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At least 19 records

Trust Not Verify? The Critical Need for Data Curation Standards in Materials Informatics

The importance of data curation has been recognized in multiple areas of research; however, the discussion of this important issue is only beginning to emerge in materials science. In this Perspective, we highlight the benefits of using the standardized data curation protocols in materials science and discuss current gaps in accurate and reproducible data reporting using case studies drawn from high-impact materials science papers and well-known databases such as the Crystallography Open Database (COD) and the Cambridge Structural Database (CSD). We argue that both experimental and computational materials scientists need to embrace a culture of rigorous data curation as part of modern research data management. We propose a sample data curation pipeline for materials chemistry and illustrate its use by creating two new materials chemistry databases. Here, we hope that this perspective will serve to catalyze further discussion and promote the continuous development of rigorous data curation practices within the materials science research community. We posit that adherence to best practices of data curation will promote and enhance the reliability, reproducibility, and integrity of materials research and enable the development of reliable AI and machine learning models that critically depend on the use of quality data.

Chemical structure↗

The impact of curation errors in the PDBBind Database on machine learning predictions of protein–protein binding affinity

The PDBBind database has been widely utilized for the computational prediction of protein–protein binding affinities. While the accuracy of the PDBBind-curated equilibrium dissociation constants (K D ) has been reported for the protein–ligand subset of the PDBBind database, the curation accuracy has not been reported for the protein–protein subset. Here, we present a detailed manual analysis for the subset of PDBBind records with PubMed Central Open Access primary publications and find that ~19% of these records had K D values that were not supported by their primary publications. The impact of these putative curation errors on the machine learning-based prediction of K D from experimental protein–protein 3D structures was evaluated and correcting the curation errors improved the Pearson correlation coefficient between measured and random forest-predicted log 10 (K D ) values by ~8 percentage points. This finding underscores the importance of dataset accuracy for computational modelling and highlights the need for more stringent curation processes when extracting information from the scientific literature.

59 BASIC BIOLOGICAL SCIENCES↗

Curation and Dissemination of Complex Multi-Modal Datasets for Radiation Detection, Localization, and Tracking

The PANDAWN sensor network in Chicago, IL, is a state-of-the-art testbed for networked, multi-modal sensing. It integrates AI/data science methods into its operation, from data acquisition to automated data labeling and curation workflows. The curation and dissemination of diverse multi-modal datasets will enable the development of new radiological/nuclear (R/N) detection, localization, and tracking algorithms and methods relevant across the nonproliferation mission space. This article first introduces the PANDAWN sensor network and the features that make it stand out from previous multi-modal data acquisition efforts. We then review the various data streams acquired on the PANDAWN nodes and present the implementation of an automated data curation pipeline that includes the labeling of radiation and contextual data streams. Here, we finally provide a short overview of different studies that leveraged the curated datasets.

Data curation↗

Knowledge-guided learning with curated prior genetic biomarkers for robust model interpretation

Abstract Motivation Knowledge-guided learning offers effective and robust model training strategies in data-scarce settings by incorporating established domain knowledge, thereby enhancing generalization, robustness, and interpretability. By contrast, conventional deep learning approaches rely purely on data-driven learning, which can limit robust model interpretability, particularly in high-dimensional settings with limited size samples. In computational biology, knowledge-guided learning has primarily leveraged network- and structural-based knowledge, leading to biologically interpretable representations and enhanced predictive performance compared to conventional approaches. However, curated biomarkers, one of the most accessible forms of biological knowledge, remain largely unexplored within knowledge-guided paradigms. Results In this study, we propose a model-agnostic training paradigm, Biomarker-driven Explainable Prior-guided Learning (BioExPL), that can be applied to any neural networks that incorporates curated prior knowledge. BioExPL enforces neural networks to reflect curated biomarker priors in their latent representations through a novel knowledge-alignment loss. BioExPL consistently demonstrated significantly improved predictive performance and enhanced model interpretability with minimized computational overhead in simulation studies and intensive experiments on multiple cancer datasets. BioExPL not only integrates prior curated knowledge into the model but also accurately identifies unknown associated signals additionally. BioExPL is model-agnostic and domain-independent, enabling its integration into diverse neural network architectures. Availability and implementation The open-source is publicly available at: https://github.com/datax-lab/BioExPL.

