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Objective:To investigate the effects of growth hormone combined with triptoreline acetate on growth and sex hormone in girls with central precocious puberty.Methods:Sixty-two girls with central precocious puberty who received treatment in Xin'an International Hospital from January 2017 to December 2019 were included in this study. They were randomly assigned to receive treatment with either triptorelin acetate (control group, n = 31) or triptorelin acetate plus growth hormone (observation group, n = 31) for 12 successive months. Before and after treatment, bone age difference/chronological age difference (△BA/△CA), body height, body weight, uterine and ovarian volume and sex hormone level were compared between the control and observation groups. Results:△BA/△CA in the observation group was significantly lower than that in the control group [(0.64 ± 0.17) vs. (0.95 ± 0.13), t = 8.065, P < 0.05). Body height and weight in the observation group were (127.32 ± 1.08) cm and (33.42 ± 2.37) kg, respectively, which were significantly higher than those in the control group [(126.34 ± 0.87) cm and (31.01 ± 2.15) kg, t = 3.934 and 4.193, both P < 0.05]. Uterine and ovarian volume in the observation group were (1.68 ± 0.29) cm 3 and (1.26 ± 0.18) cm 3, respectively, which were significantly lower than those in the control group [(2.41 ± 0.46) cm 3 and (1.83 ± 0.26) cm 3, t = 7.474 and 10.036, both P < 0.05). After treatment, there were no significant differences in serum estradiol and luteinizing hormone levels between the two groups (both P > 0.05). Conclusion:Growth hormone combined with triptoreline acetate has a good effect on central precocious puberty in girls because it can improve the growth and development of girls and reduce serum levels of estradiol and luteinizing hormone.
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Background and purpose: Currently, intraoperative radiation therapy (IORT) has become the adjuvant therapy of cancer. The study was to establish the daily quality assurance (QA) program and analyze dosimetric characteristics’ long-term stability for mobile IORT accelerator. Methods:The QA program of this study included two parts:safety and functionality and energy and output. The two years’ QA datasets were acquired and analyzed to investigate the stability of energy and output. Results:All safety and functionality tests passed on a daily basis. The energy index was (0.666±0.015)mm, (0.839±0.009)mm, (0.781±0.010)mm, (0.724±0.009)mm and the output dose error was (0.511 ± 0.671)%, (0.278 ± 0.516)%, (0.368 ± 0.532)%, (0.382 ± 0.912)%for all energy, respectively. There was no signiifcant time trend in the dosimetric characteristics. Conclusion:The daily QA program is suitable for mobile IORT accelerator. The long-term stability is acceptable for IORT in clinical use.
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ObjectiveTo discuss dosimetric characteristics of an intensity-modulated radiotherapy (IMRT) technique for treating the chest wall and regional nodes as an integrated volume after modified radical mastectomy ( MRM ),and observe acute side-effects following irradiation.Methods From June 2009 to August 2010,75 patients were randomly enrolled.Of these,41 had left-sided breast cancer.Each eligible patient had a planning CT in treatment position,on which the chest wall,supraclavicular,and infraclavicular nodes,+/-internal mammary region,were contoured as an integrated volume.A muhi-beam IMRT plan was designed with the target either as a whole or two segments divided at below the clavicle head.A dose of 50 Gy in 25 fractions was prescribed to cover at least 90％ of the PTV.Internal mammary region was included in 31 cases.Dose volume histograms were used to evaluate the IMRT plans.The acute side effects were followed up regularly during and after irradiation.The independent two-sample t-test was used to compare the dosimetric parameters between integrated and segmented plans.ResultsPlanning design was completed for all patients,including 55 integrated and 20 segmented plans,with median number of beams of 8.The conformity index and homogeneity index was 1.43 ± 0.15 and 0.14 ± 0.02,respectively.Patients with internal mammary region included in PTV had higher homogeneity index PT.The percent volume of PTV receiving ＞ 110％ prescription dose was ＜ 5％.None of the dose constraints to normal structures was violated.There were statistically significant differences in the means of dosimetric parameters of PTV,such as Dmax,DmeanV107％,and V110％,between integrated and segmented plans (t=2.19 -2.53,P=0.013-0.031 ).≥ grade 2 radiation dermatitis was identified in 3 2 patients ( grade 2 in 2 2 patients,grade 3 in 10 patients ),mostly occurred within 1 - 2 weeks after treatment.The sites of moist desquamation were anterior axillary fold (27/37) and chest wall (10/37).Only 2 patients developed grade 2 radiation pneumonitis.Conclusions The IMRT technique applied after MRM with integrated locoregional target volume is dosimetrically feasible,and the treatment was proved to be well-tolerated by most patients.
