Day 2 :
Keynote Forum
Bogusław Maciejewski
Cancer Center-Institute, Poland
Keynote: To boost or not to boost in radiotherapy
Time : 09:00- 09:30
Biography:
Bogusław Maciejewski has completed his PhD and Scientific Title of a Full Professor in Radiotherapy. He has done many research projects in the UCLA Los Angeles, Gray Lab London, MGH Harvard University Boston, MDACC Houston and other Cancer Centers in Europe. He was the Director of Cancer Center-Institute Gliwice, Poland till 2015. He is the author of over 200 papers which are published in reputed journals (IF=1650 and citation index=3500). He was awarded the G F Fletcher Gold Medal and Gold Medal of Life Achievements in Oncology by all European Oncologic Societies. He is an Honorary Member of American College of Radiology, Radiotherapy Expert of the IAEA in Vienna and for 10 years he was a Member of European Board of Radiotherapy. His major interest focuses on the importance of treatment time and tumor repopulation; and altered dose fractionation in Clinical Radiotherapy for human tumors.
Abstract:
Bogusław Maciejewski has completed his PhD and Scientific Title of a Full Professor in Radiotherapy. He has done many research projects in the UCLA Los Angeles, Gray Lab London, MGH Harvard University Boston, MDACC Houston and other Cancer Centers in Europe. He was the Director of Cancer Center-Institute Gliwice, Poland till 2015. He is the author of over 200 papers which are published in reputed journals (IF=1650 and citation index=3500). He was awarded the G F Fletcher Gold Medal and Gold Medal of Life Achievements in Oncology by all European Oncologic Societies. He is an Honorary Member of American College of Radiology, Radiotherapy Expert of the IAEA in Vienna and for 10 years he was a Member of European Board of Radiotherapy. His major interest focuses on the importance of treatment time and tumor repopulation; and altered dose fractionation in Clinical Radiotherapy for human tumors.
Keynote Forum
Mahmoud H Abdel Kader
German University, Egypt
Keynote: Oncological applications of photodynamic diagnosis and therapy: An overview
Time : 09:30-10:00
Biography:
Mahmoud H Abdel Kader is a Professor of Photochemistry at Cairo University and currently the President of German University in Cairo. He has received his PhD at Stuttgart University, 1979. He has published over 100 publications in peer reviewed journals and in conference proceedings. He is an Inventor of 9 patents. He was awarded the distinguished State Prize in Chemistry, 1996 as well as the State Medal in Chemistry, 1998. He was awarded the 2012 Excellence Award of Science from Cairo University. He was awarded the State Award Discretion in Advanced Technological Sciences, 2014.
Abstract:
Although photodynamic diagnosis (PDD) and therapy (PDT) are now more than hundreds of years old and nowadays there exists well defined diagnostic and treatment protocols approved by FDA for clinical use, PDT still deserves to receive more attention from physicians to expand its application. PDD and PDT depend on the interaction of three harmless components; namely a light source, a photosensitizer (PS) and molecular oxygen. When light of a specific wavelength is absorbed by the PS, fluorescence emission is induced which is the basis for PDD. When the energy is transferred to tissues oxygen, toxic reactive oxygen species (ROS) are generated which lead to irreversible cellular damage causing cell death and tumor destruction. This technique possesses numerous advantages such as targeting as PS is selectively taken up and retained by tumor cells, lack of resistance upon repetitive applications and importantly the ability to use them in combination with standard cancer treatment approaches. In this presentation, an overview of PDT fundamentals along with its clinical implications for different types of cancer will be illustrated. In addition, the successful field applications of PDT in control of malaria vector and other parasites will be briefly discussed.
