Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN113030-20190618-00008
Cheng Wang, Zongwen Liu, Ge Hou, Jun Yang, Yang-yang Huang
Objective To evaluate the effect of long-chain non-coding RNA (LncRNA) UCA1 on the proliferation, apoptosis and radiosensitivity of lung cancer cell and to explore the underlying mechanism. Methods qRT-PCR was used to detect the expression of UCA1 and miR-513a-5p in lung cancer cell A549, H1299 and normal human lung cell HBE. The si-con group (transfected si-con), si-UCA1 group (transfected si-UCA1), miR-513a-5p group (transfected miR-513a-5p mimics), miR-NC group (transfected miR-NC), IR+ si-con group (transfected si-con, and irradiated), IR+ si-UCA1 group (transfected miR-NC and irradiated), IR+ miR-513a-5p group (transfected miR-513a-5p mimics and irradiated), IR+ miR-NC group (transfected miR-NC and irradiated), IR+ si-UCA1+ anti-miR-513a-5p group (co-transfected si-UCA1, anti-miR-513a-5p and irradiated) were transfected into the A549 and H1299 cells by liposome method, and then the cells in certain groups were subject to 4Gy irradiation. The cell proliferation of each group was detected by MTT assay. The sensitivity enhancement ratio was assessed by clone formation assay. The cell apoptosis of each group was detected by flow cytometry. The fluorescence activity of each group was detected by dual-fluorescein gene detection assay. Results Compared with human normal lung cell HBE, the expression levels of UCA1 were significantly up-regulated in the lung cancer cell A549 and H1299(both P<0.05), whereas those of miR-513a-5p were significantly down-regulated (both P<0.05). Inhibition of UCA1 and overexpression of miR-513a-5p significantly inhibited cell proliferation, promoted cell apoptosis and increased the sensitivity of radiation exposure of A549 and H1299(sensitivity enhancement ratio=1.897, 2.146 and 1.615, 1.872). miR-513a-5p could suppress the fluorescence activity of wild-type UCA1 cells, and UCA1 could negatively regulate the expression of miR-513a-5p. Inhibition of miR-513a-5p could reverse the enhancement effect of inhibiting UCA1 upon the radiosensitivity of lung cancer cells. Conclusions Inhibition of LncRNA UCA1 can enhance the sensitivity of radiation exposure to lung cancer cells. The mechanism may be related to the targeted inhibition of miR-513a-5p. Key words: UCA1 gene; miR-513a-5p gene; Radiosensitivity; Lung cancer cell line
{"title":"Effect of LncRNA UCA1 on radiosensitivity of lung cancer cells and its mechanism","authors":"Cheng Wang, Zongwen Liu, Ge Hou, Jun Yang, Yang-yang Huang","doi":"10.3760/CMA.J.CN113030-20190618-00008","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113030-20190618-00008","url":null,"abstract":"Objective \u0000To evaluate the effect of long-chain non-coding RNA (LncRNA) UCA1 on the proliferation, apoptosis and radiosensitivity of lung cancer cell and to explore the underlying mechanism. \u0000 \u0000 \u0000Methods \u0000qRT-PCR was used to detect the expression of UCA1 and miR-513a-5p in lung cancer cell A549, H1299 and normal human lung cell HBE. The si-con group (transfected si-con), si-UCA1 group (transfected si-UCA1), miR-513a-5p group (transfected miR-513a-5p mimics), miR-NC group (transfected miR-NC), IR+ si-con group (transfected si-con, and irradiated), IR+ si-UCA1 group (transfected miR-NC and irradiated), IR+ miR-513a-5p group (transfected miR-513a-5p mimics and irradiated), IR+ miR-NC group (transfected miR-NC and irradiated), IR+ si-UCA1+ anti-miR-513a-5p group (co-transfected si-UCA1, anti-miR-513a-5p and irradiated) were transfected into the A549 and H1299 cells by liposome method, and then the cells in certain groups were subject to 4Gy irradiation. The cell proliferation of each group was detected by MTT assay. The sensitivity enhancement ratio was assessed by clone formation assay. The cell apoptosis of each group was detected by flow cytometry. The fluorescence activity of each group was detected by dual-fluorescein gene detection assay. \u0000 \u0000 \u0000Results \u0000Compared with human normal lung cell HBE, the expression levels of UCA1 were significantly up-regulated in the lung cancer cell A549 and H1299(both P<0.05), whereas those of miR-513a-5p were significantly down-regulated (both P<0.05). Inhibition of UCA1 and overexpression of miR-513a-5p significantly inhibited cell proliferation, promoted cell apoptosis and increased the sensitivity of radiation exposure of A549 and H1299(sensitivity enhancement ratio=1.897, 2.146 and 1.615, 1.872). miR-513a-5p could suppress the fluorescence activity of wild-type UCA1 cells, and UCA1 could negatively regulate the expression of miR-513a-5p. Inhibition of miR-513a-5p could reverse the enhancement effect of inhibiting UCA1 upon the radiosensitivity of lung cancer cells. \u0000 \u0000 \u0000Conclusions \u0000Inhibition of LncRNA UCA1 can enhance the sensitivity of radiation exposure to lung cancer cells. The mechanism may be related to the targeted inhibition of miR-513a-5p. \u0000 \u0000 \u0000Key words: \u0000UCA1 gene; miR-513a-5p gene; Radiosensitivity; Lung cancer cell line","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"289-293"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48638155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN113030-20181125-00014
