International Journal of Cancer Therapy and Oncology
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Unusual bone metastasis from follicular carcinoma thyroid: presenting as a primary bone malignancy
Get PDFOsseous metastasis in patients of thyroid carcinoma is not very common, and appendicular skeleton is very rare. Bone metastasis represents a complication, especially of follicular thyroid carcinoma and severely reduces the quality of life causing pain, and fractures. Diagnosis is typically done by correlating clinical suspicion with imaging. Occult clinical presentations usually delay the detection and management of patients with bone metastasis from thyroid carcinoma. There is limited information about the clinical presentations and prognosis of patients with follicular thyroid carcinoma with bone metastasis. We hereby present a case report of right arm swelling diagnosed as metastatic carcinoma having metastasis from thyroid primary
High Impact Papers from November – December, 2013
Get PDFHigh impact papers from a particular Issue are selected based on the quality of the article and the number of citations. High impact papers are typically recognized once the Issue completes the publication time period of 12 months. View in PDFFollowing articles are recognized as High Impact Papers from November-December, 2013.Lu L. Dose calculation algorithms in external beam photon radiation therapy. Int J Cancer Ther Oncol 2013; 1(2):01025.DOI: 10.14319/ijcto.0102.5Read Download CitationsKhosa F, Khan A, Shuaib W, Clouse M, Budoff M, Blankstein R, Nasir K. Radiation exposure for coronary artery calcium score at prospective 320 row multi-detector computed tomography. Int J Cancer Ther Oncol 2013; 1(2):01023.DOI: 10.14319/ijcto.0102.3Read Download Citations(High impact papers from January-March, 2014 will be recognized in the next Issue of the IJCTO
Assessment of ocular beta radiation dose distribution due to 106Ru/106Rh brachytherapy applicators using MCNPX Monte Carlo code
Get PDFPurpose: Melanoma at the choroid region is the most common primary cancer that affects the eye in adult patients. Concave ophthalmic applicators with 106Ru/106Rh beta sources are the more used for treatment of these eye lesions, mainly lesions with small and medium dimensions. The available treatment planning system for 106Ru applicators is based on dose distributions on a homogeneous water sphere eye model, resulting in a lack of data in the literature of dose distributions in the eye radiosensitive structures, information that may be crucial to improve the treatment planning process, aiming the maintenance of visual acuity. Methods: The Monte Carlo code MCNPX was used to calculate the dose distribution in a complete mathematical model of the human eye containing a choroid melanoma; considering the eye actual dimensions and its various component structures, due to an ophthalmic brachytherapy treatment, using 106Ru/106Rh beta-ray sources. Two possibilities were analyzed; a simple water eye and a heterogeneous eye considering all its structures. Two concave applicators, CCA and CCB manufactured by BEBIG and a complete mathematical model of the human eye were modeled using the MCNPX code. Results and Conclusion: For both eye models, namely water model and heterogeneous model, mean dose values simulated for the same eye regions are, in general, very similar, excepting for regions very distant from the applicator, where mean dose values are very low, uncertainties are higher and relative differences may reach 20.4%. For the tumor base and the eye structures closest to the applicator, such as sclera, choroid and retina, the maximum difference observed was 4%, presenting the heterogeneous model higher mean dose values. For the other eye regions, the higher doses were obtained when the homogeneous water eye model is taken into consideration. Mean dose distributions determined for the homogeneous water eye model are similar to those obtained for the heterogeneous eye model, indicating that the homogeneous water eye model is a reasonable one. The determined isodose curves give a good visualization of dose distributions inside the eye structures, pointing out their most exposed volume....................................................Cite this article as:Barbosa NA, da Rosa LAR, de Menezes AF, Reis JP, Facure A, Braz D. Assessment of ocular beta radiation dose distribution due to 106Ru/106Rh brachytherapy applicators using MCNPX Monte Carlo code. Int J Cancer Ther Oncol 2014; 2(3):02038. DOI: 10.14319/ijcto.0203.
Cancer research and therapy: Where are we today?
