Concurrent chemoradiotherapy followed by consolidation chemotherapy and sequential chemoradiotherapy for stage III non-small cell lung cancer: comparison in 93 patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SCRT) in the treatment of stage III non-small cell lung cancer.</p><p><b>METHODS</b>From February, 2007 to June, 2010, 93 patients with unresectable stage III non-small cell lung cancer were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of cisplatin plus gemcitabine, docetaxel or vinorelbine. Radiotherapy was administered using two-dimensional conformal irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy).</p><p><b>RESULTS</b>The response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant metastasis than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included radiation pneumonitis, radiation esophagitis, nausea/vomiting and anemia/leucopenia/thrombocytopenia. CCRT-CT group had a significantly higher rate of III-IV grade nausea/vomiting and anemia/leucopenia/thrombocytopenia than SCRT group.</p><p><b>CONCLUSION</b>Compared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant metastasis, but is associated with a higher toxicity.</p>

Study of intra-operative radiotherapy in primary liver cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the feasibility of intraoperative radiotherapy (IORT) in primary liver cancer.</p><p><b>METHODS</b>Based on the target of dose curves, the dose-volume histogram (DVH) and cost of radiation equipment and radiation therapy, IORT was compared with protonbeam therapy (PBT) and 3DCRT in 16 patients with primary liver cancer using the therapy plan system (TPS).</p><p><b>RESULTS</b>IORT had significantly better performance than 3DCRT to allow a target region surrounded by 90% of the dose lines. IORT was similar to protonbeam therapy in terms of target region surroundings and absorbed dose in the normal organs, but the cost of IORT was significantly lower.</p><p><b>CONCLUSION</b>The TPS of IORT is better than 3DCRT and similar to protonbeam therapy in the treatment of primary liver cancer with similar cost to 3DCRT. IORT can effectively protect the neighboring sensitive organs and improve the absorbed dose in the tumors and the local control rate.</p>

Clinical pharmacokinetic study of cisplatin in enhancing cervical cancer radiosensitivity / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the pharmacokinetics of cisplatin in enhancing the radiosensitivity of stage IIa-IIb bulky cervical cancer.</p><p><b>METHODS</b>Thirty-six patients with stage IIa-IIb bulky cervical cancer were treated intravenously with cisplatin (30 mg/m(2)) and cisplatin levels were measured in tumor tissues and serum of the patients at the random time points of 1, 2, 4, 6, 10, 18, and 24 h following the injection. Cisplatin levels were also measured in the tissues following administration of different radiation doses by flameless atomic absorption spectrometry.</p><p><b>RESULTS</b>Cisplatin level in the tumor tissues was the highest at 4 h following the injection, and its serum level showed obvious reduction within 2 h following the injection. Radiation increased cisplatin level in the tumor tissue.</p><p><b>CONCLUSION</b>Cisplatin level reaches the highest level in the cancer tissue at 4 h following intravenous injection, a time when cisplatin can best execute its effect in enhancing the radiosensitivity of cervical cancer, and cisplatin administration in later stage of radiotherapy may achieve better effect than early stage administration.</p>