A Polymorphism Within the Promoter of the TGFβ1 Gene Is Associated With Radiation Sensitivity Using an Objective Radiologic Endpoint

Purpose To evaluate whether single nucleotide polymorphisms (SNPs) in the transforming growth factor-β1 ( TGFβ1 ) gene are associated with radiation sensitivity using an objective radiologic endpoint. Methods and Materials Preradiation therapy and serial postradiation therapy single photon emission...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:International journal of radiation oncology, biology, physics biology, physics, 2012-02, Vol.82 (2), p.e247-e255
Hauptverfasser: Kelsey, Chris R., M.D, Jackson, Lauren, B.S, Langdon, Scott, Ph.D, Owzar, Kouros, Ph.D, Hubbs, Jessica, M.S, Vujaskovic, Zeljko, M.D., Ph.D, Das, Shiva, Ph.D, Marks, Lawrence B., M.D
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page e255
container_issue 2
container_start_page e247
container_title International journal of radiation oncology, biology, physics
container_volume 82
creator Kelsey, Chris R., M.D
Jackson, Lauren, B.S
Langdon, Scott, Ph.D
Owzar, Kouros, Ph.D
Hubbs, Jessica, M.S
Vujaskovic, Zeljko, M.D., Ph.D
Das, Shiva, Ph.D
Marks, Lawrence B., M.D
description Purpose To evaluate whether single nucleotide polymorphisms (SNPs) in the transforming growth factor-β1 ( TGFβ1 ) gene are associated with radiation sensitivity using an objective radiologic endpoint. Methods and Materials Preradiation therapy and serial postradiation therapy single photon emission computed tomography (SPECT) lung perfusion scans were obtained in patients undergoing treatment for lung cancer. Serial blood samples were obtained to measure circulating levels of TGFβ1. Changes in regional perfusion were related to regional radiation dose yielding a patient-specific dose–response curve, reflecting the patient’s inherent sensitivity to radiation therapy. Six TGFβ1 SNPs (-988, -800, -509, 869, 941, and 1655) were assessed using high-resolution melting assays and DNA sequencing. The association between genotype and slope of the dose–response curve, and genotype and TGFβ1 ratio (4-week/preradiation therapy), was analyzed using the Kruskal-Wallis test. Results 39 white patients with preradiation therapy and ≥6-month postradiation therapy SPECT scans and blood samples were identified. Increasing slope of the dose–response curve was associated with the C(-509)T SNP ( p  = 0.035), but not the other analyzed SNPs. This SNP was also associated with higher TGFβ1 ratios. Conclusions This study suggests that a polymorphism within the promoter of the TGFβ1 gene is associated with increased radiation sensitivity (defined objectively by dose-dependent changes in SPECT lung perfusion).
doi_str_mv 10.1016/j.ijrobp.2011.02.064
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_916521381</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301611004664</els_id><sourcerecordid>916521381</sourcerecordid><originalsourceid>FETCH-LOGICAL-c331t-b470c8364f1e724c9014858cc5b9b592b02db892af8f5fea91b81988c62578bc3</originalsourceid><addsrcrecordid>eNqFks9u1DAQhy0EokvhDRDyjVOCJ3-dC9KqapdKlVrRVnCzYmfSnZDYi52ttA_AC_EgPBPe3cKBCydrrO83o_k0jL0FkYKA6sOQ0uCd3qSZAEhFloqqeMYWIOsmycvy63O2EHklkjzCJ-xVCIMQkayLl-wkg0qUTSEW7MeS37hxNzm_WVOY-Bea12T5vEZ-493kZvTc9Yf6bnXx6yfwFVrkl4EvQ3CG2hm7Q4h_brtYkbP8Fm2gmR5p3vH7QPaBt5Zf6wFN_MQD6Eb3QIaf227jyM6v2Yu-HQO-eXpP2f3F-d3Zp-TqenV5trxKTJ7DnOiiFkbmVdED1llhGgGFLKUxpW502WRaZJ2WTdb2si97bBvQEhopTZWVtdQmP2Xvj3033n3fYpjVRMHgOLYW3TaoBqoyg1xCJIsjabwLwWOvNp6m1u8UCLX3rwZ19K_2_pXIVPQfY--eBmz1hN3f0B_hEfh4BDCu-UjoVTCE1mBHPvpRnaP_Tfi3gRnJkmnHb7jDMLitt1GhAhViQN3ub2B_AgBCFFVs8BuBda62</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>916521381</pqid></control><display><type>article</type><title>A