Pub Date : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.003
Yuanyuan Chen, Peijing Li, Shuangyan Yang, J. Fang, Jiang Zhang, Q. Hu, Ming Chen, Xiaozhong Chen, Ye Tian
Objective To evaluate the value of two oral mucosal contouring methods for predicting acute radiation-induced oral mucositis (A-ROM) in nasopharyngeal carcinoma (NPC) patients. Methods A total of 150 AJCC 7th stage Ⅱ-IVB NPCs receiving radical tomotherapy (TOMO) in Zhejiang Cancer Hospital from 2017 to 2019 were included in this prospective observational study. Oral cavity contour (OCC) and mucosal surface contour (MSC) were applied to delineate the oral mucosal structure. A-ROM grade was prospectively assessed and recorded weekly according to RTOG scoring criteria. The prediction value of two methods for A-ROM was statistically compared. Results The incidence rate of ≥3 grade A-ROM was 33.3%. In univariate analysis, V5, V10, V15, V45, V50, V55, V60, V65 and V70 of OCC and V5, V10, V50, V55, V60, V65, V70 and Dmean of MSC were significantly correlated with the risk of ≥3 grade A-ROM (all P<0.05). In binary logistic regression analysis, gender and smoking were significantly associated with the incidence of ≥3 grade A-ROM by using OCC (male vs. female: OR=0.141, 95%CI=0.037-0.538, P=0.004; smoking vs.non-smoking: OR=5.109, 95%CI=1.413-18.470, P=0.013). For MSC, gender, smoking, N stage and MSC- V55 were the independent predictors (male vs. female: OR=0.129, 95%CI=0.032-0.519, P=0.004; smoking vs.non-smoking: OR=4.448, 95%CI=1.224-16.164, P=0.023; N stage: OR=2.291, 95%CI=1.268-4.137, P=0.006; MSC-V55: OR=1.432, 95%CI=1.008-2.033, P=0.045). The cutoff value of MSC-V55 was 7.70%, the area under ROC curve was 0.754, the sensitivity and specificity were 0.680 and 0.740, retrospectively (all P<0.001). Conclusions Compared with OCC, MSC yields a higher prediction accuracy for the severity of A-ROM in nasopharyngeal carcinoma patients receiving TOMO treatment. Key words: Nasopharyngeal neoplasms/tomography therapy; Acute radiation-induced oral mucositis; Dosimetric parameter
{"title":"Recommendation for an oral mucosal contouring method in nasopharyngeal carcinoma patients receiving tomotherapy","authors":"Yuanyuan Chen, Peijing Li, Shuangyan Yang, J. Fang, Jiang Zhang, Q. Hu, Ming Chen, Xiaozhong Chen, Ye Tian","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.01.003","url":null,"abstract":"Objective \u0000To evaluate the value of two oral mucosal contouring methods for predicting acute radiation-induced oral mucositis (A-ROM) in nasopharyngeal carcinoma (NPC) patients. \u0000 \u0000 \u0000Methods \u0000A total of 150 AJCC 7th stage Ⅱ-IVB NPCs receiving radical tomotherapy (TOMO) in Zhejiang Cancer Hospital from 2017 to 2019 were included in this prospective observational study. Oral cavity contour (OCC) and mucosal surface contour (MSC) were applied to delineate the oral mucosal structure. A-ROM grade was prospectively assessed and recorded weekly according to RTOG scoring criteria. The prediction value of two methods for A-ROM was statistically compared. \u0000 \u0000 \u0000Results \u0000The incidence rate of ≥3 grade A-ROM was 33.3%. In univariate analysis, V5, V10, V15, V45, V50, V55, V60, V65 and V70 of OCC and V5, V10, V50, V55, V60, V65, V70 and Dmean of MSC were significantly correlated with the risk of ≥3 grade A-ROM (all P<0.05). In binary logistic regression analysis, gender and smoking were significantly associated with the incidence of ≥3 grade A-ROM by using OCC (male vs. female: OR=0.141, 95%CI=0.037-0.538, P=0.004; smoking vs.non-smoking: OR=5.109, 95%CI=1.413-18.470, P=0.013). For MSC, gender, smoking, N stage and MSC- V55 were the independent predictors (male vs. female: OR=0.129, 95%CI=0.032-0.519, P=0.004; smoking vs.non-smoking: OR=4.448, 95%CI=1.224-16.164, P=0.023; N stage: OR=2.291, 95%CI=1.268-4.137, P=0.006; MSC-V55: OR=1.432, 95%CI=1.008-2.033, P=0.045). The cutoff value of MSC-V55 was 7.70%, the area under ROC curve was 0.754, the sensitivity and specificity were 0.680 and 0.740, retrospectively (all P<0.001). \u0000 \u0000 \u0000Conclusions \u0000Compared with OCC, MSC yields a higher prediction accuracy for the severity of A-ROM in nasopharyngeal carcinoma patients receiving TOMO treatment. \u0000 \u0000 \u0000Key words: \u0000Nasopharyngeal neoplasms/tomography therapy; Acute radiation-induced oral mucositis; Dosimetric parameter","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45516981","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.017
B. Tan
