Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.03.015
Yiru Wang, Yong Zhang, Tong Wu, Meizhu Shen
Preoperative neoadjuvant chemoradiotherapy (NCR) combined with total mesorectal excision (TME) is the standard treatment mode for locally advanced rectal cancer. Compared with postoperative NCR, preoperative NCR increases the tumor down-staging, sphincter-preserving rate and local control rate. Patients who attain pathological complete response (pCR) after preoperative NCR have better prognosis compared with their counterparts. This article reviews the research progress on preoperative NCR in recent years. Key words: Rectal neoplasm/radiochemotherapy; Radiochemotherapy, neoadjuvant; Research progress
{"title":"Research progresson neoadjuvant chemoradiotherapy for locally advanced rectal cancer","authors":"Yiru Wang, Yong Zhang, Tong Wu, Meizhu Shen","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.015","url":null,"abstract":"Preoperative neoadjuvant chemoradiotherapy (NCR) combined with total mesorectal excision (TME) is the standard treatment mode for locally advanced rectal cancer. Compared with postoperative NCR, preoperative NCR increases the tumor down-staging, sphincter-preserving rate and local control rate. Patients who attain pathological complete response (pCR) after preoperative NCR have better prognosis compared with their counterparts. This article reviews the research progress on preoperative NCR in recent years. \u0000 \u0000Key words: \u0000Rectal neoplasm/radiochemotherapy; Radiochemotherapy, neoadjuvant; Research progress","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"225-228"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43557468","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.012
Xianliang Wang, Pei Wang, Churong Li, Jie Li, Shengwei Kang, Min Liu, Ta-Wei Ting, Zhangwen Wu, Q. Hou
Objective To report an implementation method and results of an independent brachytherapy dose verification software (DVS). Methods The DVS was developed based on Visual C+ + and the modular structure design was adopted. The DICOM RT files exported from the treatment planning system (TPS) were automatically loaded into the DVS. The TG-43 formalism was employed for dose calculation. Six cervical cancer patients who underwent brachytherapy were retrospectively selected to test the DVS. Different applicators were utilized for each patient. Dosimetric parameters and γ analysis (0.1cm, 5%) were used to evaluate the dose difference between the DVS and the TPS. Results Compared with the TPS dose, the γ pass rates of the doses calculated by the DVS were higher than 98%. For CTV, the dosimetric differences were less than 0.29% and 0.53% for D100% and D90%. For bladder, rectum and sigmoid, the agreement of D0.1cm3, D1cm3 and D2cm3 within a 0.5% level. Conclusion With minimal human-computer interactions, the DVS can verify the accuracy of dose calculated by TPS for brachytherapy. Key words: Brachytherapy; Dose verification; Treatment planning system; Quality assurance
{"title":"A study of an independent dose verification software for brachytherapy","authors":"Xianliang Wang, Pei Wang, Churong Li, Jie Li, Shengwei Kang, Min Liu, Ta-Wei Ting, Zhangwen Wu, Q. Hou","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.012","url":null,"abstract":"Objective \u0000To report an implementation method and results of an independent brachytherapy dose verification software (DVS). \u0000 \u0000 \u0000Methods \u0000The DVS was developed based on Visual C+ + and the modular structure design was adopted. The DICOM RT files exported from the treatment planning system (TPS) were automatically loaded into the DVS. The TG-43 formalism was employed for dose calculation. Six cervical cancer patients who underwent brachytherapy were retrospectively selected to test the DVS. Different applicators were utilized for each patient. Dosimetric parameters and γ analysis (0.1cm, 5%) were used to evaluate the dose difference between the DVS and the TPS. \u0000 \u0000 \u0000Results \u0000Compared with the TPS dose, the γ pass rates of the doses calculated by the DVS were higher than 98%. For CTV, the dosimetric differences were less than 0.29% and 0.53% for D100% and D90%. For bladder, rectum and sigmoid, the agreement of D0.1cm3, D1cm3 and D2cm3 within a 0.5% level. \u0000 \u0000 \u0000Conclusion \u0000With minimal human-computer interactions, the DVS can verify the accuracy of dose calculated by TPS for brachytherapy. \u0000 \u0000 \u0000Key words: \u0000Brachytherapy; Dose verification; Treatment planning system; Quality assurance","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47466553","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.002
