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Objective:To compare the efficacies of MRI, X-ray mammography (XMG) and Ultrasound (US) in detecting and diagnosing breast ductal carcinoma in situ (DCIS).Methods:Two hundred and forty one consecutive patients with pathology-confirmed DCIS were retrospectively recruited from January 2011 to December 2017 in PLA General Hospital. The imaging examination modalities included MRI and/or XMG and/or US.The breast imaging reporting and data system (BI-RADS) categorizations by MRI, XMG and US were compared and their sensitivities of detecting DCIS were calculated. The causes of underestimation on MRI were interpreted with the information of XMG and US. Chi-square test was used to compare the differences.Results:The diagnostic sensitivity of XMG, US and MRI was 65.9% (29/44), 71.6% (101/141) and 91.2% (145/159), respectively, with statistical significant differences (χ2 =24.034, P<0.001). Breast density and lesion type would influence the sensitivity of XMG. And the sensitivity of US was decreased because of non-mass lesion. Of the 14 cases under-evaluated as BI-RADS category 1 to 3 on MRI, 5 were corrected by XMG and/or US to BI-RADS category 4. The cause of underestimation on MRI was the coexistence of DCIS with adenoma or other benign lesion. Conclusion:The retrospective comparison of MRI, XMG and US in this study showed that MRI had significant higher sensitivity in detecting breast DCIS, while the false negative rates of XMG and US were un-negligible.
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Objective To evaluate the incidence of nasopharyngeal hemorrhage after radiotherapy of nasopharyngeal carcinoma (NPC) in order to adjust adequately the dose of fractionated stereotactic radiosurgery (FSRS). Methods Eighteen NPC patients were treated by FSRS following conventional radiotherapy of D T65～74?Gy. Of them, 5 patients (T 4) with uncontrolled lesions received a boost dose of 24～40?Gy/6～8 f and 13 patients (T 2～3 ) with local recurrence received their second course of treatment with different regimens. Group A: 8 patients received routine radiotherapy 30～40?Gy followed by FSRS 24～30?Gy/6～9 f; Group B: 5 patients received FSRS 40～42?Gy/6～8 f alone. Results The frequency of nasopharyngeal hemorrhage was 3/5 for skull base invasion (T 4 ) lesions. The incidence of morbidity for re radiation after local recurrence of T 2～3 tumor was 1/8 in Group A and 1/5 in Group B.Conclusions The frequency of nasopharyngeal hemorrhage is high in skull base invasion by NPC (T 4).Therefore the dose of FSRS combined with conventional radiotherapy should be limited when re treating local recurrence of NPC.
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Objective To study the role of three-dimensional conformal radiation therapy(3DCRT) in the treatment of elderly non-small cell lung cancer(NSCLC) patients.Methods From 2000 to 2004,39 elderly NSCLC patients(range 70-87 years) were treated by 3DCRT.Their Karnovsky performance score was 50-60 in 20 patients and those of the other 19 patients were not less than 70.Prescription dose were 40-60?Gy,with a median of 50?Gy.Results Thirty-six(92%) patients'symptoms were relieved at the end of treatment,with the other three patients' symptoms steady.Complete response and partial response was achieved in 19 and 17 patients respectively.The 1-year survival rate was 60%,with a median survival time of 10 months.Conclusions Three dimensional conformal radiotherapy is effective for elderly NSCLC patients in terms of symptom relief.For treatment choice of these senior NSCLC patients,the balance between tumor control and quality of life should be carefully considered.