bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of platelet parameters in invasive squamous cell carcinoma of uterine cervix
Authors: Anand Ankit , Raju Kalyani 
Published: March 2024

Background:
Cervical cancer is the second most common cancer among females worldwide. The role of platelets in cancer progression and metastasis have been evaluated in various cancers. This study is done to assess the association between platelet parameters and invasive squamous cell carcinoma of the cervix.

Materials and Methods:
Eighty cases of squamous cell carcinoma of the cervix were retrospectively collected from the medical record department. Values of platelet parameters such as platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet-large cell ratio (P-LCR), platelet-lymphocyte ratio (PLR), platelet-neutrophil ratio (PNR), and platelet-monocyte ratio (PMR) are collected from automated hematology analyzer. These values were compared with 80 healthy controls which were randomly selected. Values of platelet parameters were also compared among Federation Internationale de Gynecolgie et d’Obstetrique (FIGO) stages in 80 cases.

Result:
Mean ± standard deviation (SD) for platelet count, MPV, PDW, PCT, P-LCR, PLR, PNR, and PMR among cases were 316 ± 100.37 × 109/L, 9.98 ± 0.96, 11.11 ± 2.27, 0.31 ± 0.092, 24.09 ± 7.62, 179.35 ± 85.53, 63.89 ± 42.10, and 492.29 ± 192.86, respectively, and in controls were 300.30 ± 79.40 × 109/L, 9.97 ± 0.83, 10.97 ± 1.80, 0.59 ± 2.65, 23.94 ± 6.81, 137.72 ± 50.52, 60.07 ± 26.68, and 563.65 ± 602.55, respectively. The PLR between cases and controls was statistically significant. The platelet count and PCT between stages was statistically significant wherein the values increased from stage II to stage IV.

Conclusion:
Platelet parameters are importance in cervical cancer. PLR, platelet count, and PCT are platelet parameters that can be used as predictors and prognostic parameters in cervical cancer. These parameters are cost-effective and can be considered in low resource settings. However, a multicentric study with a larger sample size should be done to extrapolate the findings for patient care.
Modified FOLFIRINOX (mFOLFIRINOX) as neoadjuvant therapy and ‘salvage’ in patients with high risk locally advanced rectal cancers – tolerance and early outcomes
Authors: Prajapati Ramjas , Ostwal Vikas , Srinivas Sujay , Engineer Reena , Bhargava Prabhat , Saklani Avanish , D’Souza Ashwin , Kumar Suman , Peelay Zoya , Manali P. , Ramaswamy Anant 
Published: March 2024

Background:
There is limited data with regard to the use of modified 5-fluoroural-leucovorin-irinotecan-oxaliplatin (mFOLFIRINOX) in terms of tolerance and enabling total mesorectal excision (TME) of locally advanced rectal adenocarcinomas (LARC) with high-risk characteristics (T4b status, signet ring histology etc) post standard neoadjuvant long course chemoradiation (NACTRT) or short course radiation (SCRT) and chemotherapy.

Materials and Methods:
Patients with LARC from January 2018 to December 2020 receiving mFOLFIRINOX post NACTRT/SCRT to facilitate TME were evaluated. The primary endpoint was assessment of grade 3 and grade 4 treatment related toxicity and TME rates. Event free survival (EFS), where event was defined as disease progression or recurrence post resection after mFOLFIRINOX, was calculated by Kaplan Meier method.

Results:
Forty-seven patients were evaluated with a median age of 33 years (Range:18-59), 45% T4b status, 96% radiological circumferential margin (CRM) involved (79% CRM positive post NACTRT/SCRT), 43% extramural venous invasion (n=33) and 36% signet ring histology. 62% had received prior NACTRT and 38% had received SCRT with chemotherapy before receiving mFOLFIRINOX. The most common grade 3 and grade 4 treatment related side effects included diarrhoea (7%), anaemia (4%) and infections (4%). Intended duration of mFOLFIRINOX or beyond was completed in 94% of patients. 60% of patients underwent curative local resection with R0 resection rates of 100% (n=28) and pathological complete response rates of 21%. The most common surgeries done were exenterations and abdominoperineal in 22% and 17% patients respectively. With a median follow up of 19 months, 24 patients had recurred or progressed for a median EFS of 20 months [95% confidence interval (CI): 15-24].

