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At least 1,711 records · Page 95

Direct 2-Arm Comparison Shows Benefit of High-Dose-Rate Brachytherapy Boost vs External Beam Radiation Therapy Alone for Prostate Cancer

Purpose: To evaluate the outcomes of patients treated for intermediate- and high-risk prostate cancer with a single schedule of either external beam radiation therapy (EBRT) and high-dose-rate brachytherapy (HDRB) boost or EBRT alone. Methods and Materials: From 2001-2006, 344 patients received EBRT with HDRB boost for definitive treatment of intermediate- or high-risk prostate cancer. The prescribed EBRT dose was 46 Gy in 23 fractions, with a HDR boost of 19.5 Gy in 3 fractions. This cohort was compared to a contemporaneously treated cohort who received EBRT to 74 Gy in 37 fractions, using a matched pair analysis. Three-dimensional conformal EBRT was used. Matching was performed using a propensity score matching technique. High-risk patients constituted 41% of the matched cohorts. Five-year clinical and biochemical outcomes were analyzed. Results: Initial significant differences in prognostic indicators between the unmatched treatment cohorts were rendered negligible after matching, providing a total of 688 patients. Median biochemical follow-up was 60.5 months. The 5-year freedom from biochemical failure was 79.8% (95% confidence interval [CI], 74.3%-85.0%) and 70.9% (95% CI, 65.4%-76.0%) for the HDRB and EBRT groups, respectively, equating to a hazard ratio of 0.59 (95% CI, 0.43-0.81, P=.0011). Interaction analyses showed no alteration in HDR efficacy when planned androgen deprivation therapy was administered (P=.95), but a strong trend toward reduced efficacy was shown compared to EBRT in high-risk cases (P=.06). Rates of grade 3 urethral stricture were 0.3% (95% CI, 0%-0.9%) and 11.8% (95% CI, 8.1%-16.5%) for EBRT and HDRB, respectively (P<.0001). No differences in clinical outcomes were observed. Conclusions: This comparison of 2 individual contemporaneously treated HDRB and EBRT approaches showed improved freedom from biochemical progression with the HDR approach. The benefit was more pronounced in intermediate- risk patients but needs to be weighed against an increased risk of urethral toxicity.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Volumetric Radiosurgery for 1 to 10 Brain Metastases: A Multicenter, Single-Arm, Phase 2 Study

Purpose: Interest is growing in treating multiple brain metastases with radiosurgery. We report on the effectiveness and tolerability of volumetric radiosurgery (VRS). Methods and Materials: We enrolled patients with a ≥6-month estimated life expectancy and 1 to 10 brain metastases with a diameter of ≤3 cm at 5 cancer centers. Volumetric radiosurgery was delivered in 5 fractions with 98% target coverage, prescribed as 95% of 50 Gy (47.5 Gy in 5 fractions) to the metastases with no margin and 95% of 40 Gy (38 Gy in 5 fractions) to their 2-mm planning target volumes, concurrent with 20 Gy to the whole brain planning target volume. The treatment was delivered with daily image guidance using conventional linear accelerators and volumetric modulated arc therapy. A magnetic resonance imaging scan was obtained every 3 months. The primary endpoint was the 3-month objective response in the brain according to the Response Evaluation Criteria in Solid Tumors, version 1.1. The principal secondary endpoint was 1-year actuarial control of treated metastases. Toxicities were graded using the Common Terminology Criteria for Adverse Events, version 4.0. The present study is registered with (ClinicalTrials.gov) ( (clinicaltrials.gov) identifier (NCT01046123)). Results: From July 2010 to May 2013, 60 patients underwent VRS with 47.5 Gy in 5 fractions for 12 metastases in the thalamus and basal ganglia (deep metastases) and 207 non-deep metastases. The median follow-up period was 30.5 months, and the median survival was 10.1 months. For the 43 patients assessable at 3 months, the objective response in the brain was 56%. The treated metastases were controlled in 88% of patients at 1 year and 84% at 3 years. Overall survival did not differ for patients with 4 to 10 versus 1 to 3 metastases (hazard ratio 1.18, P=.6). The crude incidence of severe radionecrosis (grade 3-5) was 25% (3 of 12) per deep metastasis, 1.9% (4 of 219) per non-deep metastasis, and 10% (6 of 60) per patient. Conclusions: For non-deep brain metastases, 47.5 Gy in 5 fractions was tolerable. Volumetric radiosurgery was effective for long-term control of treated brain metastases.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Prospective Single-Arm Phase 1 and 2 Study: Ipilimumab and Nivolumab With Thoracic Radiation Therapy After Platinum Chemotherapy in Extensive-Stage Small Cell Lung Cancer

