ABSTRACT
Objective:To compare the dosimetric differences between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) on planning target volume (PTV) and organ-at-risk (OAR) for breast cancer after modified radical mastectomy, aiming to provide evidence-based reference for clinical practice.Methods:According to strict inclusion and exclusion criteria, literature search was performed in PubMed, Cochrane Library, FMRS, CNKI, Wanfang Data and VIP full text databases from the inception of databases up to March 2020. The controlled clinical trials of dosimetric comparison between VMAT and IMRT for breast cancer following modified radical mastectomy were selected. The meta-analysis was performed using Stata14 software.Results:The meta-analysis included 281 patients from 13 observational studies. Compared with IMRT, VMAT significantly increased the PTV dose coverage D 95%( P<0.001) and significantly improved the PTV homogeneity index (HI, P<0.001) and conformity index (CI, P=0.004). Compared with IMRT, VMAT more effectively decreased the ipsilateral lung V 20Gy (WMD=1.332, P=0.027) and contralateral lung V 10Gy ( P=0.003). There were no significant differences in theD mean, V 5Gy, V 10Gy and V 30Gy of the ipsilateral lung, D mean and V 5Gy of the contralateral lung, D mean, V 10Gy and V 30Gy of the heart between VMAT and IMRT (all P>0.05). Compared with VMAT, IMRT reduced the cardiac V 5Gy ( P=0.001). However, sensitivity analysis of included literature on cardiac V 5Gy showed that the P value was reversed, indicating that the stability of the results was poor. VMAT significantly shortened the delivery time ( P<0.001) and the number of monitor units ( P<0.001) compared to IMRT. Conclusion:Compared with IMRT, VMAT can achieves superior target dose coverage, HI and CI, better protection for the ipsilateral and contralateral lung, fewer monitor units and shorter delivery time.
ABSTRACT
OBJECTIVE@#To study the assessed value of 64 slice spiral CT perfusion imaging (CTPI) in laryngeal squamous cell carcinoma after chemotherapy and radiotherapy.@*METHOD@#Forty five patients diagnosed with local advanced laryngeal squamous cell carcinoma were selected. Conventional CT and CTPI were performed before treatment and at the time of radiation dose up to 40 Gy. Blood flow, blood volume, mean transit time and surface permeability were measured at the same time. According to the decrease of tumor volume in final examination, patients were divided into sensitive group and insensitive group. The tumor perfusion indexes were compared between groups.@*RESULT@#Blood flow, blood volume, surface permeability after 40Gy treatment were lower than before treatment in both sensitive group and the insensitive group ascended(P<0. 05). The AUC of ROC of blood flow, blood volume, mean transit time and surface permeability were 0. 804, 0. 843, 0. 852 and 0. 826. The sensitivity, specificity and accuracy of blood flow was 89. 7%, 86.8% and 90. 9%. There were 100. 0%, 91. 4% and 93. 7% in blood volume; 100. 0%, 67. 7% and 88. 3% in mean transit time; 91. 2%, 69. 4% and 90. 6% in surface permeability(P<0. 01).@*CONCLUSION@#Sixty-four slice spiral CT perfusion imaging is able to assess tumor status of laryngeal squamous cell carcinoma after chemotherapy and radiotherapy effectively.
Subject(s)
Humans , Carcinoma, Squamous Cell , Diagnosis , Drug Therapy , Radiotherapy , Head and Neck Neoplasms , Diagnosis , Drug Therapy , Radiotherapy , Laryngeal Neoplasms , Diagnosis , Drug Therapy , Radiotherapy , Perfusion Imaging , Sensitivity and Specificity , Squamous Cell Carcinoma of Head and Neck , Tomography, Spiral Computed , Tumor BurdenABSTRACT
10.3969/j.issn.1007-3969.2013.04.011
ABSTRACT
Objective To investigate the predictive value of combined analysis on single nucleotide polymorphisms (SNPs) of X-ray cross-complementing1 ( XRCC1 ) gene 194 and 399 codon,xeroderma pigmentosum group D (XPD) gene 312 codon and glutathione S-transferase P1 (GSTP1) gene 105 codon in platinum based chemotherapy.Methods Direct sequencing was performed to detect XRCC1,XPD and GSTP1 genotypes in peripheral blood from 50 cancer patients receiving platinum-based chemotherapy.Genetic polymorphisms of these genes related to sensitivity of platinum were reviewed.Results Favorable genotypes were Arg/Trp and Trp/Trp in XRCC1 194 codon,Arg/Arg in XRCC1 399 codon,Asn/Asn in XPD 312 codon and Val/Val in GSTP1 105 codon.The response rate to chemotherapy was 57.1％,75.0％,60.9％,85.7％ and 87.5％,respectively.The response rate for patients possessing ≥2 favorable genotypes and those possessing 1 or 0 favorable genotype was 78.9％,36.4％ and 0,respectively.Patients possessing ≥2 favorable genotypes demonstrated higher sensitivity to platinum based chemotherapy,compared with those possessing 1 or 0 favorable genotype ( x2 =25.79,P ＜ 0.01 ).Conclusions Combination analysis of genomic polymorphisms of XRCC1,XPD and GSTP1 may be useful in predicting sensitivity of platinum based chemotherapy.
