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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 1,405 records · Page 78
All sourcesNASA NTRSDOE OSTI
DOE OSTI2018

The SCF ubiquitin ligase Slimb controls Nerfin-1 turnover in Drosophila

Highlights: • Slimb associates with Nerfin-1 and promotes Nerfin-1 turnover. • The C-terminal half of Nerfin-1 is required for Slimb-binding and Slimb-mediated degradation by UPS. • Slimb regulates Nerfin-1 activity in vivo. The C2H2 type zinc-finger transcription factor Nerfin-1 expresses dominantly in Drosophila nervous system and plays an important role in early axon guidance decisions and preventing neurons dedifferentiation. Recently, increasing reports indicated that INSM1 (homologue to nerfin-1 in mammals) is a useful marker for prognosis of neuroendocrine tumors. The dynamic expression of Nerfin-1 is regulated post-transcriptionally by multiple microRNAs; however, its post-translational regulation is still unclear. Here we showed that the protein turnover of Nerfin-1 is regulated by Slimb, the substrate adaptor of SCF{sup Slimb} ubiquitin ligase complex. Mechanistically, Slimb associates with Nerfin-1 and promotes it ubiquitination and degradation in Drosophila S2R{sup +} cells. Furthermore, we determined that the C-terminal half of Nerfin-1 (Nerfin-1{sup CT}) is required for its binding to Slimb. Genetic epistasis assays showed that Slimb misexpression antagonizes, while knock-down enhances the activity of Nerfin-1{sup CT} in Drosophila eyes. Our data revealed a new link to understand the underlying mechanism for Nerfin-1 turnover in post-translational level, and provided useful insights in animal development and disease treatment by manipulating the activity of Slimb and Nerfin-1.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Protective effect of vitreous against hemoglobin neurotoxicity

Highlights: • Bovine vitreous protected cultured neurons from the oxidative toxicity of hemoglobin. • Complete neuroprotection was provided by a 3% vitreous solution. • Ascorbate accounted for most protection in diluted vitreous. • Transferrin and selenium content may contribute in undiluted vitreous. • Vitreous may protect adjacent neurons from hemorrhagic injury. Hemorrhage into the brain parenchyma or subarachnoid space is associated with edema and vascular injury that is likely mediated at least in part by the toxicity of hemoglobin. In contrast, extravascular blood appears to be less neurotoxic when localized to the retina or adjacent vitreous, the gel filling the posterior segment of the eye. In this study, the hypothesis that vitreous protects neurons from hemoglobin toxicity was investigated in a primary cortical cell culture model. Consistent with prior observations, hemoglobin exposure for 24 h resulted in death of most neurons without injury to co-cultured glia. Neuronal loss was reduced in a concentration-dependent fashion by bovine vitreous, with complete protection produced by 3% vitreous solutions. This effect was associated with a reduction in malondialdehyde but an increase in cell iron. At low vitreous concentrations, its ascorbate content was sufficient to account for most neuroprotection, as equivalent concentrations of ascorbate alone had a similar effect. However, other vitreous antioxidants provided significant protection when applied at concentrations present in undiluted vitreous, and prevented all neuronal loss when combined in the absence of ascorbate. These results indicate that vitreous is an antioxidant cocktail that robustly protects neurons from hemoglobin toxicity, and may contribute to the relative resistance of retinal neurons to hemorrhagic injury.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Propranolol increases vascular permeability through pericyte apoptosis and exacerbates oxygen-induced retinopathy

Highlights: • Propranolol increased pericyte apoptosis more sensitively than endothelial cells. • Propranolol weakened the tight junction of endothelial cells in co-cultures of pericytes and endothelial cells. • Propranolol increased endothelial permeability in vitro and vascular permeability in OIR retinas of mice in vivo. Retinopathy of prematurity (ROP) is an eye disease that causes blindness due to delayed vascular growth, retinal ischemia, and resulting abnormal angiogenesis. Nonselective β-antagonist propranolol is in clinical trials for the treatment of ROP due to its effect of reducing VEGF expression and inhibiting retinal angiogenesis in oxygen-induced ROP models (OIR), but the mechanism by which propranolol acts on ROP vessels is still unclear. In the present study, we have focused on the effect of propranolol on pericyte survival and vascular permeability. We demonstrated that propranolol increases pericyte apoptosis more sensitively than endothelial cells (ECs), thereby weakening EC tight junctions to increase endothelial permeability in co-cultures of pericytes and ECs. Mechanistically, pericyte apoptosis by propranolol was due to the inhibition of Akt signaling pathway. We also demonstrated that propranolol increases pericyte loss and vascular permeability of retinal vessels in a mouse model of OIR. These results suggest that propranolol may be negative for blood vessels in retinas of OIR, and that the efficacy of propranolol for the treatment of ROP needs to be more thoroughly verified.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Circular orientation fluorescence emitter imaging (COFEI) of rotational motion of motor proteins

