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Objective:To evaluate and summarize the teaching effect of" New Technology of Radiotherapy and Oncology" in the form of questionnaire, understand the degree of demand for the course of all kinds of medical students and improve the teaching contents and methods.Methods:The course of" New Technology of Radiotherapy and Oncology" was a specialized elective course in Peking Union Medical College. After two rounds of teaching practices, we evaluated the students participating in the course or non-course participants by anonymous questionnaire. The questionnaire items include the course content, setting, teachers and improvement suggestions.Results:A total of 73 questionnaires were sent out, and the recovery rate was 100%. Among them, 52(71%) were from students who chose the courses. 83% of the students" strongly agree" that the teaching content of this course is the latest development, the latest achievement or the problem to be solved, 94% were" satisfied" or" very satisfied" with their learning effect, and 92% and 83% were satisfied with the teachers and teaching plan, respectively. After taking the course, students rated" broadening of mind" (96%) as the biggest gain, followed by" facilitating interdisciplinary collaboration" (79%). 86% of the non-course participants felt the need to supplement the existing curriculum with new techniques in oncology radiotherapy, hoping that the curriculum would" broaden the mind" (76%), improve clinical application (81%) and facilitate interdisciplinary collaboration (71%).Conclusion:The questionnaire results show that the teaching practice of this course covers the different needs of all kinds of students, which is worthy of implementation and further improvement.
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Radiation therapy plays an important role in the adjuvant treatment of patients with early endometrial carcinoma. Vaginal stump is a common site of disease failure for early endometrial carcinoma patients with intermediate-high risk factors for recurrence. Compared with external beam radiotherapy, vaginal brachytherapy (VBT) can achieve comparable local control rate with fewer toxicities. In this article, research progresses upon the application of VBT in patients with early endometrial carcinoma after hysterectomy were investigated from multiple perspectives of the selection of patients, the selection of vaginal applicator, factors influencing dose distribution, image-guided adaptive brachytherapy, the design and implementation of radiotherapy regime. In addition, the application of intensity-modulated VBT and the usage of novel quality assurance equipment were also discussed.
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Objective: Spinocerebellar ataxia type 2 (SCA2) is one of the most common autosomal dominant ataxias in the world. Several reports revealed that CAG repeats in some polyQ-containing genes may affect the age at onset (AAO) of patients with SCA2, however, little studies were conducted among Chinese patients with SCA2. Thus, the aim of this study is to evaluate the effect of CAG repeats on the AAO of patients with SCA2 in China.Methods:A total of 119 patients with SCA2 were enrolled and were divided into 2 groups according to their major phenotype:17 patients from 9 families with Parkinson ' s syndrome were grouped as the Parkinson ' s disease-SCA2 (PD-SAC2); 91 patients from 66 SCA2 families and 11 sporadic SCA2 patients were grouped as the ataxia-SCA2 (A-SCA2). Blood samples were obtained from the subjects, and the CAG repeat length in ATXN2 and other (CAG)n-containing genes was screened using fluorescent PCR. The Spearman ' s rank correlation between the CAG repeat length in (CAG)n-containing genes and AAO was analyzed. Regression analysis was performed to investigate whether the CAG repeat length could explain the variant of AAO. A t-test was used to compare the difference of CAG repeat length in (CAG)n-containing genes between the PD-SAC2 and A-SCA2 groups. Results:The CAG repeat length in the longer allele of ATXN2 was negatively correlated with AAO of SCA2 (R=?0.251, P<0.05), and the CAG repeat length could explain 41.7％of the variation of AAO. AAO negatively correlated with the CAG repeat length in the shorter allele of ATXN7 (R=?0.251, P=0.006) or in the longer allele of TBP gene (R=?0.197, P=0.034). A tendency of delay in the AAO was also observed in patients with SCA2 carrying the CAG repeat within the ATXN3, CACNA1A, ATXN7, TBP, and RAI1. In addition, we found that the CAG repeat length in ATXN7 and ATXN2 between the A-SCA2 and the PD-SCA2 groups was significantly different (both P<0.05).Conclusion:The CAG repeat in ATXN2 is a major genetic factor for the AAO of patients with SCA2 in China. The CAG repeat length in ATXN3, CACNA1A, ATXN7, TBP, and RAI1 genes might be a potential factor associated with the AAO of SCA2. The CAG repeat in ATXN7 might be a potential factor affecting the Parkinson??s syndrome in SCA2.
