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Radiotherapy is the most common treatment for nasopharyngeal carcinoma, and the radiotherapy technique is essential for the prognosis of nasopharyngeal carcinoma. Due to the complexity of the structure of the intensity-modulated device and the accuracy of the clinical requirements of radiotherapy, it is inevitable that higher requirements will be imposed on the process of intensity-modulated radiotherapy. Currently, gaps exist in the radiotherapy equipment and personnel qualification among radiotherapy units, and thus the homogenization in the radiotherapy remains to be strengthened in China. With the application of radiotherapy information management system, digital medicine and artificial intelligence technologies in the field of radiotherapy, the original process fails to meet the application needs of the new precise radiotherapy technology. Therefore, this process is designed based on the existing radiotherapy procedures for nasopharyngeal carcinoma in combination with the latest developments in the field of radiotherapy, aiming to establish a novel standard process recommendation, ensuring the standardization and homogenization of radiotherapy and achieve the individualized intensity-modulated radiotherapy for nasopharyngeal carcinoma patients.
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Objective To compare the early outcomes of laparoscopic and open resection and evaluate the safety and feasibility of laparoscopic surgery in patients with colorectal cancer aged ≥ 70 years.Methods A total of 91 consecutive patients with colorectal adenocarcinoma underwent surgery in Yizheng City People's Hospital between Jan.2009 and Dec.2015.In 91 patients included in this study,38 received laparoscopic surgery and 53 underwent open surgery.Main outcome measures were clinical data,postoperative recovery status and short-term outcomes.Results There were no significant differences between two groups with respect to demographic indicators,clinicopathological results and chronic comorbidities had no significant difference between two groups.No death cases occured in both groups.One patient in the laparoscopic group required conversion to open surgery due to ureteral injury.Laparoscopic surgery was associated with significantly longer operating time [(238 ± 71.3) minutes vs (175 ± 60.8) minutes,P ＜ 0.001],less estimated blood loss [(145 ± 58 ml) vs (186 ± 45) ml,P ＜ 0.001)],a shorter postoperative hospital stay [(11.9 ± 3.9) days vs (14.5 ± 3.7) days],lower overall postoperative complication rate (23.7％ vs 45.3％,P =0.035),wound-related complication rate (2.6％ vs 22.6％,P =0.017) when compared with open surgery.Quality of surgical specimen,lymph nodes harvested were not significantly different between two groups.Conclusion Laparoscopic colorectal cancer surgery is safe and feasible in elderly patients,associated with better short-term outcomes when compared with open surgery.
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Objective To study the feasibility of Brainlab plus 6-degree-of-freedom(6D) couch in the radiotherapy of head and neck by using their setup error.Methods Twenty-four patients with head and neck neoplasms in our hospital during AugustOctober 2016 were taken as the examples.After positioning by technician,each Brainlab was carried out,the setup errors in 3 translation directions of left-to-right(X),head-to-foot(Y) and abdomen to-back(Z) and 3 pivoting directions of Rx,Ry and Rz were obtained after registration of positioned CT image.After adjustment,Brainlab re-scanning was conducted for getting corrected errors.Results The online correction by Brainlab plus 6D obviously reduced the setup errors.The setup errors in all directions approached to 0,in which the difference between Ry and Rz directions had no statistical significance(P＞0.05),while the difference among the X,Y,Z and RX directions was statistically significant(P＜0.05).Conclusion The online corrections of Brainlab combined with 6D considerably reduces the errors in translation and rotation directions in radiotherapy of head and neck neoplasms,thus reduces normal tissue received amount and increases the radiotherapeutic accuracy.
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Objective To explore the feasibility of reduction by using cone beam computed tomography (CBCT) before intensity modulated radiation therapy(IMRT) in the patients with nasopharyngeal carcinoma.Methods Twenty-three patients with nasopharyngeal carcinoma (NPC) undergoing IMRT were included in this study.The reverse IMRT plan with CBCT verification was prepared with location center coordinates origin as the planned central point.Before therapy,the CBCT reduction was adopted,the CBCT scanning was performed before the second and third radiotherapies.The registering data in 3 times were analyzed and summarized.Results In CBCT reduction,the absolute value at any direction≤3 mm accounted for 89.9％ (62/69),＜5 mm accounted for 98.6 ％ (68/69),and the deviation value at every direction was (0.6 ± 2.1)mm;in the second and third CBCT,the absolute value at any direction ≤3 mm accounted for 92.8％ (128 q38),＜5 mm accounted for 99.3％ (137/138),and the deviation value at every direction was (0.4 ± 2.0) mm:the difference between the two sets of data had no statistically significant difference (P＞ 0.05).Conclusion In formulating the nasopharyngeal carcinoma IMRT plan withthe location center coordinates origin as the planned central point,adopting the CBCT reduction is intuitional,convenient,practicable and feasible.
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Objective To explore the feasibility of reduction by using cone beam computed tomography (CBCT) before intensity modulated radiation therapy(IMRT) in the patients with nasopharyngeal carcinoma.Methods Twenty-three patients with nasopharyngeal carcinoma (NPC) undergoing IMRT were included in this study.The reverse IMRT plan with CBCT verification was prepared with location center coordinates origin as the planned central point.Before therapy,the CBCT reduction was adopted,the CBCT scanning was performed before the second and third radiotherapies.The registering data in 3 times were analyzed and summarized.Results In CBCT reduction,the absolute value at any direction≤3 mm accounted for 89.9％ (62/69),＜5 mm accounted for 98.6 ％ (68/69),and the deviation value at every direction was (0.6 ± 2.1)mm;in the second and third CBCT,the absolute value at any direction ≤3 mm accounted for 92.8％ (128 q38),＜5 mm accounted for 99.3％ (137/138),and the deviation value at every direction was (0.4 ± 2.0) mm:the difference between the two sets of data had no statistically significant difference (P＞ 0.05).Conclusion In formulating the nasopharyngeal carcinoma IMRT plan withthe location center coordinates origin as the planned central point,adopting the CBCT reduction is intuitional,convenient,practicable and feasible.
