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Radiotherapy, chemotherapy and immunotherapy have a synergistic effect. With the clinical application of immune checkpoint inhibitors, their combination with radiotherapy or chemoradiotherapy of non-small cell lung cancer shows good short-term and long-term efficacy, and is safe and reliable.
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Objective To investigate the effect of different fractionated radiotherapy of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) on peripheral blood lymphocytes in patients with breast cancer. Methods This retrospective analysis enrolled 40 patients with early breast cancer who underwent radiotherapy post breast conserving surgery in Xuzhou Central Hospital from November 2019 to August 2021. The patients were randomly divided into the observation group (HFRT, n = 20) and the control group (CFRT, n = 20). Changes in peripheral blood lymphocyte count (PLC) before and during radiotherapy were compared between the two groups. Results The baseline PLC was comparable between the observation group and the control group (1.53 ± 0.54 vs 1.64 ± 0.56, P > 0.05). In both groups, the PLC declined steadily during radiotherapy, and the incidence of lymphopenia in the observation group was lower than that in the control group (32.5% vs 50.0%, P > 0.05); the PLC nadir was higher in the observation group than in the control group (0.91 ± 0.28 vs 0.55 ± 0.22, P < 0.001). The ratio of the PLC nadir during treatment to baseline was significantly higher in the observation group than in the control group (0.64 ± 0.24 vs 0.38 ± 0.21, P < 0.05). Conclusion Patients with breast cancer receiving HFRT show a lower risk of radiation-induced lymphopenia versus those receiving CFRT.
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Objective To explore the optimal radiotherapy method by comparing the dosimetric differences of target and organs at risk of four radiotherapy plans for left sided breast cancerafter breast-conserving surgery. Methods Twenty-three patients with left breast cancer were randomly selected and given PTV 25 fractions, 50 Gy prescription dose.TheHybrid_IMRT, rj_IMRT, VMAT and t_VMAT plans were designed for each patients. Dosimetric differences were compared, including dose volume histograms of target and OARs, target homogeneity indexes (HI), conformal indexes (CI) and the machine MUs. Results Target Dosimetric comparison, HI: t_VMAT plan target has highest HI and had significant difference (P ≤ 0.001); The target CI of VMAT plans were 0.967 ± 0.016, had significant difference compared with the other 3 plans (P < 0.05). The CI of rj_ IMRT were 0.942 ± 0.018 better than that of IMRT and t_VMATs. Dosimetric comparison of OARs, left_lung mean dose (MLD_L): rj_IMRT were （8.76 ± 1.52） Gy which were best of 4 plans, and had statistical significance (P < 0.05). Heart mean dose: rj_IMRT were （4.68 ± 0.87） Gy were better than that of VMAT (P < 0.05). Conclusion All of these four plans could be applied in clinical treatments, while the limitations of treatment equipment, patients’ physical conditions and some other factors should be considered before selecting an appropriate one.
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Objective To compare the dosimetric difference between the biological function based on equivalent uniform dose (EUD) and the physical function based on dose volume (DV) in the intensity modulated radiotherapy for stage Ⅲ non-small cell lung cancer. Methods Four different radiotherapy plans were designed for 15 stage Ⅲ non-small cell lung cancer patients: Group A, physical function optimization (DV + DV) was used for target area and organs at risk; GroupB, in the target region, biological function optimization conditions were added on the basis of physical function optimization, and physical function optimization of organs at risk (DV－EUD + DV) was added. Group C, biological function optimization (EUD + EUD) was used for target area and organs at risk. Group D, in the target area, physical function optimization conditions were added on the basis of biological function optimization, and biological function optimization of organs at risk (EUD－DV + DV) was added. The differences in dosimetric parameters of the four plans were compared. Results Target area: PTV: D2%, D98%, D50%, D105% and Dmax values of group C (P < 0.05) is the highest while group B and group D were relatively small (P > 0.05); The homogeneity index: the results of the group B and the group D were better than those of the other two groups (P < 0.05). conformity index: The results of the four groups were similar (P>0.05). Organ at risk: lung tissue mean dose (MLD), V5, V10, V20, V30 and heart V30, V40, Dmean dose parameters were similar (P > 0.05). Spinalcord: Group C and group D D1% were better than the other two groups (P < 0.05). There was no statistical difference in the number ofmonitor unit (MU) among the four groups (P > 0.05). Conclusion The optimization method combining physical and biological function optimization in the target area can improve the conformity of the target area on the premise of ensuring the treatment. The Spinalcord load would be significantly reduced when using biological function optimization or the combination of biological function and physical function optimization.
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Brain metastases are common in oncologic patients. Stereotactic radiosurgery (SRS) is an effective treatment for oligo brain metastases. However, SRS is not suitable for large metastatic lesions. Fractionated stereotactic radiation therapy (FSRT) is a new option for the treatment of brain metastases. It can deliver high doses of radiation to tumor while protecting the normal tissues and organs outside the irradiation field as much as possible and maintaining good local control rate of tumors. This article reviews the dose-response relationship and adverse reactions of FSRT with different fractionated dose schemes, and the progress of FSRT combined with targeted therapy and immunotherapy.
