Effects of hormone receptor changes on endocrine therapy with breast cancer before and after neoadjuvant chemotherapy / 中国现代普通外科进展

Objective:To evaluate the impact of change in the hormone receptor (HR) status on the long-term outcomes of breast cancer patients treated with neoadjuvant chemotherapy (NAC).Methods:There were 215 patients for the HR status of their lesions before and after NAC.After surgery,59 cases were confirmed to have achieved complete remission of pathology,The expression of hormo ne receptors was not consistent in 63 patients before and after neoadjuvant chemotherapy.63 patients were divided into two groups,Group A:39 patients received standard endocrine therapy for 5 years after surgery and chemotherapy;Group B:24 patients were not treated with standard endocrine therapy after surgery and chemotherapy.Conclusions:The 3-year DFS rates were 77.4％ and 54.2％ in Group A and Group B patients,respectively,There was not statistical significancebetween the two groups.The 5-year overall survival rate for Group A patients was higher than that of Group B patients(74.3％ vs 45.8％,P=0.028),The difference was statistically significant.Conclusions:This study revealed that breast cancer patients with HR altered after NAC still benefit from standard endocrine therapy.

The protection of Xihuang Capsules against acute radiation-induced oral mucositis and its mechanisms / 中成药

AIM To explore the radioprotective function of Xihuang Capsules (Bovis Calculus artijactus,Moschus,Olibanum,Myrrha) in patients with acute radiation-induced oral mucositis and its mechanisms.METHODS Eighty patients with nasopharyngeal carcinoma undergone radiotherapy were randomized into two groups:treatment group (radiation plus Xihuang Capsules) and control group (radiation alone).The comparison of two groups in the onset and the tolerated dose of mucositis was made according to the acute radiation injury classification standard.The levels of TNF-α and IL-6 in saliva were detected by ELISA.RESULTS After the treatment with Xihuang Capsules,the onset of oral mucositis delayed significantly and the tolerated dose elevated markedly comparing with the control group (t =2.180,12.930,P ＜ 0.05).The morbidity rate of Ⅲ-N-degree of oral mucositis in the treatment group was lower than that of the control group at the dosage of 40 Gy and 70 Gy,respectively (Z =3.661,4.270,P ＜0.01).Furthermore,there was no difference in the levels of TNF-α and IL-6 in the pre-treatment in the two groups (t =1.010,1.469,P ＞ 0.05).With the increase in radiant dose,the levels of TNF-α and IL-6 in the two groups both elevated dramatically,and peaked at the dose of 40 Gy,but both levels in the treatment group were lower than those of the control group (t =8.305,6.069,P ＜ 0.05).When DT =70 Gy,the levels of TNF-α and IL-6 were lower than pre-radiation,and the levels of TNF-α and IL-6 in the treatment group were lower than those in the radiation alone group (t =3.835,2.488,P ＜ 0.05).CONCLUSION Xihuang Capsules can delay and reduce acute radiation-induced oral mucositis and improve radiation tolerated dose,so it may involve the release of TNF-oα and IL-6 in saliva.

Measurement of morphological parameters of internal acousticmeatus using thin-section CT / 中华耳鼻咽喉头颈外科杂志

Objective@#This study aimed to measure the morphological parameters of the internal acoustic meatus(IAM) and its adjacent structures using temporal-bone thin-section CT(computed tomography).@*Methods@#CT images were obtained from 50 Chinese adult patients (25 males and 25 females, 100 sides) which had no visible lesion in the petrous part of the temporal bone and inner ear, the morphological parameters of all inner ear parts were sectionally measured on the specified plane using SPSS 22.0 software for statistical analysis.@*Results@#The integral morphological characteristics of the IAM were observed. These results revealed that anterior-posterior diameter of the internal acoustic poer(IAP)(CD) was (6.93±1.85)mm, the superior-inferior diameter of the IAP(EF) was (4.40±0.86)mm, the length of the IAM(AB) was (9.30±1.60)mm, the superior-inferior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (4.13±0.83)mm, the superior-inferior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (4.61±1.02)mm, the anterior-posterior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (6.62±1.92)mm, the anterior-posterior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (6.28±1.65)mm, the depth of transverse crest (superior wall) was (3.10±0.75)mm, the depth of transverse crest (interior wall)the was (1.46±0.59)mm, the distance from transverse crest vertex A to the superior wall of the IAM was (2.05±0.42)mm, the distance from transverse crest vertex A to the interior wall of the IAM was (2.93±0.41)mm, the thickness of the superior bone wall of the IAM (the intersection of inner 1/3 section and middle 1/3 section) was (4.45±1.34)mm, the thickness of the superior bone wall of the IAM (the intersection of middle 1/3 section and outer 1/3 section) was (4.32±1.12)mm, the thickness of the superior bone wall of the IAM (the intersection of outer 1/3 section and transverse crest vertex) was (4.37±1.28)mm, and the appearance ratio of the cells in the whole IAM superior wall was 32%.The whole IAM assumed the shape of short cylinder, inclining about 1 cm outward, with the upper-lower diameter and anterior-posterior diameter about 5 mm.@*Conclusion@#It is necessary for carrying out preoperative the temporal-bone thin-section CT to obtain the morphological parameters of the IAM, determine its basic morphology, and provide references to avoid damaging the other important structures during IAM surgeries.

