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At least 1,117 records · Page 62
All sourcesNASA NTRSDOE OSTI
DOE OSTI2018

Visualization of local phosphatidylcholine synthesis within hippocampal neurons using a compartmentalized culture system and imaging mass spectrometry

Highlights: • A compartmentalized neuron culture system was combined with imaging mass spectrometry. • Phosphatidylcholine (PC) species within rat hippocampal neurons were visualized. • Differential synthetic activity of a PC species within neurons was observed. • Neurites synthesized a PC species using local extracellular free fatty acids in situ. Neurons extend neurites with an increased synthesis of phosphatidylcholine (PC) that is not only a membrane component but also a functional regulator with specific fatty acid composition. To analyze the local synthesis of the PC molecular species within neurons, we combined a compartmentalized culture system with matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS). We observed that a newly synthesized PC, which contains exogenously administered palmitic acid-d{sub 3}, is accumulated at the cell bodies and the tips of the distal neurites. The local accumulation within distal neurites is formed by distinct metabolic activity from cell bodies, suggesting that the local extracellular composition of free fatty acid can be a key to regulate specific functions of each PC molecular species. We expect our simple method to be a starting point for more sophisticated in vitro analytical methods for unveiling detailed lipid metabolisms within neurons.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Transcription of blunt snout bream (Megalobrama amblycephala) HIF3α and its localization in the nucleus under both normoxic and hypoxic conditions

Highlights: • HIF3α cDNA was characterized the in hypoxia-sensitive blunt snout bream. • HIF3α mRNA was stably expressed during embryogenesis and different adult tissues. • HIF3α mRNA was upregulated in the liver, brain, and kidney under hypoxia. • HIF3α was distributed in the nucleus under normoxic and hypoxic conditions. • Hypoxia simulation caused a significant increase in HIF3α protein levels. • There was a nuclear localization signal (NLS) sequence at the C-terminus of HIF3α. Although hypoxia-inducible factor (HIF) 1α and 2α function as master regulators of the transcriptional response to hypoxia, the function of HIF3α and its responses to hypoxic stress remain unclear in teleost fish. Here, we characterized the HIF3α cDNA in hypoxia-sensitive blunt snout bream (Megalobrama amblycephala), with 3059 bp length, consisting of an open reading frame (ORF) encoding 643 amino acid residues. Blunt snout bream HIF3α mRNA was stably expressed during stages of embryonic development and in adult tissues. After a 4 h hypoxia stress, HIF3α mRNA of the juvenile fish was significantly upregulated in the liver, brain, and kidney, and restored to the pretreatment levels after a 24 h recovery. When tagged with enhanced green fluorescent protein (EGFP) and transfected into cultured HeLa cells, blunt snout bream HIF3α was mainly distributed in the nucleus under normoxia. Treatment of the cells with CoCl{sub 2} to mimic hypoxic conditions showed that there was no effect about the nuclear localization of HIF3α but a statistically significant increase in HIF3α protein levels. A nuclear localization signal (NLS) sequence at the C-terminus of HIF3α may exert positive effects in the process of nuclear localization. These results suggest that blunt snout bream HIF3α could be involved in different physiological functions under normoxia and hypoxia conditions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Kin1 kinase localizes at the hyphal septum and is dephosphorylated by calcineurin but is dispensable for septation and virulence in the human pathogen Aspergillus fumigatus