Keynote Forum
David Huang
Duke Kunshan University, China
Keynote: Medical physics education and radiation medicine
Time : 10:00-10:30
Biography:
David Huang, upon completion of his PhD in Particle Physics, was trained at Medical Physics Residency Program at UC San Francisco, San Francisco. Then he worked at Memorial Sloan-Kettering Cancer Center, New York as a Faculty Physicist before moving to Long Island Jewish Medical Center, New York as Senior Medical Physicist. In 1995, he went back to Taiwan to help in establishing the first cancer center and was there for 7 years as Chairman of Medical Physics Department at Sun Yat-Sen Cancer Center in Taipei. In 2002, he went back to Memorial Sloan-Kettering Cancer Center as Associate Attending and Chief Physicist/Radiation Safety Officer at Rockville Centre Site. In 2014 summer, he retired from Memorial Sloan-Kettering Cancer Center and accepted offer from Duke University as Professor and Director at Medical Physics Graduate Program at Duke Kunshan University, China. Besides the clinical experiences, he is also a Professor at Young-Ming University, Taiwan and Central Taiwan Technology University, Taiwan, a Visiting Professor at Beijing University, School of Oncology, China and at Tsing-Hwa University, China and Adjunct Professor at University of Missouri, USA.
Abstract:
During the past three decades, advances in radiological imaging techniques (both in hardware and software), computer technology and radiotherapy techniques (both in hardware and software) moved the radiation medicine into a new era. It has significantly enhanced our ability to achieve the goals of early cancer detection through accurate diagnosis and of better cancer treatment outcome through advanced treatment modalities. In the diagnostic radiology, besides, the conventional anatomical imaging, there are many new modalities developed for functional/molecular imaging, such as PET and functional MRI. Now, researchers even work further on imaging of cell and DNA to have more “Personalized” diagnosis for the disease in the future. In radiotherapy, intensity-modulated radiation therapy (IMRT) is an advanced method of conventional 3DCRT that utilizes sophisticated computer controlled radiation beam delivery to improve the conformality of the dose distribution. For the better tumor control, the new treatment technique, VMAT (Volumetric Modulated Arc Therapy), was developed and applied to clinic to improve the treatment outcome and to minimize the radiation side effect. Both IMRT and VMAT utilize sophisticated strategies for patient immobilization and positioning, image-guided treatment planning, computer enhanced treatment verification and image-guided treatment delivery (IGRT). In the heart of these techniques is advanced computer technology and 3D patient imaging with CT, MR and/or PET. However, the new advanced technologies create problem of “how to apply these new technologies to the patient effectively and safely”. The key person to assure the quality of the equipment and the treatment and to assure the radiation safety is the medical physicists. Without qualified physicists, even with state of arts equipment, patient cannot be benefited from these advanced technologies, imaging or treatment. Furthermore, patient may suffer from radiation side effects. On the top of that, most of new technologies were developed by the medical physicists. Therefore, the medical physicists are important in the radiation medicine field. Unfortunately, nowadays for the most area, there are either not enough medical physicists on-site or the on-site physicists were not well trained in the radiation field to learn the core knowledge and to gain the solid clinical experiences. Therefore, I would introduce here a comprehensive medical physicist’s education program to the audiences. My talk will use the Medical Physics Two-year Graduate Program at Duke Kunshan University as an example.
- Anti- Cancer Therapy | Cancer Imaging | Radiation Therapy | Cancer Screening
Location: Salon VI & VII
Chair
Nuri Unal
Akdeniz University, Turkey
Co-Chair
Nina Tuncel
Akdeniz University, Turkey
Session Introduction
Sanjay R Jain
Morehouse School of Medicine, USA
Title: Cancer Immunotherapy
Time : 10:50-11:10
Biography:
Sanjay R Jain has obtained his Medical degree from the University of Rajasthan in India and then pursued his MS and PhD in Immunology at Kent State University in Kent, OH. He has then completed his Residency training in Internal Medicine at Brown University in Providence, RI, and his Fellowship training in Hematology and Oncology at Harvard Medical School in Boston, MA. He has been in academic medicine since 1999 and particularly interested in novel drug discovery and development, especially immune therapies and the toxicities associated with the use of these agents.