Conclusions:
Locally advanced rectal cancers with high-risk characteristics are a niche group of cancers with less-than-optimal outcomes post standard neoadjuvant strategies. mFOLFIRINOX appears to be well tolerated and enables TME in a significant proportion of these patients.
Evaluation of the neuroprotective effect of quercetin against damage caused by gamma radiation
Authors: Baran Munevver , Başaran Kemal E. , Gergin Ozlem Oz , Cengız Ozge , G.Yıldız Oğuz , Yay Arzu 
Published: March 2024

Background and Objective:
Radiation therapy is a routine clinical practice that has been used for a long time in the treatment of cancer patients. The most important dose-limiting organ in patients receiving radiotherapy for various conditions is the brain. The mechanisms underlying brain and pituitary gland damage caused by radiation are largely unknown. It is of great importance to use radioprotective agents to protect against damage. This study aims to evaluate the neuroprotective effects of quercetin in experimental radiation-induced brain and pituitary gland damage.

Materials and Methods:
A total of 60 adult male Wistar-albino rats were randomly divided into six groups (control, sham, radiation, quercetin, radiation + quercetin, and quercetin + radiation groups, with ten rats in each group). Quercetin was given to rats by oral gavage at 50 mg/kg/day. A whole-body single dose of 10 Gy radiation was applied to the rats. Tissue samples belonging to the groups were compared after excision. Histopathological changes in the brain tissue and pituitary gland were examined with hematoxylin-tissue samples in the groups and compared histologically and immunohistochemically.

Results:
The histopathological examination of the brain and anterior pituitary gland sections showed marked damage in the radiation-treated rats, while the quercetin-administered groups showed normal tissue architecture. While neuropeptid Y immunoreactivity was increased, synaptophysin immunoreactivity was decreased in the brains of radiation-treated rats. However, when neuropeptide Y and synaptophysin expression were assessed in the anterior pituitary gland, there was no significant difference between the groups.

Conclusion:
Consequently, quercetin may be a potential pharmacological agent in modulating radiation-induced damage in rats. However, extra experimental and preclinical studies are needed to confirm our findings before they can be used clinically.
Extracts of Jamun seeds inhibited the growth of human (Hep-2) cancer cells
Authors: Mauti Godfrey O. 
Published: March 2024

Introduction:
In the last century, the human laryngeal epithelioma has become a life-threatening disease leading to a high rate of mortality worldwide. The current investigation is focusing on the antiproliferative effect of Eugenia jambolana seed extracts against Hep-2 cancer cells.

Methods:
The active compounds from the seeds of E. jambolana were extracted by the decoction extraction method using acetone, ethanol, and methanol. The filtrates from the different solvents were subjected to liquid-liquid separation before drying by a rotary evaporator. In various doses, the crude extracts and carcinoma were subjected to a methylthiazolyl diphenyl tetrazolium bromide assay. Cell viability was determined under ultraviolet visualization at an absorbance of 540 nm. The data of the viable cells were subjected to analysis of variance at P ≤ .01.

Results:
Crude compounds of E. jambolana seeds extracted by acetone, methanol, and methanol extract had an anticarcinoma effect. Among the extracts, methanol extract possessed a recommendable anti-carcinoma effect compared to acetone and ethanol crude extracts. At a concentration of 125 µg/mL, the crude extracts of methanol, acetone, and ethanol destroyed 49.57, 35.01, and 27.67 carcinomas, respectively. The concentration of 31.25 µg/mL of acetone extract and 125 µg/mL of ethanolic extract affected 28.11 and 27.67 carcinomas, respectively.

Conclusions:

E.
jambolana seeds possess anticarcinoma potency and thus can be administered in the reduction of proliferative carcinoma. The study recommended further studies which will involve the elution of pure compounds from the methanol extract of E. jambolana that possess antitumour and antiproliferative activity against Hep-2 cell lines.
Epithelial ovarian cancer in younger age versus older age groups: Survival and clinicopathological features
Authors: Kongkamsuan Walaiporn , Boonyapipat Sathana 
Published: March 2024

Objectives:
This study aimed to analyze the survivals and clinicopathological features of epithelial ovarian cancer (EOC) in younger age patients and to determine the impact of age on survival.