Cancer pain is one of the main symptoms of patients suffering from malignant tumors. If it is not timely treated, it will lead to refractory pain and increase the burden on both the individuals and society. In China, the program titled" Good Pain Management" has been carried out for nearly 7 years, which increases the overall assessment and treatment levels for cancer pain among medical personnel. Nevertheless, the clinical efficacy for cancer pain treatment is not satisfactory. As an important treatment for malignant tumors, radiation therapy is also one of the main methods for treating cancer pain. For the first time, we proposed the concept of " peri-radiotherapeutic period" , and emphasized the continuous analgesic treatment for patients with cancer pain before, during and after radiotherapy. In this article, current status of cancer pain treatment at home and abroad was illustrated, and standardized assessment and management of cancer pain during the " peri-radiotherapeutic period" were summarized. Key words: Cancer pain; Neoplasm/radiotherapy; Peri-radiotherapeutic period; Opioid drug
{"title":"Progress on standardized treatment for patients with general cancer pain and cancer pain during \" peri-radiotherapeutic period\"","authors":"B. Tan","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.01.017","url":null,"abstract":"Cancer pain is one of the main symptoms of patients suffering from malignant tumors. If it is not timely treated, it will lead to refractory pain and increase the burden on both the individuals and society. In China, the program titled\" Good Pain Management\" has been carried out for nearly 7 years, which increases the overall assessment and treatment levels for cancer pain among medical personnel. Nevertheless, the clinical efficacy for cancer pain treatment is not satisfactory. As an important treatment for malignant tumors, radiation therapy is also one of the main methods for treating cancer pain. For the first time, we proposed the concept of \" peri-radiotherapeutic period\" , and emphasized the continuous analgesic treatment for patients with cancer pain before, during and after radiotherapy. In this article, current status of cancer pain treatment at home and abroad was illustrated, and standardized assessment and management of cancer pain during the \" peri-radiotherapeutic period\" were summarized. \u0000 \u0000 \u0000Key words: \u0000Cancer pain; Neoplasm/radiotherapy; Peri-radiotherapeutic period; Opioid drug","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48604677","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.013
Kai Mao, Xiaohua Ding, Liping Wu, Y. Mao, Liguo Zhang, Jun Li, Jiang Lu
Objective To investigate the effect of LncRNA OIP5-AS1 on radiosensitivity of non-small cell lung cancer (NSCLC) cells and its mechanism. Methods The radiation-resistant cell A549R was established by using A549 cells irradiated by X-ray 6Gy in 5 fractions. The expression levels of OIP5-AS1 and miR-34c-5p in A549 and A549R cells were detected by qRT-PCR. OIP5-AS1 inhibitor or miR-34c-5p mimetic was transfected into A549R cells, or OIP5-AS1 overexpression plasmid was transfected into A549 cells. Cell apoptosis was detected by flow cytometry. Cell radiosensitivity was analyzed by colony formation assay. The expression levels of p-Chk2 and p-ATM proteins were measured by Western blot. Dual luciferase assay was adopted to verify the relationship between OIP5-AS1 and miR-34c-5p. Results Compared with A549 cells, the expression of OIP5-AS1 was significantly up-regulated in A549R cells (1.97±0.11 vs.1.01±0.05, P<0.05), whereas the expression of miR-34c-5p was remarkably down-regulated (0.43±0.02 vs.1.02±0.06, P<0.05). The expression levels of p-Chk2 and p-ATM proteins in A549R cells in the silencing OIP5-AS1+ 6Gy group were significantly lower (0.43±0.03 vs.1.39±0.15, 0.51±0.0 5 vs.1.21± 0.11, both P<0.05), whereas the apoptotic rate was significantly higher than those in the silencing control+ 6Gy group [(13.29±1.25)% vs. (28.47±2.31)%, P<0.05)]. The expression levels of p-Chk2 and p-ATM proteins in A549 cells in overexpressing OIP5-AS1+ 6Gy group were significantly higher than those in overexpression control+ 6Gy group (1.23±0.13 vs.0.75±0.06, 1.08±0.11 vs.0.59±0.04, both P<0.05). Inhibiting miR-34c-5p expression reversed the effect of silencing OIP5-AS1 on survival fraction of A549R cells (SER=1.42). OIP5-AS1 negatively regulated the expression of miR-34c-5p. Conclusion Silencing OIP5-AS1 enhances the radiosensitivity of radiation-resistant A549 cells by up-regulating the expression of miR-34c-5p, providing a potential target for radiotherapy of NSCLC cells. Key words: A549 cell line; A549R cell line; OIP5-AS1 gene; miR-34c-5p gene; radiosensitivity
