Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2012 Vol.21 Issue.5 Published 2012-09-10

	Head and Neck Tumors Abdominal Tumors Review Thoracic Tumors Physics·Biology·Technique

Head and Neck Tumors

	407	A prospective, multicentric clinical study of intensity modulated radiotherapy in the treatment of nasopharyngeal carcinoma
		WU Fang^*, WANG Ren-sheng, FENG Guo-sheng, LI Gui-sheng, LIU Mei-lian, YAN Hao-lin, ZHU Jin-xian, ZHANG Yong, HU Kai
		Objective To evaluate the treatment efficacy, toxicities and prognostic factors ofnasopharyngeal carcinoma (NPC) treated with intensity modulated radiation oncology (IMRT).MethodsBetween January 2006 and August 2008, 300 patients with pathologically diagnosed NPC from 6 center received IMRT. The number of patients with stageⅠ, Ⅱ, Ⅲ and Ⅳ_a+b disease (UICC/AJCC 2002 staging system) were 6, 45,141 and 108, respectively. The prescription doses were as follows:70－74 Gy/30f to planning target volume of primary nasopharynx tumor (PTV_nx), 68－70 Gy/30f to planning target volume of positive lymphnode (ptv_nd), 60－64 Gy/30f to higher risk region (PTV₁), 50－54 Gy/30f to lower risk region (PTV₂). Patients with stage Ⅲ and Ⅳ_a+b disease also received cisplatin-based chemotherapy. Cox method was used for Multivariate analysis. Results The follow-up rate was 99.7%. The 4-year rate of local control, regional control, metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0%, 95.5%, 87.4%, 80.8%, 86.1%, respectively. Mucositis was the most severe acute toxicity, with 18.0% grade 1, 48.7% grade 2, 33.3% grade 3. No patient suffered from grade 4 mucositis. Xerostomia was the most common late toxicity, with 12.0% grade 0, 75.7% grade 1, 12.3% grade 2. No grade 3－4 xerostomia was observed. There were 18,15 and 42 patients failed in local, regional and distant metastasis, respectively. Multivariate analysis showed that N stage was the only prognostic factor for OS (χ²=5.17,P=0.023),DMFS (χ²=6.91,P=0.009) and DFS (χ²=8.15,P=0.004) in these patients. Conclusions IMRT can improve the treatment efficacy of NPC. The acute and late toxicities were tolerated. Distant metastasis becomes the main treatment failure. N stage is a significant prognostic factors.
		2012 Vol. 21 (5): 407-410 [Abstract] ( 4803 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	412	Phase Ⅱ study of gemcitabine plus cisplatin chemotherapy combined with intensity modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma
		OU Dan, HE Xia-yun, HU Chao-su, YING Hong-mei, ZHU Guo-pei
		Objective To evaluate the efficacy and toxicity of gemcitabine plus cisplatin (GP) chemotherapy combined with intensity-modulated radiation therapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (NPC). Methods 71 patients (Stage Ⅲ:41, Stage Ⅳ_A:30) with locoregionally advanced NPC were entered this study. Neoadjuvant chemotherapy was consisted of cisplatin 25 mg/m² intravenously on d1-3 and gemcitabine 1000 mg/m² in 30 minutes intravenous infusion on days 1 and 8, every 3 weeks for 2 cycles. Adjuvant chemotherapy consisted of 2 cycles of the same GP regimen was given at 28 days after the end of radiotherapy. The prescription doses was 66.0－70.4 Gy to the gross tumor volume, 66 Gy to positive neck nodes, 60 Gy to the high-risk clinical target volume, 54 Gy to the low-risk clinical target volume. Results The overall response rate to neoadjuvant chemotherapy was 91.2%,acute toxicity was mainly grade 1－2 myleosuppression. All patients completed IMRT. The median follow-up duration was 38 months. The 3-year nasopharyngeal local control, regional control, distant metastasis-free survival rate and overall survival rate were 93%, 99%, 91%, 90%, respectively. Severe late toxicities included grade 3 trismus in 1 patient, grade 3 hearing impairment in 2 patients and cranial nerve palsy in 2 patients, respectively. No grade 4 late toxicities were observed. Conclusions The combination of GP chemotherapy and IMRT for locoregionally advanced nasopharyngeal carcinoma is well-tolerated, convenient, effective, and warrants further studies of more proper cycles of GP regimen.
		2012 Vol. 21 (5): 412-414 [Abstract] ( 5726 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	417	Study on delineation of tumor volume of primary locally advanced nasopharyngeal carcinoma after induction chemotherapy
		LONG Jin-hua^*, DONG Shi, JIN Feng, WU Wei-li, GAN Jia-ying, CHEN Hai-xia, LI Yuan-yuan, GONG Xiu-yun
		Objective To investigate the delineation of gross tumor volume (GTV) in locally advanced nasopharyngeal carcinoma (LANC) according to imageological changes before and after induction chemotherapy (IC) in order to decrease high dose area and protect normal tissue better. Methods Between Mar 2010 to Jan 2011, 11 patients with LANC were enrolled and treated with TPF regimen followed by intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy, target volumes were delineated based on fused CT imaging before and after IC following project determination. Tumor target volumes after and before IC were respectively delineated according to imaging tumor residues and were overlaid by CTV_nx in order to ensure radical doses for the imaging tumor volume before IC, the resulting differences of tumor target volumes of IC before and after were measured and analyzed by paired t-test. Results Before and after IC, the average volumes of GTV_nx were respectively 44.72 cm³ and 28.87(t=3.89,P=0.003), the average volumes of GTV_nd were respectively 32.76 cm³ and 19.82 cm³(t=2.47,P=0.033), the volumes of maximum dose area in brainstem and spinal cord as well as eyeball decreased (t=2.93－4.59,all P<0.05). Conclusions LANC treated by 3 cycle TPF regimen followed by IMRT with concurrent chemotherapy showes significant shrinkage of tumor volume. The volume of high dose region which caused by normally recovered tissues were decreased by re-delineation of target volume in brainstem and spinal cord as well as eyeball of CT images after IC.
		2012 Vol. 21 (5): 417-419 [Abstract] ( 4433 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

