Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.016
Wenyan Yao, Q. Peng, Yaqun Zhu, Ye Tian
Neoadjuvant chemoradiotherapy (NCRT) has become the standard treatment for patients with locally advanced rectal cancer (LARC). However, the response to NCRT varies among LARC patients and a subset of patients show resistance to NCRT. NCRT may delay the timing of surgery and even reduce the overall survival. Therefore, it is of significance to identify biomarkers for predicting the clinical efficacy of NCRT, screen patients who are resistant to NCRT and perform surgery as early as possible, eventually establishing an individualized therapeutic strategy. MicroRNAs are a class of small non-coding RNAs that post-transcriptionally regulate gene expression, which areinvolved in multiple signaling pathways and DNA damage repair process and affect the radiosensitivity of rectal cancer cells. Many recent studies have evaluated the role of microRNA in predicting the response to NCRT. The purpose of this article is to review the research progress and validate the role of microRNA in predicting the clinical efficacy of NCRT for rectal cancer. Key words: Rectal neoplasm/neoadjuvant chemoradiotherapy; MicroRNA; Predict
{"title":"Role of microRNA in predictingclinical efficacy of neoadjuvant chemoradiotherapy for rectal cancer","authors":"Wenyan Yao, Q. Peng, Yaqun Zhu, Ye Tian","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.016","url":null,"abstract":"Neoadjuvant chemoradiotherapy (NCRT) has become the standard treatment for patients with locally advanced rectal cancer (LARC). However, the response to NCRT varies among LARC patients and a subset of patients show resistance to NCRT. NCRT may delay the timing of surgery and even reduce the overall survival. Therefore, it is of significance to identify biomarkers for predicting the clinical efficacy of NCRT, screen patients who are resistant to NCRT and perform surgery as early as possible, eventually establishing an individualized therapeutic strategy. MicroRNAs are a class of small non-coding RNAs that post-transcriptionally regulate gene expression, which areinvolved in multiple signaling pathways and DNA damage repair process and affect the radiosensitivity of rectal cancer cells. Many recent studies have evaluated the role of microRNA in predicting the response to NCRT. The purpose of this article is to review the research progress and validate the role of microRNA in predicting the clinical efficacy of NCRT for rectal cancer. \u0000 \u0000Key words: \u0000Rectal neoplasm/neoadjuvant chemoradiotherapy; MicroRNA; Predict","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"229-232"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41317181","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.1004-4221.2020.03.018
Junjun Zhang, S. Cai, Yongqiang Yang, Junyan Li, Ye Tian
Recently, the relationship between intestinal flora and its metabolites and tumorigenesis, inflammatory bowel diseasesas well as radiation-induced intestinal injury has captivated widespread attention from researchers. Accumulated evidence derived from nuclear accident investigation, animal model experiment and clinical research has proven the role of intestinal flora and its metabolites as the biomarkers to evaluate the radiation dose and severity of radiation-induced intestinal injury. This article reviews the relationship between intestinal flora and its metabolites and radiation-induced intestinal injury, aiming to provide theoretical reference for assessing the risk of radiation-induced intestinal injury. Key words: Intestinal flora; Metabolite; Radiation-induced injury; Biomarker
{"title":"Research progress on biomarkers for radiation-induced intestinal injury based on intestinal flora","authors":"Junjun Zhang, S. Cai, Yongqiang Yang, Junyan Li, Ye Tian","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.018","url":null,"abstract":"Recently, the relationship between intestinal flora and its metabolites and tumorigenesis, inflammatory bowel diseasesas well as radiation-induced intestinal injury has captivated widespread attention from researchers. Accumulated evidence derived from nuclear accident investigation, animal model experiment and clinical research has proven the role of intestinal flora and its metabolites as the biomarkers to evaluate the radiation dose and severity of radiation-induced intestinal injury. This article reviews the relationship between intestinal flora and its metabolites and radiation-induced intestinal injury, aiming to provide theoretical reference for assessing the risk of radiation-induced intestinal injury. \u0000 \u0000Key words: \u0000Intestinal flora; Metabolite; Radiation-induced injury; Biomarker","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"237-240"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47561404","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.1004-4221.2020.03.003
