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中华放射肿瘤学杂志最新文献

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Patterns and risk factors of lymph node metastasis in locally advanced supraglottic squamous cell carcinoma 局部晚期声门上鳞癌淋巴结转移模式及危险因素分析
Pub Date : 2020-01-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.002
Yi Xu, Ye Zhang, Shaoyan Liu, Xiaolei Wang, Xiao-dong Huang, Y. Qu, Kai Wang, R. Wu, Xue-song Chen, Qingfeng Liu, Shiran Sun, Xi Luo, Jingwei Luo, Li Gao, Guo-zhen Xu, J. Yi
Objective To investigate the pattern of lymph node metastasis (LNM) in patients with locally advanced (T3, T4) laryngeal squamous cell carcinoma (LALSC) and provide reference for the delineation of clinical target volume. Methods Clinical data of 272 patients with LALSC treated in our hospital from 2000 to 2017 were retrospectively analyzed. All patients underwent bilateral neck dissection (at least level Ⅱ-Ⅳ). The LNM ratio of each node level was calculated. The risk factors of LNM were identified by univariate and multivariate logistic regression analyses. Results LNM was found in 156 of 272 patients (57.1%). According to the location of primary lesions, all patients were divided into group A (n=72; unilateral without midline involvement), group B (n=86; unilateral with midline involvement) and group C (n=114; giant or central). In group A, the LNM ratio at ipsilateral level Ⅱ, Ⅲ and Ⅳ was 36.3%, 26.4% and 6.9%, whereas 13.9%, 8.3% and 1.4% at the contralateral level, respectively. In group B, the LNM ratio at ipsilateral level Ⅱ, Ⅲ and IV was 1.9%, 29.1% and 11.6%, whereas 18.6%, 14.0% and 1.2% at the contralateral level, respectively. In group C, the LNM ratio at the left neck level Ⅱ, Ⅲ and Ⅳ was 24.6%, 23.7% and 2.6%, whereas 21.9%, 26.3% and 6.1% at the right neck, respectively. Bilateral LNM ratio did not significantly differ between group A and group B/C (15.3%, 25.0%, P=0.093). Ipsilateral level Ⅲ metastasis (OR=2.929, 95%CI 1.041-8.245, P=0.042) and clinical N stage (OR=0.082, 95%CI 0.018-0.373, P=0.001) were associated with contralateral LNM. Ipsilateral level Ⅱ(P=0.043) or Ⅲ(P=0.009) metastasis were risk factors of the ipsilateral level Ⅳ metastasis. Conclusions Neck levels Ⅱ and Ⅲ are the high-risk LNM regions, whereaslevels Ⅳ and V are the low-risk areas. Ipsilateral level Ⅱ or Ⅲ metastases are the risk factors of ipsilateral level Ⅳ and contralateral cervical LNM. Contralateral neck LNM rarely occurs in cN0 stage patients. Key words: Locally advanced laryngeal cancer; Squamous cell carcinoma; Lymph node metastasis; Risk factor