Highlights: • Kin1 deletion in A. fumigatus does not affect septation, growth and virulence. • Fluorescence microscopy revealed Kin1 localization at the center of the septum. • Bimolecular fluorescence assay confirmed interaction of Kin1 and calcineurin. • Phosphoproteomics identified Kin1 as a substrate of calcineurin. • Kin1 is differentially phosphorylated in vivo in the absence of calcineurin. Studies in yeasts have implicated the importance of Kin1 protein kinase, a member of the eukaryotic PAR1/MARK/MELK family, in polarized growth, cell division and septation through coordinated activity with the phosphatase, calcineurin. Kin1 is also required for virulence of the fungal pathogens Cryptococcus neoformans and Fusarium graminearum. Here we show that kin1 deletion in the human fungal pathogen Aspergillus fumigatus does not affect hyphal growth and septation but results in differential susceptibility to antifungals targeting the cell wall and cell membrane. The Δkin1 strain remained virulent in a Galleria mellonella model of invasive aspergillosis. Expression of Kin1 tagged to GFP or RFP showed its stable localization at the septum. Co-localization experiments revealed calcineurin (CnaA) localization on either side of Kin1 at the septum suggesting possible interaction. Bimolecular fluorescence complementation assay confirmed the interaction of Kin1 with CnaA at the hyphal tips and septa in the presence of the antifungal caspofungin. Furthermore, phosphoproteomic analyses for the first time revealed Kin1 as a substrate of calcineurin providing novel insight into Kin1 regulation through calcineurin-mediated dephosphorylation mechanism.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Bumble bee colony growth and reproduction depend on local flower dominance and natural habitat area in the surrounding landscape

Conservation measures for bees often focus on increasing the diversity and abundance of floral resources. But it has not been clear if observed benefits of floral enhancements result from greater population growth, which is critical for the long-term success of conservation, or from mobile foragers aggregating in high-resource locations. Experimental evidence is only beginning to emerge in favor of the former mechanism and it is not well-established how different aspects of floral resources affect population growth. For example, bumble bee colonies may benefit from greater overall floral abundance, richness, or relative dominance of resource species. Because bumble bees are highly mobile, resource variability in the surrounding landscape is also important for colonies and may mediate local-scale effects. We experimentally assessed the growth and reproduction of bumble bee colonies (Bombus impatiens) deployed in grasslands in different local- and landscape-scale resource environments. Furthermore, we found that floral dominance, rather than the overall abundance or richness of floral resources, was the most important local factor for colony growth and reproduction. This may reflect more efficient foraging on a few numerically dominant and abundant resource species. Local- and landscape-scale predictor variables had interacting effects on colony growth and reproduction, suggesting that foraging distance depends on where in the landscape efficiently used resources are located. Our results provide further evidence that conservation strategies aimed at enhancing floral resources can increase bumble bee population growth. However, the most effective form of floral enhancement may vary among bee species.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Band structure dependent electronic localization in macroscopic films of single-chirality single-wall carbon nanotubes

Significant understanding has been achieved over the last few decades regarding chirality-dependent properties of single-wall carbon nanotubes (SWCNTs), primarily through single-tube studies. However, macroscopic manifestations of chirality dependence have been limited, especially in electronic transport, despite the fact that such distinct behaviors are needed for many applications of SWCNT-based devices. In addition, developing reliable transport theory is challenging since a description of localization phenomena in an assembly of nanoobjects requires precise knowledge of disorder on multiple spatial scales, particularly if the ensemble is heterogeneous. Here, we report an observation of pronounced chirality-dependent electronic localization in temperature and magnetic field dependent conductivity measurements on macroscopic films of single-chirality SWCNTs. The samples included large-gap semiconducting (6,5) and (10,3) films, narrow-gap semiconducting (7,4) and (8,5) films, and armchair metallic (6,6) films. Experimental data and theoretical calculations revealed Mott variable-range-hopping dominated transport in all samples, while localization lengths fall into three distinct categories depending on their band gaps. Armchair films have the largest localization length. Here our detailed analyses on electronic transport properties of single-chirality SWCNT films provide significant new insight into electronic transport in ensembles of nanoobjects, offering foundations for designing and deploying macroscopic SWCNT solid-state devices.

36 MATERIALS SCIENCE↗
DOE OSTI2017

Asynchronous space–time domain decomposition method with localized uncertainty quantification

The computational cost associated with uncertainty quantification of engineering problems featuring localized phenomenon can be reduced by confining the random variability of the model parameters within a region of interest. Here in this case, a localized treatment of mesh and time resolutions is required to capture the effect of the confined material uncertainty on the global response. We present a computational approach for localized uncertainty quantification with the capability of asynchronous treatment of mesh and time resolutions. In particular, we allow each subdomain to have its local uncertainty representation and the corresponding mesh and time resolutions. As a result, computing resources can be directed toward a small region of interest where a model with high spatial and temporal resolutions is required. To verify the numerical implementation, we consider elastic wave propagation in an axially loaded beam. Moreover, we perform convergence studies with respect to the spatial and temporal discretizations as well as the size of an uncertain subdomain. A projectile impacting a composite sandwich plate is considered as an engineering application for the proposed method.