X. Pang, D. Qing, Bin Zhao, D. Ma
Objective To define the maximum-tolerated dose (MTD) of lobaplatin (LBP) in a weekly regimen combined with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 18 cases with stage Ⅲ/IV A NPC were enrolled. Concurrent chemoradiotherapy was given to all the patients with a dose escalation of LBP. The initial dose of LBP was 15 mg/m2 with an escalating dose of 5 mg/m2. At least 3 patients were assigned into each group. Patients were proceeded into the next dose group if no dose-limiting toxicity (DLT) occurred until the MTD was achieved. Efficacy and toxicity were evaluated regularly. Results Three patients were assigned into the 10 mg/m2, 3 into the 15 mg/m2, and 6 into the 20 mg/m2 and 25 mg/m2 groups, respectively. Two patients experienced DLT in the 25 mg/m2 group. Hence, the MTD was determined as 20 mg/m2. At 3 months after corresponding treatment, the remission rate of nasopharyngeal tumors and neck-positive lymph nodes of the patients was 100%. The most common toxicity was reversible bone marrow suppression. Conclusions The MTD of weekly lobaplatin plus concurrent IMRT is 20 mg/m2 for locally advanced NPC. This regimen is reliable and safe, which is worthy of further clinical study. Key words: Nasopharyngeal neoplasm/concurrent chemoradiotherapy; Lobaplatin; Dose-limiting toxicity; Maximum tolerated dose
{"title":"Dose-escalation trial of lobaplatin weekly plus concurrent radiotherapy for local-regionally advanced nasopharyngeal carcinoma","authors":"X. Pang, D. Qing, Bin Zhao, D. Ma","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.003","url":null,"abstract":"Objective \u0000To define the maximum-tolerated dose (MTD) of lobaplatin (LBP) in a weekly regimen combined with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). \u0000 \u0000 \u0000Methods \u0000A total of 18 cases with stage Ⅲ/IV A NPC were enrolled. Concurrent chemoradiotherapy was given to all the patients with a dose escalation of LBP. The initial dose of LBP was 15 mg/m2 with an escalating dose of 5 mg/m2. At least 3 patients were assigned into each group. Patients were proceeded into the next dose group if no dose-limiting toxicity (DLT) occurred until the MTD was achieved. Efficacy and toxicity were evaluated regularly. \u0000 \u0000 \u0000Results \u0000Three patients were assigned into the 10 mg/m2, 3 into the 15 mg/m2, and 6 into the 20 mg/m2 and 25 mg/m2 groups, respectively. Two patients experienced DLT in the 25 mg/m2 group. Hence, the MTD was determined as 20 mg/m2. At 3 months after corresponding treatment, the remission rate of nasopharyngeal tumors and neck-positive lymph nodes of the patients was 100%. The most common toxicity was reversible bone marrow suppression. \u0000 \u0000 \u0000Conclusions \u0000The MTD of weekly lobaplatin plus concurrent IMRT is 20 mg/m2 for locally advanced NPC. This regimen is reliable and safe, which is worthy of further clinical study. \u0000 \u0000 \u0000Key words: \u0000Nasopharyngeal neoplasm/concurrent chemoradiotherapy; Lobaplatin; Dose-limiting toxicity; Maximum tolerated dose","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"171-174"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43278864","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.1004-4221.2020.03.005
C. Fan, Zhu Feng, H. Ge, K. Ye, Hao Wang, Xiao-li Zheng, Yougai Zhang, Hui Luo
Objective To evaluate the recurrence pattern and identify the risk factors of esophageal squamous cell carcinoma after neoadjuvant therapy combined with surgery. Methods Clinical data of 275 patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant therapy combined with surgery from December 2011 to December 2015 were retrospectively analyzed. The follow-up data of the enrolled patients were complete and analyzable. The recurrence pattern, recurrence time, recurrence location and influencing factors after neoadjuvant therapy in combination with surgery were analyzed. The recurrence rate was calculated by Kaplan-Meier method. The multivariate analysis was performed by Cox regression model. Results The median follow-up time was 32(3-84) months, and the median time of the first recurrence was 10.6(2.0-69.1) months. The 1-, 2-and 3-year recurrence rates were 32.0%, 45.1% and 52.3%, respectively. A total of 152 cases (55.3%) had recurrence. Among