twelve good fit cases is 12.2%, which is considerable smaller than that of the LQ model (19.7%), GLQ model (19.1%) and FLCP model (16.6%). Correlation analysis results reveal that for small tumors, there is a positive correlation (correlation coefficient r=0.9416) between hypoxic fraction and tumor volume, whereas the correlation becomes negative and not significant (r=−0.4365) for large tumors. It is demonstrated from sensitivity analysis that the production rate of lethal lesions (ηl) has a far greater impact on tumor volume than other parameters. The hypoxic fraction has insignificant impact on tumor volume, but it has notable influence on the volume of surviving cells. The final volume of surviving cells athf=0.5 is almost 8 ×102 times that of hf=0.01. The potentially lethal lesion-related parameters (ηpl,εpl, ε2pl) have rather small impacts (<1%) on both tumor volume and the volume of surviving cells, which indicates that the repaired and misrepaired sublethal cells only take up a small portion of the total cancer cell population. ConclusionsA population-based tumor-volume model for HN cancer during radiotherapy with a dynamic oxygenated compartment was developed in this study. Comprehensively considering the damage process of tumor cells caused by radiation therapy, the accurate prediction of the volume change of head-and-neck tumors during treatment has been revealed. Meanwhile, various cell activities and their principles in the process of anti-tumor treatment were reflected, and it has positive clinical reference significance for radiobiology.