Yong Li, Fenghua Liu, Kangning Liang, Xianjun Shao, Li Zhang, Xiaohua Liang, Mianshun Pan
Objective To compare the clinical efficacy of stereotactic radiotherapy (SRT) and stereotactic radiosurgery (SRS) in the treatment of brain metastases from January 2006 to December 2016, lung adenocarcinoma and analyze the related factors. Methods In this multi-center retrospective analysis, clinical data of 208 patients with brain metastases from lung adenocarcinoma were retrospectively analyzed and assigned into the SRT (n=86) and SRS groups (n=122). The clinical characteristics of patients in two groups were analyzed. The local tumor control rate, median survival time and radiation brain injury were statistically compared between two groups. Results At the end of follow-up, the objective response rates (ORR) were 70.9% and 71.3% in the SRT and SRS groups (P=0.772). The local tumor control rates at 12 months were 89% and 86% in the SRT and SRS groups (P=0.383). The median overall survival time of all patients was 14.3 months, 15.6 months in the SRT group and 13.7 months in the SRS group (P=0.349). Multivariate analysis showed that large target volume (P<0.001), low GPA score (P=0.012) and no insensitive gene mutation (P<0.001) were the main factors of poor prognosis. The incidence of late radiation brain injury was 5.8% and 14.8% in two groups (P=0.043). Conclusions SRT and SRS yield similar clinical efficacy in the treatment of brain metastases from lung adenocarcinoma. SRT may have a lower incidence of late radiation brain injury than SRS. Key words: Brain metastasis/lung neoplasms; Stereotactic radiotherapy; Stereotactic radiosurgery
{"title":"A comparative analysis of SRT and SRS in the treatment of brain metastases from lung adenocarcinoma","authors":"Yong Li, Fenghua Liu, Kangning Liang, Xianjun Shao, Li Zhang, Xiaohua Liang, Mianshun Pan","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.002","url":null,"abstract":"Objective \u0000To compare the clinical efficacy of stereotactic radiotherapy (SRT) and stereotactic radiosurgery (SRS) in the treatment of brain metastases from January 2006 to December 2016, lung adenocarcinoma and analyze the related factors. \u0000 \u0000 \u0000Methods \u0000In this multi-center retrospective analysis, clinical data of 208 patients with brain metastases from lung adenocarcinoma were retrospectively analyzed and assigned into the SRT (n=86) and SRS groups (n=122). The clinical characteristics of patients in two groups were analyzed. The local tumor control rate, median survival time and radiation brain injury were statistically compared between two groups. \u0000 \u0000 \u0000Results \u0000At the end of follow-up, the objective response rates (ORR) were 70.9% and 71.3% in the SRT and SRS groups (P=0.772). The local tumor control rates at 12 months were 89% and 86% in the SRT and SRS groups (P=0.383). The median overall survival time of all patients was 14.3 months, 15.6 months in the SRT group and 13.7 months in the SRS group (P=0.349). Multivariate analysis showed that large target volume (P<0.001), low GPA score (P=0.012) and no insensitive gene mutation (P<0.001) were the main factors of poor prognosis. The incidence of late radiation brain injury was 5.8% and 14.8% in two groups (P=0.043). \u0000 \u0000 \u0000Conclusions \u0000SRT and SRS yield similar clinical efficacy in the treatment of brain metastases from lung adenocarcinoma. SRT may have a lower incidence of late radiation brain injury than SRS. \u0000 \u0000 \u0000Key words: \u0000Brain metastasis/lung neoplasms; Stereotactic radiotherapy; Stereotactic radiosurgery","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"88-92"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47299498","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.001
Man Xu, M. Shi, J. Zang, Jan-hong Wang, Lina Zhao, S. Luo, F. Xiao
Objective To retrospectively analyze the characteristics of nasopharyngeal carcinoma, long-term efficacy, adverse reactions of intensity-modulated radiotherapy (IMRT) in non-endemic northwest China and summarize the experience of IMRT in the treatment of nasopharyngeal carcinoma in the past decade. Methods Clinical data of 658 patients newly diagnosed with nasopharyngeal carcinoma without distant metastasis admitted to First affiliated hospital from January 2006 to December 2016 were retrospectively analyzed. All patients were treated with IMRT. The survival analysis was performed by Kaplan-Meier method. The multivariate analysis was conducted with Cox’s regression model. Results In non-endemic northwest China, a large proportion of patients were newly