them, 77 cases (50.6%) had local-regional recurrence (LRR), 34 cases (23.4%) had distant metastasis (DM), 33 cases (21.7%) had LRR+ DM and 8 cases (6.0%) had recurrence in unknown site. Among the patients with LRR, lymph node recurrence was the most common (n=98, 89.1%). For DM patients, lung metastasis (n=33, 49.3%), liver metastasis (n=16, 23.9%), bone metastasis (n=14, 20.9%) and non-regional lymph node metastasis (n=14, 20.9%) were commonly observed. The multivariate analysis showed that postoperative T stage (P=0.008), N stage (P<0.001) and the number of lymph node dissection (P<0.001) were the independent risk factors for recurrence after treatment. Conclusions The recurrence rate after neoadjuvant therapy remains relatively high for esophageal squamous cell carcinoma, and the regional lymph node is the most common site of recurrence. Postoperative pathological T staging, N staging and the number of lymph node dissection are the independent risk factors for recurrence after treatment. Key words: Esophageal neoplasm/neoadjuvant treatment; Recurrence pattern; Risk factor
{"title":"Analysis of recurrence pattern of neoadjuvant therapy combined with surgical treatment for esophageal squamous cell carcinoma","authors":"C. Fan, Zhu Feng, H. Ge, K. Ye, Hao Wang, Xiao-li Zheng, Yougai Zhang, Hui Luo","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.005","url":null,"abstract":"Objective \u0000To evaluate the recurrence pattern and identify the risk factors of esophageal squamous cell carcinoma after neoadjuvant therapy combined with surgery. \u0000 \u0000 \u0000Methods \u0000Clinical data of 275 patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant therapy combined with surgery from December 2011 to December 2015 were retrospectively analyzed. The follow-up data of the enrolled patients were complete and analyzable. The recurrence pattern, recurrence time, recurrence location and influencing factors after neoadjuvant therapy in combination with surgery were analyzed. The recurrence rate was calculated by Kaplan-Meier method. The multivariate analysis was performed by Cox regression model. \u0000 \u0000 \u0000Results \u0000The median follow-up time was 32(3-84) months, and the median time of the first recurrence was 10.6(2.0-69.1) months. The 1-, 2-and 3-year recurrence rates were 32.0%, 45.1% and 52.3%, respectively. A total of 152 cases (55.3%) had recurrence. Among them, 77 cases (50.6%) had local-regional recurrence (LRR), 34 cases (23.4%) had distant metastasis (DM), 33 cases (21.7%) had LRR+ DM and 8 cases (6.0%) had recurrence in unknown site. Among the patients with LRR, lymph node recurrence was the most common (n=98, 89.1%). For DM patients, lung metastasis (n=33, 49.3%), liver metastasis (n=16, 23.9%), bone metastasis (n=14, 20.9%) and non-regional lymph node metastasis (n=14, 20.9%) were commonly observed. The multivariate analysis showed that postoperative T stage (P=0.008), N stage (P<0.001) and the number of lymph node dissection (P<0.001) were the independent risk factors for recurrence after treatment. \u0000 \u0000 \u0000Conclusions \u0000The recurrence rate after neoadjuvant therapy remains relatively high for esophageal squamous cell carcinoma, and the regional lymph node is the most common site of recurrence. Postoperative pathological T staging, N staging and the number of lymph node dissection are the independent risk factors for recurrence after treatment. \u0000 \u0000 \u0000Key words: \u0000Esophageal neoplasm/neoadjuvant treatment; Recurrence pattern; Risk factor","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"179-183"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47251245","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.1004-4221.2020.03.017
Jianing Qian, Zhi-bing Wu
Since the 21st century, with the changes of people′s living habits and the aggravation ofenvironmental pollution, the incidence of tumors has been increasing day by day, which has become the main deathcauseof human diseases. Atpresent, in addition to the three major conventional treatments of tumors, the emergence of hyperthermia provides a safer and more effective solution for the prevention and treatment of tumors. Attributed to the rapid development of mechanical manufacturing, computertechnology, molecularbiology, materials science and other disciplines, precision hyperthermia presented by radiofrequency and ultrasonic focusing hyperthermia guided by magnetic resonance imaging (MRI) non-invasive temperature measure technology, as well as molecular level targeted hyperthermia have provided a broader perspective for the treatment of tumors. This article reviews the partial research progress on precision hyperthermia to understand the current general situation of precision hyperthermia for tumors. Key words: Neoplasm/hyperthermia; Research progress