42 ENGINEERING↗
DOE OSTI2024

A B-spline based gradient-enhanced micropolar implicit material point method for large localized inelastic deformations

The quasi-brittle response of cohesive-frictional materials in numerical simulations is commonly represented by softening plasticity or continuum damage models, either individually or in combination. However, classical models, particularly when coupled with non-associated plasticity, often suffer from ill-posedness and a lack of objectivity in numerical simulations. Moreover, the performance of the finite element method significantly degrades in simulations involving finite strains when mesh distortion reaches excessive levels. This represents a challenge for modeling cohesive-frictional materials, given their tendency to experience strongly localized deformations, such as those occurring during shear band dominated failure. Hence, accurate modeling of the response of cohesive-frictional solids is a demanding task. To address these challenges, we present an extension of the material point method (MPM) for the unified gradient-enhanced micropolar continuum, aiming at the analysis of finite localized inelastic deformations in cohesive-frictional materials. The generalized gradient-enhanced micropolar continuum formulation is employed to tackle challenges related to localization and softening material behavior, while the MPM addresses issues arising from excessive deformations. The method utilizes a B-spline formulation for the rigid background mesh to mitigate the well-known cell crossing errors of the MPM. To demonstrate the performance of the method, 2D and 3D numerical studies on localized failure in sandstone in plane strain compression and triaxial extension tests are presented. A comparison with finite element results confirms the suitability of the formulation. Moreover, an efficient numerical implementation of the formulation is presented, and it is demonstrated that the additional MPM specific overhead is negligible.

B-spline↗
DOE OSTI2023

The large decline in carbonate $\delta^{238}$U from a PETM section at Tingri (South Tibet) was driven by local sea-level changes, not global oceanic anoxia

Uranium isotope compositions (δ 238 ) and Th/U in carbonates are being explored as paleoredox proxies to study global oceanic anoxia. However, the impact of changes to local depositional environments that might cause a decline in δ 238 U and an increase in Th/U has not been thoroughly investigated. Here we report a decline in δ 238 U (from +0.1 to -0.3‰) and an increase in Th/U from shallow-marine carbonates during the Paleocene-Eocene thermal maximum at Tingri (south Tibet). Changes of δ 238 U and Th/U are not fully coupled. The decline in δ 238 U coincided with a local sea-level fall, whereas the increase in Th/U occurred mainly during a sea-level rise. The decline in δ 238 U likely results from changes in redox conditions of pore waters and in primary carbonate mineralogy. The increase in Th/U is ascribed to reduced authigenic U(IV) accumulation. Here our results suggest that changes in local depositional environments can cause behavior of δ 238 U and Th/U resembling that induced by expanded global oceanic anoxia. This finding calls for caution to consider local factors before applying δ 238 U and Th/U as global paleoredox proxies.

58 GEOSCIENCES↗
DOE OSTI2021

Effect of neighboring grain orientation on strain localization in slip bands in HCP materials

Particularly in plastically anisotropic crystals, such as hexagonal close packed (HCP) materials, plastic deformation is realized by slip acting in the small volumes within individual crystals. Here we extend a full field fast Fourier transform (FFT)-based elasto-viscoplastic formulation to simulate the development of a single slip band on either prismatic or basal planes spanning a crystal. Calculations of the strain and stress fields induced locally within the band and parent crystal, and ahead of the band/grain boundary junction in the neighboring crystal are analyzed as the slip band intensifies under increasing applied strain. We report a substantial influence of the crystallographic orientation of the nearest neighboring grain on the rate of slip band localization. Performing the analysis on two materials, CP-Ti and Mg, indicates that the strength of the material affects the rate of localization, with stronger materials tending to localize more easily. A slip band tip stress-based criterion is proposed for identifying the nearest neighbor orientations in which slip band transmission is possible and the likely slip system for which it occurs. This indicator is validated against experimental studies on commercially pure Ti, an Mg–Y alloy, and Ti–6Al–4V. Finally, we show that for low GB misorientations, the slip band is likely to transmit into another slip band of the same type in the neighbor grain, while for high GB misorientations, it is likely to transmit into one of a different type or to not transmit at all.