diagnosed with locally advanced nasopharyngeal carcinoma, and a majority of them were pathologically characterized as differentiated subtypes. The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) rates were 75.7%, 70.1%, 91.2%, 97.0% and 81.0%, respectively. Multivariate analysis showed that age, pathological type, nasopharyngeal tumor volume>23 cm3 and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DFS (all P<0.05). Age, pathological type, neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of OS (all P<0.05). N stage and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DMFS (both P<0.05). Conclusions Similar clinical efficacy has been achieved in terms of IMRT for nasopharyngeal carcinoma in non-endemic northwest China compared with that in endemic area. Induction chemotherapy combined with concurrent radiochemotherapy can provide clinical benefits for patients with locally advanced nasopharyngeal carcinoma in non-endemic area. Key words: Nasopharyngeal neoplasm/intensity-modulated radiotherapy; Non-endemic area; Prognosis
{"title":"Long-term efficacy and adverse reactions of intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma in non-endemic northwest China","authors":"Man Xu, M. Shi, J. Zang, Jan-hong Wang, Lina Zhao, S. Luo, F. Xiao","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.001","url":null,"abstract":"Objective \u0000To retrospectively analyze the characteristics of nasopharyngeal carcinoma, long-term efficacy, adverse reactions of intensity-modulated radiotherapy (IMRT) in non-endemic northwest China and summarize the experience of IMRT in the treatment of nasopharyngeal carcinoma in the past decade. \u0000 \u0000 \u0000Methods \u0000Clinical data of 658 patients newly diagnosed with nasopharyngeal carcinoma without distant metastasis admitted to First affiliated hospital from January 2006 to December 2016 were retrospectively analyzed. All patients were treated with IMRT. The survival analysis was performed by Kaplan-Meier method. The multivariate analysis was conducted with Cox’s regression model. \u0000 \u0000 \u0000Results \u0000In non-endemic northwest China, a large proportion of patients were newly diagnosed with locally advanced nasopharyngeal carcinoma, and a majority of them were pathologically characterized as differentiated subtypes. The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) rates were 75.7%, 70.1%, 91.2%, 97.0% and 81.0%, respectively. Multivariate analysis showed that age, pathological type, nasopharyngeal tumor volume>23 cm3 and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DFS (all P<0.05). Age, pathological type, neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of OS (all P<0.05). N stage and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DMFS (both P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Similar clinical efficacy has been achieved in terms of IMRT for nasopharyngeal carcinoma in non-endemic northwest China compared with that in endemic area. Induction chemotherapy combined with concurrent radiochemotherapy can provide clinical benefits for patients with locally advanced nasopharyngeal carcinoma in non-endemic area. \u0000 \u0000 \u0000Key words: \u0000Nasopharyngeal neoplasm/intensity-modulated radiotherapy; Non-endemic area; Prognosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46923628","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.008
C. Yuan, Lu Ma, Feifei Kong
Objective To evaluate the effect and mechanism of down-regulating the expression of REV7 on the radiosensitivity of human colon cancer cell HCT116. Methods HCT116 cells were cultured and the expression of REV7 was down-regulated by RNA interference technique. HCT116 cells were divided into the blank group, negative control transfected with negative RNA oligo group and REV7 expression down-regulation transfected with REV7 RNA oligo group, respectively. The cell proliferation was determined by colony formation assay. The expression levels of the proteins of relevant genes were detected by Western blot. The level of cell apoptosis and non-homologous end joining was evaluated. Results The colony formation rate was significantly reduced in THE REV7 siRNA group after 6Gy irradiation (P 60% in the REV7 siRNA group. The expression levels of γH2AX and Caspase9 were significantly up-regulated, whereas those of KU80 and XRCC4 were remarkably down-regulated in the REV7 siRNA group (all P<0.05). Conclusions The radiosensitivity of human colon cancer cell HCT116 can be increased by down-regulating the expression of REV7. The underlying mechanism may be related to the lower incidence rate of non-homologous end joining. Key words: REV7 gene; HCT116 cell line; Radiosensitivity; Non-homologous end joining
