Research progress on bevacizumab in the treatment of radiation-induced brain necrosis / 中华放射肿瘤学杂志

Radiation-induced brain necrosis (RIBN) is a serious late and irreversible complication after radiation therapy for primary or secondary brain tumors as well as head and neck tumors, and there is no effective treatment. In recent years, bevacizumab has been increasingly applied in the treatment of RIBN, which has been proven to yield certain efficacy and improve patient survival. However, the optimal treatment timing and regimen have been controversial and lack of basic consensus. In this article, research progress on these issues was briefly reviewed.

The relationship of fractional exhaled nitric oxide with eosinophils and inflammatory factors in elderly patients with asthma-chronic obstructive pulmonary disease overlap syndrome / 中华老年医学杂志

Objective:To analyze the relationship of fractional exhaled nitric oxide(FeNO)levels with eosinophils(EOS), C-reactive protein(CRP), procalcitonin(PCT)levels in elderly patients with asthma-chronic obstructive pulmonary disease overlap(ACO).Methods:A retrospective study was conducted.According to the inclusion criteria, 60 elderly patients with ACO admitted in Fujian Geriatric Hospital from May 2016 to May 2019 were enrolled in the ACO group.During the same period, 60 patients with bronchial asthma were included in the asthma group, 60 patients with chronic obstructive pulmonary disease(COPD)were recruited in the COPD group, and 60 people taking health examination were included in the health group.Levels of FeNO, EOS, CRP and PCT were detected and compared between the groups.Correlations of FeNO levels with EOS and inflammatory factors were analyzed by the Spearman correlation.Results:The group with asthma alone showed the highest levels of FeNO, followed by the ACO group, the COPD group and the healthy group( F=970.235, P=0.000). The ACO group had the highest levels of EOS, CRP and PCT, followed by the COPD group, the asthma group and the healthy group( F=103.74, 76.648 and 57.042, P=0.000). Spearman bivariate correlation analysis showed that FeNO levels were positively correlated with levels of EOS, CRP and PCT in the asthma, COPD and ACO groups(the asthma group: r=0.646, 0.326 and 0.497, P=0.000, 0.014 and 0.000; the COPD group: r=0.398, 0.613 and 0.432, P=0.009, 0.000 and 0.001 the ACO group: r=0.654, 0.573 and 0.516, P=0.000, 0.000 and 0.000). Conclusions:High levels of FeNO are found in elderly patients with ACO.Levels of FeNO are positively correlated with EOS, CRP and PCT levels in peripheral blood, and can be used as a sensitive index for airway hyperinflammatory responses.

The clinical significance of MGMT promoter methylation in the treatment and progno-sis of glioma patients / 中国肿瘤临床

Adjuvant temozolomide-based chemotherapy has become the standard of care for most postoperative glioma patients. However, a large proportion of these patients do not respond to temozolomide. DNA repair enzyme O6-methylguanine-DNA methyl-transferase (MGMT) promoter methylation has emerged as an important molecular marker in patients with gliomas. It is associated with prognosis and resistance to alkylated drugs such as temozolomide. MGMT promoter methylation is the key mechanism of MGMT gene silencing, thereby inhibiting DNA repair and increasing the sensitivity of chemotherapy. We reviewed current data on the prog-nostic and predictive relevance of MGMT testing and clinical trials, summarized the clinical application of MGMT promoter methyla-tion, in order to provide reference for the individualized treatment of glioma patients.

Preliminary study of the relationship between the expression of NRAGE and the therapeutic effect of radiotherapy in patients with esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective@#To detect the expression of NRAGE protein in esophageal squamous cell carcinoma and investigate the relationship between NRAGE and therapeutic effect of radiotherapy.@*Methods@#The expression level of NRAGE in 44 patients with esophageal squamous cell carcinoma was evaluated by immunohistochemistry and statistically analyzed along with clinical data by using multivariate analysis using Cox regression model.@*Results@#The overall expression level of NRAGE protein in esophageal squamous cell carcinoma (P=0.025) and the expression level of NRAGE nuclear protein (P=0.008) were negatively correlated with short-term efficacy. In terms of the overall expression level of NRAGE protein, the 3-year survival rates in the strongly positive group and the positive weakly positive group were 16% and 36%(P=0.198). As for the expression of NRAGE nuclear protein, the 3-year survival rates in the strongly positive group and the positive+ weakly positive group were 0% and 41%(P<0.001). Multivariate analysis using Cox regression model demonstrated that as for the expression of NRAGE nuclear protein, the risk of death in the strongly positive group was significantly higher than those in the positive+ weakly positive group (P=0.002).@*Conclusion@#The overall expression level of NRAGE protein in the esophageal cancer is negatively correlated with the short-term efficacy of radiotherapy, whereas it is not correlated with long-term survival rate. The strongly positive expression level of NRAGE nuclear protein is negatively correlated with the short-term efficacy of radiotherapy and the long-term survival rate, prompting that NRAGE may be a molecular indicator for predicting radiation resistance and even the efficacy of radiotherapy for esophageal squamous cell carcinoma