Sudden deafness as the initial manifestation of chronic myelogenous leukemia: case report / 临床耳鼻咽喉头颈外科杂志

To study the pathogenesis of hearing loss in chronic myelogenous leukemia (CML). To report one case with CML whose first sign was sudden unilateral hearing loss. Sudden hearing loss in CML was presented with dramatic high white blood cell count in peripheral blood. Some cases of sudden hearing loss in CML may be improved or even cured by leukapheresis and intrathecal chemotherapy. The proposed pathogenesis for deafness in leukemia is due to hyperleukocytosis, hyperviscosity syndrome, leukemic infiltration and the inner ear hemorrhage. In treatment, clinicians should quickly reduce the number of white blood cells to lighten the tumor burden. Intrathecal injection of MTX and plasmapheresis is commonly used.

The study of mechanical movement displacement for three amorphous silicon electronic portal imaging devices / 中华放射肿瘤学杂志

Objective To study corrective method for displacement in the procedure of electronic portal imaging device (EPID)-based intensity-modulated radiotherapy dose valuation by studying the relative mechanical displacement of different vendor EPID (aS1000,Varian; aS500,Varian; iViewGT,Elekta).Methods A 5 cm × 5 cm field was set up to acquire portal images for three kinds of EPID,then a in house software was used to analysis the portal images.The relative displacement was acquired via analyzing a series of comparation between center positions of gantry angle ranging from 0° to 360° and gantry angle at 0°.Results In the lateral direction,the maximum relative displacement of EPID with aS1000,S500 and iViewGT were (-0.23 ±0.17) mm,(2.94±0.17) mm and (0.35 ±0.09) mm,respectively.In the longitude direction,the displacements were (-4.16 ± 0.20) mm,(-4.15 ± 0.25) mm and (-1.66 ±0.11) mm,respectively.As to longitude direction,the displacements could be well fitted with the usage of quadruplicate empiric function.Conclusions There is a significant difference at the aspect of relative displacement between different vendors EPID at different gantry angles.And the displacement in the longitude direction is obviously larger than in the lateral direction.The relative displacement should be corrected when applying EPID to the intensity-modulated radiotherapy dose verification at different gantry angles.

Comparative determination of absorbed doses for high-energy photon beam with different cylindrical chambers / 中华放射医学与防护杂志

Objective To study the difgerence between the IAEA code of practice TRS-Z77 and TRS-398 in the determination of the absorbed dose to water for high-energy photon beams using several cylindrical chambers. Methods For 6 different types of cylindrical chambers,the calibration factors ND,W,Q0 in terms of absorbed dose to water were calculated from the air exposure calibration factors N,,and were compared with the ND,W,Q0 measured in European standard laboratory. Accurate measurements were performed in Varian 6 MV photon beam using 6 cylindrical chambers according to TRS-277 and TRS-398.The beam quality correction factors kQ.Q0 as well as the water absorbed doses were compared.Results For the set of chambers,the difference between ND,W,Q0 computed from Nx and ND.-.Q0 obtained in European standard laboratory was 0.13％ ～ 1.30％.The difference of beam quality correction factors for TRS-277 and TRS-398 was 0.09％ ～0.45％.The distinction of the water absorbed doses obtained according to the two different protocols was 0.27％ ～ 1.40％,and was primarily due to their different calibration factors.Conclusions The discrepancy in absorbed doses determined according to two protocols using different cylindrical chambers is clinically acceptable.However,TRS-398 allows a more convenient localization of chambers,provides a more simple formulation,and offers the reduced uncertainty in the dosimetry of radiotherapy beams.