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Objective To evaluate the clinical effects and adverse reaction of raltitrexed combined with radiation for esophageal carcinoma in elderly patients.Methods Sixty patients were randomly divided into two groups by the envelope method, 30 patients in experimental group received raltitrexed combined with radiotherapy and 30 patients in control group received radiotherapy only.Patients in both groups received conventional radiotherapy with a total dose of 56-60 Gy/28-30 F.In experimental group, raltitrexed 2.6 mg/m2 was administered concurrently with the radiotherapy on d1 and d22.Two cycles of concurrent chemotherapy were administered during radiotherapy.The short-term effects, survival times and adverse reactions of the two groups were compared.Results The total effective rates of experimental group and control group were 93.3% and 73.3%, respectively, and there was statistically significant difference between the two groups (χ2=4.320, P=0.038).The median survival times of experimental group and control group was 24.0 months and 12.0 months, respectively, and there was statistically significant difference by Log-rank test (χ2=6.048, P=0.014).The major adverse reactions of grade 3-4 in experimental group and control group were radiation-induced esophagitis (10.0% vs.3.3%;χ2=0.268, P=0.605), leukopenia (13.3% vs.10.0%;χ2=0.000, P=1.000), thrombocytopenia (3.3% vs.0;P=1.000), nausea and vomiting (6.7% vs.0;χ2=0.517, P=0.472), and the differences were not statistically significant.Conclusion Raltitrexed combined with radiotherapy can enhance the short-term effect and prolong the survival time for the elderly esophageal carcinoma patients, and the adverse reactions are mild.It is worthy of further clinical study.
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In the field of colorectal cancer molecular biology,there are a number of biomarkers of prognosis and curative effect,including orotate phosphoribosyltransferase,P53,thymidylate synthase,glutathione S-transferase,methylenetetrahydrofolate reductase,dihydropyfimidine dehydrogenase,uridine-diphosphoglucuronosyl transferase,which can select the effective patients or the patients who can't bear the side effects and contribute to the individualized treatment of colorectal cancer.
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<p><b>OBJECTIVE</b>To investigate the different expressions of ER and ER gene status between primary and relapsed/metastatic lesions and their clinical significance.</p><p><b>METHODS</b>ER and ER gene status of primary and relapse/metastatic breast cancer masked in 70 metastatic breast cancer patients were assessed by determination of methylation status by immunohistochemistry (IHC) and methylation specific polymerase chain reaction (MSP), respectively.</p><p><b>RESULTS</b>Positive rate of ER in the primary breast cancers was 64.3%, and in the relapse/metastatic lesions was 41.4% (P < 0.05). There were six patients whose positive ER status was changed to negative, among them the ER gene status was changed from demethylation to hypermethylation in four cases. Another four patients with negative ER status changed to positive, and their ER gene hypermethylation changed to ER demethylation status.</p><p><b>CONCLUSIONS</b>The discordance of ER expression status in primary and relapse/metastatic lesions of breast cancer might be related to DNA methylation status.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Breast Neoplasms , Genetics , Metabolism , Pathology , Breast Neoplasms, Male , Genetics , Metabolism , Pathology , Carcinoma, Ductal, Breast , Genetics , Metabolism , Pathology , DNA Methylation , Gene Expression Regulation, Neoplastic , Immunohistochemistry , Liver Neoplasms , Genetics , Metabolism , Lung Neoplasms , Genetics , Metabolism , Neoplasm Recurrence, Local , Receptors, Estrogen , Genetics , MetabolismABSTRACT
Objective:The aim of this study was to investigate the association of mRNA expressions of ERCC1 (excision repair cross-complementing group 1) and BRCA1 (breast cancer 1) with chemosensitivity to cisplatin in malignant pleural and peritoneal effusions.Methods:Malignant pleural and peritoneal effusions were collected from 46 patients diagnosed with stage Ⅳ malignant tumor, prospectively. The tumor cells were isolated and the sensitivity of tumor cells to cisplatin was detected by adenosine triphosphate-bioluminescence assay (ATP-TCA). Real-time quantitative PCR was used to determine the mRNA expressions of ERCC1 and BRCA1. Results:The expression level of ERCC1 mRNA was negatively correlated with sensitivity of non-small cell lung cancer (NSCLC) to cisplatin (P= 0.001, r=0.685). BRCA1 mRNA expression level had negative correlation with sensitivity to cisplatin in both NSCLC (P=0.014, r=0.541) and gastric cancer (P=0.002, r=0.625). A significant interaction was found between the effects of ERCC1 and BRCA1 mRNA expressions on sensitivity to cisplatin (P=0.010 for all patients;P=0.027 for gastric cancer patients).Conclusion:ERCC1 and BRCA1 mRNA expression levels correlated with ex vivo chemosensitivity of tumor cells to cisplatin in malignant pleural and peritoneal effusions. Detection of both ERCC1 and BRCA1 may have a higher reliability in predicting the sensitivity of tumor cells to cisplatin than detection of single ERCC1 or BRCA1 expression.
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Objective To evaluate the effects of double collagen and epidermal growth factor (EGF) on morphology, viability and function of Sprague-Dawley (SD) rat hepatocytes after cryopreservation and thawing. To investigate a kind of more ideal liver cell cultivation in situ, for offering the most basic material in liver cell transplantation.Methods Rat hepatocytes were isolated by a two-step collagenase technique and cultured in different conditions. After freeze-thaw-cycle, the viability and function of the cells were measured. Results The viability and function of hepatocytes in collagen and in collagen with EGF groups were prior to those in other groups. ( P