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Objective To observe the incidence of acute radiation pneumonitis (ARP) in patients with nonsmall cell lung cancer treated by three-dimensional conformation radiotherapy or intersity-modulated radiation therapy,and investigate the predictive value of high dose volume and low dose volume of the total and ipsilateral lung on ARP.Methods 174 patients with non-small-cell lung cancer verified by pathology who received radical radiotherapy in our hospital from Aug 2013 to Nov 2015 were screened.Radioactive dose was 60 Gy-70 Gy,with 97 patients' dose of 60-64 Gy and 77 patients' dose of 65-70 Gy.Chemotherapy was done by paclitaxel + pentium first line treatment.155 patients were treated with radiotherapy alone and 19 with radiotherapy combined with chemotherapy.The V5～ V30,MLD (mean lung dose),V5ipis ～ V30ipsi,MLDipsi were calculated from the dose volume histogram system.The ARP was evaluated according to Common Toxicity Criteria 4.0 (CTC4.0).Univafiate and nultivariate analysis and receiver operating characteristic (ROC) curves were performed to assess the correlated factors of ARP.Results Of 174 patients,26 patients (14.94％) developed radioactive pneumonia at grade 2,11 patients (6.32％) at grade 3,2 patients (1.15％) at grade 4.The correlative factors included the radiochemotherapy regimen (sequential chemotherapy to radiotherapy or concurrent radiochemotherapy),V5,V10,V20,V30,MLD of the total lung and ipsilateral lung according to univariate analysis.Multivariate analysis of all the factors mentioned above showed the V5,V20ipsi and MLD were the independent predictive factors associated with ARP.ROC analysis indicated that the cut-off point of V5,V20ipsi,MLD were 62.38％,47.14％and 16.85Gy respectively.According to the V5,V20ipsi value,174 patients were divided into three groups:B group V5＜62％+V20ipsi≥47％,C group V5≥62％+V20ipsi＜47％,D group V5≥62％+V20ipsi≥47％.The chisquare test between the C group and D group has statistical significance.Conclusion V5,V20ipsi,and MLD are the independent risk factors of ARP.Compared with V5,limiting V20ipsi threshold is more likely to result in ARP.
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Objective To observe the efficacy and adverse reaction of Durogesic (thansdermal fenfanul) for analgesia in patients with malignant tumors, who occur moderate or severe pain from mucosal response during radiochemotherapy. Methods 50 patients were divided into two groups randomly. The treatment group received Durogesic and normal therapy, the contrast group received normal therapy. The analgesic effects, the quality of life and the side effects after medicine were observed. Results The pain remission rates of treatment group and control group were 100 % (25/25) and 52 % (13/25), respectively (χ2 =15.78, P ＜ 0.01)[(9.66±0.35), (10.01±0.34) min]and[(18.12±0.46), (14.68±0.19) min].The quality of life in treatment group was improved significantly (t = 8.11, P ＜0.01).The main adverse reactions of Durogesic included constipation, itch of skin, drowsiness, nausea, vomiting and so on. All of adverse reactions were tolerable. Conclusion Durogesic for analgesia have high curative effect and slight adverse effects in pain of oral cavity and laryngeal pharynx in patients with malignant tumors during radiochemotherapy which make patients complete radiochemotherapy successfully.
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Objective To observe the effect of DNA-PKCS antisense oligodeoxynucleotides (ASODN) on the radiosensitivity of lung cancer cell line A549 through transfecting DNA-PKcs ASODN into A549 cells.Methods DNA-PKCS ASODN and unrelated ODN were transfected into A549 cells (testing group and control group).These cells were irradiated with 0,0.5,1.0,2.0,4.0,6.0 or 8.0 Gy X-ray.Clo nogenic assay was performed to determine the survival fraction.The parameters Do,Dq and N for the multi target single-hit model,as well as the parameters a,13 and SF2 for the linear-quadratic model,were calculated to evaluate cell radiesensitivity.ResultsIn the control group and testing group,the α value was 0.14 and O.31 ,The βvalue was 0.030 and 0.018 ,the SF2 was 0.63 and 0.41 ,the Do was 2.38 and 2.09 ,the Dq was 1.43 and 0.60 ,respectively.In the testing group,the α value of A549 cells was increased,but the β value, SF2,DO and Dq were decreased.Conclusions DNA-PKCS ASODN can enhance the radiosensitivity of A549 cells and is a potential target in treating lung cancer.
