Development of actual measurement-based RBE calculation model for carbon beam therapy and high-precision clinical analysis

Cancer can reduce quality of life, place strain on families and even kill. Treatment methods are not always effective nor precise and involve either surgical removal of cancerous tissues or a combination of drugs and radiation. Advances in physics are providing new hope for treatment options in the form of radiation and, specifically, particle therapy, which includes proton beam therapy and carbon ion radiotherapy (CIRT). This improves treatment precision as the beam can be targeted so that it kills cancer and not the surrounding tissue. Ryosuke Kohno, Department of Accelerator and Medical Physics, National Institutes for Quantum and Radiological Science and Technology, Japan, is interested in how applied physics can bridge with medicine, becoming medical physics. He has developed several beam therapies protocols over the years and is particularly interested in CIRT and how the technique can be improved. Kohno is currently working on fine tuning a model that can be optimally calibrated to attack all types of tumours. He and his team are also working on Intensity-Modulated Composite Particle Therapy (IMPACT). Kohno is collaborating with a multidisciplinary radiotherapy team and his interdisciplinary research involves the integration of radiation/medical physics, radiation biology and radiation oncology. He is also assisting early-stage researchers so that the next-generation of researchers can form new bridges between basic science and medicine.

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Multimodality Treatment Options and Outcomes of Laryngeal Carcinosarcoma: A Clinical Analysis of a Rare Tumor from a Single Hospital

BioMed Research International ◽

10.1155/2019/1754675 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Yang Zhang ◽

Zhigang Huang ◽

Neil Gross ◽

Jugao Fang ◽

Xiaohong Chen ◽

...

Keyword(s):

Neck Dissection ◽

Clinical Symptoms ◽

Early Stage ◽

Postoperative Radiotherapy ◽

Treatment Options ◽

Case Series ◽

Multimodality Treatment ◽

Clinical Analysis ◽

Partial Laryngectomy ◽

Rare Type

Primary laryngeal carcinosarcoma is a rare type of malignancies, and the standard therapeutic protocol for its treatment has yet to be established. This retrospective study analyzed the clinical and pathological characteristics, risk factors, treatment options, and prognosis of 13 patients with primary laryngeal carcinosarcomas. This case series included 11 males and 2 females with an age range from 32 to 78 years at diagnosis. The initial clinical symptoms included hoarseness, dyspnea, and foreign body sensation in the throat. The primary tumor sites were at the glottis, supraglottis, and larynx. All these patients were active or passive smokers, and more than half of them were alcohol addictive. The surgical treatment for laryngeal carcinosarcomas included CO2 laser surgery in seven cases, partial laryngectomy and neck dissection in three cases, and total laryngectomy and neck dissection in three cases. Among them, seven cases received postoperative radiotherapy. After follow-up with a mean of 31.15-month, four cases died. Primary laryngeal carcinosarcoma is a rare but more aggressive malignancy. Contralateral lymph node metastasis can occur at the early stage of this disease. A treatment combining surgery and postoperative radiotherapy is strongly recommended.

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Bioactive Inks Development for Osteochondral Tissue Engineering: A Mini-Review

Gels ◽

10.3390/gels7040274 ◽

2021 ◽

Vol 7 (4) ◽

pp. 274

Author(s):

Negar Bakhtiary ◽

Chaozong Liu ◽

Farnaz Ghorbani

Keyword(s):

Tissue Engineering ◽

Inflammatory Responses ◽

Early Stage ◽

Treatment Options ◽

Biologically Active ◽

Joint Disease ◽

Surrounding Tissue ◽

Bioactive Materials ◽

Bioactive Scaffolds ◽

Osteochondral Tissue

nowadays, a prevalent joint disease affecting both cartilage and subchondral bone is osteoarthritis. Osteochondral tissue, a complex tissue unit, exhibited limited self-renewal potential. Furthermore, its gradient properties, including mechanical property, bio-compositions, and cellular behaviors, present a challenge in repairing and regenerating damaged osteochondral tissues. Here, tissue engineering and translational medicine development using bioprinting technology provided a promising strategy for osteochondral tissue repair. In this regard, personalized stratified scaffolds, which play an influential role in osteochondral regeneration, can provide potential treatment options in early-stage osteoarthritis to delay or avoid the use of joint replacements. Accordingly, bioactive scaffolds with possible integration with surrounding tissue and controlling inflammatory responses have promising future tissue engineering perspectives. This minireview focuses on introducing biologically active inks for bioprinting the hierarchical scaffolds, containing growth factors and bioactive materials for 3D printing of regenerative osteochondral substitutes.