Baek, Beomsu [Department of Computer Science, Univ↗

Curated BLAST for Genomes

Given a microbe’s genome sequence, we often want to predict what capabilities the organism has, such as which nutrients it requires or which energy sources it can use. Or, we know the organism has a capability and we want to find the genes involved. Scientists often use automated gene annotations to find relevant genes, but automated annotations are often vague or incorrect. Curated BLAST finds candidate genes for a capability without relying on automated annotations. First, Curated BLAST finds proteins (usually from other organisms) whose functions have been studied experimentally and whose curated descriptions match a query. Then, it searches the genome of interest for similar proteins and returns a list of candidates. Curated BLAST is fast and often finds relevant genes that are missed by automated annotation.

59 BASIC BIOLOGICAL SCIENCES↗

Data Curation for Machine Learning Applied to Geothermal Power Plant Operational Data for GOOML: Geothermal Operational Optimization with Machine Learning: Preprint

Geothermal Operational Optimization with Machine Learning (GOOML) is a transferable and extensible component-based geothermal asset modeling framework that considers complex steamfield relationships and identifies optimization prospects using a data-driven approach to physics-guided, data-centric machine learning. This framework has been used to develop digital twins that provide steamfield operators with operational environments to analyze and understand historical and forecasted power production, explore new steamfield configuration possibilities, and seek optimal asset management in real world applications. To create, test, and apply the GOOML framework, diverse time-series datasets spanning multiple years were sourced from various geothermal power plant components within several complex real-world geothermal operations. These operations are based in the United States and New Zealand and include a variety of technologies, end-uses and configurations, collectively covering nearly all relevant operating conditions for modern geothermal fields. Datasets were acquired from multiple sources to ensure that machine learning experiments generalized properly to various operating conditions. It was found that the data varied in quality, format, and completeness. To ensure consistency between the various datasets, a standardized data curation process was developed to reliably streamline data preparation. This paper will discuss best practices as learned from the GOOML data curation process which takes the following steps: 1) acquisition of large quantities of data from power plant operators, 2) digestion of data to gain an initial understanding of what is included, 3) data transformation, which includes converting the data into a standardized machine-readable format so that they can be visualized, quality checked, and cleaned, 4) quality assurance and quality control, involving identification of significant data gaps and apparent anomalies through mapping of data features to real world componentry via the GOOML historical model, followed by discussion with modelers and power plant operators to identify additional data needs and to resolve issues, 5) use in machine learning algorithms, and 6) repetition of steps one through five until all data needs are met and data are deemed suitable for producing trustworthy modeling results which may be disseminated, ideally along with the curated dataset. This iterative process is focused on improving the quality of the data rather than tuning machine learning model parameters and supports a shift towards data-centric AI as a means to improving real-world applicability of geothermal machine learning projects.