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Psoraleae Fructus (PF) is a well-known traditional herbal medicine in China, and it is widely used for osteoporosis, vitiligo, and other diseases in clinical settings. However, liver injury caused by PF and its preparations has been frequently reported in recent years. Our previous studies have demonstrated that PF could cause idiosyncratic drug-induced liver injury (IDILI), but the mechanism underlying its hepatotoxicity remains unclear. This paper reports that bavachin isolated from PF enhances the specific stimuli-induced activation of the NLRP3 inflammasome and leads to hepatotoxicity. Bavachin boosts the secretion of IL-1β and caspase-1 caused by ATP or nigericin but not those induced by poly(I:C), monosodium urate crystal, or intracellular lipopolysaccharide. Bavachin does not affect AIM2 or NLRC4 inflammasome activation. Mechanistically, bavachin specifically increases the production of nigericin-induced mitochondrial reactive oxygen species among the most important upstream events in the activation of the NLRP3 inflammasome. Bavachin increases the levels of aspartate transaminase and alanine aminotransferase in serum and hepatocyte injury accompanied by the secretion of IL-1β via a mouse model of lipopolysaccharide-mediated susceptibility to IDILI. These results suggest that bavachin specifically enhances the ATP- or nigericin-induced activation of the NLRP3 inflammasome. Bavachin also potentially contributes to PF-induced idiosyncratic hepatotoxicity. Moreover, bavachin and PF should be evaded among patients with diseases linked to the ATP- or nigericin-mediated activation of the NLRP3 inflammasome, which may be a dangerous factor for liver injury.
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Animals , Humans , Mice , Adenosine Triphosphate , Chemical and Drug Induced Liver Injury/etiology , Flavonoids , Inflammasomes , NLR Family, Pyrin Domain-Containing 3 Protein , NigericinABSTRACT
With the outbreak of COVID-19 around the globe, the epidemic prevention and control in China will take a long-term trend. As the main treatment of gynecological malignant tumor, rational application of radiotherapy bring patients with both "epidemic prevention" and "anti-tumor" benefits. This recommendation combined the domestic epidemic prevention guidelines, foreign literature related to epidemic prevention and gynecological tumor treatment, and the experiences of Peking Union Medical College Hospital during the prophase of epidemic period, aiming to provide guidance for the clinical work for radiotherapy and gynecological departments during COVID-19 crisis from the perspectives of gynecological radiotherapy principles, clinical trials, MDT and academic activities.
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In recent years,along with the clinical exploration and application of magnetic resonance simulation localization and radiotherapy equipment,more and more studies have been performed to focus on the excellent ability of MRI in identifying soft tissues,aiming to explore the potential application value of magnetic resonance imaging (MRI) in radiotherapy for breast cancer patients.In this article,the research progress on MRI in radiotherapy after breast-conserving surgery was reviewed to provide certain ideas and references for subsequent research.