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CONTEMPORARY TREATMENT APPROACH OF SQUAMOUS CELL SKIN CANCER: REVIEW

Problems in oncology ◽

10.37469/0507-3758-2019-65-1-7-15 ◽

2019 ◽

Vol 65 (1) ◽

pp. 7-15

Author(s):

Aleksey Belyaev ◽

Georgiy Prokhorov ◽

Zamira Radzhabova ◽

Olga Baykalova

Keyword(s):

Skin Cancer ◽

Squamous Cell ◽

New Technologies ◽

Treatment Options ◽

Epidermoid Carcinoma ◽

Surgical Removal ◽

Cochrane Central Register ◽

Epithelial Tumor ◽

Randomized Controlled Studies ◽

Skin Malignancy

The incidence of skin cancer is a steady increasing around the world. Tumors of epithelial origin occupy the first place in the structure of all skin malignancy. Epidermoid carcinoma is the most malignant epithelial tumor of the skin and mucous membranes with squamous differentiation. Generally, squamous cell carcinoma is successfully treated by surgical and radiological methods. Often a different kind of plastic defect reconstructions are required after surgical removal. The incidence of epidermoid carcinoma increases with age (average age of patients falls on 65 years) therefore variants of treatment options is limited by comorbidities. However, surgical oncologist do not have enough date and randomized controlled studies on this theme. Minimally invasive methods, especially cryothechnology are increasingly used, but unfortunately their advantage requires additional evidence. We suppose Inclusion in the conventional treatment of new technologies may possibly improve the results of treatment. We reviewed the literature, summarizing data on various methods of treating squamous cell skin cancer. Comprehensive and systematic search was based on MedLine, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus and PubMed among original articles for the period from January 1974 to October 2018.

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Benign Intracranial Lesions - Radiotherapy: An Overview of Treatment Options, Indications and Therapeutic Results

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666191111100635 ◽

2020 ◽

Vol 15 (2) ◽

pp. 93-121

Author(s):

Vasileios Tzikoulis ◽

Areti Gkantaifi ◽

Filippo Alongi ◽

Nikolaos Tsoukalas ◽

Haytham Hamed Saraireh ◽

...

Keyword(s):

Effective Treatment ◽

Treatment Modality ◽

Radiation Effects ◽

Treatment Options ◽

Proton Beam Therapy ◽

Tumor Control ◽

Control Growth ◽

Effective Treatment Modality ◽

Intracranial Lesions

Background: Radiation Therapy (RT) is an established treatment option for benign intracranial lesions. The aim of this study is to display an update on the role of RT concerning the most frequent benign brain lesions and tumors. Methods: Published articles about RT and meningiomas, Vestibular Schwannomas (VSs), Pituitary Adenomas (PAs), Arteriovenous Malformations (AVMs) and craniopharyngiomas were reviewed and extracted data were used. Results: In meningiomas RT is applied as an adjuvant therapy, in case of patientrefusing surgery or in unresectable tumors. The available techniques are External Beam RT (EBRT) and stereotactic ones such as Stereotactic Radiosurgery (SRS), Fractionated Stereotactic RT (FSRT), Intensity Modulated RT (IMRT) and proton-beam therapy. The same indications are considered in PAs, in which SRS and FSRT achieve excellent tumor control rate (92-100%), acceptable hormone remission rates (>50%) and decreased Adverse Radiation Effects (AREs). Upon tumor growth or neurological deterioration, RT emerges as alone or adjuvant treatment against VSs, with SRS, FSRT, EBRT or protonbeam therapy presenting excellent tumor control growth (>90%), facial nerve (84-100%), trigeminal nerve (74-99%) and hearing (>50%) preservation. SRS poses an effective treatment modality of certain AVMs, demonstrating a 3-year obliteration rate of 80%. Lastly, a combination of microsurgery and RT presents equal local control and 5-year survival rate (>90%) but improved toxicity profile compared to total resection in case of craniopharyngiomas. Conclusion: RT comprises an effective treatment modality of benign brain and intracranial lesions. By minimizing its AREs with optimal use, RT projects as a potent tool against such diseases.

