A study of lung protection in intensity?modulated radiotherapy with split field and fixed jaw techniques for peripheral lung cancer with mediastinal lymph node metastasis / 中华放射肿瘤学杂志

Objective To retrospectively design an intensity?modulated radiotherapy ( IMRT) plan with split field and fixed jaw techniques for peripheral lung cancer with mediastinal lymph node metastasis, to compare dosimetric characteristics between the IMRT plans with fixed jaw and dynamic jaw, and to study lung protection by the plan with split field and fixed jaw. Methods Treatment plans were collected from 12 patients with peripheral lung cancer and mediastinal lymph node metastasis who were treated with IMRT in our hospital. All plans used the dynamic jaw technique. The plans with split field and fixed jaw were designed based on the identical computed tomography images and planning target volume ( PTV) . Each jaw position in split field depended on each separate PTV. The prescription dose was 60 Gy in 30 fractions. 95%PTV was planned to receive 100% of the prescription dose. Dosimetric parameters of PTV, conformity index ( CI) , heterogeneity index ( HI) , number of monitor units ( MUs) , and dose?volume values of the lung and heart were obtained from dose?volume histogram. Comparison between the two plans was made by paired t test. Results Both plans met clinical requirements. There were no significant differences in D2 , D98 , CI, or HI of PTV between the two plans ( all P>005) . Compared with the dynamic jaw plan, the fixed jaw plan had MUs increased by 15%?20%( P=0010) . The V5 , V10 , V20 , V30 , and mean dose for the whole lungs were significantly lower in the fixed jaw plan than in the dynamic jaw plan ( P=0000, 0000, 0000, 0002,0000) . The V5 , V20 , and mean dose for the healthy lung were also significantly lower in the fixed jaw plan than in the dynamic jaw plan ( P=0000,0017,0000) . There were no significant differences in dose?volume values for the spinal cord or heart between the two plans ( all P>005) . Conclusions IMRT with split field and fixed jaw is recommended for patients with peripheral lung cancer and mediastinal lymph node metastasis. The therapy to a certain extent reduces low?dose volume for the lung and the incidence of radiation?induced pneumonitis.

Efficacy and Health-Related Quality of Life for small cell lung cancer patients after prophylactic cranial irradiation / 中华放射医学与防护杂志

Objective To analyze the survival,brain metastases and health-related quality of life (HRQOL) for small cell lung cancer patients after prophylactic cranial irradiation(PCI).Methods From Aug 2007 to Apr 2011,42 small cell lung cancer patients were eligible for analysis.Overall survival rate was estimated by the Kaplan-Meier method.The HRQOL scores before and after PCI were compared by the nonparameter wilcoxon test.Results The median survival time from the start of PCI was 23 months(95％ CI,15.05-30.95),progression free survival time was 17 months (95％ CI,14.33-19.67),1-,2-and 3-year survival rates were 85.5％,45.8％ and 36.6％,respectively.The median time from PCI to brain metastases was 15 months(95％ CI,12.44-17.56),1-and 2-year brain metastases rates were 77.6％ and 54.1％.PCI had a little influence on HRQOL scales except for cognitive function.Conclusions For patients with limited stage small cell lung cancer who achieve complete or nearly complete remission after initial treatment as well as patients with extensive stage who respond to initial chemotherapy,PCI is effective in decreasing the rate of brain metastasis and improving survival,while the adverse effects is acceptable.There is no significant impact on HRQOL scales during short term.

Preliminary investigation of stereotactic body radiation therapy for medically inoperable stage Ⅰ / Ⅱ non-small cell lung cancer / 中华放射肿瘤学杂志

Objective To evaluate the therapeutic efficacy and treatment-related toxicity of stereotactic body radiation therapy(SBRT)in patients with medically inoperable stage Ⅰ/Ⅱ non-small cell lung cancer(NSCLC). Methods SBRT was applied to 30 patients, including clinically staged T1 ,T2(≤5cm)or T3(chest wall primary tumors only), N0, M0 ,biopsy-confirmed NSCLC. All patients were precluded from lobotomy because of physical condition or comorbidity. No patients developed tumors of any T-stage in the proximal zone. SBRT was performed with the total dose of 50 Gy to 70 Gy in 10 - 11 fractions during 12 - 15 days. prescription line was set onthe edge of the PTV. Results The follow-up rate was 100%. The number of patients who completed the 1-, and 2-year follow-up were 15, and 10, respectively. All 30 patients completed therapy as planned. The complete response(CR), partial response(PR)and stable disease(SD)rates were 37%, 53% and 3%, respectively. With a median follow-up of 16 months(range,4-36 months), Kaplan-Meier local control at 2 years was 94%. The 2-year overall survival was 84% and the 2-year cancer specific survival was 90%. Seven patients(23%)developed Grade 2 pneumonitis, no grade ＞ 2 acute or late lung toxicity was observed. No one developed chest wall pain. Conclusions It is feasible to deliver 50 Gy to 70 Gy of SBRT in 10 - 11 fractions for medically inoperable patients with stage Ⅰ / Ⅱ NSCLC. It was associated with low incidence of toxicities and provided sustained local tumor control.The preliminary investigation indicated the cancer specific survival probability of SBRT was high. It is necessary to perform similar investigation in a larger number of patients with long-term follow-up.

Detection of genomic abnormalities in chronic lymphocytic leukemia by fluorescence in situ hybridization / 中华检验医学杂志

Objective To investigate the value of panel fluorescence in situ hybridization (panel FISH)for detection of genomic aberrations in chronic lymphocytic leukemia(CLL). Methods Five types of fluorescein-labelled DNA probes including five sequence specific probes D13S25 for 13q14. 3, RB1, p53, ATM (11 q23)and centromeric probe for chromosome (CSP12) were used to perform fluorescence in situ hybridization assays in 17 patients with CLL. Its results were compared with that obtain by conventional cytogenetic (CC)examination. Results In 17 patients with CLL, CC examination showed that only one case (1/17) was found to have chromosomal abnormality that was simultaneous trisomies 3,8 and 18, whereas panel FISH assay showed that 10 cases (10/17) were found to have genomic aberrations including deletion of D13S25 in 4 cases,deletion of ATM in 2 cases,deletion of p53 in 1 case,deletion of D13S25 combined RB1 in 1 case and 1 case with a variety of abnormalities. Conclusions Panel FISH is a useful method for detection of genomic aberration in CLL If it is combined with CC,it can obviously enhance the detection rate of chromosomal abnormalities in CLL.

Prognostic value of WHO histological subtype and Masaoka clinical stage in postoperative radiotherapy for thymoma / 中华放射肿瘤学杂志

ween WHO histological subtype and Masaoka clinical stage, and their combination is valuable for guiding postoperative treatment in thymoma.

The comparison of concurrent chemoradiotherapy with sequential chemo-and radiotherapy for the treatment of patients with stage Ⅲ esophageal carcinoma / 中国癌症杂志

0.05).Conclusions:Concurrent chemoradiotherapy can be well tolerated even though the acute side-effects less than grade 2 were higher in concurrent chemoradiotherapy than other group.Immediate response was very encouraging in the concurrent group.There was no advantage in terms of survival rate in the concurrent group compared to the sequential group.