No abstract

Lung adenocarcinomas are more commonly associated with brain metastases (BM). Epidermal growth factor receptor (EGFR) mutations have been demonstratedto be both predictive and prognostic for patients with lung adenocarcinoma. We aimed to explore the potential association between EGFR mutation and the risk of BM in pulmonary adenocarcinoma patients. Data of 234 patients from 2007 to 2014 were retrospectively reviewed. A total of 108 patients had EGFR mutations in the entire cohort. Among them, 76 patients developed BM during their disease course. The incidence of BM was statistically higher in patients with EGFR mutations both at initial diagnosis (P=0.014) and at last follow-up (P<0.001). Multivariate logistic regression analysis revealed that EGFR mutation significantly increased the risk of BM at initial diagnosis (OR=2.515, P=0.022). In patients without BM at initial diagnosis, the accumulative rate of subsequent BM was significantly higher with EGFR mutations (P=0.001). Multivariate Cox regression analysis identified EGFR mutation as the only independent risk factor for subsequent BM (HR=3.036, P=0.001). Patients with EGFR mutations demonstrated longer overall survival (OS) after BM diagnosis than patients with wild-type EGFR (P=0.028). Our data suggest that EGFR mutation is an independent predictive and prognostic risk factor for BM and a positive predictive factor for OS in patients with BM.

A: An online cryogenic distillation system for the removal of krypton and radon from xenon was designed and constructed for PandaX-4T, a highly sensitive dark matter detection experiment. The krypton content in a commercial xenon product is expected to be reduced by 7 orders of magnitude with 99% xenon collection efficiency at a flow rate of 10 kg/h by design. The same system can reduce radon content in xenon by reversed operation, with an expected radon reduction factor of about 1.8 in PandaX-4T under a flow rate of 56.5 kg/h. The commissioning of this system was completed, with krypton and radon operations tested under respective working conditions. The krypton concentration of the product xenon was measured with an upper limit of 8.0 ppt.

No abstract

No abstract

No abstract

No abstract

was seen in 13 and recurrence in 7 patients (3 had prior RT to brain or spine). All had chemotherapy, and 42% received HD-AuSCR prior to CSI. All but two required anesthesia. In total, 270 fractions were delivered. Duration of CSI was a median of 20 days (max 30) with a median daily setup and radiation time of 20 minutes. The longest treatment times for each patient varied due to setup difficulties or anesthetic issues (25% >1 hour, max 76 min). The median CSI PTV was 2294cm 3 , with excellent PTV coverage (V95 mean 98.9%, V107 mean 7.4%, point dose <112%). As a percentage of CSI dose, the mean doses to the lenses, thyroid, and heart were 34.8%, 35.5%, and 30.6%, respectively. The mean lung V5 was 65% and V20 was 2.8%. With a short median follow-up of 7 months, 5 patients progressed (2 local, 3 leptomeningeal) at a median of 3.5 months post CSI; 2 died of disease. The most common acute toxicity was hematologic: lymphopenia (11% Grade 2, 26% Gr 3, 63% Gr 4), anemia (89% Gr 2), and thrombocytopenia (16% Gr 1-2, 26% Gr 3, 37% Gr 4). Despite lymphopenia, we encountered only two Gr 3 infections (UTI and lung). The majority required blood products (89% RBC, 68% platelets). Weight loss was also common (47% Gr 1, 26% Gr 2). Conclusion: Volume modulated arc therapy CSI, along with chemotherapy and anesthesia, is feasible with supportive care. Daily IGRT without matched-and-feathered field junctions improves accuracy and reduces the risk of spinal cord overdose without increasing treatment time. Further research is needed to determine whether reducing doses to organs, such as thyroid, heart, or hippocampus offsets the risk of increased volume of lowdose irradiation.