Chemo-Radiation

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The indoleamine 2,3-dioxygenase pathway controls complement-dependent enhancement of chemo-radiation therapy against murine glioblastoma

The indoleamine 2,3-dioxygenase pathway controls complement-dependent enhancement of chemo-radiation therapy against murine glioblastoma

We found that GL261 tumors from untreated mice did not stain for C3, and tumors from mice treated with TMZ + RT showed only scattered interstitial C3 staining (Figure 4A). However, when we combined TMZ + RT with IDO-blockade using either 1MT or NLG919, we ob- served extensive and confluent C3 deposition (Figure 4B). To test whether IDO was required for complement depos- ition, we treated IDO-deficient mice with TMZ + RT. We observed the same deposition of C3 in tumors from IDO- deficient host mice treated with TMZ + RT as we found in tumors from WT mice treated with IDO-blockade plus TMZ + RT (Figure 4B). We also found that C3 accumu- lation in tumors required the full combination of IDO- blockade with chemo-radiation therapy, as comple- ment deposition was not seen in mice treated with IDO-blockade alone, IDO-blockade with TMZ (no RT), or IDO-blockade with RT (no TMZ) (Additional file 1: Figure S8). We also found that C3 deposition was strictly confined to the tumor microenvironment, and adjacent brain tissue was completely spared (Figure 4B). Thus, host IDO activity regulated complement deposition in glioblastoma tumors after chemo-radiation therapy, and complement deposition was highly selective and confined to the tumor itself.
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Evaluation of the response rate of chemo-radiation and brachytherapy in patients with locally advanced carcinoma cervix in a tertiary care center

Evaluation of the response rate of chemo-radiation and brachytherapy in patients with locally advanced carcinoma cervix in a tertiary care center

Background: Incidence and mortality estimates are used to measure the burden of cancer in a population and survival estimates are ideal for evaluating the outcome of cancer control activities. Survival studies evaluate the quality and quantity of life of a group of patients after diagnosing the disease. The patient survival after the diagnosis of cervical cancer is indirectly influenced by socio-economic factors. The present study was carried out with an aim to evaluate the success rate of chemo-radiation followed by brachytherapy to the patients of locally advanced carcinoma (Ca.) cervix in a tertiary care center.
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Lateral pelvic lymph node dissection after neoadjuvant chemo radiation for preoperative enlarged lateral nodes in advanced low rectal cancer: study protocol for a randomized controlled trial

Lateral pelvic lymph node dissection after neoadjuvant chemo radiation for preoperative enlarged lateral nodes in advanced low rectal cancer: study protocol for a randomized controlled trial

Rectal cancer is the third most common cancer and the fourth leading cause of cancer-related deaths worldwide [1]. Local recurrence of middle/low rectal cancer is not only a poor prognostic factor but also a threat of a ter- rible quality of life. Although universal usage of neoadju- vant chemo-radiation (nCRT) and total mesorectal excision (TME) have decreased local recurrence rates to 5–10%, the ratio of local recurrence has occupied almost 30% of total metastases and recurrence incidences, which heavily limits the therapeutic effect for advanced rectal cancer [2]. Increasing evidence has demonstrated that lateral pelvic lymph node (LLN) metastasis is a major cause of local recurrence of advanced rectal can- cer [3]. At the time of diagnosis, 10–25% of patients with advanced rectal cancer have synchronous LLN me- tastases, which consequently lead to local recurrence and poor overall survival [4, 5].
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Comparison of altered fractionation schedule with concurrent chemo-radiation for squamous cell carcinoma of head and neck

Comparison of altered fractionation schedule with concurrent chemo-radiation for squamous cell carcinoma of head and neck

In curative intent radiotherapy of HNSCC, besides tumor- related prognostic factors, differences in clinical outcome could be accounted for by the addition of chemotherapy. The addition of chemotherapy to radiation helps to sensitize tumors by inhibiting the repair of sublethal radiation damage and preferentially killing hypoxic cells. Concurrent chemo-radiotherapy (CTRT) has shown to improve loco-regional control and has become the standard of care for locally advanced HNSCC. The benefit in terms of locoregional control and survival, in altered fractionation, led many investigators to evaluate concurrent CTRT versus altered fractionation. The altered fractionation schedules have been compared with definitive radiotherapy alone which was the standard of care earlier, but there are no studies comparing altered fractionation schedule with concurrent chemo radiotherapy arm. Hence, this study was aimed to compare the locoregional response of altered fractionation schedule with concurrent chemo-radiation and its acute toxicities in patients with locally advanced head and neck cancers.
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Concurrent chemo radiation with cisplatin and bleomycin versus cisplatin alone in locally advanced squamous cell carcinoma of oral  cavity:  a retrospective study.

