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Effects of autophagy on radiosensitivity 自噬对放射敏感性的影响
Pub Date : 2019-12-15 DOI: 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
自噬广泛存在于真核生物中,它利用溶酶体降解受损的细胞器或蛋白质,维持细胞内环境的稳定并提供能量。它还可以通过自噬相关基因和信号通路参与肿瘤细胞的生长、增殖和凋亡。放射治疗是癌症的主要治疗方法之一,而肿瘤细胞往往具有辐射耐药性,这降低了临床疗效。先前的研究表明,自噬与肿瘤细胞的放射敏感性有关,但结论不同。本文综述了自噬对肿瘤细胞放射增敏的不同影响。关键词:自噬;肿瘤/放疗
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引用次数: 0
Effect of HMGB1 knockdown by RNA interference on cell proliferation and migration of esophageal squamous cell carcinoma after X-ray radiation RNA干扰敲低HMGB1对食管鳞状细胞癌X射线照射后细胞增殖和迁移的影响
Pub Date : 2019-12-15 DOI: 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
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引用次数: 0
Comparison of clinical prognosis of chemo-radiotherapy and surgical treatment for patients with limited stage small cell lung cancer after matching 有限期小细胞肺癌配术后放化疗与手术治疗的临床预后比较
Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.005
Meng-yuan Chen, Xiao Hu, X. Qi, Yu-jin Xu, Baiqiang Dong, Yamei Chen, Ming Chen
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
目的比较癌症小细胞肺癌(LS-SCLC)患者化疗和手术治疗的总生存率(OS)、无进展生存率(PFS)和无脑转移生存率(BMFS)。方法收集2000~2016年浙江省癌症医院手术治疗的69例LS-SCLC患者的临床资料。根据T、N分期、治疗时间、年龄、性别和是否预防性颅骨照射(PCI),采用配对病例对照法将503例接受标准放化疗的LS-SCLC患者中的69例分为放化疗组。结果138例患者中,69例分为手术组(Ⅰ期24例,Ⅱ期14例,Ⅲ期31例)和放化疗组69例(Ⅰ期2 4例,Ⅱ阶段14例,Ⅳ阶段31例)。手术组的中位OS时间为37.1个月(95%可信区间:24.1-50.2个月),放化疗组为45.0个月(95%CI:15.8-74.2个月)。手术组的2年和5年OS发生率分别为60%和45%,放化疗组为64%和45%(P=0.846)。手术组和放化疗组的中位PFS时间分别为27.1个月(95%可信区间:0.00-60.3个月)和36.2个月(95%可信区间:20.9-51.4个月)。手术组2年和5年PFS发生率分别为52%和38%,放化疗组分别为56%和40%(P=0.610),手术组Ⅰ期LS-SCLC患者的5年OS发生率(62%对40%,P=0.038)和5年PFS发生率(80%对40%,P=0.048)明显高于放化疗组。然而,Ⅰ期LS-SCLC患者的5年BMFS发生率在两组之间没有显著差异(92%对95%,P=0.816)。Ⅱ期SCLC的5年OS发生率(41%对51%,P=0.946)、5年PFS发生率(65%对42%,P=0.280)和5年BMFS发生率(75%对78%,P=0.720)在两组间没有显著差异。对于Ⅲ期SCLC患者,OS发生率(25%vs.48%,P=0.220)、5年PFS发生率(28%vs.36%,P=0.333)和5年BMFS发生率(76%vs.74%,P=0.84)在两组之间没有显著差异。结论手术治疗可提高Ⅰ期LS-SCLC患者的生存率。两组Ⅱ期患者的生存预后相当。与接受手术的患者相比,接受放化疗的Ⅲ期LS-SCLC患者获得了更好的生存趋势。这一结论有待于更大样本量的研究或前瞻性调查的验证。关键词:肺部肿瘤/外科;肺部肿瘤/放化疗;预后
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引用次数: 1
Dosimetric effect of set-up errors on nasal NK/T cell lymphoma based on dose reconstruction 基于剂量重建的设置误差对鼻腔NK/T细胞淋巴瘤的剂量学影响
Pub Date : 2019-11-15 DOI: 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}
引用次数: 0
