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请输入您需要翻译的文本！Smaller pre-surgery radiation targets reduce long term side effects, not survival rates - Medical News Today
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Smaller pre-surgery radiation targets reduce long term side effects, not survival rates
Adapted Media Release
New standard of care will help save lives and limbs of sarcoma patients
Using advanced imaging technology to more precisely target radiation beams to treat soft tissue cancers () in the extremities significantly reduces long term side effects without effecting survival rates, according to research results published online in the Journal of Clinical Oncology.
The findings should establish a new standard of care for soft tissue sarcomas. "This study proves that we are able to use this modern technology --image-guided
--to irradiate smaller target volumes (less normal tissue included) and reduce long term side effects in extremity sarcoma patients compared with conventional radiotherapy," says Dr. Dian Wang, the lead author of the paper. He is professor of Radiation Oncology at Rush University Medical Center and chair of the NRG Oncology Sarcoma Working Group.
"This is one of few successful multi-institutional studies on localized sarcoma in almost a decade," Dr. Wang said "It should provide oncologists with validation and evidence of this new radiotherapy approach that takes full advantage of rapidly developing technologies. The absence of marginal-field recurrence and favorable toxicity profiles suggest that parameters used in this study are appropriate for preoperative image-guided radiotherapy of extremity sarcoma," Wang added.
The study results came from a multi-year, multi-institution phase 2 clinical trial conducted by the Radiation Therapy Oncology Group (RTOG), now conducting research as NRG Oncology.
The RTOG 0630 trial studied more than one hundred patients with extremity-based soft tissue sarcomas (STS) who received pre-surgical radiation delivered to a substantially smaller area than typically targeted when treating this type of . Prior to
removal surgery, a series of daily pre-treatment images of the tumor were digitally integrated with previous scans to determine a custom tailored radiation dose that minimized exposure to adjacent normal tissue. Assessments two years later showed that long term side effects were 10.5 percent, significantly fewer than the 37 percent of patients in a previous study who received radiation to a larger target area.
The paper, "Significant reduction of late toxicities in extremity sarcoma patients treated with image-guided radiotherapy to a reduced target volume: results of RTOG 0630," was designated for rapid publication as the prestigious journal because the findings are considered to be among "the most important clinical cancer research." The trial was conducted over three years at eighteen medical centers across the country, including several rated among the nation's top cancer hospitals.
Soft tissue sarcomas are cancerous tumors that begin in the muscle, fat, nerves, tendons, blood vessels or connective tissues. Though relatively rare, soft tissue sarcomas are quite deadly due to the presence of advanced disease, or metastasis, at initial diagnosis. Nearly 12,000 new cases of soft tissue sarcoma are expected to be diagnosed in 2015 with approximately 5,000 deaths from the disease projected.
Rush is among the leaders in sarcoma patients--bone and soft tissue -- treated in Illinois. A team of specialists at Rush work together to create a personalized treatment plan that typically involves surgery in combination with radiation therapy or
before or after tumor resection.
"Although radiation oncology is a technologically intense discipline, wisdom in using these technologies is essential for optimal outcomes. Dr. Wang and his collaborators in the Sarcoma Working Group of the NRG co-operative oncology group are to be lauded for improving the use of these technologies in a way that makes the limb preservation care of patients with sarcoma less toxic without compromising efficacy. While these results will need to be confirmed by other groups, I am excited that one of my colleagues and faculty at Rush was a leader in this effort." said Dr. Ross Abrams, Chairman of Rush's Radiation Oncology Department.
"These positive results are an excellent example of the important multi-institutional research carried out by the research groups that comprise the NCI Clinical Trials Network. No other research enterprise is likely to investigate strategies to reduce treatment-related toxicities for patients with these rare tumors," said Dr. Walter J. Curran, Jr., an NRG Oncology Group Chairman and Executive Director of the Winship Cancer Institute of Emory University in Atlanta.