{"title":"Silencing LncRNA OIP5-AS1 increases radiosensitivity of non-small cell lung cancer A549 cell line by up-regulating miR-34c-5p expression","authors":"Kai Mao, Xiaohua Ding, Liping Wu, Y. Mao, Liguo Zhang, Jun Li, Jiang Lu","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.01.013","url":null,"abstract":"Objective \u0000To investigate the effect of LncRNA OIP5-AS1 on radiosensitivity of non-small cell lung cancer (NSCLC) cells and its mechanism. \u0000 \u0000 \u0000Methods \u0000The radiation-resistant cell A549R was established by using A549 cells irradiated by X-ray 6Gy in 5 fractions. The expression levels of OIP5-AS1 and miR-34c-5p in A549 and A549R cells were detected by qRT-PCR. OIP5-AS1 inhibitor or miR-34c-5p mimetic was transfected into A549R cells, or OIP5-AS1 overexpression plasmid was transfected into A549 cells. Cell apoptosis was detected by flow cytometry. Cell radiosensitivity was analyzed by colony formation assay. The expression levels of p-Chk2 and p-ATM proteins were measured by Western blot. Dual luciferase assay was adopted to verify the relationship between OIP5-AS1 and miR-34c-5p. \u0000 \u0000 \u0000Results \u0000Compared with A549 cells, the expression of OIP5-AS1 was significantly up-regulated in A549R cells (1.97±0.11 vs.1.01±0.05, P<0.05), whereas the expression of miR-34c-5p was remarkably down-regulated (0.43±0.02 vs.1.02±0.06, P<0.05). The expression levels of p-Chk2 and p-ATM proteins in A549R cells in the silencing OIP5-AS1+ 6Gy group were significantly lower (0.43±0.03 vs.1.39±0.15, 0.51±0.0 5 vs.1.21± 0.11, both P<0.05), whereas the apoptotic rate was significantly higher than those in the silencing control+ 6Gy group [(13.29±1.25)% vs. (28.47±2.31)%, P<0.05)]. The expression levels of p-Chk2 and p-ATM proteins in A549 cells in overexpressing OIP5-AS1+ 6Gy group were significantly higher than those in overexpression control+ 6Gy group (1.23±0.13 vs.0.75±0.06, 1.08±0.11 vs.0.59±0.04, both P<0.05). Inhibiting miR-34c-5p expression reversed the effect of silencing OIP5-AS1 on survival fraction of A549R cells (SER=1.42). OIP5-AS1 negatively regulated the expression of miR-34c-5p. \u0000 \u0000 \u0000Conclusion \u0000Silencing OIP5-AS1 enhances the radiosensitivity of radiation-resistant A549 cells by up-regulating the expression of miR-34c-5p, providing a potential target for radiotherapy of NSCLC cells. \u0000 \u0000 \u0000Key words: \u0000A549 cell line; A549R cell line; OIP5-AS1 gene; miR-34c-5p gene; radiosensitivity","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"57-60"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48994411","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.010
Yuewen Cui, Haitao Sun, Yuliang Jiang
Objective To compare the dosimetric data between preoperative plans and postoperative verification in computed tomography (CT)-guided and 3D-printing non-coplanar template-assisted 125I seed implantation for head and neck tumor, aiming to explore the safety, feasibility and accuracy of the individualized template design method. Methods A total of 42 patients with recurrent/metastatic malignant head and neck tumor admitted to Peking University Third Hospital from January to December 2016 were recruited in this study. A prescribed dose of 110-160Gy was adopted.3D-printing non-coplanar templates were designed for 42 cases. The dosimetric parameters including D90, minimum peripheral dose (mPD), V100, V150, V200, conformal index (CI), external index (EI) and homogeneity index (HI) were statistically compared before and after surgery. Results All templates were properly implanted intraoperatively. Compared with preoperative planning, postoperative D90, V100, CI, EI and HI did not significantly differ (P=0.490, 0.407, 0.893, 0.143 and 0.079), whereas mPD, V150 and V200 significantly differed (P=0.036, 0.007 and 0.000). Conclusion After postoperative verification, the main dosimetric parameters have high therapeutic accuracy and properly match with preoperative planning, which can meet clinical requirements. Key words: Three-dimensional printing; Individualized non-coplanar template; Dosimetry; Head and neck neoplasm/radioactive seed implantation