Methods:
EOC patients aged ≤40 years were matched to patients aged >40 years at a 1:4 ratio. Disease-specific survival (DSS), progression-free survival (PFS), and clinicopathological and treatment features were compared between patients aged ≤40 and >40 years.

Results:
A total of 763 EOC patients were reviewed. During a median follow-up period of 41 (range, 1–195) months, EOC patients aged ≤40 and >40 years did not show any statistically significant difference in median DSS (120 versusversus 84.7 months; hazard ratio, 0.78; 95% confidence interval, 0.58, 1.06); however, the median PFS was better in patients aged ≤40 years (median PFS not reached versusversus 41 months; HR, 0.65; 95% CI, 0.5, 0.85). Age ≤40 years was an independent favorable prognostic factor for DSS at 3 years after diagnosis. In contrast, younger age was an independent poor prognostic factor prior to this time point. EOC patients aged ≤40 years exhibited a significantly higher rate of early-stage disease, a higher proportion of mucinous subtype, and lower cancer antigen-125 level.

Conclusion:
Overall, EOC patients in the younger age group were associated with more favorable prognostic factors and showed better PFS, but not DSS, than those in the older age group. Younger age was identified as an unfavorable prognostic factor within 3 years of diagnosis and became a favorable prognostic factor after 3 years.
Ewing’s sarcoma in adolescents and adults – 10-year experience from a tertiary cancer center in India
Authors: Narayanan Geetha , Kamala Lakshmi H. , Nair Sreejith G. , Purushothaman Prakash N. , Kumar Aswin , Kattoor Jayasree 
Published: March 2024

Background:
Ewing’s sarcoma (EWS) is an aggressive small round cell tumor, affecting bone and soft tissues and is mostly seen in childhood and second decade of life. EWS accounts for 10–12% of bone tumors in more than 15 years age group and is even rarer after 40 years of age.

Materials and Methods:
This retrospective analysis was conducted among patients aged more than 15 years with histologically proven EWS.

Results:
Among 240 cases of EWS treated at our center during 2001–2010, 130 (54%) were more than 15 years of age. The median age was 20 years with a male: female ratio of 2.4:1. Ninety percent had skeletal EWS, 10% had extra skeletal EWS, and 37% patients were metastatic at presentation. Eighty-two received curative treatment with chemotherapy (vincristine, doxorubicin, cyclophosphamide, ifosfamide, etoposide (VAC/IE)) along with local treatment, radiotherapy (RT) in 61, surgery alone in seven, and RT plus surgery in 14. Two- and 5-year overall survival (OS) was 43.3% and 25.5%, respectively, for the entire series. The OS for the non-metastatic group was 63.2% at 2 years and 36.5% at 5 years, and the progression free survival was 53.7% at 2 years and 37.8% at 5 years. High lactate dehydrogenase was found to be a significant poor prognostic factor (P = 0.001). Median OS for localized central EWS was 49.2 months and that for peripheral EWS was 24 months. Patients more than 20 years of age with non-metastatic disease had better OS compared to those with 15–20 years of age.

Conclusion:
Treatment of EWS requires a multidisciplinary approach with radical surgery and/or radiation to control local disease and multiagent chemotherapy to control systemic disease. Long-term follow-up is essential because of disease relapse and treatment-related complications.
Exploring the Influence of Initial Estimates on Iterative Maximum Likelihood Expectation–maximization in Tomographic Reconstruction
Authors: Qutbi Mohsen 
Published: March 2024

Purpose:
To explore the influence of initial guess or estimate (uniform as “ones” and “zeros” vs. filtered back projection [FBP] image) as an input image for maximum likelihood expectation–maximization (MLEM) tomographic reconstruction algorithm and provide the curves of error or convergence for each of these three initial estimates.

Methods:
Two phantoms, created as digital images, were utilized: one was a simple noiseless object and the other was a more complicated, noise-degraded object of the section of lower thorax in a matrix of 256 × 256 pixels. Both underwent radon transform or forward projection process and the corresponding sinograms were generated. For filtering during tomographic image reconstruction, ramp and Butterworth filters, as high-pass and low-pass ones, were applied to images. The second phantom (lower thorax) was radon-transformed and the resulting sinogram was degraded by noise. As initial guess or estimate images, in addition to FBP tomographic image, two uniform images, one with all pixels having a value of 1 (“ones”) and the other with all having zero (“zeros”), were created. The three initial estimates (FBP, ones, and zeros) were reconstructed with iterative MLEM tomographic reconstruction (with 1, 2, 4, 8, 16, 32, and 64 iterations). The difference between the object and the updated slice was calculated at the end of each iteration (as error matrix), and the mean squared error (MSE) was computed and plotted separately or in conjunction with the MSE curves of other initial estimates. All computations were implemented in MATLAB software.

