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Objective To evaluate the dose distribution and clinical efficacy of hippocampal-sparing prophylactic cranial irradiation ( HS-PCI ) in patients with small cell lung cancer by using helical tomotherapy. Methods Clinical data of 49 patients with small cell lung cancer receiving HS-PCI using helical tomotherapy in Cancer Hospital between 2014 and 2017 were retrospectively analyzed. All patients received brain MRI to exclude the possibility of brain metastasis within 1 month after standard surgery or radio-and chemo-therapy. The prescription dose was 95% PTV,25 Gy in 10 fractions. The adverse reactions and cognitive functions of patients were observed before,6 months and 1 year after treatment,and the dose distribution in the hippocampal gyrus,survival rate and brain metastasis rate were analyzed. Results The median follow-up time was 16 months. The average dose in the hippocampal gyrus was 7. 23 Gy and 8. 46 Gy in the reduction region,which was reduced by 71. 88% and 66. 16% compared with the prescription dose. The maximum dose in the hippocampal gyrus was 10. 66 Gy and 15. 43 Gy in the reduction region. Among 49 patients,8 died,the 1-year survival rate was 85. 1% and the 2-year survival rate was 70. 3%.Nine patients (18. 3%) had brain metastases,and one of them with extensive multiple brain metastases (n＝13) presented with metastasis adjacent to the hippocampal gyrus. The main adverse reactions included mild headache, dizziness and brain edema,whereas no ≥ grade 2 adverse reactions occurred. At 6 months after treatment, the HVLT-R score was significantly decreased,and declined by 6. 78% at 12 months after treatment. The HVLT-R scores did not significantly differ in patients without brain metastasis before and 12 months after treatment ( P＞0. 05 ). Conclusion Application of HS-PCI using helical tomotherapy meets the dose requirement,effectively protects the cognitive function and yields slight adverse reactions.
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Objective:To explore the expression of miR-139-5p in small cell lung cancer (SCLC)tissue and its clinical significance, and to clarify the role of miR-139-5p in the occurrence and development of SCLC. Methods:The biological function of miR-139-5p was examined by cell growth,apoptosis and cell cycle analysis. The expressions of miR-139-5p in 50 cases of cancer tissue and paracarcinoma normal tissue were examined by QRT-PCR.Combined with the clinical data,the role of miR-139-5p in clinic was anzlyzed.Results:The expression level of miR-139-5p in SCLC tumor tissue was lower than that in normal lung tissue (P 0.05).The expression level of miR-139-5p in the patient at LD stage was lower than that of the patients at ED stage (P <0.01).The expression level of miR-139-5p in the resistant patients was higher than that of the patients sensitive to chemotherappy (P <0.01).The expression level of miR-139-5p in the survival patients was lower than that in the death patients (P <0.01).Cox regression analysis indicated that miR-139-5p expression and disease stage were the independent prognostic factors for SCLC.Conclusion:miR-139-5p in participates in the occurrence and development of SCLC by inhibiting the cell proliferation,promoting apoptosis and inducing the cell cycle arrest;it may be used as a target gene to evaluate the prognosis of SCLC patients.