Hongfei Sun, Xinye Ni, Jianhua Yang
Image-guided techniques are critical to improving the accuracy of radiotherapy for tumors. Ultrasound images have been gradually applied in the set-up verification of clinical radiotherapy and adaptive radiotherapy because of the real-time, reproducible and non-radiative characteristics. In this paper, the application of ultrasound image-guided technology in radiotherapy was classified and analyzed, and the latest research progress was introduced. Key words: Neoplasm/ultrasound-guided radiotherapy; Research status
{"title":"Research status of ultrasound-guided radiotherapy for tumors","authors":"Hongfei Sun, Xinye Ni, Jianhua Yang","doi":"10.3760/CMA.J.CN113030-20181125-00014","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113030-20181125-00014","url":null,"abstract":"Image-guided techniques are critical to improving the accuracy of radiotherapy for tumors. Ultrasound images have been gradually applied in the set-up verification of clinical radiotherapy and adaptive radiotherapy because of the real-time, reproducible and non-radiative characteristics. In this paper, the application of ultrasound image-guided technology in radiotherapy was classified and analyzed, and the latest research progress was introduced. \u0000 \u0000Key words: \u0000Neoplasm/ultrasound-guided radiotherapy; Research status","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"317-320"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44616725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN113030-20190614-00012
Q. Zeng, Y. Zhai, Xiao-dan Wang, Q. Feng
Surgical resection is the most important treatment of thymoma. However, the role of postoperative adjuvant radiotherapy (PORT) has been controversial. The survival benefits of two-dimensional radiotherapy are not significant. However, precision radiotherapy has significantly changed tumor radiotherapy. The value of PORT for thymoma may also be altered. At present, the effect of radiotherapy in patients with positive surgical margins or inoperable resection is confirmed. For patients with complete surgical resection, Masaoka-Koga stage Ⅰ patients do not require PORT. Whether PORT should be given for stage Ⅱ patients remains debated if stage Ⅱb, large volume and B2/B3 type were considered during radiotherapy. The role of PORT for stage Ⅲ patients is also in disputed, whereas a majority of findings support the application of PORT. Precision technology is recommended during PORT. The clinical target volume suggests that the three-dimensional expansion of the tumor bed is 0.5 cm, including the mediastinal pleura involved by the tumor and 0.5-1.0 cm along the anterior and posterior direction of the mediastinal pleura, the cranial and caudal direction, the lung side is expanded within the 0.5 cm, and the vascular wall around the tumor and part of the vascular space, so as to avoid including too much normal tissue. The dose for complete resection is 45-50 Gy and 54-60 Gy or slightly higher for incomplete resection, which may increase the benefits and reduce the risk of PORT.The application of new radiotherapy techniques such as particle therapy can gain the advantage of dosimetric distribution, and whether it can be transformed into clinical benefits needs to be further explored. Key words: Thymoma/radiotherapy; Radiotherapy, postoperative; Progress
{"title":"Current situation and research progress on postoperative adjuvant radiotherapy for thymoma","authors":"Q. Zeng, Y. Zhai, Xiao-dan Wang, Q. Feng","doi":"10.3760/CMA.J.CN113030-20190614-00012","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113030-20190614-00012","url":null,"abstract":"Surgical resection is the most important treatment of thymoma. However, the role of postoperative adjuvant radiotherapy (PORT) has been controversial. The survival benefits of two-dimensional radiotherapy are not significant. However, precision radiotherapy has significantly changed tumor radiotherapy. The value of PORT for thymoma may also be altered. At present, the effect of radiotherapy in patients with positive surgical margins or inoperable resection is confirmed. For patients with complete surgical resection, Masaoka-Koga stage Ⅰ patients do not require PORT. Whether PORT should be given for stage Ⅱ patients remains debated if stage Ⅱb, large volume and B2/B3 type were considered during radiotherapy. The role of PORT for stage Ⅲ patients is also in disputed, whereas a majority of findings support the application of PORT. Precision technology is recommended during PORT. The clinical target volume suggests that the three-dimensional expansion of the tumor bed is 0.5 cm, including the mediastinal pleura involved by the tumor and 0.5-1.0 cm along the anterior and posterior direction of the mediastinal pleura, the cranial and caudal direction, the lung side is expanded within the 0.5 cm, and the vascular wall around the tumor and part of the vascular space, so as to avoid including too much normal tissue. The dose for complete resection is 45-50 Gy and 54-60 Gy or slightly higher for incomplete resection, which may increase the benefits and reduce the risk of PORT.The application of new radiotherapy techniques such as particle therapy can gain the advantage of dosimetric distribution, and whether it can be transformed into clinical benefits needs to be further explored. \u0000 \u0000Key words: \u0000Thymoma/radiotherapy; Radiotherapy, postoperative; Progress","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"308-312"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41522835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.009