Abstract:
The role of immune system in protection of the host against spontaneously arising tumors has been recognized for several centuries. The Natural Killer Cells perform an important function of immune surveillance against such tumors. However, our understanding of the mechanisms involved and more importantly of the mechanisms by which tumors escape and evade an immune response is limited. We are now beginning to better understand some of the pathways responsible for tumor destruction by immune cells. Therapeutic advances in the treatment of malignant melanoma and renal cancer and now lung cancer have allowed us an opportunity to harness the immune system against tumors and limit the use of cytotoxic chemotherapy with its attendant side effects. We still do not fully understand the epitopes on tumor cells towards which NK cells and other components of the immune system are directed; doing so will enable us to develop more effective immune therapies which have a sustained and effective response against tumors. Enrichment of Tumor Infiltrating Lymphocytes, the use of chimeric antigen receptors, anti CTLA-4, PD-1 and PD-L1 directed therapies are a beginning in that effort and the combination of cellular and humoral approaches against tumors would likely allow for effective and relatively non-toxic and safer mechanisms of achieving durable and possibly life-long tumor control. Such approaches could also be utilized in primary prevention of sporadic and familial tumors. The history and current landscape of immune therapies is discussed. Also discussed are the toxicities and adverse effects associated with the use of immune therapies and possible future approaches of combinations of different components of the innate and adaptive immune systems, as well other classes of agents (chemotherapy, biological agents and radiation therapy). Possible experimental and clinical trial models are proposed.
Biography:
Nuri Ünal has completed his PhD from Ankara University and Postdoctoral studies from Free University Department of Physics Berlin Germany. He is the Head of Physics Department in Science Faculty at Akdeniz University, Antalya, Turkey. He has published more than 40 papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Since the discovery of X-rays in 1895, radiation therapy has been prompted by continuous technological advances. Radiotherapy aims to achieve the optimal dose on the tumour volume while sparing normal tissues. The benefits can be entitled by patient cure, organ preservation and cost-efficiency. The efficacy of radiotherapy was demonstrated by many studies. The major importance for the treatment quality has been fostered during the past decade by linear accelerators produced X-rays, protons etc., with computer-assisted technology. More recently, these developments were augmented by proton and particle beam radiotherapy, usually combined with surgery and medical treatment in a multidisciplinary and personalized strategy against cancer. Current limiting factors of treatment with protons are the size, heavy weight and cost regarding conventional machines. New technological innovations are ongoing, such as those consisting of designing machines can be installed at a reasonable price in hospital‑based centres. Heavy particles as C-12 have the same treatment advantage as protons. The Bragg peak characteristics of them have made them attractive especially for radioresistant cancers. The main goal was to improve the ratio between an optimal dose in the tumour and the lowest dose possible in the organs at risk. This talk reviews the timeline of radiotherapy with a focus on breakthroughs in the physics of radiotherapy and technology during the past two decades. In conclusions, innovations in radiation therapy technology need continuous effort of research that would not be possible without the scientists, engineers, radiation oncologists and all the persons involved in the field of science and medical practice.
Larysa M. Skivka
Taras Shevchenko National University, Ukraine
Title: Optic characteristics of anticancer drug NSC 631570 in urine samples sort healthy donors and prostate adenocarcinoma patients: Can it be exploited for the cancer diagnostics
Time : 11:30-11:50
Biography:
Larysa M Skivka has completed her PhD from R E Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine and Post-doctoral studies from Taras Shevchenko National University of Kyiv. She is currently the Head of the Department of Microbiology and General Immunology of SCE Institute of Biology - Taras Shevchenko National University of Kyiv. Her areas of scientific activities are: Immunomodulation as a component of adjuvant cancer therapy and functional polarization of phagocytes in the pathogenesis of inflammatory diseases. She has published more than 13 papers in reputed journals and more than 40 abstracts in scientific congresses.
Abstract:
NSC 631570 (the mixture of alkaloids from C. majus) has shown anticancer activities against different types of solid tumor. Previous studies showed an anticancer effect of NSC 631570 in prostate cancer patients. The cytotoxic effect of the drug was evident in preclinical studies in prostate cancer cell line (PC-3). The aim of the work was to perform comparative investigation of optic characteristics of urine samples from prostate cancer patients (PCs) and healthy volunteers (HVs) to confirm different uptake of alkaloids mixture in both normal and cancer patients. Five PCs and five HVs were recruited to participate in this study. Urine samples were obtained before and 2, 4 and 6 hours after the sublingual administration of the drug. The UV light absorption spectrum characteristic for NSC 631570 was registered 2 h after the drug administration in HVs. PC1 showed an absorption spectrum similar to NSC 631570 4 hours after the drug intake. But absorption spectra of PC 2-5 was completely different during the entire observation period when compared with those observed in HVs (p<0.05). Patterns of urine fluorescence in PCs had substantial differences from those in HVs. Urine fluorescence was increasing in all PCs after the drug administration, till the end of the observation period followed by a moderate decrease of the fluorescence intensity 6 hours after the drug intake. Thus urine optic characteristics after the drug intake make the differences between PCs and HCs. It suggests that this method could be potentially used to test whether non-clinically pathologic subject might be affected by cancer.
