Investigation and analysis of daily diet and living habits of Hashimoto's thyroiditis patients / 中华地方病学杂志

Objective:To investigate the daily diet and living habits of Hashimoto's thyroiditis (HT) patients, and to explore the influencing factors of HT.Methods:The patients admitted to the Thyroid Surgery Clinic of Cancer Hospital Affiliated to Harbin Medical University from March to December 2021 were selected as the investigation subjects and were divided into observation group (106 patients with HT) and control group (63 healthy people). Questionnaire was used to collect the information of daily diet and living habits of the two groups, and physical examination was used to collect the information of height and weight. The levels of serum thyroid function indicators thyroid stimulating hormone (TSH), free triiodothyronine (FT 3) and free thyroxin (FT 4) were tested by automatic chemiluminescence immunoassay, and the comparison and analysis were conducted between the two groups. Multivariate logistic regression was used to analyze the influencing factors of HT. Results:The results of univariate analysis showed that there were significant differences in sex ratio and serum TSH levels between the two groups ( P < 0.05); the proportion of people in observation group who slept for less than 6 hours per day, frequently looked at their mobile phones, ate fried food ≥1 time per week, and ate meat ≥1 kg per week was higher than that in control group; however, the proportion of people in observation group who drank tea ≥1 time per week, smoked ≥1 time per week, had a salty daily taste, ate nuts ≥1 time per week, and ate vegetables ≥1 kg per week was lower than that in control group, and the differences were statistically significant ( P < 0.05). The results of multivariate logistic regression analysis showed that female, slept duration < 6 hours/day, weekly meat consumption ≥1 kg, and elevated serum TSH levels were risk factors for the onset of HT [odds ratios ( OR) = 3.37, 4.11, 2.48, 1.14, and 95% confidence intervals ( CI): 1.08 - 10.55, 1.46 - 11.59, 1.00 - 6.51, 1.00 - 1.30]; eating ≥1 kg of vegetables per week was a protective factor for the onset of HT ( OR = 0.36, 95% CI: 0.17 - 0.79). Conclusion:Female, poor diet and lifestyle habits are risk factors for the onset of HT.

Effects of flattening filter on dosimetry in fractionated stereotactic radiotherapy for brain metastases / 中国辐射卫生

@#<b>Objective</b> To investigate the dosimetric differences between volumetric modulated arc therapy (VMAT) with a flattening filter (FF) and flattening filter-free (FFF) VMAT in fractionated stereotactic radiotherapy for brain metastases. <b>Methods</b> Seventeen patients with brain metastases were divided into FF-VMAT group (VMAT plans with the FF mode) and FFF-VMAT group (VMAT plans with the FFF mode). The two groups were compared in terms of target volume dose parameters (<i>D</i>_98%, <i>D</i>_2% and <i>D</i>_mean), the conformal index (<i>CI</i>), the gradient index (<i>GI</i>), the gradient, normal brain tissue dose parameters (<i>V</i>_5Gy, <i>V</i>_10Gy, <i>V</i>_12Gy and <i>D</i>_mean), monitor units, and beam-on time. <b>Results</b> Compared with the FF-VMAT group, the FFF-VMAT group had significantly lower <i>GI</i> (3.33 ± 0.37 <i>vs</i> 3.27 ± 0.35, <i>P</i> = 0.001), a significantly lower gradient [(0.85 ± 0.20) cm <i>vs</i> (0.84 ± 0.19) cm, <i>P</i> = 0.002], a significantly shorter beam-on time [(177.05 ± 62.68) s <i>vs</i> (142.71 ± 34.59) s, <i>P</i> = 0.001], and significantly higher <i>D</i>_2% [(65.69 ± 2.15) Gy <i>vs</i> (66.99 ± 2.03) Gy, <i>P</i> = 0.001] and <i>D</i>_mean [(58.77 ± 1.60) Gy <i>vs</i> (59.95 ± 1.43) Gy, <i>P</i> <0.001]. There were no significant differences in the <i>CI</i>, the<i> D</i>_98%of the target volume, the <i>V</i>_5Gy, <i>V</i>_10Gy, <i>V</i>_12Gy and <i>D</i>_mean of the normal brain tissue, and monitor units between FFF-VMAT and FF-VMAT. <b>Conclusion</b> FFF-VMAT can better protect the normal tissue around the target volume, reduce the beam-on time, and improve treatment efficiency.