Xinyuan Chen, K. Men, Yu Tang, Shulian Wang, J. Dai
Objective In this study, the deep learning algorithm and the commercial planning system were integrated to establish and validate an automatic segmentation platform for clinical target volume (CTV) and organs at risk (OARs) in breast cancer patients. Methods A total of 400 patients with left and right breast cancer receiving radiotherapy after breast-conserving surgery in Cancer Hospital CAMS were enrolled in this study. A deep residual convolutional neural network was used to train CTV and OARs segmentation models. An end-to-end deep learning-based automatic segmentation platform (DLAS) was established. The accuracy of the DLAS platform delineation was verified using 42 left breast cancer and 40 right breast cancer patients. The overall Dice Similarity Coefficient (DSC) and the average Hausdorff Distance (AHD) were calculated. The relationship between the relative layer position and the DSC value of each layer (DSC_s) was calculated and analyzed layer-by-layer. Results The mean overall DSC and AHD of global CTV in left/right breast cancer patients were 0.87/0.88 and 9.38/8.71 mm. The average overall DSC and AHD range for all OARs in left/right breast cancer patients were ranged from 0.86 to 0.97 and 0.89 to 9.38 mm. The layer-by-layer analysis of CTV and OARs reached 0.90 or above, indicating that the doctors were only required to make slight or no modification, and the DSC_s ≥ 0.9 of CTV automatic delineation accounted for approximately 44.7% of the layers. The automatic delineation range for OARs was 50.9%-89.6%. For DSC_s< 0.7, the DSC_s values of CTV and the regions of interest other than the spinal cord were significantly decreased in the boundary regions on both sides (layer positions 0-0.2, and 0.8-1.0), and the level of decrease toward the edge was more pronounced. The spinal cord was delineated in a full-scale manner, and no significant decrease in DSC_s was observed in a particular area. Conclusions The end-to-end automatic segmentation platform based on deep learning can integrate the breast cancer segmentation model and achieve excellent automatic segmentation effect. In the boundary areas on both sides of the superior and inferior directions, the consistency of the delineation decreases more obviously, which needs to be further improved. Key words: Automatic segmentation; Deep learning; Breast neoplasm/radiotherapy
{"title":"Clinical application and evaluation of automatic segmentation model based on deep learning for breast cancer radiotherapy","authors":"Xinyuan Chen, K. Men, Yu Tang, Shulian Wang, J. Dai","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.009","url":null,"abstract":"Objective \u0000In this study, the deep learning algorithm and the commercial planning system were integrated to establish and validate an automatic segmentation platform for clinical target volume (CTV) and organs at risk (OARs) in breast cancer patients. \u0000 \u0000 \u0000Methods \u0000A total of 400 patients with left and right breast cancer receiving radiotherapy after breast-conserving surgery in Cancer Hospital CAMS were enrolled in this study. A deep residual convolutional neural network was used to train CTV and OARs segmentation models. An end-to-end deep learning-based automatic segmentation platform (DLAS) was established. The accuracy of the DLAS platform delineation was verified using 42 left breast cancer and 40 right breast cancer patients. The overall Dice Similarity Coefficient (DSC) and the average Hausdorff Distance (AHD) were calculated. The relationship between the relative layer position and the DSC value of each layer (DSC_s) was calculated and analyzed layer-by-layer. \u0000 \u0000 \u0000Results \u0000The mean overall DSC and AHD of global CTV in left/right breast cancer patients were 0.87/0.88 and 9.38/8.71 mm. The average overall DSC and AHD range for all OARs in left/right breast cancer patients were ranged from 0.86 to 0.97 and 0.89 to 9.38 mm. The layer-by-layer analysis of CTV and OARs reached 0.90 or above, indicating that the doctors were only required to make slight or no modification, and the DSC_s ≥ 0.9 of CTV automatic delineation accounted for approximately 44.7% of the layers. The automatic delineation range for OARs was 50.9%-89.6%. For DSC_s< 0.7, the DSC_s values of CTV and the regions of interest other than the spinal cord were significantly decreased in the boundary regions on both sides (layer positions 0-0.2, and 0.8-1.0), and the level of decrease toward the edge was more pronounced. The spinal cord was delineated in a full-scale manner, and no significant decrease in DSC_s was observed in a particular area. \u0000 \u0000 \u0000Conclusions \u0000The end-to-end automatic segmentation platform based on deep learning can integrate the breast cancer segmentation model and achieve excellent automatic segmentation effect. In the boundary areas on both sides of the superior and inferior directions, the consistency of the delineation decreases more obviously, which needs to be further improved. \u0000 \u0000 \u0000Key words: \u0000Automatic segmentation; Deep learning; Breast neoplasm/radiotherapy","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42848054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.001
Jiyi Hu, Jing Gao, Weixu Hu, Jing Yang, X. Guan, Xianxin Qiu, L. Kong, J. Lu
Objective To evaluate the short-term efficacy and toxicities of intensity-modulated carbon ion radiotherapy (IMCT) for patients with locoregionally recurrent nasopharyngeal carcinoma after intensity-modulated radiotherapy (IMRT). Methods A total of 112 patients with locoregionally recurrent nasopharyngeal carcinoma undergoing salvaging IMCT between May 2015 and February 2018were enrolled in the study. All patients previously received one course of definitive X-ray IMRT. Among them, 10 patients (9%) were diagnosed with stage Ⅰ, 26 patients (23%) with stage Ⅱ, 41 patients (37%) with stage Ⅲ and 35 patients (31%) with stage Ⅳnasopharyngeal carcinoma, respectively. The median age of the cohort was 48 years (range, 17-70 years) old. The median dose to the gross tumor volume (GTV) was 60 GyE (range, 50-69 GyE). Results With a median follow-up time of 20 months (range, 5-45 months), 20 patients died and 42 patients developed local recurrence. The 2-year overall survival (OS) and local progression-free survival (LPFS) rates were 85% and 52%. Both univariate and multivariate analyses demonstrated that stage Ⅳ disease was associated with significantly worse OS. No predictors were found for LPFS. No acute toxicity of grade 3 or higher was observed during reirradiation. Severe (grade 3 or above) late toxicities included xerostomia (n=1), hearing impairment (n=2), temporal lobe injury (n=1) and mucosal necrosis (n=19). Conclusions IMCT is an efficacious and safe treatment for patients with locoregionally recurrent nasopharyngeal carcinoma with acceptable toxicity profile. Long-term follow-up is necessary to further evaluate the long-term efficacy and late toxicities. Key words: Nasopharyngeal neoplasm/intensity-modulated carbon ion radiotherapy; Second-course radiotherapy; Treatment outcome
{"title":"Preliminary study of intensity-modulated carbon ion reirradiation for locoregionally recurrent nasopharyngeal carcinoma after definitive IMRT——Clinical experience from Shanghai Proton Heavy Ion Hospital","authors":"Jiyi Hu, Jing Gao, Weixu Hu, Jing Yang, X. Guan, Xianxin Qiu, L. Kong, J. Lu","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.001","url":null,"abstract":"Objective \u0000To evaluate the short-term efficacy and toxicities of intensity-modulated carbon ion radiotherapy (IMCT) for patients with locoregionally recurrent nasopharyngeal carcinoma after intensity-modulated radiotherapy (IMRT). \u0000 \u0000 \u0000Methods \u0000A total of 112 patients with locoregionally recurrent nasopharyngeal carcinoma undergoing salvaging IMCT between May 2015 and February 2018were enrolled in the study. All patients previously received one course of definitive X-ray IMRT. Among them, 10 patients (9%) were diagnosed with stage Ⅰ, 26 patients (23%) with stage Ⅱ, 41 patients (37%) with stage Ⅲ and 35 patients (31%) with stage Ⅳnasopharyngeal carcinoma, respectively. The median age of the cohort was 48 years (range, 17-70 years) old. The median dose to the gross tumor volume (GTV) was 60 GyE (range, 50-69 GyE). \u0000 \u0000 \u0000Results \u0000With a median follow-up time of 20 months (range, 5-45 months), 20 patients died and 42 patients developed local recurrence. The 2-year overall survival (OS) and local progression-free survival (LPFS) rates were 85% and 52%. Both univariate and multivariate analyses demonstrated that stage Ⅳ disease was associated with significantly worse OS. No predictors were found for LPFS. No acute toxicity of grade 3 or higher was observed during reirradiation. Severe (grade 3 or above) late toxicities included xerostomia (n=1), hearing impairment (n=2), temporal lobe injury (n=1) and mucosal necrosis (n=19). \u0000 \u0000 \u0000Conclusions \u0000IMCT is an efficacious and safe treatment for patients with locoregionally recurrent nasopharyngeal carcinoma with acceptable toxicity profile. Long-term follow-up is necessary to further evaluate the long-term efficacy and late toxicities. \u0000 \u0000 \u0000Key words: \u0000Nasopharyngeal neoplasm/intensity-modulated carbon ion radiotherapy; Second-course radiotherapy; Treatment outcome","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"161-165"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44573858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.004
W. Yan, Xuan Liu, Zongmei Zhou, Yuxia Wang, Z. Xiao, Q. Feng, Dong-fu Chen, L. Ji-ma, Jun Liang, L. Deng, Tao Zhang, Wenqing Wang, N. Bi, Xin Wang, Xiaozhen Wang, Z. Hui, Luhua Wang