目的探讨局部晚期(T3、T4)喉鳞癌(LALSC)患者的淋巴结转移(LNM)模式,为临床靶体积的划定提供参考。方法回顾性分析我院2000 ~ 2017年收治的272例LALSC患者的临床资料。所有患者均行双侧颈部清扫术(至少Ⅱ-Ⅳ段)。计算各节点级别的LNM比率。通过单因素和多因素logistic回归分析确定LNM的危险因素。结果272例患者中有156例出现LNM,占57.1%。根据原发病灶的位置,将所有患者分为A组(n=72;单侧无中线受累),B组(n=86;单侧中线受累)和C组(n=114;巨型或中央)。A组同侧Ⅱ、Ⅲ和Ⅳ的LNM比例分别为36.3%、26.4%和6.9%,对侧分别为13.9%、8.3%和1.4%。B组同侧Ⅱ、Ⅲ和IV的LNM率分别为1.9%、29.1%和11.6%,对侧LNM率分别为18.6%、14.0%和1.2%。C组左颈部水平Ⅱ、Ⅲ和Ⅳ的LNM比例分别为24.6%、23.7%和2.6%,右颈部水平分别为21.9%、26.3%和6.1%。A组与B/C组双侧LNM比例差异无统计学意义(15.3%,25.0%,P=0.093)。同侧水平Ⅲ转移(OR=2.929, 95%CI 1.041 ~ 8.245, P=0.042)和临床N分期(OR=0.082, 95%CI 0.018 ~ 0.373, P=0.001)与对侧LNM相关。同侧水平Ⅱ(P=0.043)或Ⅲ(P=0.009)转移是同侧水平Ⅳ转移的危险因素。结论颈部级Ⅱ、Ⅲ为LNM的高危区,Ⅳ、V级为LNM的低危区。同侧水平Ⅱ或Ⅲ转移是同侧水平Ⅳ和对侧宫颈LNM的危险因素。对侧颈部LNM很少发生在cN0期患者。关键词:局部晚期喉癌;鳞状细胞癌;淋巴结转移;风险因素
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引用次数: 0
Prognostic analysis of recurrent esophageal squamous cell carcinoma after neoadjuvant therapy combined with surgical treatment 新辅助治疗联合手术治疗复发性食管鳞状细胞癌的预后分析
Pub Date : 2020-01-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2020.01.006
C. Fan, Zhu Feng, H. Ge, K. Ye, Hao Wang, Xiao-li Zheng, Yougai Zhang
Objective To evaluate the clinical efficacy and prognostic factors of recurrent esophageal squamous cell carcinoma after neoadjuvant therapy combined with surgery. Methods From December 2011 to December 2015, 152 cases of recurrent thoracic esophageal squamous cell carcinoma after neoadjuvant therapy combined with surgery were retrospectively analyzed. The overall survival (OS) after treatment failure, clinical efficacy and prognostic factors of different salvage treatments were analyzed. OS was calculated by Kaplan-Meier method. Prognostic analysis was performed by using multivariate Cox regression model. Results The median interval of the first recurrence was 10.6(2.0 to 69.1) months. The median OS after recurrence was 8.0(0.8 to 43.3) months. The 1-, 2-and 3-year OS rates after recurrence were 36.0%, 15.1% and 5.2%, respectively. The median OS of patients with locoregional recurrence alone, distant metastasis alone and locoregional recurrence combined with distant metastasis was 11.3(1.8 to 43.3) months, 6.7(1.2 to 28.6) months and 5.1(0.8 to 22.9) months, respectively. Multivariate analysis demonstrated that neoadjuvant chemotherapy (P=0.009), ypTNM stage (P=0.012), comprehensive treatment after recurrence (P=0.000) and locoregional recurrence (P=0.026) were independently correlated with the OS of patients with recurrent esophageal squamous cell carcinoma. Conclusions Neoadjuvant therapy, ypTNM stage, recurrence pattern and