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Objective To explore the relationship of expression and the effect of preoperative radiotherapy of endothelin-1 (ET-1) and pyruvate kinase M-2 (PKM2) in rectal carcinoma.Methods Immunohistochemical method was used to detect the expression of ET-1 and PKM2 proteins of rectal cancer tissues in 96 cases.The expressions of ET-1 and PKM2 were analyzed with the effect of preoperative radiotherapy in rectal cancer tissue.Results The high expression of ET-1 protein was 59 cases (61.46％).The high expression of PKM2 proteins was 54 cases (56.25％).The high expressions of ET-1 and PKM2 protein were worsen the effect of tumor regressive grade (TRG) than lower expressions of those after preoperative radiotherapy of rectal cancer tissue (P ＜ 0.05).The protein expression of ET-1 and PKM2 were positively correlated (P =0.006).Conclusions The high expressed ET-1 and PKM2 proteins in rectal cancer are closely related to preoperative radiotherapy resistance.ET-1 and PKM2 proteins are expected to become new targets of radiotherapy sensitivity and radiotherapy sensitization of rectal cancer.
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Adjuvant radiotherapy (RT) can improve the rate of loco-regional control for patients with gastric cancer (GC),while the selection of patients plays a key role.As the research moves along,several relatively comprehensive molecular classifications emerged such as the TCGA classification and the ACRG classification.Studies have demonstrated that molecular classifications are closely related to the clinicopathologic characteristics,prognosis and treatment response.However,there is not recognized molecular classification of GC presently.It is a great challenge for radiation oncologists to make use of the individual bioinformation and accurately select patients who would benefit from RT.Meanwhile,precision RT could also be achieved with the prediction of radiosensitivity,combination of RT with targeted therapy and the application of ctDNA within the field of RT.
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Objective To explore the dosimetric effect of using a split of the gross tumor volume (GTV) delineation approach during intensity-modulated radiotherapy (IMRT) treatment planning for advanced T-stage nasopharyngeal carcinoma (NPC) with prevertebral space involvement (PSI).Methods Twenty NPC patients with T3-T4 tumors with prevertebral space involvement were studied.Two kinds of plans were generated based on the same protocol.The first plan was GTV-split consisting of organ at risk (including spine cord and brain stem) overlapping and non-overlapping subsegments.The subsegments were assigned independent dose constraint.The second plan was done based on a standard treatment planning protocol.The two plans were compared with respect to target coverage and organ at risk (OAR) sparing,and target conformity index.Results Two plans both met requirement of dose coverage of target and constraints on normal tissue.Regarding the planning gross target volume (PGTV),the doses of ＜ 93％ volume of plan 1 and plan 2 were [(0.63 ± 0.21)％,and (0.68 ± 0.10)％,P =0.049];the doses of ＞ 110％ volume of plan 1 and plan 2 were [(11.59 ± 7.Ol) ％,and (12.71 ± 6.03) ％,P =0.041];the doses of ＞115％ volume of plan 1 and plan 2 were [(2.05 ± 0.80)％,and (2.76 ± 1.14)％,P =0.049];about OARs,the maximal dose of spine cord for plan 1 and plan 2 were (41.00 ± 4.52) Gy and (45.00 ± 3.25) Gy (P =0.048);and the target coverage and target conformity index of plan 1 were better than those of plan 2,the p-values were 0.063,and 0.135,respectively.The difference between two plans was statistically significant (P ＜ 0.05).Conclusions A split-GTV delineation,independent dose constraint,and multi-course IMRT for advanced T-stage nasopharyngeal carcinoma with prevertebral space involvement optimized IMRT treatment planning,improved target coverage and target conformity index,and decreased the maximal dose for the spine cord and brain stem.It is feasible and has advantage to decrease the dose to OARs.The approach deserves to be further studied.
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Objective To investigate elderly patients with thoracic radiotherapy nausea result after risk factors associated with radiation pneumonitis.Methods The clinical data of a total of 440 cases of cancer patients with chest radiation therapy during January 2010-January 2014 were collected retrospectively.Of them,76 cases of radiation pneumonitis after radiotherapy were compared with other patients.The unconditional Logistic regression analysis was used to analyze the relationship of radiation pneumonitis and different factors including smoking,pulmonary dysfunction,combination with chemotherapy,radiation dose,and radiation sites.Results Elderly incidence of radiation pneumonitis was 17.27％.Multivariate Logistic regression analysis revealed the chi-square value of smoking,pulmonary dysfunction,combined with chemotherapy,radiation dose,and radiation sites was significant correlation (x2 =16.936,19.633,11.531,17.133,10.178,P ＜0.05),and the correlation degree was gradually decreased from pulmonary dysfunction,radiation dose,smoking,combined chemotherapy,to radiation site.Conclusions Elderly patients with thoracic malignancies after radiotherapy had more radiation pneumonitis,which was related to smoking,previous chemotherapy PO2 ＜ 80％,combined with chemotherapy,radiation dose ≥ 55 Gy,and low-lung radiation.The correlation degree was gradually decreased from chemotherapy before PO2 ＜ 80％,the radiation dose ≥55 Gy,smoking,combined chemotherapy,to low-lung radiation.