{"title":"3D-printing non-coplanar template assisted 125I seed implantation for head and neck tumor: individualized template design and application","authors":"Yuewen Cui, Haitao Sun, Yuliang Jiang","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.01.010","url":null,"abstract":"Objective \u0000To compare the dosimetric data between preoperative plans and postoperative verification in computed tomography (CT)-guided and 3D-printing non-coplanar template-assisted 125I seed implantation for head and neck tumor, aiming to explore the safety, feasibility and accuracy of the individualized template design method. \u0000 \u0000 \u0000Methods \u0000A total of 42 patients with recurrent/metastatic malignant head and neck tumor admitted to Peking University Third Hospital from January to December 2016 were recruited in this study. A prescribed dose of 110-160Gy was adopted.3D-printing non-coplanar templates were designed for 42 cases. The dosimetric parameters including D90, minimum peripheral dose (mPD), V100, V150, V200, conformal index (CI), external index (EI) and homogeneity index (HI) were statistically compared before and after surgery. \u0000 \u0000 \u0000Results \u0000All templates were properly implanted intraoperatively. Compared with preoperative planning, postoperative D90, V100, CI, EI and HI did not significantly differ (P=0.490, 0.407, 0.893, 0.143 and 0.079), whereas mPD, V150 and V200 significantly differed (P=0.036, 0.007 and 0.000). \u0000 \u0000 \u0000Conclusion \u0000After postoperative verification, the main dosimetric parameters have high therapeutic accuracy and properly match with preoperative planning, which can meet clinical requirements. \u0000 \u0000 \u0000Key words: \u0000Three-dimensional printing; Individualized non-coplanar template; Dosimetry; Head and neck neoplasm/radioactive seed implantation","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"43-46"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49406241","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.007
X. Zhao, Shulian Wang, Yong-wen Song, Yu Tang, Yong Yang, H. Fang, Jianyang Wang, H. Jing, Jiang-hu Zhang, G. Sun, Siye Chen, J. Jin, Yueping Liu, Bo Chen, S. Qi, Ning Li, Yuan Tang, N. Lu
Objective To analyze the failure patterns of locoregional recurrence (LRR) and investigate the range of radiotherapy in T1-2N1 breast cancer patients undergoing modified radical mastectomy. Methods From September 1997 to April 2015, 2472 women with T1-2N1 breast cancer after modified radical mastectomy without neoadjuvant systemic therapy were treated in our hospital. 1898 patients who did not undergo adjuvant radiotherapy were included in this study. The distribution of accumulated LRR was analyzed. The LR and RR rates were estimated by the Kaplan-Meier method, and the prognostic factors were identified in univariate analyses with Log-rank test. Multivariate analysis was performed using Cox logistic regression analysis. Results With a median follow-up of 71.3 months (range 1.1-194.6), 164 patients had LRR, including supraclavicular/infraclavicular lymph nodes in 106(65%), chest wall in 69(42%), axilla in 39(24%) and internal mammary lymph nodes (IMNs) in 19 patients (12%). In multivariate analysis, age (>45 years vs.≤45 years), tumor location (other quadrants vs. inner quadrant), T stage (T1vs. T2), the number of positive axillary lymph nodes (1 vs. 2-3), hormone receptor status (positive vs. negative) were significant prognostic factors for both LR and RR. Conclusions In patients with T1-2N1 breast cancer after modified radical mastectomy, the most common LRR site is supraclavicular/infraclavicular nodal region, followed by chest wall. The axillary or IMN recurrence is rare. The prognostic factors for LR and RR are similar, which indicates that supraclavicular/infraclavicular and chest wall irradiation should be considered for postmastectomy radiotherapy. Key words: Breast neoplasm/modified radical mastectomy; Positive lymph node; Locoregional recurrence patterns
{"title":"Failure patterns of locoregional recurrence in women with T1-2N1 breast cancer after modified radical mastectomy","authors":"X. Zhao, Shulian Wang, Yong-wen Song, Yu Tang, Yong Yang, H. Fang, Jianyang Wang, H. Jing, Jiang-hu Zhang, G. Sun, Siye Chen, J. Jin, Yueping Liu, Bo Chen, S. Qi, Ning Li, Yuan Tang, N. Lu","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.01.007","url":null,"abstract":"Objective \u0000To analyze the failure patterns of locoregional recurrence (LRR) and investigate the range of radiotherapy in T1-2N1 breast cancer patients undergoing modified radical mastectomy. \u0000 \u0000 \u0000Methods \u0000From September 1997 to April 2015, 2472 women with T1-2N1 breast cancer after modified radical mastectomy without neoadjuvant systemic therapy were treated in our hospital. 1898 patients who did not undergo adjuvant radiotherapy were included in this study. The distribution of accumulated LRR was analyzed. The LR and RR rates were estimated by the Kaplan-Meier method, and the prognostic factors were identified in univariate analyses with Log-rank test. Multivariate analysis was performed using Cox logistic regression analysis. \u0000 \u0000 \u0000Results \u0000With a median follow-up of 71.3 months (range 1.1-194.6), 164 patients had LRR, including supraclavicular/infraclavicular lymph nodes in 106(65%), chest wall in 69(42%), axilla in 39(24%) and internal mammary lymph nodes (IMNs) in 19 patients (12%). In multivariate analysis, age (>45 years vs.