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The APAC Score: A Novel and Highly Performant Serological Tool for Early Diagnosis of Hepatocellular Carcinoma in Patients with Liver Cirrhosis

Journal of Clinical Medicine ◽

10.3390/jcm10153392 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3392

Author(s):

Joeri Lambrecht ◽

Mustafa Porsch-Özçürümez ◽

Jan Best ◽

Fabian Jost-Brinkmann ◽

Christoph Roderburg ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

At Risk ◽

Liver Cirrhosis ◽

Early Stage ◽

Treatment Options ◽

Growth Factor Receptor ◽

Serum Samples ◽

Disease Etiology ◽

Risk Patients ◽

Scoring Tool

(1) Background: Surveillance of at-risk patients for hepatocellular carcinoma (HCC) is highly necessary, as curative treatment options are only feasible in early disease stages. However, to date, screening of patients with liver cirrhosis for HCC mostly relies on suboptimal ultrasound-mediated evaluation and α-fetoprotein (AFP) measurement. Therefore, we sought to develop a novel and blood-based scoring tool for the identification of early-stage HCC. (2) Methods: Serum samples from 267 patients with liver cirrhosis, including 122 patients with HCC and 145 without, were collected. Expression levels of soluble platelet-derived growth factor receptor beta (sPDGFRβ) and routine clinical parameters were evaluated, and then utilized in logistic regression analysis. (3) Results: We developed a novel serological scoring tool, the APAC score, consisting of the parameters age, sPDGFRβ, AFP, and creatinine, which identified patients with HCC in a cirrhotic population with an AUC of 0.9503, which was significantly better than the GALAD score (AUC: 0.9000, p = 0.0031). Moreover, the diagnostic accuracy of the APAC score was independent of disease etiology, including alcohol (AUC: 0.9317), viral infection (AUC: 0.9561), and NAFLD (AUC: 0.9545). For the detection of patients with (very) early (BCLC 0/A) HCC stage or within Milan criteria, the APAC score achieved an AUC of 0.9317 (sensitivity: 85.2%, specificity: 89.2%) and 0.9488 (sensitivity: 91.1%, specificity 85.3%), respectively. (4) Conclusions: The APAC score is a novel and highly accurate serological tool for the identification of HCC, especially for early stages. It is superior to the currently proposed blood-based algorithms, and has the potential to improve surveillance of the at-risk population.

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Advances in Targeting Cutaneous Melanoma

Cancers ◽

10.3390/cancers13092090 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2090

Author(s):

Dimitri Kasakovski ◽

Marina Skrygan ◽

Thilo Gambichler ◽

Laura Susok

Keyword(s):

Cutaneous Melanoma ◽

Clinical Investigation ◽

Early Stage ◽

Treatment Options ◽

Treatment Resistance ◽

Immune Checkpoint Blockade ◽

Oncolytic Viruses ◽

Cancer Site ◽

Western World ◽

Pharmacological Agents

To date, the skin remains the most common cancer site among Caucasians in the western world. The complex, layered structure of human skin harbors a heterogenous population of specialized cells. Each cell type residing in the skin potentially gives rise to a variety of cancers, including non-melanoma skin cancer, sarcoma, and cutaneous melanoma. Cutaneous melanoma is known to exacerbate and metastasize if not detected at an early stage, with mutant melanomas tending to acquire treatment resistance over time. The intricacy of melanoma thus necessitates diverse and patient-centered targeted treatment options. In addition to classical treatment through surgical intervention and radio- or chemotherapy, several systemic and intratumoral immunomodulators, pharmacological agents (e.g., targeted therapies), and oncolytic viruses are trialed or have been recently approved. Moreover, utilizing combinations of immune checkpoint blockade with targeted, oncolytic, or anti-angiogenic approaches for patients with advanced disease progression are promising approaches currently under pre-clinical and clinical investigation. In this review, we summarize the current ‘state-of-the-art’ as well as discuss emerging agents and regimens in cutaneous melanoma treatment.

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Medication of Hydroxychloroquine, Remdesivir and Convalescent Plasma during the COVID-19 Pandemic in Germany—An Ethical Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115685 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5685

Author(s):

Katja Voit ◽

Cristian Timmermann ◽

Florian Steger

Keyword(s):

Early Stage ◽

Treatment Options ◽

Drug Distribution ◽

Experimental Treatment ◽

Ethical Analysis ◽

Ethical Principles ◽

Ethical Challenges ◽

Ethical Guidelines ◽

Negative Effects ◽

Experimental Drug

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions.

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New polyp image classification technique using transfer learning of network-in-network structure in endoscopic images

Scientific Reports ◽

10.1038/s41598-021-83199-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Young Jae Kim ◽

Jang Pyo Bae ◽

Jun-Won Chung ◽

Dong Kyun Park ◽

Kwang Gi Kim ◽

...