ABSTRACT
Objective To explore the changes and the tendency of breast cancer radiotherapy in China within the past decade.Methods A survey on breast cancer radiotherapy in 1 999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China,including patients'clinical characteristics,the purpose of radiotherapy and its techniques.Results The percentage of breast conservative treatment(BCT)increased from 3%in 1999 to 13%in 2006.For radiotherapy techniques in 2006 compared with 1999,the growth trend was found in use of breast immobilization devices(80% vs.46%),treatment planning system(70% vs.23%),and CT simulation(14%vs.0).The frequency was increased in the chest wall irradiation after masteetomy(90%vs.67%),but decreased in internal mammary region(30%vs.76%)and axilla(37%vs.69%)treatment.There were no differences in total dose and fractionation prescription.Conclusions BCT was performed more frequently,but postmastectomy radiotherapy was still essential option in China at present.Although some advanced techniques were applied frequently in clinical practice.Simulation,treatment planning,and irradiation target design were urgent for improvement and standardization.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the therapeutic effect of shenqi fanghou recipe (SFR) in preventing and treating radiation injury in patients with head and neck tumor.</p><p><b>METHODS</b>One hundred and forty patients with head and neck tumor, including nasopharyngeal carcinoma, carcinoma of tonsil or tongue, were randomly divided into 2 groups, 70 patients in the observed group were given modified SFR as adjuvant to radiotherapy, while 70 patients in the control group were treated with radiotherapy alone. The radiation reactions during radiotherapy and the condition of late stage radiation injury radiotherapy in patients in the 2 groups were observed.</p><p><b>RESULTS</b>The degree of oropharyngeal mucosa reaction, dryness in mouth and radiation dermatitis in cervical region in the observed group was milder than those in the control group, and the radiation injury induced late stage sequelae, such as the degree of mouth-opening was better and the cervical muscular sclerosis was better in the observed group than in the control group, showing significant difference (P < 0.01).</p><p><b>CONCLUSION</b>SFR has definite effect in preventing and treating radiation reaction and late stage radiation injury in patients with head and neck tumor.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Combined Modality Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Head and Neck Neoplasms , Drug Therapy , Radiotherapy , Phytotherapy , Radiation Injuries , Drug TherapyABSTRACT
OBJECTIVE To explore the efficientcy of washing and sterilization methods for the endoscopic cell brush. METHODS The contaminated cell brush with the mixture of Bacillus subtilis var.niger spore and blood was washed by four methods:manually washing,multienzyme plus manually washing,ultrasonic cleaner washing,and multienzyme plus ultrasonic cleaner washing,and then dipped in glutaraldehyde for 5 h or 10 h,fumigated with glutaraldehyde for 5 h,and sterilized with 3M ethylene oxide box.The positive rates of occult blood test(OB test),the cleaning rates of B.subtilis var.niger spore and the sterilization eligibility ratio of four serilization methods were compared. RESULTS The washing method that multienzyme plus ultrasonic cleaner washing could clear effectively the contaminated cell brush that the positive rates of OB test was 0 and the cleaning rates of B.subtilis var.niger spore was 99.90%.The positive rates of OB test and the cleaning rates of B.subtilis var.niger spore of manually washing was 56.67% and 90.87%.Fumigated in 3M ethylene oxide box or dipped in glutaraldehyde for 10 h could kill all the spores,but dipped in glutaraldehyde for 5 h or fumigated with glutaraldehyde for 5 h could not. CONCLUSIONS The mixed contaminated endoscopic cell brush should be washed effectively by multienzyme+ ultrasonic cleaner washing,and should be sterilized by fumigated in ethylene oxide box or dipped in glutaraldehyde for 10 h.
ABSTRACT
Objective To investigate the effect of Arsenic Trioxide(As_2O_3) combined with radiation on the apoptosis of nasopharyngeal carcinoma cells in vitro.Methods Using MTT and FCM to detect the cytotoxic and apoptosis at different As_2O_3 concentrations combined with 2Gy radiation on nasopharyngeal carcinoma cells(CNE1).Results Inhibition of cell proliferation seemed more dependent on the increase of As_2O_3 concentration.Cell survival rate was lower in the combination of As_2O_3 and radiation group than As_2O_3 alone.Conclusion As_2O_3 can enhance radiation effect obviously in nasopharyngeal carcinoma cells,especially at lower radiation dose.
ABSTRACT
Objective To explore the effect of breast-conserving operation for the treatment of early-stage breast cancer. Methods From November 1999 to Octorber 2001, the patients with early-stage breast cancer were treated with breast-conserving surgery followed by radical irradiation according to the patients' will. The cosmetic results and quality of life were analyzed after surgery and radiation. Results In all the patients received operation treatment from 1999 to 2001, eighteen patients were treated with breast-conserving surgery with breast conservation rate of 10.2%, of which 7 cases with quadrantetomy plus axillary lymph node dissection (ALND), 8 cases with lumpectomy plus ALND and 3 cases with lumpectomy. Pathological staging was as follow: 4 cases in stage 0, 12 cases in stage Ⅰ, and 2 cases in stage Ⅱ. All cases were followed-up. The cosmetic results were good in 94%(17/18) and fair in 6%(1/18). All the patients had not local recurrence and distant metastasis. Conclusions Breast-conserving surgery followed by radiation therapy is superior to mastectomy in terms of improving breast cosmesis and quality of life. Postoperative radiation therapy does not affect the cosmetic result.
ABSTRACT
0.05 ). Conclusions The non-mended injury does not affect the therapeutic effect of the Madigan prostatectomy with the urethral injuries due to the operation.
ABSTRACT
50 Gy in the upper neck as compared to those treated with seperate facial and neck fields to 0.05)Conclusions We suggest that patients with neck negative NPC should be treated with conjoint facio cervical lateral fields and prophylactic whole neck irradiation with more than 50 Gy to the upper neck.