36 MATERIALS SCIENCE↗
DOE OSTI2010

Stereotactic Body Radiotherapy and Gemcitabine for Locally Advanced Pancreatic Cancer

Purpose: Patients with nonmetastatic locally advanced unresectable pancreatic cancer have a dismal prognosis. Conventional concurrent chemoradiotherapy requires 6 weeks of daily treatment and can be arduous. We explored the safety and effectiveness of a 3-day course of hypofractionated stereotactic body radiotherapy (SBRT) followed by gemcitabine in this population. Patients and Methods: A total of 36 patients with nonmetastatic, locally advanced, unresectable pancreatic cancer with {>=}12 months of follow-up were included. They received three fractions of 8, 10, or 12 Gy (total dose, 24-36 Gy) of SBRT according to the tumor location in relation to the stomach and duodenum, using fiducial-based respiratory motion tracking on a robotic radiosurgery system. The patients were then offered gemcitabine for 6 months or until tolerance or disease progression. Results: With an overall median follow-up of 24 months (range, 12-33), the local control rate was 78%, the median overall survival time was 14.3 months, the median carbohydrate antigen 19-9-determined progression-free survival time was 7.9 months, and the median computed tomography-determined progression-free survival time was 9.6 months. Of the 36 patients, 28 (78%) eventually developed distant metastases. Six patients (17%) were free of progression at the last follow-up visit (range, 13-30 months) as determined by normalized tumor markers with stable computed tomography findings. Nine Grade 2 (25%) and five Grade 3 (14%) toxicities attributable to SBRT occurred. Conclusion: Hypofractionated SBRT can be delivered quickly and effectively in patients with nonmetastatic, locally advanced, unresectable pancreatic cancer with acceptable side effects and minimal interference with gemcitabine chemotherapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Dosimetric Comparison of Intensity-Modulated Stereotactic Radiotherapy With Other Stereotactic Techniques for Locally Recurrent Nasopharyngeal Carcinoma

Purpose: Locally recurrent nasopharyngeal carcinoma (NPC) patients can be salvaged by reirradiation with a substantial degree of radiation-related complications. Stereotactic radiotherapy (SRT) is widely used in this regard because of its rapid dose falloff and high geometric precision. The aim of this study was to examine whether the newly developed intensity-modulated stereotactic radiotherapy (IMSRT) has any dosimetric advantages over three other stereotactic techniques, including circular arc (CARC), static conformal beam (SmMLC), and dynamic conformal arc (mARC), in treating locally recurrent NPC. Methods and Materials: Computed tomography images of 32 patients with locally recurrent NPC, previously treated with SRT, were retrieved from the stereotactic planning system for contouring and computing treatment plans. Treatment planning of each patient was performed for the four treatment techniques: CARC, SmMLC, mARC, and IMSRT. The conformity index (CI) and homogeneity index (HI) of the planning target volume (PTV) and doses to the organs at risk (OARs) and normal tissue were compared. Results: All four techniques delivered adequate doses to the PTV. IMSRT, SmMLC, and mARC delivered reasonably conformal and homogenous dose to the PTV (CI <1.47, HI <0.53), but not for CARC (p < 0.05). IMSRT presented with the smallest CI (1.37) and HI (0.40). Among the four techniques, IMSRT spared the greatest number of OARs, namely brainstem, temporal lobes, optic chiasm, and optic nerve, and had the smallest normal tissue volume in the low-dose region. Conclusion: Based on the dosimetric comparison, IMSRT was optimal for locally recurrent NPC by delivering a conformal and homogenous dose to the PTV while sparing OARs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases

Purpose: To report tumor local control after treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) to extracranial metastatic sites. Methods and Materials: A total of 126 metastases in 103 patients were treated with SD-IGRT to prescription doses of 18-24 Gy (median, 24 Gy) between 2004 and 2007. Results: The overall actuarial local relapse-free survival (LRFS) rate was 64% at a median follow-up of 18 months (range, 2-45 months). The median time to failure was 9.6 months (range, 1-23 months). On univariate analysis, LRFS was significantly correlated with prescription dose (p = 0.029). Stratification by dose into high (23 to 24 Gy), intermediate (21 to 22 Gy), and low (18 to 20 Gy) dose levels revealed highly significant differences in LRFS between high (82%) and low doses (25%) (p < 0.0001). Overall, histology had no significant effect on LRFS (p = 0.16). Renal cell histology displayed a profound dose-response effect, with 80% LRFS at the high dose level (23 to 24 Gy) vs. 37% with low doses ({<=}22 Gy) (p = 0.04). However, for patients who received the high dose level, histology was not a statistically significant predictor of LRFS (p = 0.90). Target organ (bone vs. lymph node vs. soft tissues) (p = 0.5) and planning target volume size (p = 0.55) were not found to be associated with long-term LRFS probability. Multivariate Cox regression analysis confirmed prescription dose to be a significant predictor of LRFS (p = 0.003). Conclusion: High-dose SD-IGRT is a noninvasive procedure resulting in high probability of local tumor control. Single-dose IGRT may be effectively used to locally control metastatic deposits regardless of histology and target organ, provided sufficiently high doses (> 22 Gy) of radiation are delivered.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Accelerated Partial Breast Irradiation With Interstitial Implants: Risk Factors Associated With Increased Local Recurrence

Purpose: To analyze patient, disease, and treatment-related factors regarding their impact on local control after interstitial multicatheter accelerated partial breast irradiation (APBI). Methods and Materials: Between November 2000 and April 2005, 274 patients with early breast cancer were recruited for the German-Austrian APBI Phase II trial ( (ClinicalTrials.gov) identifier: NCT00392184). In all, 64% (175/274) of the patients received pulsed-dose-rate (PDR) brachytherapy and 36% (99/274) received high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3 to 4 days. Results: The median follow-up time was 64 months (range, 9-110). The actuarial 5-year local recurrence free survival rate (5-year LRFS) was 97.7%. Comparing patients with an age <50 years (49/274) vs. {>=}50 years (225/274), the 5-year LRFS resulted in 92.5% and 98.9% (exact p = 0.030; 99% confidence interval, 0.029-0.032), respectively. Antihormonal treatment (AHT) was not applied in 9% (24/274) of the study population. The 5-year LRFS was 99% and 84.9% (exact p = 0.0087; 99% confidence interval, 0.0079-0.0094) in favor of the patients who received AHT. Lobular histology (45/274) was not associated with worse local control compared with all other histologies (229/274). The 5-year LRFS rates were 97.6% and 97.8%, respectively. Conclusions: Local control at 5 years is excellent and comparable to therapeutic successes reported from corresponding whole-breast irradiation trials. Our data indicate that patients <50 years of age ought to be excluded from APBI protocols, and that patients with hormone-sensitive breast cancer should definitely receive adjuvant AHT when interstitial multicatheter APBI is performed. Lobular histology need not be an exclusion criterion for future APBI trials.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Local Tumor Control, Visual Acuity, and Survival After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

