Purpose: It is well known that the majority of the extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues (MALT lymphomas) are associated with microbiota, e.g., gastric MALT lymphoma with Helicobacter pylori. In general, they are very sensitive to low-dose radiotherapy and chemotherapeutic agents. The microbiota profile is not clearly elucidated in bronchus-associated lymphoid tissue (BALT) lymphoma, a rare type of MALT lymphoma in the lung. Thus, this study aimed to clarify the intratumor microbiome in BALT lymphoma using the third-generation next-generation sequencing (NGS) method. Materials and Methods: DNAs were extracted from 12 formalin-fixed paraffin-embedded (FFPE) tumor tissues obtained from BALT lymphoma patients diagnosed between 1990 and 2016. 16S rRNA gene was amplified by polymerase chain reaction. Amplicons were sequenced using a Nanopore platform. Next-generation sequencing analysis was performed to assess microbial profiles. For comparison, FFPE specimens from nine non-cancerous lung tissues were also analyzed. Results: Specific bacterial families including Burkholderiaceae, Bacillaceae, and Microbacteriaceae were associated with BALT lymphoma by a linear discriminant analysis effect size approach. Although the number of specimens was limited, BALT lymphomas exhibited significantly higher microbial abundance and diversity with distinct microbial composition patterns and correlation networks than non-cancerous lung tissues. Conclusion This study provides the first insight into intratumor microbiome in BALT lymphoma using the third-generation NGS method. A distinct microbial composition suggests the presence of a unique tumor microenvironment of BALT lymphoma.

Purpose: It is well known that the majority of the extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues (MALT lymphomas) are associated with microbiota, e.g., gastric MALT lymphoma with Helicobacter pylori. In general, they are very sensitive to low-dose radiotherapy and chemotherapeutic agents. The microbiota profile is not clearly elucidated in bronchus-associated lymphoid tissue (BALT) lymphoma, a rare type of MALT lymphoma in the lung. Thus, this study aimed to clarify the intratumor microbiome in BALT lymphoma using the third-generation next-generation sequencing (NGS) method. Materials and Methods: DNAs were extracted from 12 formalin-fixed paraffin-embedded (FFPE) tumor tissues obtained from BALT lymphoma patients diagnosed between 1990 and 2016. 16S rRNA gene was amplified by polymerase chain reaction. Amplicons were sequenced using a Nanopore platform. Next-generation sequencing analysis was performed to assess microbial profiles. For comparison, FFPE specimens from nine non-cancerous lung tissues were also analyzed. Results: Specific bacterial families including Burkholderiaceae, Bacillaceae, and Microbacteriaceae were associated with BALT lymphoma by a linear discriminant analysis effect size approach. Although the number of specimens was limited, BALT lymphomas exhibited significantly higher microbial abundance and diversity with distinct microbial composition patterns and correlation networks than non-cancerous lung tissues. Conclusion This study provides the first insight into intratumor microbiome in BALT lymphoma using the third-generation NGS method. A distinct microbial composition suggests the presence of a unique tumor microenvironment of BALT lymphoma.

Purpose: It is well known that the majority of the extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues (MALT lymphomas) are associated with microbiota, e.g., gastric MALT lymphoma with Helicobacter pylori. In general, they are very sensitive to low-dose radiotherapy and chemotherapeutic agents. The microbiota profile is not clearly elucidated in bronchus-associated lymphoid tissue (BALT) lymphoma, a rare type of MALT lymphoma in the lung. Thus, this study aimed to clarify the intratumor microbiome in BALT lymphoma using the third-generation next-generation sequencing (NGS) method. Materials and Methods: DNAs were extracted from 12 formalin-fixed paraffin-embedded (FFPE) tumor tissues obtained from BALT lymphoma patients diagnosed between 1990 and 2016. 16S rRNA gene was amplified by polymerase chain reaction. Amplicons were sequenced using a Nanopore platform. Next-generation sequencing analysis was performed to assess microbial profiles. For comparison, FFPE specimens from nine non-cancerous lung tissues were also analyzed. Results: Specific bacterial families including Burkholderiaceae, Bacillaceae, and Microbacteriaceae were associated with BALT lymphoma by a linear discriminant analysis effect size approach. Although the number of specimens was limited, BALT lymphomas exhibited significantly higher microbial abundance and diversity with distinct microbial composition patterns and correlation networks than non-cancerous lung tissues. Conclusion This study provides the first insight into intratumor microbiome in BALT lymphoma using the third-generation NGS method. A distinct microbial composition suggests the presence of a unique tumor microenvironment of BALT lymphoma.

