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Objective@#To evaluate the clinical efficacy and adverse events of recombinant human interleukin-11(rhIL-11) in the prevention of thrombocytopenia induced by craniospinal irradiation.@*Methods@#In this randomized control study, 100 patients were randomly divided into A (rhIL-11 group, n=50) and B groups (control group, n=50). In the A group, subcutaneous injection of rhIL-11 was delivered at a dose of 50 μg/kg/d, once daily when the platelet count was< 100×109/L during radiotherapy or decreased by> 50% compared with the baseline level. The administration of rhIL-11 was terminated when the platelet count was ≥ 200×109/L. In the B group, the same protocol was conducted when the platelet count was< 50×109/L and terminated until the platelet count was ≥ 100×109/L. The clinical efficacy was assessed in 92 patients. Subcutaneous injection of rhIL-11 could significantly elevate the minimal platelet count during craniospinal irradiation (P<0.01), considerably shorten the duration of thrombocytopenia (P<0.01) and effectively shorten the duration of radiotherapy (P<0.01). Main adverse events included mild pain at the injection site, sclerosis, redness and fatigue, etc.@*Conclusions@#Injection of rhIL-11 can significantly enhance the platelet count, effectively reduce the incidence of thrombocytopenia throughout craniospinal irradiation, guarantee the success of radiotherapy and yield mild adverse events.
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Objective:This study investigates the clinical effect of bodyγ-knife combined with radiosensitizer and/or hyperthermia. for the recurrence of soft tissue sarcoma. Methods:Sixty-three patients with recurrent soft tissue sarcoma from January 2012 to March 2014 were treated by bodyγ-knife combined with radiosensitizer and/or hyperthermia. The patients were exposed to radiation dose levels of 4-5.5 Gy/fraction (10-13 fractions) with total doses of 44-55 Gy and 55%-70%isodose, including 95%PTV. The radiosensitizer, sodium glycodidazolum (CMNa), was administered to all patients at 1.00-1.50 g V.D qod at 5-6 fractions 0-3 h before bodyγ-knife treat-ment. Hyperthermia for 30 patients was delivered during the bodyγ-knife treatment with two fractions/week for a total of six frac-tions. Results:The total response rate was 77.7%three months after the treatment. The one and two year local control rates were 78.8%and 63.6%, respectively, while the survival rates of patients treated with bodyγ-knife with radiosensitizer at one and two years were 75.7%and 63.6%, respectively. The local control rates at one and two years were 83.6%and 70.0%, respectively, while the surviv-al rates at one and two years for bodyγ-knife combined with radiosensitizer and hyperthermia treatments were 80.0%and 63.3%, re-spectively. Serious complications of radiotherapy were not observed. Conclusion:Bodyγ-knife combined with radiosensitizer and/or hyperthermia is effective for recurrent soft tissue sarcoma.
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Objective To collect the hot spots, development trends, high yield authors and their affiliated institutions by analyzing the papers on pancreatic cancer chemotherapy in recent 5 years. Methods The papers on pancreatic cancer chemotherapy were downloaded from PubMed. Their high frequency subject headings extracted by BICOMB were analyzed by bibliometric double clustering analysis and strategic coordinate analysis. The high yield authors were analyzed by co-authorship group analysis. Results The current studies on pancreatic cancer chemotherapy in foreign countries were focused on the pathological features of pancreatic duct adenocarcinoma before and after chemotherapy, drug therapy of pancreatic cancer according to its genetics, metabolism and pharmacology of antitumor drugs, surgical treatment combined with radiotherapy and chemotherapy for pancreatic cancer. The high yield authors could be divided into two large groups from Japan and USA and a number of small groups. Conclusion New breakthrough points should be found from the matured topics, the topics with a further developmental space should be greatly concerned, and cooperation should be strengthened between study groups or teams.
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The treatment of recurrent head and neck cancers has improved from single modality interventions of surgery and radiation therapy alone to include combined modality therapy with surgery, chemotherapy and radiation. Combined therapy has led to improved local control and disease-free survival. New developments in radiation oncology such as intensity-modulated radiotherapy, brachytherapy, stereotactic radiosurgery, fractionated stereotactic radiotherapy, have helped to improve this outlook even further. These recent advances allow for a higher dose to be delivered to the tumor while minimizing the dose delivered to the surrounding normal tissue. This article provides an update of the new developments in radiotherapy in the management of previously-irradiated recurrent head and neck carcinoma.