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. Published online before print February 9, 2015, doi: 10.1200/JCO.8 JCO
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Please use one of the following formats to cite this article in your essay, paper or report:MLARush University Medical Center. "Smaller pre-surgery radiation targets reduce long term side effects, not survival rates." Medical News Today. MediLexicon, Intl., 13 Feb. 2015. Web.11 Jul. 2016. &/releases/289288.php&APARush University Medical Center. (2015, February 13). "Smaller pre-surgery radiation targets reduce long term side effects, not survival rates." Medical News Today. Retrieved from.Please note: If no author information is provided, the source is cited instead.
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All rights reserved. MNT is the registered trade mark of MediLexicon International Limited.Pain injections for hip arthroscopy patients may not predict surgical outcomes
- Medical News Today
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Pain injections for hip arthroscopy patients may not predict surgical outcomes
Adapted Media Release
How best to treat and recover from complicated hip injuries is a growing field in orthopaedic medicine. While diagnostic hip injections are commonly performed for patients with labral tear to confirm the pain etiology, research presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day suggests that pain relief from this diagnostic injection may not predict better outcomes following arthroscopic hip surgery.
"Our study looked to assess if the amount of pain relief from a preoperative diagnostic intra-articular (IA) injection correlated with patient outcomes following surgery of an individual with femoracetabular impingement (FAI). However, our data indicated that the amount of pain relief from an IA injection is a poor predictor of short-term positive outcomes at our institution," said lead author, Aaron Krych, MD of the Mayo Clinic in Rochester, MN.
Krych and his team analyzed records of patients who were undergoing hip arthroscopy for FAI from . Pre-operative radiographs were reviewed along with degree of osteoarthritis. Ninety-six patients met the study's inclusion criteria, including 71 females and 25 males with an average age of 37.5 years that were followed prospectively. There was no significant difference in the outcome scores for individuals with greater than 50 percent pain relief compared to patients that had less than 50 percent pain relief on preoperative diagnostic injection. Even with an adjustment for chondral degeneration and , the difference in pain relief and outcomes was minimal.
"Looking at different ways to treat hip pain and improve patient selection for surgery is a critical part of orthopaedic medicine. Even though our study did not show any significant improvements in outcomes, it does highlight the need for future investigations of what might be increase success," said Krych. "While there are no current absolute indications for FAI surgery, we believe that careful evaluation of the patient and correlation of presenting symptoms, physical examination, and imaging findings are the most important factors in considering patients for surgery."
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Please use one of the following formats to cite this article in your essay, paper or report:MLAAmerican Orthopaedic Society for Sports. "Pain injections for hip arthroscopy patients may not predict surgical outcomes ." Medical News Today. MediLexicon, Intl., 1 Apr. 2015. Web.11 Jul. 2016. &/releases/291671.php&APAAmerican Orthopaedic Society for Sports. (2015, April 1). "Pain injections for hip arthroscopy patients may not predict surgical outcomes ." Medical News Today. Retrieved from.Please note: If no author information is provided, the source is cited instead.
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All rights reserved. MNT is the registered trade mark of MediLexicon International Limited.New neurons generated in brains, spinal cords of living adult mammals - Medical News Today
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New neurons generated in brains, spinal cords of living adult mammals
Adapted Media Release
UT Southwestern Medical Center researchers created new nerve cells in the brains and spinal cords of living mammals without the need for
transplants to replenish lost cells.
Although the research indicates it may someday be possible to regenerate neurons from the body's own cells to repair
or spinal cord damage or to treat conditions such as , the researchers stressed that it is too soon to know whether the neurons created in these initial studies resulted in any functional improvements, a goal for future research.
Spinal cord injuries can lead to an irreversible loss of neurons, and along with scarring, can ultimately lead to impaired motor and sensory functions. Scientists are hopeful that regenerating cells can be an avenue to repair damage, but adult spinal cords have limited ability to produce new neurons. Biomedical scientists have transplanted stem cells to replace neurons, but have faced other hurdles, underscoring the need for new methods of replenishing lost cells.
