Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.12.001
J. Zong, Yuhong Zheng, Cheng Lin, Yan Chen, Chuanben Chen, Jianji Pan, Shaojun Lin
Objective To investigate the clinical value of plasma EBV DNA in monitoring clinical efficacy in the treatment of nasopharyngeal carcinoma (NPC). Methods Clinical data of 799 patients initially diagnosed with NPC treated with radical intensity-modulated radiotherapy (IMRT) in our hospital from 2016 to 2017 were analyzed retrospectively. Prior to treatment, the correlation between plasma EBV DNA, clinical stage and tumor progression was analyzed. The relationship between EBV DNA and tumor progression was analyzed after radiotherapy and during follow-up. Results Before IMRT, the level of EBV DNA was positively correlated with both clinical stage and tumor progression (both P<0.001). At 6 to 8 weeks after IMRT, 19(2.3%) patients positive for plasma EBV DNA obtained the worst prognosis and 14 cases had tumor progression. At 6-8 weeks after IMRT, 9 patients were negative for EBV DNA and 3 cases had tumor progression. The tumor progression rate of patients with undetectable plasma EBV DNA at the end of IMRT was only 8.3%(64/772), and the progression-free survival rate significantly differed among three groups (all P<0.05). The sensitivity, specificity and accuracy rates of persistent positive plasma EBV DNA during follow-up were calculated as 77.6%, 100% and 98.1%, respectively. Conclusions The level of plasma EBV DNA in patients with NPC is correlated with tumor bearing and tumor progression prior to IMRT. At 6-8 weeks after IMRT, patients who are persistently positive for EBV DNA obtain the worst prognosis and should be given with appropriate adjuvant therapy. The correlation between persistent positive plasma EBV DNA during follow up and tumor progression yields a high accuracy rate, indicating that plasma EBV DNA is a reliable biomarker for monitoring the clinical efficacy after radical treatment for NPC patients. Key words: Nasopharyngeal neoplasm/intensity-modulated radiotherapy; EBV; DNA; Monitoring
{"title":"The value of plasma EBV DNA in monitoring the therapeutic effect of nasopharyngeal carcinoma","authors":"J. Zong, Yuhong Zheng, Cheng Lin, Yan Chen, Chuanben Chen, Jianji Pan, Shaojun Lin","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.001","url":null,"abstract":"Objective \u0000To investigate the clinical value of plasma EBV DNA in monitoring clinical efficacy in the treatment of nasopharyngeal carcinoma (NPC). \u0000 \u0000 \u0000Methods \u0000Clinical data of 799 patients initially diagnosed with NPC treated with radical intensity-modulated radiotherapy (IMRT) in our hospital from 2016 to 2017 were analyzed retrospectively. Prior to treatment, the correlation between plasma EBV DNA, clinical stage and tumor progression was analyzed. The relationship between EBV DNA and tumor progression was analyzed after radiotherapy and during follow-up. \u0000 \u0000 \u0000Results \u0000Before IMRT, the level of EBV DNA was positively correlated with both clinical stage and tumor progression (both P<0.001). At 6 to 8 weeks after IMRT, 19(2.3%) patients positive for plasma EBV DNA obtained the worst prognosis and 14 cases had tumor progression. At 6-8 weeks after IMRT, 9 patients were negative for EBV DNA and 3 cases had tumor progression. The tumor progression rate of patients with undetectable plasma EBV DNA at the end of IMRT was only 8.3%(64/772), and the progression-free survival rate significantly differed among three groups (all P<0.05). The sensitivity, specificity and accuracy rates of persistent positive plasma EBV DNA during follow-up were calculated as 77.6%, 100% and 98.1%, respectively. \u0000 \u0000 \u0000Conclusions \u0000The level of plasma EBV DNA in patients with NPC is correlated with tumor bearing and tumor progression prior to IMRT. At 6-8 weeks after IMRT, patients who are persistently positive for EBV DNA obtain the worst prognosis and should be given with appropriate adjuvant therapy. The correlation between persistent positive plasma EBV DNA during follow up and tumor progression yields a high accuracy rate, indicating that plasma EBV DNA is a reliable biomarker for monitoring the clinical efficacy after radical treatment for NPC patients. \u0000 \u0000 \u0000Key words: \u0000Nasopharyngeal neoplasm/intensity-modulated radiotherapy; EBV; DNA; Monitoring","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"881-884"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41751533","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.1004-4221.2019.12.010
Xudong Kong, TengXiang Li, G. Gong
Objective To analyze the magnetic resonance imaging (MRI) radiomic performance of hypoxic area in nasopharyngeal carcinoma patients, aiming to provide a reference for identification and analysis of hypoxic area. Methods The MRI-T1, MRI-T2, MRI-T1+ and PET/CT images of 32 patients initially diagnosed with nasopharyngeal carcinoma were retrospectively analyzed. The gross tumor volume (GTV) of nasopharynx was countoured and the hypoxic areas (GTV-H) were identified by 18F-FMISO-PET images. The non-hypoxic areas (GTV-NH) were defined as the rest of areas removed GTV-H from GTV. The radiomic features of GTV-H and GTV-NH were extracted and compared. Results The average volume of GTV-H and GTV-NH was (10.92±11.02) cm3 and (7.21±5.70) cm3, respectively. The maximum rate of change was 46% for intensity direct-global min (ID-GM) on MRI-T1(P 0.7 and Youden index>0.5). The average rate of change was 136% for long run emphasis (LRE), long run high gray level emphasis (LRHGLE) and long run low gray level emphasis (LRLGLE) on MRI-T2(P 0.7 and Youden index>0.5). The high change rates was greater than 90% on MRI-T1+ (P 0.7 and Youden index>0.5) for ID-GM, LRE, LRHGLE and LRLGLE. Conclusions The hypoxic area of tumor target can be reflected by MRI radiomics on T1/T2/T1+ . Quantifying and tracking the variations of these features can bring benefit to recognize the hypoxic area of nasopharyngeal carcinoma tumor target. Key words: Nasopharyngeal neoplasm hypoxic area; Radiomics; Hypoxic area identification
