Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multiinstitutional analysis (KROG 19-04)

Objective:The effectiveness of adjuvant treatments for resected gallbladder carcinoma(GBC)has remained unclear due to lack of randomized controlled trials;thus,the aim of present study was to evaluate the role of adjuvant treatments,including chemoradiotherapy(CRT)and/or chemotherapy(CTx),in patients with resected GBC.Methods:A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database.Of 733 patients,372(50.8%)did not receive adjuvant treatment,whereas 215(29.3%)and 146(19.9%)received adjuvant CTx and CRT,respectively.The locoregional recurrence-free survival(LRFS),recurrence-free survival(RFS),and overall survival(OS)of the adjuvant treatment groups were compared according to tumor stage(stage II vs.stage III–IV).Results:In stage II disease(n=381),the 5-year LRFS,RFS,and OS were not significantly different among the no-adjuvant therapy,CTx,and CRT groups,and positive resection margin,presence of perineural invasion,and Nx classification were consistently associated with worse LRFS,RFS,and OS in the multivariate analysis(P<0.05).For stage III–IV(n=352),the CRT group had significantly higher 5-year LRFS,RFS,and OS than the no-adjuvant therapy and CTx groups(67.8%,45.2%,and 56.9%;37.9%,28.8%,and 35.4%;and 45.0%,30.0%,and 45.7%,respectively)(P<0.05).Conclusions:CRT has value as adjuvant treatment for resected GBC with stage III–IV disease.Further study is needed for stage II disease with high-risk features.

Radiation therapy for extrahepatic bile duct cancer: Current evidences and future perspectives

Extrahepatic bile duct cancer (EBDC) is a rare malignancy that involves neoplastic changes extending from both hepatic ducts to the common bile duct. The treatment of choice is surgical resection, but the predominant pattern of initial treatment failure is locoregional recurrence. Accordingly, adjuvant radiotherapy has been administered after surgical resection based on these rationales. At this time, there is minimal evidence supporting adjuvant radiotherapy, because there have been no phase III trials evaluating its benefit. Relatively small retrospective studies have tried to compare outcomes associated with EBDC treated with or without radiotherapy. We aimed to review studies investigating adjuvant radiotherapy for resected EBDC. Because less than onethird of EBDC cases are amenable to curative resection at diagnosis, other locoregional treatment modalities need to be considered, including radiotherapy. The next aim of this review was to summarize reports of definitive radiotherapy for unresectable EBDC. Patients with advanced EBDC often experience biliary obstruction, which can lead to jaundice and progress to death. Biliary stent insertion is an important palliative procedure, but stents are prone to occlusion after subsequent ingrowth of the EBDC. Radiotherapy can be effective for maintaining the patency of inserted stents. We also reviewed the benefit of palliative radiotherapy combined with the biliary stent insertion. Lastly, we discuss the existing gaps in the evidence supporting radiotherapy in the management of EBDC.

Evolution of microstructure and mechanical characteristics of(CrFeNiCu)_(100-x)Ti_(x)high-entropy alloys

Cr Fe Ni Cu)_(100-x)Ti_(x)(x=0,3,5,7 and 10;at%)high-entropy alloys have been designed by the consideration of the thermophysical relationship between Ti and other principal elements to investigate the influence of Ti on the microstructural evolution and mechanical properties of(CrFeNiCu)_(100-x)Ti_(x)high-entropy alloys.The addition of Ti content in HEAs leads to a change in phase formation from dual-phase(FCC1 and FCC2,FCC:face-centered cubic)to the mixture of FCC1,FCC2 phases,and an additional body-centered cubic(BCC)phase.The yield strength and Vickers hardness of the alloys are enhanced from 291 to 1511 MPa and HV 134 to HV 531,respectively,which depends strongly on the volume fraction of BCC phase.On the one hand,the plasticity of the alloys reduces from 45.00%to 24.09%,but it could be considered reasonable plasticity.These results revealed that the addition of a minor alloying element in high-entropy alloys with consideration of thermophysical parameters led to the formation of a multiple solid solution structure with excellent mechanical properties.

Understanding microstructure and mechanical properties of(AlTa(0.76))xCoCrFeNi(2.1) eutectic high entropy alloys via thermo-physical parameters

(AlTa(0.76))xCoCrFeNi(2.1)(x values in molar ratio,x=0.1,0.3,0.5,0.7,1.0,and 1.5) alloys were designed to investigate the microstructure and mechanical properties of the eutectic high entropy alloys(EHEAs)consisting of FCC,B2,and Laves phases.Depending on the compositional variatio,clear microstructural variation was observed,as follows:(1) Group 1:FCC dendrite+Laves interdendrite(x=0.1),(2) Group 2:FCC dendrite+fine-eutectic structure consisting of FCC and Laves phases(x=0.3,0.5 and 0.7),(3) Group 3:B2 dendrite+bimodal eutectic structure [FCC/B2+Laves](x=1.0),(4) Group 4:Laves dendrite+eutectic structure consisting of B2 and Laves phases(x=1.5).As the fraction of Laves or B2 phases increases,yield stress increases from 293 to 2336 MPa,while the plastic strain decreases from 50 % to 2%.Thermo-physical parameters,such as mixing entropy(△S(mix)),mixing enthalpy(△H(mix)),valence electron concentration(VEC),and atomic size difference(δr),were calculated to understand the microstructural variation.Two criteria(δr-VEC and δr-△H(mix)) were utilized to elucidate the formation of the eutectic structures in the present EHEAs,revealing the usefulness of the thermo-physical parameters in the development of EHEAs.

Formation of photo-reactive heterostructure from a multicomponent amorphous alloy with atomically random distribution

In this study,metallic glass is designed tunable for promising functional applications via a facile and stable,one-step process.Creative approach about alloy design and process is based on the unique properties of the Ti-Cu-Ni-Sn metallic glass that are afforded by the varying oxygen affinities of the four constituent elements.This metallic glass exhibits homogeneous nucleation of oxides and uniform formation of the various metal oxides.The alloy design and hydrothermal synthesis to customize the metallic glasses are the most critical factors that determine the characteristics of the metal oxides and the resulting nanostructures and photoelectrode properties.This enables the desired element to be selectively grown via a facile single-step process.These results provide a promising road map for the application of metallic glasses to photoelectrochemical(PEC)solar water splitting,as well as various other new possibilities.