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Objective To study the radioactive concentration of 131I in the air of workplaces where sodium iodide [131I] oral solution was administrated for patients with differentiated thyroid cancer (DTC) in the Department of Nuclear Medicine, and to estimate the internal radiation dose to the staff. Methods Workplaces of radioiodine 131I therapy for DTC patients in the Department of Nuclear Medicine of a hospital were investigated. Air samples in 131I administration areas and treatment wards were collected respectively and were measured by low-background gamma-ray spectrometry to calculate the activity concentration of 131I in the air and to further estimate the internal radiation dose to staffs. Results The activity concentration in the 131I administration area within the first 3 h of administration was 3～187 Bq/m3. During administration and within the first 3 h of administration, the staff exposed in the administration area for 5～30 min received an internal radiation dose of 0.08～0.50 μSv and 0.00～0.04 μSv, respectively. The highest activity concentration of 131I in the air of the ward was measured on the day of administration, reaching 3091 Bq/m3. After patients were discharged, the activity concentration in the ward gradually decreased to 10～242 Bq/m3 within 48 h. Within 48 h after patients were discharged, the staff exposed in the ward for 5～30 min received an internal radiation dose of 0.01～14.11 μSv. Conclusion A high activity concentration of 131I in the air was recorded during administration for DTC patients in radioiodine 131I therapy, and thus we recommend remote instructed administration or administration through a shielded window. We also recommend that non-treatment related personnel except medical staffs should not enter the ward during patients’ hospitalization at which the activity concentration of 131I in the ward was the highest. After patients were discharged, a delayed entry into the ward is recommended to reduce the internal radiation dose.
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Objective:To compare and analyze the differences in the setup accuracy of different immobilization method in breast cancer radiotherapy after breast-conserving surgery.Methods:A retrospective study was conducted on 60 patients who received radiotherapy after breast-conserving surgery from January to August, 2021. These patients were divided into two groups. One group consisted of 30 cases who were immobilized using a modified body thermoplastic membrane combined with a multifunction body board during the breast cancer radiotherapy and was called the modified body thermoplastic membrane group. The other group comprised 30 cases immobilized using a vacuum cushion during breast cancer radiotherapy and was referred to as the vacuum cushion group. The setup errors, 3D vector errors, the proportion of errors of > 5 mm, and the dosimetric differences in the planning target volume (PTV) and the clinical target volume (CTV) before and after simulated treatment bed moving (including the PTV_ V100, PTV_ V95, and CTV_ V95 before simulated treatment bed moving and the PTV_ V100 S, PTV_ V95 S, and CTV_ V95 S after simulated treatment bed moving) were compared between two groups. Moreover, for the modified body thermoplastic membrane group, the changes in the average setup errors at different radiotherapy stages were also analyzed. Results:A total of 369 cone-beam CT scans were conducted for 60 patients, including 195 CT scans for the modified body thermoplastic membrane group and 174 CT scans for the vacuum cushion group. The setup errors in the x, y, and z directions (right-left, anterior-posterior, and superior-inferior, respectively) of the modified body thermoplastic membrane group were (2.59±1.98) mm, (2.38±2.04) mm, and (1.45±1.16) mm, respectively, while those of the other group were (2.24±1.63) mm, (2.78±2.17) mm, and (2.70±1.88) mm, respectively. The 3D vector errors of both groups were (4.32±2.28) mm and (5.13±2.14) mm, respectively. Therefore, the setup error in direction z and the 3D vector error of the modified body thermoplastic membrane group were less than those of the vacuum cushion group ( t = -7.77, -3.41, P<0.05). Moreover, the proportion of setup errors of > 5 mm in the x direction of the vacuum cushion group was lower than that of the modified body thermoplastic membrane group ( χ2 = 7.13, P<0.05), while such proportion in the z direction of the modified body thermoplastic membrane group was lower than that of the vacuum cushion group ( χ2= 5.90, P<0.05). After the simulated treatment bed moving, the PTV_ V100 S of the modified body thermoplastic membrane group was better than that of the vacuum cushion group ( t = 2.47, P < 0.05). Furthermore, for the modified body thermoplastic membrane group, the setup errors in the x direction in the first week were higher than those in the 2-3 weeks and 4-5 weeks ( P<0.05). Conclusions:The modified body thermoplastic membrane combined with a multifunction body board yield better immobilization effects than a vacuum cushion. However, it produces high setup errors in the x direction in the first week of the radiotherapy, to which special attention should be paid.
