ABSTRACT
To analyze the impact of body mass factors (BMFs) including body mass index (BMI), umbilical circumference (UC), and hip circumference (HC), on setup errors in gynecological tumors, and whether the planned tumor volumes (PTVs) are adequate for obese patients. A retrospective study was conducted among 46 consecutive women with gynecological tumors, who were treated with Volumetric Modulated Arc Therapy (VMAT) at the radiotherapy (RT) unit. Setup accuracy was verified using daily cone-beam computed tomography (CBCT). BMFs were measured at baseline for all patients, and at fractions #10 and #20. Total vector errors (TVEs) were computed and linear regression was used to analyze their relationship with baseline BMFs. Accuracy was determined for each fraction by testing two different PTVs (Cutoff I: ≤0.7cm and II: ≤1.0cm). A pooled analysis was conducted to test the association of accuracy levels (within vs beyond-PTV) with the mean and variance of BMI, UC, and HC, considering the repeated measures. Receiver operating characteristics (ROC) curve analysis was carried out to test the sensitivity of BMI, UC, and HC in predicting inaccurate setup The mean (SD) TVE was 0.86 (0.34) cm and 0.79 (0.30) cm in systematic and random settings respectively. Random TVE showed weakly positive relationships with BMI (B=0.005 [95%CI=0.001-0.010];R2=0.090;p=0.042) and UC (B=0.013 [95%CI=0.002-0.025];R2=0.119;p=0.019. The pooled analysis showed a higher mean BMI with setups beyond the PTV compared to within PTV, with a mean difference of approximately 3.50 kg/m2, (p=0.001), in the lateral direction. Similarly, measures of UC (mean difference ∼10 cm) and HC (∼8 cm) were significantly higher in setups beyond the PTV compared with accurate setups (p<0.001). With respect of the vertical direction, BMI (mean difference=7.4 kg/m2, p=0.001), UC (5.3 cm, p<0.001), and HC (16.0 cm, p<0.001) were higher in setups beyond the PTV versus those within PTV;however, this was only observed using Cutoff I. Using Cutoff II, only HC showed a statistically significant difference, with a mean difference of 11.7 cm between inaccurate setups and accurate setups (0=0.041). ROC curve analysis showed that a BMI>31.4 kg/m2 was predictive for inaccurate setup in the vertical direction with 90.0% sensitivity, with respect of Cutoff I. Furthermore, a BMI>30.3 kg/m2 was predictive for inaccurate setup in the lateral direction with 92.5% sensitivity, with respect of Cutoff II. The accuracy of RT setups in gynecological tumors are highly sensitive to patients' BMI, notably in the lateral and vertical directions. To facilitate workflow during the Covid-19 crisis, we suggest that daily CBCT should be applied on patients with a BMI>30.3 kg/m2 or the PTVs should be adapted for obese patients to enhance setup accuracy of RT [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Background: For cancer patients' treatment, coronavirus disease 2019 (COVID-19) poses a great challenge. COVID-19 presents as a severe respiratory infection in aging individuals, including patients with lung cancer. COVID-19 may be linked to the progression of aggressive lung cancer. Conversely, chemotherapy's side effects, such as chemotherapy resistance, acceleration of cellular senescence, could worsen COVID-19. Considering the above-mentioned facts, our present work was aimed to investigate the role of paclitaxel (a chemotherapy drug) in cell proliferation, apoptosis, and cellular senescence of gefitinib-resistant NSCLC cells (PC9-MET) and reveal the underlying mechanisms. Methods: PC9-MET cells were treated with paclitaxel for 72 h and then evaluated by cell viability assay, DAPI staining, Giemsa staining, apoptosis assay, ROS assay, SA-ß-Gal staining, TUNEL assay and western blotting. Results: Our results revealed that paclitaxel significantly reduced the viability of PC9-MET cells and induced morphological signs of apoptosis. The apoptotic effects of paclitaxel were observed by increased levels of cleaved caspase-3, cleaved caspase-9 and cleaved PARP. Additionally, paclitaxel increased ROS production, leading to DNA damage. Importantly, paclitaxel eliminated cellular senescence, which was observed by SA-ß-Gal staining. Conclusion: In light of these findings, paclitaxel could be a promising anticancer drug and could offer a new therapeutic strategy for gefitinib-resistant non-small cell lung cancer (NSCLC) during the COVID-19 pandemic.