Polymorphism Within the Promoter of the TGFβ1 Gene Is Associated With Radiation Sensitivity Using an Objective Radiologic Endpoint</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Kelsey, Chris R., M.D ; Jackson, Lauren, B.S ; Langdon, Scott, Ph.D ; Owzar, Kouros, Ph.D ; Hubbs, Jessica, M.S ; Vujaskovic, Zeljko, M.D., Ph.D ; Das, Shiva, Ph.D ; Marks, Lawrence B., M.D</creator><creatorcontrib>Kelsey, Chris R., M.D ; Jackson, Lauren, B.S ; Langdon, Scott, Ph.D ; Owzar, Kouros, Ph.D ; Hubbs, Jessica, M.S ; Vujaskovic, Zeljko, M.D., Ph.D ; Das, Shiva, Ph.D ; Marks, Lawrence B., M.D</creatorcontrib><description>Purpose To evaluate whether single nucleotide polymorphisms (SNPs) in the transforming growth factor-β1 ( TGFβ1 ) gene are associated with radiation sensitivity using an objective radiologic endpoint. Methods and Materials Preradiation therapy and serial postradiation therapy single photon emission computed tomography (SPECT) lung perfusion scans were obtained in patients undergoing treatment for lung cancer. Serial blood samples were obtained to measure circulating levels of TGFβ1. Changes in regional perfusion were related to regional radiation dose yielding a patient-specific dose–response curve, reflecting the patient’s inherent sensitivity to radiation therapy. Six TGFβ1 SNPs (-988, -800, -509, 869, 941, and 1655) were assessed using high-resolution melting assays and DNA sequencing. The association between genotype and slope of the dose–response curve, and genotype and TGFβ1 ratio (4-week/preradiation therapy), was analyzed using the Kruskal-Wallis test. Results 39 white patients with preradiation therapy and ≥6-month postradiation therapy SPECT scans and blood samples were identified. Increasing slope of the dose–response curve was associated with the C(-509)T SNP ( p  = 0.035), but not the other analyzed SNPs. This SNP was also associated with higher TGFβ1 ratios. Conclusions This study suggests that a polymorphism within the promoter of the TGFβ1 gene is associated with increased radiation sensitivity (defined objectively by dose-dependent changes in SPECT lung perfusion).</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2011.02.064</identifier><identifier>PMID: 21605940</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Dose-Response Relationship, Radiation ; Female ; Genotype ; Hematology, Oncology and Palliative Medicine ; Humans ; Lung - blood supply ; Lung - diagnostic imaging ; Lung - radiation effects ; Lung Neoplasms - blood ; Lung Neoplasms - blood supply ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - genetics ; Lung Neoplasms - radiotherapy ; Male ; Middle Aged ; Neoplasm Proteins - blood ; Neoplasm Proteins - genetics ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic - genetics ; Radiation Injuries - blood ; Radiation Injuries - genetics ; Radiation Injuries - physiopathology ; Radiation sensitivity ; Radiation Tolerance - genetics ; Radiology ; Radiotherapy Dosage ; Sequence Analysis, DNA - methods ; Single nucleotide polymorphism ; Single photon emission computed tomography ; Statistics, Nonparametric ; Tomography, Emission-Computed, Single-Photon ; Transforming Growth Factor beta1 - blood ; Transforming Growth Factor beta1 - genetics ; Transforming growth factor β1</subject><ispartof>International journal of radiation oncology, biology, physics, 2012-02, Vol.82 (2), p.e247-e255</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c331t-b470c8364f1e724c9014858cc5b9b592b02db892af8f5fea91b81988c62578bc3</citedby><cites>FETCH-LOGICAL-c331t-b470c8364f1e724c9014858cc5b9b592b02db892af8f5fea91b81988c62578bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2011.02.064$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21605940$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kelsey, Chris