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Objective@#To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy.@*Methods@#The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively.@*Results@#The percentage of normal lung receiving at least 20 Gy (V20) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V30) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients′age (HR=1.023, P=0.038) and tumor diameter (HR=1.243, P=0.028)were the independent prognostic factors for OS, while tumor volume were the independent prognostic factor for PFS.@*Conclusions@#Definitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients′ age, tumor diameter and tumor volume may impact patients′ prognosis.
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Objective@#This study collected and analyzed data from patients with microtia in multiple clinical centers to obtain the incidence characteristics of microtia in Chinese.@*Methods@#Data from 746 patients with microtia were collected from six hospitals, including theThird Hospital of Hebei Medical University, Hunan Provincial People′s Hospital, the Second Hospital of Hebei Medical University, Weihai Municipal Hospital, West China Hospital Sichuan University, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2017. These data included the results of physical examination and the results of auxiliary examination such as electrocardiogram, chest CT, and abdominal ultrasound. Then, the accompanying malformations of the microtia were statistically analyzed and discussed. Data were entered and processed using SPSS 19.0 statistical software. The relationship between microtia deformities and associated malformations was analyzed by Pearson χ2 test. P<0.05 was considered statistically significant.@*Results@#A total of 746 patients with microtia were included, including 513 males and 233 females, aged 5-27 years old. There were 678 cases of unilateral microtia, 68 cases of bilateral microtia; 128 cases of Ⅰ degree, 564 cases of Ⅱ degree, and 54 cases of Ⅲ degree. In addition, 336 cases (45%) were associated with dysplasia of other systems. Detected anomalies were 321 cases of the ear, face, and neck, 261 cases of musculoskeletal system and 76 cases of cardiovascular system, 30 cases of anomalies of the urogenital system, eye, 27 cases of respiratory system, 7 cases of central nervous system, 5 case of digestive system and 1case of diaphragmatic hernia. The proportion of male and female with microtia was 47.0% (241/513) and 40.8% (95/233), respectively, and there was no significant difference in between (χ2=2.493, P=0.114); The composition ratios of unilateral and bilateral associated malformations were 45.7% (310/678) and 38.2% (26/68 ), and there was no significant difference in between (χ2=1.400, P=0.237); The composition ratios of Ⅰ, Ⅱ, Ⅲ degree-associated malformations were 39.8% (51/128), 42.6% (240/564), and 83.3% (45/54), and the difference was statistically significant (χ2= 34.794, P<0.001).@*Conclusions@#Microtia has significant clinical heterogeneity with a higher proportion of associated malformations. A higher incidence of associated deformities in patients with severe microtia was observed. Systematic examination is required, which will be helpful to clinical therapy and etiology analysis.
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Objective:To evaluate the effect of definitive radiotherapy with different doses on overall survival (OS) and identify the prognostic factors of patients with non-metastatic esophageal squamous cell carcinoma (ESCC).Methods:Clinical data of 2 344 ESCC patients treated with definitive radiotherapy (RT) alone or chemoradiotherapy from 2002 to 2016 in 10 hospitals were collected and analyzed retrospectively. After the propensity score matching (PSM)(1 to 2 ratio), all patients were divided into the low-dose group (equivalent dose in 2 Gy fractions, EQD 2Gy<60 Gy; n=303) and high-dose group (EQD 2Gy≥60 Gy; n=606) based on the dose of radiation. Survival analysis was conducted by Kaplan- Meier method. Multivariate prognostic analysis was performed by Cox′s regression model. Results:The median follow-up time was 59.6 months. After the PSM, the 1-, 3- and 5-year overall survival (OS) rate was 66.5%, 34.7%, 27.2% in the low-dose group, 72.9%, 41.7% and 34.7% in the high-dose group, respectively ( P=0.018). The 1-, 3-and 5-year progression-free survival rate was 52.2%, 27.2%, 23.1% in the low-dose group, 58.3%, 38.1% and 33.9% in the high-dose group, respectively ( P=0.001). The outcomes of univariate analysis indicated that cervical/upper esophagus location, early (stage Ⅱ) AJCC clinical stage, node negative status, tumor length ≤5 cm, receiving intensity-modulated radiation therapy (IMRT), receiving concurrent chemotherapy and EQD 2Gy≥60 Gy were closely associated with better OS (all P<0.05). Multivariable analysis demonstrated that tumor location, regional lymph node metastasis, concurrent chemotherapy and EQD 2Gy were the independent prognostic factors for OS (all P<0.05). Conclusion:Three-dimensional conformal or IMRT with EQD 2Gy≥60 Gy yields favorable survival outcomes for patients with locally advanced ESCC.