{"title":"Partial research progress on precision hyperthermia for malignant tumors","authors":"Jianing Qian, Zhi-bing Wu","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.017","url":null,"abstract":"Since the 21st century, with the changes of people′s living habits and the aggravation ofenvironmental pollution, the incidence of tumors has been increasing day by day, which has become the main deathcauseof human diseases. Atpresent, in addition to the three major conventional treatments of tumors, the emergence of hyperthermia provides a safer and more effective solution for the prevention and treatment of tumors. Attributed to the rapid development of mechanical manufacturing, computertechnology, molecularbiology, materials science and other disciplines, precision hyperthermia presented by radiofrequency and ultrasonic focusing hyperthermia guided by magnetic resonance imaging (MRI) non-invasive temperature measure technology, as well as molecular level targeted hyperthermia have provided a broader perspective for the treatment of tumors. This article reviews the partial research progress on precision hyperthermia to understand the current general situation of precision hyperthermia for tumors. \u0000 \u0000Key words: \u0000Neoplasm/hyperthermia; Research progress","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"233-236"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44204825","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.1004-4221.2020.03.011
Xujuan Sun, Lifang Sun, M. Yu, Ying Li, Mingyan Li, Ke Yang, Yujie Li, G. Xing, Q. Han
Objective To investigate the effect and underlying mechanism of lncRNA MEG3 on the radiosensitivity of nasopharyngeal carcinoma cells. Methods this experiment, overexpression control group, MEG3 overexpression group, miR-NC inhibition group, miR-7-5p inhibition group, overexpression control+ 4 Gy group, MEG3 overexpression+ 4 Gygroup, miR-NC inhibition+ 4 Gy group, miR-7-5p inhibition+ 4 Gy group, MEG3 overexpression+ miR-NC overexpression group, MEG3 overexpression+ miR-7-5p overexpression group were established. The expression of miR-7-5p and MEG3 was detected by qRT-PCR. The radiosensitivity of nasopharyngeal carcinoma cells was measured by clone formation assay. Cell apoptosis was assessed by flow cytometry. The fluorescence activity was evaluated by dual luciferase reporter assay. Results MEG3 was lowly expressed in nasopharyngeal carcinoma tissues and cells. Overexpression of MEG3 and inhibition of miR-7-5p expression increased the radiosensitivity of nasopharyngeal carcinoma cells and promoted radiation-induced cell apoptosis. MEG3 could targetedly regulate the miR-7-5p expression. Overexpression of miR-7-5p reversed the effect of overexpression of MEG3 on the sensitization of nasopharyngeal carcinoma cells and the promotion of apoptosis induced by radiation exposure. Conclusions Overexpression of MEG3 increases the radiosensitivity of nasopharyngeal carcinoma cells and promotes radiation-induced cell apoptosis. The mechanism may be related to the down-regulation of miR-7-5p expression. Key words: lncRNA MEG3; miR-7-5p; Nasopharyngeal carcinoma cell line; Radiosensitivity; Apoptosis
{"title":"Effect of lncRNA MEG3 on radiosensitivity of nasopharyngeal carcinoma cells by down-regulating miR-7-5p expression","authors":"Xujuan Sun, Lifang Sun, M. Yu, Ying Li, Mingyan Li, Ke Yang, Yujie Li, G. Xing, Q. Han","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.011","url":null,"abstract":"Objective \u0000To investigate the effect and underlying mechanism of lncRNA MEG3 on the radiosensitivity of nasopharyngeal carcinoma cells. \u0000 \u0000 \u0000Methods \u0000this experiment, overexpression control group, MEG3 overexpression group, miR-NC inhibition group, miR-7-5p inhibition group, overexpression control+ 4 Gy group, MEG3 overexpression+ 4 Gygroup, miR-NC inhibition+ 4 Gy group, miR-7-5p inhibition+ 4 Gy group, MEG3 overexpression+ miR-NC overexpression group, MEG3 overexpression+ miR-7-5p overexpression group were established. The expression of miR-7-5p and MEG3 was detected by qRT-PCR. The radiosensitivity of nasopharyngeal carcinoma cells was measured by clone formation assay. Cell apoptosis was assessed by flow cytometry. The fluorescence activity was evaluated by dual luciferase reporter assay. \u0000 \u0000 \u0000Results \u0000MEG3 was lowly expressed in nasopharyngeal carcinoma