R., M.D</creatorcontrib><creatorcontrib>Jackson, Lauren, B.S</creatorcontrib><creatorcontrib>Langdon, Scott, Ph.D</creatorcontrib><creatorcontrib>Owzar, Kouros, Ph.D</creatorcontrib><creatorcontrib>Hubbs, Jessica, M.S</creatorcontrib><creatorcontrib>Vujaskovic, Zeljko, M.D., Ph.D</creatorcontrib><creatorcontrib>Das, Shiva, Ph.D</creatorcontrib><creatorcontrib>Marks, Lawrence B., M.D</creatorcontrib><title>A Polymorphism Within the Promoter of the TGFβ1 Gene Is Associated With Radiation Sensitivity Using an Objective Radiologic Endpoint</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To evaluate whether single nucleotide polymorphisms (SNPs) in the transforming growth factor-β1 ( TGFβ1 ) gene are associated with radiation sensitivity using an objective radiologic endpoint. Methods and Materials Preradiation therapy and serial postradiation therapy single photon emission computed tomography (SPECT) lung perfusion scans were obtained in patients undergoing treatment for lung cancer. Serial blood samples were obtained to measure circulating levels of TGFβ1. Changes in regional perfusion were related to regional radiation dose yielding a patient-specific dose–response curve, reflecting the patient’s inherent sensitivity to radiation therapy. Six TGFβ1 SNPs (-988, -800, -509, 869, 941, and 1655) were assessed using high-resolution melting assays and DNA sequencing. The association between genotype and slope of the dose–response curve, and genotype and TGFβ1 ratio (4-week/preradiation therapy), was analyzed using the Kruskal-Wallis test. Results 39 white patients with preradiation therapy and ≥6-month postradiation therapy SPECT scans and blood samples were identified. Increasing slope of the dose–response curve was associated with the C(-509)T SNP ( p  = 0.035), but not the other analyzed SNPs. This SNP was also associated with higher TGFβ1 ratios. Conclusions This study suggests that a polymorphism within the promoter of the TGFβ1 gene is associated with increased radiation sensitivity (defined objectively by dose-dependent changes in SPECT lung perfusion).</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Female</subject><subject>Genotype</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Lung - blood supply</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - radiation effects</subject><subject>Lung Neoplasms - blood</subject><subject>Lung Neoplasms - blood supply</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - genetics</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Proteins - blood</subject><subject>Neoplasm Proteins - genetics</subject><subject>Polymorphism, Single Nucleotide</subject><subject>Promoter Regions, Genetic - genetics</subject><subject>Radiation Injuries - blood</subject><subject>Radiation Injuries - genetics</subject><subject>Radiation Injuries - physiopathology</subject><subject>Radiation sensitivity</subject><subject>Radiation Tolerance - genetics</subject><subject>Radiology</subject><subject>Radiotherapy Dosage</subject><subject>Sequence Analysis, DNA - methods</subject><subject>Single nucleotide polymorphism</subject><subject>Single photon emission computed tomography</subject><subject>Statistics, Nonparametric</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Transforming Growth Factor beta1 - blood</subject><subject>Transforming Growth Factor beta1 - genetics</subject><subject>Transforming growth factor