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Objective: To compare the difference of Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) and modified Re-sponse Evaluation Criteria in Solid Tumors (mRECIST) in the treatment of hepatocellular carcinoma (HCC) after stereotactic body radio-therapy (SBRT). Methods:From Janurary 2014 to August 2015, thirty-five patients with HCC treated with SBRT were included in De-partment of Radiation Oncology and Integrative Oncology of Navy General Hospital of PLA, and SBRT efficacy was evaluated based on RECIST 1.1 and mRECIST criteria. Results:Under RECIST 1.1, one patient had complete response (CR), 20 had partial response (PR), and 11 achieved stable disease (SD) at three months. Three patients had progressive disease (PD). The overall best response rate (CR+PR) was 60%. In comparison, under mRECIST, 10 patients had CR, 16 had PR, and 6 achieved SD at three months. Three patients had PD. The overall best response rate was 74.28%. The statistical analysis showed that Kappa=0.402 (χ2=43.3, P<0. 001) was less than 0.75 but greater than 0.4, indicating that it had not reached the two diagnostic criteria of consistency degree of satisfaction. According to the mRECIST criteria, the objective remission group (CR+PR) was superior to the nonobjective remission group (SD+PD) in progression-free survival (P<0.001). Conclusion:For unresectable HCC, mRECIST may be more useful than RECIST 1.1 in evaluating HCC response to SBRT.
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Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ (7/23) and 13.6 ％ (3/22),the response rates were 91.3 ％ (21/23) and 63.6 ％ (14/22) (x2 =4.980,P =0.026).The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ (x2 =1.267,P =0.260),myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ (x2 =1.171,P =0.279).The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group (x2 =4.874,P =0.027).The median progression-free survival (PFS) rates of two groups were 8 months and 6 months respectively (x2 =1.357,P ＞ 0.05),the median survival period were 17 months and 14 months (x2 =1.017,P ＞ 0.05),1 year survival rates were 60.9 ％ and 54.5 ％ respectively (x2 =0.184,P ＞ 0.05).Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.
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Objective:To investigate the efficacy of stereotactic body radiation therapy with gamma-knife (γ-SBRT) combined with targeted drug sorafenib and hyperthermia for the treatment of recurrent and metastatic hepatocellular carcinoma. Methods:A total of 71 patients with recurrent and metastatic hepatocellular carcinoma were admitted from August 2007 to December 2009. Among these patients, 39 were treated with γ-SBRT and hyperthermia (group 1); 19 were treated with γ-SBRT combined with sorafenib and hyperthermia (group 2). Results: The total efficacy rate after a three-month treatment was 83.1% (59/71). In group 1, the following results were obtained:one-and three-year local control rates of 41.0%(16/39) and 18%(7/39), respectively;one-and three-year overall survival (OS) rates of 41.2% and 17.9%, respectively; and one- and three-year progression-free survival (PFS) rates of 38.4% and 15.4%, respectively. In group 2, the following results were obtained:one-and three-year local rates of 56.3%(18/32) and 28.1%(9/32), respectively;one-and three-year OS rates of 62.5%and 28.1%, respectively;and one-and three-year PFS rates of 59.4%and 25.0%, respectively. Significant differences in OS and PFS were observed between the two groups. Conclusion:The combination ofγ-SBRT with targeted drug sorafenib and hyperthermia can be used effectively to treat recurrent and metastatic hepatocellular carcinoma. Adverse reactions are mild, and patients can tolerate this treatment.
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Objective To analyse the survival time and related factors of patients with brain stem glioma who received 3DCRT.Methods Thirty-six patients with brain stem tumor were admitted from October 2004 to December 2008 and all received 3D-CRT with the dosage (50-54 Gy,25-30 f,5-6 weeks).During treatment,the patients’ outcomes were analyzed by observing the changes of symptoms,signs and adverse radiotherapy reaction and all of them were followed-up in the next 3 years.The survival data were analyzed by Kaplan-Meire method.Results The median survival time was 9 months in the 23 pediatric patients and 15 months in 13 adult patients.One-,two-and three-year survival rates between pediatric group and the adult group were 43.5 ％ (10/13) vs 76.9 ％ (10/13),26.1％ (6/23) vs 46.2 ％ (6/13),8.7 ％ (2/23) vs 38.5 ％ (5/13).Karnofsky performance scale score at admission (x2 =20.059,P =0.000),tumor site (x2 =17.585,P =0.000),growth pattern (x2 =21.247,P =0.000) were associate with survival time.Conclusion 3DCRT is an effective therapy to brain stem glioma,childhood onset,pontine glioma,diffusion style and Karnofsky performance scale less than 80 are risk factors of poor prognosis.