tissues and cells. Overexpression of MEG3 and inhibition of miR-7-5p expression increased the radiosensitivity of nasopharyngeal carcinoma cells and promoted radiation-induced cell apoptosis. MEG3 could targetedly regulate the miR-7-5p expression. Overexpression of miR-7-5p reversed the effect of overexpression of MEG3 on the sensitization of nasopharyngeal carcinoma cells and the promotion of apoptosis induced by radiation exposure. \u0000 \u0000 \u0000Conclusions \u0000Overexpression of MEG3 increases the radiosensitivity of nasopharyngeal carcinoma cells and promotes radiation-induced cell apoptosis. The mechanism may be related to the down-regulation of miR-7-5p expression. \u0000 \u0000 \u0000Key words: \u0000lncRNA MEG3; miR-7-5p; Nasopharyngeal carcinoma cell line; Radiosensitivity; Apoptosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"207-210"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46671389","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.1004-4221.2020.03.013
Xiang Chen, Jianliang Zhou, Xiang-hua Zhang, Binbing Wang
Objective To compare the dosimetric differences between free-hand method and virtually optimized method for implanting needles in intracavitary and interstitial combined brachytherapy (IC/IS BT) of cervical cancer, and to explore the improvement space of the existing interstitial brahcytherapy plan. Methods High-dose-rate cervical cancer IC/IS BT plans (short for Treatment-Plan) of 18 cases were retrospectively analyzed. For each treatment plan, Nucletron Oncentra 3D brachytherapy planning system was utilized to redesign the virtually optimized insertion method IC/IS BT plan (short for Optimized-Plan). Dose volume histogram was adopted to evaluate the dose distribution in high-risk clinical target areas and exposure dose to organ at risk (OAR). The plan execution efficiency between two plans was also assessed. Results Comparing these two plans, the differences in conformity and uniformity of dose distribution of the target area were statistically significant (P=0.000, 0.008). The differences of D0.01 cm3, D1 cm3, D2 cm3 and D5 cm3 in bladder, rectum, sigmoid and small bowel were all statistically significant (all P<0.05). Optimized-Plan could reduce the D2 cm3 of bladder, rectum, sigmoid and small bowel by 60.41, 36.43, 27.53 and 12.43 cGy, respectively. The execution time for the Treatment-Plan and Optimized-Plan were (857.92±243.39) s and (804.53±239.13) s with statistical significance (P<0.001). Conclusions Compared with the free-hand method, virtually optimized method yields more conformable coverage of the target area and more uniform dose distribution. At the same time, the doses of each OAR are reduced to different degrees and the execution time of the plan is also shortened. Key words: Cervical neoplasm/brachytherapy; Interstitial implant; Intracavitary irradiation
{"title":"Study of the feasibility of needle path optimization in 3D brachytherapy for cervical cancer","authors":"Xiang Chen, Jianliang Zhou, Xiang-hua Zhang, Binbing Wang","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.013","url":null,"abstract":"Objective \u0000To compare the dosimetric differences between free-hand method and virtually optimized method for implanting needles in intracavitary and interstitial combined brachytherapy (IC/IS BT) of cervical cancer, and to explore the improvement space of the existing interstitial brahcytherapy plan. \u0000 \u0000 \u0000Methods \u0000High-dose-rate cervical cancer IC/IS BT plans (short for Treatment-Plan) of 18 cases were retrospectively analyzed. For each treatment plan, Nucletron Oncentra 3D brachytherapy planning system was utilized to redesign the virtually optimized insertion method IC/IS BT plan (short for Optimized-Plan). Dose volume histogram was adopted to evaluate the dose distribution in high-risk clinical target areas and exposure dose to organ at risk (OAR). The plan execution efficiency between two plans was also assessed. \u0000 \u0000 \u0000Results \u0000Comparing these two plans, the differences in conformity and uniformity of dose distribution of the target area were statistically significant (P=0.000, 0.008). The differences of D0.01 cm3, D1 cm3, D2 cm3 and D5 cm3 in bladder, rectum, sigmoid and small bowel were all statistically significant (all P<0.05). Optimized-Plan could reduce the D2 cm3 of bladder, rectum, sigmoid and small bowel by 60.41, 36.43, 27.53 and 12.43 cGy, respectively. The execution time for the Treatment-Plan and Optimized-Plan were (857.92±243.39) s and (804.53±239.13) s with statistical significance (P<0.001). \u0000 \u0000 \u0000Conclusions \u0000Compared with the free-hand method, virtually optimized method yields more conformable coverage of the target area and more uniform dose distribution. At the same time, the doses of each OAR are reduced to different degrees and the execution time of the plan is also shortened. \u0000 \u0000 \u0000Key words: \u0000Cervical neoplasm/brachytherapy; Interstitial implant; Intracavitary irradiation","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"215-219"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43008388","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.1004-4221.2020.03.014