β1</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9u1DAQhy0EokvhDRDyjVOCJ3-dC9KqapdKlVrRVnCzYmfSnZDYi52ttA_AC_EgPBPe3cKBCydrrO83o_k0jL0FkYKA6sOQ0uCd3qSZAEhFloqqeMYWIOsmycvy63O2EHklkjzCJ-xVCIMQkayLl-wkg0qUTSEW7MeS37hxNzm_WVOY-Bea12T5vEZ-493kZvTc9Yf6bnXx6yfwFVrkl4EvQ3CG2hm7Q4h_brtYkbP8Fm2gmR5p3vH7QPaBt5Zf6wFN_MQD6Eb3QIaf227jyM6v2Yu-HQO-eXpP2f3F-d3Zp-TqenV5trxKTJ7DnOiiFkbmVdED1llhGgGFLKUxpW502WRaZJ2WTdb2si97bBvQEhopTZWVtdQmP2Xvj3033n3fYpjVRMHgOLYW3TaoBqoyg1xCJIsjabwLwWOvNp6m1u8UCLX3rwZ19K_2_pXIVPQfY--eBmz1hN3f0B_hEfh4BDCu-UjoVTCE1mBHPvpRnaP_Tfi3gRnJkmnHb7jDMLitt1GhAhViQN3ub2B_AgBCFFVs8BuBda62</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Kelsey, Chris R., M.D</creator><creator>Jackson, Lauren, B.S</creator><creator>Langdon, Scott, Ph.D</creator><creator>Owzar, Kouros, Ph.D</creator><creator>Hubbs, Jessica, M.S</creator><creator>Vujaskovic, Zeljko, M.D., Ph.D</creator><creator>Das, Shiva, Ph.D</creator><creator>Marks, Lawrence B., M.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120201</creationdate><title>A Polymorphism Within the Promoter of the TGFβ1 Gene Is Associated With Radiation Sensitivity Using an Objective Radiologic Endpoint</title><author>Kelsey, Chris R., M.D ; Jackson, Lauren, B.S ; Langdon, Scott, Ph.D ; Owzar, Kouros, Ph.D ; Hubbs, Jessica, M.S ; Vujaskovic, Zeljko, M.D., Ph.D ; Das, Shiva, Ph.D ; Marks, Lawrence B., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c331t-b470c8364f1e724c9014858cc5b9b592b02db892af8f5fea91b81988c62578bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Female</topic><topic>Genotype</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Lung - blood supply</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - radiation effects</topic><topic>Lung Neoplasms - blood</topic><topic>Lung Neoplasms - blood supply</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - genetics</topic><topic>Lung Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Proteins - blood</topic><topic>Neoplasm Proteins - genetics</topic><topic>Polymorphism, Single Nucleotide</topic><topic>Promoter Regions, Genetic - genetics</topic><topic>Radiation Injuries - blood</topic><topic>Radiation Injuries - genetics</topic><topic>Radiation Injuries - physiopathology</topic><topic>Radiation sensitivity</topic><topic>Radiation Tolerance - genetics</topic><topic>Radiology</topic><topic>Radiotherapy Dosage</topic><topic>Sequence Analysis, DNA - methods</topic><topic>Single nucleotide polymorphism</topic><topic>Single photon emission computed tomography</topic><topic>Statistics, Nonparametric</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Transforming Growth Factor beta1 - blood</topic><topic>Transforming Growth Factor beta1 - genetics</topic><topic>Transforming growth factor β1</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kelsey, Chris R., M.D</creatorcontrib><creatorcontrib>Jackson, Lauren, B.S</creatorcontrib><creatorcontrib>Langdon, Scott, Ph.D</creatorcontrib><creatorcontrib>Owzar, Kouros, Ph.D</creatorcontrib><creatorcontrib>Hubbs, Jessica, M.S</creatorcontrib><creatorcontrib>Vujaskovic, Zeljko, M.D., Ph.D</creatorcontrib><creatorcontrib>Das, Shiva, Ph.D</creatorcontrib><creatorcontrib>Marks, Lawrence B., M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kelsey, Chris R., M.D</au><au>Jackson, Lauren, B.S</au><au>Langdon, Scott, Ph.D</au><au>Owzar, Kouros, Ph.D</au><au>Hubbs, Jessica, M.S</au><au>Vujaskovic, Zeljko, M.D., Ph.D</au><au>Das, Shiva, Ph.D</au><au>Marks, Lawrence B., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Polymorphism Within the Promoter of the TGFβ1 Gene Is Associated With Radiation Sensitivity Using an Objective Radiologic Endpoint</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>82</volume><issue>2</issue><spage>e247</spage><epage>e255</epage><pages>e247-e255</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To evaluate whether single nucleotide polymorphisms (SNPs) in