Single-molecule fluorescence polarization technique has been utilized to detect structural changes in biomolecules and intermolecular interactions. Here we developed a single-molecule fluorescence polarization measurement system, named circular orientation fluorescence emitter imaging (COFEI), in which a ring pattern of an acquired fluorescent image (COFEI image) represents an orientation of a polarization and a polarization factor. Rotation and pattern change of the COFEI image allow us to find changes in the polarization by eye and further values of the parameters of a polarization are determined by simple image analysis with high accuracy. We validated its potential applications of COFEI by three assays: 1) Detection of stepwise rotation of F{sub 1}-ATPase via single quantum nanorod attached to the rotary shaft γ; 2) Visualization of binding of fluorescent ATP analog to the catalytic subunit in F{sub 1}-ATPase; and 3) Association and dissociation of one head of dimeric kinesin-1 on the microtubule during its processive movement through single bifunctional fluorescent probes attached to the head. These results indicate that the COFEI provides us the advantages of the user-friendly measurement system and persuasive data presentations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

A role for myosin VI in retinal pigment epithelium phagocytosis

Highlights: • Quashing myosin VI activity reduces rates of phagosome trafficking in RPE cells. • Trafficked phagosomes in RPE cells undergo two modes of motion. • The more randomly directed mode of phagosome trafficking is myosin VI dependent. • The more directed mode of phagosome trafficking is myosin VI independent. The retinal pigment epithelium (RPE) is a monolayer of pigmented cells adjacent to the choroid coat, the vascular layer of the eye. Among other functions, these cells are responsible for the phagocytosis of rod and cone cell waste shed from the photoreceptor outer segments. We describe here studies to understand the involvement of the motor protein myosin VI in the trafficking of internalized microspheres by a human retinal pigment epithelium primary cell line (ARPE-19). We perturbed the myosin VI-actin interaction by overexpressing a dominant negative myosin VI construct in these cells. We used single particle tracking to characterize the trajectories of internalized fluorescent microspheres. Analysis of the speed of the microspheres' motions revealed that the magnitude of the average speed over short time scales is reduced in the presence of the dominant negative motor. Analysis of the mean-squared displacement of these trajectories demonstrated that trafficking of phagosomes involves two modes of motion, a rapid, more randomly directed motion that is myosin VI dependent and a slower, more directed motion that is independent of the motor. From these data, we posit that this trafficking process involves an interplay between myosin VI motors, which are involved in motion through the actin periphery of the cell, and microtubule motors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

Field validation of isotropic analytical models for simulating fabric shades

Fabric roller shades are common shading materials used in commercial and residential buildings. Accurately characterizing and modeling shades helps practitioners select the appropriate product and its control strategy based on climate and occupants' priorities, such as visual comfort and view to outdoors. Previous studies established a generalized method for modeling complex fenestration systems using data-driven tabulated bidirectional scattering distribution functions. However, deploying such a method at scale to all fabric shading products on the market is too costly and time-consuming. Analytical models that are based on a limited set of measurements (e.g., normal-normal and normal-hemispherical visible transmittance and reflectance, and directional cut-off angles) can be used to model the wide variety of shading products on the market. This study evaluates the performance of two isotropic analytical models, Roos-Wienold and Modified-Kotey, for modeling fabric roller shades, with a focus on the model's ability to predict occupant visual comfort. The performance evaluation was conducted through laboratory and field measurements and simulations. The results showed that both models are sufficient for predicting vertical illuminance at seated eye-level. Roos-Wienold model was able to predict binary visual comfort classification (glare/no-glare) under a wide range of luminance conditions, while Modified-Kotey model did not perform as well under high-contrast low-adaptation conditions. Both models are insufficient in predicting visual comfort at a four-point scale (e.g., imperceptible, perceptible, disturbing, intolerable). The two isotropic models become less accurate when the fabric exhibits high anisotropy.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2021

Strain hardening magnesium-silicate-hydrate composites (SHMSHC) reinforced with short and randomly oriented polyvinyl alcohol microfibers

