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Objective To study the clinical efficacy of sodium cantharidinate and vitamin B6 injection combined with concurrent chemoradiotherapy in treatment of locally advanced nasopharyngeal carcinoma (LA-NPC).Methods 115 patients with LA-NPC in Shanxi Cancer Hospital were randomly assigned to observation group (61 cases) and control group (54 cases) from February 2014 to April 2016.The patients in the observation group were treated with sodium cantharidate and vitamin B6 injection combined with concurrent chemoradiotherapy.The patients in the control group were treated with concurrent chemoradiotherapy.The differences between the two groups were compared in respect of recent curative effect,the quality of life (QOL) and the adverse reactions.Results The recent effective rate was 93.44 ％ (57/61) in the observation group and 79.63 ％ (43/54) in the control group,and there was significant difference between the two groups (x2 =4.818,P =0.049).The improvement rate of QOL was 73.77 ％ (45/61) in the observation group and 53.70 ％ (29/54) in the control group,and there was significant difference between the two groups (x2 =5.028,P =0.032).The incidence rates of oral cavity mucous membrane inflammation,hematology toxicity,pharynx and esophagus adverse reactions,the gastrointestinal tract adverse reactions and skin fibrosis in the observation group were lower than those in the control group,and there were significant differences between the two groups (all P ＜ 0.05).Conclusion The recent effect of sodium cantharidinate and vitamin B6 injection combined with concurrent chemoradiotherapy on the patients with LA-NPC is obvious.The comprehensive treatment can also reduce adverse reactions and improve the QOL.
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Objective To explore the related factors of tumor regression speed during radiotherapy for esophageal cancer and analyze the relationship between recent clinical curative effect and tumor regression speed.Methods 68 previously untreated esophageal cancer patients were treated with three dimensional conformal intensity modulated radiation therapy (3D-IMRT).The radiation dose was 64 Gy/32 times (95 ％ PTV).All the patients were divided into 3 groups according to the size of primary lesions during the entire course of radiotherapy.Fast regression was defined as a complete response before dose 32 Gy,slow regression with dose in the range of 64 Gy and other cases as residual disease.The correlations of tumor regression speed with age,gender,classification,length of lesion and the lesion location were analyzed.And the relationship between recent clinical curative effect and tumor regression speed was discussed.Results The age,gender,classification and the lesion location were not associated with tumor regression (P ＞ 0.05).There was a negative correlation between tumor regression speed and the length of lesion [88.9 ％ (16/18),69.2 ％ (18/26) and 12.5 ％ (3/24) in fast,slow and residual group,respectively,x2 =27.923,P ＜ 0.05].There was a positive correlation between recent clinical curative effect and tumor regression speed (r =0.415,P ＜ 0.05).Conclusion The length of primary lesion is an independent risk factor for recent clinical curative effect and tumor regression speed of esophageal cancer patients treated with 3D-IMRT.
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Objective To evaluate the efficacy and untoward effects of brucea javanica oil emulsion combined with radiotherapy in the treatment of patients with esophageal cancer. Methods 50 initial treatment patients with esophageal squamous cell carcinoma were randomly assigned to observation group (25 cases) and control group (25 cases). All patients were treated with three dimensional conformal intensity modulated radiation therapy (3D-IMRT) and the radiation dose was 64 Gy/32 times (95 % PTV). The patients in observation group received the treatment of brucea javanica oil emulsion during radiotherapy. The differences between the two groups were compared in respect of the efficacy, the adverse reactions and the quality of life (QOL). Results The effective rate in observation group was 92%(23/25) and it was 68%(17/25) in control group, there was significant difference between the two groups (χ2 = 4.500, P= 0.034). The incidence of radiation esophagitis at the level of RTOG2 and above in observation group was 20%(5/25) and it was 60%(15/25) in the control group, there was significant difference between the two groups (χ2= 8.333, P=0.004). The improvement rate of QOL in observation group was 68 % (17/25) and it was 40 % (10/25) in control group, there was significant difference between the two groups (χ2 = 3.945, P= 0.047). Conclusion Brucea javanica oil emulsion combined with radiotherapy for the treatment of patients with esophageal cancer can improve the therapeutic effect and QOL,it can also reduce radiation reactions.
