Publications by authors named "J Patrick Kociolek"

27 Publications

Two new species of (Bacillariophyta) from Southeast Asia.

PhytoKeys 2022 18;190:69-85. Epub 2022 Feb 18.

Museum of Natural History, Boulder, Colorado, 80309, USA Museum of Natural History Boulder United States of America.

We present light and scanning electron microscopical observations on two new species of Bory sensu stricto from Southeast Asia. Chudaev, Glushchenko, Kulikovskiy & Kociolek, differs from taxa with similar outline and size by the combination of simple drop-like external raphe endings deflected to the primary valve side, presence of well-developed external longitudinal grooves and relatively low lineolae density. Chudaev, Glushchenko, Kulikovskiy & Kociolek, can be discriminated from the taxa of similar valve shape and size by consistently lower lineolae density, and from the majority of them also by the structure of external proximal raphe endings with small projections in proximal parts and larger triangular insertions in distal parts. Some remarks on species diversity and its distribution in the Southeast Asia are given.
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http://dx.doi.org/10.3897/phytokeys.190.78164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881437PMC
February 2022

Urethra Sparing With Target Motion Mitigation in Dose-Escalated Extreme Hypofractionated Prostate Cancer Radiotherapy: 7-Year Results From a Phase II Study.

Front Oncol 2022 29;12:863655. Epub 2022 Mar 29.

Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal.

Purpose: To explore whether the rectal distension-mediated technique, harnessing human physiology to achieve intrafractional prostate motion mitigation, enables urethra sparing by inverse dose painting, thus promoting dose escalation with extreme hypofractionated stereotactic ablative radiotherapy (SABR) in prostate cancer.

Materials And Methods: Between June 2013 and December 2018, 444 patients received 5 × 9 Gy SABR over 5 consecutive days. Rectal distension-mediated SABR was employed insertion of a 150-cm air-inflated endorectal balloon. A Foley catheter loaded with 3 beacon transponders was used for urethra visualization and online tracking. MRI-based planning using Volumetric Modulated Arc Therapy - Image Guided Radiotherapy (VMAT-IGRT) with inverse dose painting was employed in delivering the planning target volume (PTV) dose and in sculpting exposure of organs at risk (OARs). A 2-mm margin was used for PTV expansion, reduced to 0 mm at the interface with critical OARs. All plans fulfilled D ≥45 Gy. Target motion ≥2 mm/5 s motions mandated treatment interruption and target realignment prior to completion of the planned dose delivery.

Results: Patient compliance to the rectal distension-mediated immobilization protocol was excellent, achieving reproducible daily prostate localization at a patient-specific retropubic niche. Online tracking recorded ≤1-mm intrafractional target deviations in 95% of treatment sessions, while target realignment in ≥2-mm deviations enabled treatment completion as scheduled in all cases. The cumulative incidence rates of late grade ≥2 genitourinary (GU) and gastrointestinal (GI) toxicities were 5.3% and 1.1%, respectively. The favorable toxicity profile was corroborated by patient-reported quality of life (QOL) outcomes. Median prostate-specific antigen (PSA) nadir by 5 years was 0.19 ng/ml. The cumulative incidence rate of biochemical failure using the Phoenix definition was 2%, 16.6%, and 27.2% for the combined low/favorable-intermediate, unfavorable intermediate, and high-risk categories, respectively. Patients with a PSA failure underwent a Ga-labeled prostate-specific membrane antigen (Ga-PSMA) scan showing a 20.2% cumulative incidence of intraprostatic relapses in biopsy International Society of Urological Pathology (ISUP) grade ≥3.

Conclusion: The rectal distension-mediated technique is feasible and well tolerated. Dose escalation to 45 Gy with urethra-sparing results in excellent toxicity profiles and PSA relapse rates similar to those reported by other dose-escalated regimens. The existence of intraprostatic recurrences in patients with high-risk features confirms the notion of a high α/β ratio in these phenotypes resulting in diminished effectiveness with hypofractionated dose escalation.
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http://dx.doi.org/10.3389/fonc.2022.863655DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9012148PMC
March 2022

Early PSA density kinetics predicts biochemical and local failure following extreme hypofractionated radiotherapy in intermediate-risk prostate cancer.

Radiother Oncol 2022 04 18;169:35-42. Epub 2022 Feb 18.

The Champalimaud Centre for the Unknown, Lisbon, Portugal; Memorial Sloan Kettering Cancer Center, New York, USA.

Purpose: The present study explores PSA density (PSA-D) as predictor of biochemical and local failure in organ-confined prostate cancer at 3-6 months after hypofractionated stereotactic ablative radiotherapy (SABR).

Methods And Materials: A cohort of 219, hormone-naïve, NCCN intermediate-risk prostate cancer patients were derived from a phase 2 study of 5 × 9 Gy prostate cancer SABR. PSA-D was calculated at 3 and 6 months by dividing serum PSA by the MR-derived prostate CTV, while the slope of the 3-6 months curve was used to express the kinetics of PSA-D decay.