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Objective:An investigation on the prevention and control measures taken by radiotherapy centers of various hospitals in Beijing during the COVID-19 pandemic was conducted. The experience was summarized to provide reference for further work.Methods:Electronic questionnaires were distributed to each radiotherapy center through members of the radiation oncology therapeutics branch of Beijing medical association and members of Society of Radiotherapy Specialists (Technicians) of Beijing Medical Doctors Association. Statistical analysis was performed based on the feedback results of electronic questionnaires.Results:All forty radiotherapy centers in Beijing returned the questionnaires by the end of April 10, 2020. Except for the suspension of treatment in one center due to COVID-19 pandemic, all radiotherapy centers have taken corresponding prevention and control measures and continued to carry out radiotherapy. No COVID-19 infection of patients or medical staffs occurred during this pandemic.Conclusions:During the COVID-19 pandemic, all radiotherapy centers attach great importance to optimizing the clinical process and adopt reasonable prevention and control measures. On the basis of efficient prevention and control measures, radiotherapy is delivered to fulfill the treatment demands of cancer patients.
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With the outbreak of COVID-19 around the globe, the epidemic prevention and control in China will take a long-term trend. As the main treatment of gynecological malignant tumor, rational application of radiotherapy bring patients with both "epidemic prevention" and "anti-tumor" benefits. This recommendation combined the domestic epidemic prevention guidelines, foreign literature related to epidemic prevention and gynecological tumor treatment, and the experiences of Peking Union Medical College Hospital during the prophase of epidemic period, aiming to provide guidance for the clinical work for radiotherapy and gynecological departments during COVID-19 crisis from the perspectives of gynecological radiotherapy principles, clinical trials, MDT and academic activities.
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Objective:To present briefly introductions and evaluations on the constructs, psychometric properties (reliability, validity, reactivity etc.) and applications of the system of Quality of Life Instruments for Cancer Patients QLICP(V1.0) including 12 kinds of scales for patients with head and neck cancer, brain cancer, lung cancer, breast cancer, esophageal cancer, gastric cancer, colorectal cancer, liver cancer, cervical cancer, ovarian cancer, leukemia and lymphoma.Methods:Based on our measuring data from relevant patients at hospitals, the constructs, characteristics and psychometrics of the system above were analyzed and presented. Internal consistency reliability for each domain and the overall scale was assessed using Cronbach's alpha coefficient, and test-retest reliability through calculating the Pearson correlation coefficient between the first and second assessments. The criterion-related validity was evaluated by correlating corresponding domains of two instruments. Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatments with standardized response mean (SRM). The use agreements and literature reviews of this system were used to understand the applications of 12 kinds measurement scales.Results:The quality of life scales for 12 kinds of cancer patients of the system QLICP(V1.0) have good construct( 5 domains, 11-15 facets), reliability, validity and a certain degree of responsiveness. The internal consistency reliability Cronbach's α coefficients for the overall scale of QLICP in different cancers was from 0.67 to 0.92, and the test-retest reliability (correlation coefficient) was from 0.61 to 0.99. The criterion-related validity (correlation coefficient) was for the overall scale of QLICP in different cancers was from 0.28 to 0.89, and the responsiveness SRM was from 0.25 to 1.28. And also they were widely used in clinical practice and relevant studies for the corresponding cancers.Conclusion:The system QLICP(V1.0) is of outstanding characteristics with all psychometrics meeting requirements and better construct (clear hierarchical structure with items→ facets→ domains→ overall ), and can be used widely in clinical practice further.