{"title":"Analysis of MRI radiomic features of hypoxic area in nasopharyngeal carcinoma patients","authors":"Xudong Kong, TengXiang Li, G. Gong","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.010","url":null,"abstract":"Objective \u0000To analyze the magnetic resonance imaging (MRI) radiomic performance of hypoxic area in nasopharyngeal carcinoma patients, aiming to provide a reference for identification and analysis of hypoxic area. \u0000 \u0000 \u0000Methods \u0000The MRI-T1, MRI-T2, MRI-T1+ and PET/CT images of 32 patients initially diagnosed with nasopharyngeal carcinoma were retrospectively analyzed. The gross tumor volume (GTV) of nasopharynx was countoured and the hypoxic areas (GTV-H) were identified by 18F-FMISO-PET images. The non-hypoxic areas (GTV-NH) were defined as the rest of areas removed GTV-H from GTV. The radiomic features of GTV-H and GTV-NH were extracted and compared. \u0000 \u0000 \u0000Results \u0000The average volume of GTV-H and GTV-NH was (10.92±11.02) cm3 and (7.21±5.70) cm3, respectively. The maximum rate of change was 46% for intensity direct-global min (ID-GM) on MRI-T1(P 0.7 and Youden index>0.5). The average rate of change was 136% for long run emphasis (LRE), long run high gray level emphasis (LRHGLE) and long run low gray level emphasis (LRLGLE) on MRI-T2(P 0.7 and Youden index>0.5). The high change rates was greater than 90% on MRI-T1+ (P 0.7 and Youden index>0.5) for ID-GM, LRE, LRHGLE and LRLGLE. \u0000 \u0000 \u0000Conclusions \u0000The hypoxic area of tumor target can be reflected by MRI radiomics on T1/T2/T1+ . Quantifying and tracking the variations of these features can bring benefit to recognize the hypoxic area of nasopharyngeal carcinoma tumor target. \u0000 \u0000 \u0000Key words: \u0000Nasopharyngeal neoplasm hypoxic area; Radiomics; Hypoxic area identification","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"924-927"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46370294","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.1004-4221.2019.12.017
Guanchu Song, Dan Liu, Genyan Guo
Autophagy extensively exists in eukaryotes, which utilizes lysosomes to degrade the damaged organelles or proteins, maintain the stability of the intracellular environment and provide energy. It can also participate in the growth, proliferation and apoptosis of tumor cells through autophagy-related genes and signaling pathways. Radiotherapy is one of the main treatments for cancer, whereas tumor cells often have radiation resistance, which reduces the clinical efficacy. Previous studies have demonstrated that autophagy is associated with the radiosensitivity of tumor cells, but the conclusions are different. In this article, different effects of autophagy upon the radiosensitity of tumor cells were reviewed. Key words: Autophagy; Neoplasm/radiotherapy
{"title":"Effects of autophagy on radiosensitivity","authors":"Guanchu Song, Dan Liu, Genyan Guo","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.017","url":null,"abstract":"Autophagy extensively exists in eukaryotes, which utilizes lysosomes to degrade the damaged organelles or proteins, maintain the stability of the intracellular environment and provide energy. It can also participate in the growth, proliferation and apoptosis of tumor cells through autophagy-related genes and signaling pathways. Radiotherapy is one of the main treatments for cancer, whereas tumor cells often have radiation resistance, which reduces the clinical efficacy. Previous studies have demonstrated that autophagy is associated with the radiosensitivity of tumor cells, but the conclusions are different. In this article, different effects of autophagy upon the radiosensitity of tumor cells were reviewed. \u0000 \u0000 \u0000Key words: \u0000Autophagy; Neoplasm/radiotherapy","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"953-956"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44628127","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.1004-4221.2019.12.012
Xing-xiao Yang, Xue-yuan Zhang, Naiyi Zou, M. Ma, Shuchai Zhu
Objective To evaluate the effect of X-ray radiation on cell proliferation, migration, survival ability and cell cycle of human esophageal squamous cell carcinoma after RNA interference-mediated down-regulation of HMGB1 gene expression. Methods The expression of HMGB1 at mRNA and protein levels in the human esophageal squamous cell carcinoma cell lines ECA109 and KYSE30 was determined using RT-PCR and Western blot assays. MTS and Transwell assays were employed to examine the proliferation and migration of ECA109 and KYSE30 cell lines. The cellular survival ability in vitro was assessed by clone formation assay. The cell cycle after X-ray radiation in different groups was detected by flow cytometry. Results The expression of HMGB1 at mRNA and protein levels in ECA109 and KYSE30 cells were markedly higher in a dose-dependent and time-dependent manner in the radiation group than that in the control group (all P<0.05). MTS results demonstrated that the proliferation of ECA109 and KYSE30 cells was obviously lower at each time point after radiation than that in the group without radiation (all P<0.01). The expression of HMGB1 at mRNA and protein levels was significantly inhibited in the HMGB1 siRNA group than those in the control and NC groups (both P<0.01). The data from the clone formation assay revealed that the radiosensitivity was significantly increased after down-regulation of HMGB1 expression (P<0.01). Transwell migration assay revealed that the number of migrating cells at the fourth hour after X-ray irradiation in the HMGB1 siRNA group was significantly lower than those in the control and negative groups (both P<0.01). In the HMGB1 siRNA group, the percentage of cells at G0/G1 phase was obviously higher, whereas the percentage of S phase was significantly lower than those in the control and NC groups, and the trend was even more significant after X-ray radiation (all P<0.01). Conclusion Inhibition of HMGB1 expression by siRNA can suppress the proliferation and migration of ECA109 and KYSE30 cells and enhance the radiosensitivity by increasing the cell cycle arrest at G0/G1 stage after X-ray irradiation in vitro. Key words: HMGB1 gene; Cell proliferation and migration; Cell cycle; Radiosensitivity