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Objective@#To investigate the clinical features and prognosis of primitive neuroectodermal tumor (PNET).@*Methods@#The clinical data of 99 patients with PNET from February 1, 1998 to February 1, 2017 were retrospectively analyzed. Univariate analysis was performed using Kaplan-Meier and Log rank test. Multiviate Cox regression was applied to analyzed independent prognostic factor for patient survival.@*Results@#Among the 99 patients, 81 were peripheral PNET(pPNET) and 18 were central PNET (cPNET) . Biopsy was performed exclusively in 16 cases, with R0 resection in 61 cases, with R1 resection in 4 cases, and with R2 resection in 18 cases. Twelve patients underwent surgery only, nine had chemotherapy only, and one received radiotherapy only. There were 72 patients who had combined treatment including chemotherapy, and 48 patients had combined therapy including radiotherapy. The one-year, three-year and five-year overall survival(OS) rates of the 99 PNET patients were 79.2%, 63.9% and 56.1% respectively, and median OS time was 14.0 months. The one-year, three-year and five-year progression free survival (PFS) rates of these patients were 42.7%, 25.7% and 19.8% respectively, and median PFS time was 8.0 months. The univariate analysis revealed that lymph node metastasis, surgical resection, numbers of cycles of chemotherapy and radiotherapy dose were the main factors affecting the OS (all P<0.05). Gender, age, lymph node metastasis, staging, and chemotherapy cycles were related to PFS in PNET patients (P<0.05). Multivariate analysis showed that the degree of surgical resection, chemotherapy cycle, and radiotherapy dosage were independent influencing factors of OS in PNET patients (risk ratio=1.856, 0.398, and 0.408, respectively, all P<0.05), and gender was an independent factor influencing PFS in PNET patients (risk ratio=0.494, P<0.05).@*Conclusions@#Comprehensive therapy is the main therapy for PNET patients. The surgical resection, cycles of chemotherapy and radiotherapy dosage are independent prognostic factors for patient′s OS.
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Objective To analyze the clinical features and prognosis of extra-nodal nasal NK/T cell lymphoma originated from the larynx. Methods Clinical data of 15 cases of extra-nodal nasal NK/T-cell lymphoma originated from the larynx were retrospectively analyzed. The overall survival ( OS ) and progression-free survival ( PFS) were calculated by Kaplan-Meier survival analysis. The effect of different clinical factors on the clinical prognosis was assessed by univariate analysis. Results Among 15 patients,13 cases were male and 2 female. The median age of onset was 40 years. In 8 cases,the lesions were confined to the larynx,and only 4 cases suffered from cervical lymph node involvement. According to Ann Abor staging, 11 cases were classified as grade I,3 as gradeⅡand 1 as gradeⅢ.The median OS was 28. 0 months and the 5-year OS was 32. 0％.The median PFS was 24. 7 months and the 5-year PFS was 33. 3％.Among 14 patients with stage Ⅰ/Ⅱ,the clinical prognosis of patients receiving combined chemo-radiotherapy was significantly better than those of their counterparts undergoing radiotherapy or chemotherapy alone ( median OS:37. 2 vs. 11. 2 vs.3. 7 months,P=0. 004) . Conclusion Extra-nodal nasal NK/T cell lymphoma originated from the larynx is extremely rare, predominantly in middle-aged male patients. The general condition is relatively favorable. Patients present with multiple lesions in the early stage and relatively poor prognosis. The clinical efficacy of chemotherapy combined with radiotherapy is probably higher compared with that of radiotherapy or chemotherapy alone.
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Objective To retrospectively analyze the clinical pathological features and treatment outcomes of primary non-Hodgkin'slymphoma (NHL) of the female reproductive system.Methods A retrospective analysis was performed on the clinical data of 28 patients with primary NHL of the female reproductive system who were admitted to our hospital from 1990 to 2016.The lymphomas were classified and staged based on the WHO histological classification and the Ann Arbor staging system,respectively.Of the 28 patients,18 (64％) underwent surgery,27 (96％) received chemotherapy,and 8 (29％) received radiotherapy.The Kaplan-Meier method was used to calculate survival rates.Results The 5-year follow-up rate was 86％.The median age was 56.5 years (13-80 years).The ovary was involved in 11 patients (39％).The lymphoma was staged as IVE in 18 patients (64％).The most common pathological type was diffuse large B-cell lymphoma.The median survival time was 23.5 months.The 1-,3-,and 5-year overall survival rates were 89％,74％,and 59％,respectively.Conclusions Primary NLH of the female reproductive system is an extremely rare neoplastic disorder with no typical clinical symptoms and mostly diagnosed in advanced stage.The combined treatment with surgery,chemotherapy,and radiotherapy plays an important role in the treatment of the disorder.