Consolidative thoracic radiation therapy (TRT) has been shown to improve outcomes for patients with extensive stage small cell lung cancer. We hypothesized that the addition of ipilimumab (IPI) and nivolumab (NIVO) after TRT would improve outcomes for patients with extensive stage small cell lung cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Radiation Therapy Alone for Human Papillomavirus-Related Squamous Cell Carcinoma of the Oropharynx: A Single-Arm, Phase 2 Study

Human papillomavirus (HPV)-related squamous cell carcinoma of the oropharynx (OPSCC) is extremely radiosensitive. Radiation therapy plus high-dose cisplatin remains the standard of care but causes long-term toxicity. Treatment deintensification approaches that reduce toxicity while maintaining survival are desirable for HPV-related OPSCC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Arm and shoulder muscle segmentation in axial MRI with UNet deep learning model

Quantifying individual upper-limb muscle volumes from MRI provides key insight into muscle-specific strength, deficits, and adaptations. Manual delineation is the gold standard but time‑intensive, and the performance of current deep learning approaches, particularly for small or anatomically complex muscles, remains incompletely characterized. We evaluated a state‑of‑the‑art deep learning framework across the entire upper limb and analyzed factors governing segmentation performance, with attention to the forearm. Three previously published MRI datasets (1.5 T, 3D GRE T1‑weighted; total n = 39) spanning young, middle‑aged, and older adults were curated and quality‑checked, including expert manual segmentations for 31 muscles. Following multiclass mask reconstruction, we trained three 3D nnU‑Net multiclass models matched to the muscle subsets present across datasets, using five‑fold cross‑validation and a composite Dice Similarity Coefficient (DSC) + cross entropy loss. Segmentation accuracy was assessed with DSC. Performance varied across muscles (mean DSC = 0.806 ± 0.098), ranging from 0.920 (Deltoid) to 0.461 (Extensor pollicis brevis). In uncertainty‑weighted regressions, muscle volume was positively associated with DSC (R2 = 0.36, p < 0.001), whereas training segmentation count and muscle orientation showed negligible associations (R2 ≤ 0.06). A weighted mixed‑effects model identified volume as the strongest evaluated predictor, explaining 23.9% of variance in DSC; orientation and training count each contributed <1%, leaving 61.5% unexplained. These results indicate that deep learning–based segmentation can accurately quantify muscle volume for many upper‑limb muscles but remains constrained for small, low‑contrast forearm muscles.

Gillespie, Samuel↗

Influence of biphenyl spacer appended to the flexible phosphonate arms in modulating the dimensionality of the coordination polymers: Synthesis, structural chemistry and magnetic properties