Wassil Nowicky
Ukranian Anticancer Institute, Austria
Title: Physico-chemical properties of anticancer drug NSC631570
Time : 11:50-12:10
Biography:
Wassil Nowicky has received his degree of a Dr. Sci. Tech from the University of Vienna. He is the Director of Nowicky Pharma and the Inventor of the Anticancer Preparation NSC631570. He is a Member of New York Academy of Sciences, European Union for Applied Immunology and American Association for Scientific Progress. He has more than 49 papers published in reputed journals.
Abstract:
One of the most significant problems of cancer therapy is the damaging activity of anticancer drugs against normal body cells. All attempts to develop a therapeutic agent with a selective cytotoxic effect on tumor cells had no much success because of the high degree of biological identity between healthy and malignant cells. The celandine is being used in the medicine over more than 3500 years. The first data concerning the therapeutic effect of the juice of celandine in the patient with malignant melanoma were published in Germany in 1536. From that time drugs based on biologically active substances of celandine are widely used to treat cancer and non-cancer disease. It is well known that tumor cell is more negatively charged as compared to normal cell. We have used this feature of the tumor cell to give NSC631570 a property to selectively interact with it, without endangering healthy cells and tissues. The drug is strongly positively charged. Due to this it has an ability to be selectively accumulated in tumor tissue and to induce tumor cell apoptosis only in tumor cells without harmful effect on normal cells. Potent selective antitumor effect of NSC631570 has been repeatedly proven by the results of clinical trials. There is an assumption that the same high selective cytotoxicity of drug on tumor cells of different origin is the result of its interaction with a ubiquitous tumor-specific (or overexpressed in tumor cells) compound involved in the induction of cell death. It remains to find this compound.
Bogusław Maciejewski
Cancer Center-Institute, Poland
Title: Time factor and dose fractionation in radiotherapy for head and neck cancer
Time : 12:10-12:30
Biography:
Bogusław Maciejewski has completed his PhD and Scientific Title of a Full Professor in Radiotherapy. He has done many research projects in the UCLA Los Angeles, Gray Lab London, MGH Harvard University Boston, MDACC Houston and other Cancer Centers in Europe. He was the Director of Cancer Center-Institute Gliwice, Poland till 2015. He is the author of over 200 papers which are published in reputed journals (IF=1650 and citation index=3500). He was awarded the G F Fletcher Gold Medal and Gold Medal of Life Achievements in Oncology by all European Oncologic Societies. He is an honorary member of American College of Radiology, Radiotherapy Expert of the IAEA in Vienna and for 10 years he was a Member of European Board of Radiotherapy. His major interest focuses on the importance of treatment time and tumor repopulation; and altered dose fractionation in Clinical Radiotherapy for human tumors.
Abstract:
Results of our studies on dose fractionation and time factor for more than 1000 head and neck cancer cases are presented. For a constant total dose (TCD50) extension of overall treatment time (OTT) significantly decreases tumor cure probability by 1-1.50% per each one day extension of the OTT for laryngeal cancer. Further studies focused on oral cavity and oropharyngeal cancer and showed that due to accelerated repopulation of tumor clonogens starting about week 3 of irradiation of conventional fractionation 5 days/week, about 0.6 Gy/day (Drep) of 2.0 Gy fractions is balanced by repopulation. In early 80-ties it became a basic rationale for altered fractionation (accelerated, hyperfractionation and hybrid fractionation). There were over 50 clinical trials carried out through the next 20 years but meta-analysis of these results has shown only 6-7% overall therapeutic gain, much lower than expected. Because of various fractionation schedules, it is not possible to separate biological effect of dose escalation from that of changes in dose per fraction. When hypofractionated radiosurgery became the object of interest, there is promising perspectives to improve tumor local control at least for some tumor types and sites. The results of these studies will be presented and discussed.
