Short Telomere Length as a Biomarker Risk of Lung Cancer Development Induced by High Radon Levels: A Pilot Study

Long-term exposure to radon has been determined to be the second leading cause of lung cancer after tobacco smoking. However, an in-depth study of this topic has not been explicitly carried out in Chiang Mai (Thailand). This paper presents the results of an indoor radon level measurement campaign in dwellings of Chiang Mai using total of 110 detectors (CR-39) during one year. The results show that the average radon levels varied from 35 to 219 Bq/m3, with an overall average of 57 Bq/m3. The finding also shows that the average value is higher than the global average value of 39 Bq/m3. In addition, to examine the cause of lung cancer development among people with risk of chronic exposure to radon during their lifetime, 35 non-smoker lung cancer patients and 33 healthy nonsmokers were analyzed for telomere length. As expected, telomere length was significantly shorter in lung cancer patients than in healthy nonsmokers. Among healthy nonsmokers, the telomere length was significantly shorter in a high radon group than in an unaffected low radon group. To the best of our knowledge, our research provides the first attempt in describing the shortened telomeres in areas with high levels of environmental radon that might be related to lung cancer development

Analysis of the planned, delivered dose distributions and quality assurance for helical tomotherapy and volumetric modulated arc therapy in locally advanced non-small cell lung cancer

Background: With full access to both helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT), we compared locally advanced non-small cell lung cancer (LA-NSCLC) treatment plans and verified the plans using patient‐specific pretreatment quality assurance (PSQA). Materials and methods: For each of the seventeen patients included in the study, two treatment plans (i.e. HT and VMAT) were created. Optimized plans were evaluated following the ICRU 83 criteria. Planned quality indexes and dosimetric parameters were compared. Lastly, all plans were subjected to PSQA assessment by determining the gamma passing rate (GPR). Results: All dosimetry results obtained from the planning target volume passed the ICRU 83 criteria. With regard to similar homogeneity indices, VMAT produced better conformity number values than HT (0.78 vs. 0.64), but differences in the values were insignificant. Furthermore, VMAT was associated with a significantly shorter mean treatment time (1.91 minutes vs. 6.66 minutes). For PSQA assessment, both techniques resulted in adequate GPR values (> 90% at the 3%/3 mm criteria). Conclusion: Both HT and VMAT techniques led to the generation of clinically satisfactory and reliable radiotherapy plans. However, the VMAT plan was associated with a non-significantly better degree of conformity and a significantly shorter treatment time. Thus, VMAT was determined to be a better choice for LA-NSCLC

Clinical outcomes and dosimetric study of hypofractionated Helical TomoTherapy in breast cancer patients.

We present a single center's experience of treatment outcomes and dosimetric parameters for breast cancer patients treated with hypofractionated Helical TomoTherapy (HT). This is a retrospective study of one hundred and thirty-six patients with invasive breast cancer treated between March 2012 and October 2016. Dosimetric parameters and 3-year loco-regional failure free survival (LRFFS) were analyzed. Dose to ipsilateral lung, heart and contralateral breast as well as acute and late toxicities were recorded. The median follow-up time is 45 months (range: 5-83). Two patients had loco-regional failure. The 3-year LRFFS was 99%. Acute grade 1 and 2 skin toxicities occurred in 95% and 1%, respectively. Coverage of the target volumes was achieved with the mean ± standard deviation (SD) of homogeneity and conformity index being 0.1 ± 0.04, and 0.8 ± 0.07, respectively. Dose to ipsilateral lung, contralateral breast, and heart was also within the limited constraints regardless of the complexity of target volumes. Only two percent of patients experienced late grade 2 skin toxicity. No late grade 2 subcutaneous tissue toxicity was found. Nine percent of patients developed late grade 1 lung toxicity. Hypofractionated radiotherapy using Helical TomoTherapy in breast irradiation provides excellent 3-year LRFFS and minimal acute and late toxicities. A careful, longer follow-up of healthy tissue effects to lung, heart, and contralateral breast is warranted

The Potential Biomarkers for Screening Lung Cancer Risk in High Residential Radon

IntroductionConsidering that radon is likely the second most common cause of lung cancer after smoking and the need to incorporate new biomarkers useful for early screening would be promising for the improvement of the treatment outcome. So, our study aims to evaluate the potential clinical use of serum biomarkers and teleomeres length in lung cancer patients and high residential radon.MethodsA passive radon-thoron discriminative monitor (RADUET) using a solid-state track detector (CR-39) was used to evaluate the indoor radon in 227 dwellings in a 5-7 months period. According to indoor radon measurements, serum samples from 38 lung cancer patients and 38 matched healthy controls (low- and high radon group) were analysed for 7 proteins (CEA, Cyfra 21-1, IL-8, TNF-alpha, HE4, MIF, VEGF) and teleomere length using the luminex multiplex assay and monochrome multiplex realtime PCR (MMQPCR), respectively.ResultsThe radon concentration were distributed in the range of 23- 229 Bq/m3 with an average value of 50 Bq/m3. The data indicated that the radon concentration seems quite high when considering the climatic condition and housing structure. Interestingly, the result showed that CEA, Cyfra 21-1, IL-8 levels were significantly higher in lung cancer patients than in healthy volunteers. However, the levels of CEA and IL-8 were higher in high radon group than low radon group. Consequently, a high level of CEA and IL-8 are sound to indicate the at high risk for lung cancer from high radon exposure. Further, lung cancer patients had significantly shorter telomere length compared with healthy controls. This may indicate that shortened telomere length with increased lung cancer risk.ConclusionThe results suggest that CEA, IL-8 and short telomere length should be a useful biomarkers of lung cancer risk in high residential radon area and for future studies on personalized therapy of lung cancer.ReferencesUNSCEAR. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, Effects and risks of ionizing radiation. Report to the General Assembly, United Nations 2000)EPRBio Dose 2018 Munic