Results:
The results of ones and zeros seemed strikingly similar. The curves of uniform ones and uniform zeros were so close to each other that overlap near-perfectly. However, in the FBP slice as an initial estimate, the resulting tomographic slice was similar with a much higher extent to the object even after 1 or 2 iterations. The pattern of convergence for all three curves was roughly similar. The normalized MSE decreased sharply up to 5 iterations and then, after 10 iterations, the curves reached a plateau until 32 iterations. For the phantom of the lower thorax section with its noise-degraded sinogram, similar to the pattern observed for simple disk-shaped phantom, the curves (normalized MSE) fell sharply up to 10 iterations and then rapidly converged thereafter until 64 iterations.

Conclusion:
Similar results are observed when choosing different initial guesses or estimates (uniform vs. FBP) as the starting point, based on the error calculation using MSE. The algorithm converges almost similarly for all initial estimates. Therefore, selecting a uniform initial guess image can be an appropriate choice and may be preferred over an FBP image. Reducing the processing time can be a valid reason for this choice.
Delta4-based Dosimetric Error Detection in Volumetric-modulated Arc Therapy: Clinical Significance and Implications
Authors: Udee Nuntawat , Commukchik Supada , Khamfongkhruea Chirasak , Kaewlek Titipong , Chusin Thunyarat , Yabsantia Sumalee 
Published: March 2024

Background:
Volumetric-modulated arc therapy (VMAT) is an efficient method of administering intensity-modulated radiotherapy beams. The Delta4 device was employed to examine patient data.

Aims and Objectives:
The utility of the Delta4 device in identifying errors for patient-specific quality assurance of VMAT plans was studied in this research.

Materials and Methods:
Intentional errors were purposely created in the collimator rotation, gantry rotation, multileaf collimator (MLC) position displacement, and increase in the number of monitor units (MU).

Results:
The results show that when the characteristics of the treatment plans were changed, the gamma passing rate (GPR) decreased. The largest percentage of erroneous detection was seen in the increasing number of MU, with a GPR ranging from 41 to 92. Gamma analysis was used to compare the dose distributions of the original and intentional error designs using the 2%/2 mm criteria. The percentage of dose errors (DEs) in the dose-volume histogram (DVH) was also analyzed, and the statistical association was assessed using logistic regression. A modest association (Pearson’s R-values: 0.12–0.67) was seen between the DE and GPR in all intentional plans. The findings indicated a moderate association between DVH and GPR. The data reveal that Delta4 is effective in detecting mistakes in treatment regimens for head-and-neck cancer as well as lung cancer.

Conclusion:
The study results also imply that Delta4 can detect errors in VMAT plans, depending on the details of the defects and the treatment plans employed.
Effect of Detector Orientation and Influence of Jaw Position in the Determination of Small-field Output Factor with Various Detectors for High-energy Photon Beams
Authors: Godson Henry Finlay , Manickam Ravikumar , Ponmalar Y. Retna , Ganesh K. M. , Saminathan Sathiyan , Chandraraj Varatharaj , Kumar A. Sathish , George Seby , Raman Arun , Singh Rabi Raja 
Published: March 2024

Background:
Accurate dose measurements are difficult in small fields due to charge particle disequilibrium, partial source occlusion, steep dose gradient, and the finite size of the detector.

Aim:
The study aims to determine the output factor using various detectors oriented in parallel and perpendicular orientations for three different tertiary collimating systems using 15 MV photon beams. In addition, this study analyzes how the output factor could be affected by different configurations of X and Y jaws above the tertiary collimators.

Materials and Methods:
Small field output factor measurements were carried out with three detectors for different tertiary collimating systems such as BrainLab stereotactic cones, BrainLab mMLC and Millennium MLC namely. To analyze the effect of jaw position on output factor, measurements have been carried out by positioning the jaws at the edge, 0.25, 0.5, and 1.0 cm away from the tertiary collimated field.