Get PDFTill date scientists are struggling to understand the complete mechanism of carcinogenesis. In future, the real time detection of cancer may help scientists to identify some of the complicated biological mechanisms. Certain special features of cancer cells enable researchers to deliver the drug or to develop the right drug therapy. These cell properties include over expression or over activity in uptake of certain nutrients e.g. folic acid and increased permeability. Listed properties might vary depending upon the type of cancer and can be fully exploited by using nanoparticles either to detect the site of cancer or to direct the drug at the affected site. Product approach like drug conjugates, complexes serves as a good platform to solve issues like solubility, toxicity, poor penetration and stability related to cancer drugs. Beside this, several drug delivery platforms are under development by researchers in academia as well as in industry to deliver therapeutic molecules and new chemical entities to the targeted site in body. Amongst them, nanotechnology both at molecular and supramolecular level is a leading platform and can help to image, detect and treat cancer. Surface modification of nanoparticles by coating or anchoring their surface with special markers, materials, peptide, proteins, antibodies or antigens add extra feature and thereby can enhance the effectiveness. These treatments can be used individually or in combined form. In this review, advances on nanotechnological platform are discussed together with some assisting techniques like magnetic field, photo or light field, sonic rays are touched upon. New biological therapies that are advancing in this direction include the antisense therapy, cell therapy, gene therapy, radiation therapy and SiRNA interfaces which are discussed in brief in this article. This article gives short overview on use of complementary and alternative medicine for treatment of cancer such as traditional Chinese medicine (TCM), Ayurveda to avoid toxic effects of synthetic drugs
Proteasome LMP2/β1i subunit as biomarker for human uterine leiomyosarcoma
Get PDFUterine leiomyosarcoma (Ut-LMS) develops more frequently in the myometrium of the uterine body than in the uterine cervix. Although the development of gynecological tumors is often correlated with the secretion of female hormones that of Ut-LMS does not, and its risk factor(s) remain unknown. Importantly, a diagnostic biomarker that can distinguish malignant tumor Ut-LMS from benign tumor leiomyoma (LMA), has yet to be established. Therefore, the risk factor(s) associated with Ut-LMS need to be examined in order to establish a diagnosis and clinical treatment method. Mice with a homozygous deficiency for the proteasome b-ring subunit, low-molecular mass polypeptide (LMP)2/b1i spontaneously develop Ut-LMS, with a disease prevalence of ~40% by 14 months of age. In recent studies, we showed that LMP2/b1i expression was absent in human Ut-LMS, but present in other human uterine mesenchymal tumors including uterine LMA. Moreover, LMP2/b1i is also known to negatively regulate human Ut-LMS tumorigenesis. Additional experiments furthermore revealed the differential expression of cyclin E and calponin h1 in human uterine mesenchymal tumors. Therefore, LMP2/b1i is a potential diagnostic biomarker when combined with the candidate molecules, cyclin E and calponin h1 for human Ut-LMS, and may be a targeted molecule for a new therapeutic approach.---------------------------------------------Cite this article as: Hayashi T, Horiuchi A Aburatani H, Ishiko O, Yaegashi N, Kanai Y, Zharhary D, Tonegawa S, Konishi I. Proteasome LMP2/ß1i subunit as biomarker for human uterine leiomyosarcoma. Int J Cancer Ther Oncol 2014; 2(1):02018.DOI: http://dx.doi.org/10.14319/ijcto.0201.
Response to chemotherapy and association with three tumour markers in breast cancer patients in Ghana
Get PDFPurpose: Oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (HER2/neu) expression in breast cancer patients predict response to chemotherapy though recorded extent vary. This retrospective study aimed to investigate the relationship between ER, PR and HER2/neu expression and response of breast cancer to chemotherapy at a tertiary hospital in Ghana. Methods: Records of all breast cancer cases seen from 2009 through 2011 were reviewed. Their receptor status, first line treatment [4 cycles of Adriamycin (60mg/m2) + Cyclophosphamide (600mg/m2)], second line treatment [Capecitabine (1g/m2) + Paclitaxel (170mg/m2)] and clinical response were extracted.Results: Complete remission after first and second line treatments were observed in 36 (38.3%, 95% CI: 28.5 to 48.9) and 34 (58.6%, 95% CI: .44.9 to 71.4) respectively. After both first and second line treatment 70 (74.5%, 95% CI: 64.4 - 82.9) had gone into remission. Prevalence of ER, PR, HER2/neu and Triple negative breast cancer (TNBC) were 34.0% (95% CI: 24.6 to 44.5), 20.2% (95% CI: 12.6 to 29.7), 8.5% (95% CI: 3.7 to 16.1) and 59.6% (95%CI: 48.9 to 69.6) respectively. ER and PR positivity were independently associated with complete remission after first line treatment while TNBC was associated with non-remission. Conversely ER was independently associated with non-remission after second line treatment while TNBC was associated with complete remission. Conclusion: ER and TNBC status are significant predictors of complete remission and non-remission respectively after chemotherapy for breast cancer patient in Ghana.................................................................Cite this article as:Amankwaa-Frempong E, Yeboah FA, Nguah SB, Afriyie OO. Response to chemotherapy and association with three tumour markers in breast cancer patients in Ghana. Int J Cancer Ther Oncol 2014; 2(3):02034. DOI: 10.14319/ijcto.0203.