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Objective To investigate the development status of tumor radiotherapy in the Xinjiang Uygur Autonomous Region.Methods A questionnaire survey we used last time was conducted by letter,Email,telephone or fax to investigate all the medical institutions in the Xinjiang Uygur Autonomous Region for researching the current status of radiotherapy academic settings,human resources,allocation of radiotherapy facilities and standardization of medical practices.Results Up to the end of January 2015,there were 30 medical electron linear accelerators,21 simulated locators,10 breach-loading brachytherapy machines,31 treatment planning systems and 5γ or X knives in Xinjiang.Radiotherapy was carried out in 20 medical institutions,including 14 three-dimensional conformal radiotherapy and 9 intensity modulated radiation therapy,8 breach-loading brachytherapy,3 stereotactic radiotherapy,and 2 volumetric modulated arc therapy.There were 280 radiation personnel (except nurses),including 159 radiation oncologists,40 radiotherapy physicists and 81 radiotherapy technologists.There were 1167 hospital beds and 855 cancer patients received radiotherapy on average every day.Conclusions Although radiation personnel has increased,radiotherapy facilities have been improved,hospital beds and patients received radiotherapy also have become more,the improvements are needed for cause of imbalance in precise radiation therapy development.
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Radioactive esophagitis is one of the most common complications in thoracic tumor radiotherapy,biological factors such as single nucleotide polymorphisms (SNPs),miRNAs,and HIV infection may play key roles in the occurrence and development of radioactive esophagitis,and they have become an active field in protection areas of radiotherapy.We can identify the patients who may cause radioactive esophageal in high dose radiotherapy as early as possible,and modify the treatment plan to protect the esophagus.Therefore the biological factors of radioactive esophagitis are of important clinical significance.
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Primary lung cancer is one of the most common malignant tumors in China.The 2015 Edition of primary lung cancer diagnosis and treatment norms was updated based on 2010 Edition.This 2015 edition was published by the National Health and Family Planning Commission,which has referenced to the international authority of the lung cancer treatment guidelines and the actual situation of China.This paper mainly introduces the new content of lung cancer radiotherapy,including radical radiotherapy,palliative radiotherapy,adjuvant radiotherapy and preventive radiotherapy.
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Objective To investigate the influence of intensity-modulated radiation pattern on ra-diobiological effects of nasopharyngeal carcinoma cell line CNE2.Methods Colony formation assay was used to calculate cell surviving fraction, and compare the cell survival curves and the surviving fraction with single-hit multi-target model fitting survival curves to different delivery time and dose rates.Results ⑴Nasopharyngeal carcinoma cell line CNE2 was irradiated on two models:conventional radiation ( CR) mod-el;intensity modulated radiation model ( IMRT model, which was divided into 10 min IMRT irradiated group, 15 min irradiated group, and 20 min irradiated group) .Except that the parameters of radiation biol-ogy did no significantly differ between CR model and 10 min IMRT irradiated group ( P >0.05) , the other groups among radiobiology parameters surviving fraction (SF2), quasi-threshold dose(Dq) and extrapolation number(N) were all significant differences ( P SF2 600 Mu/min ( P <0.05) when the CNE2 cells were treated with dose rates of 300 Mu /min and 600 Mu/min.Conclusions ⑴There were not significant changes in the biological effects until the delivery time prolonged to more than 10 minutes.When the delivery time extended to more than 15 minutes, the survival fraction was increasing with the radiation time risen.⑵The dose rates used in the experiment did not show any effect on the radiobiology parameters without SF2 .
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Objective To investigate radio-sensitivity and expression of GRP78 protein in the survival subclones of nasopharyngeal carcinoma (NPC) C666-1 cells.Methods NPC C666-1 cells were first irradiated with X-ray at a large dose of 8Gy.Three survival subclones were selected and named as C666-1-R1, C666-1-R2, and C666-1-R3.The radio-sensitivity was analyzed for the radiated survival subclones and their parent control C666-1 cells with Methyl Thiazolyl Tetrazolium assay(MTT) and Trypan blue dye methods.The expression of GRP78 was analyzed for three survival subclones and control C666-1 with Western blot.Results After 6 Gy irradiation, the cell survival rate of three subclones was higher than that of the control cells, especially a significant difference for C666-1-R2 cells (P ＜ 0.05), which suggested a radioresistance in C666-1-R2 cells.Moreover, GRP78 expression in each subclone was significantly higher than that of parent C666-1 cells (P ＜ 0.05).Conclusions The irradiated-survival subclone C666-1-R2 was radio-resistant.GRP78 was overexpressed in the irradiated-survival subclones.GRP78 might be an ideal target for treatment of a nasopharyngeal carcinoma.