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With the deeper understanding of the pathophysiology and pathogenesis of non-small cell lung cancer (NSCLC) which threatens human health, NSCLC treatment has entered a new era. Transition from traditional treatment based on surgery, radiotherapy and chemotherapy to individualized and precise targeted therapy and safer and more effective immunotherapy. Immune checkpoint inhibitor therapy has been approved as a first-line or second-line treatment for advanced NSCLC, and has achieved extraordinary clinical results. Meanwhile, other types of immunotherapy are rarely explored in NSCLC. Chimeric antigen receptor modified T cells (CAR-T cells) perform well in treating several hematological malignancies. However, it is not ideal for treating patients with solid tumors including NSCLC. This review aims to systematically explain the latest progress of CAR-T in the treatment of NSCLC, mainly including: CAR molecular target selection, CAR-T function enhancement and related toxicity management, as well as the difficulties and prospects of CAR-T treatment of NSCLC. It aims to open up new perspectives and unique ideas for the immunotherapy of NSCLC, and contribute to the building of tumor immunotherapy. .
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Objective:To present a new treatment method using orbital septum for mild blepharoptosis.Methods:Patients with mild blepharoptosis from December 2015 to October 2017 were included in this study. We incised the orbital septum horizontally. The adhesion between the levator aponeurosis and orbital fat was released. The lower part of the dissected orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. The efficacy of this surgical procedure was analyzed.Results:Fourty-four eyes of 31 patients were included in the final analysis. Stitches were removed 7 days after surgery. The double eyelid lines were well formed. The eyelid closed well. The 6-month follow-up revealed that blepharoptosis was corrected in all analyzed eyes. No upper eyelid retraction or incomplete eye closure was observed. Before the operation and 6 months after the operation, the height of upper eyelid covering the cornea were 3.03±0.32, 1.55±0.19, respectively ( P<0.01). 25 patients were fully satisfied with the surgical results and 6 were basically satisfied with the surgical results. Conclusions:Turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and pretarsal fascia is a promising method for correcting mild blepharoptosis.
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Objective To explore the expression of angiopoietin 1 in scar during the scar strophying.Methods The rabbit ear scar model was established in the same position of each ear ventral center skin regardless of gender.The weight of each rabbit was greater than 2.0 kg weight.The scars were collected at weeks 1,2,4,8,and 12.After 12 weeks of scar tissue samples were collected,together with normal skin tissues in the rabbit ear ventral normal skin.The tissues were preseved in 10％ formalin liquid and cryopreserved in liquid nitrogen,respectively.The general form of scar tissues and the expression of Ang-1 in scar were investigated by hematoxylin and eosin staining and Western-blot.Results The expression of Ang-1 increased gradually,and the highest at 2 week after epithelial change as (0.29±0.11),then decreased gradually,and the lowset at week 12 as (0.00± 0.00),which was close to normal skin expression as (0.05±0.01) (P＜0.05).Conclusions Ang-1 may play an important role during the scar atrophying.
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Objective To evaluate the clinical efficacy and toxicity of intensity-modulated radiation therapy (IMRT) following prostatectomy for elderly patients with prostate cancer.Methods Ninety-eight prostate cancer patients receiving IMRT after prostatectomy were included in this study.The median age was 68 years old.The number of patients with low-,middle-and high-risk prostate cancer was 10,21 and 67,respectively.Two patients had oligometastases (pelvic bone metastases).Sixty-four patients were treated with IMRT combined with endocrine therapy.Among them,43 cases received adjuvant volumetric modulated arc therapy (VMAT),and 55 patients received salvage IMRT.The median radiotherapy dose was 72 Gy for the tumor bed.Twenty-nine patients received radiotherapy of the pelvic node region with a median dose of 50 Gy.Results The median follow-up time was 40 months.The 5-year overall survival (OS),biochemical recurrence-free survival (BRFS) and local control (LC) were 90％,76％ and 100％,respectively.The OS (88.8％ vs.90.8％,P=0.94),BRFS (75.9％ vs.71％,P=0.79) or LC (100％ vs.100％,P=0.32) did not significantly differ between the adjuvant and salvage radiotherapy groups,respectively.The incidence of grade Ⅰ-Ⅱ late rectal toxicities was 24.1％,and no ≥ grade 3 late toxicity was observed.The incidence of grade 1-2 late bladder toxicities was 29.9％,and 3.4％ for grade 3.Conclusion IMRT following prostatectomy yields high clinical efficacy and slight late toxicities in elderly patients with prostate cancer.
