ABSTRACT
Objective:To investigate the dosimetry advantage of 3D-printed minimally invasive guided template used in local advanced cervical cancer intracavitary combined with interstitial radiotherapy.Methods:A total of 68 cases with locally advanced cervical cancer who were admitted to Hebei Cangzhou Hospital of intergrated traditional Chinese medicine and western medicine from May 2016 to August 2019 were selected. All the patients had eccentric tumor or large tumor (tumor diameter >5 cm) after radiotherapy. Intensity modulated radiotherapy was used for external radiotherapy, and intracavitary combined with interstitial radiotherapy was used for brachytherapy. The prescription dose of high-risk clinical target volume (HR-CTV) is 6 Gy/fraction, once a week, five fractions in total. Sixty-eight patients were randomly divided into two groups, 35 cases in the template group who received minimally invasive 3D printing guided template assisted intrauterine tube implantation and insertion needle implantation, and 33 patients in the free implantation group who received free hand intrauterine tube implantation and insertion needle implantation. The position and depth of the insertion needle were adjusted by CT-guidance, and the final CT image was transmitted to the Oncentra Brachy treatment planning system, then the target volume and organs at risk were delineated for planning and treatment.Results:A total of 340 brchytherapy plans were made, including 175 in the template group and 165 in the free implantation group. The D90 values of the HR-CTV and intermediate-risk clinical target volume (IR-CTV) in the template group were increased ( t=3.63, 2.45, P<0.05), and D2 cm3 values (dose of 2 cm 3 of organ at risk) of bladder, rectum and sigmoid colon were significantly decreased ( t=-2.81, -2.54, -2.33, P<0.05). At the same time, the average CT scanning times of each treatment in the template group was (1.78±0.53) times, the average duration of each treatment was (11.35±3.98) min, and the average number of needles used in each implant treatment was (5.21±1.37). The result of free implantation group was higher than that of the template group. The differences were statistically significant ( t=-2.26, -4.53, -3.21, P<0.05). Conclusions:For localized advanced cervical cancer patients with eccentric or large tumors, the 3D printed minimally invasive guided template for intracavitary and interstitial implantation has obvious dosimetry advantages, and the operation is simpler and the duration is shorter.
ABSTRACT
Objective@#To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application.@*Methods@#A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5.0 mg/kg repeated every 14 d and 7.5 mg/kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded.@*Results@#Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5.0 mg/kg group were increased by 31.66 points on average compared with those before treatment. The KPS scores of 7.5 mg/kg group were increased by 27.50 points on average compared with those before treatment. The volume of CRN lesions were decreased(46.0±9.4)%(t=6.57, P<0.05) and the volume of edema lesions decreased(68.9±8.9)%(t=3.32, P<0.05) in 5.0 mg/kg group. In 7.5 mg/kg group, these two parameters were reduced by(53.9±10.7)%(t=7.89, P<0.05 and (77.1±14.3)%(t=4.22, P<0.05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0.05). In this study, the incidence of adverse events in the 5.0 mg/kg group was similar to that in the 7.5 mg/kg group, with no significant difference(P>0.05).@*Conclusions@#Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5.0 mg/kg treatment regimen repeated every 14 d is similar to that of 7.5 mg/kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.
ABSTRACT
Objective To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application. Methods A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5. 0 mg/ kg repeated every 14 d and 7. 5 mg/ kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded. Results Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5. 0 mg/ kg group were increased by 31. 66 points on average compared with those before treatment. The KPS scores of 7. 5 mg/ kg group were increased by 27. 50 points on average compared with those before treatment. The volume of CRN lesions were decreased (46. 0±9. 4)％ (t = 6. 57, P<0. 05) and the volume of edema lesions decreased (68. 9±8. 9)％ (t= 3. 32, P<0. 05) in 5. 0 mg/ kg group. In 7. 5 mg/ kg group, these two parameters were reduced by (53. 9±10. 7)％ (t = 7. 89, P<0. 05 and (77. 1±14. 3)％ (t = 4. 22, P<0. 05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0. 05). In this study, the incidence of adverse events in the 5. 0 mg/ kg group was similar to that in the 7. 5 mg/ kg group, with no significant difference (P> 0. 05). Conclusions Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5. 0 mg/ kg treatment regimen repeated every 14 d is similar to that of 7. 5 mg/ kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.
ABSTRACT
QKI protein is a kind of STAR protein family and mainly contains three subtypes of QKI-5,QKI-6 and QKI-7. Early studies showed that QKI protein is closely related to the development of nerve myelin and embryo. With the development of molecular biology and the extensive application of gene technology,the effect of QKI protein on malignant tumors has received increas-ing attention. The studies of QKI protein from lung,gastric and prostate cancers have shown that it has the ability to inhibit tumor inva-sion,and may become a new target for the diagnosis and treatment of malignant tumors. Although significant progress has been made in the extensive research of QKI protein in malignant tumors,there are still many doubtful points that need to be answered. Thus,further research and exploration of QKI are needed in malignant tumor.