Objective To investigate localized regional recurrence after chemotherapy and chest radiotherapy in limited stage small cell lung cancer (LS-SCLC), and explore the relationship between recurrence location and radiotherapy and chemotherapy and its influencing factors. Methods From 2006 to 2014, pathological LS-SCLC treated in CAMS, 125 patients had local recurrence, Kaplan-Meier statistical method was used to analyze the survival rate and PFS of each recurrence site. Log-rank was used to compare the survival rate of each group. Univariate analysis includes Chi-squareand t-test for the factors for the recurrence site. Multivariate analysis using Logistic regression. Results The 1-, 2-and 5-year overall survival rates were 92.0%, 46.4% and 14.7%, respectively. The median progression time was 12.96 months, The median survival time after progression was 11.5 months, and the 1-, 2-, and 5-year overall survival rates were 45.0%, 23.0%, and 10.0%, respectively. The recurrence sites include intrapulmonary recurrence (67 patients), regional lymph nodes (21 patients), simultaneous intrapulmonary and regional lymph nodes (28 patients), and contralateral or supraclavicular lymph nodes (9 patients). The median survival time were 23.96 months, 24.76 months, 23.23 months, and 18.66 months, and the 2-year survival rates were 49%, 52%, 46%, and11%, respectively (P=0.000, 0.004, 0.008). In 6 patients (4.0%), 5 patients were located in the supraclavicular region, and 1 patient (0.8%) in the field. Conclusions For LS-SCLC undergoing IMRT and chemotherapy, the local failure location is mainly located in the pulmonary, and further treatment of the split dose and targets requires further clinical exploration. Key words: Lung neoplasms/radiochemoradiation; Radiotherapy, intensity-modulated; Patterns of failure
{"title":"Analysis of local recurrence pattern for limited stage small cell lung cancer after IMRT plus chemotherapy","authors":"W. Yan, Xuan Liu, Zongmei Zhou, Yuxia Wang, Z. Xiao, Q. Feng, Dong-fu Chen, L. Ji-ma, Jun Liang, L. Deng, Tao Zhang, Wenqing Wang, N. Bi, Xin Wang, Xiaozhen Wang, Z. Hui, Luhua Wang","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.004","url":null,"abstract":"Objective \u0000To investigate localized regional recurrence after chemotherapy and chest radiotherapy in limited stage small cell lung cancer (LS-SCLC), and explore the relationship between recurrence location and radiotherapy and chemotherapy and its influencing factors. \u0000 \u0000 \u0000Methods \u0000From 2006 to 2014, pathological LS-SCLC treated in CAMS, 125 patients had local recurrence, Kaplan-Meier statistical method was used to analyze the survival rate and PFS of each recurrence site. Log-rank was used to compare the survival rate of each group. Univariate analysis includes Chi-squareand t-test for the factors for the recurrence site. Multivariate analysis using Logistic regression. \u0000 \u0000 \u0000Results \u0000The 1-, 2-and 5-year overall survival rates were 92.0%, 46.4% and 14.7%, respectively. The median progression time was 12.96 months, The median survival time after progression was 11.5 months, and the 1-, 2-, and 5-year overall survival rates were 45.0%, 23.0%, and 10.0%, respectively. The recurrence sites include intrapulmonary recurrence (67 patients), regional lymph nodes (21 patients), simultaneous intrapulmonary and regional lymph nodes (28 patients), and contralateral or supraclavicular lymph nodes (9 patients). The median survival time were 23.96 months, 24.76 months, 23.23 months, and 18.66 months, and the 2-year survival rates were 49%, 52%, 46%, and11%, respectively (P=0.000, 0.004, 0.008). In 6 patients (4.0%), 5 patients were located in the supraclavicular region, and 1 patient (0.8%) in the field. \u0000 \u0000 \u0000Conclusions \u0000For LS-SCLC undergoing IMRT and chemotherapy, the local failure location is mainly located in the pulmonary, and further treatment of the split dose and targets requires further clinical exploration. \u0000 \u0000 \u0000Key words: \u0000Lung neoplasms/radiochemoradiation; Radiotherapy, intensity-modulated; Patterns of failure","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"175-178"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46687746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.008
Zhenguo Cui, Jiayi Chen, W. Yun, Qi Liu, Yanling Bai
ObjectiveTo evaluate the impact of an external magnetic field on the dose distribution and electronic disequilibrium region around a Bebig type 60Co HDR brachytherapy source and to judge the feasibility of applying MRI scanner during brachytherapy.MethodsThe source model was established based on the Monte Carlo package Geant4 software. The simulated geometries consisted of the 60Co source inside a water phantom of 10.0cm×10.0cm×10.0cm in size. The magnetic field strength of the 0T, 1.5T and 3.0T was considered, respectively. The voxels with a size of 0.2 mm, 0.5 mm and 0.5 mm were established along the x-, y-and z-axis. The influence of the magnetic field on the Kerma (kinetic energy released to matter) distribution and dose distribution within the 10.0mm region from the source center was evaluated. Furthermore, the ratio of the Kerma to dose as a function of the distance to the center source was acquired.ResultsThe 1.5T magnetic field exerted no effect on the dose distribution adjacent to 60Co HDR brachytherapy source, whereas3.0T magnetic field caused significant increase in the dose distribution within r<6 mm from the source center. The dose distribution was increased by 40% at r=5.4 mm from the source center. The ratio of Kerma to dose was less than 1 within the region of 1.2 mm
