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  • 1
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    Online Resource
    LOCL-02 DOSIMETRIC AND CLINICAL ANALYSIS OF PSEUDO-PROGRESSION VS. RECURRENCE AFTER HYPER-FRACTIONATED RADIOTHERAPY FOR BRAIN METASTASES BASED ON ENHANCED MAGNETIC RESONANCE IMAGING
    Oxford University Press (OUP) ; 2022
    In:  Neuro-Oncology Advances Vol. 4, No. Supplement_1 ( 2022-08-05), p. i11-i11
    Details
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2022-08-05), p. i11-i11
    Abstract: The main challenge in follow-up duration of patients with brain metastases after stereotactic radiotherapy is to distinguish between pseudo-progression and tumor recurrence. The objective of this study is to retrospectively analyze the predictive factors. METHODS The study included 123 patients with enlarged brain metastases after hyper-fractionated radiotherapy in our center from 2009 to 2019, and the baseline clinical features, radiotherapy planning parameters, and enhanced magnetic resonance imaging before and after radiation therapy were analyzed. Logistic regression was performed to compare the differences between groups. independent risk factors with P & lt; 0.05 and associated with recurrence was used to establish a predicting nomogram and validated by Bootstrap in internal cohort. RESULTS The median volume of lesions was 8.4 cc. The median follow-up time was 68.4 months (interquartile range [IQR], 30.4 – 63.2 months). A total of 76 (61.8%) patients were evaluated as pseudo-progression, 47 patients (38.2%) were evaluated as tumor recurrence. The median time to tumor recurrence and pseudo-progression were 12.9 months (IQR, 8.7 – 19.6 months) and 18.3 months (IQR, 9.4 – 27.8 months) respectively. Variables associated with tumor recurrence included: gross tumor volume ≥ 6 cc, biological effective dose & lt; 60 Gy, target coverage & lt; 96% and no targeted therapy. The area under curve value was 0.730 and mean absolute error in calibration curve was 0.041. Sixty-one patients received salvage therapy, including re-irradiation (n = 32, 26.0%), surgical resection (n = 22, 17.9%) or systemic therapy (n = 22, 17.9%). The survival time in pseudo-progression and tumor recurrence groups were 66.3 months (95% CI, 56.8 – 75.9 months) and 39.6 months (95% CI, 29.2 – 50.0 months, respectively; P = 0.001). CONCLUSIONS Clinical and dosimetry features of hyper-fractionated radiation therapy based on enhanced brain magnetic resonance can help distinguish pseudo-progression from tumor recurrence after hyper-fractionated radiotherapy for brain metastases. And the individual risk could be estimated by the nomogram effectively.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    URL: Article
    DOI: 10.1093/noajnl/vdac078.044
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 2
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    A Phase II Trial of Concurrent Temozolomide and Hypofractionated Stereotactic Radiotherapy for Complex Brain Metastases
    Oxford University Press (OUP) ; 2019
    In:  The Oncologist Vol. 24, No. 9 ( 2019-09-01), p. e914-e920
    Details
    In: The Oncologist, Oxford University Press (OUP), Vol. 24, No. 9 ( 2019-09-01), p. e914-e920
    Abstract: Complex brain metastases (BMs), such as large lesions, lesions within or close to eloquent locations, or multiple recurrent/progressive BMs, remain the most challenging forms of brain cancer because of decreased intracranial control rates and poor survival. In the present study, we report the results from a single institutional phase II trial of concurrent temozolomide (TMZ) with hypofractionated stereotactic radiotherapy (HFSRT) in patients with complex brain metastases, including assessment of its feasibility and toxicity. Patients and Methods Fifty-four patients with histologically proven primary cancer and complex BMs were enrolled between 2010 and 2015. All the patients were treated with concurrent HFSRT and TMZ (administrated orally at a dosage of 75 mg/m2 per day for at least 20 days). The primary endpoint was overall survival (OS). Results The median follow-up time was 30.6 months. The local control rates at 1 and 2 years were 96% and 82%, respectively. The median OS was 17.4 months (95% confidence interval [CI], 12.6–22.2), and the OS rates at 1 and 2 years were 65% (95% CI, 52%–78%) and 33% (19%–47%). Only six patients (15.8%) died of intracranial disease. The median brain metastasis-specific survival was 46.9 months (95% CI, 35.5–58.4). Treatment-related grade 3–4 adverse events were rare and included one grade 3 hematological toxicity and two grade 3 liver dysfunctions. Conclusion Treatment using HFSRT concurrent with TMZ was well tolerated and could significantly extend OS compared with historical controls in complex BMs. Large randomized clinical trials are warranted. Trial registration ID: NCT02654106. Implications for Practice The treatment using hypofractionated stereotactic radiotherapy concurrent with temozolomide appeared to be safe and could significantly extend overall survival compared with historical control in complex brain metastases. Large randomized clinical trials are warranted to verify our results.
