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Objective:To analyze the influencing factors of short-term efficacy of 125I seed implantation for recurrent cervical metastatic lymph nodes of esophageal squamous cell carcinoma after external beam radiation therapy (RESCC). Methods:From January 2013 to March 2019, 47 patients (42 males, 5 females; age: 47-77 years) with RESCC who underwent CT guided 125I seed implantation in Hebei General Hospital were retrospectively analyzed. Patients were divided into effective group (complete remission (CR)+ partial remission (PR)) and ineffective group (stable disease (SD)+ progressive disease (PD)) according to response evaluation criteria in solid tumors (RECIST) at 3 months after implantation. Multivariate logistic regression was used to analyze the independent influencing factors of short-term efficacy. Cut-off values were determined by ROC curve. Results:Of 47 patients, 26 were effective (3 were CR and 23 were PR) and 21 were ineffective (7 were SD, 14 were PD). Multivariate regression analysis showed that tumor diameter, immediate postoperative dose delivered to 90% gross tumor volume ( D90), recurrence interval time were independent influencing factors of short-term efficacy (odds ratio ( OR; 95% CI): 4.240(1.220-14.737), 0.999(0.999-1.000), 0.989(0.979-1.000), Wald values: 5.163, 5.043, 3.956, all P<0.05). ROC curve showed that the AUC of tumor diameter, D90 and recurrence interval time were 0.782, 0.786 and 0.838 respectively, with cut-off values of 4.85 cm, 115.78 Gy and 297.5 d respectively. Conclusions:The short-term efficacy of 125I seed implantation for RESCC is mainly related to the tumor diameter, immediate postoperative D90 and recurrence interval time. Patients with tumor diameter <4.85 cm, immediate postoperative D90>115.78 Gy and recurrence interval time >297.5 d have better efficacy.
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Objective:To investigate the relationship between dosimetric parameters and tumor volume change after 125I implantation for thyroid cancer and obtain better dosimetric parameters that predict the curative effect more accurately. Methods:A total of 22 consecutive patients with thyroid cancer (23 targets) who received 125I interstitial brachytherapy in Department of Oncology, Hebei General Hospital were retrospectively analyzed. All the patients received post-operative dose verification, and the D 90 (Minimum dose received by 90% target volume) was calculated. After a regular follow-up, the tumor volume reduction ratio after t months (R t) , actual absorbed dose (D 1m) , efficacy corrected absorbed dose (D 1e) , and sensitivity corrected absorbed dose (D 1s) of the first month were calculated according to the actual follow-up CT images. The statistical test was carried out by SPSS21.0. The Spearman linear analysis was applied to analyze the relationship between D 90, D 1m, D 1e, D 1s and R t, and the curve fitting was also completed. Results:The post-operative D 90, D 1m, D 1e, D 1s and R t were (129.73±14.22) Gy, (36.95±7.35) Gy, (43.45±11.32) Gy, (41.78±13.39) Gy, and (32.00±19.00) %, respectively. And the correlation coefficient were 0.692, 0.551, 0.728, and 0.858, respectively, which showed significant positive relevance between dosimetric parameters and tumor volume change ( P<0.01) , the curve fitting presented cubic function. Conclusion:The post-operative D 90, D 1m, D 1e, and D 1s can be predictors for curative effect, and D 1s is the best predictor.