Effect of phantoms with different cavity thickness on dose verificationupper esophageal cancer / 中国辐射卫生

Objective To investigate the dose calculation accuracy of two algorithms in Monaco TPS for self-made phantoms with different cavity thickness, and analyze the influence of phantoms with different cavity thickness on dose verification of upper esophageal cancer. Methods The phantoms with different cavity thickness were placed on the simulated CT positioning machine to scan and acquire images. In Monaco TPS, the irradiation fields with energy of 6 MV, 100 MU and different square field sizes were added to the acquired images. The dose of the cavity of the ionization chamber was calculated by two algorithms, and measured on the accelerator by dosimeter under the same conditions. At the same time, 20 patients with upper esophageal cancer who received dynamic intensity modulation in fixed field were randomly selected and included in the study, and two algorithms were used for dose verification on phantoms with different cavity thickness. The results were statistically analyzed by SPSS 22.0 software. Results The maximum deviations between the calculated values and the measured values were 0.66% and −1.8%, in the calculation of phantoms with different cavity thickness by algorithms of Monte Carlo and Pencil Beam. In Monte Carlo algorithm, the result of RD pair t test is P > 0.05. Paired t test of AD (0 mm, 10 mm), (5 mm, 10 mm) and (10 mm, 20 mm) groups showed no significant difference (P < 0.05). The maximum deviation was 1.1%, and the rest groups were not statisticely significant (P > 0.05); In Pencil Beam algorithm the t test results of RD (0 mm, 20 mm) and (5 mm, 20 mm) pairs were (P < 0.05), the maximum deviation was 0.58%, and the rest groups were (P > 0.05). In AD group, (P < 0.05), the maximum deviation was 2.78%; The paired t test between the two algorithms was (P < 0.05), and the maximum deviations in RD and AD groups were 2.49% and 4.14%, respectively. Conclusion Monte Carlo algorithm has accurate calculation and high gamma pass rate of dose verification, and there is no clinical difference in gamma pass rate of dose verification among phantoms with different cavity thickness, pencil Beam algorithm is not recommended in cavity phantom calculation.

Dosimetric analysis of intensity-modulated radiotherapy in cervical carcinoma / 肿瘤研究与临床

Objective To compare the dosimetric difference on organ at risk (OAR) in intensitymodulated radiotherapy (IMRT) with three-dimensional conformal radiotherapy (3D-CRT) in treatment with cervical carcinoma. Methods 36 cases of cervical cancer patients accepted radiotherapy both on IMRT and 3D-CRT in the same time,clinical target volume (CTV) focused on primary tumor and its lymphatic drainage area.Lymphatic drainage area was determined as follows:1.0 cm extension were added to the margin of pelvic vessels,the obturator lymph nodes region was extended by 1.8 cm from the pelvis inner margin.CTV does not include pelvic tissue. Data of dose distribution and irradiation volume of OAR on the basis of distributing on 45 Gy and 50 Gy were analyzed individually. The margins of planning target volume (PTV) was obtained based on CTV margins by which added 1.0 cm extension in inferior and superior directions,0.7 cm were added in all other directions. Results With the comparison of variety on irradiation volume of organs at risk (OAR) by DVH in both groups,underlying the treatment dose 45 Gy,the individual volume of D30,D40 and D45 were all lesser in IMRT plan than that of 3D-CRT plan. Even on the dose 50 Gy at pelvic wall lymph nodes regions,the volume of OAR was lesser than that in 3D-CRT plan.Conclusion In the radiotherapy of cervical cancer,IMRT should have improved protections for tumor surrounding OAR which has domestic superiority in clinical application.

Efficacy analysis on simplified intensity-modulated radiotherapy with high or conventional dose and concurrent chemotherapy for patients with N1 esophageal carcinoma / 中华放射医学与防护杂志

Objective To investigate the feasibility of simplified intensity-modulated radiotherapy (sIMRT) and concurrent chemotherapy against neck and upper thoracic esophageal carcinoma with lymph node metastasis.Methods sIMRT plans were designed for 44 patients of neck and upper thoracic esophageal carcinoma with lymph node metastasis, 20 of which underwent high dose sIMRT (hsIMRT group) and 24 underwent conventional dose sIM RT (csIMRT group).Three target volumes were defined:PGTVnd, target volume of lymph node lesion, irradiated to 68.1 Gy ( 2.27 Gy × 30 fractions ) for the hsIMRT group, and 60 Gy (2.0 Gy ×30 fractions) the csIMRT group; PTV1, the target volume of primary lesion, to be irradiate to 63.9 Gy (2.13 Gy × 30 fractions) for the hsIMRT group and 60 Gy (2.0 Gy × 30fractions) for the csIMRT group; PTV2 , the prophylacticly irradiated volume, to be irradiated to 54 Gy (1.8 Gy ×30) for both groups.The sIMRT plan included 5 equiangular coplanar beams.All patients received DDP + 5-FU regimen concurrently with radiotherapy at 1 -5 d and 29- 33 d, respectively.Chemotherapy was repeated for two cycles 28 days after the radiotherapy was finished.Results The treatment was completed for all patients within 6 weeks.During the treatment only one patient with grade 3 acute bronchitis was observed in the hsIMRT group.The complete response (CR) rate for the lymph node lesion of the hsIMRT group was 75% ( 15/20 ), significantly higher than that of the csIMRT group [45.8% ( 11/24), x2 = 3.84, P ＜ 0.05].The 1-, 2-, and 3-year progression-free survival rates of the hsIMRT group were 60%, 40%, and 25% , respectively,all significantly higher than those of the csIMRT group (41.7%, 25%, and 8.3% respectively, x2 = 4.11,P ＜ 0.05).However, there were not significant differences in the total survival rate, and the CR and PR of the esophageal lesion between these 2 groups.The major toxicity observed was grade Ⅰ -Ⅱ leukoctyopenia.Conclusions sIMRT generates desirable dose distribution for neck and upper thoracic esophageal carcinoma.hsIMRT has a better short-term efficacy than csIMRT.High dose radiotherapy toward metastatic lymph nodes helps increase progression-free survival.

