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Objective:To investigate the safety and dose of 4D template (real-time adjustable angle template) in the treatment of advanced malignant tumors with 125I seeds. Methods:98 patients with advanced malignant tumors admitted to Department of Thoracic Surgery of Shaanxi Provincial Tumor Hospital were treated with 4D template-navigated radioactive 125I seed implantation from June 2018 to December 2019. Preoperative TPS plan, intraoperative optimization, postoperative verification of immediate dose and postoperative evaluation of implantation dose were performed. The treatment results were observed. Results:All 98 patients completed the seed implantation. The implantation dose of GTV of implantation site receiving external irradiation was (12 489±414) cGy and the dose of no external irradiation was (15 036±514) cGy. V 100% was 84.7%-94.1%, and 88.2%-93.7%. The implantation dose of CTV was (7 450±621) cGy, and (9 080±761) cGy. The quality of dose implantation was evaluated as: excellent in 89 cases (91%, 89/98), good in 7 cases (7%, 7/98), fair in 2 cases (2%, 2/98), and poor in 0 case, respectively. The symptom relief rate of patients with pain was 92%(36/39). The 1-and 2-year local control rates were 61%, 36% and 82%, 54% in patients treated with and without external irradiation, respectively. The difference was statistically significant ( P=0.02). The incidence rates of pneumothorax and hemoptysis were 19%(9/48) and 10%(5/48). No corresponding complications were observed in other parts of the patients. Conclusion:4D template-assisted 125I seed therapy is safe and effective for malignant tumors, and intraoperative adjustment of needle angle and dose optimization can realize the precise control of implantation dose.
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"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
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Objective: To investigate the safety and efficacy of 125I radioactive seed implantation in the treatment of mediastinal lymph node metastasis. Methods: Records of 53 patients enrolled in Shaanxi Provincial Tumor Hospital from June 2014 to June 2018 with me-diastinal lymph node metastasis treated by computed tomography (CT)-guided 125I seed implantation were analyzed retrospectively. The preoperative treatment planning system was validated after the surgery. Intraoperative and post-operative complications were re-corded. The improvement in quality of life was observed. Chest CT follow-up was conducted 1 month, 3 months, 6 months, 1 year, and 2 years after treatment. The local focus control was evaluated. The median survival and total survival were recorded, and the survival prognosis and causes of death were analyzed. Results: The median survival time was 254 days (8.5 months), one-year survival rate was 48.67%, and complete and partial response rate was 83.02% (44/53). Multivariate Cox model analysis showed that the survival progno-sis was related to the Eastern Cooperative Oncology Group (ECOG) score, distant metastasis at the time of implantation, concurrent chemotherapy after implantation, and secondary seed implantation (P<0.05). The rates of developing pneumothorax and hemoptysis during and after the surgery were 20.75% (11/55) and 13.20% (7/55), respectively. No patients died. After implantation, the remission rate of cough, shortness of breath, pain, hoarseness, and superior vena cava syndrome was 60.00%-82.61%. Conclusions: CT-guid-ed 125I seed implantation in the treatment of mediastinal lymph node metastasis has the advantages of minimal trauma, remarkable cu-rative effect, safety, and feasibility. It has important application value and is worthy of further clinical application.
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BACKGROUND:Co-culture withembryonic stem cels or embryonic tissues can induce differentiation of carcinoma cels into normal epithelial cels or decreasemalignancyof carcinoma cels.Acelular embryoid bodies retain the structure and important cytokines of embryonic tissues. OBJECTIVE:To prepare acelular embryoid bodies from mouse embryonic stem cels and to investigate their effects on differentiation of mouse Lewis lung carcinoma cels at three-dimensional culturein vitro. METHODS:Mouse embryonic stem cels(D3)were dynamicaly cultured for 7 days to produce embryoid bodiesfolowedbydecelularization with 0.1% sodium dodecyl sulfate. Mouse Lewis lung carcinoma cels were co-cultured with acelular embryoid bodiesas test group or culturedinthree-dimensionalmatrigel mediumfor 7 days as control group, respectively. Cel proliferation and expression of E-cadherin were detected by immunohistochemical staining and western blot assay, respectively. In addition, mRNA expressions ofSlug and E-cadherin were observed using RT-PCR technology. RESULTSAND CONCLUSION:Uniform mouse embryoid bodieswere successfuly prepared, andwere completely decelularized with sodium dodecyl sulfate. After 7-day three-dimensionalmatrigelculture, in the control group,multicelular tumor spheroidswere formed,accompanied byahigherKi67positive rate;Lewis lung carcinoma cels in the test group were repopulated in the acelular embryoid bodies showing significantly lowerKi67positive rate. Compared with the control group, the absorbance ofPaxilin in the test group was significantly smaler, and the absorbance of E-cadherin was significantly higher (P< 0.05). Besides, mRNA expressions of Slug and E-cadherin were significantly decreased and increasedin the test group compared with the control group, respectively(P< 0.05). These findings indicate that the acelular embryoid bodies can promote differentiation of mouse Lewis lung carcinoma celsinthree-dimensional culturein vitro.