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Objective: To observe the therapeutic efficacy of astragalus polysaccharide (APS) in combination with three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 80 elderly patients with I～IV stage NSCLC were randomly divided into two groups. The 40 patients in the therapeutic group received radiotherapy in combination with APS. The 40 patients in the control group received radiotherapy alone. Both groups received 3D-CRT with a total dose of 50～ 70Gy, 2.0Gy/fraction, once a day, 5 times per week. The patients in the therapeutic group were treated with radiotherapy combined with injection of APS (250mg in 5% glucose) or normal saline (500 mL) intravenously once a day until the end of radiotherapy. The short-term efficacy and patients' quality of life were evaluated. The T-lymphocyte subpopulation and peripheral blood leukocyte count were also measured after treatment. Results: The short-term effective rates of the therapeutic group and the control group were 87.5% and 72.5%, respectively, without significant difference between the two groups (P＞0.05). The decrease of peripheral blood leukocyte count after treatment in the control group was significant (P＜0.05). In the therapeutic group, the T-lymphocyte subsets CD8 and CD4/CD8 were improved after treatment, with a significant difference (P＜ 0.05). But in the control group, no significant changes in T-lymphocyte subsets CD8 and CD4/CD8 were observed after treatment (P＞0.05). Patients' quality of life in the therapeutic group was superior to that in the control group, with a significant difference (P＜0.05). Conclusion: APS in combination with 3D-CRT can reduce the side effects of radiation and improve the quality of life of elderly patients with NSCLC.
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BACKGROUND: There are several ways for treating the trigeminal neuralgia, such as medication, block therapy and surgery, etc. But few reports throughout the world described stereotactic radiotherapy(SRT) for it, which is efficient, non-invasive and painless.OBJECTIVE: To investigate the improvement of SRT for trigeminal neuralgia.DESIGN: Case analysis based on patients.SETTING: X-knife Treatment Center, First Affiliated Hospital, Henan University of Science and Technology.PARTICIPANTS: Totally 30 patients with trigeminal neuralgia were selected from X-knife Treatment Center, the First Affiliated Hospital of Henan Science and Technology University between March 1999 and March 2002. All patients were diagnosed with CT or MRI, and no other diseases were found. Patients without obvious effect from a long-term medicine treatment or surgery were selected as the investigative subjects.METHODS: Thirty patients with trigeminal neuralgia wearing face cover were treated with non-coplanarity fractional stereotactic radiotherapy. The patients received 2 target regions and peripheral does of 60 - 75 Gy. 5 mm collimator and isodose curves referred to ranged from 85% - 90%.MAIN OUTCOME MEASURES: Results of therapeutic assessment and follow up.RESULTS: The follow up period ranged from 1 to 22 months. Among 30patients, 6 patients' symptoms were lightened or eased up over 12-24hours, 20 patients received a marked effect over 1 - 3 months, 4 patients'treatment effects were not obvious. The effect rate reached 87%. A patient occurred numbness in sick face, and a patient showed no obvious effect in the first treatment, but the efficacy became evident in the second treatment.CONCLUSION: It is efficient in the treatment of trigeminal neuralgia with stereotaetic radiotherapy and there is no special side effect.
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Objective To evaluate the results and side effects in three dimensional conformal radiation therapy (3DCRT) for esophageal carcinoma. Methods From December 1996 to December 1998,67 patients with esophageal carcinoma were treated with 3DCRT(3DCRT group),in which all were treated once every other day to a total dose of 40 42 ?Gy in 13 15 days at 5 6?Gy per fraction totally 7 8 fractions, and during the same interval, another 112 patients treated by conventional fractionation radiotherapy(CF group) to a total dose of 64 68?Gy over 44 48 days at 2.0?Gy per fraction 5 days per week were analyzed and compared. Results The 1 ,2 ,3 and 4 year local control rates in 3DCRT group were 71.6% ,62.7%,49.3% and 43.3% ,compared to 53.6%, 43.8% ,33.9% and 25.9% in CF group (P = 0.011). And the survival rates in 1 ,2 ,3 and 4 years in 3DCRT group were 62.7%,52.2%,43.3% and 38.8%, as compared with 49.1%, 41.1% ,30.4% and 22.3% in CF group (P = 0.027). However, in the 3DCRT group, the incidence of acute radiation esophagitis was higher (P=0.003) and those of hematogenous side effects and B symptom were lower(P=0.007,0.021). Conclusion Compared with conventional fractionation radiotherapy,3DCRT is able to improve the local control rate of esophageal carcinoma, with tolerable acute and late radiation side effects.