Relations between radiotherapy resources and breast cancer patient survival rates.

In Japan, the number of patients that have been treated with radiotherapy (RT), particularly those with breast cancer, has increased in the past decade, and is expected to double in the next decade. There is, however, a shortage of RT resources, particularly personnel, which represents a social problem. The shortage of RT resources might cause a difference in survival rate among treated patients. This study analyzed the characteristics of RT resources in RT facilities from Osaka based on the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) database with principle component analysis and cluster analysis. In addition, the relation between RT resources and treatment outcome of breast cancer patients was investigated by linking together Osaka Cancer Registry (OCR) and JASTRO data via a stratified key cord. By using the linked dataset it was shown that the prognosis of breast cancer patients was highly correlated with the scale of RT resources available at the RT facilities collaterally. From cluster analysis, four groups were identified based on RT facility information. The breast cancer survival rates for localized stage patients obtained in classified hospital groups showed a similar pattern, however, large differences (up to 20%) were seen in regional stage patients. Additional findings were: RT facilities with less than 1 radiation oncologist had the poorest outcome; RT was performed primarily at University hospitals; and differences in RT resources within the RT facilities had an effect on breast cancer patient prognosis in Osaka, Japan.

Nuclear TAR DNA binding protein 43 expression in spinal cord neurons correlates with the clinical course in amyotrophic lateral sclerosis.

TAR DNA binding protein 43 (TDP-43) has been considered a signature protein in frontotemporal dementia and amyotrophic lateral sclerosis (ALS), but not in ALS associated with the superoxide dismutase 1 (SOD1) gene mutations (ALS1). To clarify how TDP may be involved in ALS pathogenesis, clinical and pathological features in cases of sporadic ALS ([SALS] n = 18) and ALS1 (n = 6) were analyzed. In SALS patients with rapid clinical courses, TDP mislocalization (i.e. cytoplasmic staining and TDP-positive cytoplasmic inclusions) in anterior horn cells was frequent. In SALS patients with slow clinical courses, TDP-43 mislocalization was rare. In an ALS1 patient with the SOD1 gene mutation C111Y, there were numerous TDP-positive inclusions and colocalization of SOD1 and TDP. In mutant SOD1 transgenic (G93A) mice at the end stage (median, 256 days), TDP-positive inclusions and TDP colocalization with SOD1 were also observed; nuclear TDP-43 immunoreactivity was highly correlated with life span in these mice. In both humans and mice, nuclei that stained strongly for TDP were large and circular; weakly stained nuclei were atrophic or deformed. In conclusion, low levels of TDP expression in the nucleus cor relate with a rapid clinical course in SALS and in ALS1 model mice, suggesting that nuclear TDP may play a protective role against motor neuron death resulting from different underlying etiologies.