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Objective To investigate the clinical effect of 595 nm tunable pulsed dye laser (PDL) in treating fresh trauma scars.Methods 85 patients had been selected,of which,117 sites were treated with a 595 nm tunable PDL one time or two times at a fluence of 7-15 J/cm2 and pulse widths of 1.5-3 ms,7 mm spot size.Nursing skill of burn wound was also used on treatment area after laser treatment.Scars were evaluated for melanin,height,vascularity and pliability using the Vancouver Scar Scale (VSS) before treatment and after the last treatment 8weeks.Results Total score of 117 sites decreased from (8.30 ± 2.63) to (2.70 ± 1.25),melanin decreased from (1.60 ± 0.84) to (0.60 ± 0.97),height decreased from (1.30 ± 0.82) to (0.40 ± 0.51),vascularity decreased from (2.40 ± 0.52) to (0.40 ±0.52),pliability decreased from (2.80 ± 1.32) to (1.30 ±0.48),with statistical significance between before treatment and after treatment (P ＜ 0.05).Conclusions 595 nm tunable pulsed dye laser appears to have a beneficial clinical effect on patient's fresh trauma scar.
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Objective@#To compare the differences and similarities among the system of quality of life instruments for cancer patients (QLICP) V1.0, the quality of life questionnaire (QLQ) from European Organization for Research and Treatment of Cancer (EORTC) and Functional Assessment of Cancer Therapy (FACT) from Center on Outcomes, Research and Education (CORE) of America.@*Methods@#Based on literatures and our measuring data from patients at hospitals, the constructs, characteristics and psychometrics of the systems above were analyzed and compared. Internal consistency reliability was assessed using Cronbach α coefficient for each domain, and test-retest reliability through calculating the Pearson correlation coefficient r between the first and second assessments as well as intra-class correlation (ICC). Construct validity was evaluated by Pearson correlation coefficient r (item-domains correlations) and factor analysis. The criterion-related validity was evaluated by correlating corresponding domains of two instruments. Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatment with standardized response mean (SRM).@*Results@#The instruments of three systems were of different outstanding characteristics with all psychometrics meeting requirements. Measurements for 12 types of cancers showed that the internal consistency reliability Cronbach α coefficient for the overall scale of QLICP (V1.0) was 0.67-0.92, and for FACT was 0.79-0.98. The test-retest reliability (r or ICC) for the overall scale of QLICP (V1.0) was 0.61-0.99, and for FACT was 0.60-0.98. The SRM for the overall scale of QLICP (V1.0) was 0.25-1.28, and for FACT was 0.11-0.83. However, the QLICP was of better construct (clear hierarchical structure with items→facets→domains→overall) and Chinese culture.@*Conclusion@#The instruments of three systems can be used as the instruments to assess quality of life for patients with cancer with selections basing on different settings.
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Objective@#To investigate a new approach for double-eyelid blepharoplasty.@*Methods@#Double-eyelid blepharoplasty was performed by turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia, which is imitating physiological mechanical conduction. During double-eyelid blepharoplasty, the orbital septum was cut horizontally. Using the fusion of the levator aponeurosis with septum as a pedicle, the lower part of the orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. We evaluated the outcomes of this double-eyelid surgical procedure in patients undergoing the procedure from December 2015 to February 2018.@*Results@#622 eyes of 311 patients were included in the final analysis. Sutures were removed 7 days after surgery. All double-eyelid lines were well-formed, and the eyelids closed well. Three-to twelve-month follow-up results revealed that the double-eyelid shape was natural, no patients experienced upper eyelid retraction or incomplete eye closure. Notched scars did not occur, and patient satisfaction was achieved in all cases. 281 patients were fully satisfied with the surgical results and 30 were basically satisfied with the surgical results.@*Conclusions@#Turning the orbital septum downward is a good approach for double-eyelid blepharoplasty.