≤45 years), tumor location (other quadrants vs. inner quadrant), T stage (T1vs. T2), the number of positive axillary lymph nodes (1 vs. 2-3), hormone receptor status (positive vs. negative) were significant prognostic factors for both LR and RR. \u0000 \u0000 \u0000Conclusions \u0000In patients with T1-2N1 breast cancer after modified radical mastectomy, the most common LRR site is supraclavicular/infraclavicular nodal region, followed by chest wall. The axillary or IMN recurrence is rare. The prognostic factors for LR and RR are similar, which indicates that supraclavicular/infraclavicular and chest wall irradiation should be considered for postmastectomy radiotherapy. \u0000 \u0000 \u0000Key words: \u0000Breast neoplasm/modified radical mastectomy; Positive lymph node; Locoregional recurrence patterns","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"29 1","pages":"31-34"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44797959","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.12.015
W. Ni
In China, radical esophagectomy remains the main strategy for resectable esophageal cancer. However, the high locoregional recurrence rate and hematogenous metastasis rate are the main causes of surgical failure. Therefore, whether postoperative adjuvant therapy can become one of the important means for esophageal cancer remains controversial. In this article, the research progress on the postoperative recurrent pattern and adjuvant therapy for esophageal carcinoma was reviewed to provide references for clinicians. Key words: Esophageal neoplasm/Surgery; Esophageal neoplasm/chemotherapy; Esophageal neoplasm/radiotherapy; Research progress
{"title":"Research progress on postoperative adjuvant therapy for esophageal carcinoma","authors":"W. Ni","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.015","url":null,"abstract":"In China, radical esophagectomy remains the main strategy for resectable esophageal cancer. However, the high locoregional recurrence rate and hematogenous metastasis rate are the main causes of surgical failure. Therefore, whether postoperative adjuvant therapy can become one of the important means for esophageal cancer remains controversial. In this article, the research progress on the postoperative recurrent pattern and adjuvant therapy for esophageal carcinoma was reviewed to provide references for clinicians. \u0000 \u0000 \u0000Key words: \u0000Esophageal neoplasm/Surgery; Esophageal neoplasm/chemotherapy; Esophageal neoplasm/radiotherapy; Research progress","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"945-948"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48539267","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 analyze the clinical efficacy and prognostic factors of patients with early-stage diffuse large B-cell lymphoma of Waldeyer′s ring (WR-DLBCL) treated with CHOP-based chemotherapy. Methods A total of 137 patients diagnosed with WR-DLBCL admitted to our hospitalfrom 2006 to 2018 were enrolled, including 22 patients with stage Ⅰ and 115 patients with stage Ⅱ WR-DLBCL. All patients received CHOP-based chemotherapy, of whom 62 receiving rituximab and 87 receiving involved-field radiotherapy. The overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRRFS) were calculated by Kaplan-Meier method. Log-rank test, was conducted for univariate analysis and Cox’s regression model was performed for multivariate analysis. Results The 5-year OS, PFS, and LRFFS in the whole group were 78.6%, 69.5% and 83.2%, and 87.5%, 80.2%, 90.9% in the comprehensive treatment group, and 64.2%, 53.6% 72.9% in the chemotherapy group, respectively. Univariate analysis showed that lactate dehydrogenase (LDH), international prognostic index score, large mass, rituximab, chemotherapy cycle and comprehensive treatment were the prognostic factors of OS and PFS. In addition, LDH, large mass and comprehensive treatment were the prognostic factors associated with LRFFS. Multivariate analysis demonstrated that LDH, comprehensive treatment mode and rituximab were the prognostic factors of OS. LDH and comprehensive treatment mode were the prognostic factors associated with PFS. LDH was a prognostic factor of LRFFS. Conclusion Patients with early-stage WR-BLBCL obtain excellent clinical prognosis. In the era of rituximab treatment, chemotherapy combined with radiotherapy remains an efficacious treatment of early-stage WR-BLBCL. Key words: Diffuse large B-cell lymphoma of Waldeyer′s ring/targeted therapy; Diffuse large B-cell lymphoma of Waldeyer′s ring/radiotherapy; Diffuse large B-cell lymphoma of Waldeyer′s ring/chemotherapy; Prognosis