Magnesium-silicate-hydrate (M-S-H) cement has emerged as an alternative binder with potentially lower energy requirements and emissions. Due to the intrinsically low pH values of its matrix, however, normal steel reinforcement is not appropriate for M-S-H system. To toughen the matrix and to overcome the brittle nature of the material, a new strain hardening magnesium-silicate-hydrate composite (SHMSHC) is developed for the first time by incorporating 2 vol% short and randomly oriented polyvinyl alcohol (PVA) microfibers. The resulting SHMSHC exhibits significant strain hardening with a tensile strain capacity of more than 3%, a compressive strength beyond 50 MPa and a tensile strength of around 3 MPa. Remarkably, saturated multiple cracking with a tight crack width less than 10 μm invisible to the human naked eyes was observed. The newly developed SHMSHC addresses the fundamental challenge of M-S-H binder and is expected to widen possible application areas of M-S-H system.

36 MATERIALS SCIENCE↗
DOE OSTI2024

The activity of antimicrobial peptoids against multidrug-resistant ocular pathogens

Background: Ocular infections caused by antibiotic-resistant pathogens can result in partial or complete vision loss. The development of pan-resistant microbial strains poses a significant challenge for clinicians as there are limited antimicrobial options available. Synthetic peptoids, which are sequence-specific oligo-N-substituted glycines, offer potential as alternative antimicrobial agents to target multidrug-resistant bacteria. Methods: The antimicrobial activity of synthesised peptoids against multidrug-resistant (MDR) ocular pathogens was evaluated using the microbroth dilution method. Hemolytic propensity was assessed using mammalian erythrocytes. Peptoids were also incubated with proteolytic enzymes, after which their minimum inhibitory activity against bacteria was re-evaluated. Results: Several alkylated and brominated peptoids showed good inhibitory activity against multidrug-resistant Pseudomonas aeruginosa strains at concentrations of ≤15 μg mL -1 (≤12 µM). Similarly, most brominated compounds inhibited the growth of methicillin-resistant Staphylococcus aureus at 1.9 to 15 μg mL -1 (12 µM). The N-terminally alkylated peptoids caused less toxicity to erythrocytes. The peptoid denoted as TM5 had a high therapeutic index, being non-toxic to either erythrocytes or corneal epithelial cells, even at 15 to 22 times its MIC. Additionally, the peptoids were resistant to protease activity. Conclusions: Peptoids studied here demonstrated potent activity against various multidrug-resistant ocular pathogens. Their properties make them promising candidates for controlling vision-related morbidity associated with eye infections by antibiotic-resistant strains.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Computer-aided classification of suspicious pigmented lesions using wide-field images

Early identification of melanoma is conducted through whole-body visual examinations to detect suspicious pigmented lesions, a situation that fluctuates in accuracy depending on the experience and time of the examiner. Computer-aided diagnosis tools for skin lesions are typically trained using pre-selected single-lesion images, taken under controlled conditions, which limits their use in wide-field scenes. Here, we propose a computer-aided classifier system with such input conditions to aid in the rapid identification of suspicious pigmented lesions at the primary care level. 133 patients with a multitude of skin lesions were recruited for this study. All lesions were examined by a board-certified dermatologist and classified into “suspicious” and “non-suspicious”. A new clinical database was acquired and created by taking Wide-Field images of all major body parts with a consumer-grade camera under natural illumination condition and with a consistent source of image variability. 3–8 images were acquired per patient on different sites of the body, and a total of 1759 pigmented lesions were extracted. A machine learning classifier was optimized and build into a computer aided classification system to binary classify each lesion using a suspiciousness score. In a testing set, our computer-aided classification system achieved a sensitivity of 100% for suspicious pigmented lesions that were later confirmed by dermoscopy examination (“SPL_A”) and 83.2% for suspicious pigmented lesions that were not confirmed after examination (“SPL_B”). Sensitivity for non-suspicious lesions was 72.1%, and accuracy was 75.9%. With these results we defined a suspiciousness score that is aligned with common macro-screening (naked eye) practices. This work demonstrates that wide-field photography combined with computer-aided classification systems can distinguish suspicious from non-suspicious pigmented lesions, and might be effective to assess the severity of a suspicious pigmented lesions. We believe this approach could be useful to support skin screenings at a population-level.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Multi-level Monte Carlo methods in chemical applications with Lennard-Jones potentials and other landscapes with isolated singularities