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Objective To evaluate the prognostic value of anemia in patients diagnosed with extranodal nasal-type natural killer (NK)/T cell lymphoma (NKTCL).Methods Clinical data of 1 225 NKTCL patients receiving the first course of treatment from 10 medical institutions in China were retrospectively analyzed.According to the diagnostic criteria in China,anemia was defined as the hemoglobin (Hb) level＜ 120 g/L for the male and＜ 110 g/L for the female from the sea-level area.The severity of anemia was classified into the extremely severe anemia (Hb ≤ 30 g/L),severe anemia (31-60 g/L),moderate anemia (61-90 g/L) and mild anemia (＞90 g/L).Results Among 1 225 patients,199(16.2％) were complicated with anemia,who had more adverse prognostic factors compared with their counterparts without anemia.Among NKTCL patients with anemia,the proportion of patients with stage Ⅱ-ⅣV,a median age＞ anemia,Eastern Cooperative Oncology Group (ECOG) score of 2-4 and NK/T-cell lymphoma prognostic index (NKTCLPI) ≥ 2 was relatively high.Patients with anemia obtained worse clinical prognosis than those without anemia.The 5-year overall survival (OS) and progression-free survival (PFS) in NKTCL patients with anemia were calculated as 49.4％ and 35.4％,significantly lower compared with 63.3％ and 56.0％ in their counterparts without anemia (both P＜0.01).Single factor analysis demonstrated that anemia,age,ECOG score,group B symptom,lactate dehydrogenase,primary tumor site,primary tumor invasion and staging were the prognostic factors of OS and PFS.Multivariate analysis revealed that anemia was still the independent prognostic factor.Conclusions Anemia is not common in patients with NKTCL and these patients obtain poor clinical prognosis.Anemia is an independent prognostic factor for patients with NKTCL.
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Objective To examine the interfractional dosimetric variations among inverse three-dimensional (3D) plan, forward 3D plan, and two-dimensional (2D) plan of intracavitary brachytherapy for cervical cancer, and to discuss the risk of implementing the interval plan on different implantation applicators at short time intervals.Methods Twenty-five groups of CT-guided intracavitary brachytherapy (two consecutive radiations at ≤4 d apart) plans from 11 cervical cancer patients who received radical radiation therapy in our hospital were reviewed and compared.The dwelling location and time of the first intracavitary brachytherapy plan (Plan-1) were simulated on the CT image of the second intracavitary brachytherapy to form Plan-1-S.The target coverage indices and D 2 cc of organs at risk (OARs) of Plan-1-S and Plan 2(actual plan of the second intracavitary brachytherapy) under the three planning modes were recorded and compared using the paired t-test, Wilcoxon signed rank test, and ANOVA.Results The D90, D100, and V100 of high-risk CTV were significantly lower in Plan-1-S created under the inverse mode in the actual plan (-9.11±13.46%,-13.16±18.79%, and-7.80±13.34%, P=0.002, 0.002, and 0.005, respectively).D90, D100, and V100 of the interval plan had the greatest reduction under the inverse mode (76%, 80%, and 76%, respectively).The maximum reductions in D90, D100, and V100 were 332.14 cGy (2D), 244.12 cGy (forward), and 41.76%(inverse).OAR overdose occurred most frequently under the forward mode;the rates of D90, D100, and V100 reductions accompanied by one OAR overdose were 29.41%, 37.50%, and 25.00%, and the rates of D90, D100, and V100 reductions by two OAR overdoses were 5.88%, 12.50%, and 6.25%,respectively.Overdose occurred most frequently in the small intestine (36%).Comparison of the three planning modes showed that the inverse plan had a greater reduction in each target coverage index than the 2D plan.Conclusions The simulated interval plan can significantly reduce target coverage and increase the risk of OAR overdose regardless of the planning mode and the short time intervals, and is therefore not recommended for clinical application.