Preliminary study of the relationship between the expression of NRAGE and the therapeutic effect of radiotherapy in patients with esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective To detect the expression of NRAGE protein in esophageal squamous cell carcinoma and investigate the relationship between NRAGE and therapeutic effect of radiotherapy.Methods The expression level of NRAGE in 44 patients with esophageal squamous cell carcinoma was evaluated by immunohistochemistry and statistically analyzed along with clinical data by using multivariate analysis using Cox regression model.Results The overall expression level of NRAGE protein in esophageal squamous cell carcinoma (P=0.025) and the expression level of NRAGE nuclear protein (P=0.008) were negatively correlated with short-term efficacy.In terms of the overall expression level of NRAGE protein,the 3-year survival rates in the strongly positive group and the positive weakly positive group were 16％ and 36％(P=0.198).As for the expression of NRAGE nuclear protein,the 3-year survival rates in the strongly positive group and the positive+ weakly positive group were 0％ and 41％(P＜0.001).Multivariate analysis using Cox regression model demonstrated that as for the expression of NRAGE nuclear protein,the risk of death in the strongly positive group was significantly higher than those in the positive+ weakly positive group (P=0.002).Conclusion The overall expression level of NRAGE protein in the esophageal cancer is negatively correlated with the short-term efficacy of radiotherapy,whereas it is not correlated with long-term survival rate.The strongly positive expression level of NRAGE nuclear protein is negatively correlated with the shortterm efficacy of radiotherapy and the long-term survival rate,prompting that NRAGE may be a molecular indicator for predicting radiation resistance and even the efficacy of radiotherapy for esophageal squamous cell carcinoma

Current status and research progress on diagnosis and treatment of choroid plexus carcinoma / 中华放射肿瘤学杂志

Choroid plexus carcinoma is a relatively rare primary intracranial malignant tumor which is derived from the choroid plexus epithelium.It is classified as World Health Organization (WHO) grade Ⅲ and mainly occurs in children.Currently,maximal surgical resection is still the main therapeutic strategy.The clinical efficacy of postoperative adjuvant therapies remains controversial.Recent studies have promoted that postoperative combination of radiotherapy and chemotherapy can enhance the clinical prognosis and prolong the survival time for choroid plexus carcinoma patients undergoing sub-radical resection.In this review,relevant articles published in the recent 15 years were retrieved to summarize the current status and research progress on the diagnosis and treatment of choroid plexus carcinoma.

Research progress on the relationship between the canonical Wnt signaling pathway and tumor radiation resistance / 中华放射医学与防护杂志

Radiotherapy is one of major cancer treatment methods.However,radiation resistance is an important reason to restrict the efficacy of radiotherapy and lead to treatment failure.In recent years,the relationship between the canonical Wnt signaling pathway and tumor radiation resistance has more and more attention of the scholars.This review summarized recent ten years findings concerning the canonical Wnt signaling pathway and tumor radiation resistance and tried to find some valuable rules or some internal relationships among different pathways by systemically analyzing.

Effects of subcellular localization of neurotrophin receptor p75 interacting MAGE homologue on the epithelial to mesenchymal transition and radioresistance of esophageal cancer cells / 中华放射医学与防护杂志

Objective To investigate the role of NRAGE subcellular localization in the EMT and radioresistance of esophageal cancer cells.Methods EMT model cells were established by the treatment of TE13 cells with TGF-β1.To verify the establishment of EMT model and the phenotype of EMT-like TE13R120 cells,EMT marker mRNA and protein were detected by Real-time PCR and Western blot,respectively.Real-time PCR was also used to detect the expression of NRAGE mRNA in three groups.Total NRAGE protein,cytoplasm protein and nuclear protein were measured by Western blot.Results It was found that TGF-β1 could induce morphological alterations of TE13 cells from epithelial to mesenchymal and change the expressions of EMT maker E-cadherin and vimentin (t =13.56,-232.84,P ＜ 0.05),indicating the successful establishment of EMT model cells.Similar expression trends of EMT makers were observed in TE13R120cells (t=15.84,-54.54,P＜0.05).NRAGE mRNA (t=-8.73,-5.62,P＜ 0.05) and total protein in both EMT model cells and TE13R120 cells were higher than that in TE13 cells,especially for the nuclear proteins.However,no differences in NRAGE cytoplasm protein expression were found among the three groups.In addition,there were also no difference of NRAGE mRNA (t =-0.88,P ＞0.05),cytoplasm and nuclear protein between TE13R120 cells and EMT model cells.Conclusions The radioresistant cell line TE13R120 has the EMT-like phenotype that may cause cell radioresistance by changing the subcelluar localization of NRAGE.

