Sole conformal perioperative interstitial brachytherapy of early stage breast carcinoma using high-dose rate afterloading: longer-term results and toxicity

Aims and BackgroundThis study of high-dose-rate brachytherapy to the lumpectomy site as the sole radiation presents longer-term results and toxicity of accelerated partial-breast irradiation, using three-dimensional treatment planning.Materials and MethodsFrom March 2002 to July 2004, 25 patients were prospectively included in this study. Six patients were excluded because of definitive histology of lobular carcinoma or positive margin. The median age at the time of treatment was 63.2 years (range 44–77 years). Median follow-up of all patients was 44 months (range 30–53 months) with a minimum follow-up of 30 months. Radiation was delivered using the high-dose-rate remote afterloader VariSource with 192Ir source. The patients received radiation twice a day at least 6 hours apart for a total of 10 fractions over five days with a single dose of 3.4 Gy. The total dose was 34.0 Gy prescribed as a minimum peripheral dose to match or minimally exceed the volume defined by the surgical clips as seen on computed-tomography (CT) scans. Free-hand technique allows conformal placement of the catheters to the shape of the lumpectomy cavity. Side-effects and toxicity were scored using the EORTC/RTOG scale.ResultsAt a median follow-up of 44 months none of the women had developed in-field breast recurrences, one patient had out-of-field recurrences and one patient presented distant metastases. There were no regional nodal recurrences. In each woman, target volume size in cm3 (median 91.3 cm3), dose volume histogram (DVH), and dose homogeneity index (DHI) were calculated. Median DHI was 0.42. Median volume of breast tissue receiving 100% of the prescription dose, V100, was 87%; and V150 48.5%. We noticed two treatment complications: haematoma and abscess in the place of the tumour bed after extirpation. At last follow-up, all patients rated the overall cosmetic outcome as excellent or good.ConclusionsThis method is suitable only for patients with histologically confirmed small tumours

Craniospinal irradiation of medulloblastoma in the supine position

BackgroundMedulloblastoma, a primitive neuroectodermal tumour growing in the cerebellum, is one of the most sensitive childhood brain tumours to radiation therapy. The most common malignant CNS tumour of children is medulloblastoma with an overall incidence among children aged 0–19 years of 16–20% of all paediatric brain tumours. Radiotherapy is an essential method of treatment for these tumours, but surgery is the primary treatment of choice in medulloblastoma. Postoperative radiation therapy has a significant impact on local control and overall survival.AimMedulloblastoma is the most common malignant brain tumour of children. The tumour is sensitive to chemotherapy and radiotherapy. Radiotherapy is an essential method of treatment for these tumours, but surgery is the primary treatment of choice in medulloblastoma.Materials/MethodsBetween January 1997 and March 2005 there were in this study post-operatively irradiated a total number of 33 paediatric patients aged under 15 years (median age 6.6 years) with medulloblastoma. All tumours were histologically proven and were located infratentorially in the posterior fossa. All of the patients were irradiated with a dose of 24–36 Gy to the whole craniospinal axis and boost with conformal therapy restricted to the tumour bed to the total dose of 50–54 Gy (30–36 Gy “high risk”, 24–30 Gy “standard risk” group). 26 patients (78%) received chemotherapy. Patients with craniospinal irradiation were placed in the supine position and fixed by a vacuum-form body immobilizer and head mask. Irradiation was performed using standard fractionation (5 fractions per week) with a single dose of 1.5–1.8 Gy for craniospinal axis by photon beam (6MV) of the linear accelerator.ResultsThe median overall survival for the whole group was 55.3 months. The median disease-free survival was 20.6 months. The overall survival rate at 5 years was 41%; 8 patients (24%) died. No relationship was found between survival and age, sex or tumour size. Endocrine deficits occurred in 30% (8 patients of the group were hypothyroid, growth retardation occurred in 7 patients).ConclusionsResults of overall and disease-free survival and side-effects of the technique of craniospinal axis irradiation in supine position are comparable with results of the technique in prone position

Sole conformal perioperative interstitial brachytherapy of early stage breast carcinoma using high-dose rate afterloading: longer-term results and toxicity