Concurrent chemo radiation with cisplatin and bleomycin versus cisplatin alone in locally advanced squamous cell carcinoma of oral cavity: a retrospective study.

In locally advanced carcinoma concurrent chemo radiation is the alternate treatment of choice. The small tumors can effectively treated by brachytherapy and the result is same as that of surgery. The advanced cancers generally require combined modality approach. The treatment of oral cavity cancers is highly individualized and depends on stage of disease, subsite involved, and physician preferences and varies from institution to institutions. There are no definite guidelines for the treatment of oral cavity cancers. Patients who are unable to withstand major surgery can be treated with radiation therapy and concurrent chemotherapy. The choice of treatment depends on the cosmetic changes, complications and functional consequences that the treatment is expected to cause. The overview of treatment option by tumor site, local control and five year survival rates by tumor site and disease stage summarized in the following tables.
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Effectiveness of moderate walking exercise program (mwep) on fatigue and quality of sleep among cancer patients receiving chemo radiation

Effectiveness of moderate walking exercise program (mwep) on fatigue and quality of sleep among cancer patients receiving chemo radiation

highly prevalent in cancer patients receiving chemo-radiation quality of life. In literature, exercise has been recognized as one of the most effective intervention to combat against these commonest symptoms either related Keeping the importance of exercise during cancer therapy in mind, study is aimed to assess the effectiveness of ‘moderate walking exercise program (MWEP)’ on fatigue and quality of sleep among cancer patients receiving chemo-radiation in a tertiary care experimental, two group pre-test post-test control group design was adopted to collect the data from 60 conveniently selected eligible adult radiation in selected study setting. Ludwig Von 68) was adopted to guide the study. Data were collected using demographic profile sheet, BFI (Brief Fatigue Inventory) and VSH (VerranSynydern and Study revealed that the fatigue scores of cancer patients significantly day of the chemo-radiation. MWEP radiation (p≤0.05). Conclusion: Study concludes that the moderate walking exercise program is very effective as an intervention to reduce fatigue and improve quality of sleep and should be followed by cancer patients receiving combined Recommendations: MWEP should be followed by and decreased quality of sleep. Nurses should be highly involved in oncology wards for encouraging the patients to sustain MWEP in order to improve quality of life.
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Nimotuzumab with Induction Chemotherapy and Chemo Radiation in Patients with Advanced Head and Neck Cancer

Nimotuzumab with Induction Chemotherapy and Chemo Radiation in Patients with Advanced Head and Neck Cancer

of radiation. Patients were evaluated using RECIST criteria, 4 weeks after the last cycle of chemo- therapy. Results: Sixteen patients were included in this study, with mean age of 54 ± 11 years. Most common sub-site of cancer was oral cavity in 69% (n = 11), followed by pharynx in 19% (n = 3). Four patients had metastasis at the time of presentation. Six patients (37.5%) had progressive disease and four patients (25%) were lost to follow-up. The combination chemotherapy with ni- motuzumab was well tolerated. Addition of nimotuzumab to TPF regimen was not associated with added toxicity. Conclusion: Addition of anti-EGFR monocloncal antibody (nimotuzumab) to induc-
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Prognostic significance of survivin in rectal cancer patients treated with surgery and postoperative concurrent chemo- radiation therapy

Prognostic significance of survivin in rectal cancer patients treated with surgery and postoperative concurrent chemo- radiation therapy

Patients with histologically confirmed locally advanced rectal adenocarcinoma at Samsung Medical Center (Seoul, Korea) between June 2001 and September 2004 were enrolled in the present study. Eligibility criteria were (1) treatment with curative surgical resection, (2) pathologic T stage of 2 to 3 and/or regional lymph node metastasis, and (3) adjuvant CCRT with 5-fluorouracil (FU)-based chemotherapeutic agents. Patients who underwent preoperative chemotherapy and/or radiation therapy (RT), had pT4 or N0 disease, or received adjuvant chemotherapy with other than a 5-FU based regimen, such as capecitabine, were excluded from this study.
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Inter Comparison of Concurrent versus Sequential Chemo Radiation in Limited-Stage Small Cell Carcinoma of Lung in Kashmir, North India

Inter Comparison of Concurrent versus Sequential Chemo Radiation in Limited-Stage Small Cell Carcinoma of Lung in Kashmir, North India

