ABSTRACT
Objective The objective of this study was to study the dosimetric characteristics and advantages of Non-coplanar IMRT techniques stereotactic body radiation therapy(SBRT)in the early stage of NSCLC.Methods Ten patients were selected with early stage of NSCLC.Treatment planning designed 9 fields coplanar IMRT and 9 fields Non-coplanar IMRT,respectively.Non-coplanar plans include five coplanar fields and four non-coplanar fields.Two group patients' plans compared V2.5,V5,V20,V25 of the whole lung,the average exposure doses of the whole lung,and the average exposure doses of the contralateral lung.The comparison of the other OARs include:spinal cord Dmax,heart Dmax,esophagus Dmax,trachea Dmax,chest wall Dmax and V30 of chest wall.At the meantime,we compared the conformal index of PTV(CI)and the homogenization index of PTV(HI).Results Non-coplanar plans reduced V20 of the whole lung(P=0.001),the average exposure dose of the contralateral lung(P=0.001),but V5 of the whole lung non-coplanar plans were increased than that in coplanar plans(P=0.002).Non-coplanar technology reduce max dose of spinal cord,esophagus,trachea,chest wall and V30 of chest wall(P=0.026,0.001,0.026,0.008,0.016).Heart Dmax of the non-coplanar plans was high in coplanar plans with no statistical significance difference(P=0.296).The conformal index of PTV of the non-coplanar plans was better(P=0.036),there was no difference in the homogenization index of PTV(P=0.254).Conclusion The stereotactic body radiation therapy of the early stage of NSCLC,the non-coplanar technology can effectively reduce exposure doses of the lung tissue and the other most OARs,also improve the conformal index of the PTV.The non-coplanar technology have possibility in reducing complications when compared with the coplanar technology and therefore has certain dosimetry advantage.
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Objective · To explored the correlation of preoperative peripheral blood neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) with clinical characteristics and prognosis of ovarian cancer. Methods · Patients' clinicopathological data of 127 cases of benign tumors and 286 cases of malignant tumor were collected, and the correlation between the level NLR and PLR in patients with ovarian cancer clinical pathology indicators and overall survival was analyzed. Results · preoperative NLR and PLR levels in patients with ovarian cancer were higher than those in benign tumors(P=0.000). The optimal cut-off point of NLR and PLR were 3.0 and 151. There was statistical significant difference between the high level of NLR group (NLR ≥ 3) and the low level of NLR group in pathological type, FIGO staging, lymph node metastasis, CA125 level and the amount of ascites (P<0.05). There was statistical significant difference between the high level of PLR group (PLR ≥ 151) and the low level of PLR group in FIGO stage,transfer status, CA125 level and quantity of ascites (P<0.05). The median survival time for NLR/PLR in the high level group were 33 and 33.5 months lower than that ofthe corresponding group of 44.5 and 49.5 months (P=0.044, P=0.000). Multivariate Cox regression analysis showed that PLR ≥ 151 were independent risk factors affectOS in ovarian cancer patients (HR=1.936, 95% CI=1.013-3.698, P=0.045). Conclusion · The elevated blood preoperative PLR indicates poor prognosis of ovarian cancer patients. Preoperative PLR may serve as an important independent prognostic factor for ovarian cancer patients.
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As one of important B vitamins,folate is an essential nutrient for the body and involves in various biochemical and metabolic reactions.Studies have shown that as an important methyl donor in the carbon metabolism cycle,folate has an important impact on pregnancy,pregnancy complications,and birth defects.Further studies have shown that in the folate metabolic pathway,the gene polymorphism and folic acid metabolism of a key enzyme,5,10-methylenetetetrahydrofolate reductase (MTHFR),play an important role in ovarian function.Gene polymorphism and the high homocysteine levels caused by it can lead to the damage of reproductive function and endocrine function,including follicular development,embryonic development,and hormone secretion.Gene polymorphism is also associated with the occurrence and development of ovarian disease and its response to treatment.With the deep understanding of folate metabolism,MTHFR gene polymorphism may become a new genetic marker for predicting the risk of disease and a new target for related gene therapies.
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Objective To evaluate the impact of PET/CT on the clinical therapeutical strategy of patients with non-small cell lung cancer (NSCLC). Methods Sixty patients with histologically confirmed NSCLC supposed to accept radical radiotherapy or surgical operation were firsthy divided into group A (stage Ⅰ-Ⅱ) and group B (stage Ⅲ) according to CT findings, and the individualized treatment strategy was designed, then restage and compare with different stage and management with initial treatment strategy by PET/CT scanning. Results ①PET/CT scanning restaged the TNM stage in 53.33% (32/60) patients, including 3 of T stage, 23 of N stage and 9 of M stage. Changes of stage occurred in 65.85% (27/41) patients with adenocarcinoma and in 26.32% (5/19) with squamous carcinoma (P＜0.05), while in 34.29 (12/35) with central and 57.14% (20/35) with peripheral NSCLCs (P＜0.05). ②PET/CT scanning resulted in alteration of the managements of NSCLC patients. The management changed from radical into palliative strategy with PET/CT information in 9 (15.00%) patients. In 25 patients who were supposed to accept surgical operation, the treatment changed to radical radiotherapy in 8 (8/25, 32.00%) and to palliative radiotherapy in 5 (20.00%) patients. In 35 patients who were supposed to accept radiotherapy, surgical operation or palliative radiotherapy was finally chosen in 5.71% (2/35) and 11.43% (4/35) patients, respectively. Conclusion PET/CT images can make significant alteration to clinical stage and treatment plan in patients with NSCLC.