TY - JOUR A1 - Richter, Anne A1 - Weick, Stefan A1 - Krieger, Thomas A1 - Exner, Florian A1 - Kellner, Sonja A1 - Polat, Bülent A1 - Flentje, Michael T1 - Evaluation of a software module for adaptive treatment planning and re-irradiation JF - Radiation Oncology N2 - Background: The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. Methods: The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. Results: The Dynamic Planning Tool was used in 20% of treated patients per year for both approaches nearly equally (42% plan adaptation and 58% re-irradiation). Most cases were assessed for the thoracic body region (51%) followed by pelvis (21%) and head and neck cases (10%). The sub-group evaluation showed that unintended plan adaptation was performed in 38% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4–35 days) was observed. PTV changed by 12 ± 12% on average (maximum change 42%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. Conclusion: The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to consider the pretreatment dose, to adapt the actual treatment schema more specifically and to review the accumulated dose. KW - re-irradiation KW - lung cancer KW - adaptation KW - re-planning Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158711 VL - 12 IS - 205 ER - TY - JOUR A1 - Kunz, Meik A1 - Göttlich, Claudia A1 - Walles, Thorsten A1 - Nietzer, Sarah A1 - Dandekar, Gudrun A1 - Dandekar, Thomas T1 - MicroRNA-21 versus microRNA-34: Lung cancer promoting and inhibitory microRNAs analysed in silico and in vitro and their clinical impact JF - Tumor Biology N2 - MicroRNAs are well-known strong RNA regulators modulating whole functional units in complex signaling networks. Regarding clinical application, they have potential as biomarkers for prognosis, diagnosis, and therapy. In this review, we focus on two microRNAs centrally involved in lung cancer progression. MicroRNA-21 promotes and microRNA-34 inhibits cancer progression. We elucidate here involved pathways and imbed these antagonistic microRNAs in a network of interactions, stressing their cancer microRNA biology, followed by experimental and bioinformatics analysis of such microRNAs and their targets. This background is then illuminated from a clinical perspective on microRNA-21 and microRNA-34 as general examples for the complex microRNA biology in lung cancer and its diagnostic value. Moreover, we discuss the immense potential that microRNAs such as microRNA-21 and microRNA-34 imply by their broad regulatory effects. These should be explored for novel therapeutic strategies in the clinic. KW - biomarker KW - microRNA–target interaction KW - microRNAs KW - lung cancer KW - therapeutic strategy KW - bioinformatics Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158399 VL - 39 IS - 7 ER - TY - THES A1 - Iltzsche, Fabian T1 - The Role of DREAM/MMB-mediated mitotic gene expression downstream of mutated K-Ras in lung cancer T1 - Die Rolle DREAM/MMB-vermittelter mitotischer Genexpression unterhalb von mutiertem K-Ras in Lungenkrebs N2 - The evolutionary conserved Myb-MuvB (MMB) multiprotein complex has an essential role in transcriptional activation of mitotic genes. MMB target genes as well as the MMB associated transcription factor B-Myb and FoxM1 are highly expressed in a range of different cancer types. The elevated expression of these genes correlates with an advanced tumor state and a poor prognosis. This suggests that MMB could contribute to tumorigenesis by mediating overexpression of mitotic genes. Although MMB has been extensively characterized biochemically, the requirement for MMB to tumorigenesis in vivo remains largely unknown and has not been tested directly so far. In this study, conditional knockout of the MMB core member Lin9 inhibits tumor formation in vivo in a mouse model of lung cancer driven by oncogenic K-Ras and loss of p53. The incomplete recombination observed within tumors points towards an enormous selection pressure against the complete loss of Lin9. RNA interference (RNAi)-mediated depletion of Lin9 or the MMB associated subunit B-Myb provides evidence that MMB is required for the expression of mitotic genes in lung cancer cells. Moreover, it was demonstrated that proliferation of lung cancer cells strongly depends on MMB. Furthermore, in this study, the relationship of MMB to the p53 tumor suppressor was investigated in a primary lung cancer cell line with restorable p53 function. Expression analysis revealed that mitotic genes are downregulated after p53 re-expression. Moreover, activation of p53 induces formation of the repressive DREAM complex and results in enrichment of DREAM at mitotic gene promoters. Conversely, MMB is displaced at these promoters. Based on these findings the following model is proposed: In p53-negative cells, mitogenic stimuli foster the switch from DREAM to MMB. Thus, mitotic genes are overexpressed and may promote chromosomal instability and tumorigenesis. This study provides evidence that MMB contributes to the upregulation of G2/M phase-specific genes in p53-negative cells and suggests that inhibition of MMB (or its target genes) might be a strategy for treatment of lung cancer. N2 - Der evolutionär konservierte Myb-MuvB (MMB) Multiproteinkomplex hat eine wesentliche Rolle in der transkriptionellen Aktivierung mitotischer Gene. Zielgene des MMB sowie die MMB assoziierten Transkriptionsfaktoren B-Myb und FoxM1 sind hoch exprimiert in einer Bandbreite verschiedener Krebsarten. Die erhöhte Expression dieser Gene korreliert mit einem fortgeschrittenen Tumorstadium und einer geringen Prognose. Das weißt auf darauf hin, dass MMB an der Tumorentstehung beteiligt sein könnte indem es die Überexpression mitotischer Gene fördert. Obwohl MMB biochemisch eingehend untersucht wurde, ist die Erfordernis von MMB zur Tumorentstehung in vivo weitestgehend unbekannt und wurde bisher nicht direkt getestet. In dieser Studie hemmt der konditionale Knockout der MMB Kerneinheit Lin9 die Tumorbildung in vivo in einem Lungenkrebs-Mausmodell angetrieben durch onkogenes K-Ras und den Verlust von p53. Die unvollständige Rekombination welche in Tumoren beobachtet wurde deutet auf einen starken Selektionsdruck gegen den kompletten Verlust von Lin9 hin. Die Verminderung von Lin9 und der MMB- assoziierten Untereinheit B-Myb durch RNAi-Interferenz (RNAi) liefert Beweise dafür, dass MMB für die Expression mitotischer Gene in Lungenkrebszellen notwendig ist. Zudem wurde gezeigt, dass das Zellwachstum von Lungenkrebszellen stark von MMB abhängig ist. Weiterhin wurde der Zusammenhang zwischen MMB und dem p53-Tumorsuppressor in einer primären Lungenkrebszelllinie mit wiederherstellbarer p53-Funktion untersucht. Expressionsanalysen zeigen, dass mitotische Gene nach Re-expression von p53 runterreguliert werden. Außerdem induziert die Aktivierung von p53 die Bildung des repressiven DREAM-Komplexes und führt zu einer Anreicherung von DREAM an Promotoren mitotischer Gene. Im Gegenzug wird MMB an den Promotoren verdrängt. Basierend auf den Ergebnissen wird das folgende Model vorgeschlagen: In p53- negativen Zellen begünstigen mitogene Reize den Wechsel von DREAM zu MMB. Dadurch werden mitotische Gene überexprimiert und können so chromosomale Instabilität und Tumorentstehung fördern Diese Studie liefert Hinweise, dass MMB an der Hochregulation G2/M- Phasenspezifischer Gene in p53-negativen Zellen beteiligt ist und dass die Hemmung von MMB (oder seiner Zielgene) eine Strategie zur Behandlung von Lungenkrebs sein könnte. KW - Nicht-kleinzelliges Bronchialkarzinom (NSCLC) KW - Lungenkrebs KW - lung cancer KW - DREAM complex KW - MMB KW - K-Ras KW - mitotic gene expression KW - Mitose Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-154108 ER -