{"title":"Effect and mechanism of down-regulating REV7 expression on the radiosensitivity of human colon cancer cell HCT116","authors":"C. Yuan, Lu Ma, Feifei Kong","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.008","url":null,"abstract":"Objective \u0000To evaluate the effect and mechanism of down-regulating the expression of REV7 on the radiosensitivity of human colon cancer cell HCT116. \u0000 \u0000 \u0000Methods \u0000HCT116 cells were cultured and the expression of REV7 was down-regulated by RNA interference technique. HCT116 cells were divided into the blank group, negative control transfected with negative RNA oligo group and REV7 expression down-regulation transfected with REV7 RNA oligo group, respectively. The cell proliferation was determined by colony formation assay. The expression levels of the proteins of relevant genes were detected by Western blot. The level of cell apoptosis and non-homologous end joining was evaluated. \u0000 \u0000 \u0000Results \u0000The colony formation rate was significantly reduced in THE REV7 siRNA group after 6Gy irradiation (P 60% in the REV7 siRNA group. The expression levels of γH2AX and Caspase9 were significantly up-regulated, whereas those of KU80 and XRCC4 were remarkably down-regulated in the REV7 siRNA group (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The radiosensitivity of human colon cancer cell HCT116 can be increased by down-regulating the expression of REV7. The underlying mechanism may be related to the lower incidence rate of non-homologous end joining. \u0000 \u0000 \u0000Key words: \u0000REV7 gene; HCT116 cell line; Radiosensitivity; Non-homologous end joining","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"115-117"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47491180","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.011
Min Liu, Xianliang Wang, K. Yuan, B. Wan, Feng Yang, Shengwei Kang, Jie Li
Objective To investigate the Offset values of different applicators in afterloading brachytherapy. Methods Six types of applicators were selected in this study which included stainless steel interstitial needle (Part#083.062), proguide round needle (Part#189.608), proguide sharp needle (Part#189.601), vaginal multi-channel applicator (Part#110.800), fletcher CT/MR applicator (Part#189.745) and henschke titanium applicator (Part#110.437). According to the sources imaging in the fluorography film, the distance of applicators between the first dwell position and the top could be measured. Marker was pasted on the surface of applicator corresponding to the first dwell position. And then the applicator was put into the pelvic phantom for a CT scan. During applicator reconstruction in the treatment planning system, the Offset values of all applicators could be acquired through adjusting the value of offset to superimpose the first dwell and the marker images. On account of the density of plastic material applicators were similar to human tissues, it was difficult to reconstruct the top of the applicator. With the help of stopper or simulation source, the value of offset could be acquired for plastic material applicators. Based on the measurement results, the differences were analyzed among different applicators. Results The Offset values significantly differed among various applicators. The Offset value for stainless steel interstitial needle was -11.4 mm, -4.1 mm for proguide round needle, -3.5 mm for proguide sharp needle, 0 mm or -5.0 mm for vaginal multi-channel applicator, -6.5 mm for fletcher CT/MR applicator and -7.5 mm for henschke titanium applicator, respectively. Conclusion To adapt to the rapid development of precise radiotherapy, it is necessary to verify the Offset value in afterloading brachytherapy. Key words: Applicator reconstruction; Offset value; Radionuclide imaging
{"title":"A verification study of Offset values of different applicators in afterloading brachytherapy","authors":"Min Liu, Xianliang Wang, K. Yuan, B. Wan, Feng Yang, Shengwei Kang, Jie Li","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.011","url":null,"abstract":"Objective \u0000To investigate the Offset values of different applicators in afterloading brachytherapy. \u0000 \u0000 \u0000Methods \u0000Six types of applicators were selected in this study which included stainless steel interstitial needle (Part#083.062), proguide round needle (Part#189.608), proguide sharp needle (Part#189.601), vaginal multi-channel applicator (Part#110.800), fletcher CT/MR applicator (Part#189.745) and henschke titanium applicator (Part#110.437). According to the