Xiaoli Jin, Ying Lu, Qinying Shi, Lin Hao, Xiaofen Xing
Objective To analyze the quality control data of linear accelerator detected by Daily QA3 and to evaluate this quality control process using statistical process control. Methods After the calibrations of the accelerator and Daily QA3, Daily QA3 device was used to perform daily quality control by technicians and physicists and 100 groups and 30 groups of daily quality control data were collected. After the accelerator and Daily QA3 were re-calibrated, Daily QA3 device was utilized to perform daily quality control by technicians and 100 groups of the daily quality control data were repeatedly collected. The variations of normalized signal-to-noise ratio of quality control data collected after two calibrations were analyzed. The first 30 groups of daily quality control data measured by technicians and physicists were adopted to calculate the I-MR control chartsand compare the location of CL and the range of UCL and LCL. The process capability indices were calculated for three different quality control processes bytechnicians and physicists, respectively. Results For twice calibrations, normalized signal-to-noise ratio of quality control data significantly changed before 6 weeks, became stable between 6 and 8 weeks, and the changes became smaller after 8 weeks. For dose output measured by physicists, the rang of UCL and LCL was more narrow. In terms of flatness and symmetry, the location of CL was closer to zero. Regarding dose output and flatness, the process capability indices of three different quality control process were all satisfied ≥1, whereas unsatisfied for transverse symmetry. Conclusions The first 30-40 data points should be adopted to delineate I-MR control chart of the linear accelerator in daily quality control process. The quality control process should be completed by a fixed and small group of personnel and an optimal tolerance level should be customized. Key words: Linear accelerator; Quality control; Statistical process control; Control chart; Process capability index
{"title":"Daily quality control data analysis and process evaluation of linear accelerator","authors":"Xiaoli Jin, Ying Lu, Qinying Shi, Lin Hao, Xiaofen Xing","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.014","url":null,"abstract":"Objective \u0000To analyze the quality control data of linear accelerator detected by Daily QA3 and to evaluate this quality control process using statistical process control. \u0000 \u0000 \u0000Methods \u0000After the calibrations of the accelerator and Daily QA3, Daily QA3 device was used to perform daily quality control by technicians and physicists and 100 groups and 30 groups of daily quality control data were collected. After the accelerator and Daily QA3 were re-calibrated, Daily QA3 device was utilized to perform daily quality control by technicians and 100 groups of the daily quality control data were repeatedly collected. The variations of normalized signal-to-noise ratio of quality control data collected after two calibrations were analyzed. The first 30 groups of daily quality control data measured by technicians and physicists were adopted to calculate the I-MR control chartsand compare the location of CL and the range of UCL and LCL. The process capability indices were calculated for three different quality control processes bytechnicians and physicists, respectively. \u0000 \u0000 \u0000Results \u0000For twice calibrations, normalized signal-to-noise ratio of quality control data significantly changed before 6 weeks, became stable between 6 and 8 weeks, and the changes became smaller after 8 weeks. For dose output measured by physicists, the rang of UCL and LCL was more narrow. In terms of flatness and symmetry, the location of CL was closer to zero. Regarding dose output and flatness, the process capability indices of three different quality control process were all satisfied ≥1, whereas unsatisfied for transverse symmetry. \u0000 \u0000 \u0000Conclusions \u0000The first 30-40 data points should be adopted to delineate I-MR control chart of the linear accelerator in daily quality control process. The quality control process should be completed by a fixed and small group of personnel and an optimal tolerance level should be customized. \u0000 \u0000 \u0000Key words: \u0000Linear accelerator; Quality control; Statistical process control; Control chart; Process capability index","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"220-224"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44873949","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.1004-4221.2020.03.002