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Objective There is still a lack of effective clinical prognostic factors for predicting outcomes and guiding treatments in extranodal nasal-type NK/T-cell lymphoma (NKTCL).This study was aimed to investigate the clinical features and prognostic role of primary tumor burden (PTB).Methods A total of 1383 patients were recruited from ten hospitals, including 947 stage Ⅰ patients (68.5%), 326 stage Ⅱ patients (23.6%), and 110 stage Ⅲ-IV patients (8.0%).There were 751 patients (54.3%) presenting with high PTB (H-PTB).The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was conducted for survival difference analysis.Meanwhile, a multivariate analysis was performed using the Cox regression model.Results H-PTB was associated with high invasive potential, high frequency of B symptoms, advanced stage, regional lymph node involvement, lactate dehydrogenase elevation, and poor performance status.The patients with H-PTB had significantly lower 5-year overall survival (OS) and progression-free survival (PFS) rates than those with low PTB (L-PTB)(OS:50.2% vs.72.1%, P=0.000;PFS:41.8% vs.62.5, P=0.000).PTB was an independent prognostic factor for both OS (HR=1.851) and PFS (HR=1.755) according to the Cox multivariate analysis.Moreover, H-PTB was associated with significantly lower locoregional control (LRC) in early-stage NKTCL, and the 5-year LRC rate was 71.6% in patients with H-PTB and 84.3% in those with L-PTB (P=0.000).Conclusions H-PTB is associated with multiple adverse clinical features in NKTCL, and it is an independent indicator for poor outcomes and LRC.H-PTB can be used as a reliable indicator for risk stratification and treatment decision.
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Objective To investigate the treatment outcomes of 41 patients with suprasellar and pineal germinoma who are treated in our department in recent 18 years,and to explore related therapeutic strategies.Methods A total of 41 patients with concurrent suprasellar and pineal germinoma who were treated in our department from January 1996 to August 2013 were enrolled.There were 35 male patients and 6 female patients,and the median age was 16 years (range 5-39 years).Five patients had pathologically confirmed germinoma and 36 patients had clinically diagnosed germinoma.Conventional radiotherapy was performed for 33 patients, and intensity-modulated radiotherapy was performed for 8 patients.Combined-modality chemoradiotherapy was performed for the 5 patients with pathologically diagnosed germinoma.The 6 MV X-ray was applied for radiotherapy;6 patients received whole ventricular irradiation and a boost in tumor region, 16 received whole-brain radiotherapy and a boost in tumor region,and 19 received craniospinal irradiation and a boost in tumor region.The median radiation dose for tumor region was 45.0 Gy (37.8-50.0 Gy),and the median dose for prophylactic irradiation was 25.0 Gy (17.8-35.0 Gy).The survival was caculated using Kaplan-Meier method.Results The number of patients followed were 26 at 5-years.The 5-year overall survival rate and relapse-free survival rate were 95% and 85%,respectively.Relapse and metastasis were noted in 8 patients,and 3 of them died.There were 4 patients with spinal cord metastasis,1 patient with ventricular dissemination,and 3 patients with periventricular relapse.Among the 22 patients who did not undergo spinal irradiation,4(18.2%) experienced spinal cord metastasis,and all the other 19 patients who underwent spinal irradiation did not experience spinal cord metastasis.The 8 patients undergoing intensity-modulated radiotherapy and the 5 patients undergoing combined-modality chemoradiotherapy did not experience treatment failure during follow-up.Conclusions Radiotherapy for intracranial germinoma has a good therapeutic effect,and the patients with suprasellar and pineal germinoma who do not undergo spinal cord irradiation have a high failure rate.It is suggested to perform spinal cord irradiation for patients with suprasellar and pineal lesions.