sources imaging in the fluorography film, the distance of applicators between the first dwell position and the top could be measured. Marker was pasted on the surface of applicator corresponding to the first dwell position. And then the applicator was put into the pelvic phantom for a CT scan. During applicator reconstruction in the treatment planning system, the Offset values of all applicators could be acquired through adjusting the value of offset to superimpose the first dwell and the marker images. On account of the density of plastic material applicators were similar to human tissues, it was difficult to reconstruct the top of the applicator. With the help of stopper or simulation source, the value of offset could be acquired for plastic material applicators. Based on the measurement results, the differences were analyzed among different applicators. \u0000 \u0000 \u0000Results \u0000The Offset values significantly differed among various applicators. The Offset value for stainless steel interstitial needle was -11.4 mm, -4.1 mm for proguide round needle, -3.5 mm for proguide sharp needle, 0 mm or -5.0 mm for vaginal multi-channel applicator, -6.5 mm for fletcher CT/MR applicator and -7.5 mm for henschke titanium applicator, respectively. \u0000 \u0000 \u0000Conclusion \u0000To adapt to the rapid development of precise radiotherapy, it is necessary to verify the Offset value in afterloading brachytherapy. \u0000 \u0000 \u0000Key words: \u0000Applicator reconstruction; Offset value; Radionuclide imaging","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46625174","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 develop and evaluate an automatic intensity-modulated radiation therapy (IMRT) program for cervical cancer based on a database of overlap volume histogram (OVH) and high-quality cervical IMRT plans for previously-treated patients. Methods A database consisting of high-quality IMRT plans and OVHs from 200 cervical cancer patients was established. OVHs of another 26 cervical cancer patients were converted into gray level images to calculate the image similarity compared with those from the database. The planning optimization function of the patients from the database with the highest image similarity was selected and inherent Pinnacle3 scripts were utilized to automatically generate IMRT plan. Finally, the dosimetric parameters, plan quality and design time were statistically compared between the automatic and manual plans. Results The target coverage, conformity index and homogeneity index did not significantly differ between two plans (all P>0.05). The V40, V45 and mean dose for the rectum in the automatic plans were significantly decreased by 6.1%, 1.3% and 50.7 cGy than those in the manual plans (all P 0.05). The plan design time was shortened by 71% in the automatic plans. Conclusions The automatic IMRT plans based on a database of OVH and high-quality IMRT plans can not only significantly shorten the plan design time, but also reduce the irradiated dose of normal tissues without compromising the target coverage and conformity index. Key words: Cervical neoplasm/intensity-modulated radiation therapy; Overlap volume histogram; Automatic plan
{"title":"Feasibility of automatic IMRT planning for cervical cancer based on a database of previously-treated patients","authors":"Jihong Chen, P. Bai, Wenjuan Chen, Kaiqiang Chen, Qi-xin Li, Xiu-chun Zhang, Yitao Dai, X. Weng, Jiewei Qian","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.014","url":null,"abstract":"Objective \u0000To develop and evaluate an automatic intensity-modulated radiation therapy (IMRT) program for cervical cancer based on a database of overlap volume histogram (OVH) and high-quality cervical IMRT plans for previously-treated patients. \u0000 \u0000 \u0000Methods \u0000A database consisting of high-quality IMRT plans and OVHs from 200 cervical cancer patients was established. OVHs of another 26 cervical cancer patients were converted into gray level images to calculate the image similarity compared with those from the database. The planning optimization function of the patients from the database with the highest image similarity was selected and inherent Pinnacle3 scripts were utilized to automatically generate IMRT plan. Finally, the dosimetric parameters, plan quality and design time were statistically compared between the automatic and manual plans. \u0000 \u0000 \u0000Results \u0000The target coverage, conformity index and homogeneity index did not significantly differ between two plans (all P>0.05). The V40, V45 and mean dose for the rectum in the automatic plans were significantly decreased by 6.1%, 