LncRNA ANRIL target miR-195 experimental study of radiation sensitivity of HCT116 cells and nude mouse transplant tumors LncRNA ANRIL靶向miR-195对HCT116细胞和裸鼠移植瘤辐射敏感性的实验研究
Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.013
Xiaoyan Chen, Che-Hsiang Wu, X. Tian, Xiaoli Gou, Ying-jun Wu, K. Zhao, Ruihui Xie
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
目的探讨LncRNA ANRIL对HCT116细胞系和裸鼠移植瘤放射敏感性的影响及其机制。方法采用qPCR方法检测大肠癌细胞中LncRNA ANRIL的表达。将阴性对照siRNA、ANRIL siRNA、miR-NC模拟物、miR-195模拟物、iR-NC抑制剂和miR-195抑制剂转染到HCT116细胞中,并标记为阴性对照组、沉默ANRIL组、过表达miR-NC组、过度表达miR-195组、抑制miR-NC和抑制miR-195,将未经任何处理的HCT116细胞标记为空白对照组。克隆形成法检测大肠癌癌症细胞的放射敏感性,流式细胞术检测细胞凋亡。网站StarBase用于预测ANRIL的下游miRNA,双荧光素酶报告基因测定用于进一步验证。采用皮下肿瘤移植法检测ANRIL对大肠癌癌症细胞照射后生长的影响。结果2、4、6和8Gy照射后,沉默ANRIL组的细胞存活率与阴性对照组相比显著降低(P<0.05),放射敏感性为1.52。沉默ANRIL+4Gy组的细胞凋亡率显著高于阴性对照+4Gy(27.86±2.78)%对(12.06±1.46)%,P<0.05)。裸鼠移植瘤实验结果显示,阴性对照组在第13、16、19、22和25天的肿瘤体积低于沉默ANRIL组((234±66)mm3、(273±63)mm3,(296±72)mm3、(321±85)mm3和(403±94)mm3vs。MiR-195是ANRIL的靶基因,抑制MiR-195可以逆转沉默ANRIL对HCT116细胞放射敏感性、细胞凋亡和异种移植物的抑制作用。结论LncRNA ANRIL通过miR-195调节结直肠癌癌症细胞的放射敏感性,为临床结直肠癌放疗提供了新的致敏靶点。关键词:ANRIL基因;miR-195基因;HCT116细胞系;裸鼠移植瘤;辐射敏感性
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引用次数: 0
Research progress on PET-CT in radiotherapy planning for non-small cell lung cancer PET-CT在非小细胞肺癌放疗计划中的研究进展
Pub Date : 2019-11-15 DOI: 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
推荐18F-FDG PET-CT用于癌症(NSCLC)的诊断和治疗,并指导放疗计划的优化。由功能图像携带的生物信息确定的目标区域被定义为生物目标体积(BTV)。然而,BTV与国际辐射单位和测量委员会(ICRU)报告定义的总肿瘤体积(GTV)和内靶体积(ITV)有显著差异。将BTV直接应用于放射治疗规划仍然是一项具有挑战性的任务。PET图像的局限性、与辅助解剖图像融合的准确性以及呼吸运动的影响导致了非小细胞肺癌患者BTV定义的不确定性。参考不同的解剖图像,可以采用多种方法来实现BTV运动信息补偿。PET-CT在预测NSCLC患者放疗后预后和区分生物亚靶点复发风险方面的应用有助于实现放疗计划的剂量规划。关键词:非小细胞肺癌;放射治疗计划;正电子发射断层扫描计算机断层扫描
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引用次数: 0
Relationship between breast reconstruction surgery and radiotherapy after mastectomy-a cross-sectional survey based on 110 hospitals in China 乳腺重建手术与乳房切除术后放疗的关系——基于中国110家医院的横断面调查
Pub Date : 2019-11-15 DOI: 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
目的了解我国乳腺重建手术的现状,分析我国医生对放疗与乳腺重建手术关系的具体看法。方法选择全国110家每年乳腺癌症手术200多例的医疗机构进行问卷调查。问卷调查包括外科医生及其所在医院的基本情况、2017年癌症乳腺癌手术情况、重建手术类型以及对放疗与重建手术关系的具体看法。结果共有110家医院参与调查,其中96家(87.3%)接受过乳房重建手术。植入物重建占重建手术总数的65.7%,自体重建的比例为20.1%。对于可能需要术后放疗的患者,调查医院首选的手术程序是基于植入物的重建手术。对于那些确认接受术后放疗或在乳房切除术后接受过放疗的患者,建议进行自体组织重建。术后放疗是立即乳房重建的一个负面因素,大多数医院认为放疗对手术的影响很小。延迟立即乳房重建的比例达到66%,86%的医院倾向于在放疗后6个月更换假体。保乳手术后局部复发的患者也可以立即进行重建,植入物重建是首选的手术程序。结论我国乳腺再造的比例相对较低,医生对技术的掌握程度还不够。面对与放疗的冲突,中国医生选择的方案与指南和共识建议的方案不一致,这促使中国医生应该接受更多的专业培训,以进一步促进中国乳房重建的发展。关键词:乳腺肿瘤/外科;乳房重建;乳腺肿瘤/放射治疗;调查表