Xin Wang, S. Dou, Rongrong Li, Si-cheng Wu, Gang Chen, Lin Zhang, Wenjun Yang, G. Zhu
Objective To assess the efficacy and safety of post operative adjuvant concurrent chemoradiotherapy for patients with high-risk salivary gland tumors (SGT). Methods Fifty-two patients with moderate or high malignant pathological stage complicated with locally advanced stage Ⅲ/ⅣA±positive margin/close margin admitted to Shanghai Ninth People′s Hospital from 2016 to 2018 were enrolled in this study. Among them, 35 patients were male and 17 female with a median age of 55.5 years old (range: 21-73 years old). All 52 patients were treated with intensity-modulated radiotherapy and concurrent chemotherapy. Patients with adeno carcinoma of the salivary gland receives concurrent chemotherapy with TP regimen. Patients with lympho epithelial cancer and squamous cell carcinoma were treated with cisplatin regimen. Results Forty-seven patients (90%) completed two cycles of concurrent chemotherapy, and five patients (10%) completed one cycle of concurrent chemotherapy. The median follow-up time was 15.7 months (3.2-34.8 months). The 2-year disease-free survival (DFS) and overall survival (OS) rates were 74% and 98%. Three patients experienced regional lymph recurrence and 6 cases had distant metastasis. Grade Ⅲ oral mucositis was observed in 30 patients. Grade Ⅲ dermatitis occurred in 5 cases. Only one patient experienced Grade IV neutropenia, and 2 patients developed Grade Ⅲ neutropenia. DFS was positively correlated with the cycle of postoperative adjuvant concurrent chemotherapy (P=0.006). Conclusions Patients with high-risk SGT can obtain higher 2-year DFS and OS rates and tolerable adverse events after postoperative concurrent chemoradiotherapy. Nevertheless, the long-term outcomes remain to be validated by randomized controlled clinical trials. Key words: High-risk salivary gland tumor; Postoperative adjuvant; Concurrent chemoradiotherapy; Prospective study
{"title":"Prospective phase II study of postoperative concurrent chemoradiotherapy for patients with high-risk malignant salivary gland tumors","authors":"Xin Wang, S. Dou, Rongrong Li, Si-cheng Wu, Gang Chen, Lin Zhang, Wenjun Yang, G. Zhu","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.002","url":null,"abstract":"Objective \u0000To assess the efficacy and safety of post operative adjuvant concurrent chemoradiotherapy for patients with high-risk salivary gland tumors (SGT). \u0000 \u0000 \u0000Methods \u0000Fifty-two patients with moderate or high malignant pathological stage complicated with locally advanced stage Ⅲ/ⅣA±positive margin/close margin admitted to Shanghai Ninth People′s Hospital from 2016 to 2018 were enrolled in this study. Among them, 35 patients were male and 17 female with a median age of 55.5 years old (range: 21-73 years old). All 52 patients were treated with intensity-modulated radiotherapy and concurrent chemotherapy. Patients with adeno carcinoma of the salivary gland receives concurrent chemotherapy with TP regimen. Patients with lympho epithelial cancer and squamous cell carcinoma were treated with cisplatin regimen. \u0000 \u0000 \u0000Results \u0000Forty-seven patients (90%) completed two cycles of concurrent chemotherapy, and five patients (10%) completed one cycle of concurrent chemotherapy. The median follow-up time was 15.7 months (3.2-34.8 months). The 2-year disease-free survival (DFS) and overall survival (OS) rates were 74% and 98%. Three patients experienced regional lymph recurrence and 6 cases had distant metastasis. Grade Ⅲ oral mucositis was observed in 30 patients. Grade Ⅲ dermatitis occurred in 5 cases. Only one patient experienced Grade IV neutropenia, and 2 patients developed Grade Ⅲ neutropenia. DFS was positively correlated with the cycle of postoperative adjuvant concurrent chemotherapy (P=0.006). \u0000 \u0000 \u0000Conclusions \u0000Patients with high-risk SGT can obtain higher 2-year DFS and OS rates and tolerable adverse events after postoperative concurrent chemoradiotherapy. Nevertheless, the long-term outcomes remain to be validated by randomized controlled clinical trials. \u0000 \u0000 \u0000Key words: \u0000High-risk salivary gland tumor; Postoperative adjuvant; Concurrent chemoradiotherapy; Prospective study","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41475213","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.1004-4221.2020.03.012
