Brachytherapy for targeting the immune system in cervical cancer patients.

BACKGROUND: New combinations based on standard therapeutic modalities and immunotherapy require understanding the immunomodulatory properties of traditional treatments. The objective was to evaluate the impact of brachytherapy (BT) on the immune system of cervical cancer and to identify the best modality, High-dose-rate brachytherapy (HDR-BT) vs. Pulsed-dose-rate (PDR-BT), to target it. METHODS: Nineteen patients enrolled in a prospective study received chemoradiation (CRT) and subsequently HDR-BT or PDR-BT. Peripheral blood samples were obtained for immunophenotyping analysis by flow-cytometry before CRT, BT, and two and four weeks after BT. The Friedman one-way ANOVA, Conover post hoc test, and the Wilcoxon signed-rank test were used to compare changes in cell populations at different periods, perform multiple pairwise comparisons and assess differences between treatment groups (PDR and HDR). RESULTS: Natural killer cells (NKs) were the best target for BT. Patients receiving HDR-BT achieved significantly higher values ​​and longer time of the CD56dimCD16 + NK cells with greater cytotoxic capacity than the PDR-BT group, which presented their highest elevation of CD56-CD16 + NK cells. Furthermore, both BT modalities were associated with an increase in myeloid-derived suppressor cells (MDSCs), related to a worse clinical prognosis. However, there was a decrease in the percentage of CD4 + CD25 + Foxp3 + CD45RA + regulatory T cells (Tregs) in patients receiving HDR-BT, although there were no significant differences between BT. CONCLUSIONS: Immune biomarkers are important predictive determinants in cervical cancer. Higher cytotoxic NK cells and a trend toward lower values of Tregs might support the use of HDR-BT to the detriment of PDR-BT and help develop effective combinations with immunotherapy.

Changes in peripheral immune cells after intraoperative radiation therapy in low-risk breast cancer.

A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30-0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.

Corrigendum to "Why should radiation oncology do translational research?" [Rep Pract Oncol Radiother 2019;24(1):60-64].

[This corrects the article DOI: 10.1016/j.rpor.2018.10.008.].

Enhancing radiotherapy effect in breast cancer with nanoparticles: A review.

Amongst all efforts for improving oncological management outcomes, nanoparticles enhanced radiation for breast cancer patient's treatment is a novel approach that has grown interest for research in the last decade. Multiple preclinical data has been published, from all around the globe; however, clinical evidence is still insufficient for implementing the method in routine practice and in disease specific management. Gold nanoparticles (AuNP), which may be among the most studed materials, account for the majority of available data; however, some new materials have also been used in preclinical settings. Without any safety data available at the moment to support an active use, dosimetric in vitro and in vivo information seems to be consistent with a very promising and hopeful panorama for clinical applications. This review evaluates existing dosimetric data in breast cancer tissue, and a probable future impact in treatment choices and patient outcomes, as further investigation is required in a clinical setting.

Nanoparticles applied to cancer immunoregulation.

AIM: In recent years, we have seen a considerable increase in the relevance of nanostructures for the safe delivery of therapeutic agents and their capacity as an immunomodulatory tool. MATERIALS AND METHODS: Potential clinical applications related to their unique structural properties have been described in the evolving landscape of immunotherapy. RESULTS: This review briefly summarizes the evidence for the role of nanoparticles in regulating the immune response. CONCLUSIONS: Their main features to highlight how to provide an innovative means of biomedical application to oncology research.

Síndrome de SAPHO como diagnóstico diferencial de metástasis / SAPHO syndrome in the differential diagnosis of metastasis

El síndrome de SAPHO fue propuesto a finales de los años 80 para agrupar diversas manifestaciones osteoarticulares con hallazgos radiológicos propios como la hiperostosis de la pared anterior del tórax. La prevalencia, la causa y la patogénesis de la enfermedad son desconocidas. El diagnóstico se realiza tanto por la clínica como por la imagen específica gammagráfica de «asta de toro» en la articulación esternoclavicular. Se presenta el caso de una mujer de 64 años diagnosticada de carcinoma ductal infiltrante de mama derecha pT1N0Mx. En el estudio de extensión de la enfermedad se evidenció imagen gammagráfica de lesión blástica, difusa, en manubrio esternal, sospechosa de enfermedad de Paget o lesión metastásica. Se completó el estudio con TC torácica en la que se evidenció esclerosis del manubrio esternal, sugerente de metástasis. Por el resultado de los estudios se pensó en el síndrome de SAPHO como opción diagnóstica más probable. El bajo estadio tumoral de la paciente hizo pensar en posibles alternativas diagnósticas. Conocer esta entidad clínica puede evitar errores a la hora de clasificar en estadios tumorales más avanzados a un sujeto y, por tanto, evitar tratamientos quimioterápicos y radioterápico más agresivos (AU)

SAPHO syndrome was proposed in the late 80s in order to group different osteoarticular manifestations with specific radiological findings such as the hyperostosis of the front part of the chest wall. Prevalence, etiology and pathogenesis of the disease are unknown, while diagnosis is made both clinically and by the specific gammagraphic image of «bull horn» in the sternoclavicular joint. The following case of a 64-year-old woman diagnosed with infiltrating ductal carcinoma of the right breast pT1N0Mx is reported. When studying the extent of the disease, a gammagraphic image of diffuse blast injury in the sterna manubrium was evidenced, which allowed the suspicion of Paget's disease or metastatic injury. Study was completed with a chest CT in which manubrium sclerosis was evidenced, suggesting metástasis. Res ults of the studies pointed out SAPHO syndrome as the most likely diagnostic option. The low tumor stage of the patient prompted the idea of possible alternative diagnoses. A deeper knowledge of this clinical condition may be crucial to avoid mistakes when classifying a subject in more advanced tumor stages, and consequently, to prevent the use of more aggressive chemotherapy and radiotherapy treatment (AU)

Leiomiomatosis esofágica difusa como diagnóstico diferencial de disfagia / Diffuse esophageal leiomyomatosis as a differential diagnosis of dysphagia

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SAPHO syndrome in the differential diagnosis of metastasis. / Síndrome de SAPHO como diagnóstico diferencial de metástasis.

SAPHO syndrome was proposed in the late 80s in order to group different osteoarticular manifestations with specific radiological findings such as the hyperostosis of the front part of the chest wall. Prevalence, etiology and pathogenesis of the disease are unknown, while diagnosis is made both clinically and by the specific gammagraphic image of «bull horn¼ in the sternoclavicular joint. The following case of a 64-year-old woman diagnosed with infiltrating ductal carcinoma of the right breast pT1N0Mx is reported. When studying the extent of the disease, a gammagraphic image of diffuse blast injury in the sterna manubrium was evidenced, which allowed the suspicion of Paget's disease or metastatic injury. Study was completed with a chest CT in which manubrium sclerosis was evidenced, suggesting metástasis. Res ults of the studies pointed out SAPHO syndrome as the most likely diagnostic option. The low tumor stage of the patient prompted the idea of possible alternative diagnoses. A deeper knowledge of this clinical condition may be crucial to avoid mistakes when classifying a subject in more advanced tumor stages, and consequently, to prevent the use of more aggressive chemotherapy and radiotherapy treatments.