We describe and compare outcomes of various Multi-Level Monte Carlo (MLMC) method variants, motivated by the potential of improved computational efficiency over rejection based Monte Carlo, which scales poorly with problem dimension. With an eye toward its application to computational chemical physics, we test MLMC's ability to sample trajectories on two problems — a familiar double-well potential, with known stationary distributions, and a Lennard-Jones solid potential (a Galton Board). By sampling Brownian motion trajectories, we are able to compute expectations of observable averages. These multi-basin potential energy problems capture the essence of the challenges with using MLMC, namely, maintaining correspondence of sample paths as time-resolution is varied. Addressing this challenge properly can lead to MLMC significantly outperforming standard Monte Carlo path sampling. We describe the essence of this problem and suggest strategies that circumvent diverging multilevel sample paths for an important class of problems. In the tests we also compare the computational cost of several, “adaptive,” variants of MLMC. Our results demonstrate that MLMC overcomes the collision, time scale limitation of the more familiar Brownian path MC samplers, and our implementation provides tunable error thresholds, making MLMC a promising candidate for application to larger and more complex molecular systems.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2015

Evaluation of glare at the Ivanpah Solar Electric Generating System

The Ivanpah Solar Electric Generating System (ISEGS), located on I-15 about 40 miles (60 km) south of Las Vegas, NV, consists of three power towers 459 ft (140 m) tall and over 170,000 reflective heliostats with a rated capacity of 390 MW. In addition, reports of glare from the plant have been submitted by pilots and air traffic controllers and recorded by the Aviation Safety Reporting System and the California Energy Commission since 2013. Aerial and ground-based surveys of the glare were conducted in April, 2014, to identify the cause and to quantify the irradiance and potential ocular impacts of the glare. Results showed that the intense glare viewed from the airspace above ISEGS was caused by heliostats in standby mode that were aimed to the side of the receiver. Evaluation of the glare showed that the retinal irradiance and subtended source angle of the glare from the heliostats in standby were sufficient to cause significant ocular impact (potential for after-image) up to a distance of ~6 miles (10 km), but the values were below the threshold for permanent eye damage. Glare from the receivers had a low potential for after-image at all ground-based monitoring locations outside of the site boundaries. A Letter to Airmen has been issued by the Federal Aviation Administration to notify pilots of the potential glare hazards. Additional measures to mitigate the potential impacts of glare from ISGES are also presented and discussed.

14 SOLAR ENERGY↗
DOE OSTI2021

Building envelope anomaly characterization and simulation using drone time-lapse thermography

Defects in building envelopes deteriorate over time without being visible to the human eye, while significantly impacting energy performance due to unaccounted heat transfer. Defects can be characterized in the infrared (IR) spectrum. However, IR readings are typically recorded at singular points in time, when in several cases anomalies can only be revealed at specific times of the day, possibly in different seasons of the year. This paper presents a novel workflow for 3D envelope defect characterization and modeling using aerial time-lapse IR data collection using drones. A comprehensive envelope thermal profile is developed for a case study building employing the photogrammetry software Agisoft Photoscan, which generates temporal IR inspections of building skins using multiple thermography orthomosaics. Point-cloud data is then translated into a CAD model and thermal zones for whole Building Energy Modeling (BEM) using Honeybee as a frontend to EnergyPlus to showcase the potential of inclusion of detailed 4D data. Envelope contributions in this case study’s anomalies showed heat losses of 6447.6 kWh, and Energy Use Intensity (EUI) differences of ~2 kWh/m 2 /year from the baseline. Finally, why there is currently little translation of this work in BEM software is discussed, while identifying limitations and future research in the employment of time-lapse thermography using drones for more accurate building envelope inspection and modeling.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2016

Prospective study of ultraviolet radiation exposure and risk of breast cancer in the United States