Purpose: This study assessed and compared the dosimetric performance of HyperArc and RapidArc in stereotactic radiosurgery (SRS) for a single brain metastasis. Methods: Twenty patients with intracranial brain metastases, each presenting a distinct target volume, were retrospectively selected. Subsequently, volumetric modulated arc therapy (VMAT) plans were designed using RapidArc (VMATRA ) and HyperArc (VMATHA ) for each patient. For planning comparisons, dose-volumetric histogram (DVH) parameters for planning target volumes (PTVs) and normal brain regions were computed across all VMAT plans. Subsequently, their total monitor units (MUs), total beam-on times, and modulation complexity scores for the VMAT (MCSv ) were compared. A statistical test was used to evaluate the dosimetric disparities in the DVHparameters, total MUs, total beam-on times, and MCSv between the MATHA and VMAT sub>RA plans. Results: For the PTVs, VMATHA presented a higher homogeneity index (HI) than VMAT RA . Moreover, VMATHA presented significantly smaller gradient index (GI) values (P<0.001) than VMATRA . Thus, VMATHA demonstrated better performance in the DVH parameters for the PTV than VMATRA . For normal brain tissues, VMATHA presented lower volume receiving 50% of the prescription dose and V 2Gy to the normal brain tissues than VMATRA (P<0.0001). While the total MUs required for VMATHA was significantly higher than those for VMATRA , the total beam-on time for VMATHA was superior to that for VMATRA . Conclusions Thus, VMATHA exhibited superior performance in achieving rapid dose fall-offs (as indicated by the GI) and a higher HI at the PTV compared to VMATRA in brain SRS. This advancement positions HyperArc as a significant development in the field of radiation therapy, offering optimized treatment outcomes for brain SRS.

Purpose: This study assessed and compared the dosimetric performance of HyperArc and RapidArc in stereotactic radiosurgery (SRS) for a single brain metastasis. Methods: Twenty patients with intracranial brain metastases, each presenting a distinct target volume, were retrospectively selected. Subsequently, volumetric modulated arc therapy (VMAT) plans were designed using RapidArc (VMATRA ) and HyperArc (VMATHA ) for each patient. For planning comparisons, dose-volumetric histogram (DVH) parameters for planning target volumes (PTVs) and normal brain regions were computed across all VMAT plans. Subsequently, their total monitor units (MUs), total beam-on times, and modulation complexity scores for the VMAT (MCSv ) were compared. A statistical test was used to evaluate the dosimetric disparities in the DVHparameters, total MUs, total beam-on times, and MCSv between the MATHA and VMAT sub>RA plans. Results: For the PTVs, VMATHA presented a higher homogeneity index (HI) than VMAT RA . Moreover, VMATHA presented significantly smaller gradient index (GI) values (P<0.001) than VMATRA . Thus, VMATHA demonstrated better performance in the DVH parameters for the PTV than VMATRA . For normal brain tissues, VMATHA presented lower volume receiving 50% of the prescription dose and V 2Gy to the normal brain tissues than VMATRA (P<0.0001). While the total MUs required for VMATHA was significantly higher than those for VMATRA , the total beam-on time for VMATHA was superior to that for VMATRA . Conclusions Thus, VMATHA exhibited superior performance in achieving rapid dose fall-offs (as indicated by the GI) and a higher HI at the PTV compared to VMATRA in brain SRS. This advancement positions HyperArc as a significant development in the field of radiation therapy, offering optimized treatment outcomes for brain SRS.