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Objective@#To analyze the factors influencing the short-term efficacy of CT-guided 125I seeds implantation in the treatment of recurrent and metastatic tumors in head and neck.@*Methods@#A total of 73 patients (61 males, 12 females; age: (59.1±11.5) years) with head and neck tumors recurrence and metastasis treated by 125I seeds implantation in Hebei General Hospital from January 2015 to April 2019 were retrospectively enrolled. The implanted seeds activity was 11.1-29.6 MBq, and the prescription dose was 80.0-145.0 Gy. CT examination was conducted 3 months after 125I seeds implantation. According to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, short-term efficacy was classified as effective (complete remission (CR), partial remission (PR)) and ineffective (stable disease (SD), progressive disease (PD)). Univariate analysis of factors affecting short-term effect (gender, age, history of radiation therapy, Karnofsky performance status (KPS) scores, pathological type, the longest diameter of tumor, implantation patterns, seeds activity, immediate postoperative dose delivered to 90% gross tumor volume (D90), and with adjuvant chemotherapy post-surgery or not) were conducted. Variables with P<0.2 were enrolled in logistic multivariate regression analysis. In addition, artificial neural network (ANN) was constructed with all influencing factors as independent variables and short-term efficacy as dependent variables. Finally, receiver operating characteristic (ROC) curve analysis was performed for the common influencing factors in logistic regression analysis and ANN analysis.@*Results@#There were 34 with effective results and 39 with ineffective results. Logistic regression analysis indicated that the longest diameter of tumor, immediate postoperative D90, with adjuvant chemotherapy post-surgery or not had significant impacts on the short-term efficacy (Wald values: 6.950, 4.804, 4.790, all P<0.05); According to results of ANN analysis, the top 5 in order of importance for short-term efficacy prediction were immediate postoperative D90, the longest diameter of tumor, age, seeds activity and gender. ROC curve analysis indicated that the longest diameter of tumor and immediate postoperative D90 were the best predictors for short-term efficacy, with the threshold of 5.25 cm and 110.05 Gy respectively, and the area under the curve (AUC) was 0.843 and 0.847 respectively (both P<0.001).@*Conclusions@#The short-term efficacy of 125I seeds implantation in the recurrence and metastasis of head and neck tumors is mainly related to the longest diameter of tumor and immediate postoperative D90. Patients with the longest diameter of tumor <5.25 cm and with D90>110.05 Gy can achieve better efficacy.
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Objective To analyze the factors influencing the short-term efficacy of CT-guided 125I seeds implantation in the treatment of recurrent and metastatic tumors in head and neck.Methods A total of 73 patients (61 males,12 females;age:(59.1±11.5) years) with head and neck tumors recurrence and metastasis treated by 125I seeds implantation in Hebei General Hospital from January 2015 to April 2019 were retrospectively enrolled.The implanted seeds activity was 11.1-29.6 MBq,and the prescription dose was 80.0-145.0 Gy.CT examination was conducted 3 months after 125I seeds implantation.According to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1,short-term efficacy was classified as effective (complete remission (CR),partial remission (PR)) and ineffective (stable disease (SD),progressive disease (PD)).Univariate analysis of factors affecting short-term effect (gender,age,history of radiation therapy,Karnofsky performance status (KPS) scores,pathological type,the longest diameter of tumor,implantation patterns,seeds activity,immediate postoperative dose delivered to 90％ gross tumor volume (D90),and with adjuvant chemotherapy post-surgery or not) were conducted.Variables with P＜ 0.2 were enrolled in logistic multivariate regression analysis.In addition,artificial neural network (ANN) was constructed with all influencing factors as independent variables and short-term efficacy as dependent variables.Finally,receiver operating characteristic (ROC) curve analysis was performed for the common influencing factors in logistic regression analysis and ANN analysis.Results There were 34 with effective results and 39 with ineffective results.Logistic regression analysis indicated that the longest diameter of tumor,immediate postoperative D90,with adjuvant chemotherapy post-surgery or not had significant impacts on the shortterm efficacy (Wald values:6.950,4.804,4.790,all P＜0.05);According to results of ANN analysis,the top 5 in order of importance for short-term efficacy prediction were immediate postoperative D90,the longest diameter of tumor,age,seeds activity and gender.ROC curve analysis indicated that the longest diameter of tumor and immediate postoperative D90 were the best predictors for short-term efficacy,with the threshold of 5.25 cm and 110.05 Gy respectively,and the area under the curve (AUC) was 0.843 and 0.847 respectively (both P＜0.001).Conclusions The short-term efficacy of 125I seeds implantation in the recurrence and metastasis of head and neck tumors is mainly related to the longest diameter of tumor and immediate postoperative D90.Patients with the longest diameter of tumor ＜5.25 cm and with D90＞110.05 Gy can achieve better efficacy.
