ABSTRACT
Purpose: To analyze the effects of different bladder and rectal volumes on the dose of organ at risks (OARs) and primary tumors following uniform preparation procedure. Material and methods: In this retrospective study, a total of 60 patients with cervical cancer treated with external beam radiation therapy (EBRT) combined with chemotherapy and brachytherapy (BT) during 2019-2022 were included (300 insertions). Then, tandem-ovoid applicators were placed and computed tomography (CT) scanning was performed after each insertion. Delineation of OARs and clinical target volumes (CTVs) were done according to GEC-ESTRO group recommendations. Finally, doses of high-risk clinical target volume (HR-CTV) and OARs were obtained from dose volume histogram (DVH) automatically generated by BT treatment planning system. Results: Following a uniform preparation procedure, the median bladder volume of 68.36 cc (range, 29.9-235.68 cc) was in optimal agreement with the recommended bladder volume of ≤ 70 ml, which avoided more manipulation and possible risk of adverse events during general anesthesia. As the bladder filling volume increased, there was no corresponding increase in rectal, HR-CTV, and small bowel volumes, while the sigmoid colon volume decreased. The median rectal volume was 54.95 cc (range, 24.92-168.1 cc), and as the rectal volume increased, HR-CTV, sigmoid colon, and rectum volumes increased, and conversely, small bowel volume decreased. HR-CTV changes with volume affected the rectum, bladder, and HR-CTV, but not the sigmoid colon and small intestine. Conclusions: Following a uniform preparation procedure, the bladder and rectum can also be controlled to an optimal volume (B ≤ 70 cc, R ≈ 40 cc), which is related to the dose of the bladder, rectum, and sigmoid colon.
ABSTRACT
MicroRNA-145-5p downregulation has been shown to play important roles in the oncogenesis and progression of many cancer types including glioblastoma (GBM). However, the potential role of serum miR-145-5p in the diagnosis and prognosis of glioblastoma (GBM) remains poorly known. This study was designed to explore the clinical significance of serum miR-145-5p in patients with GBM. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was carried out to measure the serum levels of miR-145-5p in 117 GBM patients, 52 grade I/II glioma patients and 50 healthy volunteers. The associations between serum miR-145-5p level and the clinical variables as well as prognosis were analyzed. The bioinformatic analysis of the downstream targets of miR-145-5p was also performed. Compared to grade I/II glioma patients and healthy controls, serum miR-145-5p levels were significantly decreased in GBM patients. In addition, the receiver operating characteristic (ROC) analysis demonstrated that serum miR-145-5p might be a reliable diagnostic marker of GBM with an AUC of 0.895, combing with 84.6% sensitivity and 78.0% specificity. Low serum miR-145-5p level had significant correlation with aggressive clinicopathological parameters. Moreover, the Kaplan-Meier curve revealed that patients in the high serum miR-145-5p group survived significantly longer than those in the low serum miR-145-5p group. Multivariate analysis confirmed that serum miR-145-5p expression was an independent prognostic indicator for overall survival. The bioinformatic analysis revealed that many downstream genes and pathways that miR-145-5p regulated were closely associated with the initiation and development of cancer. Taken together, decreased serum miR-145-5p is a promising diagnostic and prognostic biomarker for GBM.