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Objective@#To investigate a new approach for double-eyelid blepharoplasty.@*Methods@#Double-eyelid blepharoplasty was performed by turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia, which is imitating physiological mechanical conduction. During double-eyelid blepharoplasty, the orbital septum was cut horizontally. Using the fusion of the levator aponeurosis with septum as a pedicle, the lower part of the orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. We evaluated the outcomes of this double-eyelid surgical procedure in patients undergoing the procedure from December 2015 to February 2018.@*Results@#622 eyes of 311 patients were included in the final analysis. Sutures were removed 7 days after surgery. All double-eyelid lines were well-formed, and the eyelids closed well. Three-to twelve-month follow-up results revealed that the double-eyelid shape was natural, no patients experienced upper eyelid retraction or incomplete eye closure. Notched scars did not occur, and patient satisfaction was achieved in all cases. 281 patients were fully satisfied with the surgical results and 30 were basically satisfied with the surgical results.@*Conclusions@#Turning the orbital septum downward is a good approach for double-eyelid blepharoplasty.
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Objective@#To explore a good method for locating reconstructed auricle.@*Methods@#An X-ray film ear template was modelled with the opposite healthy ear, then the template was reversely placed on the malformed side. The position of template was adjusted according to the observation at a standard frontal view and the relations with local anatomic landmarks until bilateral auricular symmetry was reached. At that time the position of template was fixed, and three points were marked. The first point was the most front point of helix, that is in front of the junction of helix and inferion crura of antihelix. The second point was the junction of superior edge of earlobe and tragus. The third point was the junction of inferior edge of the earlobe and face.After marking the three points, the template was placed in flat based on the three points, and the shape of auricle was drawn.Whether the remnant earlobe was dislocated was decided by the difference between the position of remnant earlobe and the marked points.@*Results@#In this study, 118 cases had completed the three stages of ear reconstruction. In the first stage of the operation, 28 cases were residual earlobe moved, 1 case had hematoma postoperatively, and no case had serious complications such as infection and skin flap necrosis.In the second stage of the operation, the position of reconstructed ears were nearly symmetrical to the opposite sides. There were partial necrosis of grafted skins in 2 cases and partial necrosis of skin flaps in 3 cases, which were repaired with simple skin grafting or skin grafting after coverage of superficial temporal fascia flap. In the third stage of the operation, the position of reconstructed auricles was mostly symmetrical to the opposite side, and the wound were healed primarily.The satisfaction rate was 81.4%.@*Conclusions@#Triple-point Marking at a standard frontal view is a simple and practical method for locating reconstructed auricle in ear reconstruction.
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Objective To compare the differences and similarities among the system of quality of life instruments for cancer patients (QLICP) V1.0,the quality of life questionnaire (QLQ) from European Organization for Research and Treatment of Cancer (EORTC) and Functional Assessment of Cancer Therapy (FACT) from Center on Outcomes,Research and Education (CORE) of America.Methods Based on literatures and our measuring data from patients at hospitals,the constructs,characteristics and psychometrics of the systems above were analyzed and compared.Internal consistency reliability was assessed using Cronbach α coefficient for each domain,and test-retest reliability through calculating the Pearson correlation coefficient r between the first and second assessments as well as intra-class correlation (ICC).Construct validity was evaluated by Pearson correlation coefficient r (item-domains correlations) and factor analysis.The criterion-related validity was evaluated by correlating corresponding domains of two instruments.Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatment with standardized response mean (SRM).Results The instruments of three systems were of different outstanding characteristics with all psychometrics meeting requirements.Measurements for 12 types of cancers showed that the internal consistency reliability Cronbach α coefficient for the overall scale of QLICP (V1.0) was 0.67-0.92,and for FACT was 0.79-0.98.The test-retest reliability (r or ICC) for the overall scale of QLICP (V1.0) was 0.61-0.99,and for FACT was 0.60-0.98.The SRM for the overall scale of QLICP (V1.0) was 0.25-1.28,and for FACT was 0.11-0.83.However,the QLICP was of better construct (clear hierarchical structure with items→facets→domains→overall) and Chinese culture.Conclusion The instruments of three systems can be used as the instruments to assess quality of life for patients with cancer with selections basing on different settings.