A clinical test and application research of IMRT dose verification system based on patient' s anatomical structure and on-line dosimetry / 中华放射肿瘤学杂志

ObjectiveTo test a three-dimensional dose verification system,which reconstructing dose to anatomy based on modeling and online measurements ( RDBMOM ),and to evaluate the accuracy and feasibility of its application in clinical intensity-modulated radiotherapy (IMRT) quality assurance.Methods Phantom plans of regular and irregular fields were selected for the testing.All test plans were implemented and the dose distributions were measured using the thimble ion-chamber and two-dimensional ion-chamber array,the accuracy of RDBMOM were then evaluated by comparing the corresponding results.Two practical treated nasopharyngeal carcinoma IMRT plans were verified with RDBMOM and the clinic significancy were valued.ResultsCompared with measurements of the thimble ion-chamber,deviations of RDBMOM were within 1％ in all tested cases except small field of 3 cm ×3 cm.The largest deviation of reconstructed dose in IMRT cases was 2.12％.The dose profile reconstructed by RDBMOM coincided with the measurement using two-dimensional ion-chamber array.The γ rates (3％/3 mm) were 94.56％ - 100％.The RDBMOM verification of IMRT cases shown that the γ rate ＞ 99％ in total and ＞ 98％ in planning target volume,deviation in D95 ＜0.4％,but the largest deviations in mean dose of the parotids and lens were 2.97％ and 59.58％ respectively.ConclusionsAccuracy of the tested system satisfies the demand of IMRT dose verification.RDBMOM is able to provide information of volumetric dosimctry and anatomical location of dose error,which is benefit for evaluating the clinical value of verification results.

The study of two-dimensional dosimetric verifications of volumetric intensity-modulated arc therapy based on electronic portal imaging devices / 中华放射肿瘤学杂志

Objective To develop an accurate 2D dose reconstruction model using electronic portal imaging device (EPID).2D dosimetric verifications of volumetric intensity-modulated arc therapy (VIMAT)were done using the model.And the results were compared to other dosimeters.Methods The EPID-based dose reconstruction model was using convolve,deconvolve and correction function.The dose profiles which were obtained by the ion chamber were used to determine the model parameters.A total of 12 VIMAT plans for the treatment of anatomical sites of various complexities were chosen.The results obtained from EPID were compared to other dosimeters and treatment planning system (TPS).The ion chamber was used to measure the central point absolute doses.Other dosimeters were used to measure the plane dose distributions.All dosimeters measured the dose at 10 cm depth.The results were analyzed using γevaluation method.Results Regarding absolute central point doses,the ion chamber results were within 1.5％ of the EPID results.For the comparison to Seven29 and Matrixx,the average γ pass rates with 2％and 2 mm criteria were 98.9％ and 99.8％ respectively.For the dose distributions measured by EPID and calculated by TPS,the γ pass rates with 3％ and 3 mm criteria were 99.9％.Conclusions The presented results which were obtained from the comparison of measured and calculated doses show the reliability of our EPID-based dose reconstruction model.With the model,EPID can be a reliable and fast tool for IMRT plan dosimetric verification.The model expanded to the 3D dosimetric verification in the uniform phantom will be considered as the next work.

The diagnosis and treatment value of fibroptic ductoscopy in non-malignant mammary lesion / 国际外科学杂志

Objective To evaluate the clinical value of fiberoptic ductoscopy in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia. Methods From November 2005 to March 2008, fiberoptic ductoscopy were performed in 120 women with nipple discharge. The duct of 95 cases as non-malignant lesion were insufflated and perfusioned with entamycin and dexamethasone. Results Ninty-five of 120 cases were non-malignant disease,which contained one side 81 and two sides 14; the discharge was bloody,ivory, stramineous in 21, 17, 57 patinents, respectively; and the dignosis were 17 mammary duct ectasia, 53 galactophoritis, and 25 mammary duct ectasia with galactophoritis. Of the 95 cases, hich were intradutal insufflated and perfusioned with gentamycin and dexamethasone, the nipple discharge were decreased or disappeared in 81 cases, the effective rate was 85.3%. Conclusion Fiberoptic ductoscopy is a convenient,safe, accurate method in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia.