Publications by authors named "Combs S"

Prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) has improved localization of prostate cancer (PC) lesions in biochemical recurrence (BCR) for salvage radiotherapy (SRT). We conducted a retrospective review of patients undergoing F-rhPSMA-7 or F-flotufolastat (F-rhPSMA-7.3)-PET-guided SRT compared with conventional-SRT (C-SRT) without PET.

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Purpose: General practitioners (GPs) play a crucial role in providing interdisciplinary care for radiation oncology patients. This study aims to understand the specific needs and challenges faced by general practitioners in Germany when treating oncology patients.

Methods: A comprehensive web-based questionnaire with 24 items was disseminated to GPs in Germany via email using survio.

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Purpose: Recent advancements in imaging, particularly 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET/CT), have improved the detection of involved lymph nodes, thus influencing staging accuracy and potentially treatment outcomes. This study is a post hoc analysis of the GAZAI trial data to evaluate the impact of FDG-PET/CT versus computed tomography (CT) alone on radiation target volumes for involved-site radiotherapy (IS-RT) in early-stage follicular lymphoma (FL).

Methods: All patients in the GAZAI trial underwent pretherapeutic FDG-PET/CT examinations, which were subject to central quality control.

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Objectives: The present study aimed to compare the tumor growth delay between conventional radiotherapy (CRT) and the spatially fractionated modalities of microbeam radiation therapy (MRT) and minibeam radiation therapy (MBRT). In addition, we also determined the influence of beam width and the peak-to-valley dose ratio (PVDR) on tumor regrowth.

Methods: A549, a human non-small-cell lung cancer cell line, was implanted subcutaneously into the hind leg of female CD1 mice.

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Purpose: Increasing life expectancy and advances in cancer treatment will lead to more patients needing both radiation therapy (RT) and cardiac implantable electronic devices (CIEDs). CIEDs, including pacemakers and defibrillators, are essential for managing cardiac arrhythmias and heart failure. Telemetric monitoring of CIEDs checks battery status, lead function, settings, and diagnostic data, thereby identifying software deviations or damage.

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Purpose: The aim of this review is to give an overview of the results of prospective and retrospective studies using allogenic reconstruction and postmastectomy radiotherapy (PMRT) in breast cancer and to make recommendations regarding this interdisciplinary approach.

Materials And Methods: A PubMed search was conducted to extract relevant articles from 2000 to 2024. The search was performed using the following terms: (breast cancer) AND (reconstruction OR implant OR expander) AND (radiotherapy OR radiation).

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This study addresses issues in developing spatially controlled magnetic fields for particle guidance, synthesizing biocompatible and chemically stable MNPs and enhancing their specificity to pathological cells through chemical modifications, developing personalized adjustments, and highlighting the potential of tumor-on-a-chip systems, which can simulate tissue environments and assess drug efficacy and dosage in a controlled setting. The research focused on two MNP types, uncoated magnetite nanoparticles (mMNPs) and carboxymethyl dextran coated superparamagnetic nanoparticles (CD-SPIONs), and evaluated their transport properties in microfluidic systems and porous media. The original uncoated mMNPs of bimodal size distribution and the narrow size distribution of the fractions (23 nm and 106 nm by radii) were demonstrated to agglomerate in magnetically driven microfluidic flow, forming a stable stationary web consisting of magnetic fibers within 30 min.

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3D-printed microporous titanium scaffolds enjoy good biointegration with the residuum's soft and bone tissues, and they promote excellent biomechanical properties in attached prostheses. Implant-associated infection, however, remains a major clinical challenge. Silver-based implant coatings can potentially reduce bacterial growth and inhibit biofilm formation, thereby reducing the risk of periprosthetic infections.

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Glioblastoma (GBM) constitutes the most common primary brain tumor and it remains incurable despite therapeutic advances. The high infiltration/invasion potential of GBM cells is considered to be one of the reasons for the inevitable recurrence of the disease. Radiotherapy (RT) is part of the standard care for patients with GBM, and its benefits on overall survival are extensively reported.