Results:
The data acquired with 15 MV photon beams show significant differences in output factor obtained with different detectors for all collimating systems. For smaller fields when compared to microDiamond, the SRS diode underestimates the output by up to -1.7% ± 0.8% and -2.1% ± 0.3%, and the pinpoint ion chamber underestimates the output by up to -8.1% ± 1.4% and -11.9% ± 1.9% in their parallel and perpendicular orientation respectively. A large increase in output factor was observed in the small field when the jaw was moved 0.25 cm symmetrically away from the tertiary collimated field.

Conclusion:
The investigated data on the effect of jaw position inferred that the position of the X and Y jaw highly influences the output factors of the small field. It also confirms that the output factor highly depends on the configuration of X and Y jaw settings, the tertiary collimating system as well as the orientation of the detectors in small fields.
The Investigating Image Registration Accuracy and Contour Propagation for Adaptive Radiotherapy Purposes in Line with the Task Group No. 132 Recommendation
Authors: Archawametheekul Kamonchanok , Puttanawarut Chanon , Suphaphong Sithiphong , Jiarpinitnun Chuleeporn , Sakulsingharoj Siwaporn , Stansook Nauljun , Khachonkham Suphalak 
Published: March 2024

Purpose:
Image registration is a crucial component of the adaptive radiotherapy workflow. This study investigates the accuracy of the deformable image registration (DIR) and contour propagation features of SmartAdapt, an application in the Eclipse treatment planning system (TPS) version 16.1.

Materials and Methods:
The registration accuracy was validated using the Task Group No. 132 (TG-132) virtual phantom, which features contour evaluation and landmark analysis based on the quantitative criteria recommended in the American Association of Physicists in Medicine TG-132 report. The target registration error, Dice similarity coefficient (DSC), and center of mass displacement were used as quantitative validation metrics. The performance of the contour propagation feature was evaluated using clinical datasets (head and neck, pelvis, and chest) and an additional four-dimensional computed tomography (CT) dataset from TG-132. The primary planning and the second CT images were appropriately registered and deformed. The DSC was used to find the volume overlapping between the deformed contours and the radiation oncologist (RO)-drawn contour. The clinical value of the DIR-generated structure was reviewed and scored by an experienced RO to make a qualitative assessment.

Results:
The registration accuracy fell within the specified tolerances. SmartAdapt exhibited a reasonably propagated contour for the chest and head-and-neck regions, with DSC values of 0.80 for organs at risk. Misregistration is frequently observed in the pelvic region, which is specified as a low-contrast region. However, 78% of structures required no modification or minor modification, demonstrating good agreement between contour comparison and the qualitative analysis.

Conclusions:
SmartAdapt has adequate efficiency for image registration and contour propagation for adaptive purposes in various anatomical sites. However, there should be concern about its performance in regions with low contrast and small volumes.
Program for Determining the Dosimetric Contribution of Tc-99m Biokinetics in Estimating the Dose to the Heart of a Male Adult
Authors: Morales-Nizama Rosa Adela , Gallozzo-Cárdenas Moisés Miguel , Chinchay-Espino Héctor Almanzor , Murga-Torres Emzon , Alvarez-Escobedo Amilu M. , Nazario-Naveda Renny 
Published: March 2024

Purpose:
To calculate the contribution of absorbed dose by organs in the biokinetics of Tc-99m when used for radiodiagnosis of the adult male heart employing a Matlab program.

Methods:
The absorbed self-dose of the adult male heart and absorbed dose by organs in the biokinetics of the heart when administering Tc-99m are estimated using the MIRD formalism and the Cristy-Eckerman representation, which have been employed to develop the algorithm in Matlab.

Results:
The results indicate that electron capture emissions of 1.446 (mGy/MBq) and Auger electrons of 0.062 (mGy/MBq) are entirely directed towards the target organ (heart) and contribute 29.33% and 1.25% respectively to its total dose. Additionally, the dosimetric contributions of biokinetic organs correspond to characteristic radiation emissions and gamma photons at 2.578 (mGy/MBq) for Tc-99m, representing 52.29% of its total dose.

Conclusion:
These dosimetric contributions are significant in estimating the total absorbed dose by the heart in adult males and should not be disregarded.