1.3% and 50.7 cGy than those in the manual plans (all P 0.05). The plan design time was shortened by 71% in the automatic plans. \u0000 \u0000 \u0000Conclusions \u0000The automatic IMRT plans based on a database of OVH and high-quality IMRT plans can not only significantly shorten the plan design time, but also reduce the irradiated dose of normal tissues without compromising the target coverage and conformity index. \u0000 \u0000 \u0000Key words: \u0000Cervical neoplasm/intensity-modulated radiation therapy; Overlap volume histogram; Automatic plan","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"141-145"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44476545","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.004
W. Shen, Hong-mei Gao, Jinrui Xu, Y. Cao, Shu-guang Li, You-mei Li, Shuchai Zhu
Objective To evaluate the effect of locoregional risk factors of esophageal cancer on the recurrence of gross tumor volume (GTV) in patients with N0 esophageal squamous cell carcinoma after radical intensity-modulated radiotherapy (IMRT) and to evaluate its effect on the 10-year survival of patients. Methods Clinical data of 374 patients with clinical N0 esophageal squamous cell carcinoma who underwent radical IMRT in the Fourth Hospital of Hebei Medical University from 2005 to 2010 were retrospectively analyzed. Involved-field irradiation was performed in 284 patients and selective lymph node irradiation was given in 90 patients. Concurrent radiochemotherapy was conducted in 69l patients and sequential radiochemotherapy was performed in 38 patients. The survival analysis was carried out by Kaplan-Meier method. The prognosis analysis was performed by multivariate Cox’s regression model. Results A total of 143 patients (38.2%) had recurrence in GTV. The maximum transverse diameter (GTV-D), GTV volume (GTV-V) and GTV volume/length (GTV-V/L) of GTV patients were significantly longer than those without recurrence in GTV (P=0.008, 0.043, 0.001). ROC curve analysis showed that the optimal diagnostic thresholds for GTV-D, GTV-L, GTV-V and GTV-V/L for GTV recurrence were 3.5 cm, 5.5 cm, 24.0 cm3 and 4.6 cm2, respectively (P=0.000, 0.003, 0.000 and 0.000), and the ratio of recurrence within GTV in the patient group was significantly greater than that in the smaller group (P=0.000, 0.002, 0.001 and 0.000). GTV-L and GTV-V/L were the independent risk factors of recurrence in GTV (P=0.021 and 0.009). The 3-, 5-and 10-year survival rates of all patients in the whole group were 42.9%, 23.2% and 7.9%, respectively. Multivariate analysis demonstrated that age, T stage, concurrent radiochemotherapy, GTV-D and GTV-V/L were the independent risk factors of survival (P=0.027, 0.000, 0.018, 0.009 and 0.034). The main cause of death in patients with a survival time of more than 5 years was still associated with cancer. Conclusions The locoregional risk factors of esophageal cancer exert significant effect on the recurrence of GTV in patients with N0 esophageal squamous cell carcinoma undergoing radical radiochemotherapy, which can be utilized as the predicting markers. Both GTV-D and GTV-V/L are significantly correlated the 10-year survival of patients. Key words: Esophageal neoplasm/radiochemotherapy; Recurrence of primary tumor bed; Prognosis
{"title":"Effect of locoregional risk factors on long-term prognosis of patients with N0 stage esophageal cancer receiving intensity-modulated radiotherapy","authors":"W. Shen, Hong-mei Gao, Jinrui Xu, Y. Cao, Shu-guang Li, You-mei Li, Shuchai Zhu","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.004","url":null,"abstract":"Objective \u0000To evaluate the effect of locoregional risk factors of esophageal cancer on the recurrence of gross tumor volume (GTV) in patients with N0 esophageal squamous cell carcinoma after radical intensity-modulated radiotherapy (IMRT) and to evaluate its effect on the 10-year survival of patients. \u0000 \u0000 \u0000Methods \u0000Clinical data of 374 patients with clinical N0 esophageal squamous cell carcinoma who underwent radical IMRT in the Fourth Hospital of Hebei Medical University from 2005 to 2010 were retrospectively analyzed. Involved-field irradiation was performed in 284 patients and selective lymph node irradiation was given in 90 patients. Concurrent radiochemotherapy was conducted in 69l patients and sequential radiochemotherapy was performed in 38 patients. The survival analysis was carried out by Kaplan-Meier method. The prognosis analysis was performed by multivariate Cox’s regression model. \u0000 \u0000 \u0000Results \u0000A total of 143 patients (38.2%) had recurrence in GTV. The maximum transverse diameter (GTV-D), GTV