Yi-Qiang Tang, L. Zeng, Fan Ao, Yulu Liao, Min Huang, Shulan Chen, Xiaowei Rao, Jingao Li
Objective To explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma. Methods CT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software. The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV). Individualized cavity applicators were created by using 3D printer. The applicator was inserted into the patient′s nasopharyngeal cavity through oral cavity. The source tube and false source were inserted into the preset pipe of the applicator. CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system. After delineating the target volume and organ at risk, treatment plan was optimized. After completing the first treatment, the applicator was removed. Before second treatment in a few days, CT scan was reviewed to confirm whether the position was correct. Results When the applicator was inserted into the nasopharyngeal cavity, it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures. Comparing the location of false source in multiple reviews of CT scan, the error was ≤1 mm. No significant discomfort was reported throughout the treatment. In optimized three-dimensional treatment, 100% prescription dose curve included the full rGTV, maximum dose of the brain stem and spinal cord was<30% prescription dose. Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week. No tumor recurrence was observed at postoperative 3 months in two cases. Conclusions The 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation, accurate location, good repeatability and good patient tolerance. The short-term outcome is effective, whereas its long-term clinical effect and adverse reactions need to be further observed. Key words: 3D printed; Individualized applicator; Nasopharyngeal neoplasm/intracavitary radiotherapy
{"title":"Preliminary exploration of 3D printed individualized applicator for 3D-image-guided intracavitary HDR-brachytherapy for nasopharyngeal carcinoma","authors":"Yi-Qiang Tang, L. Zeng, Fan Ao, Yulu Liao, Min Huang, Shulan Chen, Xiaowei Rao, Jingao Li","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.012","url":null,"abstract":"Objective \u0000To explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma. \u0000 \u0000 \u0000Methods \u0000CT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software. The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV). Individualized cavity applicators were created by using 3D printer. The applicator was inserted into the patient′s nasopharyngeal cavity through oral cavity. The source tube and false source were inserted into the preset pipe of the applicator. CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system. After delineating the target volume and organ at risk, treatment plan was optimized. After completing the first treatment, the applicator was removed. Before second treatment in a few days, CT scan was reviewed to confirm whether the position was correct. \u0000 \u0000 \u0000Results \u0000When the applicator was inserted into the nasopharyngeal cavity, it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures. Comparing the location of false source in multiple reviews of CT scan, the error was ≤1 mm. No significant discomfort was reported throughout the treatment. In optimized three-dimensional treatment, 100% prescription dose curve included the full rGTV, maximum dose of the brain stem and spinal cord was<30% prescription dose. Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week. No tumor recurrence was observed at postoperative 3 months in two cases. \u0000 \u0000 \u0000Conclusions \u0000The 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation, accurate location, good repeatability and good patient tolerance. The short-term outcome is effective, whereas its long-term clinical effect and adverse reactions need to be further observed. \u0000 \u0000 \u0000Key words: \u00003D printed; Individualized applicator; Nasopharyngeal neoplasm/intracavitary radiotherapy","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"211-214"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49436305","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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