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Objective To compare the planning quality and volume of organ at risk (OAR) between volumetric-modulated arc therapyv (VMAT) and nine-field dynamic intensity-modulated radiation therapy (IMRT) in radiotherapy for cervical cancer patients,explore the best way to cervical cancer radiotherapy,Methods Selected 20 patients with cervical cancer were divided into 2 groups,10 cases for each group.Cervical cancer patients with no surgery was performed for A group (group A),received the radical radiotherapy,prescription dose gross tumor volume (GTV) 56 Gy,clinical target volume (CTV) 50 Gy.Another group of patients with cervical cancer radical surgery (group B),giving the whole basin lymph node auxiliary radiation therapy,prescription dose CTV 50 Gy.Each cervical cancer patient received VMAT and IMRT program designs,the differences in dose volume histogram (DVH),irradiated volume of organ at risk (OAR),heterogeneity index (HI),conformity index (CI),maximum dose (PTVmax),minimum dose (PTVmin) and mean dose (PTV mean) were compared between two plans in 2 groups.Results Two kinds of radiation technology in target area dosimetry were not statistical difference between two groups (P ＞ 0.05).In endanger organs on the protection of two groups of VMAT planning groups in the small intestine V20 and left femoral head V20 had obvious advantages with statistically significance (P ＜ 0.05).Conclusions Two groups of dosimetry between VMAT and IMRT program design are similar in cervical cancer.Two groups of VMAT planning groups to protect endanger organ slightly better than that of IMRT group,but VMAT planning group shortens treatment time and improves the accuracy and efficacy of treatment.
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Objective To analyze the clinical effects of internal radiation of iodine-125 seed implantation in the treatment of advanced pancreatic carcinoma.Methods 22 patients with unresectable and advanced pancreatic carcinoma were treated by the internal and interstitial radiation using iodine-125 seed implantation.Results Survival of 20 months was observed in 5 patients,10 ～ 20 months in 9 patients,2 ～10 months in 8,patients with an average of (13.47 ± 8.12) months.Among the 22 patients,complete response was obtained in 5 patients,partial response in 8 patients,no response in 7 paticnts,and the other showing PD.The response rate( CR + PR) was 59％.Conclusions Intra - operative internal radiation by iodine - 125 seed implantation does show some therapeutic effects for advanced pancreatic carcinoma.
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Objective To explore the relationships among pulmonary function,DVH and acute radiation pneumonitis after three-dimensional conformal radiation treatment in patients with non-small-cell lung cancer.MethodsPulmonary function tests were conducted on 68 inoperable patients (male 42,female 26,median age 52,KPS≥80) before and after three months radiotherapy respectively.After 3 months of follow-up,radiation pneumonitis were graded,and V20,V30 and MLD were derived from dose volume histogram (DVH).ResultsAll patients were treated with radiotherapy at the irradiation dose of 60～70Gy.Acute radiation pneumonitis occurred in 24 patients with 11 Grade Ⅰ,7 Grade Ⅱ,3 Grade Ⅲ,3 Grade Ⅳ.There were no significant difference between the pre-irradiation and the three months after irradiation for FVC (P＞0.05).But there were significant different between pre-irradiation and three months after irradiation for FEV1.0 and DLCO (P＜0.05).V20,V30 and MLD were observed in patients treated with high radiation pneumonitis.ConclusionsThere were close relationships among pulmonary function,DVH and radiation pneumonitis in patients with non-small cell lung cancer.
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Objective To investigate the effect of ionization to the expression of HIF-1α and p53 of nasopharyngeal carcinoma (NPC) in anoxia condition. Method Nasopharyngeal carcinoma cell line CNE-1 was divided into three groups, control group, radiation group, and hypoxia plus radiation group. The cell viability was analyzed by MTT method, Immunofluorescent technique was performed to de-termine the expression location of HIF-1α in CNE-1. And the expression of HIF-1α and P53 protein were measured with flow cytometry. Re-sults The results of MTr detection showed that the survival fraction of the control group was the highest. The minimum survival fraction was found in the radiation group (P<0.05). There was no HIF-1αprotein expression in cytoplasm except the radiation plus hypoxia group. With the flow cytometer technique, the expression of HIF-1αprotein in the radiation plus hypoxia group was higher than that in the radiation group. No statistical significance was found between the radiation group and the control group. When detecting the expression of P53 protein with the same technique, the expression of P53 was highest in the hypoxia plus radiation group and lowest in the control group (P<0.05). Conclusion The expression of HIF-1α inducted by Hypoxia can prevent NPC cell from the damages of radiation. The HIF-1α decreases the radiosensitivlty through inducing p53 expression in NPC CNE-1 cell line.