Two new compounds [Co (2,2 Prime -bipy) (H{sub 2}dbp)]{sub n} (1) and [Ni (2,2 Prime -bipy){sub 2}(H{sub 2}dbp)(H{sub 2}O)]{center_dot}H{sub 2}O (2) based on the flexible ligand 4,4 Prime -dimethylenebiphenyldiphosphonic acid (H{sub 4}dbp) with 2,2 Prime -bipyridine as secondary ligand have been synthesized under hydrothermal conditions. Both the compounds are well characterized by routine elemental analysis, IR, electronic spectroscopies, thermogravimetric analysis and finally by single crystal X-ray diffraction analysis. Compound 1 is a 1D extended coordination polymer and 2 is a discrete molecular compound. A comparative study between the geometries of H{sub 4}dbp ligand (in compounds 1 and 2, present study) and p-xylylenediphosphonic acid (H{sub 4}pxp) ligand (in previously reported compounds [Cu(2,2 Prime -bipy)(H{sub 2}pxp)]{center_dot}nH{sub 2}O (1A) and Ni(2,2 Prime -bipy){sub 2}H{sub 4}pxp]{sub n}[H{sub 2}pxp]{sub n} (2A), see text) demonstrate the effect of the twisting in the benzene rings in changing higher dimensional H{sub x}pxp (x refers to number of protonated hydroxyl groups) compounds to lower dimensional H{sub x}dbp compounds. The eight membered Co-dimer rings formed in compound 1 represents the simple and isolated Co-dimer, exhibiting weak antiferromagnetic exchange between metal centers through OPO bridges. - Graphical abstract: Two new compounds based on the dimethylenebiphenyldiphosphonic acid have been synthesized. The effect of twisting of benzene rings in the biphenyl spacer containing multidentate ligands alters dimensionality of final compounds. Highlights: Black-Right-Pointing-Pointer Cobalt containing coordination polymer and a nickel discrete compound have been synthesized. Black-Right-Pointing-Pointer Flexible ligand 4,4'-dimethylenebiphenyldiphosphonic acid has been employed. Black-Right-Pointing-Pointer Co(II) and Ni(II) ions are square pyramidal and octahedral respectively. Black-Right-Pointing-Pointer The effect of the twisting in the benzene rings in the associated ligand has been demonstrated.

36 MATERIALS SCIENCE↗

Online eco-routing for electric vehicles using combinatorial multi-armed bandit with estimated covariance

Identifying energy-efficient routes in real-time has significant implications for the energy-optimal operations of electric vehicles (EVs). Here, this study proposes a novel model for EV online eco-routing problem, which obtains the minimal expected energy consumption paths (MECPs) for multiple origin-destination (OD) pairs simultaneously. Specifically, we formulate the routing problem as a bandit problem and solve it with online algorithms. We extend the algorithms by implementing a path elimination mechanism to reduce the candidate path set and introducing the variance and covariance of the energy consumption to reduce the uncertainties. The numerical results show that the proposed algorithms can efficiently obtain near-optimal MECPs, and the solution is significantly better than the widely used shortest trip time path algorithm (STTP) and shortest trip distance path algorithm (SDP). The variation considering link energy covariance and path elimination generates paths that save 4.1% of energy compared to the SDP and 5.4% to the STTP.

33 ADVANCED PROPULSION SYSTEMS↗

Capacity of wild-type and chemokine-armed parvovirus H-1PV for inhibiting neo-angiogenesis

Anti-angiogenic therapy has been recognized as a powerful potential strategy for impeding the growth of various tumors. However no major therapeutic effects have been observed to date, mainly because of the emergence of several resistance mechanisms. Among novel strategies to target tumor vasculature, some oncolytic viruses open up new prospects. In this context, we addressed the question whether the rodent parvovirus H-1PV can target endothelial cells. We show that cultures of human normal (HUVEC) and immortalized (KS-IMM) endothelial cells sustain an abortive viral cycle upon infection with H-1PV and are sensitive to H-1PV cytotoxicity. H-1PV significantly inhibits infected KS-IMM tumor growth. This effect may be traced back by the virus ability to both kill proliferating endothelial cells and inhibit VEGF production Recombinant H-1PV vectors can also transduce tumor cells with chemokines endowed with anti-angiogenesis properties, and warrant further validation for the treatment of highly vascularized tumors. - Highlights: • The oncolytic parvovirus H-1PV can target endothelial cells. • Abortive viral cycle upon infection of endothelial cells with H-1PV. • Inhibition of VEGF expression and KS-IMM tumor growth by H-1PV.

60 APPLIED LIFE SCIENCES↗