access↗

G2Aero Database of Airfoils - Curated Airfoils

This dataset contains a curated set of 19,164 airfoil shapes from various applications and the data-driven design space of separable shape tensors (PGA space), which can be used as a parameter space for machine-learning applications focused on airfoil shapes. We constructed the airfoil dataset in two main stages. First, we identified 13 baseline airfoils from the NREL 5MW and IEA 15MW reference wind turbines. We reparameterized these shapes using least-squares fits of 8-order CST parametrizations, which involve 18 coefficients. By uniformly perturbing all 18 CST coefficients by +/-20% around each baseline airfoil, we generated 1,000 unique airfoils. Each airfoil was sampled with 1,001 shape landmarks whose x-coordinates followed a cosine distribution along the chord. This process resulted in a total of 13,000 airfoil shapes, each with 1,001 landmarks. In the second phase, we gathered additional airfoils from the extensive BigFoil database, which consolidates data from sources such as the University of Illinois Urbana-Champaign (UIUC) airfoil database, the JavaFoil database, the NACA-TR-824 database, and others. We undertook a thorough pre-processing step to filter out shapes with sparse, noisy, or incomplete data. We also removed airfoils with sharp leading edge and those exceeding our threshold for trailing edge thickness. Additionally, we thinned out the collection of NACA airfoils-- parametric sweeps of NACA airfoils with increasing thickness and camber present in BigFoil database-- by selecting every fourth step in the parameter sweeps. Finally, we regularized the airfoils by reparametrizing them with an 8-order CST parametrization (with 1,001 shape landmarks with x coordinated following cosine distribution along the chord) and removing airfoils with high reconstruction errors. This data pre-processing resulted in a set of 6,164 airfoils. In total, our curated airfoil dataset comprises 19,164 airfoils, each with 1,001 landmarks, and is stored in the curated_airfoils.npz file. Using this curated airfoil dataset, we utilized the separable shape tensors framework to develop a data-driven parameterization of airfoils based on principal geodesic analysis (PGA) of separable shape tensors. This PGA space is provided in PGAspace.npz file.

airfoils↗

Long-Term Results of Radiochemotherapy for Solitary Lymph Node Metastasis After Curative Resection of Esophageal Cancer

Purpose: To evaluate the long-term efficacy and toxicity of definitive radiochemotherapy for solitary lymph node metastasis after curative surgery of esophageal cancer. Methods and Materials: We performed a retrospective review of 35 patients who underwent definitive radiochemotherapy at Tohoku University Hospital between 2000 and 2009 for solitary lymph node metastasis after curative esophagectomy with lymph node dissection for esophageal cancer. Radiotherapy doses ranged from 60 to 66 Gy (median, 60 Gy). Concurrent chemotherapy was platinum based in all patients. The endpoints of the present study were overall survival, cause-specific survival, progression-free survival, irradiated-field control, overall tumor response, and prognostic factors. Results: The median observation period for survivors was 70.0 months. The 5-year overall survival was 39.2% (median survival, 39.0 months). The 5-year cause-specific survival, progression-free survival, and irradiated-field control were 43.3%, 31.0% and 59.9%, respectively. Metastatic lesion, size of the metastatic lymph node, and performance status before radiochemotherapy were significantly correlated with prognosis. Complete response and partial response were observed in 22.9% and 57.1% of the patients, respectively. There was no Grade 3 or higher adverse effect based on theCommon Terminology Criteria for Adverse Events (CTCAE v3.0) in the late phase. Conclusions: Based on our study findings, approximately 40% of patients with solitary lymph node metastasis after curative resection for esophageal cancer have a chance of long-term survival with definitive radiochemotherapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Long-Term Outcomes and Patterns of Relapse of Early-Stage Extranodal Marginal Zone Lymphoma Treated With Radiation Therapy With Curative Intent