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Objective:To study the infiltration mode of local immune cells in prostate cancer and to explore the role of immune cells in the development of prostate cancer.Methods:Gene expression profile chip dataset of normal prostate and prostate cancer tissues were downloaded from Gene Expression Omnibus (GEO) database. The proportion of 22 immune cells in the two groups was calculated by using R and SPSS software; the differences in the proportion of immune cells between the two groups were compared. The correlation coefficients among immune cells in prostate cancer tissues were calculated.Results:The dataset GSE62872 was downloaded, and a total of 424 samples were obtained, including 160 normal prostate tissues and 264 prostate cancer tissues. There were 20 228 mRNA detected in each sample. Deconvolution algorithm was used to obtain the proportion data of 22 kinds of immune cells after data correction. The samples were screened with P < 0.01, and 63 normal prostate tissues and 57 prostate cancer tissues were obtained. The immune cells with higher expression included CD8 + T cells [(23.48±6.16)%], plasma cells [(18.46±5.74)%], monocytes [(12.15±3.82)%] and activated NK cells [(11.11±2.97)%]. The immune cells with higher constituent ratio correlation coefficient included CD8 + T cells and unactivated memory CD4 + T cells ( r = -0.609, P < 0.01), M 0 macrophages and M 2 macrophages ( r = -0.596, P < 0.01). Compared with normal tissues, the infiltration degree of M 1 macrophages and unactivated dendritic cell was increased, and the difference was statistically significant ( Z = -2.783, P = 0.005; Z = -2.129, P = 0.033). Conclusions:The infiltrated immune cells in the tumor microenvironment of prostate cancer are mainly CD8 + T cells, plasma cells, monocytes and activated NK cells. With the effect of the tumor microenvironment, M 0 macrophages mainly differentiate into M 2 macrophages cells, which may be involved in the occurrence and development of prostate cancer, providing new clues to find potential immunotherapy targets.
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Objective: The objective of the study is to test whether three-dimensional (3D)-printed template can be used reproducibly for guiding malignant tumors brachytherapy and study the dosimetric consistency and adequacy between pre- and post-plan. Materials and Methods: Between January and December 2016 in our hospital, a total of 14 patients underwent 3D-printed template-guided brachytherapy. All the patients were fixed into position using a vacuum cushion before undertaking a computed tomography (CT) scan. After the preplan was designed, the templates were printed. The tumors were punctured through predesigned needle holes. Following this, another CT scan was used to confirm the locations of needles, and then the 125 I radioactive seeds were implanted into the tumor according to the preplan. Postplan was performed after the operation. Data of the D90 (minimum absorbed dose of 90% target volume), V90 (90% prescription dose coverage volume percentage of target volume), V100, V150, and seed number pre- and post-operation were collected and compared. Results: The mean D90, V90, V100, V150, and seed number preoperation were 94.96 ± 16.43 Gy, 94.64% ± 1.43%, 91.21% ± 1.59%, 65.01% ± 5.78%, and 46.67 ± 21.87, respectively. The mean D90, V90, V100, V150, and seed number postoperation were 91.97 ± 17.54 Gy, 93.35% ± 2.45%, 89.35% ± 3.21%, 63.40% ± 6.36%, and 46.60 ± 22.85, respectively. No significant difference between pre- and post-operation was observed across the data (P >0.05). Conclusion: For immobilized malignant tumors, 3D-printed template can be used reproducibly. The dose parameters in preplan can be achieved easily and satisfactorily by 3D-printed template guided brachytherapy, and it may become an easily reproducible standardized procedure in the future