Srinagar, J&K, India. It was a prospective randomized study. The study was conducted from May 2008 to October 2010. The aim of the study was to compare the tumor response ,toxicity profile and survival rates between concurrent versus sequential chemo radiotherapy in limited-stage small cell lung carcinoma. The age of the patients ranged from 45 to 75 years with a mean age of 59.67 ± 3.67 years, consistent with the study of Hasan Tathsoz et al [16] , with a mean age of 58 ± 8.1 years. In the

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Circulating tumor cells: A promising marker of predicting tumor response in rectal cancer patients receiving neoadjuvant chemo- radiation therapy

Circulating tumor cells: A promising marker of predicting tumor response in rectal cancer patients receiving neoadjuvant chemo- radiation therapy

A total of 115 patients, diagnosed with locally advanced rectal cancer, were enrolled in this study between February 2012 and June 2013. The pretreatment evaluation of the patients included a complete clinical history, physical examination, colonoscopy, relevant blood examination, pelvic magnetic resonance imaging and chest/abdominal computed tomography. The recruitment criteria was as follows: pathologically confirmed with rectal adenocarcinoma; diagnosed as locally advanced rectal cancer (cT3-4 and/or N+) by pelvic magnetic resonance imaging; no evidence of distant metastases; tumor distance from anal verge ≤10 cm; no previous chemotherapy, pelvic radiotherapy or surgery for rectal cancer; Karnofsky ≥70 or ECOG 0-2. The characteristics of enrolled patients were shown in Table 1. All patients received neoadjuvant radiotherapy (pelvic radiation therapy with a total dose of 50-55Gy in 25 fractions) and concurrent chemotherapy using Capecitabine (625 mg/m2, twice daily, day1-5/week) and Oxaliplatin (85 mg/m2, day1/week). A standard total mesorectal excision was performed 6-8 weeks after the completion of neoadjuvant CRT. After radical surgery, 5-6 cycles of XELOX(CapeOX) regimen were given to all patients: Oxaliplatin 130 mg/m2 d1, Capecitabine 1000 mg/m2 bid d1-14, q3w. For all these patients, 5ml peripheral blood samples were obtained one week before the initiation of CRT and one week after the completion of CRT, respectively.
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Correlation of dose to bone marrow with hematological toxicity and mri based estimation of conversion of active to inactive bone marrow in long course chemo-radiation for locally advanced rectal cancer.

Correlation of dose to bone marrow with hematological toxicity and mri based estimation of conversion of active to inactive bone marrow in long course chemo-radiation for locally advanced rectal cancer.

This   is   to   certify   that   the   dissertation   entitled   “CORRELATION   OF   DOSE   TO   BONE   MARROW   WITH   HEMATOLOGICAL   TOXICITY   AND   MRI   BASED   ESTIMATION  OF  CONVERSION  OF  ACTIVE  TO  INACTIVE  BONE  MARROW  IN   LONG   COURSE   CHEMO-­‐   RADIATION   FOR   LOCALLY   ADVANCED   RECTAL   CANCER   ”   is     a   bonafide   work     done     by     Dr.   Jayant   J   Bhargav,   Post   Graduate     Registrar  in  the  Department  of  Radiotherapy,  Christian  Medical  College,  Vellore     during  the  period  from  June  2013  to  April  2015  and  is  being  submitted  to  The   Tamil  Nadu  Dr.  M.  G.  R  Medical  University  in  partial  fulfillment  of  the  MD  Branch   IX  Radiotherapy  examination  conducted  in  April  2015.  
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Mifepristone improves chemo-radiation response in glioblastoma xenografts

Mifepristone improves chemo-radiation response in glioblastoma xenografts

VEGF expression analysis with Quantitative Real-Time PCR The effect of Mifepristone on the expression of angiogenic factors during concomitant chemo-radiotherapy was ex- amined using quantitative real-time PCR (QrtPCR). VEGF expression levels in the tumor tissue from glioma xeno- grafts were evaluated at the end of the study. Briefly, the whole tumors were lysed and the total RNA was isolated from each tumor with a method based on guanidine iso- thiocyanate/phenol/chloroform extraction using TRIzol reagent (Invitrogen Life Technologies) and quantified with UV spectroscopy. After quantification, 200 ng of total RNA was used in the presence of the TaqMan W RNA-to -CT™ 1-Step Kit (Applied Biosystems) to perform one- step RT-PCR TaqMan Gene Expression Assays of vascular endothelial growth factor A (VEGF-A) (Hs00900055_m1, Applied Biosystems) by using a FAM probe and Endogen- ous Control Human GAPDH (4310884E, Applied Biosystems) with VIC Probe. Real-time quantization was realized on the Spectrum 48 thermocycler Instrument (Esco, Micro Pte Ltd, Singapore).
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Acute Toxicity of Three Dimensional Conformal Concurrent Chemoradiation with Dose Optimization for External Beam Radiation in Carcinoma Cervix—A Prospective Study