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In patients with pancreatic ductal adenocarcinoma (PDAC), intratumoural and intertumoural heterogeneity increases chemoresistance and mortality rates. However, such morphological and phenotypic diversities are not typically captured by organoid models of PDAC. Here we show that branched organoids embedded in collagen gels can recapitulate the phenotypic landscape seen in murine and human PDAC, that the pronounced molecular and morphological intratumoural and intertumoural heterogeneity of organoids is governed by defined transcriptional programmes (notably, epithelial-to-mesenchymal plasticity), and that different organoid phenotypes represent distinct tumour-cell states with unique biological features in vivo.

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Acute and requiring attention problem of oncotheranostics is a necessity for the urgent development of operative and precise diagnostics methods, followed by efficient therapy, to significantly reduce disability and mortality of citizens. A perspective way to achieve efficient personalized treatment is to use methods for operative evaluation of the individual drug load, properties of specific tumors and the effectiveness of selected therapy, and other actual features of pathology. Among the vast diversity of tumor types-brain tumors are the most invasive and malignant in humans with poor survival after diagnosis.

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Background: Post-Therapy-Pneumonitis (PTP) is a critical side effect of both, thoracic radio(chemo)therapy (R(C)T) and immune checkpoint inhibition (ICI). However, disease characteristics and patient-specific risk factors of PTP after combined R(C)T + ICI are less understood. Given that RT-triggered PTP is strongly dependent on the volume and dose of RT [1], driven by inflammatory mechanisms, we hypothesize that combination therapy of R(C)T with ICI influences the dose-volume-effect correlation for PTP.

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Article Synopsis
  • Randomized studies suggest that (ultra-)hypofractionation is just as effective as a traditional 5-week radiation schedule for treating postoperative breast cancer, but there's limited data on its long-term impact on secondary cancers.
  • A study involving 20 breast cancer patients examined different radiation schedules and found that (ultra-)hypofractionation significantly reduced the risk of secondary malignancies like lung cancer, contralateral breast cancer, and soft tissue sarcoma.
  • The results indicated that using (ultra-)hypofractionation could lower the risk of developing secondary malignancies more than conventional scheduling, with varying effects based on the radiation technique (3D-CRT vs. VMAT).
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  • Percutaneous implants for amputees need to prevent infections and provide stability, but a reliable natural barrier between the implant and surrounding tissues is still a challenge.* -
  • The use of a microporous structure in a new implant design (SBIP) could help by allowing soft and bone tissues to integrate into the implant, potentially enhancing infection resistance and osseointegration.* -
  • Research using 3D-printed titanium discs showed that pore sizes between 200-500 µm support better adhesion of skin cells, while larger pores (400-800 µm) are more effective for promoting bone cell differentiation, indicating specific pore sizes are crucial for optimal cell interactions.*
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Article Synopsis
  • Salvage radiation therapy (sRT) is crucial for patients who experience biochemical recurrence after prostate surgery, and a new nomogram has been developed to predict their chances of remaining free from this recurrence.
  • * This study aims to evaluate the effectiveness of PSMA-PET-based assessments in guiding sRT for cases of prostate-specific antigen (PSA) persistence or recurrence, and it seeks to improve predictive models using random survival forests compared to traditional Cox models.
  • * Data from 1029 patients across five countries were analyzed to validate these predictive models, utilizing machine learning techniques to better understand outcomes related to biochemical failure after treatment.
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Purpose: Spinal stereotactic body radiation therapy (SBRT) has become the standard of care in management of patients with limited sites of metastatic disease, radioresistant histologies, painful vertebral metastases with long life expectancy and cases of reirradiation. Our case-based guidelines aim to assist radiation oncologists in the appropriate utilization of SBRT for common, yet challenging, cases of spinal metastases.

Methods And Materials: Cases were selected to include scenarios of large volume sacral disease with nerve entrapment, medically inoperable disease abutting the thecal sac, and local failure after prior SBRT.

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Purpose: For women with locoregionally advanced cervical cancer, the standard of care treatment is the curatively intended chemoradiation therapy (CRT). A relationship between bone marrow (BM) dose-volume histograms (DVHs) and acute hematological toxicity (HT) has been debated recently. Aim of this study was the evaluation of BM dose constraints and HT in a contemporary patient cohort.