Results: The median follow-up was 60.3 (range 46-76) months, and the actuarial 7-year bRFS was 98.0% for intermediate-risk favorable (FIR) patients versus 84.5% for the unfavorable (UIR) subgroup (P = 0.02). Fourteen patients developed a Phoenix-defined biochemical PSA relapse (bRFS) at a median of 34.2 months, 11 confirmed with Ga-PSMA PET/CT scan that revealed tracer uptake at the site of dominant intraprostatic pretreatment lesion in 8 patients. The 3-month PSA-D concertation (cut-off 0.08 ng/ml) and 3-6 months decay slope (cut-off -0.45) values were predictive of long-term bRFS. A dual adverse PSA-D permutation was detected in 25/148 UIR patients, exhibiting 47.5% 7-year bRFS compared with 94.1% for the remaining 123 UIR patients with favorable PSA-D kinetics (P = 0.0006). Intraprostatic local relapse in patients with a 3-month PSA-D > 0.080 ng/ml was 11.0% vs. 1.7% for patients with PSA-D ≤ 0.080 ng/ml (P = 0.01) and 2.3% vs. 4.3%, respectively, for nodal progression (P = 0.68).

Conclusions: Early post-treatment PSA-D kinetics transcends pre-treatment risk stratification of tumor relapse and adds a nuance in the biological characterization of intermediate-risk prostate cancer phenotypes. The dual adverse PSA-D algorithm may serve as a tool to validate current search of classifiers of radioresistance in prostate cancer with therapeutic implications.
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http://dx.doi.org/10.1016/j.radonc.2022.02.016DOI Listing
April 2022

Positron Emission Tomography-Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy.

Adv Radiat Oncol 2022 Mar-Apr;7(2):100864. Epub 2021 Dec 5.

Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal.

Purpose: Early positron emission tomography-derived metrics post-oligometastasis radioablation may predict impending local relapses (LRs), providing a basis for a timely ablation.

Methods And Materials: Positron emission tomography data of 623 lesions treated with either 24 Gy single-dose radiation therapy (SDRT) (n = 475) or 3 ×  9 Gy stereotactic body radiation therapy (SBRT) (n = 148) were analyzed in a training data set (n = 246) to obtain optimal cutoffs for pretreatment maximum standardized uptake value (SUV) and its 3-month posttreatment decline (ΔSUV) in predicting LR risk, validated in a data set unseen to testing (n = 377).

Results: At a median of 21.7 months, 91 lesions developed LRs: 39 of 475 (8.2%) after SDRT and 52 of 148 (35.1%) after SBRT. The optimal cutoff values were 12 for SUV and -75% for ΔSUV. Bivariate SUV/ΔSUV permutations rendered a 3-tiered LR risk stratification of dual-favorable (low risk), 1 adverse (intermediate risk) and dual-adverse (high risk). Actuarial 5-year local relapse-free survival rates were 93.9% versus 89.6% versus 57.1% ( < .0001) and 76.1% versus 48.3% versus 8.2% ( < .0001) for SDRT and SBRT, respectively. The SBRT area under the ROC curve was 0.71 (95% CI, 0.61-0.79) and the high-risk subgroup yielded a 76.5% true positive LR prediction rate.

Conclusions: The SBRT dual-adverse SUV/ΔSUV category LR prediction power provides a basis for prospective studies testing whether a timely ablation of impending LRs affects oligometastasis outcomes.
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http://dx.doi.org/10.1016/j.adro.2021.100864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752878PMC
December 2021

Marine and brackish D.G.Mann (Bacillariophyta) species from the Java Sea and South China Sea coasts with the description of three new species.

PhytoKeys 2021 22;183:115-142. Epub 2021 Oct 22.

Université de Nantes, EA 2160 Mer - Molécules - Santé 2, Rue de la Houssinière, 44322 Nantes, France.

In this study, samples were collected from the Java Sea coasts, from the South China Sea in Hainan Island coasts and Quảng Yên region and Rú Chá mangrove near Hue in Central Vietnam. In studied samples a total of eight species have been observed. Three of the taxa studied are described herein as species new to science - , and Under light microscopy (LM) and are similar with rhombic-lanceolate to rhombic/ elliptic-lanceolate to elliptic valve shapes and narrowly rounded apices. Both species can be easily distinguished by stria density (higher density in ). Under SEM is characterized by cribrate areola occlusions, a character thus far observed only in three established species. The remaining species of the whole genus known thus far are characterized by hymenate areola. Similar morphology species have been observed from tropical mangrove forests from Madagascar but they all can be easily distinguished based on the lack of grooves in the central area. The third species - has rhombic-elliptic to rhombic-lanceolate valves with broadly rounded to slightly protracted apices in larger specimens. This species has a relatively broad central area. Also unique among brackish-water is the small, rounded stigma positioned almost midway between the valve center and valve margin. In the habitats from which the new species are described we also identified five established taxa including, , , , and . For those species we provide detailed SEM characteristics of valve ultrastructure, as well as the range of environmental conditions and geographic distribution within the study area.
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http://dx.doi.org/10.3897/phytokeys.183.71049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556211PMC
October 2021
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