The evidences suggest that gene polymorphism of LAPTM4B may influence the individuals' susceptibility to primary liver cancer and allele *2 being considered as a potential risk factor.
Background: Cyber Knife robotic stereotactic radiosurgery is minimally invasive tumor treatment modality that can deliver high precision radiotherapy to any part of the body with minimal exposure to adjacent and surrounding vital organs and is used to treat oligometastasis of the lung from primary breast cancer patients. In the modern high precision treatment delivery, utmost care should be taken for motion management of tumor targets. The Objective of this study was to investigate the accuracy and efficacy of Cyber knife in the treatment of lung metastasis from breast cancer using fuducial free respiratory tracking system using cyberknife stereotactic radiosurgery. Method: We examined toxicity and local control rate with fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for lung metastases from 20 breast cancer patients. All patients had favorable performance status (ECOG 0e2), oligometastatic disease. Total of 56 Lungs lesions were treated with a prescribed dose of 30e35 Gy delivered in five fractions to the planning target volume (PTV) using the CyberKnife with X-sight lung tracking. A median 30 Gy (IQR, 30e35 Gy) dose was delivered to a median prescription isodose line of 70% (IQR, 65e77%) to 20 patients with a total median follow up of 34 months. Results: The toxicity and local control rates were favourable and 1-and 2-year local control estimates were 87% and 73%, respectively. Two of the five local failures were infield in patients who had received irradiation to the gross tumor volume and remaining 3 were in patients who had received irradiation to clinical target volume. No local failures were identified beyond 21 months of therapy. There was no lung, oesophageal or spinal cord toxicity noted in the above patients. Conclusion: Initial evaluation with fiducial free based respiratory tracking system using five-fraction CyberKnife SBRT is a promising treatment option for lung metastasis from breast cancer patients, demonstrating encouraging local control rates with no toxicity. a dose escalation study for the pheripheral lung metastasis from breast cancers is being planned.Background: Recent randomized phase III trials (ALTA-1L and ALEX) reported the robust efficacy of next-generation anaplastic lymphoma kinase (ALK) inhibitors (brigatinib and alectinib) for the first-line treatment of patients with advanced ALK-positive non-small-cell lung cancer (NSCLC). However, there is no head-to-head comparison of brigatinib vs. alectinib. In this study, we aimed to explore the optimal choice of ALK inhibitors treatment for advanced ALK-Positive NSCLC. Method: We performed an indirect comparison of ALTA-1L and ALEX to compared therapeutic efficacy and adverse event (AE) between brigatinib and alectinib as the first-line treatment of advanced ALK-Positive NSCLC. The clinical outcomes were progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and AE. Hazard ratio (HR, for PFS and OS) / risk ratio (RR, for ORR and AE) and its 95% confidence interval (CI) were extracted. R...
8.4%. CRT was delivered concurrently in 98% of the patients. Median radiation dose was 61.2Gy (range 39.6-69.6Gy); 89% receiving 60Gy. Radiation technique was (3D) conformal (71.0%) or intensity-modulated radiotherapy (IMRT) (27.1%). The 30-day and 90-day surgical mortality rates were 4.7% and 7.5%, respectively. At a median followup of 30 months (range: 3-186 months), estimated OS and FFR (median/5-year) were 61 months/ 49% and 29 months/ 35%, respectively. On univariate analysis (UVA), age 60 (HR, 1.776; 95% CI, 1.084e2.909; P¼0.023) and having no health insurance (HR, 3.071; 95% CI, 1.060e8.902; P¼0.039; as compared to those with private insurance) predicted for an increased risk of death, while receiving consolidation chemotherapy was associated with improved survival (HR, 0.472; 95% CI, 0.258e0.864; P¼0.015). On MVA, age 60 was the only characteristic with a continued association with OS (HR, 1.779; 95% CI, 1.056e2.998; P¼0.039). On UVA, lack of health insurance was the only predictor of disease recurrence (HR, 6.059; 95% CI, 2.244-16.360; P<0.001). Conclusion: In a carefully selected population, full dose neoadjuvant CRT followed by surgery can achieve high OS and FFR even for stage III NSCLC patients, much higher than recent reports of bimodality therapy (RTOG 0617: median OS of 28.7 months and PACIFIC study: median PFS of 16.8 months). Prospective evaluation of high-dose radiation trimodality therapy versus induction chemotherapy alone is warranted.
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