Purpose: To evaluate long-term local tumor control, visual acuity, and survival after hypofractionated linear accelerator-based stereotactic photon radiotherapy in patients with choroidal melanoma. Methods and Materials: Between 1997 and 2007, 212 patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at a linear accelerator with 6-MV photon beams at the Medical University of Vienna in five fractions over 7 days. Twenty-four patients received a total dose of 70 Gy (five fractions of 14 Gy), 158 a total dose of 60 Gy (five fractions of 12 Gy) and 30 patients a total dose of 50 Gy (five fractions of 10 Gy) applied on the 80% isodose. Ophthalmologic examinations were performed at baseline and every 3 months in the first 2 years, every 6 months until 5 years, and once a year thereafter until 10 years after radiotherapy. Assessment of visual acuity, routine ophthalmologic examinations, and measurement of tumor base dimension and height using standardized A-scan and B-scan echography were done at each visit. Funduscopy and fluorescein angiography were done when necessary to document tumor response. Results: Median tumor height and volume decreased from 4.8 mm and 270.7 mm{sup 3} at baseline to 2.6 mm and 86.6 mm{sup 3} at the last individual follow-up, respectively (p < 0.001, p < 0.001). Median visual acuity decreased from 0.55 at baseline to hand motion at the last individual follow-up (p < 0.001). Local tumor control was 95.9% after 5 years and 92.6% after 10 years. Thirty-two patients developed metastatic disease, and 22 of these patients died during the follow-up period. Conclusion: Hypofractionated stereotactic photon radiotherapy with 70 to 50 Gy delivered in five fractions in 7 days is sufficient to achieve excellent local tumor control in patients with malignant melanoma of the choroid. Disease outcome and vision are comparable to those achieved with proton beam radiotherapy. Decreasing the total dose below 60 Gy seems to be possible.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Image-Guided Localization Accuracy of Stereoscopic Planar and Volumetric Imaging Methods for Stereotactic Radiation Surgery and Stereotactic Body Radiation Therapy: A Phantom Study

Purpose: To evaluate the positioning accuracies of two image-guided localization systems, ExacTrac and On-Board Imager (OBI), in a stereotactic treatment unit. Methods and Materials: An anthropomorphic pelvis phantom with eight internal metal markers (BBs) was used. The center of one BB was set as plan isocenter. The phantom was set up on a treatment table with various initial setup errors. Then, the errors were corrected using each of the investigated systems. The residual errors were measured with respect to the radiation isocenter using orthogonal portal images with field size 3 x 3 cm{sup 2}. The angular localization discrepancies of the two systems and the correction accuracy of the robotic couch were also studied. A pair of pre- and post-cone beam computed tomography (CBCT) images was acquired for each angular correction. Then, the correction errors were estimated by using the internal BBs through fiducial marker-based registrations. Results: The isocenter localization errors ({mu} {+-}{sigma}) in the left/right, posterior/anterior, and superior/inferior directions were, respectively, -0.2 {+-} 0.2 mm, -0.8 {+-} 0.2 mm, and -0.8 {+-} 0.4 mm for ExacTrac, and 0.5 {+-} 0.7 mm, 0.6 {+-} 0.5 mm, and 0.0 {+-} 0.5 mm for OBI CBCT. The registration angular discrepancy was 0.1 {+-} 0.2{sup o} between the two systems, and the maximum angle correction error of the robotic couch was 0.2{sup o} about all axes. Conclusion: Both the ExacTrac and the OBI CBCT systems showed approximately 1 mm isocenter localization accuracies. The angular discrepancy of two systems was minimal, and the robotic couch angle correction was accurate. These positioning uncertainties should be taken as a lower bound because the results were based on a rigid dosimetry phantom.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Retrospective Analysis of Local Control and Cosmetic Outcome of 147 Periorificial Carcinomas of the Face Treated With Low-Dose Rate Interstitial Brachytherapy

Purpose: Skin cancer is the most common malignancy in white populations. We evaluated the local cure rate and cosmetic outcome of patients with basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) of the face treated with low-dose rate brachytherapy. Methods and Materials: Between February 1990 and May 2000, 147 facial carcinomas in 132 patients were treated by {sup 192}Ir wire implantation. Side effects of brachytherapy were noted. Follow-up was 2 years or more. Locoregional recurrence-free survival (LRFS) and overall survival were recorded. Group A included patients treated by primary brachytherapy, and Group B included those treated after recurrence. Results: A total of 121 carcinomas were BCCs (82.3%) and 26 were SCCs (17.7%); the median tumor size was 10 mm. Of the tumors, 86 (58.5%) were in men and 61 (41.5%) were in women; the median age was 71 years. Group A comprised 116 lesions (78.9%), and Group B, 31 (21.1%). There were 17 relapses (11.6%) after a median follow-up of 72 months: 12 local, 4 nodal, and 1 local and nodal. Locoregional-free survival was 96.6% at 2 years and 87.3% at 5 years. Five-year LRFS was 82.6% in men and 93.3% in women (p = 0.027). After adjustment for gender, LRFS was better after primary treatment than after recurrence (hasard ratio HR, 2.91; 95% confidence interval, 1.06-8.03; p = 0.039). Five-year LRFS was 90.4% for BCC and 70.8% for SCC (p = 0.03). There were no Grade 3 complications. Conclusions: Low-dose rate brachytherapy offers good local control and cosmetic outcome in patients with periorificial skin carcinomas, with no Grade 3 complications. Brchytherapy is more efficient when used as primary treatment.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2010