post-recurrence treatment are the independent risk factors for clinical prognosis of patients with recurrent esophageal squamous cell carcinoma after neoadjuvant therapy combined with surgery. Clinical prognosis of patients with recurrent esophageal squamous cell carcinoma after neoadjuvant therapy is not satisfactory. After recurrence, combined treatment mode should be adopted according to the site of recurrence and neoadjuvant treatment mode to maximize the benefits of salvage treatment. Key words: Esophageal neoplasm, recurrent/ neoadjuvant treatment; Locoregional recurrence; Distant metastasis; Prognosis
目的评价新辅助治疗联合手术治疗复发性食管鳞状细胞癌的临床疗效及影响预后的因素。方法回顾性分析2011年12月至2015年12月152例经新辅助治疗并手术治疗的复发性胸段食管鳞状细胞癌。分析了治疗失败后的总生存率、不同挽救治疗的临床疗效和预后因素。OS采用Kaplan-Meier法计算。采用多变量Cox回归模型进行预后分析。结果首次复发的中位时间间隔为10.6个月(2.0~69.1)。复发后的中位OS为8.0(0.8至43.3)个月。复发后1、2和3年OS发生率分别为36.0%、15.1%和5.2%。单独局部复发、单独远处转移和局部复发合并远处转移患者的中位OS分别为11.3(1.8-43.3)个月、6.7(1.2-28.6)个月和5.1(0.8-22.9)个月。多因素分析表明,新辅助化疗(P=0.009)、ypTNM分期(P=0.012)、复发后综合治疗(P=0.000)和局部复发(P=0.026)与复发性食管鳞状细胞癌患者的OS独立相关。结论新辅助治疗、ypTNM分期、复发方式和复发后治疗是影响食管鳞状细胞癌术后复发患者临床预后的独立危险因素。复发性食管鳞状细胞癌患者新辅助治疗后的临床预后不理想。复发后,应根据复发部位采用联合治疗模式和新辅助治疗模式,最大限度地发挥抢救性治疗的效益。关键词:食管肿瘤,复发/新辅助治疗;局部复发;远处转移;预后
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引用次数: 0
Recommendation for an oral mucosal contouring method in nasopharyngeal carcinoma patients receiving tomotherapy 鼻咽癌患者接受断层治疗时口腔黏膜轮廓法的推荐
Pub Date : 2020-01-15 DOI: 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
目的评价两种口腔黏膜轮廓法对鼻咽癌患者急性放射性口腔黏膜炎(A-ROM)的预测价值。方法选取2017 - 2019年在浙江省肿瘤医院接受根治性放疗(TOMO)的AJCC 7期Ⅱ-IVB NPCs患者150例作为前瞻性观察研究对象。采用口腔轮廓(OCC)和粘膜表面轮廓(MSC)来描绘口腔粘膜结构。根据RTOG评分标准,每周对A-ROM评分进行前瞻性评估和记录。统计比较两种方法对A-ROM的预测值。结果≥3级A-ROM发生率为33.3%。单因素分析中,OCC的V5、V10、V15、V45、V50、V55、V60、V65、V70和MSC的V5、V10、V50、V55、V60、V65、V70和Dmean与A-ROM≥3级的风险显著相关(均P<0.05)。在二元logistic回归分析中,性别和吸烟与OCC检测的≥3级A-ROM发生率显著相关(男vs女:OR=0.141, 95%CI=0.037 ~ 0.538, P=0.004;吸烟vs.不吸烟:OR=5.109, 95%CI=1.413-18.470, P=0.013)。对于MSC,性别、吸烟、N期和MSC- V55是独立预测因素(男性vs女性:OR=0.129, 95%CI=0.032-0.519, P=0.004;吸烟vs.不吸烟:OR=4.448, 95%CI=1.224 ~ 16.164, P=0.023;N期: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)。回顾性分析,MSC-V55的截止值为7.70%,ROC曲线下面积为0.754,敏感性和特异性分别为0.680和0.740 (P均<0.001)。结论与OCC相比,MSC对接受TOMO治疗的鼻咽癌患者a - rom严重程度的预测准确度更高。关键词:鼻咽肿瘤/断层扫描治疗;急性放射性口腔黏膜炎;剂量测定的参数
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引用次数: 0
Progress on standardized treatment for patients with general cancer pain and cancer pain during " peri-radiotherapeutic period" 一般性癌性疼痛及“围放疗期”癌性疼痛的规范化治疗进展
Pub Date : 2020-01-15 DOI: 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