Nina Tuncel
Akdeniz University, Turkey
Title: Adaptive radiotherapy from past to future
Time : 12:30-12:50
Biography:
Nina Tunçel has completed her PhD from Istanbul University Oncology Institutes in Medical Radiation Physics. She was the Chief Medical Physicist from 1999 to 2013 at Akdeniz University Medical School, Radiation Oncology Department. She has her career as teaching staff for training in Medical Physics at Physics Department of Science Faculty of Akdeniz University. She has published more than 30 papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Adaptive radiation therapy (ART) is a radiation therapy process where treatment is adapted to account for internal anatomical changes. Some organs in the body that require radiation therapy can change in size and shape over the days and weeks that a course of treatment can take. The aim of ART is to account for these changes and deliver the radiation dose to the tumor as accurately as possible. With the emergence of the onboard-volumetric-imaging device, the implication of ART has dramatically changed. For the first time, it leads to construction of the patient’s on-treatment geometric model. Thus, one can adaptively modify not only the PTV margin, but also the spatial dose distribution to best accommodate any change in patient anatomy as well as the dosimetric deviation from the prescription incurred in previous fractions. A treatment plan provides an overall estimate of the treatment. In the last few years, much research has been devoted and also notably, various vendors are making significant efforts. With technical advancements, particularly in computer, network technology and optimization algorithms, online practices is becoming increasingly feasible and may likely become a “Standard Practice” in the near future. In this approach, the role of simulation geometry and treatment plan is different from that in current practice. In conclusion, the workflow and technology features are essential factors for introducing and providing robust adaptation of the treatment plan throughout the course of treatment. Indeed the useful measure to identify patients in need for an adaptive treatment is the goal of strategy.
- Special Session
Location: Salon VI & VII
Chair
Simona Donina
Riga Eastern Clinical University, Latvia
Session Introduction
Simona Donina
Riga Eastern Clinical University, Latvia
Title: Oncolytic virotherapy with Rigvir®
Time : 14:40-15:10
Biography:
Simona Doniņa, MD, PhD, Assoc. Prof., Latvian Oncology Centre, is Oncologist and Immunologist at the Institute of Microbiology and Virology of Riga Stradiņš University, with over 20 years of experience in Clinical Oncology. She is author of 11 scientific publications indexed in PubMed.
Abstract:
Statement of Problem: Melanoma is one of the fastest growing cancers and has the highest mortality-rate of skin cancers. The oncolytic property of viruses has been observed for over a century and is presently intensively studied. Rigvir® is the first registered oncolytic virus and the only one approved that has not been genetically modified. It is an ECHO-7 virus registered for melanoma therapy. The present retrospective study was made to determine the effectiveness of Rigvir® in sub-stage IB, IIA, IIB and IIC melanoma patients on overall survival.
Methodology & Theoretical Orientation: Caucasian patients (N=79) who had surgical excision of the primary melanoma tumor and histologically verified diagnosis were included in the study. Circulating levels of clinical chemistry parameters were recorded. Survival was analyzed by multivariate Cox regression. Current guidelines for melanoma advise no treatment for patients who are classified into sub‑stages IB and IIA. Patients in sub-stages IIB and IIC were given three options: Participation in a clinical trial, observation, and interferon. Thus, 52 study participants received Rigvir® and 27 were observed according to guidelines. Due to the low number, the patients treated with interferon are excluded. The study was approved by the respective ethics committee.
Findings: Rigvir® significantly prolonged survival in sub-stage IB-IIC melanoma patients following surgery compared to patients who were under observation. The hazard ratio (HR) for patients under observation vs. treated with Rigvir® is statistically significantly different: HR 6.27 for all, 4.39 for sub-stage IIA-IIB-IIC and 6.57 for sub-stage IIB-IIC patients. Safety assessment of adverse events according to NCI-CTCAE did not show any value above grade 2 in Rigvir® treated patients.
Conclusions & Significance: These results show that the patients treated with Rigvir® had 4.39-6.57 times lower mortality than those under observation. In this study, there was no untoward side effect or discontinuation of Rigvir® treatment.