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The construction of open course for information literacy education in the era of ubiquitous network was described according to the COOC self learning platform that we developed with information retrieval course construc-tion as its standards.
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The xMOOC model of campus open course was analyzed according to the problems in domestic and foreign MOOC construction and the specific characteristics of online learning in campus open course. The roles of students, teachers, performance assessment system and observers were analyzed, which showed that their roles were not accu-rately positioned. Suggestions were put forward for improving the campus open course xMOOC.
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The course evaluation scheme oriented ability cultivation was established. The for-mative evaluation indexes which were practiced in information retrieval course were divided into two indicators:classroom learning and performance including five secondary indexes(classroom discipline, classroom learning, homework, questions and answer questions online, personal essay and group dis-cussion reports) with the and seven observation points(pre-class preparation, teacher-student interac-tions, classroom discussions and classroom reports, experimental class performance, homework com-pletion, the utilization of network teaching platform, personal essay and group discussion), and these were practiced in the teaching of “information retrieval” curriculum, the usual results was composed with the usual academic performance and utilization of the network teaching platform. Finally, the practice results were discussed and summarized in order to cultivate the ability of the students who major in information management and to improve the teaching quality.
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Euphorbia lathyris （Caper spurge） is a toxic and potent Chinese materia medica （T/PCMM）. This study sought a method for identifying five diterpenoids （Euphorbia factors LI-L3, L7a, and Ls） with the spectra of UV and mass, quantifying three diterpenoids L1, L2, and L8 in crude extracts of unprocessed and processed E. lathyris seeds by liquid chromatography/ electrospray ionization mass spectrometry （LC-ESI-MS）. The analysis was achieved on an Agilent Eclipse XDB-C18 column （4.6 mm× 150mm i.d., 5 μm） with an isocratic elution with a mobile phase consisting of water and acetonitrile at a flow rate of 0.25 mL/min at column temperature of 30 ℃ and UV detection was set at 272 nm. An ESI source was used with a positive ionization mode. The calibration curve was linear in the ranges of 9.9-79 μg/mL for Euphorbia factor Lb 3.8-30.5μg/mL for Euphorbia factor L2, and 1.0-20.6 μg/mL for Euphorbia factor LB. The average recoveries （n=6） of three diterpenoids were 98.39%, 91.10% and 96.94%, respectively, with RSD of 2.5%, 2.4% and 2.1%, respectively. The contents of the three diterpenoids in processed E. lathyris seeds were 3.435, 1.367 and 0.286 mg/g, respectively, which decreased more sharply than those in unprocessed E. lathyris seeds which were 4.915, 1.944 and 0.425 mg/g, respectively. The method is simple, accurate, reliable and reproducible, and it can be applied to control the quality of unprocessed and processed E. lathyris seeds.
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Euphorbia lathyris (Caper spurge) is a toxic and potent Chinese materia medica (T/PCMM).This study sought a method for identifying five diterpenoids (Euphorbia factors L1-L3,L7a and L8) with the spectra of UV and mass,quantifying three diterpenoids L1,L2,and L8 in crude extracts of unprocessed and processed E.lathyris seeds by liquid chromatography/electrospray ionization mass spectrometry (LC-ESI-MS).The analysis was achieved on an Agilent Eclipse XDB-C18 column (4.6 mm × 150 mm i.d.,5 μm) with an isocratic elution with a mobile phase consisting of water and acetonitrile at a flow rate of 0.25 mL/min at column temperature of 30 ℃ and UV detection was set at 272 nm.An ESI source was used with a positive ionization mode.The calibration curve was linear in the ranges of 9.9-79 μg/mL for Euphorbia factor L1,3.8-30.5 μg/mL for Euphorbia factor L2,and 1.0-20.6 μg/mL for Euphorbia factor L8.The average recoveries (n=6) of three diterpenoids were 98.39％,91.10％ and 96.94％,respectively,with RSD of 2.5％,2.4％ and 2.1％,respectively.The contents of the three diterpenoids in processed E.lathyris seeds were 3.435,1.367 and 0.286 mg/g,respectively,which decreased more sharply than those in unprocessed E.lathyris seeds which were 4.915,1.944 and 0.425 mg/g,respectively.The method is simple,accurate,reliable and reproducible,and it can be applied to control the quality of unprocessed and processed E.lathyris seeds.