Scientists in UT Southwestern's Department of Molecular Biology first successfully turned astrocytes - the most common non-neuronal brain cells - into neurons that formed networks in mice. They now successfully turned scar-forming astrocytes in the spinal cords of adult mice into neurons. The latest findings are published today in Nature Communications and follow previous findings published in Nature Cell Biology.
"Our earlier work was the first to clearly show in vivo (in a living animal) that mature astrocytes can be reprogrammed to become functional neurons without the need of cell transplantation. The current study did something similar in the spine, turning scar-forming astrocytes into progenitor cells called neuroblasts that regenerated into neurons," said Dr. Chun-Li Zhang, assistant professor of molecular biology at UT Southwestern and senior author of both studies.
"Astrocytes are abundant and widely distributed both in the brain and in the spinal cord. In response to injury, these cells proliferate and contribute to scar formation. Once a scar has formed, it seals the injured area and creates a mechanical and biochemical barrier to neural regeneration," Dr. Zhang explained. "Our results indicate that the astrocytes may be ideal targets for in vivo reprogramming."
The scientists' two-step approach first introduces a biological substance that regulates the expression of genes, called a transcription factor, into areas of the brain or spinal cord where that factor is not highly expressed in adult mice. Of 12 transcription factors tested, only SOX2 switched fully differentiated, adult astrocytes to an earlier neuronal precursor, or neuroblast, stage of development, Dr. Zhang said.
In the second step, the researchers gave the mice a drug called valproic acid (VPA) that encouraged the survival of the neuroblasts and their maturation (differentiation) into neurons. VPA has been used to treat
for more than half a century and also is prescribed to treat
and to prevent
headaches, he said.
The current study reports neurogenesis (neuron creation) occurred in the spinal cords of both adult and aged (over one-year old) mice of both sexes, although the response was much weaker in the aged mice, Dr. Zhang said. Researchers now are searching for ways to boost the number and speed of neuron creation. Neuroblasts took four weeks to form and eight weeks to mature into neurons, slower than neurogenesis reported in lab dish experiments, so researchers plan to conduct experiments to determine if the slower pace helps the newly generated neurons properly integrate into their environment.
In the spinal cord study, SOX2-induced mature neurons created from reprogramming of astrocytes persisted for 210 days after the start of the experiment, the longest time the researchers examined, he added.
growth is a concern when cells are reprogrammed to an earlier stage of development, the researchers followed the mice in the Nature Cell Biology study for nearly a year to look for signs of tumor formation and reported finding none.
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Dr. Zhida Su, a UT Southwestern visiting instructor of molecular biology from the Second Military Medical University in Shanghai, China, was lead author on the current study. Co-authors included: Dr. Wenze Niu, Dr. Meng-Lu Liu, pos and Yuhua Zou, research scientist, all from UT Southwestern's Department of Molecular Biology.
Co-authors of the Nature Cell Biology study include lead author Dr. Niu, Ms. Zou, and postdoctoral researcher Dr. Tong Zang, all of the Department of Molecular Biology, as well as former postdoctoral researcher Dr. Sanhua Fang, now a lecturer at Zhejiang University in C Dr. Robert Bachoo, an assistant professor of neurology and neurotherapeutics, and internal medicine, at UT S and Derek Smith, a graduate student of neuroscience and molecular biology.
Both studies received support from the American Heart Association, the Welch Foundation, the Ellison Medical Foundation, and the National Institutes of Health. The Nature Cell Biology study also received support from an NIH Director's New Innovator Award and from the Whitehall Foundation.
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Please use one of the following formats to cite this article in your essay, paper or report:MLAUT Southwestern Medical Center. "New neurons generated in brains, spinal cords of living adult mammals." Medical News Today. MediLexicon, Intl., 27 Feb. 2014. Web.11 Jul. 2016. &/releases/273226.php&APAUT Southwestern Medical Center. (2014, February 27). "New neurons generated in brains, spinal cords of living adult mammals." Medical News Today. Retrieved from.Please note: If no author information is provided, the source is cited instead.
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