Identification of Potential New Biomarkers for Early Detection of Lung Cancer Risk in High Residential Radon: A Preliminary Study in Chiang Mai, ThailandIdentification of Potential New Biomarkers for Early Detection of Lung Cancer Risk in High Residential Radon: A Preliminary Study in Chiang Mai, Thailand

Lung cancer is a major cause of cancer-related death worldwide and shows high incidences in Chiang Mai. The major reasons for the increasing incidence rate are smoking, radon and air pollution. In this context, the potential biomarker useful for early screening would be promising for the improvement of the treatment outcome and the reduction of mortality. However, suitable biomarkers for lung cancer risk based on radon exposure have not yet been examined and identified by any research works. So, our study aims to investigate the potential biomarkers based on the estimation of the radon concentration in Chiang Mai. Then, the estimation result will be analyzed in order to distinguish low-and high residential radon exposure in comparison with lung cancer patients.A passive radon-thoron discriminative monitor was used to evaluate the indoor radon in 55 dwellings in a 10-12 months period which are specifically selected according to the number of lung cancer. According to indoor radon measurements, serum samples from 38 lung cancer patients and 38 matched healthy controls (19 low-and 19 high- radon group) were analysed for CEA, Cyfra 21-1, IL-8, TNF-, HE4, MIF, VEGF levels using the luminex multiplex assay.The radon concentration in 55 dwellings were distributed in the range of 35- 219 Bq/m3 with an average value of 57 Bq/m3. While, the worldwide average indoor radon concentration is at 39 Bq/m3. Therefore, the result indicated that the concentration of radon in our study area seems quite high when considering the climatic condition and housing structure. More importantly, the result showed that CEA, Cyfra 21-1, IL-8 levels were significantly higher in lung cancer patients than in healthy controls. Interestingly, levels of CEA and IL-8 were higher in high radon than low radon group. Consequently, a high level of CEA and IL-8 are sound to indicate the at high risk for lung cancer from high radon exposure. Therefore, IL-8 can be a new potential biomarker for screening lung cancer from radon exposure.Consortium of Biological Sciences 2017 (ConBio 2017

Preliminary results of adjuvant image-guided vaginal brachytherapy alone for early stage endometrial carcinoma

Objective: This retrospective study evaluated the preliminary outcomes of image-guided vaginal brachytherapy (IG-VBT) in the adjuvant treatment of high intermediate risk endometrial cancer. Materials and Methods: Data were collected from 48 patients who underwent adjuvant IG-VBT between 2019 and 2022 at the Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University. The vaginal cuff clinical target volume (CTV-VC) is composed of a 4-mm-thick band around vaginal cylinder at the upper 3 cm of the vaginal cuff. A total dose of 21 Gy in three fractions was delivered to the CTV-VC, and the dose to the bladder and rectum were evaluated. Treatment details, patient characteristics, and outcomes were analyzed. Descriptive statistics were used for analysis, and Kaplan-Meier method was employed for survival analysis. Results: The mean age was 62 years, with mainly endometrioid carcinoma pathology (96 %). All patients were at stage I, with 87.5 % receiving complete surgical staging. Mean total treatment time was 10 days with mean D90 of CTV-VC was 29.7 Gy, and D2cc of bladder, rectum, and sigmoid were 24.6 Gy, 21.0 Gy, and 7.7 Gy, respectively. At a median follow-up of 37 months, 3-year local control, disease-free survival, and overall survival rates were 100 %, 100 %, and 97.9 %. respectively. Two patients (4.2 %) experienced grade 1–2 gastrointestinal toxicity, while no genitourinary toxicity or serious adverse events were observed. Conclusions: The preliminary results of IG-VBT in endometrial cancer demonstrated favorable outcomes in terms of vaginal control and toxicity. Further studies with larger cohorts and longer follow-up durations are warranted

The outcome of the first 100 nasopharyngeal cancer patients in thailand treated by helical tomotherapy

The aim of the study was to analyse of two-year loco-regional failure free survival (LRFFS), distant metastasis free survival (DMFS), overall survival (OS), and toxicity outcomes of the first 100 nasopharyngeal carcinoma patients in Thailand treated by helical tomotherapy