Purpose: This study assessed and compared the dosimetric performance of HyperArc and RapidArc in stereotactic radiosurgery (SRS) for a single brain metastasis. Methods: Twenty patients with intracranial brain metastases, each presenting a distinct target volume, were retrospectively selected. Subsequently, volumetric modulated arc therapy (VMAT) plans were designed using RapidArc (VMATRA ) and HyperArc (VMATHA ) for each patient. For planning comparisons, dose-volumetric histogram (DVH) parameters for planning target volumes (PTVs) and normal brain regions were computed across all VMAT plans. Subsequently, their total monitor units (MUs), total beam-on times, and modulation complexity scores for the VMAT (MCSv ) were compared. A statistical test was used to evaluate the dosimetric disparities in the DVHparameters, total MUs, total beam-on times, and MCSv between the MATHA and VMAT sub>RA plans. Results: For the PTVs, VMATHA presented a higher homogeneity index (HI) than VMAT RA . Moreover, VMATHA presented significantly smaller gradient index (GI) values (P<0.001) than VMATRA . Thus, VMATHA demonstrated better performance in the DVH parameters for the PTV than VMATRA . For normal brain tissues, VMATHA presented lower volume receiving 50% of the prescription dose and V 2Gy to the normal brain tissues than VMATRA (P<0.0001). While the total MUs required for VMATHA was significantly higher than those for VMATRA , the total beam-on time for VMATHA was superior to that for VMATRA . Conclusions Thus, VMATHA exhibited superior performance in achieving rapid dose fall-offs (as indicated by the GI) and a higher HI at the PTV compared to VMATRA in brain SRS. This advancement positions HyperArc as a significant development in the field of radiation therapy, offering optimized treatment outcomes for brain SRS.

Purpose: This study assessed and compared the dosimetric performance of HyperArc and RapidArc in stereotactic radiosurgery (SRS) for a single brain metastasis. Methods: Twenty patients with intracranial brain metastases, each presenting a distinct target volume, were retrospectively selected. Subsequently, volumetric modulated arc therapy (VMAT) plans were designed using RapidArc (VMATRA ) and HyperArc (VMATHA ) for each patient. For planning comparisons, dose-volumetric histogram (DVH) parameters for planning target volumes (PTVs) and normal brain regions were computed across all VMAT plans. Subsequently, their total monitor units (MUs), total beam-on times, and modulation complexity scores for the VMAT (MCSv ) were compared. A statistical test was used to evaluate the dosimetric disparities in the DVHparameters, total MUs, total beam-on times, and MCSv between the MATHA and VMAT sub>RA plans. Results: For the PTVs, VMATHA presented a higher homogeneity index (HI) than VMAT RA . Moreover, VMATHA presented significantly smaller gradient index (GI) values (P<0.001) than VMATRA . Thus, VMATHA demonstrated better performance in the DVH parameters for the PTV than VMATRA . For normal brain tissues, VMATHA presented lower volume receiving 50% of the prescription dose and V 2Gy to the normal brain tissues than VMATRA (P<0.0001). While the total MUs required for VMATHA was significantly higher than those for VMATRA , the total beam-on time for VMATHA was superior to that for VMATRA . Conclusions Thus, VMATHA exhibited superior performance in achieving rapid dose fall-offs (as indicated by the GI) and a higher HI at the PTV compared to VMATRA in brain SRS. This advancement positions HyperArc as a significant development in the field of radiation therapy, offering optimized treatment outcomes for brain SRS.

Purpose: This study assessed and compared the dosimetric performance of HyperArc and RapidArc in stereotactic radiosurgery (SRS) for a single brain metastasis. Methods: Twenty patients with intracranial brain metastases, each presenting a distinct target volume, were retrospectively selected. Subsequently, volumetric modulated arc therapy (VMAT) plans were designed using RapidArc (VMATRA ) and HyperArc (VMATHA ) for each patient. For planning comparisons, dose-volumetric histogram (DVH) parameters for planning target volumes (PTVs) and normal brain regions were computed across all VMAT plans. Subsequently, their total monitor units (MUs), total beam-on times, and modulation complexity scores for the VMAT (MCSv ) were compared. A statistical test was used to evaluate the dosimetric disparities in the DVHparameters, total MUs, total beam-on times, and MCSv between the MATHA and VMAT sub>RA plans. Results: For the PTVs, VMATHA presented a higher homogeneity index (HI) than VMAT RA . Moreover, VMATHA presented significantly smaller gradient index (GI) values (P<0.001) than VMATRA . Thus, VMATHA demonstrated better performance in the DVH parameters for the PTV than VMATRA . For normal brain tissues, VMATHA presented lower volume receiving 50% of the prescription dose and V 2Gy to the normal brain tissues than VMATRA (P<0.0001). While the total MUs required for VMATHA was significantly higher than those for VMATRA , the total beam-on time for VMATHA was superior to that for VMATRA . Conclusions Thus, VMATHA exhibited superior performance in achieving rapid dose fall-offs (as indicated by the GI) and a higher HI at the PTV compared to VMATRA in brain SRS. This advancement positions HyperArc as a significant development in the field of radiation therapy, offering optimized treatment outcomes for brain SRS.