{"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}
引用次数: 0
A meta-analysis of the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma 肝外胆管癌和胆囊癌术后辅助放疗与非放疗疗效的meta分析
Pub Date : 2019-11-15 DOI: 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
目的通过荟萃分析比较肝外胆管癌和胆囊癌术后辅助放疗和非放疗的疗效。方法从PubMed、EMbase、Cochrane Library、万方数据库、CNKI、重庆VIP和CBM数据库中检索肝外胆管癌和胆囊癌术后辅助放疗与非放疗的对照临床试验。使用RevMan 5.3和Stata 14.0统计软件对获得的数据进行分析。通过计算95%置信区间(CI)的比值比(OR)来估计两组之间的差异。结果本荟萃分析共纳入20项对照临床试验,涉及1258例肝外胆管癌和胆囊癌患者。荟萃分析显示,辅助放疗组的5年生存率显著高于非放疗组(OR=1.67,95%CI:1.29-2.18,P=0.001)。淋巴结阳性疾病(OR=7.44,95%CI:1.24-4.72,P=0.03)和边缘病变阳性(OR=3.43,95%CI:1.56-7.75,P=0.002)的5年存活率显著提高术后辅助放疗。辅助放疗组的局部复发率显著低于非放疗组(OR=0.56,95%CI:0.39-0.80,P=0.01),两组远处转移率差异无统计学意义(OR=1.22,95%CI:0.86~1.73,P=0.027),放疗引起急性毒性和3级以上慢性毒性的发生率分别为0~1.9%和0~217%。结论与非放疗相比,术后辅助放疗是一种更安全、有效的肝外胆管癌和胆囊癌术后治疗方法。关键词:肝外胆管癌/放疗;胆囊癌/放射治疗;辅助治疗;Meta分析
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引用次数: 0
Flash radiotherapy 闪光放射治疗
Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.014
Wei Zhao, Yuan Tian, Hao Peng
Flash radiotherapy (Flash-RT) is a treatment modality that uses the normal tissue sparing regimen induced by ultra-high dose rate and ultra-fast irradiation. Compared to conventional dose rate radiotherapy, Flash-RT has the potential to provide the isoefficacy for tumors while achieving the remarkable normal tissue protection. Due to this unique feature, Flash-RT is attracting more and more attention from the radiotherapy community. An abundance of groups from both academia and industry are extensively studying the therapeutic ratio and underlying biological mechanisms. Here, we review the prior knowledge about Flash-RT and summarize the results that have been reported from various groups using both in vitro and animal studies with different experimental protocols. We also discuss possible biological mechanisms and the challenging of implementing Flash-RT, as well as its possible options for clinical applications. Key words: Flash radiotherapy; Dose rate; Dosimetry; Hypoxia; Ultra-fast irradiation
闪光放射治疗(Flash RT)是一种使用超高剂量率和超快辐射诱导的正常组织保留方案的治疗方式。与常规剂量率放疗相比,Flash RT有可能在实现显著的正常组织保护的同时,为肿瘤提供等效性。由于这种独特的特性,Flash RT越来越受到放射治疗界的关注。来自学术界和工业界的许多团体正在广泛研究治疗比例和潜在的生物学机制。在这里,我们回顾了先前关于Flash RT的知识,并总结了使用不同实验方案的体外和动物研究从各个小组报告的结果。我们还讨论了可能的生物学机制和实施Flash RT的挑战,以及其临床应用的可能选择。关键词:闪光放射治疗;剂量率;剂量测定;缺氧;超快辐照