Purpose: To report the long-term outcome and patterns of relapse of a large cohort of marginal zone lymphoma (MZL) patients treated with curative-intent radiation therapy (RT) alone. Patients and Methods: We reviewed the charts of 490 consecutive patients with stage IE or IIE MZL referred between 1992 and 2012 to our institution. Of those, 244 patients (50%) were treated with RT alone. Pathology was confirmed by hematopathologists at our institution. Patient and disease factors were analyzed for association with relapse-free survival (RFS) and overall survival (OS). Results: Median age of the cohort was 59 years, and median follow-up was 5.2 years. Ann Arbor stage was IE in 92%. Most common disease sites were stomach (50%), orbit (18%), non-thyroid head-and-neck (8%), skin (8%), and breast (5%). Median RT dose was 30 Gy. Five-year OS and RFS were 92% and 74%, respectively. Cumulative incidence of disease-specific death was just 1.1% by 5 years. Sixty patients (24%) developed relapse of disease; 10 were in the RT field. Crude rate of transformation to pathologically confirmed large-cell lymphoma was 1.6%. On multivariable analysis, primary disease site (P=.007) was independently associated with RFS, along with age (P=.04), presence of B-symptoms (P=.02), and International Prognostic Index risk group (P=.03). All disease sites except for head-and-neck had worse RFS relative to stomach. Conclusion: Overall and cause-specific survival are high in early-stage extra-nodal MZL treated with curative RT alone. In this large cohort of 244 patients, most patients did not experience relapse of MZL after curative RT; when relapses did occur, the majority were in distant sites. Stomach cases were less likely to relapse than other anatomic sites. Transformation to large-cell lymphoma was rare.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Curating a comprehensive set of enzymatic reaction rules for efficient novel biosynthetic pathway design

Enzyme substrate promiscuity has significant implications for metabolic engineering. The ability to predict the space of possible enzymatic side reactions is crucial for elucidating underground metabolic networks in microorganisms, as well as harnessing novel biosynthetic capabilities of enzymes to produce desired chemicals. Reaction rule-based cheminformatics platforms have been implemented to computationally enumerate possible promiscuous reactions, relying on existing knowledge of enzymatic transformations to inform novel reactions. However, past versions of curated reaction rules have been limited by a lack of comprehensiveness in representing all possible transformations, as well as the need to prune rules to enhance computational efficiency in pathway expansion. To this end, we curated a set of 1224 most generalized reaction rules, automatically abstracted from atom-mapped MetaCyc reactions and verified to uniquely cover all common enzymatic transformations. Additionally, we developed a framework to systematically identify and correct redundancies and errors in the curation process, resulting in a minimal, yet comprehensive, rule set. These reaction rules were capable of reproducing more than 85% of all reactions in the KEGG and BRENDA databases, for which a large fraction of reactions is not present in MetaCyc. Our rules exceed all previously published rule sets for which reproduction was possible in this coverage analysis, which allows for the exploration of a larger space of known enzymatic transformations. By leveraging the entire knowledge of possible metabolic reactions through generalized enzymatic reaction rules, we are able to better utilize underground metabolic pathways and accelerate novel biosynthetic pathway design to enable bioproduction towards a wider range of new molecules.

59 BASIC BIOLOGICAL SCIENCES↗

The Gaia EDR3 view of Johnson-Kron-Cousins standard stars: the curated Landolt and Stetson collections

In the era of large surveys and space missions, it is necessary to rely on large samples of well-characterized stars for inter-calibrating and comparing measurements from different surveys and catalogues. Among the most employed photometric systems, the Johnson-Kron-Cousins has been used for decades and for a large amount of important datasets. Our goal is to profit from the Gaia EDR3 data, Gaia official cross-match algorithm, and Gaia -derived literature catalogues, to provide a well-characterized and clean sample of secondary standards in the Johnson-Kron-Cousins system, as well as a set of transformations between the main photometric systems and the Johnson-Kron-Cousins one. Using Gaia as a reference, as well as data from reddening maps, spectroscopic surveys, and variable stars monitoring surveys, we curated and characterized the widely used Landolt and Stetson collections of more than 200 000 secondary standards, employing classical as well as machine learning techniques. In particular, our atmospheric parameters agree significantly better with spectroscopic ones, compared to other machine learning catalogues. We also cross-matched the curated collections with the major photometric surveys to provide a comprehensive set of reliable measurements in the most widely adopted photometric systems. We provide a curated catalogue of secondary standards in the Johnson-Kron-Cousins system that are well-measured and as free as possible from variable and multiple sources. We characterize the collection in terms of astrophysical parameters, distance, reddening, and radial velocity. We provide a table with the magnitudes of the secondary standards in the most widely used photometric systems (ugriz, grizy, Gaia , HIPPARCOS, Tycho , 2MASS). We finally provide a set of 167 polynomial transformations, valid for dwarfs and giants, metal-poor and metal-rich stars, to transform UBVRI magnitudes in the above photometric systems and vice-versa.

