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Background/aim: To identify the clinical and dosimetric predictors of severe acute radiation esophagitis (RE) in patients with non-small cell lung cancer (NSCLC) treated with accelerated hyperfractionated concurrent chemoradiotherapy (AH-CCRT) with concomitant boost technique., Patients and Methods: A total of 159 patients who underwent AH-CCRT (64 Gy in 40 fractions twice daily) were retrospectively identified. Severe RE was designated as grade 3 or higher according to the Common Terminology Criteria for Adverse Events, version 4.0., Results: The incidence rate of grade 3 RE was 15.1% (24/159). The multivariate analysis that incorporated the Eastern Cooperative Oncology Group performance status (ECOG PS, ≥1 vs. 0) and the relative esophagus volume irradiated with at least 60 Gy (V 60 ) was optimal. Patients with a V 60 of ≥15% had a 37.8% risk of grade 3 RE compared to a 6.1% risk among those with a V 60 of <15%., Conclusion: ECOG PS (≥1 vs. 0) and the V 60 were found to be significant risk factors for severe RE in NSCLC patients who underwent AH-CCRT., (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Purpose: To evaluate the effects of intravitreal injection of aflibercept using a treat-and-extend dosing regimen on treatment-naïve neovascular age-related macular degeneration (AMD) and the development of macular atrophy., Design: Retrospective, interventional case series., Participants: Eyes (n = 137) with treatment-naïve neovascular AMD, including 18 eyes with typical AMD with classic choroidal neovascularization (CNV), 44 eyes with typical AMD with occult CNV, 58 eyes with polypoidal choroidal vasculopathy, and 17 eyes with retinal angiomatous proliferation (RAP)., Methods: Clinical records of eyes with neovascular AMD that underwent 3 consecutive monthly intravitreal injections of aflibercept followed by a treat-and-extend dosing regimen were reviewed, and the corresponding imaging studies were analyzed., Main Outcome Measures: Changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), and the extent of macular atrophy in the macular area during a 2-year follow-up period., Results: In all subtypes after 1 and 2 years, CMT and CCT were reduced significantly, whereas macular atrophy showed significant enlargement. At baseline, the extent of macular atrophy was greater in RAP than other subtypes; after 2 years, the macular atrophy enlargement was also greatest in RAP and correlated negatively with CCT (rs = -0.72; P < 0.01). Best-corrected visual acuity showed significant improvement after 1 and 2 years in all subtypes other than RAP. In RAP, BCVA was improved significantly after 1 year, but the magnitude of this improvement lost statistical significance after 2 years., Conclusions: Treat-and-extend with intravitreal aflibercept may be effective for improving BCVA and ameliorating exudative changes in neovascular AMD. However in RAP, choroidal thinning during the treatment regimen may accelerate enlargement of macular atrophy, thereby diminishing the improvement in BCVA after 2 years., (Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the effects of aflibercept therapy using a treat-and-extend regimen on treatment-naïve polypoidal choroidal vasculopathy (PCV)., Methods: In a retrospective interventional case series of 58 eyes of 58 patients with PCV, we assessed best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), and number of injections for 2 years. Polypoidal lesions were also evaluated before treatment and after the loading phase by indocyanine green angiography., Results: BCVA significantly improved after the loading phase and was maintained in the maintenance phase. CMT and CCT significantly reduced after the loading phase and were maintained throughout the follow-up period. The number of injections averaged 7.72 in the first year and 4.67 in the second year. The average number of polypoidal lesions per patient was 2.43 before treatment. In 32 patients (55.2%), polypoidal lesions regressed completely after the loading phase; these patients also needed significantly fewer injections compared to other patients. CCT at baseline was positively correlated with the decreased amount of CCT after 2 years and negatively correlated with the number of injections for 2 years., Conclusions: Treat-and-extend intravitreal therapy with aflibercept may be effective for improving BCVA and exudative change in eyes with PCV. The regression of polypoidal lesions after the loading phase and thicker choroid at baseline might lead to fewer total number of intravitreal injections of aflibercept.