Effects of postoperative 3-dimensional conformal radiotherapy on lymph node positive patients after radical resection of esophageal carcinoma / 中华放射医学与防护杂志

Objective To analyze the significance of postoperative radiotherapy for lymph node positive patients after radical resection of esophageal carcinoma.Methods Two hundred and sixty patients with esophageal squamous cell cancer,aged ≤70,with the performance status score of0 -1,who had undergone radical resection were divided into 2 equal groups:surgery alone group (Group A ) and surgery plus radiotherapy group (Group B).Group A was classified into 3 sub-groups:Group A1 (n =42)without lymph node involvement,Group A2 (n =43 ) with 1 to 3 involved lymph nodes,and Group A3(n =45) with ≥4 involved lymph nodes.Group B was classified into 3 sub-groups:Group B1 (n =43 )without lymph node involvement,Group B2 (n =44) with 1 to 3 involved lymph nodes,and Group B3(n =43 ) with ≥4 involved lymph nodes.The patients were followed up till death.Results The 1-,3-,and 5-year overall survival rates of Group A were 71.5％,35.4％ and 20％,respectively,all significantly lower than those in Group B (76.2％,48.5％ and 36.2％,respectively,x2 =7.822,P ＜0.05).The 1-,3-,and 5-year survival rates of Groups A1 were 83.3％,52.3％,and 38.1％,respectively,all not significantly different from those of Group B1 (81.3％,58.1％,and 46.5％,respectively,x2 =0.283,P ＞ 0.05 ).The 1-,3-,and 5-year survival rates of Groups A2 were 69.8％,34.9％,and 18.6％,respectively,all significantly lower than those of Group B2 (77.3％,47.7％,and 40.9％,respectively,x2 =4.188,P ＜ 0.05).The 1-,3-,and 5-year survival rates of Groups A3 were 62.2％,20％,and 4.4％,respectively,all significantly lower than those of Group B3 ( 69.8％,39.5％,and 20.9％,respectively,x2 =6.168,P ＜ 0.05).The 5-year metastatic lymph node rates of Groups A1 to A3 were 30.9％,53.4％,and 66.7％,respectively,all significantly higher than those of Groups B1 to B3 ( 11.6％,22.7％,and 30.2％,respectively,x2 =4.753,8.741,and 11.682,respectively,all P ＜0.05).The 5-year distant metastasis rates of Groups A1 to A3 were 11.9％,20.9％,and 31.1％,respectively,all not significantly different from those of Groups B1 to B3 (13.9％,20.4％,and 25.6％,respectively,x2 =0.079,0.003,and 0.203,respectively,all P ＞ 0.05 ).Conclusions Postoperative radiotherapy increases the survival rate of lymph node positive patients,but shows little efficacy on the lymph node negative patients.It reduces the occurrence of lymph node metastasis,even in the lymph node negative patients,and does not increase the morbidity of complications,especially that of anastomotic stenosis.The number of metastatic lymph node is one of the important factors affecting the survival of esophageal carcinoma.Distant metastasis increases along with the number of metastatic lymph nodes.

The Short-term clinical observation of SIB-IMRT in locally advanced nasopharyngeal carcinoma / 肿瘤研究与临床

Objective To evaluate the feasibility , toxicity and clinical efficacy of intensity-modulated radiotherapy using the simultaneous integrated boost (SIB- IMRT) and concurrent chemotherapy for advanced nasopharyngeal carcinoma. Methods Thirty nsopharyngeal carcinoma were treated with full course IMRT including nasopharynx and full neck to supraclavicle. The radiotherapy dosage is 68 Gy to the target. Concurrent chemotherapy was given, and the regimen was DDP 40 mg/m2/weekly.Results The mean dose of covering gross tumor volume(PGTV) (D95) in the nasopharynx was 70.48 Gy, and the mean volume of PGTV1 receiving the 95 % dose(V95) was 98. 46 %. The mean dose of PGTV1, PGTV2, PCTV1 and PCTV2 in the targets were 70.8 Gy, 66.4 Gy, 62.3 Gy and 54.8 Gy. According to the evaluation, the acute skin,mucositis and salivary toxicity with grade Ⅲ in those patients were 3.3 %, 10 %, 6.6 %. The patients developed different blood toxicity, but didn't affect their treatment. The median follow-up time was 6.5 months, and disease free survival rate was 100 %. Conclusion SIB-IMRT yields well dose distribution and acceptable toxicity in advanced stage nasopharyngeal carcinoma. The preliminary clinical result is encouraging.