79 ASTRONOMY AND ASTROPHYSICS↗

Meta2DB: Curated Shotgun Metagenomic Feature Sets and Metadata for Health State Prediction

Meta2DB is a curated metagenomic and metadata database that provides structurally consistent microbiome taxonomy feature count tables for 13 897 samples across 84 studies, 23 disease states, and 34 geographical locations. All samples were uniformly processed using a streamlined metagenomic classification pipeline that employs a unique and comprehensive reference database indexed to contain all sequences across all kingdoms of life that were present in the NCBI Nucleotide (nt) database retrieved on 4 January 2023. This pipeline leverages high-performance computing (HPC) resources at Lawrence Livermore National Laboratory and was used to process 50TB of publicly available raw metagenomic sequence data. Extensive metadata curation was carried out through a combination of manual curation and automated parsing, producing a consistent inter-study metadata table specifically structured to facilitate training of ML models for prediction of human health.

Kok, C [Lawrence Livermore National Laboratory (LL↗

Scientific Open-Source Software Is Less Likely to Become Abandoned Than One Might Think! Lessons from Curating a Catalog of Maintained Scientific Software

Scientific software is essential to scientific innovation and in many ways it is distinct from other types of software. Abandoned (or unmaintained), buggy, and hard to use software, a perception often associated with scientific software can hinder scientific progress, yet, in contrast to other types of software, its longevity is poorly understood. Existing data curation efforts are fragmented by science domain and/or are small in scale and lack key attributes. We use large language models to classify public software repositories in World of Code into distinct scientific domains and layers of the software stack, curating a large and diverse collection of over 18,000 scientific software projects. Using this data, we estimate survival models to understand how the domain, infrastructural layer, and other attributes of scientific software affect its longevity. We further obtain a matched sample of non-scientific software repositories and investigate the differences. We find that infrastructural layers, downstream dependencies, mentions of publications, and participants from government are associated with a longer lifespan, while newer projects with participants from academia had shorter lifespan. Against common expectations, scientific projects have a longer lifetime than matched non-scientific open-source software projects. We expect our curated attribute-rich collection to support future research on scientific software and provide insights that may help extend longevity of both scientific and other projects.

