ABSTRACT
Tumor radiotherapy is established on the basis of clinical oncology, radio-physics and radiobiology, and has become one of the three major therapeutic methods for malignant tumors. With the pace of socialist construction in China, the subject of radiotherapy in Shanxi province has developed from scratch and from small to large for more than 60 years. Remarkable achievements have been made in the establishment of departments, the updating of technical equipment, the increase of employees and clinical scientific research. This article reviews and summarizes the development history of tumor radiotherapy in Shanxi province.
ABSTRACT
Objective To evaluate the efficacy and adverse reactions of preoperative intensity-modulated radiotherapy (IMRT) combined with mFOLFOX6 chemotherapy regimen for locally advanced rectal cancer (LARC). Methods A total of 86 patients with LARC who received preoperative IMRT combined with chemotherapy in Shanxi Provincial Cancer Hospital from June 2010 to December 2012 were enrolled. The patients were randomly divided into 2 groups according to the random number table method. Forty-six patients were treated with mFOLFOX6 regimen (mFOLFOX6 group) and 40 patients were treated with fluorouracil (5-Fu) single drug injection (5-Fu group). The total dose of IMRT target region was 45-54 Gy, 25 times in total. Short-term efficacy, adverse reactions, survival and metastasis were evaluated respectively. χ 2test or Fisher test were used to compare the count variable. Kaplan-Meier method was used to calculate the survival rates and Log-rank was used to detect. Results The total follow-up rate was 97.67 % (84/86). There were no statistical differences in the rate of resection (93.5 % vs. 80.0 %), pathological complete remission (pCR) rate (6.5 % vs. 0) and 3-year overall survival (OS) rate (87.0 % vs. 70.0 %) in the mFOLFOX6 group and 5-Fu group respectively (all P ＞ 0.05). Down-staging rate, 3-year disease free survival (DFS) rate and distant metastasis free survival (DMFS) rate in the mFOLFOX6 group were significantly higher than those in 5-Fu group (58.7 % vs. 32.5 %, 79.1 % vs. 50.0 %, 89.1 % vs. 72.5 %, all P ＜0.05). Conclusions Preoperative IMRT combined with mFOLFOX6 regimen can decrease the preoperative staging of LARC patients, improve 3-year DFS rate and DMFS rate. The adverse reactions may increase, but it is tolerant.
ABSTRACT
Objective To compare the efficacy and adverse reactions of intensity-modulated radiation therapy (IMRT) and conventional pelvic field radiation therapy for middle and advanced cervical cancer. Methods A total of 144 patients with stageⅡB-ⅢB cervical cancer from October 2007 to September 2012 were divided into IMRT group (72 cases), and routine radiotherapy group (72 cases) by using random number table method. The IMRT group was exposed to the 6 MV-X line 7 field, a dose of 46-50 Gy for planning target volume (PTV), 54-60 Gy for gross tumor volume (GTVnd) simultaneously integrated boosted, in 25-28 fractions. The central block of lead 4 cm was changed to 4 fields irradiation, adding to 46-54 Gy for the conventional group after 30-40 Gy of the whole pelvic field. The total dose for the two groups of patients was 30-45 Gy, after completed 30 Gy in vitro exposure, to the cavity irradiation, 5-7 Gy/fraction, and synchronous cisplatin (DDP) sensitization chemotherapy was done synchronously. Results The recent complete remission, partial remission, overall survival ratio of two groups were compared respectively, and the difference was not statistically significant (P > 0.05). The difference in 1 year survival rate of IMRT group and routine radiotherapy group was not statistically significant (χ2= 1.455, P> 0.05). The difference in 3 and 5 year survival rate was statistically significant [76.4 % (55/72) vs. 59.7 % (43/72); 72.2 % (52/72) vs. 55.6 %(40/72), P< 0.05]. Acute radiotherapy major adverse reactions included the digestive system, urinary system, skin response and haematological toxicity (bone marrow suppression). The incidence and degree of skin response in IMRT group was lower than that in routine radiotherapy group (P<0.05). The adverse effects of late radiotherapy were mainly rectal, bladder, skin response and hematological toxicity (bone marrow suppression). The incidence rectal and skin response in IMRT group was lower than that in routine radiotherapy group (P< 0.05). Conclusion The IMRT can improve the survival rate of advanced cervical cancer patients for 3-5 years, reduce the adverse effects of acute and terminal radiotherapy, and improve the quality of life.
ABSTRACT
Objective To observe the effect of high-dose three-dimensional conformal radiotherapy (3DCRT) on recurrence and metastasiscervical cancer.Methods Sixty-one recurrence or metastasis cervical cancer patients were divided into two groups.Group high-dose 3DCRT (high-dose group) received radiotherapy using 6 MV X ray 4-8 Gy per field,three times per week,with total dose of 35-50 Gy.The other group (other group) received radiotherapy using 6 MV X ray 2 Gy per field,5 times per week,with total dose 40-60 Gy.The short-term efficacy and complications between the two groups were compared.Results The tumor regression rates of the two groups were 76.7 ％ (23/30) and 67.7 ％ (21/31) (x2 =0.604,P ＞ 0.05),which had no significant difference.The 1-year survival rates [63.3 ％ (19/30),54.8 ％ (17/31)] (x2 =0.454,P ＞ 0.05)and the 2-year survival rates [26.7 ％ (8/30),29 ％ (9/31)] (x2 =0.042,P ＞ 0.05) had no significant difference either,but in high-dose group,the bone marrow inhibition rate [53.3 ％ (16/30)] was significantly lower than other group [77.4 ％ (24/31)] (x2 =3.91,P ＜ 0.05),the reaction of digestive tract [56.7 ％ (12/30)] was also significantly lower than other group [56.7 ％ (12/30)] (x2 =4.09,P ＜ 0.05).Conclusion Compared with the other group,the high-dose 3DCRT has the same short-term efficacy but lower short-complications,and the quantity of life is better than the other group.