Although there are few environmental risk factors for breast cancer, some epidemiologic studies found that exposure to solar UV radiation (UVR) may lower risk. Prior epidemiologic studies are limited by narrow ambient UVR ranges and lack lifetime exposure assessment. To address these issues, we studied a cohort with residences representing a wide range of ambient UVR. Using the nationwide U.S. Radiologic Technologists study (USRT), we examined the association between breast cancer risk and UVR based on ambient UVR, time outdoors, a combined variable of ambient UVR and time outdoors (combined UVR), and sun susceptibility factors. Participants reported location of residence and hours spent outdoors during five age periods. Ambient UVR was derived by linking satellite-based annual UVR estimates to self-reported residences. Lifetime values were calculated by averaging these measures accounting for years spent in that location. We examined the risk of breast cancer among 36,725 participants (n=716 cases) from baseline questionnaire completion (2003–2005) through 2012–2013 using Cox proportional hazards models. Breast cancer risk was unrelated to ambient UVR (HR for lifetime 5th vs 1st quintile=1.22, 95% CI: 0.95–1.56, p-trend=0.36), time outdoors (HR for lifetime 5th vs 1st quintile=0.87, 95% confidence interval (CI): 0.68–1.10, p-trend=0.46), or combined UVR (HR lifetime 5th vs 1st quintile =0.85, 95% CI: 0.67–1.08, p-trend=0.46). Breast cancer risk was not associated with skin complexion, eye or hair color, or sunburn history. This study does not support the hypothesis that UVR exposure lowers breast cancer risk. - Highlights: • Prior studies of UVR and breast cancer are inconsistent and limited. • We assessed UVR exposure across the lifetime and in three ways. • Conducted a prospective analysis of UVR exposure and breast cancer risk. • No association of any UVR exposure metric at any age with breast cancer risk. • Our findings suggest UVR exposure does not reduce risk of breast cancer.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2017

Ambient fine particulate matters induce cell death and inflammatory response by influencing mitochondria function in human corneal epithelial cells

Ambient fine particulate matter (AFP) is a main risk factor for the cornea as ultraviolet light. However, the mechanism of corneal damage following exposure to AFP has been poorly understood. In this study, we first confirmed that AFP can penetrate the cornea of mice, considering that two-dimensional cell culture systems are limited in reflecting the situation in vivo. Then, we investigated the toxic mechanism using human corneal epithelial (HCET) cells. At 24 h after exposure, AFP located within the autophagosome-like vacuoles, and cell proliferation was clearly inhibited in all the tested concentration. Production of ROS and NO and secretion of pro-inflammatory cytokines were elevated in a dose-dependent manner. Additionally, conversion of LC3B from I-type to II-type and activation of caspase cascade which show autophagic- and apoptotic cell death, respectively, were observed in cells exposed to AFP. Furthermore, AFP decreased mitochondrial volume, inhibited ATP production, and altered the expression of metabolism-related genes. Taken together, we suggest that AFP induces cell death and inflammatory response by influencing mitochondrial function in HCET cells. In addition, we recommend that stringent air quality regulations are needed for eye health. - Highlights: • In this study, we studied a toxic mechanism of AFP in human corneal epithelial cells. • AFP located within autophagosome-like vacuoles at 24 h after exposure. • AFP induced apoptotic cell death with mitochondrial dysfunction and membrane damage. • AFP elevated level of ROS, NO, and pro-inflammatory cytokines. • Levels of Apoptosis/autophagy-related protein and metabolism-related gene increased.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2020

Quantitative assessment of eddy viscosity rans models for turbulent mixed convection in a differentially heated plane channel

Turbulent mixed convection between two vertical, infinite parallel plates at different temperatures is studied using various two-equation turbulence models. The numerical simulations are performed at a turbulent Reynolds number of Re τ = 150 and a Grashof number of Gr = 9.6 × 10 5 . Comparisons are made against the highly trusted DNS results. Consistent with the DNS approach, the current simulations are performed using constant properties and the Boussinesq approximation to predict the influence of buoyancy. Previous studies have provided assessments of two-equation turbulence models for various scenarios, but often rely on a qualitative “eye” test in order to determine the most appropriate model to predict a given flow. This study aims to provide a new form of quantitative assessment that accounts for both the physics captured by the turbulence model as well as the magnitude of the system response quantities (SRQ) using a modified symmetric mean absolute percent error (SMAPE) method. This method is designed to be approachable to researchers at any level and can be applied to system response quantities from multiple research fields. Uncertainty quantification is also performed to determine the discretization error for each turbulence model. Recommendations are made as to which turbulence models best capture the physics – hydrodynamically and thermally – using both local and global validation metrics. Lastly, a sensitivity analysis is performed on the damping functions used in the most accurate models. This underpins the potential of model developments and adjustments most worth pursuing for buoyant flows. Finally, this framework provides a more physics-based comparative analysis of the selected turbulence models.