- Targeted Anti- Cancer Therapy | Cancer Biomarkers | Medical Image Processing
Location: Salon VI & VII
Chair
Madhulika Singh
CSIR-Indian Institute of Toxicology Research, India
Co-Chair
Ambreen Muzaffar
Shifa International Hospital, Pakistan
Session Introduction
Madhulika Singh
CSIR-Indian Institute of Toxicology Research, India
Title: Differential miRNAs expression profiles classify Mucin 1(+)/(-) human breast cancer stem cells
Time : 15:10-15:30
Biography:
Madhulika Singh has completed PhD in the year 2003 from University of Lucknow (India) and Postdoctoral studies from CSIR-Indian Institute of Toxicology Research, Lucknow (India). Presently, she is working as Faculty in Department of Zoology at Maharishi University of Information Technology, Lucknow, India. She has published more than 36 research papers, review articles and book chapters in reputed journals and also been serving as an Editorial Board Member and Reviewer in many journals. Her research is based on understanding the self-renewal and differentiation capacities of cancer stem-like cells. Along with this, she is also engaged in discovering the scientific basis for anticancer activities of phytochemicals.
Abstract:
Background: Mucin 1 (Muc1) is a secreted, oncogenic mucin that is aberrantly overexpressed in breast cancer cells but its potential role in breast cancers stem cells (BCSCs) have not been explored. MicroRNAs (miRNA), small noncoding RNAs that play critical roles in normal stem cell functions during development, have emerged as important regulators of BCSCs as well.
Methods: Muc positive (+)/(-) cells were isolated from patient-derived cancer (n=25), and normal BC tissues (n=15) and propagated in non-adhesive suspension cell culture to assess their phenotypic characteristics. Further miRNAs expression profiling was done by using microRNA TaqMan® Low Density Array Cards v2.0 (TLDA cards A, Invitrogen), based on qReal-Time PCR array.
Results: Significantly altered expression of miRNAs were found (17 upregulated and 29 down regulated) in Muc (+) BCSCs as compared to Muc(-) (p<0.05). All these miRNAs were having significant role in BCSCs self-renewal, proliferation potential and were also involved in cancer metastasis. Further, selected miRNAs expression levels were individually tested and validated in mammospheres generated from tissue samples. Muc(+) BCSCs were showing higher level of miRNAs -9, 16, 34a, 195-5p and 454 as compared to Muc(-) BCSCs. Significantly downregulated expression of miR-106a, 125b and 218 was also noted in Muc (+) BCSCs as compared to adhered and Muc(-) cell population.
Conclusions: These miRNAs can potentially be used to develop a panel for classification and prognosis in order to better predict the progression of the disease and facilitate the choice of treatment strategy.
Juhi Tiwari
Jayoti Vidyapeeth Women’s University, India
Title: Effects of histone deacetylase inhibitors on anti neo plastic activity
Time : 15:30-15:50
Biography:
Abstract:
Ambreen Muzaffar
Shifa International Hospital, Pakistan
Title: A dosimetric comparison of the 3D-CRT planning of chest wall in post-mastectomy breast cancer patients, with and without breast board setup
Time : 16:30-16:50
Biography:
Ambreen Muzaffar alongside being an experienced Medical Physicist from the last six years is keeping her dream alive and currently progressing with her research work towards completion of MPhil. She is aiming towards excelling in the field of Medical Physics. Currently, she is an active participant in the overall initiative of her organization for achieving JCI accreditation. She is in possession of multidimensional technical and professional skills such as Precise Treatment Planning System 2.15 (3DCRT/IMRT), Eclipse Treatment Planning System 13.5 (3DCRT/IMRT), Multidata Treatment Planning System (Multi Slices) (2D), using ARIA 13.5 for VARIAN LINAC, Using MOSAIQ for Elekta LINAC. Her work was 3-D treatment planning of chest wall/breast using monoisocentric technique with junction verification, and Intensity modulated radiation therapy in organ confined/locally advanced prostate cancer. She has presented at conference in March 2013 held by PSCO. Her current ongoing researches include radiation of setup errors in SIB-IMRT of head and neck cancers as a part of her course work towards MPhil in Physics in “small field dosimetry-comparison of Monte Carlo simulations with experimental measurements”.
