•Real world data showed 55.3 % of patients did not meet the criteria of the PACIFIC study.•The incidence of grade 3 radiation pneumonitis was 18.2 % in durvalumab versus 2.5 % in observation.•Active ...surveillance and treatment for radiation pneumonitis were required.
The PACIFIC study demonstrated the benefits of durvalumab consolidation on progression-free survival (PFS) and overall survival (OS) among patients with unresectable locally advanced non-small-cell lung cancer (LA-NSCLC). However, in real-world practice, patients with unresectable LA-NSCLC are heterogeneous with diverse tumor burdens and clinical factors; thus, it is important to examine the effectiveness and side effects of durvalumab when used in real clinical practice.
We investigated the efficacy of durvalumab consolidation and the incidence of radiation pneumonitis in patients who received concurrent chemo-radiotherapy (CCRT) for unresectable LA-NSCLC in a single institute.
Overall, 55.3 % of patients did not meet the criteria of the PACIFIC study; however, they still received consolidation durvalumab in real-world practice. Durvalumab consolidation was associated with favorable PFS in the total population as well as in the subgroup of patients who did not meet the criteria of the PACIFIC study. However, radiation pneumonitis occurred more frequently in the durvalumab group, especially within 3–6 months after CCRT. The incidence of grade 3 radiation pneumonitis was 14.3 % in the durvalumab group versus 2.5 % in the observation group.
Durvalumab consolidation was associated with favorable PFS in patients with LA-NSCLC in clinical practice. However, careful selection of candidates for durvalumab treatment and active surveillance and appropriate management for radiation pneumonitis are needed.
Cracks have a primary effect on the failure of a structure. Therefore, the development of crack sensors with high accuracy and resolution and cracks detection method are important. In this study, the ...crack sensors were fabricated, and the crack locations were detected with the electrical signal of the crack sensor. First, a metal grid-type micro-crack sensor based on silver was fabricated. The sensor is made with electrohydrodynamics (EHD) inkjet printing technology, which is well known as the next generation of printed electronics technology. Optimal printing conditions were established through experiments, and a grid sensor was obtained. After that, single cracks and multiple cracks were simulated on the sensor, and electrical signals generated from the sensor were measured. The measured electrical signal tracked the location of the cracks in three steps: simple cross-calculation, interpolation, and modified P-SPICE. It was confirmed that cracks could be effectively found and displayed using the method presented in this paper.
Abstract
Background
To date, there is a paucity of reports clarifying the change of spinopelvic parameters in patients with adult spinal deformity (ASD) who underwent long segment spinal fusion using ...iliac screw (IS) and S2-alar-iliac screw (S2AI) fixation.
Methods
A retrospective review of consecutive patients who underwent deformity correction surgery for ASD between 2013 and 2017 was performed. Patients were divided into two groups based on whether IS or S2AI fixation was performed. All radiographic parameters were measured preoperatively, immediately postoperatively, and the last follow-up. Demographics, intraoperative and clinical data were analyzed between the two groups. Additionally, the cohort was subdivided according to the postoperative change in pelvic incidence (PI): subgroup (C) was defined as change in PI ≥5° and subgroup (NC) with change < 5°. In subgroup analyses, the 2 different types of postoperative change of PI were directly compared.
Results
A total of 142 patients met inclusion criteria: 111 who received IS and 31 received S2AI fixation. The IS group (65.6 ± 26°, 39.8 ± 13.8°) showed a significantly higher change in lumbar lordosis (LL) and upper lumbar lordosis (ULL) than the S2AI group (54.4 ± 17.9°, 30.3 ± 9.9°) (
p
< 0.05). In subgroup (C), PI significantly increased from 53° preoperatively to 59° postoperatively at least 50% of IS cohort, with a mean change of 5.8° (
p
< 0.05). The clinical outcomes at the last follow-up were significantly better in IS group than in S2AI group in terms of VAS scores for back and leg. The occurrence of sacroiliac joint pain and pelvic screw fracture were significantly greater in S2AI group than in IS group (25.8% vs 9%,
p
< 0.05) and (16.1% vs 3.6%, p < 0.05).
Conclusions
Compared with the S2AI technique, the IS technique usable larger cantilever force demonstrated more correction of lumbar lordosis, and possible increase in pelvic incidence. Further study is warranted to clarify the clinical impaction of these results.
BACKGROUND:The majority of earlier studies of the parameters of sagittal balance did not consider the influence of spinal muscles on spinal sagittal alignment.