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Objective To study the spatial distribution of set-up errors for cervical cancer with intensity modulated radiation therapy (IMRT) and to provide referential safety margin out of clinical tumor volume (CTV) during treatment plan design. Methods Six patients with cervical cancer were treated with IMRT in prone position, belly board and thermoplastic cast was used for immobilization. Measurement were made on a daily basis setup under five consecutive treatments with electron portal images device (EPID).Portal films from two projection (one anter-posterior and one opposite lateral)were taken. Sixty portal films were analyzed. The translational and rotational deviations were analyzed by registering and comparing the bony structures of EPID and digitally reconstructed radiographs (DRR). Results The translational deviations were (3.1 ±1.8) mm, (3.9 ±3.3) mm, (4.2 ±2.6) mm in medi-lateral, cranio-caudal and anterior-posterior directions, the rotational deviations were in coronal plane (0.8±0.9)° and sagittal plane (1.2±1)°. Conclusion For the patients with cervical cancer undergoing IMRT, the margins between the CTV and PTV should be 7.1 mm in lateral direction, 10.4 mm in cranio-caudal and 10.8 mm in anterior-posterior directions. The sign on patients body can help to reduce the setup errors.
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Objective To analyze the difference of irradiation dose and volume of organs at risk (OAR) particularly in small intestine between supine position and prone position on intensity-roodulated radiotherapy(IMRT) for cervical cancer. Methods 11 patients with Ⅱ_B-Ⅲ_B cervical cancer were scanned with supine position and prone position by CT.The CT images were transported to TPS,then target volumes were delineated and the IMRT plans were designed respectively.The prescribed dose was 95%PTV receiving 45 Gy in 23 fractions of 2 Gy.The exposure volumes of the OAR at different position and different dose levels in the dose volume histograms (DVH) were compared and analyzed.Results When tlle dose di8tributions met to the clinic request,the exposure volumes of small intestine at prone position were redueed than that at supine position in dose range 46-30 Gy(P<0.05),but this phenomenon Was not distinct in low dose range(< 20 Gy)(P>0.05).The exposure volumes of bladder, rectum, femur head and spine cord were no obviously differences at dissimilar position. Conclusion IMRT of cervical cancer should adopt prone position.because their small intestine will be protected better.
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Objective To eompare the dose distribution of three-dimension conformal radiation therapy(3DCRT) and common radiation therapy (CRT) of the planning target volume(PTV) and organ at risk (OAR) in recurred cervical cancer treatment planning. Methods Thirteen patients,who had cervical cancer recurred in pelvis treated with 3DCRT in Shanxi Cancer Hospital from May to August 2007, were selected. After CT simulation, the CT images were transferred into Topslane treatment system. The same physicist designed 3DCRT plan and common radiation therapy plan for every patient,total dose 50 Gy, 90 % is dose covered PTV, then compared the dose distribution of PTV and OAR.Results At the same prescribed dose of 50Gy,there were no significant differences on OAR maximum dose between 3DCRT plans and common radiation therapy plans(P >0.05), however, there was significant differences on PTV maximum dose(P <0.01). The difference of PTV uniformity were significant between 3DCRT plans and common radiation therapy plans (P <0.001). Compared the high dose region of OAR(V40), the difference was significant (P <0.001). Between 3DCRT plans and common radiation therapy plans, they showed 53.31 ml (90.69 %), 124.00 ml (79.47 %), 655.16 m1(92.22 %) median reduction in the V40 of rectum, bladder, intestine, respectively. Conclusion At the same PTV coverage of the prescribed dose, 3DCRT plans showed worse dose uniformity, however, the radiation volume to organs at risk in 3DCRT plans were smaller than common radiation therapy plans. So patients with cervical cancer recurred in pelvis received 3DCRT may be potentially diminish the Normal Tissue Complications Probability(NTCP).