Abstract:
Purpose: Breast boards are used in breast radiation which increases normal lung and heart doses, when supraclavicular field is included. Therefore, in this study through dose volume histogram (DVHs), lung and heart doses comparison was done between two different setups i.e. with and without breast board, for the treatment of left chest wall and supraclavicular fossain postmastectomy left breast cancer.
Materials & Methods: In this study, CT-simulation scans of ten breast cancer patients were done with and without breast board, at Shifa International Hospitals Islamabad, to investigate the differences between the two different setups of the irradiation of left chest wall in terms of lung and heart doses. For immobilization, support under the neck, shoulders and arms was used. Precise PLAN 2.15 treatment planning system (TPS) was used for 3D-CRT planning. The total prescribed dose for both the plans was 5000 cGy/25 fractions. The chest wall was treated with a pair of tangential photon fields and the upper supraclavicular nodal regions were treated with an anterior photon field. A mono-isocentric technique was used to match the tangential fields with the anterior field at the isocentre. The dose volume histogram was used to compare the doses of heart and ipsilateral lung.
Results: Both the plans of each patient were generated and compared. DVH results showed that for the same PTV dose coverage, plans without breast board resulted in a reduction of lung and heart doses compared with the plans with breast board. There was significant reductions in V20, V<25 and mean doses for lung and V<9 and mean doses for heart.
Conclusion: In comparison of both the plans, setup without breast board significantly reduced the dose-volume of the ipsilateral lung and heart in left chest wall patients.
Manijeh Beigi
Tehran University of Medical Sciences, Iran
Title: Identifying the intra-tumoral heterogeneity of GBM using diffusion tensor image segmentation technique: A look inside application in prediction of overall survival
Time : 16:50-17:10
Biography:
Manijeh Beigi is a PhD student in Medical Physics from Tehran University, Iran and has worked for 6 years as a Radiotherapy Physicist in Jorjani Radiotherapy Center (Imam Hosein Hospital) in Tehran.
Abstract:
Background: GBM is the most common primary malignant brain tumors. Intra-tumoral heterogeneity causes to variable behavior, different clinical symptoms and survival time. Diffusion tensor imaging (DTI) can be used to characterize different regions of tumor, distinguishing solid regions from necrotic and edema regions.
Methods: 11 patients with GBM underwent diffusion tensor imaging and conventional MRI before chemo-radiation therapy. Patients were followed till death date. K-means clustering algorithm applied on (p,q) space to segment different regions of GBM with different isotropic and anisotropic characteristics. The percentage of each region to whole tumor volume was calculated. Correlation between tumor volume, percentage of each region (solid, necrotic and edema) with survival and age were acquired.
Results: Segments with greater isotropic diffusivity represent edema regions, segment with low isotropic and low anisotropic diffusivity represent the solid tumor and segment with high isotropic and low anisotropic diffusivity represent necrotic regions. The correlation’s results were as follows: Negative correlation between percentage of solid and edema regions with overall survival (r: 0.527, 0.469 respectively at significant level of 0.05), negative correlation between tumor volumes with ages (r: 0.687, p value: 0.021).
Discussion: Our initial result suggested that applying the k-means algorithm on (p, q) space may potentially provide contrast between edema, anisotropic solid tumor and necrotic region so can be used for prediction of overall survival. The results will be validated in a larger patient population to determine which extracted regions along with another imaging and clinical factor can be adopted as relevant biomarkers for survival time.
Shrikant Solav
Spect Lab Nuclear Medicine Services, India
Title: Pyrexia of unknown origin
Time : 17:10-17:30
Biography:
Shrikant Solav holds a Postgraduate degree in Medicine and Nuclear Medicine. Currently, he owns Spect Lab in Pune, India.
