ABSTRACT
Objective To investigate the dosimetric feasibility of volumetric modulated arc therapy (VMAT)with a simultaneous integrated boost(SIB-VMAT58.75 Gy)for preoperative chemoradiotherapy in patients with locally advanced rectal cancer(LARC),and to provide a basis for clinical practice.Methods Nine patients with stage Ⅱ-Ⅲ rectal cancer who underwent preoperative concurrent chemoradiotherapy were involved in the study,and two plans were performed for each patient:SIB-VMAT58.75 Gy and VMAT50.00 Gy. For the SIB-VMAT58.75 Gy plan,the prescribed dose was 58.75 Gy(2.35 Gy/fraction)for the local rectal tumor and positive lymph nodes(GTV 58.75 Gy),and 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)(PTV 50Gy).For the VMAT50.00 Gy plan,the prescribed dose was 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)without a boost. The conformity index(CI),homogeneity index (HI),and dose for target areas and organs at risk(OAR)were assessed according to the dose-volume histogram. The paired t-test or nonparametric rank test was used to compare the differences between the two plans. Results Both plans met the prescription goal for PTV dose coverage. There was no significant difference in CI for the PTV between the two plans(1.0±0.0 vs. 1.0±0.0,P>0.05).The SIB-VMAT58.75 Gy plan had a worse HI than the VMAT50.00 Gy plan(0.2± 0.2 vs. 0.1± 0.0,P<0.05).There was no significant difference in V10-V50of the small intestine,bladder,femoral heads,and pelvis between the two plans(P>0.05),but D 2 cm3of the small intestine was significantly higher in the SIB-VMAT58.75 Gy plan than in the VMAT50.00 Gy plan(P=0.038). Conclusions The SIB-VMAT58.75 Gy plan for LARC achieves required target volume dose coverage and OAR dose constraints,which is safe and feasible in terms of dosimetry,and its clinical efficacy and adverse effects need further evaluation.
ABSTRACT
OBJECTIVE:To systematically review the efficacy and safety of the Bushen huoxue lishi category TCM compound in the treatment of chronic prostatitis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from VIP Database,Wanfang Database,CJFD and CBM,randomized controlled trials(RCT)about Bushen huoxue lishi category TCM com-pound preparation (test group) versus conventional Western medicine (control group) in the treatment of chronic prostatitis were collected. Meta-analysis was performed by Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 22 RCTs were enrolled,involving 1 863 patients. Results of Meta-analysis showed the total effective rate [OR=4.46,95%CI(3.40, 5.84),P<0.001],total scores of chronic prostatitis symptoms[MD=-3.62,95%CI(-5.21,-2.04),P<0.001] and lecithin count [MD=7.58,95%CI(2.15,13.01),P=0.006] in test group were significantly higher than control group,prostatic fluid white blood cell count [MD=-1.68,95%CI(-3.26,-0.10),P=0.04] was significantly lower than control group,with significant differenc-es. CONCLUSIONS:Bushen huoxue lishi category TCM compound has good efficacy in the treatment of chronic prostatitis.
ABSTRACT
Objective To observe the curative effects of bezafibrate combined medroxyprogesterone acetate in the treatment of AML .Methods 40 cases of AML patients were collected and devided into experimental group (bezafibrate combined medroxypro-gesterone acetate ,6 cases) ,control group (chemotherapy ,28 cases) and non-treatment group (6 cases) ,then through a prospective analysis we studied the curative effects and related results of bezafibrate combined medroxyprogesterone acetate in the treatment of AML .Results The median survival time of the experiment group (accepted bezafibrate combined medroxyprogesterone acetate ) was 15 weeks ;the median survival time of the control group (accepted chemotherapy ) was 24 weeks ;the median survival time of the giving up group(accepted any therapy ) was 8 weeks .Conclusion Bezafibrate combined medroxyprogesterone acetate could prolong the survival time of AML patients and there were no obvious adverse reactions .