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Objective To observe the efficacy and safety of preoperative concurrent chemoradiotherapy or radiotherapy alone in patients with T3,T4 or lymph node-positive rectal cancer.Methods 141 rectal cancer patients with locally advanced or node-positive based on imaging from 2000 to 2009 were retrospective analyzed.Ninety-seven patients received preoperative concurrent chemoradiotherapy and 44 received preoperative radiotherapy alone.Two-dimensional or three-dimensional radiation technique and four types of chemotherapy regimens were used.Results The following-up rate was 91.5％.106 patients were followed up for at least 3 years and 68 patients for at least 5 years.The 3-and 5-year overall survival rates were 85.8％ and 65.7％,respectively.The 3-and 5-year local recurrence rates were 9.2％ and 14.1％,respectively.The 3-and 5-year metastasis rates were 33.8％ and 45.8％,respectively.The downstaging rate was up to 59.0％ (82/139) and the rate of sphincter preservation was 65.5％ (91/139).The median disease-free survival in patients treated with preoperative concurrent chemoradiotherapy was superior to radiotherapy alone (51 months vs 31 months,x2 =12.88,P =0.000).The time to metastasis in patients with downstaging was significantly delayed than that in patients without downstaging (60 months vs 29 months,x2 =14.65,P =0.000).Most acute toxicity was grade 1 and grade 2.The incidence of delayed wound healing and anastomotic leakage was very low.Conclusions Preoperative concurrent chemoradiotherapy or radiotherapy alone has excellent tumor downstaging effect and helps in sphincter preservation,with tolerable side effects.
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Objective To evaluate treatment results and prognostic factors of 47 patients withprimary urethral transitional cell carcinoma treated with post-operative adjuvant radiotherapy. Methods From October 1998 to October 2008, 47 patients with primary urethral transitional cell carcinoma received postoperative adjuvant radiotherapy. Thirty-one patients had stage T_3/T_4 disease, 7 had lymph node metastasis. Thirty-nine patients had G3 tumor, 13 had stump-positive. The median radiotherapy dose was 60 Gy (36-64 Gy). 81% patients (38/47) were treated with regional irradiation. Results The median follow-up time was 21 months (6 -88 months). The follow-up rate was 92%. The median overall survival time was 35 months (5 -88 months). The 2-and 5-year overall survival rates were 57% and 49%, respectively. In univariate analysis, the median overall survival time was better in patients with stage T_1 or T_2 compared with stage T_3 or T_4 tumor (42 months vs. 19 months,Χ~2 =7. 28,P=0. 007), with age of ≤65 years compared with >65 years (28 mouths vs 18 months,Χ~2 =8.23 ,P =0. 004). There was no significantdifference in the long term survival in patients with non-radical surgery compared with radical mastectomy (21 months vs. 20 months, Χ~2 = 0. 90, P = 0. 344). In multivariate analysis, the stage T_3 or T_4 (Χ~2 = 7. 89, P =0. 005), >65 years old (Χ~2 = 4.85, P = 0. 028), renal pelvis involvement (Χ~2= 5.65, P = 0. 018), and tumor located in the mid or inferior segment (Χ~2=6. 08 ,P =0. 014) were factors associated with poorer prognosis. Conclusions Postoperative adjuvant radiotherapy can improve the efficacy of patients with locally advanced urethral transitional cell carcinoma. Advanced T stage and > 65 years age are associated with poorer prognosis.