癌症疼痛是恶性肿瘤患者的主要症状之一。如果不及时治疗,将导致顽固性疼痛,并增加个人和社会的负担。在中国,名为“良好疼痛管理”的项目已经开展了近7年,这提高了医务人员对癌症疼痛的总体评估和治疗水平。然而,癌症疼痛治疗的临床疗效并不令人满意。放射治疗作为恶性肿瘤的重要治疗手段,也是治疗癌症疼痛的主要方法之一。我们首次提出了“放疗周”的概念,强调对癌症疼痛患者在放疗前、放疗中、放疗后的持续镇痛治疗。本文介绍了国内外癌症疼痛治疗的现状,总结了癌症疼痛“围治期”的规范化评估和管理。关键词:癌症疼痛;肿瘤/放疗;围放疗期;阿片类药物
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引用次数: 0
Silencing LncRNA OIP5-AS1 increases radiosensitivity of non-small cell lung cancer A549 cell line by up-regulating miR-34c-5p expression 沉默LncRNA OIP5-AS1通过上调miR-34c-5p表达增加非小细胞肺癌癌症A549细胞系的放射敏感性
Pub Date : 2020-01-15 DOI: 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
目的探讨LncRNA OIP5-AS1对非小细胞肺癌(NSCLC)细胞放射敏感性的影响及其机制。方法用6 Gy射线照射A549细胞,分5个组分建立A549R细胞株。通过qRT-PCR检测OIP5-AS1和miR-34c-5p在A549和A549R细胞中的表达水平。将OIP5-AS1抑制剂或miR-34c-5p模拟物转染到A549R细胞中,或将OIP5-AS1过表达质粒转染到A549细胞中。流式细胞仪检测细胞凋亡。通过集落形成试验分析细胞的放射敏感性。通过蛋白质印迹测定p-Chk2和p-ATM蛋白的表达水平。采用双荧光素酶测定法验证OIP5-AS1与miR-34c-5p之间的关系。结果与A549细胞相比,A549R细胞中OIP5-AS1的表达显著上调(1.97±0.11 vs.1.01±0.05,P<0.05),而miR-34c-5p的表达显著下调(0.43±0.02 vs.1.02±0.06,P<0.05)。沉默OIP5-AS1+6Gy组A549R细胞中P-Chk2和P-ATM蛋白的表达水平显著降低(0.43士0.03 vs.1.39±0.15,0.51士0.05 vs.1.21±0.11,均P<0.05),细胞凋亡率显著高于沉默对照+6Gy组[(13.29±1.25)%vs.(28.47±2.31)%,P<0.05)。抑制miR-34c-5p的表达逆转了沉默OIP5-AS1对A549R细胞存活率的影响(SER=1.42)。结论沉默OIP5-AS1通过上调miR-34c-5p的表达,增强耐辐射A549细胞的放射敏感性,为NSCLC细胞的放射治疗提供了潜在的靶点。关键词:A549细胞系;A549R细胞系;OIP5-AS1基因;miR-34c-5p基因;放射敏感性
{"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}
引用次数: 0
3D-printing non-coplanar template assisted 125I seed implantation for head and neck tumor: individualized template design and application 三维打印非共面模板辅助125I粒子植入头颈部肿瘤:个性化模板设计与应用
Pub Date : 2020-01-15 DOI: 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
目的比较计算机断层扫描(CT)引导和3D打印非共面模板辅助125I种子植入头颈部肿瘤术前计划和术后验证的剂量数据,探讨个体化模板设计方法的安全性、可行性和准确性。方法选择北京大学第三医院2016年1-12月收治的42例头颈部恶性肿瘤复发/转移患者。采用110~160Gy的剂量,设计了42例非共面三维打印模板。对D90、最小外周剂量(mPD)、V100、V150、V200、适形指数(CI)、外周指数(EI)和均匀性指数(HI)等剂量测定参数在手术前后进行统计学比较。结果所有模板均在术中正确植入。与术前计划相比,术后D90、V100、CI、EI和HI无显著差异(P=0.490、0.407、0.893、0.143和0.079),而mPD、V150和V200有显著差异(P=0.036、0.007和0.000),能够满足临床要求。关键词:三维打印;个性化非共面模板;剂量测定;头颈部肿瘤/放射性种子植入
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引用次数: 0
Failure patterns of locoregional recurrence in women with T1-2N1 breast cancer after modified radical mastectomy 改良根治性乳房切除术后T1-2N1乳腺癌症局部复发的失败模式
Pub Date : 2020-01-15 DOI: 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