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Objective To investigate the effects of propofol on the proliferation and apoptosis of lung cancer cells as well as the related molecular mechanisms.Methods HCC827 cells were seeded in well plates with a density of 1×106 and then randomly divided into 5 groups:control group (group C),intralipid group (group E),low-dose propofol group (1.5μL/mL,group P1),medium-dose propofol group (2.2μL/mL,group P2),and high-dose propofol group (3.2μL/mL,group P3).At 6 h,24 h and 48 h after propofol treatment,the cells were collected to detect their proliferation and apoptosis.At 6h after treatment,the cells were collected for the measurement of Nrf2 mRNA and protein by RT-PCR and Western blot.Results Cell inhibition rate (IR)and apoptosis as well as Nrf2 mRNA and protein expressions in group E did not differ significantly from those in group C (P>0 .0 5 ).Compared with those in groups C and E,IR and apoptosis and Nrf2 mRNA and protein expressions were significantly increased in groups P1,P2 and P3 (P<0.05).Conclusion Propofol can inhibit the proliferation of cancer cells and promote cell apoptosis,thereby inhibiting the reoccurrence and metastasis of cancer cells probably via regulating the activation of Nrf2 expression.
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Objective To explore the efficacy of implantation of 125I seeds combined with radiotherapy and/or chemotherapy for local recurrent lung cancer at a late stage.Methods A total of thirty-two patients were received implantation of 125I seeds therapy with a MPD of 110 to 140 Gy in our hospital.CT scan was used for guidance.Before the operation,a therapeutic plan was made by TPS.The therapeutic target volume(PTV)included the clinical target volume(CTV)plus the surrounding tissues 1 cm adjacent to the edge of CTV.The activity of each seeds was set at 0.7 mCi.The distribution of the seeds was checked by CT scan immediately after the implantation.Then,chemotherapy or radiotherapy was carried out in 3 to 7 days.EP,NP,or TP was used for the patients receiving chemotherapy.Results In 2 to 4 months after the treatments,the CR,PR,and NC were 46.9%(15/32),37.5%(12/32),and 15.6%(5/32),respectively.The rate of complete local control was 84.4%(CR+PR).The 1-and 2-year survival rate in this series were 78.6%(22/28)and 66.7%(10/15).Four of these patients survived over 3 years.Eleven of the patients(34.4%)developed pneumothorax after the implantation,3 of them were cured by chest drainage;9 patients(28.1%)had hemorrhage including 5 cases of intrapulmonary bleeding and 4 cases of emptysis.In 3 cases(9.4%),the seeds missed the target,and dropped into the diaphragmatic muscle at the thoracic cavity(2 cases)or out of the target area(1 case).No seeds migration or radiation-induced lung injury was found.Conclusion Implantation of 125I seeds combined with radiotherapy and/or chemotherapy is effective for patients with local recurrent lung cancer at a late stage.
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<p><b>BACKGROUND</b>Brachytherapy offers an innovative method of delivering conformal high-dose radiation to a defining target tumor. The aim of this study is to investigate the value and effect of using radioactivity ¹²⁵I seed permanent implants combined with chemotherapy in the management of stage III or IV lung cancer.</p><p><b>METHODS</b>Forty-two lung cancer patients in stage III and IV (15 center lung cancer) who couldn't be relieved by routine methods were treated with ¹²⁵I seed permanent micropuncture implant brachytherapy and chemotherapy. The dose and distribution of seeds was decided by treatment planning system, and CT was used during ¹²⁵I seed permanent implant treatment. Distribution of seeds and complication was reviewed by CT scan after treatment. Chemotherapy was performed in 3 to 7 days after implanting. The effect was observed by X-ray, CT and MRI every 3 or 4 weeks.</p><p><b>RESULTS</b>The satisfaction rate of seed distribution was 83.3% (35/42). The response rate of treatment was 85.7% (36/42), including complete response rate 26.2% (11/42), partial response rate 59.5% (25/42), no change rate 14.3% (6/42). Effective rate of pain relief was 83.3% (15/18). Thirteen patients (31.0%) had complication of mild hemothorax, 8 (19.0%) with bleeding in lung and 5 (11.9%) with hemoptysis. Three patients (7.1%) had mild pneumothorax and 1 patient (2.4%) had a malposition seed. Leucopenia and radiation pneumonia didn't occurred.</p><p><b>CONCLUSIONS</b>¹²⁵I seed micropuncture implant has less trauma and complication, and is a safe and effective method. This method might be helpful in the treatment of lung cancer and can be selectively used in clinic.</p>