Malviya Thakur, Addi [ORNL] (ORCID:000000022681999↗

COVID-19 Data Curation Effort: An Initial Analysis of the Data

During the COVID-19 pandemic of 2020, major case reporting outlets quickly coalesced around two or three primary vendors. Johns Hopkins University and The New York Times were among the more prominent, and all were of great value to the nation, particularly during the uncertain early stages of the pandemic. They primarily focused on three major attributes: number of new cases, deaths, and recovery. Recognizing that many states were reporting very detailed data sets (e.g., hospital beds) at a county level or finer, the ORNL Pandemic Modeling team embarked on a major data curation effort from March to June 2020 for the purpose of capturing this wealth of detailed data. The challenge of curating this data was daunting. The number of attributes reported by the states grew on almost on a weekly basis. States were routinely shifting their web tool strategies away from easily parsable HTML-based formatting to new Tableau and ArcGIS content. This growth in the sheer number of attributes, combined with the unpredictable shifts in data format, meant an aggressive and agile combination of automated scripting and manual scraping was required to capture new daily streams. Further, the team had to scale up staff and widen its approach for capture and storage. As a result, the team collected more than 11 million data points. Following the close of this data collection effort on June 30 th , 2020, the team embarked on a major effort to appraise what had been collected, including an inventory list, spatial completeness, temporal completeness, scale and geographic characteristics, and a determination. A report on this matter was submitted on September 15 th , 2020, titled “DOE COVID-19 Data Curation Effort: Overview of Data Collection Coverage”. Over 2000 unique attributes had been netted over a wide range of spatial scales, including state, county, zip codes, health regions, and census blocks. Over 11 million individual data points were collected across these attributes, and spatial coverage (in total) included all 50 states and multiple territories. What became apparent in the process is that in the absence of any data standards, many states reported a wide variety of unique attributes that were not always compatible with attributes reported in other states. As time continued, states began adding new attributes and offering finer grain detail in some older attributes. This meant that not all data streams existed for the entire time period; in fact, the number tended to increase dramatically towards the end. Often, states would begin an attribute series and then stop altogether. These highly variable and uncertain conditions illuminated the need for harmonization approaches that would reconcile and conflate changing attribute names and detail over time. For example, grouping racial data reported as either Black or African American, depending on the state, into a single harmonized attribute. These choices would make a within-state analysis possible during the time period and lead to potential between-state analytics later on. This was almost entirely a manual decision process, requiring some subjective decision-making at times, to prevent a fragmented, short-lived collection of time series fragments that would offer few insights into trends, patterns, and correlates. This report imports harmonized data for state and county into the World Spatio-Temporal Analytics and Mapping Project (WSTAMP). WSTAMP is a major space-time analysis and visualization tool developed at ORNL for the National Geospatial-Intelligence Agency specifically for this kind of exploratory analysis. WSTAMP offers a rich analytical and graphical environment consisting of a wide range of analytics. These include time series plots, statistical summaries, data mining techniques, trend and pattern detection, and hypothesis generation.

59 BASIC BIOLOGICAL SCIENCES↗

The disCO2ver Platform: Curating Data and Tools for Geologic Carbon Sequestration and Deep Subsurface Research Systems

The U.S. DOE National Energy Technology Laboratory has invested 12+ years of development into the data repository and digital laboratory, the Energy Data eXchange (EDX, edx.netl.doe.gov). Supporting a variety of research areas across the DOE Office of Fossil Energy and Carbon Management, the platform has successfully curated and preserved thousands of data products from DOE research. The Carbon Storage Program has successfully supported data curation, upload, and publishing of data products on EDX for many years, demonstrating a success story of how resources like EDX can effectively help with long term preservation and publishing of DOE data products. EDX continues to shift towards cloud-supported infrastructure, taking a hybrid approach combining on-premises compute and storage integrated with cloud-hosted services. The integration of cloud compute and hybrid architecture enables the development of EDX-hosted platforms that tailor the data and tools hosted on them to a specific community, enables implementation of machine learning tools for data discovery and filtering, and enables the hosting of virtual (online user interface) tools. Geologic carbon sequestration (GCS) research continues to scale up in response to the current administration goals to reduce greenhouse gas emissions and transition the energy economy. Over the last year, EDX’s disCO2ver platform has been developed in response to the need for access to data products and tools to support the scaling up of GCS research. disCO2ver provides access to data resources and tools, produced by DOE and outside authoritative external resources. The platform also provides a user-access control component for the virtualization and cloud hosting of tools. Tools that need to be virtualized, to eliminate the need for users to download the tool and use local compute resources, is essential to supporting big-data analysis and machine learning that is becoming common place in carbon storage modeling, risk analysis, and data publishing practices. This talk will review the EDX’s disCO2ver platform and the current work ongoing to curate data and tools to support GCS and deep subsurface systems research.