PURPOSE: This study aimed to identify predictors for distant metastatic behavior and build a related prognostic nomogram in breast cancer. MATERIALS AND METHODS: A total of 1,181 patients with non-metastatic breast cancer between 2003 and 2011 were analyzed. To predict the probability of distant metastasis, a nomogram was constructed based on prognostic factors identified using a Cox proportional hazards model. RESULTS: The 7-year overall survival and 5-year post-progression survival of locoregional versus distant recurrence groups were 67.6% versus 39.1% (p=0.027) and 54.2% versus 33.5% (p=0.043), respectively. Patients who developed distant metastasis showed early and late mortality risk peaks within 3 and after 5 years of follow-up, respectively, but a broad and low risk increment was observed in other patients with locoregional relapse. In multivariate analysis of distant metastasis-free interval, age (≥ 45 years vs. < 45 years), molecular subtypes (luminal A vs. luminal B, human epidermal growth receptor 2, and triple negative), T category (T1 vs. T2-3 and T4), and N category (N0 vs. N1 and N2-3) were independently associated (p < 0.05 for all). Regarding the significant factors, a well-validated nomogram was established (concordance index, 0.812). The risk score level of patients with initial brain failure was higher than those of non-brain sites (p=0.029). CONCLUSION: The nomogram could be useful for predicting the individual probability of distant recurrence in breast cancer. In high-risk patients based on the risk scores, more aggressive systemic therapy and closer surveillance for metastatic failure should be considered.
Brain ; Breast Neoplasms* ; Breast* ; Follow-Up Studies ; Humans ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Nomograms* ; Phenobarbital ; Prognosis ; Proportional Hazards Models ; Radiotherapy, Adjuvant* ; Recurrence

PURPOSE: The role of radiotherapy (RT) was largely deserted after the introduction of platinum-based chemotherapy, but still survival rates are disappointingly low. This study focuses on assessing the clinical efficacy of RT in relation to chemotherapy resistance. MATERIALS AND METHODS: From October 2002 to January 2015, 44 patients were diagnosed with epithelial ovarian cancer (EOC) and treated with palliative RT for persistent or recurrent EOC. All patients received initial treatment with optimal debulking surgery and adjuvant platinum-based chemotherapy. The biologically effective dose (BED) was calculated with α/β set at 10. Ninety-four sites were treated with RT with a median BED of 50.7 Gy (range 28.0 to 79.2 Gy). The primary end-point was the in-field local control (LC) interval, defined as the time interval from the date RT was completed to the date any progressive or newly recurring disease within the RT field was detected on radiographic imaging. RESULTS: The median follow-up duration was 52.3 months (range 7.7 to 179.0 months). The 1-year and 2-year in-field LC rates were 66.0% and 55.0%, respectively. Comparisons of percent change of in-field tumor response showed similar distribution of responses among chemoresistant and chemosensitive tumors. On multivariate analysis of predictive factors for in-field LC analyzed by sites treated, BED ≥ 50 Gy (hazard ratio, 0.4; confidence interval, 0.2–0.9; p = 0.025) showed better outcomes. CONCLUSION: Regardless of resistance to platinum-based chemotherapy, RT can be a feasible treatment modality for patients with persistent of recurrent EOC. The specific role of RT using updated approaches needs to be reassessed.
Drug Therapy ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Ovarian Neoplasms* ; Palliative Care ; Radiotherapy ; Survival Rate ; Treatment Outcome