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Objective To study the characteristics of microscopic spread of esophageal squamous-cell carcinoma (ESCC) and the influence of clinicopathological features on it to help define the clinical target volume (CTV) margin in radiotherapy.Methods Sixty-four surgical specimens of ESCC were observed for longitudinal microscopic spread per centimeter both proximally and distally from the tumor.The shrinkage ratio of each specimen was calculated and used for tissue incision.Results The further the distance beyond the tumor, the lower the incidence there was of microscopic spread.Positive rates of microscopic spread in group 3 cm of proximal and distal were 4.8% and 6.9%, respectively, and in group 4 cm were both 3.6%.Tumors longer than 5 cm in length,with poorer differentiation, lymph nodes metastasis and more aggressive phase had higher positive rates (79.3% vs 45.7%,77.4% vs 45.5%,76.0% vs 51.2%,70.5% vs 40.0%,χ2=7.52,6.86,3.91,5.36;P=0.006,0.009,0.042,0.021).Differentiation and tumor length were main factors contributing to microscopic spread (χ2=0.19,4.82;P=0.020,0.017).Conclusions To cover 95% of the microscopic spread,a margin of 3.0 cm proximal and 4.0 cm distal beyond gross tumor volume is needed and as to 90%, a margin of 3.0 cm both proximal and distal is needed.Moreover, the influence of pathological features should be taken into account.
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Objective To observe the therapeutic effect and toxicity of chemoradiation of locally advanced non-small cell lung cancer by intensity modulated irradiation combined with pemetrexed and cisplatin. Methods Fourty-two patients presented with Ⅲ - stage non-small cell lung cancer(Ⅲ、 25 patients, ⅢB 17 patients)received concurrent chemoradiotherapy. Intensity modulated irradiation technique was used to the total dose of 66 Gy and concurrent chemotherapy consisted of pemetrexed 500 mg/m2 on Day 1 and cisplatin 75 mg/m2 on Day 1 by intravenous infusion once every 3 weeks at the initiation of radiation.Patients received 4 cycles of chemotherapy. Results Thirty-four patients finished the whole of therapeutic schedule. And 2 patients received radiation with total dose of 54 Gy, 2 patients 56 Gy;3 patients received 2 cycles of chemotherapy, 1 patients 3 cycles of chemotherapy. Total effective rate was 79%. There were 2 patients with ≥3 grade marrow depression, 3 patients with 3 grade radiation esophagitis, 4 patients with ≥2 radiation pneumonitis, and 1 patient with 3 grade mucositis. The 1-year survival rate was 65%.Conclusion Recent effect was favourable and toxicity was tolerable for chemoradiation of locally advanced non-small cell lung cancer by intensity modulated irradiation combined with pemetrexed and cisplatin.
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Objective To evaluate the effectivness of photodynamic therapy (PDT) with chloroaluminum sulfonated phthalocyanine (CASPc) in B16F10 melanomas in a rabbit model. Methods B16F10 murine melanoma tumor fragments were implanted transclerally into the subchoroidal space of 38 immunosuppressed New Zealand albino rabbits and examined with indirect ophthalmoscopy and ultrasonography. When the tumors ranged from 2.0~3.8 mm in height, 30 rabbits were treated by PDT, with intravenous injection of CASPc 5 mg/kg, and irradiation at the wavelength of 675 nm of an argon-pumped dye laser after 24 hours. Light dose ranged from 20 J/cm 2 to 70 J/cm 2. The other 8 animals were treated with light only or photosensitizer only. The animals were followed up for 6~8 weeks. Results The 30 tumor-bearing rabbits were by PDT (laser and CASPc) regressed in 21 animals after treatment. At light doses under 40 J/cm 2, tumor regrowth was observed in 9 animals after two weeks of treatment. In all of the 8 control animals, the tumor-bearing eyes were filled with tumor at the third week after implantation with laser doses of 70 J/cm 2. Conclusion The study suggest that CASPc PDT may be effective in the treatment of B16F10 choroidal melanomas.
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Objective To study the synergistic effect of endostatin (YH-16) and irradiation on human non-small cell lung cancer (NSCLC) cell line A549 and the expression level of vascular endothefial growth factor. Methods ① A549 cells were exposed to various concentrations of endostatin for different time. The optimal concentration giving ≤20% inhibition concentration (IC20) by MTT assay was selected. ② The cells were divided into 4 groups:control group,chemotherapy alone,radiotherapy alone,and radio-chemotherapy group. All groups were exposed in distinct treatment,the cells survival fraction and the plating efficiency of the four groups provided to select the optimal radiotherapy dosage. ③ The radio-chemotherapy group had been exposed to endostatin for 48 hours,followed by irradiation at 48 hours with various doses:0,2,4,6,8 Gy. After 14 days,the cell clonogenic survival curves and the SER were evaluated. ④ Detect the different groups' VEGF value by ELISA kit. Results Incubating cells in 200 mg/L endostatin culture medium the value of SER radiated by linear accelerator in 2 Gy after 48 h were 1.61 and 1.04. And endostatin with proper dosage and radio-exposure time could decrease the VEGF level. Conlusion It is suggested that endostatin enhances the radiosensitivity of NSCLC A549 cell line in vitro (SER=1.61,1.04). The enhancement depends on the time of exposure drug. The optimal radiation time should be 48 hour after exposure.