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Objective The frequency and the anatomic distribution of involved regional nodes in recurrent and locally advanced breast cancer were analyzed, in order to evaluate the rational of conventional regional node radiation technique and provide evidence for target definition of breast cancer . Methods Patients with recurrent or locally advanced breast cancer who were treated in our hospital from August 2003 to December 2009 were included in this study. 111 patients had contrast enhanced chest CT images of the whole regional nodes before treatment. The regional nodes were categorized into 8 anatomical substructures including medial and lateral supraclavicular nodes ( SC-M, SC-L), axilla nodes ( ALN )- Ⅰ , Ⅱ , Ⅲ,infraclavicular nodes (IFN), Rotter's nodes (RN) and internal mammary nodes (IMN). The frequency of involvement and anatomical distribution of the involved nodes on CT images were analyzed. Results A total of 111 patients were enrolled this study and 199 anatomical substructures with involved nodes were identified. The frequency of involvement were :SC-M 33, SC-L 21, ALN- Ⅰ 30, ALN-Ⅱ 25, ALN-Ⅲ + IFN 35, RN 27, IMN 28. Supraclavicular region and axilla were the most frequently involved area (72. 3% ).The average depth of the SC-M and SC-L nodes was 33.48 mm ± 10. 57 mm and 45.62 mm ±20. 45 mm,and 51.5% and 71.4% of the SC-M and SC-L nodes were located more than 3 cm deep from the skin. The axilla nodes were located cranial and caudal to the axillary vein in 5 and 20 locally advanced breast cancer patients and in 64 and 28 patients who received prior axillary dissection. The majority of involved IMN was located within the first 3 intercostal spaces (26/28). The average distance between the center of involved IMN and chest skin was 24. 23 mm ± 10. 28 mm. The average distance between the center of involved IMN and midline of the body was 29. 38 mm ±6. 7 mm. The center of involved IMN was 6.19 mm ±5.73 mm lateral and 5.73 mm ± 4. 56 mm posterior to the internal mammary vessels. Conclusions Conventional field design is unlikely to provide sufficient dose to the entire risk region because of individual differences.Individualized treatment planning based on CT would become feasible with increasing knowledge of natural risk of nodal involvement.
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Objective To assess set-up errors measured with kilovoltage cone-beam CT (KV-CBCT), and the impact of online corrections on margins required to account for set-up variability during IMRT for patients with prostate cancer. Methods Seven patients with prostate cancer undergoing IMRT were enrolled onto the study. The KV-CBCT scans were acquired at least twice weekly. After initial set-up using the skin marks, a CBCT scan was acquired and registered with the planning CT to determine the setup errors using an auto grey-scale registration software. Corrections would be made by moving the table if the setup errors were considered clinically significant ( i. e. , ＞ 2 mm). A second CBCT scan was acquired immediately after the corrections to evaluate the residual error. PTV margins were derived to account for the measured set-up errors and residual errors determined for this group of patients. Results 197 KV-CBCT images in total were acquired. The random and systematic positioning errors and calculated PTV margins without correction in mm were:a) Lateral 3. 1,2. 1,9. 3;b) Longitudinal 1.5, 1.8, 5. 1 ;c) Vertical 4. 2,3.7, 13.0. The random and systematic positioning errors and calculated PTV margin with correction in mm were:a) Lateral 1.1,0. 9, 3.4;b) Longitudinal 0. 7, 1.1, 2. 5;c) Vertical 1.1, 1.3, 3.7. Conclusions With the guidance of online KV-CBCT, set-up errors could be reduced significantly for patients with prostate cancer receiving IMRT. The margin required after online CBCT correction for the patients enrolled in the study would be appoximatively 3-4 mm.
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Objective To monitor the performance constancy of the HS-126E automatic X-ray film processor and to investigate the effects of chemical processing time on the reproducibility of film dosimetry.Methods With films having identical exposure,15 ready-pack Kodak X-omat-V films from the same batch were divided into 5 groups and exposed one by one under the identical conditions.One group of test film was processed per day from Monday to Friday with identical temperature and time.All films were digitized with a Vidar VXR-16 bit film digitizer. The average optical density(A) at irradiation field center was analyzed with RIT113 film dosimetry system software.At the same time,another 10 films in 5 groups from the same batch were exposed with vertical method and processed to get the calibration data and sensitometric curves.The film sensitivities,i.e.,ratio of A to delivered dose,were calculated and compared between groups.Another 15 films in 5 groups were exposed with horizontal method and processed similarly to the test films,the point dose at 1.5?cm depth on the central axis was calculated with sensitometric curve and compared with the value measured by ion chamber.Results Variations of A value in each group was less than 2%.During the processing period,a trend of decrease along with time in mean A value decreased day by day was observed.Both the standard deviations and coefficients of variation in all groups were within 2%.One-way ANOVA showed that there was a significant difference of the mean A value among all films from Monday to Friday(P