Keyword(s):

Colorectal Cancer ◽

Transfer Learning ◽

Test Data ◽

State Of The Art ◽

Early Stage ◽

Statistical Significance ◽

Recall Rate ◽

Training Data ◽

Fine Tuning ◽

Accuracy Evaluation

AbstractWhile colorectal cancer is known to occur in the gastrointestinal tract. It is the third most common form of cancer of 27 major types of cancer in South Korea and worldwide. Colorectal polyps are known to increase the potential of developing colorectal cancer. Detected polyps need to be resected to reduce the risk of developing cancer. This research improved the performance of polyp classification through the fine-tuning of Network-in-Network (NIN) after applying a pre-trained model of the ImageNet database. Random shuffling is performed 20 times on 1000 colonoscopy images. Each set of data are divided into 800 images of training data and 200 images of test data. An accuracy evaluation is performed on 200 images of test data in 20 experiments. Three compared methods were constructed from AlexNet by transferring the weights trained by three different state-of-the-art databases. A normal AlexNet based method without transfer learning was also compared. The accuracy of the proposed method was higher in statistical significance than the accuracy of four other state-of-the-art methods, and showed an 18.9% improvement over the normal AlexNet based method. The area under the curve was approximately 0.930 ± 0.020, and the recall rate was 0.929 ± 0.029. An automatic algorithm can assist endoscopists in identifying polyps that are adenomatous by considering a high recall rate and accuracy. This system can enable the timely resection of polyps at an early stage.

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Regulation of Wnt Signaling by FOX Transcription Factors in Cancer

Cancers ◽

10.3390/cancers13143446 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3446

Author(s):

Stefan Koch

Keyword(s):

Transcription Factors ◽

Wnt Signaling ◽

Wnt Pathway ◽

Treatment Options ◽

Wnt Signaling Pathway ◽

Tissue Homeostasis ◽

Fine Tuning ◽

Dependent Manner ◽

Forkhead Box ◽

Signaling Activity

Aberrant activation of the oncogenic Wnt signaling pathway is a hallmark of numerous types of cancer. However, in many cases, it is unclear how a chronically high Wnt signaling tone is maintained in the absence of activating pathway mutations. Forkhead box (FOX) family transcription factors are key regulators of embryonic development and tissue homeostasis, and there is mounting evidence that they act in part by fine-tuning the Wnt signaling output in a tissue-specific and context-dependent manner. Here, I review the diverse ways in which FOX transcription factors interact with the Wnt pathway, and how the ectopic reactivation of FOX proteins may affect Wnt signaling activity in various types of cancer. Many FOX transcription factors are partially functionally redundant and exhibit a highly restricted expression pattern, especially in adults. Thus, precision targeting of individual FOX proteins may lead to safe treatment options for Wnt-dependent cancers.

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The Emerging Factors and Treatment Options for NAFLD-Related Hepatocellular Carcinoma

Cancers ◽

10.3390/cancers13153740 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3740

Author(s):

Chunye Zhang ◽

Ming Yang

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Fatty Liver ◽

Early Stage ◽

Primary Liver Cancer ◽

Treatment Options ◽

Underlying Mechanism ◽

Diagnostic Methods ◽

T Cell Therapy ◽

Nonalcoholic Fatty Liver

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, followed by cholangiocarcinoma (CCA). HCC is the third most common cause of cancer death worldwide, and its incidence is rising, associated with an increased prevalence of obesity and nonalcoholic fatty liver disease (NAFLD). However, current treatment options are limited. Genetic factors and epigenetic factors, influenced by age and environment, significantly impact the initiation and progression of NAFLD-related HCC. In addition, both transcriptional factors and post-transcriptional modification are critically important for the development of HCC in the fatty liver under inflammatory and fibrotic conditions. The early diagnosis of liver cancer predicts curative treatment and longer survival. However, clinical HCC cases are commonly found in a very late stage due to the asymptomatic nature of the early stage of NAFLD-related HCC. The development of diagnostic methods and novel biomarkers, as well as the combined evaluation algorithm and artificial intelligence, support the early and precise diagnosis of NAFLD-related HCC, and timely monitoring during its progression. Treatment options for HCC and NAFLD-related HCC include immunotherapy, CAR T cell therapy, peptide treatment, bariatric surgery, anti-fibrotic treatment, and so on. Overall, the incidence of NAFLD-related HCC is increasing, and a better understanding of the underlying mechanism implicated in the progression of NAFLD-related HCC is essential for improving treatment and prognosis.

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