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  • There is a significant lack of data on dialysis decision-making for patients with cirrhosis who are ineligible for transplants, prompting this study to explore RRT initiation processes, predictors, and outcomes.
  • The research involved evaluating 372 patients with acute kidney injury due to conditions like hepatorenal syndrome, revealing that those who received RRT had a median survival of 12.5 days, compared to just 2 days for those who didn't.
  • The study highlights that most patients receiving RRT had short-term mortality and intensive end-of-life care, and it emphasizes the need for better clinical processes for communication and decision-making regarding RRT in this vulnerable population.
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  • Skin inflammation and conditions like moist epitheliolysis and edema are common acute side effects of breast radiotherapy (RT).
  • The study aimed to evaluate the effectiveness of tissue-derived radiomics features compared to total breast volume (TBV) in predicting these side effects.
  • The best predictive model used a LASSO classifier based on TBV, achieving an AUROC of 0.74, similar to the AUROC of 0.75 for TBV alone, with mammary tissue showing greater predictive power than glandular tissue.
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  • The study investigates the lymphatic drainage to contralateral internal mammary nodes (cIMN) in breast cancer patients and highlights its neglect in current adjuvant radiotherapy practices.* -
  • It analyzes the incidental radiation dose to cIMN in 120 advanced treatment plans, noting that higher doses are observed when including internal mammary node irradiation (IMNI) and during free breathing compared to deep inspiration breath hold (DIBH).* -
  • The findings indicate that cIMN receives low radiation doses in existing randomized trials and treatment methods, prompting the need for further research on the effects of targeting cIMN in high-risk breast cancer patients.*
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  • Molecular glioblastoma (molGB) is diagnosed as glioblastoma due to specific molecular markers, despite lacking typical grade 4 histological features, making it challenging to distinguish from lower-grade astrocytomas.
  • Advanced imaging techniques revealed that molGB exhibited significantly higher relative cerebral blood volume (rCBV) and lower apparent diffusion coefficient (ADC) values compared to astrocytomas, indicating different tumor biology.
  • The study suggests that quantitative imaging analysis could improve recognition of molGB in nonenhancing tumors, supporting the idea that molGB may represent an early stage of glioblastoma development.
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Article Synopsis
  • - The article discusses the increasing role of artificial intelligence (AI) in radiation oncology, specifically its application in patient care and radiotherapy planning.
  • - It reviews AI techniques for automating the segmentation of important areas like organs at risk (OARs) and tumor volumes, highlighting improved efficiency and consistency in treatment planning.
  • - Despite challenges in applying these tools clinically, the potential for personalized treatment plans and advancements in tumor detection presents a promising future for faster and more precise radiotherapy.
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  • Membrane-associated 70 kDa heat shock protein (mHsp70) plays a crucial role in the migration and invasion of malignant brain tumor cells, as observed in patient samples.
  • Advanced techniques like inverted confocal microscopy and mass spectrometry showed that mHsp70 is prominently expressed on the surface of cancer cells, particularly in areas surrounding the tumors.
  • Inhibiting HSP70 with small molecules significantly reduced cancer cell invasiveness and delayed tumor progression in animal models, suggesting that targeting mHsp70 could be a promising strategy for developing new cancer therapies.
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  • GBM WHO CNS Grade 4 is a tough challenge in oncology due to its aggressive nature and limitations of conventional imaging in detecting tumor recurrence.
  • A study collected blood samples from seven GBM patients at various stages to identify gene-based biomarkers for early detection of recurrence, utilizing next-generation sequencing for analysis.
  • Results showed significant variability in gene expression among patients, with a promising indication that measuring gene expressions in whole blood could be a feasible alternative to traditional methods involving exosome isolation.
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Article Synopsis
  • * Early-seeder tumor cells can migrate to new locations in the body, forming dormant cells that can reactivate later, and this process is significantly influenced by heat shock proteins (HSPs).
  • * This review focuses on the biological mechanisms of tumor dormancy, the role of HSPs in maintaining this dormancy, and proposes a framework for understanding how these dormant cells can reactivate and contribute to metastatic cancer relapse.
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