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Objective To retrospectively analyze the effect of tumor length on the prognosis in stage Ⅱ/Ⅲ esophageal squamous cell carcinoma (ESCC) patients treated with definitive radiotherapy and to evaluate the role of tumor length in clinical stage for non-operative ESCC patients.Methods The data of 2 086 ESCC patients who were treated with definitive radiotherapy from 2002 to 2016 in 10 hospitals (3JECROG) were analyzed.The effect of tumor length on overall survival (OS) was analyzed and stratified analysis of tumor length was done in different stages of ESCC.Results The median OS and median progression-free survival (PFS) time of the whole group were 25.6 months and 18.2 months respectively.The Cox multivariate analysis showed that treatment moda,aga,alinical stage and tumor length were independent prognostic factors.The median,1-,3-,and 5-year OS were 28.9 months,77.3％,45.0％,and 36.3％ versus 21.9 months,69.9％,37.9％,and 28.1％ for patients with ≤ 5 cm and patients ＞ 5 cm respectively (P＜0.05).For stage Ⅱ patienta,abe median OS were 42.1 and 38.9 months respectively in ≤ 5 cm group and＞5 cm group (P=0.303).And for stage Ⅲ patienta,abe median OS were 23.9 and 19.3 months respectively in ≤5 cm group and＞5 cm group (P＜0.001).The median OS with N1was 24.1 and 18.4 montha,aespectively in ≤5 cm group and＞5 cm group (P＜0.001).Conclusions The tumor length was an independent prognostic factor for stage Ⅱ/Ⅲ patients treated definitive radiotherapy.The tumor length may be helpful in clinical staging of ESCa,aspecially for stage Ⅲ and N1.
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Objective To retrospectively analyze the safety of anti-radiation injury drug of Andorin using real-world big data.Methods A total of 87 053 hospitalized cancer patients receiving radiotherapy from 2015 to 2017 were analyzed.Ten medical institutions with the largest number of patients treated with Andorin capsules were screened.Patients with 5 types of cancer including lung cancer,cervical cancer,nasopharyngeal carcinoma,breast cancer and colorectal cancer with/without use of Andorin capsule were subject to propensity score matching (PSM).The safety of Andorin capsule as an adjuvant drug in the radiotherapy for cancer patients was evaluated by the results of blood biochemical detection and liver and kidney function test.Results In the relevant indexes of liver function,the AST and TBIL levels in the lung cancer patients with use of Andorin capsule were significantly lower than those in their counterparts without use of Andorin capsule (22.1 U/L vs.24.7 U/L,P =0.04 and 9.8 mmol/L vs.11.4 μmol/L,P =0.01),but all the results were within the normal range.In patients with cervical cancer,the ALT level in patients treated with Andorin capsule was considerably higher than that in those without use of Andorin capsule (24.7 U/L vs.21.1 U/L,P=0.01) and both the results were within the normal range.In terms of the renal function-related indexes,CRE and UREA were similar between patients with and without use of Andorin capsule in 5 types of tumors (P=0.09-0.86).In patients with cervical and colorectal cancer,the LDH in patients with Andorin capsule was significantly lower compared with that in those without use of Andorin capsule (P=0.04,0.00),but both the resuhs were within the normal range.Regarding the nutrition-related indexes,the TB level in breast cancer patients with use of Andorin capsule was significantly higher than that in those without use of Andorin capsule (69.4 g/L vs.67.1 g/L,P=0.030),but both the results were within the normal range.Conclusion As the first anti-radiation traditional Chinese medicine in China,Andorin capsule is utilized as an adjuvant drug for radiotherapy,which yields no significant liver and kidney toxicity and possesses high safety.