ABSTRACT
SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: A recent surge of novel COVID-19 has diverted the focus from other microbial organisms as the etiology of respiratory illness. Causal agents for respiratory infections have been linked to different risk factors and clinical presentations. The propose of this study is to analyze the incidence of coinfection and the factors that determine it. METHODS: Respiratory Pathogen Panel (RPP), targeting 21 different organisms, was performed to randomized individuals undergoing testing for COVID-19 RT-PCR at four testing locations in Houston, Texas between March 2020 to May 2020. Tested subjects were inquired about their demographic information, positive exposure to COVID-19, current symptoms, and comorbidities. RESULTS: A total of 10,853 RPP tests were performed alongside COVID-19 RT-PCR (43,443) tests completed across the 4 locations. 4,195 (9.6%) patients had positive results for COVID-19. The total positive results for RPP was 1,276 (11%). Both RT-PCR and RPP were positive in 78 cases (0.7%), with 12 different organisms identified as the causal agents in these cases. The most common being Rhinovirus in 37.1% (n=29), followed by Staphylococcus Aureus in 33.3% (n=26) and Haemophilus influenzae 21.7%, (n=17). Other organisms included S. pneumonia, K. pneumonia, Influenza A, Influenza B, parainfluenza virus, metapneumovirus, adenovirus, enterovirus, and other strains of coronavirus. 7 cases were identified to have 2 positive organisms in RPP, in addition to being positive to COVID-19. 5 of which included rhinovirus and 4 of them had H. influenzae. Age was found to have a great influence on the incidence of different organisms of these concomitant infections. From the 11 cases that were 18 years old or younger, 45.4% had S. aureus as the causal agent and 27.2% were positive for H. influenzae. Cases among individuals >65 years old were positive only for rhinovirus. CONCLUSIONS: A positive test for respiratory pathogens does not exclude the coinfection with COVID-19 or vice versa. Age seemed to be the factor with the highest influence in determining the causal agent of these concomitant infections. CLINICAL IMPLICATIONS: Workup for respiratory infections should include testing for COVID-19, given that a positive RPP in a symptomatic or asymptomatic patient does not exclude concomitant infection with the novel coronavirus. Age range should also be considered as a determinant factor influencing causal agent of coinfection. DISCLOSURES: No relevant relationships by Frida Andrea Alvarez Velazquez, source=Web Response No relevant relationships by Valeria Demeneghi Aleman, source=Web Response No relevant relationships by JOSE ALFONSO GARNETT CARBAJAL, source=Web Response No relevant relationships by Mariya Mohiuddin, source=Web Response No relevant relationships by Salim Surani, source=Web Response No relevant relationships by Daryelle Varon, source=Web Response No relevant relationships by Joseph Varon, source=Web Response
ABSTRACT
In December 2019, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak of respiratory disease in Wuhan, China, that quickly spread to other countries causing a global pandemic. Although the reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection has become the standard method of diagnosis, this test has limitations that cause false negative results. The sudden onset, and spread of this virus, has created an urgency to find reliable screening and diagnostic tools to identify infect ed patients, prevent further transmission, and provide treatment for these patients. A rapid and accurate diagnostic tool, the COVID-19 combined IgG and IgM “Rapid” test can detect these antibodies against SARS-CoV-2 using a finger prick blood sample detecting infection in 15 minutes. We report the use of the COVID-19 IgM Rapid Test in the presence of high clinical suspicion, along with typical chest computed tomography findings suggestive of COVID-19 infection, in a patient who tested negative twice for the nasopharyngeal swab specimen RT-PCR test.