目的探讨x射线辐射RNA干扰下调HMGB1基因表达后对人食管鳞状细胞癌细胞增殖、迁移、存活能力及细胞周期的影响。方法采用RT-PCR和Western blot方法检测HMGB1在人食管鳞癌细胞株ECA109和KYSE30中mRNA和蛋白水平的表达。采用MTS和Transwell法检测ECA109和KYSE30细胞系的增殖和迁移。通过克隆形成实验评估体外细胞存活能力。用流式细胞术检测x射线照射后各组细胞周期变化。结果放疗组ECA109和KYSE30细胞HMGB1 mRNA和蛋白表达水平均显著高于对照组，且呈剂量依赖性和时间依赖性(P<0.05)。MTS结果显示，放疗后各时间点ECA109和KYSE30细胞的增殖明显低于未放疗组(均P<0.01)。HMGB1 siRNA组HMGB1 mRNA和蛋白水平的表达均显著低于对照组和NC组(P<0.01)。克隆形成实验数据显示，下调HMGB1表达后，放射线敏感性显著提高(P<0.01)。Transwell迁移实验显示，x射线照射后第4 h HMGB1 siRNA组的迁移细胞数量显著低于对照组和阴性组(P<0.01)。HMGB1 siRNA组细胞处于G0/G1期的比例明显高于对照组和NC组，而处于S期的比例明显低于对照组和NC组，x射线照射后这种趋势更为显著(P<0.01)。结论siRNA抑制HMGB1表达可抑制体外x射线照射后ECA109和KYSE30细胞的增殖和迁移，并通过增加G0/G1期细胞周期阻滞来增强放射敏感性。关键词:HMGB1基因;细胞增殖和迁移;细胞周期;辐射敏感度
{"title":"Effect of HMGB1 knockdown by RNA interference on cell proliferation and migration of esophageal squamous cell carcinoma after X-ray radiation","authors":"Xing-xiao Yang, Xue-yuan Zhang, Naiyi Zou, M. Ma, Shuchai Zhu","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.12.012","url":null,"abstract":"Objective \u0000To evaluate the effect of X-ray radiation on cell proliferation, migration, survival ability and cell cycle of human esophageal squamous cell carcinoma after RNA interference-mediated down-regulation of HMGB1 gene expression. \u0000 \u0000 \u0000Methods \u0000The expression of HMGB1 at mRNA and protein levels in the human esophageal squamous cell carcinoma cell lines ECA109 and KYSE30 was determined using RT-PCR and Western blot assays. MTS and Transwell assays were employed to examine the proliferation and migration of ECA109 and KYSE30 cell lines. The cellular survival ability in vitro was assessed by clone formation assay. The cell cycle after X-ray radiation in different groups was detected by flow cytometry. \u0000 \u0000 \u0000Results \u0000The expression of HMGB1 at mRNA and protein levels in ECA109 and KYSE30 cells were markedly higher in a dose-dependent and time-dependent manner in the radiation group than that in the control group (all P<0.05). MTS results demonstrated that the proliferation of ECA109 and KYSE30 cells was obviously lower at each time point after radiation than that in the group without radiation (all P<0.01). The expression of HMGB1 at mRNA and protein levels was significantly inhibited in the HMGB1 siRNA group than those in the control and NC groups (both P<0.01). The data from the clone formation assay revealed that the radiosensitivity was significantly increased after down-regulation of HMGB1 expression (P<0.01). Transwell migration assay revealed that the number of migrating cells at the fourth hour after X-ray irradiation in the HMGB1 siRNA group was significantly lower than those in the control and negative groups (both P<0.01). In the HMGB1 siRNA group, the percentage of cells at G0/G1 phase was obviously higher, whereas the percentage of S phase was significantly lower than those in the control and NC groups, and the trend was even more significant after X-ray radiation (all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Inhibition of HMGB1 expression by siRNA can suppress the proliferation and migration of ECA109 and KYSE30 cells and enhance the radiosensitivity by increasing the cell cycle arrest at G0/G1 stage after X-ray irradiation in vitro. \u0000 \u0000 \u0000Key words: \u0000HMGB1 gene; Cell proliferation and migration; Cell cycle; Radiosensitivity","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"933-938"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41900791","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 compare the overall survival (OS), progression-free survival (PFS) and brain metastasis free survival (BMFS) between the chemo-radiotherapy and surgical treatment for patients with limited stage small cell lung cancer (LS-SCLC). Methods Clinical data of 69 patients diagnosed with LS-SCLC undergoing surgery in Zhejiang Cancer Hospital between 2000 and 2016 were collected. According to T, N stage, treatment duration, age, gender and whether or not prophylactic cranial irradiation (PCI), 69 patients of 503 LS-SCLC patients who underwent standard radiochemotherapy were assigned into the radiochemotherapy group by using the pair-matched case-control method. Results Among 138 patients, 69 cases were allocated into the surgery group (24 cases of stage Ⅰ, 14 cases of stage Ⅱ and 31 cases of stage Ⅲ) and 69 cases in the radiochemotherapy group (24 cases of stage Ⅰ, 14 cases of stage Ⅱ and 31 cases of stage Ⅲ). The median OS time was 37.1 months (95%CI: 24.1-50.2 months) in surgery group and 45.0 months (95%CI: 15.8-74.2 months) in the radiochemotherapy group. The 2-and 5-year OS rates were 60% and 45% in the surgery group, and 64% and 45% in the radiochemotherapy group (P=0.846). The median PFS time was 27.1 months (95%CI: 0.00-60.3 months) in the surgery group and 36.2 months (95%CI: 20.9-51.4 months) in the radiochemotherapy group. The 2-and 5-year PFS rates were 52%, and 38% in the surgery group, and 56% and 40% in the chemo-radiotherapy group (P=0.610). The 2-and 5-year BMFS rates were 81% and 76% in the surgery group, and 84% and 80% in the radiochemotherapy group (P=0.774). The 5-year OS rate (62% vs. 40%, P=0.038) and 5-year PFS rate (80% vs.40%, P=0.048) for patients with stage Ⅰ LS-SCLC in the surgery group were significantly higher than those in the radiochemotherapy group. However, the 5-year BMFS rate in patients with stage Ⅰ LS-SCLC did not significantly differ between two groups (92% vs.95%, P=0.816). The 5-year OS rate (41% vs.51%, P=0.946), 5-year PFS rate (65% vs.42%, P=0.280) and 5-year BMFS rate (75% vs.78%, P=0.720) for stage Ⅱ SCLC did not significantly differ between two groups. As for stage Ⅲ SCLC patients, the OS rate (25% vs.48%, P=0.220), 5-year PFS rate (28% vs.36%, P=0.333) and 5-year BMFS rate (76% vs. 74%, P=0.84) did not significantly differ between two groups. Conclusions Surgical treatment can bring survival benefits to patients with stage Ⅰ LS-SCLC. The survival prognosis of stage Ⅱ patients is equivalent between two groups. Patients with stage Ⅲ LS-SCLC receiving radiochemotherapy obtain better survival trend compared with those undergoing surgery. The conclusion remains to be validated by studies with larger sample size or prospective investigations. Key words: Lung neoplasm/surgery; Lung neoplasm/radiochemotherapy; Prognosis
{"title":"Comparison of clinical prognosis of chemo-radiotherapy and surgical treatment for patients with limited stage small cell lung cancer after matching","authors":"Meng-yuan Chen, Xiao Hu, X. Qi, Yu-jin Xu, Baiqiang Dong, Yamei Chen, Ming Chen","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.11.005","url":null,"abstract":"Objective \u0000To compare the overall survival (OS), progression-free survival (PFS) and brain metastasis free survival (BMFS) between the chemo-radiotherapy and surgical treatment for patients with limited stage small cell lung cancer (LS-SCLC). \u0000 \u0000 \u0000Methods \u0000Clinical data of 69 patients diagnosed with LS-SCLC undergoing surgery in Zhejiang Cancer Hospital between 2000 and 2016 were collected. According to T, N stage, treatment duration, age, gender and whether or not prophylactic cranial irradiation (PCI), 69 patients of 503 LS-SCLC patients who underwent standard radiochemotherapy were assigned into the radiochemotherapy group by using the pair-matched case-control method. \u0000 \u0000 \u0000Results \u0000Among 138 patients, 69 cases were allocated into the surgery group (24 cases of stage Ⅰ, 14 cases of stage Ⅱ and 31 cases of stage Ⅲ) and 69 cases in the radiochemotherapy group (24 cases of stage Ⅰ, 14 cases of stage Ⅱ and 31 cases of stage Ⅲ). The median OS time was 37.1 months (95%CI: 24.1-50.2 months) in surgery group and 45.0 months (95%CI: 15.8-74.2 months) in the radiochemotherapy group. The 2-and 5-year OS rates were 60% and 45% in the surgery group, and 64% and 45% in the radiochemotherapy group (P=0.846). The median PFS time was 27.1 months (95%CI: 0.00-60.3 months) in the surgery group and 36.2 months (95%CI: 20.9-51.4 months) in the radiochemotherapy group. The 2-and 5-year PFS rates were 52%, and 38% in the surgery group, and 56% and 40% in the chemo-radiotherapy group (P=0.610). The 2-and 5-year BMFS rates were 81% and 76% in the surgery group, and 84% and 80% in the radiochemotherapy group (P=0.774). The 5-year OS rate (62% vs. 40%, P=0.038) and 5-year PFS rate (80% vs.40%, P=0.048) for patients with stage Ⅰ LS-SCLC in the surgery group were significantly higher than those in the radiochemotherapy group. However, the 5-year BMFS rate in patients with stage Ⅰ LS-SCLC did not significantly differ between two groups (92% vs.95%, P=0.816). The 5-year OS rate (41% vs.51%, P=0.946), 5-year PFS rate (65% vs.42%, P=0.280) and 5-year BMFS rate (75% vs.78%, P=0.720) for stage Ⅱ SCLC did not significantly differ between two groups. As for stage Ⅲ SCLC patients, the OS rate (25% vs.48%, P=0.220), 5-year PFS rate (28% vs.36%, P=0.333) and 5-year BMFS rate (76% vs. 74%, P=0.84) did not significantly differ between two groups. \u0000 \u0000 \u0000Conclusions \u0000Surgical treatment can bring survival benefits to patients with stage Ⅰ LS-SCLC. The survival prognosis of stage Ⅱ patients is equivalent between two groups. Patients with stage Ⅲ LS-SCLC receiving radiochemotherapy obtain better survival trend compared with those undergoing surgery. The conclusion remains to be validated by studies with larger sample size or prospective investigations. \u0000 \u0000 \u0000Key words: \u0000Lung neoplasm/surgery; Lung neoplasm/radiochemotherapy; Prognosis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"821-825"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49237081","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 : 2019-11-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.011
Wang Zhanyu, Junwen Tan, Y. Long, Xiantao He, Gang Li, Yongfu Feng, Liang Weixue
Objective To evaluate the dosimetric effects of set-up errors on nasal NK/T cell lymphoma by introducing set-up errors into the radiotherapy planning system for dose reconstruction. Methods Ten patients with nasal NK/T cell lymphoma were recruited. A non-coplanar volumetric modulated arc therapy plan was designed for CT image and clinical target area of each patient. After the completion of the plan, the set-up errors were introduced into the radiotherapy plan by changing the ISO of the treatment, and dose calculation was performed to reconstruct the dose distribution. Results With the increase of system set-up errors, the dose of target was decreased and the order affected by set-up errors in different directions was: left-right direction> head-foot direction> front-rear direction. When the translational set-up errors in each direction were -3 mm to 3 mm and the rotating set-up errors were -3° to 3°, the range of dose change in all targets was less than ±3%. When the set-up errors in all directions were ≤ 3 mm, the dose of organ at risk was less than or similar to the prescribed dose. When the set-up errors were> 3 mm, the doses