Prognostication of serial post-intensity-modulated radiation therapy undetectable plasma EBV DNA for nasopharyngeal carcinoma

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Whole-brain radiotherapy with simultaneous integrated boost using volumetric modulated arc therapy (VMAT) for patients of recursive partitioning analysis (RPA) class I and II suffering from 1-3 brain metastases

Objective: We evaluated the feasibility and treatment outcomes of recursive partitioning analysis (RPA) Class I and II patients with 1-3 brain metastases treated with whole-brain radiotherapy with simultaneous integrated boost using volumetric modulated arc therapy (VMAT). Materials and methods: 11 patients (9 with lung cancer, 1 with breast cancer and 1 with renal cell carcinoma), of which 3 and 8 belonging to RPA Class I and II respectively), were treated with VMAT for their brain metastases (mean volume 2.45cm3, range 0.07 – 14.48cm3). After immobilization by thermoplastic casts, they underwent planning computed tomography (CT) scan of the whole brain with 2.5mm slice thickness. The whole brain (WB), all brain metastases (BM) and organs at risks were contoured manually. A 4-mm margin was created for the whole brain and each of the brain metastases to generate the planning target volumes (PTV-WB and PTV-BM respectively). A VMAT plan with 2 modulated arcs was generated for all patients. 30Gy and 40Gy all in 10 fractions over 2 weeks were delivered simultaneously to PTV-WB and PTV-BM by a linear accelerator with a dose rate of 600 MU/minute. Serial CT scans of the brain were performed every 2-3 months after VMAT until progression or death. Overall local response rate, local brain control rate, distant brain control rate, brain progression-free survival (BPFS), progression-free survival (PFS), overall survival (OS) and toxicities were assessed. Results: After a median follow up of 7.6 months, 6 (54.5%) patients died and all succumbed to progressive disease of their underlying malignancies. Overall local response rate, local brain control rate and distant brain control rate were 81.9%, 100% and 81.9% respectively. Median BPFS, PFS and OS were 12.6 months, 10.0 months and 14.3 months respectively whereas 1-year BPFS, 1-year PFS and 1-year OS were 75.0%, 30.0% and 58.3% respectively. 2 (18.2%) and 3 (27.3%) patients developed acute grade 1 and grade 2 treatment-related toxicities during VMAT with subsequent complete resolution. Mean monitor units was 713.4 MU (range 392-891 MU) and mean beam-on time was 1.2 minutes (range 0.7-1.5 minutes). Conclusion: VMAT for 1-3 brain metastases in RPA class I and II patients seemed promising with a favorable treatment outcome as well as well-tolerated and self-limiting toxicities

Correction: Chemopreventive Effect of PSP Through Targeting of Prostate Cancer Stem Cell-Like Population

Recent evidence suggested that prostate cancer stem/progenitor cells (CSC) are responsible for cancer initiation as well as disease progression. Unfortunately, conventional therapies are only effective in targeting the more differentiated cancer cells and spare the CSCs. Here, we report that PSP, an active component extracted from the mushroom Turkey tail (also known as Coriolus versicolor), is effective in targeting prostate CSCs. We found that treatment of the prostate cancer cell line PC-3 with PSP led to the down-regulation of CSC markers (CD133 and CD44) in a time and dose-dependent manner. Meanwhile, PSP treatment not only suppressed the ability of PC-3 cells to form prostaspheres under non-adherent culture conditions, but also inhibited their tumorigenicity in vivo, further proving that PSP can suppress prostate CSC properties. To investigate if the anti-CSC effect of PSP may lead to prostate cancer chemoprevention, transgenic mice (TgMAP) that spontaneously develop prostate tumors were orally fed with PSP for 20 weeks. Whereas 100% of the mice that fed with water only developed prostate tumors at the end of experiment, no tumors could be found in any of the mice fed with PSP, suggesting that PSP treatment can completely inhibit prostate tumor formation. Our results not only demonstrated the intriguing anti-CSC effect of PSP, but also revealed, for the first time, the surprising chemopreventive property of oral PSP consumption against prostate cancer