Localized Low-Dose Radiotherapy for Follicular Lymphoma: History, Clinical Results, Mechanisms of Action, and Future Outlooks

The extreme radiosensitivity of indolent lymphomas was reported in the early years of radiotherapy (RT). The efficacy of low-dose total body irradiation (1.5-2 Gy) was particularly demonstrative. Higher doses were considered appropriate for localized disease. The optimal (or conventional) dose of curative RT derived from the early studies was determined to be 30-35 Gy. Nevertheless, in older series addressing the tumoricidal radiation dose in non-Hodgkin's lymphomas, investigators noted that a significant number of 'nodular' lymphomas were controlled with a dose of <22 Gy for >3 years. The idea of reintroducing localized low-dose radiotherapy (LDRT) for indolent non-Hodgkin's lymphomas came from a clinical observation. The first study showing the high efficacy of LDRT (4 Gy in two fractions of 2 Gy within 3 days) in selected patients with chemoresistant, indolent, non-Hodgkin's lymphomas was published in 1994. Since this first report, at least eight series of patients treated with localized LDRT have been published, showing a 55% complete response rate in irradiated sites, with a median duration of 15-42 months. How LDRT induces lymphoma cell death remains partly unknown. However, some important advances have recently been reported. Localized LDRT induces an apoptosis of follicular lymphoma cells. This apoptotic cell death elicits an immune response mediated by macrophages and dendritic cells. Follicular lymphoma is probably an ideal model to explore these mechanisms. This review also discusses the future of LDRT for follicular lymphoma.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Higher Biologically Effective Dose of Radiotherapy Is Associated With Improved Outcomes for Locally Advanced Non-Small Cell Lung Carcinoma Treated With Chemoradiation: An Analysis of the Radiation Therapy Oncology Group

Purpose: Patients treated with chemoradiotherapy for locally advanced non-small-cell lung carcinoma (LA-NSCLC) were analyzed for local-regional failure (LRF) and overall survival (OS) with respect to radiotherapy dose intensity. Methods and Materials: This study combined data from seven Radiation Therapy Oncology Group (RTOG) trials in which chemoradiotherapy was used for LA-NSCLC: RTOG 88-08 (chemoradiation arm only), 90-15, 91-06, 92-04, 93-09 (nonoperative arm only), 94-10, and 98-01. The radiotherapeutic biologically effective dose (BED) received by each individual patient was calculated, as was the overall treatment time-adjusted BED (tBED) using standard formulae. Heterogeneity testing was done with chi-squared statistics, and weighted pooled hazard ratio estimates were used. Cox and Fine and Gray's proportional hazard models were used for OS and LRF, respectively, to test the associations between BED and tBED adjusted for other covariates. Results: A total of 1,356 patients were analyzed for BED (1,348 for tBED). The 2-year and 5-year OS rates were 38% and 15%, respectively. The 2-year and 5-year LRF rates were 46% and 52%, respectively. The BED (and tBED) were highly significantly associated with both OS and LRF, with or without adjustment for other covariates on multivariate analysis (p < 0.0001). A 1-Gy BED increase in radiotherapy dose intensity was statistically significantly associated with approximately 4% relative improvement in survival; this is another way of expressing the finding that the pool-adjusted hazard ratio for survival as a function of BED was 0.96. Similarly, a 1-Gy tBED increase in radiotherapy dose intensity was statistically significantly associated with approximately 3% relative improvement in local-regional control; this is another way of expressing the finding that the pool-adjusted hazard ratio as a function of tBED was 0.97. Conclusions: Higher radiotherapy dose intensity is associated with improved local-regional control and survival in the setting of chemoradiotherapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