Voxel-based partial volume correction for accurate quantitative voxel values
Get PDFPurpose: The accuracy of voxelized information in emission imaging is limited by spatial resolution (FWHM = 2.35σ) producing biases for objects smaller than 3 FWHM. If the signal distribution is non‐uniform within 3σ of the voxel of interest then equilibrium does not exist and partial volume effect (PVE) compromises voxel accuracy. We propose a mathematical model to improve the accuracy of quantitative images of arbitrary distribution by bounding true voxel signal and estimating PVE for each voxel.Methods: A monotonically increasing parametric dataset is created for each voxel of an emission image by radial integration from the voxel center to radius = 6σ. Each cumulative integration plot from r = 3σ to 6σ is fit to a function A*4π /3*r3 + B*ΔV derived assuming a local uniform signal distribution (A) where ΔV is the voxel volume. The constant BΔV represents the converged within 3σ integral of PVE. B > 0 implies spill‐out, B < 0 spill‐in, and B = 0 no PVE. We tested the proposed model on simulations of 1D&2D datasets containing known signal distributions and 18F‐PET/CT images of a 6cc lung lesion and bladder.Results: Signal accuracy was > 99% in simulated 1D & 2D datasets. For the tumor, the original maximum value was 10kBq/ml. We obtained A = 3.5kBq/ml and B = 14kBq/ml for a total of 17.7kBq/ml. This yields (A+B)/original = 1.8 indicating substantial spill‐out of ~80% and a large error for the original voxel value. For a voxel in the center of the bladder, the original value was 46kBq/ml with A = 44kBq/ml, B = 7kBq/ml. (A+B)/original = 1.11 indicating near‐equilibrium at center of bladder and low spill-out of ~11% as expected. Local signal images (A) resemble low‐pass filtered original image and (B) shows the magnitude and direction of PVE. Conclusion: A new mathematical model to estimate the accuracy of voxels in quantitative images of arbitrary distribution has been developed. Analysis of additional patients is underway.-------------------------------------Cite this article as: Mikell J, Kappadath SC. Voxel-based partial volume correction for accurate quantitative voxel values. Int J Cancer Ther Oncol 2014; 2(2):020229. DOI: 10.14319/ijcto.0202.2
The expression of p53 and hsp70 proteins after treatment with Annona muricata Linn leaf for activating apoptotic and lead to homeostasis program of Raji cells
Get PDFPurpose: Organic extracts of plant Annonaceae enhances apoptosis in animal cells and get the drives to reach a new homeostasis. The incidence rate of nasopharyngeal cancer in Indonesia is quite high. Protein 53Kd (p53) play a role in apoptosis process, being heat shock protein 70 (hsp70) play a role in homeostasis. The aim of this research is to identify the apoptotic effects of Annona muricata Linn leaf toward Raji cells by observing the p53 and hsp70 expression.Methods: Apoptotic assay was performed in 24 wells micro-culture plate. Raji cells were prepared as 2 × 104 cells in 100 ml RPMI media per well. Roswell Park Memorial Institute (RPMI) medium was created and solvent was controlled with Dimethyl Sulfoxide (DMSO) solvent 0.25. Apoptotic test was performed by calculating trypan-blue-dye exclution. The cells were then grown in micro-culture plate with media plus extract non-lethal concentration of partition and fractionation of Annona muricata Linn leaf. The sampling was performed for 24 hours. The number of living cells was calculated in each of these well and incubation time were determined. Immunohistochemical staining was done to identify the expression of p53 and hsp70.Results: The results showed that Raji cells treated with partition of Annona muricata Linn leaf in ethyl acetate solvent 133.00 % resulted in higher apoptosis. Another results showed that Raji cells treated with fractionation Annona muricata Linn leaf in ethyl acetate solvent 103.20 % resulted in higher apoptosis. The expression of p53 after treatment with fractionation Annona muricata Linn leaf was higher than before while hsp70 expression after treatment with fractionation Annona muricata Linn leaf was lower. Conclusion: The conclusion is the higher the dose of Annona muricata Linn the higher the p53 expression thereby activates apoptosis process The higher dose of Anonna muricata Linn also leads to lower hsp70 expression indicating stable homeostasis of Raji cells.----------------------------------------------Cite this article as: Astirin OP, Prayitno A, Artanti AN, Fitria MS, Witianingsih DA, Pranatami DA, Putra ST. The expression of p53 and hsp70 proteins after treatment with Annona muricata Linn leaf for activating apoptotic and lead to homeostasis program of Raji cells. Int J Cancer Ther Oncol 2014; 2(2):02028. DOI: 10.14319/ijcto.0202.