{"title":"Prognostic and survival analyses of early-stage diffuse large B-cell lymphoma of Waldeyer′s ring","authors":"Huan Li, Tao Wu, Qi-chang Lin, Jing Zhang, Yunfei Hu, Mengxiang Chen, Yunhong Huang","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.004","url":null,"abstract":"Objective \u0000To analyze the clinical efficacy and prognostic factors of patients with early-stage diffuse large B-cell lymphoma of Waldeyer′s ring (WR-DLBCL) treated with CHOP-based chemotherapy. \u0000 \u0000 \u0000Methods \u0000A total of 137 patients diagnosed with WR-DLBCL admitted to our hospitalfrom 2006 to 2018 were enrolled, including 22 patients with stage Ⅰ and 115 patients with stage Ⅱ WR-DLBCL. All patients received CHOP-based chemotherapy, of whom 62 receiving rituximab and 87 receiving involved-field radiotherapy. The overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRRFS) were calculated by Kaplan-Meier method. Log-rank test, was conducted for univariate analysis and Cox’s regression model was performed for multivariate analysis. \u0000 \u0000 \u0000Results \u0000The 5-year OS, PFS, and LRFFS in the whole group were 78.6%, 69.5% and 83.2%, and 87.5%, 80.2%, 90.9% in the comprehensive treatment group, and 64.2%, 53.6% 72.9% in the chemotherapy group, respectively. Univariate analysis showed that lactate dehydrogenase (LDH), international prognostic index score, large mass, rituximab, chemotherapy cycle and comprehensive treatment were the prognostic factors of OS and PFS. In addition, LDH, large mass and comprehensive treatment were the prognostic factors associated with LRFFS. Multivariate analysis demonstrated that LDH, comprehensive treatment mode and rituximab were the prognostic factors of OS. LDH and comprehensive treatment mode were the prognostic factors associated with PFS. LDH was a prognostic factor of LRFFS. \u0000 \u0000 \u0000Conclusion \u0000Patients with early-stage WR-BLBCL obtain excellent clinical prognosis. In the era of rituximab treatment, chemotherapy combined with radiotherapy remains an efficacious treatment of early-stage WR-BLBCL. \u0000 \u0000 \u0000Key words: \u0000Diffuse large B-cell lymphoma of Waldeyer′s ring/targeted therapy; Diffuse large B-cell lymphoma of Waldeyer′s ring/radiotherapy; Diffuse large B-cell lymphoma of Waldeyer′s ring/chemotherapy; Prognosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"896-900"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49613375","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.12.008
J. Zhong, Minmin Qiu, Z. Xiao
Objective To quantitatively evaluate dose accuracy of radiotherapy for cervical cancer. Methods A CT image correction algorithm based on image transformation was proposed. Referring to CBCT images, CT images of radiotherapy plan for cervical cancer were corrected to obtain the corrected images which could reflect the actual body position of treatment. The clinical plan was transplanted to the corrected images for dose recalculation as a test plan, and the dosimetry parameters were statistically compared to evaluate the dose accuracy. Results Both of the target coverage of contrast plans could meet the clinical requirements (>98%), and there was no significant difference in the homogeneity index (P=0.150). The conformability of the test plan was significantly worse than that of the clinical plan (P<0.05). The maximum dose of each organ at risk in the test plan was approximately 30 cGy higher than that of the clinical plan (P<0.05), V50 was slightly higher than that of the clinical plan, whereas the average dose (Dmean) did not significantly differ. Conclusion The CT image correction algorithm based on image transformation can quantitatively evaluate the dose accuracy of radiotherapy for cervical cancer, which provides reference for resolving similar problems in clinical practice. Key words: Image transformation; Image correction; Cervical neoplasm/radiotherapy; Dose accuracy
