Addition of Metastasis-Directed Therapy to Intermittent Hormone Therapy for Oligometastatic Prostate Cancer: The EXTEND Phase 2 Randomized Clinical Trial.

Importance: Despite evidence demonstrating an overall survival benefit with up-front hormone therapy in addition to established synergy between hormone therapy and radiation, the addition of metastasis-directed therapy (MDT) to hormone therapy for oligometastatic prostate cancer, to date, has not been evaluated in a randomized clinical trial.

Objective: To determine in men with oligometastatic prostate cancer whether the addition of MDT to intermittent hormone therapy improves oncologic outcomes and preserves time with eugonadal testosterone compared with intermittent hormone therapy alone.

Design, Setting, Participants: The External Beam Radiation to Eliminate Nominal Metastatic Disease (EXTEND) trial is a phase 2, basket randomized clinical trial for multiple solid tumors testing the addition of MDT to standard-of-care systemic therapy.

Discrete Element Modelling of Cold Crushing Tests Considering Various Interface Property Distributions in Ordinary Refractory Ceramics.

The microstructures and local properties of ordinary refractory ceramic materials are heterogeneous and play a role in the fracture behavior of ordinary refractory ceramic materials. It is important to consider them in numerical modeling. Herein, the discrete element (DE) method was applied to determine the influences of heterogeneity of ordinary refractory ceramic materials by applying statistically distributed interface properties (uniform, Weibull), as opposed to constant interface properties, among the elements.

Adding customized electron energy beams to TrueBeam linear accelerators.

Purpose: To better meet clinical needs and facilitate optimal treatment planning, we added two new electron energy beams (7 and 11 MeV) to two Varian TrueBeam linacs.

Methods: We worked with the vendor to create two additional customized electron energies without hardware modifications. For each beam, we set the bending magnet current and then optimized other beam-specific parameters to achieve depths of 50% ionization (I ) of 2.

Comparison of the Efficacy of Two Elastic Bandages for Forearm Hematoma After Transradial Coronary Intervention.

This study compares the efficacy of two elastic bandages in treating forearm hematoma after transradial coronary intervention. A total of 60 patients with moderate or severe forearm hematoma following transradial coronary intervention were enrolled in this study. They were randomly divided into two groups, as follows: an Idealast-haft elastic bandage group (the observation group) and a control group.

Overexpression of G3BP1 facilitates the progression of colon cancer by activating β‑catenin signaling.

Ras‑GTPase‑activating protein SH3 domain‑binding protein 1 (G3BP1) has been reported to be of importance in the occurrence and development of colon cancer. However, the underlying mechanisms remain largely unknown. Therefore, the aim of the present study was to investigate the role of Wnt/β‑catenin signaling in G3BP1‑mediated colon cancer progression.

Scutellarein inhibits the development of colon cancer via CDC4‑mediated RAGE ubiquitination.

Scutellarein has been identified to serve an anti‑tumor function in human colon cancer, but the underlying mechanisms remain largely unclear. The present study further investigated the effect and mechanism of scutellarein, extracted from wild chrysanthemum, in the progression of colon cancer. MTT, clone formation, flow cytometry and tumor‑bearing mice assays were used to detect cell viability, clone formation, apoptosis and tumorigenesis, respectively.

[Effect of electroacupuncture preconditioning combined with induced urination on urinary retention after milligan-morgan hemorrhoidectomy].

Objective: To investigate the effect of electroacupuncture preconditioning combined with induced urination on urinary retention after milligan-morgan hemorrhoidectomy.

Methods: Eighty patients with mixed hemorrhoids were randomly divided into an electroacupuncture group and a routine group, 40 cases in each group. Anesthesia at Yaoshu (GV 2) was given in the two groups.

[Effect of electroacupuncture preconditioning with different frequencies on anal pain after milligan-morgan hemorrhoidectomy].

Objective: To compare the effect of electroacupuncture preconditioning with different frequencies on anal pain after milligan-morgan hemorrhoidectomy.

Methods: A total of 120 patients with mixed hemorrhoids were randomly divided into an electroacupuncture group A (dilatational wave, 2 Hz/100 Hz in frequency), an electroacupuncture group B (continuous wave, 2 Hz in frequency) and an electroacupuncture group C (continuous wave, 100 Hz in frequency), 40 cases in each group. Electroacupuncture at Xialiao (BL 34) and Chengshan (BL 57) was applied with tolerant intensity for 30 min before operation in all groups.