    Type of Medium: Online Resource
    ISSN: 1083-7159 , 1549-490X
    URL: Article
    DOI: 10.1634/theoncologist.2018-0702
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2023829-0
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  • 3
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    Caudal distribution pattern of metastatic neck lymph nodes in nasopharyngeal carcinoma and prognostic significance of nodal spread distances
    Elsevier BV ; 2023
    In:  Radiotherapy and Oncology Vol. 179 ( 2023-02), p. 109443-
    Details
    In: Radiotherapy and Oncology, Elsevier BV, Vol. 179 ( 2023-02), p. 109443-
    Type of Medium: Online Resource
    ISSN: 0167-8140
    URL: Article
    DOI: 10.1016/j.radonc.2022.109443
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1500707-8
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  • 4
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    Long-term treatment outcomes and prognosis of mucosal melanoma of the head and neck: 161 cases from a single institution
    Elsevier BV ; 2017
    In:  Oral Oncology Vol. 74 ( 2017-11), p. 115-122
    Details
    In: Oral Oncology, Elsevier BV, Vol. 74 ( 2017-11), p. 115-122
    Type of Medium: Online Resource
    ISSN: 1368-8375
    URL: Article
    DOI: 10.1016/j.oraloncology.2017.09.020
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 2011971-9
    detail.hit.zdb_id: 2202218-1
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  • 5
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    Multi-Scale Integration and Distribution of Soil Organic Matter Spatial Variation in a Coal–Grain Compound Area
    MDPI AG ; 2023
    In:  Sustainability Vol. 15, No. 4 ( 2023-02-18), p. 3780-
    Details
    In: Sustainability, MDPI AG, Vol. 15, No. 4 ( 2023-02-18), p. 3780-
    Abstract: Soil organic matter (SOM) scale effects are critical for crop growth and food security, especially in coal–grain complexes. However, few studies describe the spatial variation in SOM and its influencing factors at different sampling scales. Here, geostatistical theory and mathematical statistical methods were adopted to analyze the spatial variation characteristics of and structural differences in SOM in the coal mining subsidence area at Zhaogu No. 2 Mine at different sampling scales. The results showed that SOM varied spatially at large, medium, and small scales, and the coefficients of variation were 28.07%, 14.93%, and 14.31%, respectively, which are moderate values. The characteristic functions of the SOM content at different sampling scales differed, and the spatial structure scale effect was obvious. The spatial distribution of the SOM content fitted by the multiscale fitting model method was generally the same as the spatial distribution law of the SOM content fitted by the single scale kriging interpolation method; however, in terms of the detailed expression and spatial distribution of small-scale SOM content, the fitting model method was more accurate, and the accuracy increased by 36%. At the different sampling scales, sample size and soil type had specific effects on the SOM spatial distribution. These results provide research concepts and technical countermeasures for improving food security and the ecological environment in the coal–grain complex and help ensure sustainable agricultural lands.
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su15043780
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2518383-7
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  • 6
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    Irradiation-induced nasopharyngeal necrosis (INN) in newly diagnosed nasopharyngeal carcinoma treated by intensity-modulated radiation therapy: clinical characteristics and the influence of treatment strategies
    Springer Science and Business Media LLC ; 2022
    In:  Radiation Oncology Vol. 17, No. 1 ( 2022-12)
    Details
    In: Radiation Oncology, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2022-12)
    Abstract: To define the clinical characteristics of irradiation-induced nasopharyngeal necrosis (INN) after intensity-modulated radiotherapy (IMRT) and identify the influence of treatment strategies on INN in primary nasopharyngeal carcinoma (NPC) patients. Patients and methods From 2008 to 2019, NPC patients pathologically diagnosed with INN after primary IMRT were reviewed. Those patients were matched with propensity scores for patients without INN in our center. The impact of treatment strategies on INN occurrence was assessed using univariate and multivariate logistic regression analysis. Results The incidence rate of INN was 1.9% among the primary NPC population, and 53 patients with INN were enrolled. Headache and foul odor were the main symptoms, and 71.7% of cases had pseudomembrane during or at the end of radiotherapy. All patients were in early or middle stage INN, and no one presented with skull-based osteoradionecrosis. Then 212 non-INN patients were included based on propensity scores match. Overall survival ( p  = 0.248) and progression-free survival ( p  = 0.266) curves were similar between the INN and non-INN groups. Treatment strategies including combining chemotherapy or molecular targeted therapy with radiotherapy were not associated with INN occurrence, while boost dose (OR 7.360; 95% CI 2.301–23.547; p  = 0.001) was a predictor factor for it. However, the optimal threshold for an accumulated dose to predict INN's occurrence was failed to determine. Conclusion In the IMRT era, the severity of INN in primary NPC patients is lessened. This study showed that treatment strategies contributed little to develop INN, while the accumulated dose of radiation may relate to its occurrence.