{"title":"Application of CT image correction algorithm based on image transformation in the evaluation of dose accuracy evaluation during radiotherapy for cervical cancer","authors":"J. Zhong, Minmin Qiu, Z. Xiao","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.008","url":null,"abstract":"Objective \u0000To quantitatively evaluate dose accuracy of radiotherapy for cervical cancer. \u0000 \u0000 \u0000Methods \u0000A CT image correction algorithm based on image transformation was proposed. Referring to CBCT images, CT images of radiotherapy plan for cervical cancer were corrected to obtain the corrected images which could reflect the actual body position of treatment. The clinical plan was transplanted to the corrected images for dose recalculation as a test plan, and the dosimetry parameters were statistically compared to evaluate the dose accuracy. \u0000 \u0000 \u0000Results \u0000Both of the target coverage of contrast plans could meet the clinical requirements (>98%), and there was no significant difference in the homogeneity index (P=0.150). The conformability of the test plan was significantly worse than that of the clinical plan (P<0.05). The maximum dose of each organ at risk in the test plan was approximately 30 cGy higher than that of the clinical plan (P<0.05), V50 was slightly higher than that of the clinical plan, whereas the average dose (Dmean) did not significantly differ. \u0000 \u0000 \u0000Conclusion \u0000The CT image correction algorithm based on image transformation can quantitatively evaluate the dose accuracy of radiotherapy for cervical cancer, which provides reference for resolving similar problems in clinical practice. \u0000 \u0000 \u0000Key words: \u0000Image transformation; Image correction; Cervical neoplasm/radiotherapy; Dose accuracy","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"914-918"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45092171","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.12.003
C. Fan, Zhu Feng, H. Ge, K. Ye, Hao Wang, Xiao-li Zheng, Yougai Zhang, Shuai Song, Peizan Ni, Ruiyun Zhang
Objective To compare the effect of neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant chemotherapy (NCT) on the survival of patients with esophageal cancer. Methods Clinical data of 275 cases of thoracic esophageal squamous cell carcinoma treated with neoadjuvant therapy combined with surgery from December 2011 to December 2015 were analyzed retrospectively. The data of treatment and follow-up were complete and analyzable. There were 70 cases in the NCRT group and 205 cases in the NCT group. The survival rate was calculated by Kaplan-Meier method and statistically compared by log-rank test, and multivariate analysis was performed by Cox regression model. Results The median follow-up time was 32(3-84) months. The median survival time and recurrence-free survival time was 42(3-84) months and 30(3-84) months, respectively. The overall 3-and 5-year survival rates were 56.8% and 45.9%, respectively, and the 3-and 5-year recurrence-free survival rates were 45.1% and 38.9%, respectively. The median survival time in the NCRT and NCT groups was 46(7-84) and 40(4-74) months, and the median recurrence-free survival time was 31(3-84) and 28(3-69) months, respectively. The 3-and 5-year overall survival of the two groups were 59.1%, 47.1% and 56.3%, 47.5%(P=0.515), and the 3-and 5-year recurrence-free survival were 44.5%, 40.1% and 47%, 39%, respectively. There was no significant difference in the survival between two neoadjuvant therapy modes (P=0.554). Multivariate analysis showed that postoperative pathological TNM staging was an independent factor affecting the prognosis of patients with esophageal cancer (P=0.001). Conclusions The survival results of NCRT are similar to those of NCT. Postoperative pathological staging is an independent survival factor. Key words: Esophageal neoplasm/neoadjuvant radiotherapy; Esophageal neoplasm/neoadjuvant chemotherapy; Prognosis
{"title":"Comparison of survival between neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy followed by surgery for esophageal squamous cell carcinoma","authors":"C. Fan, Zhu Feng, H. Ge, K. Ye, Hao Wang, Xiao-li Zheng, Yougai Zhang, Shuai Song, Peizan Ni, Ruiyun Zhang","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.003","url":null,"abstract":"Objective \u0000To compare the effect of neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant chemotherapy (NCT) on the survival of patients with esophageal cancer. \u0000 \u0000 \u0000Methods \u0000Clinical data of 275 cases of thoracic esophageal squamous cell carcinoma treated with neoadjuvant therapy combined with surgery from December 2011 to December 2015 were analyzed retrospectively. The data of treatment and follow-up were complete and analyzable. There were 70 cases in the NCRT group and 205 cases in the NCT group. The survival rate was calculated by Kaplan-Meier method and statistically compared by log-rank test, and multivariate analysis was performed by Cox regression model. \u0000 \u0000 \u0000Results \u0000The median follow-up time was 32(3-84) months. The median survival time and recurrence-free survival time was 42(3-84) months and 30(3-84) months, respectively. The overall 3-and 5-year survival rates were 56.8% and 45.9%, respectively, and the 