volume (GTV-V) and GTV volume/length (GTV-V/L) of GTV patients were significantly longer than those without recurrence in GTV (P=0.008, 0.043, 0.001). ROC curve analysis showed that the optimal diagnostic thresholds for GTV-D, GTV-L, GTV-V and GTV-V/L for GTV recurrence were 3.5 cm, 5.5 cm, 24.0 cm3 and 4.6 cm2, respectively (P=0.000, 0.003, 0.000 and 0.000), and the ratio of recurrence within GTV in the patient group was significantly greater than that in the smaller group (P=0.000, 0.002, 0.001 and 0.000). GTV-L and GTV-V/L were the independent risk factors of recurrence in GTV (P=0.021 and 0.009). The 3-, 5-and 10-year survival rates of all patients in the whole group were 42.9%, 23.2% and 7.9%, respectively. Multivariate analysis demonstrated that age, T stage, concurrent radiochemotherapy, GTV-D and GTV-V/L were the independent risk factors of survival (P=0.027, 0.000, 0.018, 0.009 and 0.034). The main cause of death in patients with a survival time of more than 5 years was still associated with cancer. \u0000 \u0000 \u0000Conclusions \u0000The locoregional risk factors of esophageal cancer exert significant effect on the recurrence of GTV in patients with N0 esophageal squamous cell carcinoma undergoing radical radiochemotherapy, which can be utilized as the predicting markers. Both GTV-D and GTV-V/L are significantly correlated the 10-year survival of patients. \u0000 \u0000 \u0000Key words: \u0000Esophageal neoplasm/radiochemotherapy; Recurrence of primary tumor bed; Prognosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43425980","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.013
Yanze Sun, Yongqiang Yang, J. Qian
Objective To evaluate and predict the pelvic dose by analyzing two pelvic contour definitions and identify the influencing factors of the pelvic dose in postoperative IMRT for cervical cancer, aiming to provide reference for postoperative pelvis-sparing IMRT for cervical cancer. Methods Sixty cervical cancer patients receiving postoperative IMRT with unrestricted pelvic dose were selected. Two sets of pelvic contours (pelvic anatomy and pelvic Mell) were delineated as per the anatomical and Mell methods. The dose relationship between two methods was analyzed after redesigning the treatment plan by limiting dose of pelvic anatomy. The correlation analysis was performed by Pearson’s correlation method. The factors affecting the pelvic anatomy dose were identified by Logistic multivariate regression analysis and a dose prediction model was subsequently established. Results The volumes of pelvic anatomy and pelvic Mell were 925.82 cm3 and 1141.20 cm3(P=0.000). There was a significant correlation between them (r>0.622, P=0.000). The dose of pelvic anatomy was significantly higher than that of pelvic Mell. The relationship of V10, V20 and V30 between them was y=-8+ 1.01x, y=-13+ 1.05x and y=-4+ 0.9x, respectively. The dose limits of pelvic Mell recommended by literatures(V10<90%, V20<75%, V30<60%) were translated into V10<97%, V20<83% and V30<70%, respectively. The pelvic anatomy dose was significantly reduced after dose limiting. The V10, V20, V30 and Dmean were significantly decreased by 3.64%, 12.69%, 12.02% and 6.93%(P=0.000, 0.000, 0.000), respectively. Multivariate analysis showed that the overlapping volume of pelvic anatomy within PTV was an independent influencing factor of pelvic anatomy dose (P<0.05). Patients with a relative overlapping volume of less than 18% could easily meet the dose limiting requirement. Conclusions Both two pelvic contour definitions can be applied in postoperative pelvis-sparing IMRT for cervical cancer. Use of pelvic dose limiting can significantly reduce the IMRT dose. The overlapping volume of the pelvis within PTV is an independent influencing factor of pelvic dose. Patients whose overlapping volume within the PTV relative to pelvis is less than 18% can easily meet the dose limiting requirement. Key words: Cervical cancer/intensity-modulated radiotherapy; Pelvis; Dosimetry