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Development and metastasis of NSCLC are closely related to angiogenesis.Several distinct groups of vascular-targeted therapies have evolved:anti-VEGF monoclonal antibody,small molecules inhibitors,vascular disrupting agents,endothelial cell growth inhibitors,et al.Antiangiogenic treatment could make longer survival than conventional treatment.The strategy of anti-angiogenic drugs combined conventional treatment is being studied.
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Objective To study the effect of hypoxia on EMT molecule E-cadherin, Vimentin and invasion of human breast cancer MCF-7 cells, reveal the mechanism of breast cancer invasion and metastasis and provide experimental and theoretical basis. Methods Western blot was used to observe the change of HIF-1α, E-cadherin and Vimeutin during hypoxia on MCF-7. MTT was used to study the effects of viability.Transwell chamber was used to detect the ability of invasion and metastasis. Results The expression of E-cadherin was significantly lower (0.09±0.02)(t=30.98,P=0.0007) and the expression of Vimentin was significantly higher (0.69±0.04) (t=915,P=0.0000) with the extension of hypoxia.The capability of adhesion (81.23±0.74) (t=82.05,P=0.000),invasion(120±6) (t=22.78,P=0.0009) and migration(190±6) (t=23.49,P=0.000)was significantly increased after 72 h hypoxia(P＜0.05).Conclusion Hypoxia can downregulate E-cadherin and upregulate Vimentin and enhance the adhesion,invasion and migration of MCF-7.
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Obiective To elaborate the application of PCT/CT orientation Gamma Knife in the body.Methods From May, 2007 to May, 2008, PET/CT equipment was used on 120 cases with gamma knife body positioning and image fusion, Re-sults The PET/CT scan may not have iodine in the contrast agent to enhance the effective conduct of tumor imaging and CT position provides more simple and more accurate image information to guide target(GTV) of the outline. Conclusion The PET/CT in the gamma knife treatment can improve in the positioning accuracy of GIN, and improve treatment opportunity for iodine allergy patients.
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As a new radiotherapy for carcinomas, Proton Therapy has been making progresses. Compared with conventional radiation, proton has a better physical characteristic and a similar biological effect. Proton Therapy consists of Conformal Proton Radiotherapy, Intensity-Modulated Proton Therapy, Stereotactic Radiotherapy, Proton Scanning Radiation and et al. With the utilization of Bragg peak, Proton therapy can increase the dose of carcinoma region and reduce the dose of normal tissue, and thus it has a good curative effect and can be a good cure for many indications. In spite of the above-mentioned, Proton therapy has to be improved in the future.
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To study the effects of fractioned ir radiation on the total RNA and MDR 1 mRNA of NCI H 446 small cell lung cancer cell line, NCI H446 cells in the period of exponential growth were exposed to 60 Co ? radiation at 2 Gy/fraction, 2 fraction/week, with the cumulative dose of 50 Gy by 25 fractions. The total RNA of the cells of the irradiated group and control group were extracted by the acid guanidine thiocyanate phenol chloroform method and the amount of the expression of MDR 1 mRNA was assessed by qualitative RT PCR assays. Under the conditions of same cell number and volume, in cells of the control group, the concentration of the total RNA was 25 9 ?g/ml and the ratio of MDR 1 DNA/? actinDNA was 1 078, whereas in cells of the irradiation group, the corresponding values were 16 6 ?g/ml and 1 338, respectively. It is concluded that, for the NCI H446 small cell lung cancer cell line, a high dose accumulated during fractioned irradiation can inhibit the synthesis of its total RNA and enhance the expression of its MDR 1 gene at the same time.
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Radiotherapy physics is a cross subject that studies and solves the scientific problem referring to medicine treatment based on physics.Ceaseless progresses of Radiotherapy equipments such as Cobait-60 treatment machine,Linear Accelerator,Gama Knife,Tomotherapy have provided comprehensive treatment measures for malignant tumor.Therapies including conformal Radiotherapy,Intensity Modulation Radiotherapy and Gama Knife are progressing and being perfected.Further research should be done on dose fraction.Boron Neutron Capture Therapy and Proton Therapy are being studied.Treatment Plan System and Target Delimitation need perfecting.