Target volume definition using 4DCT and dosimetric evaluation for esophageal cancer / 中华放射肿瘤学杂志

Objective To study the PTV by ng 4DCT and compare target,target displacement and dose distribution of 3D and 4D planning for thoracic middle or lower esophageal cancer,evaluate the clinical value of 4DCT in esophageal cancer radiotherapy.Methods From Jan to Dec 2012patients with primary esophageal cancer underwent 3DCT simulation scans first,then followed by 4DCT simulation scan.PTV and OARs were sketched in the ordinary 3DCT and 4DCT respectively.And designing two sets of radiotherapy plan for each patient:3D and 4D plan.We compare PTV,PTV displacement and OARs dosimetry's differences in the 3D plan and 4D plan.Using the paired t-test or Wilcoxon sign-rank test to compare the difference between the two sets of plans.Results The volume of PTV4D was larger than the PTV3D (195.19 cm3 vs.175.67 cm3,P =0.001) in all patients.The center displacement had only significantly difference (displacement was 0.25 cm,P =0.014) in left-right direction for 10 patients of thoracic middle esophageal cancer.The center displacement had no significantly different in the three direction for 9 patients of thoracic under esophageal cancer (P=0.722,0.307,0.208).The dose target area of V100,V95 and V90 in Plan3DC were significantly than those in Plan-3D for 19 patients of thoracic middle-lower esophageal cancer (88.62％ vs.95.69％,P=0.000;95.17％ vs.99.79％,P=0.001;97.19％ vs.99.99％,P=0.001).In 4D plan the lung V5,V20 and Dmean of heart were higher than that in 3D plan for all patients (39.49％vs.37.44％,P=0.016;19.93％ vs.18.87％,P=0.018 and 2607.74 cGy vs.2389.16 cGy,P=0.004).Conclusions 4DCT positioning technology can accuracy determine individualized expanding boundary by target area of radiotherapy for thoracic middle or lower esophageal cancer.The enlarging target volume increase the dose of radiotherapy for lung,and in the dose range in the 4D plan,but the increased dose of heart should be noted.

The radiation physics advantages of 4DCT on intensity-modulated radiotherapy of chest wall after radical mastectomy / 中华放射肿瘤学杂志

Objective To invesigate the influence of breathing motion on intensity-modulated radiotherapy (IMRT) of chest wall after radical mastectomy,and explore clinical value of accurately determined target volume.Methods A total of 17 radical mastectomy patients underwent 3DCT simulation scans sequentially followed by 4DCT simulation scans during free breathing.The targets and normal organs was determined based on CT images respectively.Three sets of radiotherapy plan were designed for each patient:plan 3D,plan 4D and plan 3D-A.The Plan 3D and plan 4D was designed based on 3D and 4D targets respectively.Plan 3D was copied to 4D target with the same isocenter coordinates.The dose distribution was calculated separately to evaluate the dose-volume histograms parameters for PTV,ipsilateral lung and heart,respectively.Two planning parameters was compared with paired t-test or Wilcoxon sign-rank test.Results The average volume of PTV4D was (10.35 ± 4.80) ％ larger than PTV3D (P =0.000).Compared with plan 3D,the V100,V95,V90,D95,D90,Dmin of plan 3D-A were reduced,that were (0.78 -18.0)％ (P=0.000),(0.01-3.90)％ (P=0.000),(0-2.12)％ (P=0.000),(13-222) cGy (P=0.000),(1-118) cGy (P=0.000),(6-1 910) cGy (P=0.000).However,the V20,V10,V5,Dmean of the ipsilateral lung and V30 of heart were same between 3D plan and 4D plan (P =0.288,0.407,0.435,0.758,0.575).Conclusions The respiratory motion may reduce the target dose and its coverage in chest wall treatments,so 4DCT plan could accurately define target volume without increasing the exposure dose of normal tissues.

The effect of Ulinastatin on coagulation function in patients with breast carcinoma during operation period / 中国医师杂志

Objective This trial was to observe the effect of Ulinastatin on coagulation functions in patients during operation period,and to investigate the protective mechanisms of Ulinastatin.Methods Forty patients were randomly divided into Ulinastatin group (Group U,n =20) and control group (Group C,n =20).Group U was infused intravenously ulinastatin 4000 U/kg (diluted with saline to 30 ml,20min losers) after anesthesia and before cutting skin,while Group C received the same volume of normal saline.All patients were phlebotomized 1 ml peripheral blood before administered (T0) and after 1 hour (T1),respectively.Coagulation activation time (SonACT),clot rate (CR) and platelet function (PF)were detected by sonoclot coagulation analyzer and platelet function analyzer.Results Compared with group C (controlled group),SonACT of Group U was prolonged significantly at T1 (P ＜ 0.05),and PF were increased at T1 (P ＜ 0.05) ; Compared with T0,SonACT and PF were increased at T1,respectively (P ＜ 0.01).Conclusions Ulinastatin can improve perioperative coagulation function and platelet function.It may reduce intraoperative micro-thrombosis syndrome and postoperative deep vein thrombosis.