Prostate Cancer Treatment-Related Toxicity: Comparison between 3D-Conformal Radiation Therapy (3D-CRT) and Volumetric Modulated Arc Therapy (VMAT) Techniques

Objective: This paper illustrates the results of a mono-institutional registry trial, aimed to test whether gastrointestinal (GI) and genitourinary (GU) toxicity rates were lower in localized prostate cancer patients treated with image-guided volumetric modulated arc therapy (IG-VMAT) compared to those treated with IG-3D conformal radiation therapy (IG-3DCRT). Materials and Methods: Histologically proven prostate cancer patients with organ-confined disease, treated between October 2008 and September 2014 with moderately hypofractionated radiotherapy, were reviewed. Fiducial markers were placed in the prostate gland by transrectal ultrasound guide. The prescribed total dose was 70 Gy in 28 fractions. The mean and median dose volume constraints for bladder and rectum as well as total volume of treatment were analyzed as potentially prognostic factors influencing toxicity. The Kaplan–Meier method was applied to calculate survival. Results: Overall, 83 consecutive patients were included. Forty-two (50.6%) patients were treated with 3D-CRT and 41 (49.4%) with the VMAT technique. The median follow-up for toxicity was 77.26 months for the whole cohort. The VMAT allowed for a dose reduction to the rectum and bladder for the large majority of the considered parameters; nonetheless, the only parameter correlated with a clinical outcome was a rectal dose limit V66 > 8.5% for late GI toxicity G ≥ 2 (p = 0.045). Rates of G ≥ 2 toxicities were low among the whole cohort of these patients treated with IGRT. The analysis for rectum dose volume histograms (DVHs) showed that a severe (grade ≥ 2) late GI toxicity was related with the rectal dose limit V66 > 8.5% (p = 0.045). Conclusions: This study shows that moderate hypofractionation is feasible and safe in patients with intermediate and high-risk prostate cancer. Daily IGRT may decrease acute and late toxicity to organs at risk and improve clinical benefit and disease control rate, cutting down the risk of PTV geographical missing. The adoption of VMAT allows for promising results in terms of OAR sparing and a reduction in toxicity that, also given the small sample, did not reach statistical significance

Extracellular vesicles in human preterm colostrum inhibit infection by human cytomegalovirus in vitro

Breast milk is a complex biofluid that nourishes infants, supports their growth and protects them from diseases. However, at the same time, breastfeeding is a transmission route for human cytomegalovirus (HCMV), with preterm infants being at a great risk of congenital disease. The discrepancy between high HCMV transmission rates and the few reported cases of infants with severe clinical illness is likely due to the protective effect of breast milk. The aim of this study was to investigate the anti-HCMV activity of human preterm colostrum and clarify the role of colostrum-derived extracellular vesicles (EVs). Preterm colostrum samples were collected and the EVs were purified and characterized. The in vitro anti-HCMV activity of both colostrum and EVs was tested against HCMV, and the viral replication step inhibited by colostrum-purified EVs was examined. We investigated the putative role EV surface proteins play in impairing HCMV infection using shaving experiments and proteomic analysis. The obtained results confirmed the antiviral action of colostrum against HCMV and demonstrated a remarkable antiviral activity of colostrum-derived EVs. Furthermore, we demonstrated that EVs impair the attachment of HCMV to cells, with EV surface proteins playing a role in mediating this action. These findings contribute to clarifying the mechanisms that underlie the protective role of human colostrum against HCMV infection

Više-fragmentna tvorba u reakcijama 32S+58,64Ni NA 11 A MeV

The characteristic features of the 32S+58,64Ni reaction at 11 A MeV have been investigated to evidence the possible rise of multi-fragmentation processes at low excitation energies. The importance of such phenomena consists in the fact that they could represent the signature of a nuclear phase transition from a liquid to a gas region. Evidence of multi-fragment production is displayed by the present data; even if the yield of such events is compatible with the predictions of statistical models, the partition of the mass of the decaying system cannot be easily reproduced. Some preliminary indications of isospin effects are suggested by looking at the differences between the two reacting systems.Istraživali smo značajke reakcije 32S+ 58,64Ni na 11 A MeV radi pronalaženja mogućeg porasta više-fragmentnih procesa na nižim uzbudnim energijama. Važnost se tih pojava sastoji u tome što bi one mogle predstavljati znakove nuklearnog faznog prijelaza od tekućeg u plinsko stanje. Znakovi tvorbe više fragmenata vide se u dobivenim podacima; no čak ako je i prinos tih događaja u skladu s predviđanjima statističkog modela, razdioba mase sustava koji se raspada ne uspijeva se objasniti. Usporedba dviju reakcija ukazuje na moguće izospinske efekte

Temperature measurement of fragment emitting systems in Au+Au 35 MeV/nucleon collisions

We report on the results of experiments performed to investigate the Au1Au 35 MeV/nucleon reaction. The reaction products generated in the disassembly of the unique source formed in central collisions and those coming from the decay of the quasiprojectile in peripheral and midperipheral ones ~five different impact parameters! were identified through a careful data selection based on the study of energy and angular distributions. The excitation energies of the fragment sources have been extracted through a calorimetric method and by means of a comparison with model calculations. The nuclear temperatures of these decaying systems have been measured from the relative isotopic abundances and, also for central collisions, from the relative populations of excited states. The temperatures of the quasiprojectile disassembling systems are slowly increasing going towards smaller impact parameter. The relationship between temperature and excitation energy seems to be almost independent of the characteristics of the emitting source. The extracted caloric curve shows a slow monotonic increase with increasing excitation energy. A comparison with data derived from Au fragmentation at much higher incident energies is discussed. @S0556-2813~98!04408-2

Genotyping the hepatitis B virus with a fragment of the HBV DNA polymerase gene in Shenyang, China

The hepatitis B virus (HBV) has been classified into eight genotypes (A-H) based on intergenotypic divergence of at least 8% in the complete nucleotide sequence or more than 4% in the S gene. To facilitate the investigation of the relationship between the efficacy of drug treatment and the mutation with specific genotype of HBV, we have established a new genotyping strategy based on a fragment of the HBV DNA polymerase gene. Pairwise sequence and phylogenetic analyses were performed using CLUSTAL V (DNASTAR) on the eight (A-H) standard full-length nucleotide sequences of HBV DNA from GenBank (NCBI) and the corresponding semi-nested PCR products from the HBV DNA polymerase gene. The differences in the semi-nested PCR fragments of the polymerase genes among genotypes A through F were greater than 4%, which is consistent with the intergenotypic divergence of at least 4% in HBV DNA S gene sequences. Genotyping using the semi-nested PCR products of the DNA polymerase genes revealed that only genotypes B, C, and D were present in the 50 cases, from Shenyang, China, with a distribution of 11 cases (22%), 25 cases (50%), and 14 cases (28%) respectively. These results demonstrate that our new genotyping method utilizing a fragment of the HBV DNA polymerase gene is valid and can be employed as a general genotyping strategy in areas with prevalent HBV genotypes A through F. In Shenyang, China, genotypes C, B, and D were identified with this new genotyping method, and genotype C was demonstrated to be the dominant genotype

Hypofractionated simultaneous integrated boost (IMRT-SIB) with pelvic nodal irradiation and concurrent androgen deprivation therapy for high-risk prostate cancer: results of a prospective phase II trial

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