Effect of cone-beam computed tomography image-guidance on the setup errors of stereotactic body radiotherapy for spinal metastatic tumors / 肿瘤研究与临床

Objective:To evaluate the effect of image-guided with cone-beam computed tomography (CBCT) based on volumetric modulated arc therapy (VMAT)-flattening filter free (FFF) on the setup errors of stereotactic body radiotherapy (SBRT) in patients with spinal metastatic tumors.Methods:The clinical data of 15 patients with spinal metastatic tumors who underwent SBRT in Jilin Cancer Hospital from August 2020 to January 2022 were retrospectively analyzed. The radiotherapy dose of bone metastasis was 32 Gy per 4 times and CBCT scanning was performed before and after radiotherapy. Every patient received radiotherapy 4 times; all 15 patients underwent SBRT 60 times in total and 120 CBCT volume images were finally obtained and analyzed. The systematic error (Σ) and random error (σ) were calculated at different correction threshold levels. The translational setup error and rotational setup error at the left-right (X axis), head-foot (Y axis) and front-back (Z axis) directions before and after radiotherapy were compared, which were expressed as Σ ± σ.Results:The pre-SBRT and post-SBRT translational setup errors were (0.14±0.27) cm and (0.07±0.19) cm, respectively ( P<0.001) in the X direction, (-0.05±0.33) cm and (0.00±0.19) cm, respectively ( P = 0.001) in the Y direction, (-0.13±0.19) cm and (-0.02±0.14) cm, respectively ( P = 0.012) in the Z direction. The pre-SBRT and post-SBRT rotational setup errors were (-0.31±0.76)° and (-0.09±0.34)°, respectively ( P < 0.001) in the X direction, (-0.13±0.88)° and (-0.07±0.36) °, respectively ( P < 0.001) in the Y direction, (0.10±0.51)° and (0.16±0.38)°, respectively ( P < 0.001) in the Z direction. Conclusions:CBCT correction could reduce Σ and σof the translational setup and rotational setup, increase the accuracy of SBRT based on VMAT-FFF for patients with spinal metastatic tumors.

Research progress in diagnosis and treatment of partial thickness rotator cuff tears / 国际外科学杂志

Partial thickness rotator cuff tears(PTRCTs) are a common cause of shoulder pain and dysfunction in adults, which are seen in middle-aged and older adults and young adults in over-the-shoulder sports(throwing sports are the most common). PTRCTs include partial tears on the articular side, partial tears on the bursal side, and intratendinous tears. Tears on the articular side are 2-3 times more likely than on the bursal side, but intratendinous tears are the most common type. The treatment of PTRCTs consists of both conservative and surgical treatments. Conservative treatment is suitable for most patients with PTRCTs, and recommended as the primary treatment for PTRCTs because of its good clinical efficacy and patients′ willingness to accept it. However, there is no genaral consensus on the best treatment and the results reported in the literature are controversial. In this paper, the anatomy, epidemiology, pathogenic factor, diagnosis and treatment progress of PTRCTs are summarized in light of relevant domestic and international studies in recent years to provide reference for clinical diagnosis and treatment.