Acute Toxicity of Three Dimensional Conformal Concurrent Chemoradiation with Dose Optimization for External Beam Radiation in Carcinoma Cervix—A Prospective Study

Dosimetric comparisons have been done between conventional and 3DCRT/IMRT and have demonstrated a decrease in the radiation dose delivery to bowel, bladder and bone marrow and hence a decreased toxicity to these organs [3]. Forrest et al. found that the conventional 4 field box covered both the macroscopic and micro- scopic extent of the disease but because the treated volume is large the coverage of the PTV is achieved with considerable irradiation of normal tissues with significant acute as well as late toxicity particularly of the small bowel, sigmoid, rectum and bladder [4]. Gerstner et al. showed that there was a 10% reduction in small bowel volume which is inside the treated volume and a 20% reduction in the risk of geographical miss when dose dis- tributions of conformal RT were compared with four field box techniques [5]. Published studies on acute toxici- ty and treatment tolerance of concurrent chemo radiation with 3D planning are largely lacking in literature. The objective of the 3DCRT planning in our study was to optimize the dose distribution in such a way that the PTV maximum dose is around 105% at the same time achieving 99% coverage of PTV with the 99% isodose line. We wanted to study if this dose optimization resulted in an improved acute toxicity profile. Since acute toxicity reflects tolerance and compliance of the patient to the treatment, measures to reduce acute toxicity will also re- sult in an increase in the number of patients who complete their full treatment of radiation.
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Retrospective Analysis of Rate of Larynx Preservation in Locally Advanced Laryngopharyngeal Squamous Cell Carcinoma Following Chemo RT – An Institution Based Study

Retrospective Analysis of Rate of Larynx Preservation in Locally Advanced Laryngopharyngeal Squamous Cell Carcinoma Following Chemo RT – An Institution Based Study

presentation is 58 years and 76% of patients were males. Majority of laryngeal cancer patients are now treated with organ preservation protocols. The treatment objective for early laryngeal cancer that can be treated with surgery or radiation, is to obtain cure with functional larynx with least morbidity. Treatment emphasizes avoiding combination of surgery and radiation because preservation of larynx may be compromised. There is no one treatment that has proven to be superior with regard to all treatment goals. 10,11,12 Radical radiation is as effective as radical surgery in early stage with added advantage of larynx preservation. Inmost centers, upfront radiation is preferred for T1 and T2tumors, with surgery being reserved for salvageal though hemilaryngectomy produces similar cure rates for selected T1 and T2 laryngeal cancers; irradiation is usually associated with better quality of voice. 13,14 In 1974, Bataini and colleagues published an overall loco regional control rate of 76% for relatively large series patients with T1, T2, N0-2 supraglottic carcinomas treated by radiotherapy alone. 9 In our study, 1 year larynx preservation rate in stage II is 78%. Locally advanced laryngeal cancers (stages III and IV) require radical surgery followed by external radiotherapy. Chemo-radiation is an active alternative for surgery when organ preservation is desired. The landmark trial conducted by VA group established ICT followed by radiotherapy as an alternative to radical surgery for advanced carcinoma larynx. RTOG 91-11 study showed organ preservation was finest achieved with CCRT. 3,4 In our study, we have found that overall larynx preservation of 68% could be achieved with chemo-radiotherapy (neoadjuvant chemotherapy followed by chemo- radiotherapy, concurrent chemoradiotherapy and radiotherapy alone which formed a veryfew number of patients)as the sole treatment modality inpatients of stage II-IVA laryngeal cancer. In our study 1 year larynx preservation rate in stage III and stage IV were67.06% and 64.35 % respectively. When compared with RTOG 91-11, our study does not show inferior results. Study conducted by Grouped’ Etude des Tumeurs de la
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Role of curcumin as an adjuvant in treatment of advanced head and neck squamous cell carcinoma

Role of curcumin as an adjuvant in treatment of advanced head and neck squamous cell carcinoma

Patients receiving curcumin along with chemo radiation had a marginal decrease in tumour dimensions and volume, but a statistical significance could not be achieved due to inadequate number of cases and lack of stage-match controls. Curcumin has shown to have a diversified inhibitory effect on various molecular pathways of tumorogenesis. No systemic toxicity was noticed with intake of curcumin. Further elaborate studies with more stage matched patients are required to validate its role as an adjuvant in the treatment of head and neck squamous cell carcinomas
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A novel circulating hsa_circ_0081001 act as a potential biomarker for diagnosis and prognosis of osteosarcoma