of lens, spinal cord, parotid gland and optic nerve gradually exceeded the prescribed dose. Only when the rotating set-up errors were ≥ 3°, the dose of lens exceeded the prescribed dose. Special attention should be paid to the influence of the greater set-up errors in the left and right direction on lens, spinal cord and parotid gland, as well as on the spinal cord due to the larger set-up errors in the front and rear direction. After the actual set-up errors were introduced from our department, it exerted slight effect on the irradiation dose of GTV and CTV, which was less than ±2%. In a few cases, the dose of organ at risk potentially exceeded the prescribed dose limit, and special attention should be diverted to overdose of the lens and optic nerve. Conclusions The set-up errors will result in target dose deficiency and overdose of organ at risk in nasal NK/T cell lymphoma, especially upon the set-up errors in the left and right direction. The effect of 3 mm and 3° set-up errors on target and organ at risk is limited. Therefore, it is recommended to maintain the single direction set-up errors within 3 mm and 3°. The actual set-up errors introduced from our department exert little effect on the target dose, but a small number of organs are at risk of exceeding the prescribed dose limit. It is necessary to increase the evaluation of the extension region of organ at risk. Key words: Nasal natural killer/T-cell lymphoma; Set-up error; Dosimetry
目的通过在放疗计划系统中引入设置误差进行剂量重建，评价设置误差对鼻腔NK/T细胞淋巴瘤的剂量学效应。方法选取10例鼻腔NK/T细胞淋巴瘤患者。针对每位患者的CT图像和临床靶区设计非共面体积调制弧线治疗方案。计划完成后，通过改变治疗的ISO，将设置误差引入放疗计划，进行剂量计算，重建剂量分布。结果随着系统设置误差的增大，靶药剂量逐渐减小，不同方向设置误差对靶药剂量的影响顺序为:左右方向>头足方向>前后方向。当各方向平移设置误差为-3 mm ~ 3mm，旋转设置误差为-3°~ 3°时，各靶点的剂量变化幅度均小于±3%。当各方向设置误差≤3mm时，危险器官的剂量小于或接近规定剂量。当设置误差为bb0 ~ 3mm时，晶状体、脊髓、腮腺和视神经的剂量逐渐超过规定剂量。只有旋转设置误差≥3°时，镜片剂量才会超过规定剂量。特别要注意左右方向设置误差较大对晶状体、脊髓和腮腺的影响，以及前后方向设置误差较大对脊髓的影响。经我科介绍实际设置误差后，对GTV和CTV的辐照剂量影响不大，均在±2%以内。在少数情况下，危险器官的剂量可能超过规定的剂量限制，应特别注意晶状体和视神经的过量。结论鼻腔NK/T细胞淋巴瘤的靶剂量设置错误会导致靶剂量不足和危及器官过量，尤其是左右方向设置错误。3毫米和3°的设置误差对靶和器官的影响是有限的。因此，建议将单方向设置误差保持在3mm和3°以内。从我科引进的实际设置误差对目标剂量影响不大，但少数器官有超过规定剂量限值的危险。有必要增加对危险器官延伸区域的评估。关键词:鼻腔自然杀伤/ t细胞淋巴瘤;设置错误;剂量测定法
{"title":"Dosimetric effect of set-up errors on nasal NK/T cell lymphoma based on dose reconstruction","authors":"Wang Zhanyu, Junwen Tan, Y. Long, Xiantao He, Gang Li, Yongfu Feng, Liang Weixue","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.11.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.11.011","url":null,"abstract":"Objective \u0000To evaluate the dosimetric effects of set-up errors on nasal NK/T cell lymphoma by introducing set-up errors into the radiotherapy planning system for dose reconstruction. \u0000 \u0000 \u0000Methods \u0000Ten patients with nasal NK/T cell lymphoma were recruited. A non-coplanar volumetric modulated arc therapy plan was designed for CT image and clinical target area of each patient. After the completion of the plan, the set-up errors were introduced into the radiotherapy plan by changing the ISO of the treatment, and dose calculation was performed to reconstruct the dose distribution. \u0000 \u0000 \u0000Results \u0000With the increase of system set-up errors, the dose of target was decreased and the order affected by set-up errors in different directions was: left-right direction> head-foot direction> front-rear direction. When the translational set-up errors in each direction were -3 mm to 3 mm and the rotating set-up errors were -3° to 3°, the range of dose change in all targets was less than ±3%. When the set-up errors in all directions were ≤ 3 mm, the dose of organ at risk was less than or similar to the prescribed dose. When the set-up errors were> 3 mm, the doses of lens, spinal cord, parotid gland and optic nerve gradually exceeded the prescribed dose. Only when the rotating set-up errors were ≥ 3°, the dose of lens exceeded the prescribed dose. Special attention should be paid to the influence of the greater set-up errors in the left and right direction on lens, spinal cord and parotid gland, as well as on the spinal cord due to the larger set-up errors in the front and rear direction. After the actual set-up errors were introduced from our department, it exerted slight effect on the irradiation dose of GTV and CTV, which was less than ±2%. In a few cases, the dose of organ at risk potentially exceeded the prescribed dose limit, and special attention should be diverted to overdose of the lens and optic nerve. \u0000 \u0000 \u0000Conclusions \u0000The set-up errors will result in target dose deficiency and overdose of organ at risk in nasal NK/T cell lymphoma, especially upon the set-up errors in the left and right direction. The effect of 3 mm and 3° set-up errors on target and organ at risk is limited. Therefore, it is recommended to maintain the single direction set-up errors within 3 mm and 3°. The actual set-up errors introduced from our department exert little effect on the target dose, but a small number of organs are at risk of exceeding the prescribed dose limit. It is necessary to increase the evaluation of the extension region of organ at risk. \u0000 \u0000 \u0000Key words: \u0000Nasal natural killer/T-cell lymphoma; Set-up error; Dosimetry","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"849-853"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48626845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effect and mechanism of LncRNA ANRIL on the radiosensitivity of HCT116 cells line and nude mouse transplant tumors. Methods The expression of LncRNA ANRIL in colorectal cancer cells was detected by qPCR. The negative control siRNA, ANRIL siRNA, miR-NC mimic, miR-195 mimic, miR-NC inhibitor and miR-195 inhibitor were transfected into HCT116 cells, and marked as negative control group, silencing ANRIL group, overexpressing miR-NC group, overexpressing miR-195 group, inhibiting miR-NC group and