Morkner, Paige↗

Experimental Data Curation at Large Instrument Facilities with Open Source Software

The National Synchrotron Light Source II operating at Brookhaven National Laboratory since 2014 for the US Department of Energy is one of the newest and brightest storage-ring synchrotron facility in the world. NSLS-II, like other facilities, provides pre-processing of the raw data and some analysis capabilities to its users. We describe the research collaborations and open source infrastructure developed at large instrument facilities such as NSLS-II for the purpose of curating high value scientific data along the early stages of the data lifecycle. Data acquisition and curation tasks include storing experiment configuration, detector metadata, raw data acquisition with infrastructure that converts proprietary instrument formats to industry standards. In addition, we describe a specific effort for discovering sample information at NSLS-II and tracing the provenance of analysis performed on acquired images. We show that curation tasks must be embedded into software along the data life cycle for effectiveness and ease of use, and that loosely defined collaborations evolve around shared open source tools. Finally we discuss best practices for experimental metadata capture in such facilities, data access and the new challenges of scale and complexity posed by AI-based discovery for the synthesis of new materials.

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗

Potentially Curative Radiotherapy for Non-Small-Cell Lung Cancer in Norway: A Population-Based Study of Survival

Purpose: The efficacy of curative irradiation in the treatment of non-small-cell lung cancer patients is considered limited. The purpose of this study was to evaluate long-term survival in a population-based approach. Methods and Materials: Cases of non-small-cell lung cancer diagnosed from 1993 to 2001 were identified in the Cancer Registry of Norway. Electronic linkage with national data from the hospitals' radiotherapy verification systems identified those who received potentially curative doses ({>=}50 Gy). Hospital records were reviewed for all patients. Results: A total of 497 patients (336 men) were identified with a radiation dose of {>=}50 Gy delivered to the lung region. Of these, 41% received 60 Gy or more. The majority (70%) of patients included had advanced stage disease: 24% Stage IIIA and 46% Stage IIIB. The overall 1-, 3-, and 5-year observed survival rates were 53%, 16%, and 9%, respectively. Multivariable analyses identified stage and chemotherapy, but not radiation dose, as significant independent prognostic variables for survival. However, 68% of patients treated with chemotherapy participated in prospective studies with inclusion criteria that excluded patients with less favorable prognostic factors, leading to a selection bias. The number of fractions and the radiation doses varied widely among different hospitals. Conclusion: The long-term prognosis after radiation therapy is poor. More sophisticated, targeted, and uniform delivery of radiation therapy is needed. The apparent benefit of chemotherapy may in part be due to selection of patients with more favorable prognostic factors for this therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Role of Radiotherapy as Curative Treatment of Extramammary Paget's Disease

Purpose: Extramammary Paget's disease (EMPD) is a relatively rare malignancy that usually arises in the genital areas. Wide surgical excision remains the standard and most reliable curative treatment of EMPD. However, surgery is sometimes not possible, because many patients are elderly, and complete excision can be difficult owing to the tumor location. We, therefore, performed a review to determine the role of radiotherapy (RT) for EMPD. Methods and Materials: A total of 22 patients with EMPD in their external genitalia (4 men and 18 women, age 52-94 years at RT) underwent RT with curative intent. Nine patients had regional lymph node metastases. A total dose of 45-70.2 Gy (median, 60) was delivered to the pelvis, including the tumors, in 25-39 fractions (median, 33). Results: In all but 3 patients, the irradiated tumors were controlled during a follow-up period of 8-133 months (median, 42). Of the 22 patients, 13 developed recurrences, including local progression within the radiation field in 3 and lymph node and/or distant metastases outside the radiation field in 10, at 3-43 months after treatment. The 2- and 5-year local progression-free rates were 91% and 84%, respectively. Of the 22 patients, 7 patients had died at 33-73 months after RT. The cause of death was tumor progression in 4, infectious pneumonia in 2, and renal failure in 1 patient. The overall and cause-specific survival rates were 100% for both at 2 years and 53% and 73% at 5 years, respectively. No therapy-related Grade 3 or greater toxicity was observed. Conclusions: RT is safe and effective for patients with EMPD. It appears to contribute to prolonged survival as a result of good tumor control.

62 RADIOLOGY AND NUCLEAR MEDICINE↗