    Type of Medium: Online Resource
    ISSN: 1748-717X
    URL: Article
    DOI: 10.1186/s13014-022-01980-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2224965-5
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  • 7
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    Online Resource
    Dosimetric and clinical analysis of pseudo-progression versus recurrence after hypo-fractionated radiotherapy for brain metastases
    Springer Science and Business Media LLC ; 2023
    In:  Radiation Oncology Vol. 18, No. 1 ( 2023-02-14)
    Details
    In: Radiation Oncology, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2023-02-14)
    Abstract: The main challenge in follow-up duration of patients with brain metastases after stereotactic radiotherapy is to distinguish between pseudo-progression and tumor recurrence. The objective of this study is to retrospectively analyze the predictive factors. Methods The study included 123 patients with enlarged brain metastases after hypo-fractionated radiotherapy in our center from March 2009 to October 2019, and the baseline clinical features, radiotherapy planning parameters, and enhanced magnetic resonance imaging before and after radiation therapy were analyzed. Logistic regression was performed to compare the differences between groups. Independent risk factors with P   〈  0.05 and associated with recurrence were used to establish a nomogram prediction model and validated by Bootstrap repeated sampling, which was validated in an internal cohort (n = 23) from October 2019 to December 2021. Results The median follow-up time was 68.4 months (range, 8.9–146.2 months). A total of 76 (61.8%) patients were evaluated as pseudo-progression, 47 patients (38.2%) were evaluated as tumor recurrence. The median time to pseudo-progression and tumor recurrence were 18.3 months (quartile range, 9.4–27.8 months) and 12.9 months (quartile range, 8.7–19.6 months) respectively. Variables associated with tumor recurrence included: gross tumor volume ≥ 6 cc, biological effective dose  〈  60 Gy, target coverage  〈  96% and no targeted therapy. The area under curve values were 0.730 and 0.967 in the training and validation cohorts, respectively. Thirty-one patients received salvage therapy in the tumor recurrence group. The survival time in pseudo-progression and tumor recurrence groups were 66.3 months (95% CI 56.8–75.9 months) and 39.6 months (95% CI 29.2–50.0 months, respectively; P  = 0.001). Conclusions Clinical and dosimetry features of hypo-fractionated radiation therapy based on enhanced brain magnetic resonance can help distinguish pseudo-progression from tumor recurrence after hypo-fractionated radiotherapy for brain metastases. Gross tumor volume, biological effective dose, target coverage, and having received targeted therapy or not were factors associated with the occurrence of tumor recurrence, and the individual risk could be estimated by the nomogram effectively.
    Type of Medium: Online Resource
    ISSN: 1748-717X
    URL: Article
    DOI: 10.1186/s13014-023-02214-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2224965-5
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  • 8
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    Postoperative radiotherapy for supraglottic cancer on real-world data: can we reduce dose to lymph node levels?
    Springer Science and Business Media LLC ; 2023
    In:  Radiation Oncology Vol. 18, No. 1 ( 2023-02-22)
    Details
    In: Radiation Oncology, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2023-02-22)
    Abstract: To evaluate prognosis for reducing postoperative radiotherapy (PORT) dose to lymph node levels of supraglottic cancer (SC) on real-world data. Method and materials Patients were derived from two cancer centers. In center 1, the involved nodal levels (high-risk levels, HRL) and the next level received a dose of 60.06 Gy/1.82 Gy per fraction, while the other uninvolved levels (low-risk levels, LRL) received 50.96 Gy/1.82 Gy per fraction. In center 2, all received 50 Gy/2 Gy per fraction. The rates of high-risk levels control (HRC), regional control (RC), overall survival (OS), progression-free survival (PFS) and distant metastasis-free survival (DMFS) were calculated by Kaplan–Meier method. Result Totally, 124 patients were included (62 in center 1, 62 in center 2). Most patients (106, 85.5%) had a stage T3/N + tumor. The median follow-up was 45 months (range 1–163 months). There were no significant differences in terms of OS (p = 0.126), RC (p = 0.514), PFS (p = 0.195) and DMFS (p = 0.834). Most regional recurrences (4, 80%) occurred within three years of treatment, and all occurred within the target volumes. No regional failure occurred in HRL in center 1, while three (3/4) failures occurred in center 2. Dose reduction prescription to HRL led to a lower HRC rate (100% vs. 90.6%, p = 0.009). While the rates of LRL control (98.4%) were equal between the two centers. Conclusion Compared with a standard dose, the reduced dose to involved nodal levels showed inferior regional control for PORT, while uninvolved nodal levels showed equal outcomes. A dose of 50 Gy for HRL may be an unfavorable treatment option for SC.