目的分析改良根治性乳房切除术后T1-2N1乳腺癌局部复发(LRR)的失败模式及放疗范围。方法1997年9月至2015年4月,在我院对2472例癌症T1-2N1乳腺癌患者行改良根治性乳房切除术,无需新辅助系统治疗。1898名未接受辅助放射治疗的患者被纳入本研究。分析了累积LRR的分布。采用Kaplan-Meier方法估计LR和RR发生率,并采用Log-rank检验在单变量分析中确定预后因素。采用Cox逻辑回归分析进行多变量分析。结果164例患者中位随访71.3个月(1.1-194.6),其中锁骨上/锁骨下淋巴结106例(65%),胸壁69例(42%),腋窝39例(24%),乳内淋巴结19例(12%)。在多变量分析中,年龄(>45岁vs.≤45岁)、肿瘤位置(其他象限vs.内象限)、T分期(T1vs..T2)、腋窝淋巴结阳性数(1 vs.2-3)、激素受体状态(阳性vs.阴性)是LR和RR的重要预后因素。结论改良根治性乳房切除术后T1-2N1乳腺癌症患者最常见的LRR部位为锁骨上/锁骨下结区,其次为胸壁。腋窝或IMN复发是罕见的。LR和RR的预后因素相似,这表明应考虑锁骨上/锁骨下和胸壁照射进行骨切除术后放疗。关键词:乳腺肿瘤/改良根治性乳房切除术;阳性淋巴结;局部复发模式
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引用次数: 0
Research progress on postoperative adjuvant therapy for esophageal carcinoma 食管癌术后辅助治疗的研究进展
Pub Date : 2019-12-15 DOI: 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
在中国,根治性食管切除术仍然是可切除食管癌的主要治疗策略。然而,高局部复发率和血液转移率是手术失败的主要原因。因此,术后辅助治疗能否成为食管癌治疗的重要手段之一仍存在争议。本文就食管癌术后复发类型及辅助治疗的研究进展进行综述,以期为临床医生提供参考。关键词:食管肿瘤/手术;食管肿瘤/化疗;食管肿瘤/放射疗法;研究进展
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引用次数: 0
Prognostic and survival analyses of early-stage diffuse large B-cell lymphoma of Waldeyer′s ring 早期弥漫性Waldeyer环大B细胞淋巴瘤的预后和生存率分析
Pub Date : 2019-12-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.12.004
Huan Li, Tao Wu, Qi-chang Lin, Jing Zhang, Yunfei Hu, Mengxiang Chen, Yunhong Huang
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
目的分析以CHOP为基础的化疗治疗早期弥漫性Waldeyer环大B细胞淋巴瘤(WR-DLBCL)的临床疗效及影响预后的因素。方法纳入我院2006~2018年收治的137例WR-DLBCL患者,其中Ⅰ期22例,Ⅱ期115例。所有患者均接受基于CHOP的化疗,其中62例接受利妥昔单抗治疗,87例接受现场放疗。采用Kaplan-Meier法计算总生存率(OS)、无进展生存率(PFS)和局部无复发生存率(LRRFS)。对数秩检验用于单变量分析,Cox回归模型用于多变量分析。结果全组5年OS、PFS和LRFFS分别为78.6%、69.5%和83.2%,综合治疗组分别为87.5%、80.2%和90.9%,化疗组分别为64.2%、53.6%和72.9%。单因素分析显示,乳酸脱氢酶(LDH)、国际预后指数评分、大肿块、利妥昔单抗、化疗周期和综合治疗是OS和PFS的预后因素。此外,LDH、大面积和综合治疗是LRFFS的预后因素。多因素分析表明LDH、综合治疗方式和利妥昔单抗是OS的预后因素。LDH和综合治疗方式是影响PFS的预后因素。LDH是LRFFS的预后因素。结论早期WR-BLBCL患者临床预后良好。在利妥昔单抗治疗的时代,化疗结合放疗仍然是早期WR-BLBCL的有效治疗方法。关键词:瓦尔德耶环形弥漫性大B细胞淋巴瘤/靶向治疗;Waldeyer环弥漫性大B细胞淋巴瘤/放射治疗;Waldeyer环弥漫性大B细胞淋巴瘤/化疗;预后
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引用次数: 0
Application of CT image correction algorithm based on image transformation in the evaluation of dose accuracy evaluation during radiotherapy for cervical cancer 基于图像变换的CT图像校正算法在癌症放疗剂量准确度评价中的应用
Pub Date : 2019-12-15 DOI: 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
目的定量评价癌症放疗剂量的准确性。方法提出一种基于图像变换的CT图像校正算法。参照CBCT图像,对癌症放疗方案的CT图像进行校正,得到能够反映治疗实际体位的校正图像。将临床计划移植到校正后的图像中,作为测试计划进行剂量重新计算,并对剂量测定参数进行统计比较,以评估剂量准确性。结果两种造影方案的目标覆盖率均能满足临床要求(>98%),均匀性指数无显著差异(P=0.150)。试验方案的一致性明显低于临床方案(P<0.05)。试验计划中每个危险器官的最大剂量比临床方案高约30cGy(P<0.05),V50略高于临床方案,而平均剂量(Dmean)没有显著差异。结论基于图像变换的CT图像校正算法可以定量评价癌症放疗剂量的准确性,为临床解决类似问题提供参考。关键词:图像转换;图像校正;宫颈肿瘤/放射治疗;剂量准确性
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引用次数: 0
期刊
中华放射肿瘤学杂志
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