Automatic detection of graticule isocenter and scale from kV and MV images.

Purpose: To automate the detection of isocenter and scale of the mechanical graticule on kilo-voltage (kV) or mega-voltage (MV) films or electronic portal imaging device (EPID) images.

Methods: We developed a robust image processing approach to automatically detect isocenter and scale of mechanical graticule from digitized kV or MV films and EPID images. After a series of preprocessing steps applied to the digital images, a combination of Hough transform and Radon transform was performed to detect the graticule axes and isocenter.

Randomized Trial of Hypofractionated, Dose-Escalated, Intensity-Modulated Radiation Therapy (IMRT) Versus Conventionally Fractionated IMRT for Localized Prostate Cancer.

Purpose: Hypofractionated radiotherapy delivers larger daily doses of radiation and may increase the biologically effective dose delivered to the prostate. We conducted a randomized trial testing the hypothesis that dose-escalated, moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improves prostate cancer control compared with conventionally fractionated IMRT (CIMRT) for men with localized prostate cancer.

Patients And Methods: Men were randomly assigned to 75.

[Clinical observation of electroacupuncture combined with auricular point sticking therapy for anal pain of mixed hemorrhoid after external excision and internal ligation].

Objective: On the basis of western medication, to investigate the effect of electroacupuncture (EA) combined with auricular point sticking therapy for anal pain of mixed hemorrhoid after external excision and internal ligation，so as to explore the method of improving its effect.

Methods: Ninety patients of mixed hemorrhoids who received external excision and internal ligation were randomly assigned into an EA group, an auricular point sticking group and a combined group, 30 cases in each one. All the treatment was applied 30 min before surgery.

Independent evaluation of the effectiveness of IsoCal in improving image center accuracy on Varian TrueBeam and Clinac machines.

Modern medical linear accelerators (linacs) are often equipped with image guidance systems that are capable of megavolt (MV), kilovolt (kV), planar, or volumetric imaging. On Varian TrueBeam linacs, the isocenter accuracies of the imaging systems are calibrated with a procedure named IsoCal. On Clinac series linacs from Varian, installation of IsoCal is optional and the effects of IsoCal on the imaging systems can be turned on or off after the IsoCal procedure is performed.

[Acupuncture combined with acupoint catgut embedding sequential therapy for mild and moderate ulcerative colitis].

Objective: To observe the efficacy of acupuncture combined with acupoint catgut embedding sequential therapy and medication for mild and moderate ulcerative colitis.

Methods: One hundred and twenty patients were randomized into an acupuncture and acupoint catgut embedding sequential therapy group (a combination group) and a mesalazine group, 60 cases in each one. Fifty-seven cases in the combination group and 55 cases in the mesalazine group were included into analysis.

Patient-reported Urinary, Bowel, and Sexual Function After Hypofractionated Intensity-modulated Radiation Therapy for Prostate Cancer: Results From a Randomized Trial.

Objectives: Hypofractionated prostate radiotherapy may increase biologically effective dose delivered while shortening treatment duration, but information on patient-reported urinary, bowel, and sexual function after dose-escalated hypofractionated radiotherapy is limited. We report patient-reported outcomes (PROs) from a randomized trial comparing hypofractionated and conventional prostate radiotherapy.

Methods: Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity-modulated radiation therapy (CIMRT, 75.

[Clinical observation on anal pendant expansion after PPH of mixed hemorrhoid treated with acupuncture at Xialiao (BL 34) and Changqiang (GV 1)].

Objective: To compare the difference in the clinical efficacy on anal pendant expansion after PPH (procedure for prolapse and hemorrhoids) of mixed hemorrhoid between acupuncture at Xialiao (BL 34) and Chang-qiang (GV 1) and oral administration of diosmin.

Methods: Sixty cases of mixed hemorrhoids after PPH were randomized into an observation group and a control group, 30 cases in each one. In the observation group, since the 1st day, acupuncture had been applied to Xialiao (BL 34) and Changqiang (GV 1).

On the selection of gantry and collimator angles for isocenter localization using Winston-Lutz tests.

In Winston-Lutz (WL) tests, the isocenter of a linear accelerator (linac) is determined as the intersection of radiation central axes (CAX) from multiple gantry, collimator, and couch angles. It is well known that the CAX can wobble due to mechanical imperfections of the linac. Previous studies suggested that the wobble varies with gantry and collimator angles.