    Type of Medium: Online Resource
    ISSN: 1748-717X
    URL: Article
    DOI: 10.1186/s13014-023-02228-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 9
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    Improved Cancer-Specific Risk Stratification by the Lymph Node Ratio-Based Nomogram: A Potential Role in Guiding Postoperative Management Decisions for Oral Cavity Carcinoma
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  JCO Precision Oncology , No. 7 ( 2023-01)
    Details
    In: JCO Precision Oncology, American Society of Clinical Oncology (ASCO), , No. 7 ( 2023-01)
    Abstract: To develop and validate a nomogram integrating lymph node ratio (LNR) to predict cancer-specific survival (CSS) and assist decision making for postoperative management in nonmetastatic oral cavity squamous cell carcinoma (OCSCC). MATERIALS AND METHODS We retrospectively retrieved 6,760 patients with OCSCC primarily treated with surgery from surveillance, epidemiology, and end results database between 2010 and 2015. They were randomly divided into training and validation cohorts. Performance of the nomogram was evaluated by calibration curve, consistency index, area under the curve, and decision curve analysis and was compared with that of the LNR, positive lymph nodes (PLN) and tumor node metastasis (TNM) staging. According to the individualized nomogram score, patients were classified into three risk cohorts. The therapeutic efficacy of postoperative radiotherapy and chemotherapy was evaluated in each cohort. RESULTS The nomogram incorporated six independent variables, including race, tumor site, grade, T stage, PLN, and LNR. Calibration plots demonstrated a good match between the predicted and observed CSS. C-indices for training and validation cohorts were 0.746 (95% CI, 0.740 to 0.752) and 0.726 (95% CI, 0.713 to 0.739), compared with 0.687, 0.695, and 0.669 for LNR, PLN, and TNM staging, respectively ( P 〈 .001). Decision curve analyses confirmed that nomogram showed the best performance in clinical utility. Postoperative radiotherapy presented survival benefit in medium-and high-risk groups but showed a negative effect in the low-risk group. Chemotherapy was only beneficial in the high-risk group. CONCLUSION The LN status-incorporated nomogram demonstrated good discrimination and predictive accuracy of CSS for patients with OCSCC and could identify those most likely to benefit from adjuvant therapy.
    Type of Medium: Online Resource
    ISSN: 2473-4284
    URL: Article
    DOI: 10.1200/PO.22.00365
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
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  • 10
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    Table_1.docx
    Frontiers Media SA ; 2021
    In:  Frontiers in Oncology Vol. 11 ( 2021-10-14)
    Details
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 11 ( 2021-10-14)
    Abstract: The high intracranial efficacy of targeted therapeutic agents poses a challenge in determining the optimal sequence of local radiation therapy (RT) and systemic treatment with tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC) patients with brain metastasis (BM). Therefore, we conducted a cohort study to elucidate the appropriate treatment strategy, either upfront RT or deferred RT including a toxicity assessment, in these patients. Patients and Methods We retrospectively evaluated patients with gene-driven BMs from a single institution and divided them into deferred and upfront RT groups. Survival was estimated using a log-rank test. Intracranial progression was estimated using Fine-Gray competing risks model. Cox proportional hazards regression was performed for multivariable analysis in the entire group and subgroups. Results Among the 198 eligible patients, 94 and 104 patients received deferred and upfront RT, respectively. The upfront RT group showed a lower intracranial progression risk with an adjusted sub-distribution hazard ratios of 0.41 (95% CI, 0.30–0.57) than did the deferred RT group (median intracranial progression-free survival [iPFS], 19.9 months vs. 11.1 months; p & lt; 0.001). The median overall survival (OS; 43.2 months vs. 49.1 months, p = 0.377) and BM-specific survival (92.1 months vs. 82.9 months, p = 0.810) after salvage therapy were not significantly different between the upfront and deferred groups. Among patients with progressed extracranial disease, the deferred RT group showed significantly better OS than did the upfront RT group (44.0 vs. 28.1 months, p = 0.022). Grade 3–4 treatment-related adverse events were rare, and similar toxicities were observed between the two groups. Conclusion Compared to the deferred RT group, the upfront RT group achieved longer iPFS and similar survival outcomes in most patients with gene-driven NSCLC BM, although patients with progression of extracranial disease might benefit from deferred RT. Both groups showed well-tolerated toxicities. Trial registration ID NCT04832672.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    URL: Article
    URL: Article
    DOI: 10.3389/fonc.2021.732883
    DOI: 10.3389/fonc.2021.732883.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
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