A novel circulating hsa_circ_0081001 act as a potential biomarker for diagnosis and prognosis of osteosarcoma

Actually, a previous study by Song YZ et al found that hsa_circ_0001564 was significantly overexpressed in OS tissue, as well as in OS cell lines and could act as a potential biomarker for the OS [34]. But they did not analyze the correlation of hsa_circ_0001564 expression level with OS progression, such as chemo-resistance, lung metastasis, and overall survival time and did not examine the hsa_circ_0001564 expression in serum of OS patients. Besides, in a previous study by us, we first reported that circPVT1, a potential new circular RNA biomarker, contributes to doxorubicin and cisplatin resistance of OS cells by regulating ABCB1 [22]. To further demonstrate the feasibility of hsa_circ_0081001, we compared its specificity and sensitivity with circPVT1 by ROC curve and found that AUC value of hsa_circ_0081001 is comparable to circPVT1 (AUC 0.898 vs 0.871, P>0.05), with an important value as a biomarker in OS.
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Radiations and female fertility

Radiations and female fertility

Brain tumors constitute approximately 17% of all malig- nant tumors in patients younger than 20 years of age [72] and radiotherapy plays an important role in the curative and palliative treatment of patients with primary and/or metastatic brain tumors [73]. As survival rates of patients with childhood brain tumors have increased to 75%, the side effects of cancer treatment are of particular importance [74]. Radiations induced anterior pituitary hormone deficiency represents the most common irre- versible and progressive long-term complication of anti- cancer treatment and up to 50% of childhood cancer survivors will deal with an endocrinopathy requiring strict follow up to minimize the subsequent effects on growth, bone density, pubertal development and quality of life [75]. The hypothalamic-pituitary-gonadal axis (H-P-G axis) is a hormone system extremely vulnerable to radiotherapy; indeed, both brain surgery and cranial radiation could determine gonadotropin deficiency [76]. The exact mechanism by which radiations influence the H-P-G axis is still poorly understood. A direct injury to H-P cells, rather than reduced hypothalamic blood flow seems to be the major cause of H-P-G axis dysfunction [77]. This hypothesis is supported by the fact that anter- ior pituitary hormone deficiencies follow a predictable pattern [78] where the growth hormone (GH) axis is the more radiosensitive (GH levels are reduced more than 90% after irradiation), followed by gonadotropin, adreno- corticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) axis. This is consistent with a direct radiation-induced selective hypothalamic neuronal and
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Synergistic Chemo/Biocatalytic Synthesis of Alkaloidal Tetrahydroquinolines

Synergistic Chemo/Biocatalytic Synthesis of Alkaloidal Tetrahydroquinolines

ABSTRACT: The power of complementary chemo- and biocatalytic transformations is demonstrated in the asymmetric syn- thesis of 2-substituted tetrahydroquinolines. A series of racemic tetrahydroquinolines were synthesized through a conver- gent one-pot Rh(I)-catalysed addition/condensation sequence of alkyl vinyl ketones and aminophenylboronic acids. The re- sulting tetrahydroquinolines were thereafter shown to be substrates for the flavin-dependent enzyme cyclohexylamine oxi- dase, and preparative-scale deracemizations have been demonstrated on these high-value targets.

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Clinical, dosimetric, and position factors for radiation-induced acute esophagitis in intensity-modulated (chemo)radiotherapy for locally advanced non-small-cell lung cancer

Clinical, dosimetric, and position factors for radiation-induced acute esophagitis in intensity-modulated (chemo)radiotherapy for locally advanced non-small-cell lung cancer

CCRT, concurrent chemoradiotherapy; AE, acute esophagitis; NSCLC, non-small-cell lung cancer; RTOG, Radiation Therapy Oncology Group; CTCAE, Common Toxicity Criteria for Adverse Events; 3D-CRT, three-dimensional conformal radiotherapy; IMRT, intensity-modulated radio- therapy; OARs, organs at risk; UICC, Union for International Cancer Control; GTV, gross tumor volume; CTV, clinical target volume; ITV, internal target volume; PTV, planning target volume; DVHs, dose–volume histograms; SCRT, sequential chemoradiotherapy.

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<p>Combination pembrolizumab plus chemotherapy: a new standard of care for patients with advanced non-small-cell lung cancer</p>

<p>Combination pembrolizumab plus chemotherapy: a new standard of care for patients with advanced non-small-cell lung cancer</p>

Nivolumab (Nivo) + platinum-doublet chemotherapy (Chemo) vs chemo as fi rst-line (1L) treatment (Tx) for advanced non-small cell lung cancer (NSCLC) with <1% tumor PD-L1 expression: re[r]

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