Background: The hypothesis of this retrospective study was that the duration of twice-daily (BID) thoracic radiotherapy (TRT) and time from the start of any treatment to the end of chest irradiation (SER) would predict outcomes in limited-disease small-cell lung cancer., Materials and Methods: All 81 patients received 45 Gy in 30 fractions BID with a ≥ 6-hour interval and concurrent chemotherapy of platinum and etoposide., Results: The median radiotherapy duration was 25 days (range, 21-38 days). The 5-year overall survival rates were 26.2% (95% confidence interval [CI], 14.3%-38.0%), and the median survival time was 30 months (95% CI, 15.5-44.5 months). Using multivariate regression analysis, the significant predictors of survival were the sum of the diameters of the primary tumor and metastatic lymph nodes, male gender, age ≥ 60 years, and the duration of BID-TRT (hazard ratio [HR], 1.15; 95% CI, 1.06-1.25; HR, 2.38; 95% CI, 1.13-5.02; HR, 2.38; 95% CI, 1.10-5.17; and HR, 1.08; 95% CI, 1.01-1.15, respectively). A total of 70 of 81 patients (86%) received radiotherapy during the first chemotherapy cycle. The median SER was 29 days (range, 21-109 days). The 5-year local control rate was 48.7% (95% CI, 33.9%-63.6%). The significant predictors of local control were the sum of the diameters of the primary tumor and metastatic lymph nodes, age ≥ 60 years, and SER (HR, 1.18; 95% CI, 1.06-1.31; HR, 4.18; 95% CI, 1.23-14.24; and HR, 1.02; 95% CI, 1-1.04, respectively)., Conclusions: The duration of BID-TRT and SER were identified as one of the significant predictors of survival and local control in limited-disease small-cell lung cancer treated with concurrent chemoradiotherapy at 45 Gy in 30 fractions, respectively., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Antibody therapy targeting programmed cell death-1 (PD-1) and programmed cell death-ligand 1 (PD-L1) is a promising therapy in human cancer, but only limited information on PD-L1 expression in canine tumors is available., Materials and Methods: PD-L1 expression was examined in 31 canine tumor cell lines of various origins by flow cytometry and western blotting, and in canine tumor and normal tissue specimens by immunohistochemistry., Results: PD-L1 was only expressed on the cell surface of a small number of cell lines but was found expressed within the cells of almost all cell lines. Immunohistochemistry revealed that PD-L1 is frequently expressed in malignant melanoma, mammary gland tumor, mast cell tumor and lymphoma, but less frequently in soft-tissue sarcoma and hemangiosarcoma. PD-L1 was also expressed in some of the cells of normal canine tissue specimens., Conclusion: Canine tumors with PD-L1 expression that were identified in this study are potential candidates for antiPD-1 and antiPD-L1 therapy., (Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Aim: Thymoma is a rare neoplasm of the mediastinum, for which very few data on the efficacy and safety of chemotherapy and chemoradiotherapy are available. The objective of this pilot study was to assess the safety and efficacy of cisplatin, etoposide, and radiotherapy for thymoma., Patients and Methods: Patients with advanced, previously-untreated thymoma (Masaoka classification), measurable disease, and a performance status of 0-2 were eligible, and were treated with cisplatin-plus-etoposide, together with radiotherapy when possible., Results: One patient achieved complete response, and seven achieved partial responses. Progression-free survival was 37.7 months (95% confidence interval = 18.6-56.8 months). Ten patients had grade 4 neutropenia, and five patients had grade 3 febrile neutropenia. However, other toxicities were relatively mild. To date, only five patients (45.5%) have died, and the median survival time is 128.1 months (95% confidence interval = 51.6-204.6 months). Patients treated with chemoradiotherapy had a good response and long progression-free survival., Conclusion: The combination of cisplatin and etoposide with or without radiotherapy is effective for advanced thymoma, and has an acceptable toxicity.

Spinal cord stimulation has gained widespread popularity for the treatment of pain. This literature discribed our equipments, methods, patient selection, and operative procedures for spinal cord stimulation.

Memory peripheral Th2 immune responses to infectious pathogens are not well studied due to the lack of suitable models and the difficulty of assessing Th2 cytokine expression at sites of inflammation. We have examined the localized immune response to a nematode parasite that encysts in the small intestine. An unexpected architecture was observed on day 4 of the memory response, with granulocytes and macrophages infiltrating the cyst and CD4(+), TCR-alphabeta(+) T cells surrounding the cyst. Laser capture microdissection analysis showed a pronounced CD4-dependent Th2 cytokine pattern at the cyst region only during the memory response, demonstrating that the Th2 memory response is readily distinguished from the primary response by the rapid accumulation of Th2 effector cells at the host:parasite interface.