Evaluation of the generalized gamma as a tool for treatment planning optimization
Get PDFPurpose: The aim of that work is to study the theoretical behavior and merits of the Generalized Gamma (generalized dose response gradient) as well as to investigate the usefulness of this concept in practical radiobiological treatment planning.Methods: In this study, the treatment planning system RayStation 1.9 (Raysearch Laboratories AB, Stockholm, Sweden) was used. Furthermore, radiobiological models that provide the tumor control probability (TCP), normal tissue complication probability (NTCP), complication-free tumor control probability (P+) and the Generalized Gamma were employed. The Generalized Gammas of TCP and NTCP, respectively were calculated for given heterogeneous dose distributions to different organs in order to verify the TCP and NTCP computations of the treatment planning system. In this process, a treatment plan was created, where the target and the organs at risk were included in the same ROI in order to check the validity of the system regarding the objective function P+ and the Generalized Gamma. Subsequently, six additional treatment plans were created with the target organ and the organs at risk placed in the same or different ROIs. In these plans, the mean dose was increased in order to investigate the behavior of dose change on tissue response and on Generalized Gamma before and after the change in dose. By theoretically calculating these quantities, the agreement of different theoretical expressions compared to the values that the treatment planning system provides could be evaluated. Finally, the relative error between the real and approximate response values using the Poisson and the Probit models, for the case of having a target organ consisting of two compartments in a parallel architecture and with the same number of clonogens could be investigated and quantified. Results: The computations of the RayStation regarding the values of the Generalized Gamma and the objective function (P+) were verified by using an independent software. Furthermore, it was proved that after a small change in dose, the organ that is being affected most is the organ with the highest Generalized Gamma. Apart from that, the validity of the theoretical expressions that describe the change in response and the associated Generalized Gamma was verified but only for the case of small change in dose. Especially for the case of 50% TCP and NTCP, the theoretical values (ΔPapprox.) and those calculated by the RayStation show close agreement, which proves the high importance of the D50 parameter in specifying clinical response levels. Finally, the presented findings show that the behavior of ΔPapprox. looks sensible because, for both of the models that were used (Poisson and Probit), it significantly approaches the real ΔP around the region of 37% and 50% response. The present study managed to evaluate the mathematical expression of Generalized Gamma for the case of non-uniform dose delivery and the accuracy of the RayStation to calculate its values for different organs. Conclusion: A very important finding of this work is the establishment of the usefulness and clinical relevance of Generalized Gamma. That is because it gives the planner the opportunity to precisely determine which organ will be affected most after a small increase in dose and as a result an optimal treatment plan regarding tumor control and normal tissue complications can be found
Dosimetric dependence on the collimator angle in prostate volumetric modulated arc therapy
Get PDFPurpose: The purpose of this study is to investigate the dose-volume variations of planning target volume (PTV) and organs-at-risk (OARs) in prostate volumetric modulated arc therapy (VMAT) when varying collimator angle. The collimator angle has the largest impact and is worth considering, so, its awareness is essential for a planner to produce an optimal prostate VMAT plan in a reasonable time frame. Methods: Single-arc VMAT plans at different collimator angles (0o, 15o, 30o, 45o, 60o, 75o and 90o) were created systematically using a Harold heterogeneous pelvis phantom. The conformity index (CI), homogeneity index (HI), gradient index (GI), machine monitor units (MUs), dose-volume histogram and mean and maximum dose of the PTV were calculated and analyzed. On the other hand, the dose-volume histogram and mean and maximum doses of the OARs such as the bladder, rectum and femoral heads for different collimator angles were determined from the plans.Results: There was no significant difference, based on the planned dose-volume evaluation criteria, found in the VMAT optimizations for all studied collimator angles. A higher CI (0.53) and lower HI (0.064) were found in the 45o collimator angle. In addition, the 15o collimator angle provided a lower value of HI similar to the 45o collimator angle. Collimator angles of 75o and 90o were found to be good for rectum sparing, and collimator angles of 75o and 30o were found to be good for sparing of right and left femur, respectively. The PTV dose coverage for each plan was comparatively independent of the collimator angle. Conclusion: Our study indicates that the dosimetric results provide support and guidance to allow the clinical radiation physicists to make careful decisions in implementing suitable collimator angles to improve the PTV coverage and OARs sparing in prostate VMAT