SummaryAims and BackgroundThis study of high-dose-rate brachytherapy to the lumpectomy site as the sole radiation presents longer-term results and toxicity of accelerated partial-breast irradiation, using three-dimensional treatment planning.Materials and MethodsFrom March 2002 to July 2004, 25 patients were prospectively included in this study. Six patients were excluded because of definitive histology of lobular carcinoma or positive margin. The median age at the time of treatment was 63.2 years (range 44–77 years). Median follow-up of all patients was 44 months (range 30–53 months) with a minimum follow-up of 30 months. Radiation was delivered using the high-dose-rate remote afterloader VariSource with 192Ir source. The patients received radiation twice a day at least 6 hours apart for a total of 10 fractions over five days with a single dose of 3.4 Gy. The total dose was 34.0 Gy prescribed as a minimum peripheral dose to match or minimally exceed the volume defined by the surgical clips as seen on computed-tomography (CT) scans. Free-hand technique allows conformal placement of the catheters to the shape of the lumpectomy cavity. Side-effects and toxicity were scored using the EORTC/RTOG scale.ResultsAt a median follow-up of 44 months none of the women had developed in-field breast recurrences, one patient had out-of-field recurrences and one patient presented distant metastases. There were no regional nodal recurrences. In each woman, target volume size in cm3 (median 91.3 cm3), dose volume histogram (DVH), and dose homogeneity index (DHI) were calculated. Median DHI was 0.42. Median volume of breast tissue receiving 100% of the prescription dose, V100, was 87%; and V150 48.5%. We noticed two treatment complications: haematoma and abscess in the place of the tumour bed after extirpation. At last follow-up, all patients rated the overall cosmetic outcome as excellent or good.ConclusionsThis method is suitable only for patients with histologically confirmed small tumours (<3 cm in diameter) without negative prognostic factors for local recurrence. We observed low treatment-related morbidity and mild long-term toxicity with good treatment results

Assembly of the cnidarian camera-type eye from vertebrate-like components

Animal eyes are morphologically diverse. Their assembly, however, always relies on the same basic principle, i.e., photoreceptors located in the vicinity of dark shielding pigment. Cnidaria as the likely sister group to the Bilateria are the earliest branching phylum with a well developed visual system. Here, we show that camera-type eyes of the cubozoan jellyfish, Tripedalia cystophora, use genetic building blocks typical of vertebrate eyes, namely, a ciliary phototransduction cascade and melanogenic pathway. Our findings indicative of parallelism provide an insight into eye evolution. Combined, the available data favor the possibility that vertebrate and cubozoan eyes arose by independent recruitment of orthologous genes during evolution

Spent coffee ground as renewable energy source: evaluation of the drying processes

Summarization: Spent coffee ground (SCG) is an environmental nuisance material, but, if appropriately processed it can be converted into pellets, and thus, used as an energy source. The moisture content of the final product should be below 10%, to ensure safe storage, and elimination of microorganism growth (particularly moulds). The present study aims to identify the optimal drying process for removing moisture from SCG and to investigate changes to the composition of SCG due to drying, at temperatures around 75 °C, so that the dried SCG to qualify as renewable energy source. Three drying processes were employed for SCG drying (with initial moisture content of about 65%): oven drying, solar drying and open air sun drying, while SCG samples were placed in aluminium trays with thicknesses of 1.25, 2.5 and 4 cm. Based on the experimental results for SCG samples with thickness 2.5 cm, the open air sun drying process required 10 h to reach final moisture content of 37%, while solar drying achieved 10% moisture content in 10 h and oven drying achieved 7% moisture content in 6 h. The solar drying process proved as the most advantageous, due to low energy requirements and adequate quality of dried SCG. Also, experiments indicated that SCG storage at “normal room conditions” resulted to equilibrium moisture content in SCG of 8%, regardless of the initial moisture content. Furthermore, instrumental analyses of the SCG, revealed changes to its composition for a number of chemical groups, such as aldehydes, ketones, phytosterols, alkaloids, lactones, alcohols, phenols, pyrans and furans, among others. It was also identified that the SCG colour was affected due to the drying process.Presented on: Journal of Environmental Managemen

Relationship between serum calprotectin (S100A8/9) and clinical, laboratory and ultrasound parameters of disease activity in rheumatoid arthritis: A large cohort study

<div><p>Background</p><p>Calprotectin may be a sensitive biomarker of rheumatoid arthritis (RA) disease activity.</p><p>Objectives</p><p>In the current study, we investigated whether calprotectin is a better biomarker than CRP for predicting clinical activity and ultrasound parameters in patients with RA.</p><p>Methods</p><p>A total of 160 patients with RA underwent clinical (swollen joint count—SJC, tender joint count—TJC, Disease Activity Score—DAS28, Clinical Disease Activity Index—CDAI, and simplified Disease Activity Index—SDAI) and ultrasound (German US7) examination. Clinical and laboratory measures were correlated with ultrasound findings using Spearman´s correlation coefficient. Differences in serum calprotectin levels in patients with variable disease activity according to the DAS28-ESR and CDAI scores were assessed using ANOVA. Multivariate regression analysis was used to determine the predictive values of calprotectin, CRP and SJC for CDAI and PD US synovitis scores.</p><p>Results</p><p>Serum calprotectin was significantly associated with DAS28-ESR (r = 0.321, p<0.001), DAS28-CRP (r = 0.346, p<0.001), SDAI (r = 0.305, p<0.001), CDAI (r = 0.279, p<0.001) scores and CRP levels (r = 0.556, p<0.001). Moreover, calprotectin was significantly correlated with GS (r = 0.379, p<0.001) and PD synovitis scores (r = 0.419, p<0.001). The multivariate regression analysis showed that calprotectin is a better predictor of the CDAI score and PD US synovitis than CRP.</p><p>Conclusions</p><p>The results of this study support an additional role of calprotectin in assessing inflammatory activity in patients with RA.</p></div