42 ENGINEERING↗
DOE OSTI2024

Containment strategy for subsurface H 2 storage based on time-dependent soft solids

Here, we propose an innovative containment strategy based on time-dependent soft solids, namely 2 wt% Laponite suspensions, to reinforce natural subsurface seals and engineer flow barriers, with an eye toward making H 2 subsurface storage scalable and geographically agnostic. This suspension can be injected at its initial low viscosity and elasticity into a porous medium, allowing for easy pumping and targeted delivery. Once inside the target zone, it matures into a soft solid with much higher viscosity and elasticity, acting as a potential flow barrier. We discuss the rheological properties of the suspensions and demonstrate that hydrogen does not adversely affect their microstructure, but rather increases the suspensions’ viscosity and elasticity. Moreover, the suspensions enhance the rock samples’ compressive strength, while hydrogen exposure increases their stiffness and ductility. The ability of rock samples saturated with the suspensions to contain higher injected gas pressures is enhanced by aging at higher temperatures.

08 HYDROGEN↗
DOE OSTI2010

Intensity-Modulated Radiotherapy for Sinonasal Cancer: Improved Outcome Compared to Conventional Radiotherapy

Purpose: To evaluate clinical outcome and toxicity of postoperative intensity-modulated radiotherapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: Between 2003 and 2008, 40 patients with cancer of the paranasal sinuses (n = 34) or nasal cavity (n = 6) received postoperative IMRT to a dose of 60 Gy (n = 21) or 66 Gy (n = 19). Treatment outcome and toxicity were retrospectively compared with that of a previous patient group (n = 41) who were also postoperatively treated to the same doses but with three-dimensional conformal radiotherapy without intensity modulation, from 1992 to 2002. Results: Median follow-up was 30 months (range, 4-74 months). Two-year local control, overall survival, and disease-free survival were 76%, 89%, and 72%, respectively. Compared to the three-dimensional conformal radiotherapy treatment, IMRT resulted in significantly improved disease-free survival (60% vs. 72%; p = 0.02). No grade 3 or 4 toxicity was reported in the IMRT group, either acute or chronic. The use of IMRT significantly reduced the incidence of acute as well as late side effects, especially regarding skin toxicity, mucositis, xerostomia, and dry-eye syndrome. Conclusions: Postoperative IMRT for sinonasal cancer significantly improves disease-free survival and reduces acute as well as late toxicity. Consequently, IMRT should be considered the standard treatment modality for malignancies of the nasal cavity and paranasal sinuses.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Phase I Trial of Hypofractionated Intensity-Modulated Radiotherapy With Temozolomide Chemotherapy for Patients With Newly Diagnosed Glioblastoma Multiforme

Purpose: To determine the maximal tolerated biologic dose intensification of radiotherapy using fractional dose escalation with temozolomide (TMZ) chemotherapy in patients with newly diagnosed glioblastoma multiforme. Methods and Materials: Patients with newly diagnosed glioblastoma multiforme after biopsy or resection and with adequate performance status, bone marrow, and organ function were eligible. The patients underwent postoperative intensity-modulated radiotherapy (IMRT) with concurrent and adjuvant TMZ. All patients received a total dose of 60 Gy to the surgical cavity and residual tumor, with a 5-mm margin. IMRT biologic dose intensification was achieved by escalating from 3 Gy/fraction (Level 1) to 6 Gy/fraction (Level 4) in 1-Gy increments. Concurrent TMZ was given at 75 mg/m{sup 2}/d for 28 consecutive days. Adjuvant TMZ was given at 150-200 mg/m{sup 2}/d for 5 days every 28 days. Dose-limiting toxicity was defined as any Common Terminology Criteria for Adverse Events, version 3, Grade 3-4 nonhematologic toxicity, excluding Grade 3 fatigue, nausea, and vomiting. A standard 3+3 Phase I design was used. Results: A total of 16 patients were accrued (12 men and 4 women, median age, 69 years; range, 34-84. The median Karnofsky performance status was 80 (range, 60-90). Of the 16 patients, 3 each were treated at Levels 1 and 2, 4 at Level 3, and 6 at Level 4. All patients received IMRT and concurrent TMZ according to the protocol, except for 1 patient, who received 14 days of concurrent TMZ. The median number of adjuvant TMZ cycles was 7.5 (range, 0-12). The median survival was 16.2 months (range, 3-33). One patient experienced vision loss in the left eye 7 months after IMRT. Four patients underwent repeat surgery for suspected tumor recurrence 6-12 months after IMRT; 3 had radionecrosis. Conclusions: The maximal tolerated IMRT fraction size was not reached in our study. Our results have shown that 60 Gy IMRT delivered in 6-Gy fractions within 2 weeks with concurrent and adjuvant TMZ is tolerable in selected patients with a T{sub 1}-weighted enhancing tumor <6 cm.

62 RADIOLOGY AND NUCLEAR MEDICINE↗