inhibiting miR-195 group, and the HCT116 cells without any treatment were marked as the blank control group. The clone formation assay was used to detect radiosensitivity of colorectal cancer cells, flow cytometry was used to detect apoptosis. The web site, StarBase, was used to predict the downstream miRNAs of ANRIL and dual luciferase reporter gene assay was used to further verify. Subcutaneous tumor transplantation assay was used to detect the effect of ANRIL on the growth of colorectal cancer cells after irradiation. Results After irradiation with 2, 4, 6 and 8 Gy, the cell survival fraction of silencing ANRIL group was significantly decreased when compared with that of negative control group (P<0.05), and the radiosensitivity ratio was 1.52. The apoptosis rate of the silencing ANRIL+ 4 Gy group was significantly higher than that of the negative control+ 4 Gy group ((27.86±2.78)% vs. (12.06±1.46)%, P<0.05). The results of the experiment on nude mouse transplant tumors showed that the tumor volume in the negative control group was lower than that of the silent ANRIL group on days 13, 16, 19, 22 and 25 ((234±66) mm3, (273±63) mm3, (296±72) mm3, (321±85) mm3 and (403±94) mm3vs. (357±79) mm3, (485±124) mm3, (617±143) mm3, (764±174) mm3 and (985±221) mm3P<0.05). MiR-195 is a target gene of ANRIL, and inhibition of miR-195 can reverse the inhibitory effect of silencing ANRIL on radiosensitivity, apoptosis and xenografts of HCT116 cells. Conclusions LncRNA ANRIL regulates the radiosensitivity of colorectal cancer cells by miR-195, which may provide a new sensitizing target for clinical colorectal cancer radiotherapy. Key words: ANRIL gene; miR-195 gene; HCT116 cell line; Nude mouse transplant tumors; Radiosensitivity
{"title":"LncRNA ANRIL target miR-195 experimental study of radiation sensitivity of HCT116 cells and nude mouse transplant tumors","authors":"Xiaoyan Chen, Che-Hsiang Wu, X. Tian, Xiaoli Gou, Ying-jun Wu, K. Zhao, Ruihui Xie","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.11.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.11.013","url":null,"abstract":"Objective \u0000To investigate the effect and mechanism of LncRNA ANRIL on the radiosensitivity of HCT116 cells line and nude mouse transplant tumors. \u0000 \u0000 \u0000Methods \u0000The expression of LncRNA ANRIL in colorectal cancer cells was detected by qPCR. The negative control siRNA, ANRIL siRNA, miR-NC mimic, miR-195 mimic, miR-NC inhibitor and miR-195 inhibitor were transfected into HCT116 cells, and marked as negative control group, silencing ANRIL group, overexpressing miR-NC group, overexpressing miR-195 group, inhibiting miR-NC group and inhibiting miR-195 group, and the HCT116 cells without any treatment were marked as the blank control group. The clone formation assay was used to detect radiosensitivity of colorectal cancer cells, flow cytometry was used to detect apoptosis. The web site, StarBase, was used to predict the downstream miRNAs of ANRIL and dual luciferase reporter gene assay was used to further verify. Subcutaneous tumor transplantation assay was used to detect the effect of ANRIL on the growth of colorectal cancer cells after irradiation. \u0000 \u0000 \u0000Results \u0000After irradiation with 2, 4, 6 and 8 Gy, the cell survival fraction of silencing ANRIL group was significantly decreased when compared with that of negative control group (P<0.05), and the radiosensitivity ratio was 1.52. The apoptosis rate of the silencing ANRIL+ 4 Gy group was significantly higher than that of the negative control+ 4 Gy group ((27.86±2.78)% vs. (12.06±1.46)%, P<0.05). The results of the experiment on nude mouse transplant tumors showed that the tumor volume in the negative control group was lower than that of the silent ANRIL group on days 13, 16, 19, 22 and 25 ((234±66) mm3, (273±63) mm3, (296±72) mm3, (321±85) mm3 and (403±94) mm3vs. (357±79) mm3, (485±124) mm3, (617±143) mm3, (764±174) mm3 and (985±221) mm3P<0.05). MiR-195 is a target gene of ANRIL, and inhibition of miR-195 can reverse the inhibitory effect of silencing ANRIL on radiosensitivity, apoptosis and xenografts of HCT116 cells. \u0000 \u0000 \u0000Conclusions \u0000LncRNA ANRIL regulates the radiosensitivity of colorectal cancer cells by miR-195, which may provide a new sensitizing target for clinical colorectal cancer radiotherapy. \u0000 \u0000 \u0000Key words: \u0000ANRIL gene; miR-195 gene; HCT116 cell line; Nude mouse transplant tumors; Radiosensitivity","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"858-861"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47308606","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 : 2019-11-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.017
Ying-jie Zhang, Jianbin Li
18F-FDG PET-CT is recommended for the diagnosis and treatment of non-small cell lung cancer (NSCLC), and guiding the optimization of radiotherapy planning. The target area determined by biological information carried by functional images is defined as biological target volume (BTV). However, BTV significantly differs from the gross tumor volume (GTV) and internal target volume (ITV) defined by the International Commission on Radiation Units and Measurements (ICRU) report. It is still a challenging task to directly apply BTV to radiotherapy planning. The limitation of PET image, the accuracy of fusion with auxiliary anatomic images and the influence of respiratory movement cause the uncertainty of BTV definition in NSCLC patients. Referring to different anatomical images, multiple approaches can be employed to achieve BTV motion information compensation. Application of PET-CT in predicting the prognosis of NSCLC patients after radiotherapy and distinguishing the recurrence risk of biological sub-target contribute to achieving the dose planning for radiotherapy planning. Key words: Non-small cell lung cancer; Radiotherapy planning; Positron emission tomography-computed tomography