OBJECTIVE:To analyze the relationship ...between the paraspinal muscle (quantity and quality) and sagittal alignment in elderly patients.
METHODS:We reviewed 50 full-spine lateral standing radiographs and lumbar magnetic resonance images of elderly patients at a single center. The radiographic parameters examined were thoracic kyphosis, lumbar lordosis (LL), sagittal vertical axis, pelvic tilt, sacral slope, and pelvic incidence (PI). The lumbar muscularity (LM; quantity) and fatty degeneration ratio (FD; quality) in the paraspinal muscle were measured at the L3 level on magnetic resonance images. The relationships between the parameters, LM, and FD were analyzed with the Pearson correlation coefficient and multiple linear regression.
RESULTS:Pearson analysis demonstrated that the FD had significant correlations with age (r = 0.393), thoracic kyphosis (r = −0.559), pelvic tilt (r = 0.430), sagittal vertical axis (r = 0.488), and PI − LL (r = 0.479, P < .05), and a close negative correlation was found between the FD and LL (r = −0.505, P < .01). The LM had significant correlations with the LL (r = 0.342) and PI − LL (r = −0.283, P < .05). Regression models that controlled for confounding factors such as body mass index confirmed the correlations between the above parameters and FD (P < .05).
CONCLUSION:The quality of the paraspinal muscle could be one of the various factors that influence sagittal balance.
ABBREVIATIONS:BMI, body mass indexCSA, cross-sectional areaFD, fatty degeneration ratioLL, lumbar lordosisLM, lumbar muscularityPI, pelvic incidencePT, pelvic tiltSC, subcutaneous fatSS, sacral slopeSVA, sagittal vertical axisTK, thoracic kyphosisVB, vertebral body
This study aimed to investigate whether metabolic tumor volume (MTV) measured from (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) predicts short-term outcome ...to radiotherapy with or without chemotherapy and disease-free survival (DFS) in patients with pharyngeal cancers.
The MTVs of primary sites with or without neck nodes were measured in 82 patients. Short-term outcome was assessed using the treatment response evaluation by the Response Evaluation Criteria in Solid Tumors and recurrence events during follow-up (complete response/no recurrence or residual disease/recurrence).
A total of 64 patients had complete response/no recurrence as of the last follow-up. A cutoff of 40 mL for the MTV was the best discriminative value for predicting treatment response. By univariate analyses, patients with MTV > 40 mL showed a significantly lower number of complete response/no recurrence than did patients with MTV < or =40 mL 68.2% versus 87.8%; hazard ratio (HR), 3.34; 95% confidence interval (95% CI), 1.09-10.08; P = 0.03, as is the same in tumor-node-metastasis stage (87.5% for I-II versus 90% for III versus 63.8% for IV; P = 0.02). However, MTV was only a significant predictor of short-term outcome by multivariate analyses (HR, 4.09; 95% CI, 1.02-16.43; P = 0.04). MTV > 40 mL indicated a significantly worse DFS than MTV < or =40 mL (HR, 3.42; 95% CI, 1.04-11.26;P = 0.04). The standardized uptake value for the primary tumor did not show any correlation with treatment outcome or DFS.
MTV has a potential value in predicting short-term outcome and DFS in patients with pharyngeal cancers.
The device performance of sensitizer‐architecture solar cells based on a CuSbS2 light sensitizer is presented. The device consists of F‐doped SnO2 substrate/TiO2 blocking layer/mesoporous ...TiO2/CuSbS2/hole‐transporting material/Au electrode. The CuSbS2 was deposited by repeated cycles of spin coating of a Cu‐Sb‐thiourea complex solution and thermal decomposition, followed by annealing in Ar at 500 °C. Poly(2,6‐(4,4‐bis‐(2‐ethylhexyl)‐4H‐cyclopenta2,1‐b;3,4‐b′dithiophene)‐alt‐4,7(2,1,3‐benzothiadiazole)) (PCPDTBT) was used as the hole‐transporting material. The best‐performing cell exhibited a 3.1 % device efficiency, with a short‐circuit current density of 21.5 mA cm−2, an open‐circuit voltage of 304 mV, and a fill factor of 46.8 %.
Ternary CuSbS2‐sensitized inorganic–organic heterojunction solar cells can be assembled with an efficiency of 3.12 %. The CuSbS2 is simply deposited on a F‐doped SnO2 substrate/TiO2 blocking layer/mesoporous TiO2/CuSbS2/hole‐transporting material (HTM)/Au electrode by processing with a Cu–Sb–thiourea complex (yellow solution in picture). The highest photocurrent is 21.5 mA cm−2 under standard AM 1.5 G conditions.
