High Dose-Volume SBRT Following TACE Improves Clinical Outcomes of Patients with Unresectable Hepatocellular Carcinoma

This study aimed to investigate the dose-volume effects of γ-ray stereotactic body radiotherapy (SBRT) on clinical outcomes of patients with huge-size (≥10 cm) unresectable hepatocellular carcinoma (HCC). A total of 59 patients with huge-size unresectable HCC were treated with SBRT following TACE between May 2006 and Dec. 2009. The analyzed parameters included fractional dose, marginal dose, maximal dose, and mean dose that the target received, as well as percentages of tumor volume encompassed by 60% (P60), 70% (P70), and 80% (P80) of isodose curves in entire tumor. The clinical outcomes included objective response rate (ORR), disease-free survival (DFS), overall survival (OS), and adverse event (AE). During median follow-up of 18.4 months, 81.4% of ORR (8.5% CR and 72.9% PR) was achieved, higher than 28.9% of ORR recently reported for TACE alone. 1- and 3-year DFS rates were 31.1% and 2.6% with median DFS of 8.7 months;1-, 3-, and 5-year OS rates were 46.5%, 13.7%, and 2.9%, with median OS of 11.8 months. P70 was the only factor significantly correlating to DFS (P = 0.009) and OS (P = 0.01). Neither severe radiation-related liver disease nor > grade 3 AE was observed. In conclusion, SBRT was a safe and effective option for treatment of huge-size unresectable HCC. P70 represented a parameter for predicting DFS and OS, and high dose-volume (e.g., P70) might be required to achieve improved clinical outcomes of patients with this type of HCC.

Papillary fibroblast-recruiting injectable self-healing multifunctional hydrogels for wound regeneration

The recruitment of key cells to regeneration sites is a promising strategy to promote functional wound healing.Dermal fibroblasts exhibit a heterogeneous population of cells during homeostasis and in response to injury.Papillary fibroblasts play central regulatory roles in the regeneration of skin appendages during wound healing.Inspired by the phenomenon where bait for grass carp can attract grouped grass carps to a fishing spot soon,“Grass Carp Fishing”multifunctional hydrogels,that is,codelivery of an antibody of leucine-rich repeats and immunoglobulin-like domains 1(Lrig1)on the surface of papillary fibroblasts and insulinlike growth factor 1(IGF1)with recruitment function,can recruit papillary fibroblasts.In the experiments,carboxymethyl chitosan showed positive effects in promoting cell proliferation and neovascularization,while dopamine-grafted gelatin was effective in stabilizing the structure and prolonging the degradation time.The sustained release of Lrig1 antibodies and IGF1 from injectable self-healing multifunctional hydrogels persistently accelerated the migration and proliferation of Lrig1+fibroblasts.The in vivo results from a full-thickness cutaneous wound model showed that injectable self-healing multifunctional hydrogel accelerated wound healing and skin regeneration through the recruitment of Lrig1+papillary fibroblasts in wound tissue.Our findings reveal an injectable self-healing multifunctional hydrogel for regeneration,a promising approach to promoting skin wound healing.