目的评价外磁场对贝比格型60Co HDR近距离放射治疗源周围剂量分布和电子不平衡区的影响，判断近距离放射治疗中应用MRI扫描仪的可行性。方法基于蒙特卡罗软件包Geant4软件建立源模型。模拟的几何形状包括60Co源在10.0cm×10.0cm×10.0cm大小的水影内。分别考虑0T、1.5T和3.0T的磁场强度。沿x、y、z轴分别建立尺寸为0.2 mm、0.5 mm和0.5 mm的体素。评价了磁场对源中心10.0mm范围内物质释放动能(Kerma)分布和剂量分布的影响。此外，还获得了Kerma与剂量的比值作为到中心源距离的函数。结果1.5T磁场对60Co HDR近距离放疗源附近的剂量分布没有影响，而3.0 t磁场对距离源中心r<6 mm范围内的剂量分布有显著增加。在距源中心r=5.4 mm处，剂量分布增加了40%。在1.2 mm
{"title":"The impact of a magnetic field on the dose distribution using the Bebig60Co HDR sources","authors":"Zhenguo Cui, Jiayi Chen, W. Yun, Qi Liu, Yanling Bai","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.008","url":null,"abstract":"ObjectiveTo evaluate the impact of an external magnetic field on the dose distribution and electronic disequilibrium region around a Bebig type 60Co HDR brachytherapy source and to judge the feasibility of applying MRI scanner during brachytherapy.MethodsThe source model was established based on the Monte Carlo package Geant4 software. The simulated geometries consisted of the 60Co source inside a water phantom of 10.0cm×10.0cm×10.0cm in size. The magnetic field strength of the 0T, 1.5T and 3.0T was considered, respectively. The voxels with a size of 0.2 mm, 0.5 mm and 0.5 mm were established along the x-, y-and z-axis. The influence of the magnetic field on the Kerma (kinetic energy released to matter) distribution and dose distribution within the 10.0mm region from the source center was evaluated. Furthermore, the ratio of the Kerma to dose as a function of the distance to the center source was acquired.ResultsThe 1.5T magnetic field exerted no effect on the dose distribution adjacent to 60Co HDR brachytherapy source, whereas3.0T magnetic field caused significant increase in the dose distribution within r<6 mm from the source center. The dose distribution was increased by 40% at r=5.4 mm from the source center. The ratio of Kerma to dose was less than 1 within the region of 1.2 mm<r<6.0 mm, suggesting that 3.0T magnetic field can lead to electronic disequilibrium within a larger region from the source center.ConclusionsFor Bebig 60Co HDR brachytherapy source, it is safe and reliable to apply1.5T external magnetic field. Nevertheless, 3.0T magnetic field can cause high dose risk. Consequently, safety assessment and verification should be delivered prior to clinical application.Key words: Magnetic field; Brachytherapy; Dose; Kerma","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"193-196"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43264875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.006
D. Chang, Ping Li, Jing Li, Yong Wang, J. Cui, Yingjie Wang, T. Xia
Objective To preliminarily evaluate the efficacy and safety of intensity-modulated radiotherapy (IMRT) in the treatment of inoperable stage ⅣA thymoma. Methods A retrospective analysis of 15 patients with inoperable stage ⅣA thymoma receiving IMRT from January 2010 to December 2017 was performed. Among them, 9 patients were male and 6 female, aged 31-83 years with a medianof 59 years. The dose of radiotherapy was 50Gy/60Gy/70Gy/15-20 fractions for PTV/CTV/GTV. The short-term efficacy, overall survival rate and adverse reactions were analyzed. Results The follow-up rate was 100%. The median follow-up time was 48 months. The short-term partial remission rate was 93%(14/15). The 1-, 3-and 5-year overall survival rates were 100%, 75% and 75%, respectively. One patient presented with grade 3 hematological reaction. Four patients died of tumors. Conclusion Preliminary findings demonstrate that IMRT is an efficacious and safe treatment of stageⅣA thymoma, which can be applied for patients with unresectable thymoma. Key words: Thymoma/intensity-modulated radiotherapy; Treatment outcome; Safety
{"title":"Preliminary analysis of efficacy and safety of intensity-modulated radiotherapy for stage IVA thymoma","authors":"D. Chang, Ping Li, Jing Li, Yong Wang, J. Cui, Yingjie Wang, T. Xia","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.006","url":null,"abstract":"Objective \u0000To preliminarily evaluate the efficacy and safety of intensity-modulated radiotherapy (IMRT) in the treatment of inoperable stage ⅣA thymoma. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis of 15 patients with inoperable stage ⅣA thymoma receiving IMRT from January 2010 to December 2017 was performed. Among them, 9 patients were male and 6 female, aged 31-83 years with a medianof 59 years. The dose of radiotherapy was 50Gy/60Gy/70Gy/15-20 fractions for PTV/CTV/GTV. The short-term efficacy, overall survival rate and adverse reactions were analyzed. \u0000 \u0000 \u0000Results \u0000The follow-up rate was 100%. The median follow-up time was 48 months. The short-term partial remission rate was 93%(14/15). The 1-, 3-and 5-year overall survival rates were 100%, 75% and 75%, respectively. One patient presented with grade 3 hematological reaction. Four patients died of tumors. \u0000 \u0000 \u0000Conclusion \u0000Preliminary findings demonstrate that IMRT is an efficacious and safe treatment of stageⅣA thymoma, which