{"title":"Research progress on PET-CT in radiotherapy planning for non-small cell lung cancer","authors":"Ying-jie Zhang, Jianbin Li","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.11.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.11.017","url":null,"abstract":"18F-FDG PET-CT is recommended for the diagnosis and treatment of non-small cell lung cancer (NSCLC), and guiding the optimization of radiotherapy planning. The target area determined by biological information carried by functional images is defined as biological target volume (BTV). However, BTV significantly differs from the gross tumor volume (GTV) and internal target volume (ITV) defined by the International Commission on Radiation Units and Measurements (ICRU) report. It is still a challenging task to directly apply BTV to radiotherapy planning. The limitation of PET image, the accuracy of fusion with auxiliary anatomic images and the influence of respiratory movement cause the uncertainty of BTV definition in NSCLC patients. Referring to different anatomical images, multiple approaches can be employed to achieve BTV motion information compensation. Application of PET-CT in predicting the prognosis of NSCLC patients after radiotherapy and distinguishing the recurrence risk of biological sub-target contribute to achieving the dose planning for radiotherapy planning. \u0000 \u0000Key words: \u0000Non-small cell lung cancer; Radiotherapy planning; Positron emission tomography-computed tomography","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"876-879"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49118499","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 : 2019-11-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.002
Qi Zhang, Lun Li, B. Xiu, R. Guo, Benlong Yang, Jia Wang, Yonghui Su, W. Chi, Yingying Zhang, A. Cao, Z. Shao, Jiong Wu
Objective To investigate the current status of breast reconstruction surgery in China and analyze the specific views of Chinese doctors on the relationship between radiotherapy and breast reconstruction surgery. Methods A total of 110 medical institutions nationwide with more than 200 cases of breast cancer surgery yearly were selected into this questionnaire survey. The questionnaire survey included basic information of the surgeons and their hospitals, information of breast cancer surgeries in 2017, types of reconstruction surgery and specific views on the relationship between radiotherapy and reconstruction surgery. Results In total, 110 hospitals participated in the survey, 96(87.3%) had undergone breast reconstruction surgery. Reconstruction with implants accounted for 65.7% of the total reconstruction surgery and the proportion of autologous reconstruction was 20.1%. For patients who probably required postoperative radiotherapy, the preferred surgical procedure in the surveyed hospitals was implant based reconstruction surgery. For those who were confirmed to receive postoperative radiotherapy or had undergone radiotherapy after total mastectomy, autologous tissue reconstruction was recommended. Postoperative radiotherapy was a negative factor for immediate breast reconstruction, and most hospitals believed that radiotherapy exerted slight effect on surgery. The proportion of delay-immediate breast reconstruction reached 66% and 86% of hospitals preferred to replace with the prosthesis at 6 months after radiotherapy. Patients with local recurrence after breast-conserving surgery could also receive immediate reconstruction and implant reconstruction was the preferred surgical procedure. Conclusions The proportion of breast reconstruction in China is relatively low and Chinese doctors still lack of technical mastery. In the face of conflict with radiotherapy, the regime selected by Chinese doctors is not in accordance with those recommended by the guideline and consensus, prompting that more professional training should be delivered for Chinese doctors to further promote the development of breast reconstruction in China. Key words: Breast neoplasm/surgery; Breast reconstruction; Breast neoplasm/radiotherapy; Questionnaire
{"title":"Relationship between breast reconstruction surgery and radiotherapy after mastectomy-a cross-sectional survey based on 110 hospitals in China","authors":"Qi Zhang, Lun Li, B. Xiu, R. Guo, Benlong Yang, Jia Wang, Yonghui Su, W. Chi, Yingying Zhang, A. Cao, Z. Shao, Jiong Wu","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.11.002","url":null,"abstract":"Objective \u0000To investigate the current status of breast reconstruction surgery in China and analyze the specific views of Chinese doctors on the relationship between radiotherapy and breast reconstruction surgery. \u0000 \u0000 \u0000Methods \u0000A total of 110 medical institutions nationwide with more than 200 cases of breast cancer surgery yearly were selected into this questionnaire survey. The questionnaire survey included basic information of the surgeons and their hospitals, information of breast cancer surgeries in 2017, types of reconstruction surgery and specific views on the relationship between radiotherapy and reconstruction surgery. \u0000 \u0000 \u0000Results \u0000In total, 110 hospitals participated in the survey, 96(87.3%) had undergone breast reconstruction surgery. Reconstruction with implants accounted for 65.7% of the total reconstruction surgery and the proportion of autologous reconstruction was 20.1%. For patients who probably required postoperative radiotherapy, the preferred surgical procedure in the surveyed hospitals was implant based reconstruction surgery. For those who were confirmed to receive postoperative radiotherapy or had undergone radiotherapy after total mastectomy, autologous tissue reconstruction was recommended. Postoperative radiotherapy