{"title":"Evaluation and prediction of pelvic dose in postoperative IMRT for cervical cancer","authors":"Yanze Sun, Yongqiang Yang, J. Qian","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.013","url":null,"abstract":"Objective \u0000To evaluate and predict the pelvic dose by analyzing two pelvic contour definitions and identify the influencing factors of the pelvic dose in postoperative IMRT for cervical cancer, aiming to provide reference for postoperative pelvis-sparing IMRT for cervical cancer. \u0000 \u0000 \u0000Methods \u0000Sixty cervical cancer patients receiving postoperative IMRT with unrestricted pelvic dose were selected. Two sets of pelvic contours (pelvic anatomy and pelvic Mell) were delineated as per the anatomical and Mell methods. The dose relationship between two methods was analyzed after redesigning the treatment plan by limiting dose of pelvic anatomy. The correlation analysis was performed by Pearson’s correlation method. The factors affecting the pelvic anatomy dose were identified by Logistic multivariate regression analysis and a dose prediction model was subsequently established. \u0000 \u0000 \u0000Results \u0000The volumes of pelvic anatomy and pelvic Mell were 925.82 cm3 and 1141.20 cm3(P=0.000). There was a significant correlation between them (r>0.622, P=0.000). The dose of pelvic anatomy was significantly higher than that of pelvic Mell. The relationship of V10, V20 and V30 between them was y=-8+ 1.01x, y=-13+ 1.05x and y=-4+ 0.9x, respectively. The dose limits of pelvic Mell recommended by literatures(V10<90%, V20<75%, V30<60%) were translated into V10<97%, V20<83% and V30<70%, respectively. The pelvic anatomy dose was significantly reduced after dose limiting. The V10, V20, V30 and Dmean were significantly decreased by 3.64%, 12.69%, 12.02% and 6.93%(P=0.000, 0.000, 0.000), respectively. Multivariate analysis showed that the overlapping volume of pelvic anatomy within PTV was an independent influencing factor of pelvic anatomy dose (P<0.05). Patients with a relative overlapping volume of less than 18% could easily meet the dose limiting requirement. \u0000 \u0000 \u0000Conclusions \u0000Both two pelvic contour definitions can be applied in postoperative pelvis-sparing IMRT for cervical cancer. Use of pelvic dose limiting can significantly reduce the IMRT dose. The overlapping volume of the pelvis within PTV is an independent influencing factor of pelvic dose. Patients whose overlapping volume within the PTV relative to pelvis is less than 18% can easily meet the dose limiting requirement. \u0000 \u0000 \u0000Key words: \u0000Cervical cancer/intensity-modulated radiotherapy; Pelvis; Dosimetry","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43629969","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.02.015
Zekun Wang
Perineural invasion is a unique biological behavior of tumors via nerve dissemination and metastasis, which is intimately correlated with the recurrence, metastasis and prognosis. With the deepening research, the clinical significance of perineural invasion has been widely recognized. However, due to the low incidence of head and neck neoplasms and the varying incidence of perineural invasion in different anatomical sites and pathological types, high-level evidence-based medical evidence is still lacking. Currently, the pathological mechanism of perineural invasion has not been clearly clarified. No specific treatment has been available for perineural invasion. Therefore, the treatment of perineural invasion of head and neck tumors is an enormous challenge for clinicians. In this article, the current status of clinical diagnosis and treatment of perineural invasion in head and neck malignancies was reviewed. Key words: Head and neck neoplasm; Perineural invasion; Diagnosis and treatment
{"title":"Clinical diagnosis and treatment of perineural invasion of head and neck malignant tumors","authors":"Zekun Wang","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.02.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.02.015","url":null,"abstract":"Perineural invasion is a unique biological behavior of tumors via nerve dissemination and metastasis, which is intimately correlated with the recurrence, metastasis and prognosis. With the deepening research, the clinical significance of perineural invasion has been widely recognized. However, due to the low incidence of head and neck neoplasms and the varying incidence of perineural invasion in different anatomical sites and pathological types, high-level evidence-based medical evidence is still lacking. Currently, the pathological mechanism of perineural invasion has not been clearly clarified. No specific treatment has been available for perineural invasion. Therefore, the treatment of perineural invasion of head and neck tumors is an enormous challenge for clinicians. In this article, the current status of clinical diagnosis and treatment of perineural invasion in head and neck malignancies was reviewed. \u0000 \u0000 \u0000Key words: \u0000Head and neck neoplasm; Perineural invasion; Diagnosis and treatment","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"146-149"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46875097","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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