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Objective To investigate the level and proportional relationship of free fluorine and soluble fluoride in different brands of toothpaste,and analyze possible risk factors.Methods A total of 54 samples of commercially available toothpastes of domestic,joint venture and imported in Guiyang City were collected,and the levels of free fluoride and soluble fluorine were determined,respectively,using fluorideion selective electrode.method (GB 8372-2008).Results The number of the toothpaste was 32,12,10,respectively,in domestic,joint venture and imported.The levels of free fluorine ranged from 0.98 to 1 603.50 mg/kg,3.22 to 617.50 mg/kg and 306.80 to 1 590.80 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard free fluorine was 3,0 and 1,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard free fluorine was 9.4％,0.0％ and 10.0％,respectively,in toothpastes of domestic,joint venture and imported.The levels of soluble fluorine ranged from 3.06 to 4 302.50 mg/kg,9.02 to 1 667.30 mg/kg and 9.18 to 4 013.20 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard soluble fluorine was 9,2 and 3,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard soluble fluorine was 34.4％,16.7％ and 30.0％,respectively,in toothpastes of domestic,joint venture and imported.The proportion of free fluorine and soluble fluoride was:domestic 1.0 ∶ 2.7,joint venture 1.0 ∶ 2.7,imported 1.0 ∶ 2.5,respectively.The confidence limit (R/d) was 0.98.Conclusion The fluoride level in different brands of toothpaste has exceeded the standard,the content and proportion of soluble fluoride are obviously higher than those of free fluoride,and there is a risk on tooth damage from fluoride,and factories should strengthen quality control in adding fluoride.
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Objective To evaluate the similarities and differences between four-dimensional radiotherapy (4D-CT ) and active breathing control techniques(ABC) in respiratory management in lung radiotherapy ,and investigate the indications and feasibility of different breathing control techniques for different patients .Methods Twenty-one patients treated with lung radiotherapy received respiratory management .4D-CT technology was used in 11 patients ,while ABC technology was adopted in the rest 10 .The ratios of planning target volume(PGTV) to gross tumor volume(GTV)[(PGTV/GTV)] were calculated .The differences between these two respiratory management technologies were compared in terms of the PGTV ,positioning time ,planning time and treatment time to investigate the indications .Results 4D-CT technology had higher PGTV/GTV ratio ,and shorter positioning time and irradiation time than ABC technology(P0 .05) .In patients with ABC and 4D-CT technology ,objective response rates were 50 .0% ,45 .5% ,respectively ,and the radiation pneumonitis rates were 30 .0% ,27 .3% ,respectively .There was no significant difference in both groups (P>0 .05) .Conclusion In lung tumor radiothera-py ,ABC can reduce irradiation volume ,suitable for patients with good performance status .4D-CT is time-saving and well tolerated , suitable for patients with smaller tumors .
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Objective To find a novel operative modality with sphincter preservation in the treatment of middle and low rectal carcinoma. Methods Pull through lower resection was performed on 28 rectal cancer patients. The distance between the anal verge and the lower margin of the tumor was 6～8cm(20 patients) or 8～10cm(8 patients), including 8 patients in Dukes A stage, 16 Dukes B and 4 Dukes C. The resected line from tumor distal margin was 2cm, 3cm, and 4cm, respectively. Results There was no operative death, anastomotic fistula or anastomotic stenosis in these cases. Mean follow up period was 30 months. Local recurrence was found in two cases (7.1%) 18 months after the operation, and 26 cases were cancer free till the end of the follow up. Defecation was satisfactorily controlled 8～12 weeks after the operation. Conclusions Pull through Welch procedure could meet the criterion of the radical resection of rectal carcinoma,and keep the internal and external sphincter muscles intact in the superior lower anterior resection. The normal defecationcan can maintain after the operation due to the preservation of internal and external sphincter muscles.
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Objective To analyze the efficacy,dose and complications of total body irradiation(TBI) for patients to receive hematopoietic stem cell transplantation(HSCT) in the treatment of leukemia and malignant lymphoma.Methods From May 2002 to February 2007,78 cases with leukemia or malignant lymphoma received the TBI before HSCT in our department.All the patients were irradiated with linear accelerator in 2 consecutive days at a total dose of 7 to 11 Gy,dose rate of 4.5 to 5.0 cGy/min,once per day.Among them,55 cases received traditional high-dose chemotherapy before radiotherapy,and the other 23 cases got TBI first followed by high-dose chemotherapy.Results All the cases used TBI prior to transplantation was successful,and no serious complication such as radiation pneumonitis was observed.Conclusion Our TBI regime is a safe and effective pretreatment for HSCT.TBI used before the large doses of the chemotherapy is recommended because it is proved to be effective,without affecting the survival rate,and of lesser TBI reaction and of lesser preparation work for irradiation to radiotherapist.More attention should be paid when the linear accelerator is employed for TBI.