3-and 5-year recurrence-free survival rates were 45.1% and 38.9%, respectively. The median survival time in the NCRT and NCT groups was 46(7-84) and 40(4-74) months, and the median recurrence-free survival time was 31(3-84) and 28(3-69) months, respectively. The 3-and 5-year overall survival of the two groups were 59.1%, 47.1% and 56.3%, 47.5%(P=0.515), and the 3-and 5-year recurrence-free survival were 44.5%, 40.1% and 47%, 39%, respectively. There was no significant difference in the survival between two neoadjuvant therapy modes (P=0.554). Multivariate analysis showed that postoperative pathological TNM staging was an independent factor affecting the prognosis of patients with esophageal cancer (P=0.001). \u0000 \u0000 \u0000Conclusions \u0000The survival results of NCRT are similar to those of NCT. Postoperative pathological staging is an independent survival factor. \u0000 \u0000 \u0000Key words: \u0000Esophageal neoplasm/neoadjuvant radiotherapy; Esophageal neoplasm/neoadjuvant chemotherapy; Prognosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"890-895"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47635539","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 : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.12.007
Huang Peng, Xu Yingjie, Tian Yuan, Ma Pan, D. Jianrong
Objective To design and implement an automatic independent check software (AutoReview) for the radiotherapy treatment plan and improve the efficiency of independent check. Methods The patient′s electronic treatment plan chart in the record and verify (R&V) system database accessed by the SQL language was read and parsed. Based on the treatment plan information obtained from the chart, AutoReview extracted all parameters related to the treatment plan from the treatment planning system and the R&V system, and saved the structured data into a local database. For different check items, corresponding check logic was designed and the program was written to realize the automatic independent check. In total, 664 clinical treatment plans for one month were selected as a sample to evaluate the clinical application effect. Results Compared with manual check, AutoReview improved the check efficiency by nearly 60 times and the problem detection rate was elevated by 19.2%. In the two-year clinical application, the software operation was stable, and 14509 treatment plans were automatically checked and identified 588 cases with problems, accounting for 4.05%. Conclusion AutoReview can effectively improve the efficiency and accuracy of independent check in radiotherapy treatment plan. Key words: Automatic independent check; Radiotherapy treatment plan; Quality assurance; Quality control
{"title":"Realization and application of automatic independent check software for radiotherapy treatment plans","authors":"Huang Peng, Xu Yingjie, Tian Yuan, Ma Pan, D. Jianrong","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.007","url":null,"abstract":"Objective \u0000To design and implement an automatic independent check software (AutoReview) for the radiotherapy treatment plan and improve the efficiency of independent check. \u0000 \u0000 \u0000Methods \u0000The patient′s electronic treatment plan chart in the record and verify (R&V) system database accessed by the SQL language was read and parsed. Based on the treatment plan information obtained from the chart, AutoReview extracted all parameters related to the treatment plan from the treatment planning system and the R&V system, and saved the structured data into a local database. For different check items, corresponding check logic was designed and the program was written to realize the automatic independent check. In total, 664 clinical treatment plans for one month were selected as a sample to evaluate the clinical application effect. \u0000 \u0000 \u0000Results \u0000Compared with manual check, AutoReview improved the check efficiency by nearly 60 times and the problem detection rate was elevated by 19.2%. In the two-year clinical application, the software operation was stable, and 14509 treatment plans were automatically checked and identified 588 cases with problems, accounting for 4.05%. \u0000 \u0000 \u0000Conclusion \u0000AutoReview can effectively improve the efficiency and accuracy of independent check in radiotherapy treatment plan. \u0000 \u0000 \u0000Key words: \u0000Automatic independent check; Radiotherapy treatment plan; Quality assurance; Quality control","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"909-913"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48005097","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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