can be applied for patients with unresectable thymoma. \u0000 \u0000 \u0000Key words: \u0000Thymoma/intensity-modulated radiotherapy; Treatment outcome; Safety","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"184-186"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48420988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the inhibitory effect and mechanism of Metformin (Met) combined with irradiation in CT26WT cell lines or mouse models with transplanted tumors. Methods CT26WT cell line was treated with 0.5μmol/L, 1.0μmol/L, 5.0μmol/L and 10.0μmol/L Met, and CellTiter Glo kit was used to detect the inhibitory effect of Met at different concentrations on the viability of CT26WT cells. CT26WT cell line was treated with the control, Met (10μmol/L), 15Gy irradiation and 15Gy irradiation+ Met (10μmol/L). Clone formation assay was employed to detect the cell proliferation activity. Bablc mouse models of transplanted tumors (tumor size>150 mm3) were established and randomly divided into the control, 15Gy irradiation, Met and 15Gy irradiation+ Met groups. Mice were given with 750 mg/kg Met at 24 h before irradiation. Transplanted tumor volume was measured regularly to delineate the growth curve of transplanted tumors and survival curve. The expression levels of P-H2AX and Sting proteins in CT26WT cells and transplanted tumors were detected by Western blot. The infiltration of CD8a (+ ) T cells in transplanted tumor tissues was detected by immunohistochemistry. Results The relative cell survival rate was 100%, 87.9%, 87.8%, 87.3% and 76.5% in the 0, 0.5, 1.0, 5.0 and 10.0μmol/L Met groups, respectively (all P<0.05). The inhibitory effect of 10.0μmol/L was significantly stronger than that of 5.0μmol/L (P<0.001). The colone formation rate 34.0%, 24.0%, 22.3% and 14.0% in the control, Met, 15Gy irradiation, Met+ 15Gy irradiation groups, respectively (all P<0.001). Western blot showed that compared with the control group, the expression of Sting protein was increased by 2.99-fold after Met treatment (P<0.001), and increased by 1.37-fold and 4.41-fold in the 15Gy irradiation and 15Gy irradiation+ Met groups (both P<0.01). Compared with the 15Gy irradiation group, the expression of P-H2AX protein was significantly increased by 1.43 times after treatment with 15Gy+ Met (P<0.001). The transplanted tumor growth curve showed that the transplanted tumor growth in the 15Gy+ Met group was slower than that in the control group[(1007.0±388.5) mm3vs. (2639.0±242.9) mm3, P<0.05)]. The overall survival time in the 15Gy irradiation+ Met group was 48 d, significantly longer than 32 d in the control group (P<0.001). Compared with the control group, the expression of P-H2AX and Sting proteins in the 15Gy+ Met group was increased by 8.8-fold and 1.6-fold (both P<0.001). Immunohistochemical staining showed that the infiltration of CD8a (+ ) T cells in the 15Gy irradiation+ Met group was significantly higher than that in the control group (P<0.01). Conclusions Met combined with radiotherapy can inhibit the proliferation and clone formation of colon cancer cells, probably by aggravating DNA damage and activating the Sting signaling pathway, eventually leading to the increase of CD8a (+ ) T cells in tumor tissues and enhancing the killing effect upon tran
{"title":"Study of the mechanism of anti-tumor effect of Metformin-enhanced radiotherapy in CT26WT cell lines or mouse models with transplanted tumors","authors":"X. Dai, Leilei Tao, Tingting Fang, Ping Chen, Haijun Sun, Zhifeng Wu, Xichun Dai","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.010","url":null,"abstract":"Objective \u0000To investigate the inhibitory effect and mechanism of Metformin (Met) combined with irradiation in CT26WT cell lines or mouse models with transplanted tumors. \u0000 \u0000 \u0000Methods \u0000CT26WT cell line was treated with 0.5μmol/L, 1.0μmol/L, 5.0μmol/L and 10.0μmol/L Met, and CellTiter Glo kit was used to detect the inhibitory effect of Met at different concentrations on the viability of CT26WT cells. CT26WT cell line was treated with the control, Met (10μmol/L), 15Gy irradiation and 15Gy irradiation+ Met (10μmol/L). Clone formation assay was employed to detect the cell proliferation activity. Bablc mouse models of transplanted tumors (tumor size>150 mm3) were established and randomly divided into the control, 15Gy irradiation, Met and 15Gy irradiation+ Met groups. Mice were given with 750 mg/kg Met at 24 h before irradiation. Transplanted tumor volume was measured regularly to delineate the growth curve of transplanted tumors and survival curve. The expression levels of P-H2AX and Sting proteins in CT26WT cells and transplanted tumors were detected by Western blot. The infiltration of CD8a (+ ) T cells in transplanted tumor tissues was detected by immunohistochemistry. \u0000 \u0000 \u0000Results \u0000The relative cell survival rate was 100%, 87.9%, 87.8%, 87.3% and 76.5% in the 0, 0.5, 1.0, 5.0 and 10.0μmol/L Met groups, respectively (all P<0.05). The inhibitory effect of 10.0μmol/L was significantly stronger than that of 5.0μmol/L (P<0.001). The colone formation rate 34.0%, 24.0%, 22.3% and 14.0% in the control, Met, 15Gy irradiation, Met+ 15Gy irradiation groups, respectively (all