ABSTRACT
Objective To evaluate the short-term clinical effect of 125Ⅰ seeds interstitial braehytherapy for recurrent malignant tumor after radiotherapy. Methods 21 patients with recurrent gynecologic tumors after radiotherapy received 125Ⅰ seeds interstitial braehytherapy through TPS, ultrasound. 125Ⅰ seeds radiotherapy per grain was for 20.72-29.60 MBq. The distribution of seeds was checked by X-my after treatment. The clinical therapeutic efficacy was observed by chest CT, ultrasound. Results The overall effective rate was 100 %, CR 85.71%(18/21), PR 14.29 %(3/21). Conclusion 125Ⅰ seeds interstitial brachytherapy is minimally invasive, convenient, safe, utility and feasible in clinical practice. The radioactive protection is easy. It is a new and high technology of malignant tumor treatment. Colligation treatment method is increased by this technique. But this technology cannot replace routine method.
ABSTRACT
Objective To investigate the curative effect of synchronous radio-chemotherapy in medium-term and advanced cervical carcinoma. Methods 168 cases of medium-term and advanced cervical carcinoma were selected. The treatment group(grout A) included 84 pathologically verified cases of stage Ⅱ～Ⅳ cervical carcinoma. Each patient was given DDP with hydration at the dose of 40 mg/m2 intravenously.The treatment cycle was performed once every week for 3--4 circles. Radiotherapy was given at the same time. 60Co was used for external radiation with a total dose of 50 Gy, 192 Ir afterloading unit was used for brachytherapy at the dose of 7 Gy per week at point A with a total dose of 42 Gy. The control group (group B)included 84 cases of cervical carcinoma at the same stage in the corresponding period who received radiotherapy only.Short-term effect ,2-year survival rate and complications were observed. Results Effective rate was 92.85 %(78/84) in group A and 79.76 %(67/84) in group B respectively 3 months after radiotherapy, showing a significant difference(χ2 =6.10,P <0.05). 2-year survival rate was higher in group A (83.95 %) than in Group B(60.98 %) (χ2 =9.4,P<0.05). Local recurrent and distant metastasis were lower in Group A than Group B. In group A, there were tolerable bone marrow inhibition and reaction of digestive tract. Conclusion Synchronous radiotherapy and chemotherapy can remarkably improve the survival rate of medium-term and advanced cervical carcinoma. The application of DDP is effective and safe,and its side effect can be accepted by patients, but the long-term effect needs further observation.
ABSTRACT
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).
ABSTRACT
Comprehensive treatment is the hot for cervical carcinoma,but comprehensive treatment is not the superposition of several treatment methods.Surgical treatment is the main means for early cervical carcinoma and radiotherapy for locally advanced. It's sure that radiotherapy combined with hyperthermia.Abroad,concurrent chemotherapy and radiotherapy is regarded as routine treatment methods.Improvement of hyperthermia technology is more applicated in the clinical.Reducing complications after treatment and enhancing the effectiveness of the treatment of cervical carcinoma is the ultimate goal.
ABSTRACT
Gliomas is the primary intracraniai tumors.It is mainly principle that treatment with surgery followed a comprehensive treatment.As the growth of glioma infiltrating,difficult surgical resection of all clean and easy to relapse,so post-operative adjuvant radiation therapy occupie an important position.In order to explore for brain glioma effect,mainly on the gliomas means of the status and progres with various radiation therapy and radiotherapy combined with chemotherapy.
ABSTRACT
Objective To evaluate the effects and the side effects of three-dimensional conformal radiotherapy on recurrent cervical carcinoma with pelvic wall infiltration. Methods Twenty-one patients with recurrent cervical carcinoma infiltrating the pelvic wall were irradiated by three-dimensional conformal radiotherapy. The regimen was: total dose 30-52Gy,5-8.5Gy/f, 1f/2d. Results The rates of sciatic pain and leg edema relief response were 100 % and 61 % respectively. The CR+PR response rate was 71.4 %. The overall 1-, 2- and 3-year survival rates were 38 %, 14 % and 4 %. Conclusion Three-dimensional conformal radiotherapy is more effective than conventional radiotherapy and chemotherapy for recurrent cervical carcinoma infiltrating the pelvic wall. It doesn't increase the side-effects on the digestive system and the urinary system.
ABSTRACT
Objective To evaluate the impact of different factors on long-term results in cervical carcinoma patients initially treated by surgery followed by radiotherapy. Methods In 1998, 525 cervical carcinoma patients were admitted, among whom 346 patients were first treated by surgery. 302 of these 525 patients were given postoperative radiotherapy. The stage distribution of these 302 patients were: stage I 142;stage Ⅱa 121;stage Ⅱb 23;and stage Ⅲa 16. ~ 60 Co ? or 6MV X-ray was used for radiotherapy. Perpendicular portals were alternately irradiated to 44-50Gy/4-5 week. Extending the portal, increasing the dose after constricting portal, adding intracavitary afterloading irradiation and adjuvant chemotherapy were carried out according to the different clinical requirements. Results The 5-year survival rate was 89.4%,77.7%,56.5% and 56.3% in stage I, Ⅱa, Ⅱb and Ⅲa lesion, respectively(?~2=22.22,P