was a negative factor for immediate breast reconstruction, and most hospitals believed that radiotherapy exerted slight effect on surgery. The proportion of delay-immediate breast reconstruction reached 66% and 86% of hospitals preferred to replace with the prosthesis at 6 months after radiotherapy. Patients with local recurrence after breast-conserving surgery could also receive immediate reconstruction and implant reconstruction was the preferred surgical procedure. \u0000 \u0000 \u0000Conclusions \u0000The proportion of breast reconstruction in China is relatively low and Chinese doctors still lack of technical mastery. In the face of conflict with radiotherapy, the regime selected by Chinese doctors is not in accordance with those recommended by the guideline and consensus, prompting that more professional training should be delivered for Chinese doctors to further promote the development of breast reconstruction in China. \u0000 \u0000 \u0000Key words: \u0000Breast neoplasm/surgery; Breast reconstruction; Breast neoplasm/radiotherapy; Questionnaire","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"806-810"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46190214","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 : 2019-11-15DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.008
Bixin Ren, Lei Liu, Yongqiang Yang, Q. Guo, Li-yuan Zhang, Ye Tian
Objective To compare the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy in patients with extrahepatic cholangiocarcinoma and gallbladder carcinoma by a meta-analysis. Methods The controlled clinical trials of postoperative adjuvant radiotherapy versus non-radiotherapy of extrahepatic cholangiocarcinoma and gallbladder carcinoma were searched from PubMed, EMbase, Cochrane Library, Wanfang database, CNKI, Chongqing VIP and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 statistical software. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results A total of 20 controlled clinical trials involving 1258 extrahepatic cholangiocarcinoma and gallbladder carcinoma patients were included in this meta-analysis. The meta-analysis demonstrated that the 5-year survival rate in the adjuvant radiotherapy group was significantly higher than that in the non-radiotherapy group (OR=1.67, 95%CI: 1.29-2.18, P=0.001). The 5-year survival rates in those with lymph node positive disease (OR=7.44, 95%CI: 1.24-44.72, P=0.03) and positive margins disease (OR=3.43, 95%CI: 1.56-7.75, P=0.002) were significantly enhanced by postoperative adjuvant radiotherapy. The local recurrence rate in the adjuvant radiotherapy group was significantly lower than that in the non-radiotherapy group (OR=0.56, 95%CI: 0.39-0.80, P=0.01), whereas the distant metastasis rate did not significantly differ between two groups (OR=1.22, 95%CI: 0.86-1.73, P=0.27). The incidence rates of acute toxicity and chronic toxicity of grade ≥3 caused by radiotherapy were 0-11.9% and 0-21.7%, respectively. Conclusion Compared with non-radiotherapy, postoperative adjuvant radiotherapy is a safer and more effective postoperative treatment for extrahepatic cholangiocarcinoma and gallbladder carcinoma. Key words: Extrahepatic cholangiocarcinoma/radiotherapy; Gallbladder carcinoma/radiotherapy; Adjuvant therapy; Meta-analysis
{"title":"A meta-analysis of the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma","authors":"Bixin Ren, Lei Liu, Yongqiang Yang, Q. Guo, Li-yuan Zhang, Ye Tian","doi":"10.3760/CMA.J.ISSN.1004-4221.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2019.11.008","url":null,"abstract":"Objective \u0000To compare the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy in patients with extrahepatic cholangiocarcinoma and gallbladder carcinoma by a meta-analysis. \u0000 \u0000 \u0000Methods \u0000The controlled clinical trials of postoperative adjuvant radiotherapy versus non-radiotherapy of extrahepatic cholangiocarcinoma and gallbladder carcinoma were searched from PubMed, EMbase, Cochrane Library, Wanfang database, CNKI, Chongqing VIP and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 statistical software. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). \u0000 \u0000 \u0000Results \u0000A total of 20 controlled clinical trials involving 1258 extrahepatic cholangiocarcinoma and gallbladder carcinoma patients were included in this meta-analysis. The meta-analysis demonstrated that the 5-year survival rate in the adjuvant radiotherapy group was significantly higher than that in the non-radiotherapy group (OR=1.67, 95%CI: 1.29-2.18, P=0.001). The 5-year survival rates in those with lymph node positive disease (OR=7.44, 95%CI: 1.24-44.72, P=0.03) and positive margins disease (OR=3.43, 95%CI: 1.56-7.75, P=0.002) were significantly enhanced by postoperative adjuvant radiotherapy. The local recurrence rate in the adjuvant radiotherapy group was significantly lower than that in the non-radiotherapy group (OR=0.56, 95%CI: 0.39-0.80, P=0.01), whereas the distant metastasis rate did not significantly differ between two groups (OR=1.22, 95%CI: 0.86-1.73, P=0.27). The incidence rates of acute toxicity and chronic toxicity of grade ≥3 caused by radiotherapy were 0-11.9% and 0-21.7%, respectively. \u0000 \u0000 \u0000Conclusion \u0000Compared with non-radiotherapy, postoperative adjuvant radiotherapy is a safer and more effective postoperative treatment for extrahepatic cholangiocarcinoma and gallbladder carcinoma. \u0000 \u0000 \u0000Key words: \u0000Extrahepatic cholangiocarcinoma/radiotherapy; Gallbladder carcinoma/radiotherapy; Adjuvant therapy; Meta-analysis","PeriodicalId":10288,"journal":{"name":"Chinese Journal of Radiation Oncology","volume":"28 1","pages":"836-839"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44635737","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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