Abstract:
Fever/pyrexia of unknown origin (PUO) is defined as temperature greater than 38.5 degree Celsius lasting for more than three weeks, of which at least 2 weeks have been spent in thorough investigations. The causes of PUO can be divided into infectious, malignancy, autoimmune and others. Tuberculosis, abdominal, pelvic, dental abscesses, infective endocarditis, prostatitis are some of the common infectious causes of PUO. Lymphoma, chronic leukemia, renal cell carcinoma, hepatoma, colon carcinomas are some of the malignant conditions for PUO. Rheumatic fever, rheumatoid arthritis, systemic lupus erythematosus, temporal arteritis are some of the causes of autoimmune disorders accounting for PUO. Certain drugs, sarcoidosis, deep vein thrombosis are some other causes of PUO. After thorough clinical examination, blood culture, serology, the imaging tests include chest radiograph, ultrasonography, CT and MRI of relevant regions, trans-oesophageal echocardiography for evidence of infective endocarditis. The nuclear medicine procedures include Technetium 99m-Methylene diphosphonate skeletal scintigraphy, Gallium-67 citrate for occult infection, sarcoidosis and malignancy, Tc-99m-WBC scan for abdominal/pelvic infections. Positron emission tomography using Fluorine-18-Fluorodeoxyglucose may be performed to look for occult infection or neoplasm. Presented here is a list of cases of PUO that were finally diagnosed using FDG PET/CT scan.
Sarah Koushyar
Cardiff University, UK
Title: Up-regulation of the androgen receptor co-repressor; prohibitin, leads to cell cycle arrest in an androgen dependent prostate cancer cell line; LNCaPs
Time : 17:30-17:50
Biography:
Sarah Koushyar has completed an undergraduate degree in Biomedical Science. She has also completed a Master’s and is now undertaking a PhD at Cardiff University. The PhD project is focused on mechanisms involved in androgen independence in Prostate Cancer. She has published two abstracts and two reviews during her PhD studies.
Abstract:
Prostate cancer (PC) is a worldwide health dilemma. Initially, PC cell growth is dependent upon androgen stimulation carried out by the androgen receptor (AR). Therapies which inhibit this androgen stimulation are initially successful until the tumor becomes non-reliant upon androgen supply through aberrant AR signaling, thus relapse occurs. Once the cancer transitions to an androgen-independent state, treatment options are scarce and prognosis becomes increasingly poor. The mechanisms for androgen independence and anti-androgen therapy resistance are inadequately understood, but may involve AR cofactors and co-repressors. Interestingly, a known co-repressor of the AR, namely prohibitin (PHB) has been previously identified to be down-regulated in metastatic PC when compared to healthy controls both in vivo and in vitro. PHB has also been shown to be down-regulated in bicalutamide resistant prostate cancer cells. PHB normally suppresses the cell cycle via unknown mechanisms; however this is disrupted upon AR activation. The aims of this project are to identify how PHB affects the cell cycle in a doxycycline inducible LNCaP cell line. Moreover, to identify key genes involved in both DNA replication and cell cycle regulation that PHB directly influences. Further, to understand how PHB’s interaction with these key genes is altered in the presence of androgen stimulation. RNA-Seq was used to assess genes that were modulated in response to PHB over-expression. These genes were then validated by SYBR green real time Q-PCR. A luciferase assay was used to assess PHB’s repressive function of genes involved in DNA replication; MCMs. FACs analysis was used to assess PHB’s effect on the cell cycle phases. An immunoprecipitation (IP) assay was carried out to identify the direct interaction of PHB and E2F1 (a known cell cycle activator) and how this interaction is altered in the presence of androgen. Increased expression of PHB showed a decreased expression in family members of the MCM, E2Fs, cyclins and an increase in cell cycle inhibitors (n=2). These results were further confirmed with real time SYBR green Q-PCR. FACs analysis demonstrates that PHB over-expression caused an increase in the G1 sub-population of cells and a decrease in the G2 sub-population. Activity of both MCM5 and MCM6 were significantly reduced in the presence of increasing concentrations of PHB, highlighted by a luciferase assay. Finally, an IP demonstrated the direct interaction of PHB with E2F1 in the WT LNCaP cell line that was lessened in the presence of androgen. Data presented here confirm that PHB plays a key role in halting the cell cycle by down-regulation of genes associated with the cell cycle. Such genes include members of the E2F family, that are crucial in progressing the cell cycle and members of the MCM family that enable DNA replication. As AR signaling initiates the repression of PHB expression, PHB over-expression could unveil mechanisms underlying the transition of PC from androgen dependence to androgen independence, that is essential to improve the limited options available at the moment for patient therapy.