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引用次数: 3
Analysis of the poor prognostic factors affecting 48 cases of cervical stump carcinoma 48例宫颈残端癌预后不良因素分析
Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1004-4221.2019.11.009
Y. Mu, Seyiti Ayinuer, K. Gulina
Objective To explore the poor prognostic factors of patients with cervical stump carcinoma, aiming to provide certain reference for the clinical diagnosis and treatment. Methods Clinical data of 48 patients with cervical stump carcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 1, 2005 to December 1, 2016 were retrospectively analyzed. A total of 19 patients (40%) withⅠA-ⅡA stage cervical stump carcinoma were treated with surgery+ adjuvant therapy and 29 patients (60%) in ⅡB-Ⅳ stage received radiotherapy combined with chemotherapy. The median age of onset was 51 years old. Uterine fibroids were the main cause of subtotal hysterectomy. The average time interval from subtotal hysterectomy to definite diagnosis was 10.76 years. Results The 1-, 3-, 5-year survival rate was 98%, 83% and 74%, respectively. Univariate analysis demonstrated the time interval from subtotal hysterectomy (P=0.016), tumor diameter (P=0.016), clinical stage (P=0.036), histological grade (P=0.009), lymph node metastasis (P=0.044), parametrial invasion (P=0.046), myelosuppression (P=0.013) and radical surgery (P=0.019) were the poor prognostic factors of cervical stump carcinoma. Conclusions Poor prognosis of patients with cervical stump carcinoma is correlated with tumor diameter, clinical stage, histological grade, lymph node metastasis, parametrial invasion and myelosuppression. Histological grade is an independent risk factor. Key words: Cervical stump; Malignant neoplasm/radiochemotherapy; Prognosis
目的探讨影响宫颈残端癌患者预后的因素,为临床诊断和治疗提供一定的参考。方法回顾性分析2005年1月1日至2016年12月1日新疆医科大学附属肿瘤医院收治的48例宫颈残端癌患者的临床资料。ⅠA ~ⅡA期宫颈残端癌19例(40%)采用手术+辅助治疗,ⅡB ~Ⅳ期29例(60%)采用放化疗联合治疗。发病年龄中位数为51岁。子宫肌瘤是子宫次全切除术的主要原因。从子宫次全切除术到确诊的平均时间间隔为10.76年。结果1、3、5年生存率分别为98%、83%、74%。单因素分析显示,子宫次全切除术时间间隔(P=0.016)、肿瘤直径(P=0.016)、临床分期(P=0.036)、组织学分级(P=0.009)、淋巴结转移(P=0.044)、参数性侵(P=0.046)、骨髓抑制(P=0.013)和根治性手术(P=0.019)是影响宫颈残端癌预后的因素。结论宫颈残端癌患者预后不良与肿瘤直径、临床分期、组织学分级、淋巴结转移、参数性侵及骨髓抑制有关。组织学分级是一个独立的危险因素。关键词:宫颈残端;恶性肿瘤/ radiochemotherapy;预后
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引用次数: 0
期刊
中华放射肿瘤学杂志
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