The ARTIST (Adjuvant Chemoradiation Therapy in Stomach Cancer) trial was the first study to our knowledge to investigate the role of postoperative chemoradiotherapy therapy in patients with ...curatively resected gastric cancer with D2 lymph node dissection. This trial was designed to compare postoperative treatment with capecitabine plus cisplatin (XP) versus XP plus radiotherapy with capecitabine (XP/XRT/XP).
The XP arm received six cycles of XP (capecitabine 2,000 mg/m2 per day on days 1 to 14 and cisplatin 60 mg/m2 on day 1, repeated every 3 weeks) chemotherapy. The XP/XRT/XP arm received two cycles of XP followed by 45-Gy XRT (capecitabine 1,650 mg/m2 per day for 5 weeks) and two cycles of XP.
Of 458 patients, 228 were randomly assigned to the XP arm and 230 to the XP/XRT/XP arm. Treatment was completed as planned by 75.4% of patients (172 of 228) in the XP arm and 81.7% (188 of 230) in the XP/XRT/XP arm. Overall, the addition of XRT to XP chemotherapy did not significantly prolong disease-free survival (DFS; P = .0862). However, in the subgroup of patients with pathologic lymph node metastasis at the time of surgery (n = 396), patients randomly assigned to the XP/XRT/XP arm experienced superior DFS when compared with those who received XP alone (P = .0365), and the statistical significance was retained at multivariate analysis (estimated hazard ratio, 0.6865; 95% CI, 0.4735 to 0.9952; P = .0471). CONCLUSION The addition of XRT to XP chemotherapy did not significantly reduce recurrence after curative resection and D2 lymph node dissection in gastric cancer. A subsequent trial (ARTIST-II) in patients with lymph node-positive gastric cancer is planned.
To define prognostic impact of Epstein-Barr virus (EBV) infection in diffuse large B-cell lymphoma (DLBCL), we investigated EBV status in patients with DLBCL. In all, 380 slides from ...paraffin-embedded tissue were available for analysis by EBV-encoded RNA-1 (EBER) in situ hybridization, and 34 cases (9.0%) were identified as EBER-positive. EBER positivity was significantly associated with age greater than 60 years (P = .005), more advanced stage (P < .001), more than one extranodal involvement (P = .009), higher International Prognostic Index (IPI) risk group (P = .015), presence of B symptom (P = .004), and poorer outcome to initial treatment (P = .006). The EBER+ patients with DLBCL demonstrated substantially poorer overall survival (EBER+ vs EBER− 35.8 months 95% confidence interval (CI), 0-114.1 months vs not reached, P = .026) and progression-free survival (EBER+ vs EBER− 12.8 months 95% CI, 0-31.8 months vs 35.8 months 95% CI, 0-114.1 months, respectively (P = .018). In nongerminal center B-cell–like subtype, EBER in situ hybridization positivity retained its statistical significance at the multivariate level (P = .045). Nongerminal center B-cell–like patients with DLBCL with EBER positivity showed substantially poorer overall survival with 2.9-fold (95% CI, 1.1-8.1) risk for death. Taken together, DLBCL patients with EBER in situ hybridization+ pursued more rapidly deteriorating clinical course with poorer treatment response, survival, and progression-free survival.
Abstract
Positron emission tomography/computed tomography (PET/CT) with
18
F-fluorodeoxyglucose (FDG) is widely used for management of nasopharyngeal carcinoma (NPC). Combining the radiomic features ...of pre- and post-treatment FDG PET images may improve tumor characterization and prognostic predication. We investigated prognostic value of radiomic features from pre- and post-radiotherapy FDG PET images in patients with NPC. Quantitative radiomic features of primary tumors were extracted from the FDG PET images of 145 NPC patients and the delta values were also calculated. The study population was divided randomly into two groups, the training and test sets (7:3). A random survival forest (RSF) model was adopted to perform analyses of progression-free survival (PFS) and overall survival (OS). There were 37 (25.5%) cases of recurrence and 16 (11.0%) cases of death during a median follow-up period of 54.5 months. Both RSF models with clinical variables and radiomic PET features for PFS and OS showed comparable predictive performance to RSF models with clinical variables and conventional PET parameters. Tumoral radiomic features of pre- and post-treatment FDG PET and the corresponding delta values may predict PFS and OS in patients with NPC.
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