Evaluation of the MIM Symphony treatment planning system for low-dose-rate- prostate brachytherapy.

MIM Symphony is a recently introduced low-dose-rate prostate brachytherapy treatment planning system (TPS). We evaluated the dosimetric and planning accuracy of this new TPS compared to the universally used VariSeed TPS. For dosimetric evaluation of the MIM Symphony version 5.

Evaluation of IsoCal geometric calibration system for Varian linacs equipped with on-board imager and electronic portal imaging device imaging systems.

The purpose of this study is to evaluate the accuracy and reproducibility of the IsoCal geometric calibration system for kilovoltage (kV) and megavoltage (MV) imagers on Varian C-series linear accelerators (linacs). IsoCal calibration starts by imaging a phantom and collimator plate using MV images with different collimator angles, as well as MV and kV images at different gantry angles. The software then identifies objects on the collimator plate and in the phantom to determine the location of the treatment isocenter and its relation to the MV and kV imager centers.

Risk of late toxicity in men receiving dose-escalated hypofractionated intensity modulated prostate radiation therapy: results from a randomized trial.

Objective: To report late toxicity outcomes from a randomized trial comparing conventional and hypofractionated prostate radiation therapy and to identify dosimetric and clinical parameters associated with late toxicity after hypofractionated treatment.

Methods And Materials: Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity modulated radiation therapy (CIMRT, 75.6 Gy in 1.

Quantification of beam complexity in intensity-modulated radiation therapy treatment plans.

Purpose: Excessive complexity in intensity-modulated radiation therapy (IMRT) plans increases the dose uncertainty, prolongs the treatment time, and increases the susceptibility to changes in patient or target geometry. To date, the tools for quantitative assessment of IMRT beam complexity are still lacking. In this study, The authors have sought to develop metrics to characterize different aspects of beam complexity and investigate the beam complexity for IMRT plans of different disease sites.

A fully automated method for CT-on-rails-guided online adaptive planning for prostate cancer intensity modulated radiation therapy.

Purpose: This study was designed to validate a fully automated adaptive planning (AAP) method which integrates automated recontouring and automated replanning to account for interfractional anatomical changes in prostate cancer patients receiving adaptive intensity modulated radiation therapy (IMRT) based on daily repeated computed tomography (CT)-on-rails images.

Methods And Materials: Nine prostate cancer patients treated at our institution were randomly selected. For the AAP method, contours on each repeat CT image were automatically generated by mapping the contours from the simulation CT image using deformable image registration.

Dosimetric effects of weight loss or gain during volumetric modulated arc therapy and intensity-modulated radiation therapy for prostate cancer.

Weight loss or gain during the course of radiation therapy for prostate cancer can alter the planned dose to the target volumes and critical organs. Typically, source-to-surface distance (SSD) measurements are documented by therapists on a weekly basis to ensure that patients' exterior surface and isocenter-to-skin surface distances remain stable. The radiation oncology team then determines whether the patient has undergone a physical change sufficient to require a new treatment plan.

Intensity modulated radiation therapy class solutions in Philips Pinnacle treatment planning for central nervous system malignancies: Standardized, efficient, and effective.

Background: The use of intensity modulated radiation therapy (IMRT) is becoming more commonplace in the treatment of central nervous system (CNS) malignancies. However, the determination of beam arrangements is still an empirical process, and optimization of any given plan may take hours on the part of the dosimetrist and the physician to achieve optimal conformity and normal tissue doses. Regional CNS class solutions (CS) for IMRT planning with the Philips Pinnacle treatment planning system (version 8.

Quantifying the gantry sag on linear accelerators and introducing an MLC-based compensation strategy.

Purpose: Gantry sag is one of the well-known sources of mechanical imperfections that compromise the spatial accuracy of radiation dose delivery. The objectives of this study were to quantify the gantry sag on multiple linear accelerators (linacs), to investigate a multileaf collimator (MLC)-based strategy to compensate for gantry sag, and to verify the gantry sag and its compensation with film measurements.

Methods: The authors used the Winston-Lutz method to measure gantry sag on three Varian linacs.

Measuring the wobble of radiation field centers during gantry rotation and collimator movement on a linear accelerator.

Purpose: The isocenter accuracy of a linear accelerator is often assessed with star-shot films. This approach is limited in its ability to quantify three dimensional wobble of radiation field centers (RFCs). The authors report a Winston-Lutz based method to measure the 3D wobble of RFCs during gantry rotation, collimator rotation, and collimator field size change.