P<0.001). Western blot showed that compared with the control group, the expression of Sting protein was increased by 2.99-fold after Met treatment (P<0.001), and increased by 1.37-fold and 4.41-fold in the 15Gy irradiation and 15Gy irradiation+ Met groups (both P<0.01). Compared with the 15Gy irradiation group, the expression of P-H2AX protein was significantly increased by 1.43 times after treatment with 15Gy+ Met (P<0.001). The transplanted tumor growth curve showed that the transplanted tumor growth in the 15Gy+ Met group was slower than that in the control group[(1007.0±388.5) mm3vs. (2639.0±242.9) mm3, P<0.05)]. The overall survival time in the 15Gy irradiation+ Met group was 48 d, significantly longer than 32 d in the control group (P<0.001). Compared with the control group, the expression of P-H2AX and Sting proteins in the 15Gy+ Met group was increased by 8.8-fold and 1.6-fold (both P<0.001). Immunohistochemical staining showed that the infiltration of CD8a (+ ) T cells in the 15Gy irradiation+ Met group was significantly higher than that in the control group (P<0.01). \u0000 \u0000 \u0000Conclusions \u0000Met combined with radiotherapy can inhibit the proliferation and clone formation of colon cancer cells, probably by aggravating DNA damage and activating the Sting signaling pathway, eventually leading to the increase of CD8a (+ ) T cells in tumor tissues and enhancing the killing effect upon tran","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"203-206"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48143154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.007
Weixin Liu, Shulian Wang, Yu Tang, H. Jing, Jianyang Wang, Jiang-hu Zhang, J. Jin, Yong-wen Song, Weihu Wang, Yueping Liu, H. Fang, H. Ren, S. Qi, N. Lu, Yuan Tang, Ning Li, Yexiong Li
Objective To analyze the differences in the treatment patterns, clinical characteristics, treatment outcomes and prognostic factors between breast cancer patients with ductal carcinoma in situ (DCIS) and ductal carcinoma in situ with microinvasion (DCIS-MI). Methods Clinical data of 866 female patients including 631 DCIS cases and 235 DCIS-MI cases treated in our institution between 1999 and 2013 were retrospectively analyzed. The local control (LC), disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival analysis. The prognostic factors were identified by Log-rank test. Results Similar LC, DFS and OS rates were obtained between two groups (all P>0.05). The univariate analysis demonstrated that Her-2-positive patients had worse OS and DFS than Her-2-negative counterparts. Patients undergoing breast-conserving surgery without radiotherapy had lower LC and DFS rates compared with those receiving radical mastectomy. Conclusions DCIS and DCIS-MI patients have similar clinical prognosis in terms of OS, LC and DFS. Her-2 positive is an unfavorable prognostic factor for DFS and OS. The LC and DFS rates in the breast-conserving surgery alone group are worse than those in the mastectomy group. Key words: Breast ductal carcinoma in situ; Breast ductal carcinoma in situ with microinvasion; Breast neoplasm/radiotherapy; Breast neoplasm/surgery; Prognosis
{"title":"Clinical comparison between ductal carcinoma in situ and ductal carcinoma in situ with microinvasion","authors":"Weixin Liu, Shulian Wang, Yu Tang, H. Jing, Jianyang Wang, Jiang-hu Zhang, J. Jin, Yong-wen Song, Weihu Wang, Yueping Liu, H. Fang, H. Ren, S. Qi, N. Lu, Yuan Tang, Ning Li, Yexiong Li","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.007","url":null,"abstract":"Objective \u0000To analyze the differences in the treatment patterns, clinical characteristics, treatment outcomes and prognostic factors between breast cancer patients with ductal carcinoma in situ (DCIS) and ductal carcinoma in situ with microinvasion (DCIS-MI). \u0000 \u0000 \u0000Methods \u0000Clinical data of 866 female patients including 631 DCIS cases and 235 DCIS-MI cases treated in our institution between 1999 and 2013 were retrospectively analyzed. The local control (LC), disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival analysis. The prognostic factors were identified by Log-rank test. \u0000 \u0000 \u0000Results \u0000Similar LC, DFS and OS rates were obtained between two groups (all P>0.05). The univariate analysis demonstrated that Her-2-positive patients had worse OS and DFS than Her-2-negative counterparts. Patients undergoing breast-conserving surgery without radiotherapy had lower LC and DFS rates compared with those receiving radical mastectomy. \u0000 \u0000 \u0000Conclusions \u0000DCIS and DCIS-MI patients have similar clinical prognosis in terms of OS, LC and DFS. Her-2 positive is an unfavorable prognostic factor for DFS and OS. The LC and DFS rates in the breast-conserving surgery alone group are worse than those in the mastectomy group. \u0000 \u0000 \u0000Key words: \u0000Breast ductal carcinoma in situ; Breast ductal carcinoma in situ with microinvasion; Breast neoplasm/radiotherapy; Breast neoplasm/surgery; Prognosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"187-192"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46439156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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