A comparative clinical study of postoperative intensity-modulated radiotherapy combined with concurrent and sequential chemotherapy for high-risk early-stage cervical cancer / 中华放射肿瘤学杂志

Objective To evaluate the efficacy and acute toxieities of postoperative intensity-modulated radiotherapy (IMRT) combined with concurrent (C-IMRCT) or sequential chemotherapy (S-IMRCT) in the treatment of high-risk early-stage cervical cancer.Methods A retrospective study was performed on the clinical data of 105 patients with high-risk early-stage (Ⅰ B1-Ⅱ A2) cervical cancer from 2009 to 2017.Those patients were divided into C-IMRCT group (n=73) and S-IMRCT group (n=32).The 5-year disease-free survival (DFS) and overall survival (OS) rates,recurrence rate,metastasis rate,and acute toxicities were compared between the two groups.The survival rates were calculated by the Kaplan-Meier method and analyzed by the log-rank test.Univariate prognostic analysis was performed by the log-rank test.Recurrence,metastasis,and adverse reactions were compared using continuous correction chi-square test.Results The median follow-up time was 20 and 23 months in the C-IMRCT group and the S-IMRCT group,respectively (P=0.813).There were no significant differences in the 5-year DFS and OS rates between the two groups (72.6％ vs.72.5％,P=0.918;82.8％ vs.78.5％,P=0.504).There were no significant differences in the recurrence and metastasis rates between the two groups (P=0.598;P=1.000).The univariate prognostic analysis showed that no pathological factor affected prognosis.There were no significant differences in the incidence rates of grade 1-2 hematological toxicity,diarrhea,and urinary tract infection between the two groups (46.6％ vs.41.9％,P=0.884;P=0.854;P=0.271).Conclusions Further clinical studies are needed in terms of the survival rate in patients with high-risk early-stage cervical cancer receiving C-IMRCT.

Cutaneous adverse events caused byimmune checkpoint inhibitors:classification and management / 中华放射肿瘤学杂志

Immune checkpoint inhibitors(ICPIs)have been successfully used in the treatment of multiple malignancies.However,immune-related adverse events(irAEs)may occur during treatment.Cutaneous adverse event(CAE)is acommon type of irAE. Mild CAEs include maculopapule,lichenoid reaction,bullous pemphigoid,vitiligo,psoriasis,and scleroderma. Severe and even life-threatening CAEs include Steven-Johnson syndromeand toxic epidermal necrolysis. Other CAEs include drug reactionwith eosinophiliaand systemic symptoms,Sweet′s syndrome,alopecia,Grover′s disease, and paraneoplastic syndrome. This paper reviews the treatment of cutaneous adverse events associated with ICPIs.

Intraoperative radiotherapy for soft tissue sarcoma / 医学研究生学报

Soft tissue sarcoma ( STS) , which is mostly found in extremities and retroperitoneum, is a malignant tumor of the connective tissue with the low incidence ( 1% of all malignant tumors) and various kinds of histopathological types. Intraoperative radio-therapy ( IORT) can improve the therapeutic effects of STS and to reserve the functions of the related organs, holding the apparent ad-vantage in local control rate of the tumor. IORT may cause toxicity, such as wound infections, limb ischemic necrosis and fibrosis. However, with the gradual development of IORT equipment, incidence rate of toxicity may be further reduced. This paper reviews the history, indications and advantages, clinical efficacy and adverse effect of IORT in STS.

Research advances in postoperative concurrent chemoradiotherapy(CCRT)for high-risk early stage cervical cancer / 中华放射肿瘤学杂志

Cervical cancer is one of the most common gynecologic malignancy,ranking fourth in new cases and deaths in 2012.High-risk early stage cervical cancer after operative need adjuvant treatment.Compared with postoperative radiotherapy alone,CCRT can reduce the pelvic recurrence rates and improve survival rates. And CCRT can extend median survival time and survival rates than sequential CRT after operative. CCRT plus consolidation chemotherapy may play a potential role in further improving survival outcomes for high-risk early stage cervical cancer patients compared with CCRT alone. Retrospective studies show that CCRT had equivalent effects with postoperative chemotherapy alone,but further research is needed. Factors influencing the efficacy of postoperative CCRT include chemotherapy regimens,radiotherapy technology,the interval time between surgery and CCRT,multiple pelvic lymph node metastasis and number of pelvic lymph node dissection. Toxicities mainly include hematologic and gastrointestinal toxicity. Hematologic toxicity is the most common. The incidence of toxicity can be reduced by improving radiotherapy techniques.

Research advances in gold nanoparticle radiosensitization in radiotherapy for cancer / 中华放射肿瘤学杂志

Gold nanoparticles ( AuNPs) have been widely used in biomedicine due to their unique physical and chemical properties as well as good biocompatibility. Current research in this field has been focused on AuNP radiosensitization in radiotherapy for cancer. Extensive studies in vivo and in vitro have showed the radiosensitization effect of AuNPs. However, the mechanism of radiosensitization by AuNPs still requires further studies. Right now, the radiation?insensitive phase ( G0+G1 phase) to radiation?sensitive phase ( G2+M phase ) transition of tumor cells by AuNPs is widely considered as the main cause of radiosensitization. There are many influencing factors for AuNP radiosensitization such as particle size, surface modification, microscopic distribution, radiation energy, radiation dose, and type of tumor cells. Moreover, safety should also be taken into account in AuNP radiosensitization. Clinical trials of AuNPs have been carried out right now. More studies on AuNP radiosensitization are needed to achieve real clinical transformation.