the transforming growth factor-β1 ( TGFβ1 ) gene are associated with radiation sensitivity using an objective radiologic endpoint. Methods and Materials Preradiation therapy and serial postradiation therapy single photon emission computed tomography (SPECT) lung perfusion scans were obtained in patients undergoing treatment for lung cancer. Serial blood samples were obtained to measure circulating levels of TGFβ1. Changes in regional perfusion were related to regional radiation dose yielding a patient-specific dose–response curve, reflecting the patient’s inherent sensitivity to radiation therapy. Six TGFβ1 SNPs (-988, -800, -509, 869, 941, and 1655) were assessed using high-resolution melting assays and DNA sequencing. The association between genotype and slope of the dose–response curve, and genotype and TGFβ1 ratio (4-week/preradiation therapy), was analyzed using the Kruskal-Wallis test. Results 39 white patients with preradiation therapy and ≥6-month postradiation therapy SPECT scans and blood samples were identified. Increasing slope of the dose–response curve was associated with the C(-509)T SNP ( p  = 0.035), but not the other analyzed SNPs. This SNP was also associated with higher TGFβ1 ratios. Conclusions This study suggests that a polymorphism within the promoter of the TGFβ1 gene is associated with increased radiation sensitivity (defined objectively by dose-dependent changes in SPECT lung perfusion).</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>21605940</pmid><doi>10.1016/j.ijrobp.2011.02.064</doi></addata></record>
fulltext fulltext
identifier ISSN: 0360-3016
ispartof International journal of radiation oncology, biology, physics, 2012-02, Vol.82 (2), p.e247-e255
issn 0360-3016
1879-355X
language eng
recordid cdi_proquest_miscellaneous_916521381
source MEDLINE; ScienceDirect Journals (5 years ago - present)
subjects Aged
Aged, 80 and over
Dose-Response Relationship, Radiation
Female
Genotype
Hematology, Oncology and Palliative Medicine
Humans
Lung - blood supply
Lung - diagnostic imaging
Lung - radiation effects
Lung Neoplasms - blood
Lung Neoplasms - blood supply
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - genetics
Lung Neoplasms - radiotherapy
Male
Middle Aged
Neoplasm Proteins - blood
Neoplasm Proteins - genetics
Polymorphism, Single Nucleotide
Promoter Regions, Genetic - genetics
Radiation Injuries - blood
Radiation Injuries - genetics
Radiation Injuries - physiopathology
Radiation sensitivity
Radiation Tolerance - genetics
Radiology
Radiotherapy Dosage
Sequence Analysis, DNA - methods
Single nucleotide polymorphism
Single photon emission computed tomography
Statistics, Nonparametric
Tomography, Emission-Computed, Single-Photon
Transforming Growth Factor beta1 - blood
Transforming Growth Factor beta1 - genetics
Transforming growth factor β1
title A Polymorphism Within the Promoter of the TGFβ1 Gene Is Associated With Radiation Sensitivity Using an Objective Radiologic Endpoint
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T07%3A30%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Polymorphism%20Within%20the%20Promoter%20of%20the%20TGF%CE%B21%20Gene%20Is%20Associated%20With%20Radiation%20Sensitivity%20Using%20an%20Objective%20Radiologic%20Endpoint&rft.jtitle=International%20journal%20of%20radiation%20oncology,%20biology,%20physics&rft.au=Kelsey,%20Chris%20R.,%20M.D&rft.date=2012-02-01&rft.volume=82&rft.issue=2&rft.spage=e247&rft.epage=e255&rft.pages=e247-e255&rft.issn=0360-3016&rft.eissn=1879-355X&rft_id=info:doi/10.1016/j.ijrobp.2011.02.064&rft_dat=%3Cproquest_cross%3E916521381%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=916521381&rft_id=info:pmid/21605940&rft_els_id=S0360301611004664&rfr_iscdi=true