	411


		2012 Vol. 21 (5): 411-411 [Abstract] ( 3081 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	420


		2012 Vol. 21 (5): 420-423 [Abstract] ( 3068 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	435


		2012 Vol. 21 (5): 435-435 [Abstract] ( 5272 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	455	Investigation of the feasibility of using kilovoltage cone-beam CT for accuracy dose calculation in esophageal cancer radiotherapy
		WANG Jun-qi^*, XU Zhi-yong, HU Wei-gang, Wu Zhao-xia, LI Long-gen, YANG Huan-jun
		Objective To investigate the dose calculation accuracy and feasibility of using kilovoltage cone-beam CT (KVCBCT) for esophageal cancer radiotherapy. Methods Hounsfield unit (HU) values and profile along the horizontal line of Catphan600 phantom in KVCBCT images acquired on Trilogy linear accelerator were compared to those in the planning CT. The KVCBCT value-density calibration curve was established. The intensity modulated radiotherapy plans were created on the planning CT images and copied to KVCBCT images．The dose distribution was recalculated by means of the KVCBCT value-density calibration curve in the treatment planning system. The dosimetric comparisons were performed between the KVCBCT and planning CT plans on the phantom and 10 patients with esophageal cancer. Results The KVCBCT value was stable with a maximum variation of 1.6%, and there was no significant time trend. CT value profiles showed good agreement within 1% variation except the peripheral regions. The dosimetric differences were less than 1.33% and 3.65% for the phantom case and the patient ones, respectively. The dose distribution comparison was also in good agreements. Conclusions The accurate dose calculation based on KVCBCT for esophageal cancer is feasible. The KVCBCT images can be used for monitoring the dosimetric changes during the treatment.
		2012 Vol. 21 (5): 455-459 [Abstract] ( 6202 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	460	Study the feasibility of kilovolt cone beam CT organs at risk contouring automatically using deformation registration in the radiotherapy of lung
		HOU Yong, YIN Yong, MA Chang-sheng,GONG Guan-zhong
		Objective To quantitative analysis the difference of organ contour using planning CT and kilovolt cone beam CT (KVCBCT) deformable registration. Methods One set planning CT image and ten sets of KVCBCT image of one patient were choose and total five patients. Organ contour were automatic outlined to using deformable registration. To compare the organ contours different of deformable registration (DR) and rigid registration (RR). Statistic analysis was executed with paired t-test for dice similarity coefficient (DSC) value and sensitiveness (SENS) value. Results The DSC value of body, left, right lung, heart and spinal respectively:0.971 and 0.980(t=3.89,P=0.000),0.836 and 0.873(t=4.41,P=0.000),0.873 and 0.888(t=3.88,P=0.000),0.738 and 0.764(t=4.83,P=0.000),0.666 and 0.677(t=2.04,P=0.047).The SENS value:0.975 and 0.981(t=1.41,P=0.003),0.914 and 0.803(t=－6.88,P=0.000),0.926 and 0.800(t=－7.06,P=0.045),0.782 and 0.708(t=－2.50,P=0.040),0.625 and 0.796(t=－9.09,P=0.000). Conclusions RR is at a competitive disadvantage in terms of organ contour outline. The body, left and right lung that are used DR have advantage over the heart and spinal.
		2012 Vol. 21 (5): 460-463 [Abstract] ( 4382 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	464	Evaluation of the linearity characteristic of the cone-beam CT fixed on the Varian 23EX linear accelerator
		ZHANG Jun^*, XU Li-ming, LIU Hui, XIE Cong-hua, ZHONG Ya-hua, ZHOU Fu-xiang, ZHANG Gong, DENG Di
		Objective To investigate the CT number linearity of the cone-beam CT (CBCT) images at the different spatial locations in the scanning area. Methods The Catphan504 phantom at the different locations are scanned repeatedly using the CBCT on the Varian 23EX linear accelerator. The phantom is located the isocenter point, eccentric 3 cm, eccentric 6 cm, and different points on the z-axis successively on the accelerator. The scanned mode is the standard head mode. The reconstructive thickness is 2.5 cm. The different densities inserts of CTP404 module on the different locations are measured via Eclips treatment planning system (TPS) and computed by Matlab 7.0 and the CT linear fitting are then processed. In order to understand better the linear distribution along with the value of CT in the spatial distribution the results are compared with the fan-beam CT. Results Phantom studies show that:CBCT has good linearity performance not only under the standard header (body) of the scanning conditions, but also on such locations including the cross-sectional, the sagittal, the coronal plane and the eccentric position (R²>0.953). Bowtie filtration device does not change the CT linearity but changes the value of CT. Conclusions The linearity of X-ray CBCT on the Varian linear accelerator is favorable. CBCT will be used in the TPS dose calculation via further correction of the CT value.
		2012 Vol. 21 (5): 464-467 [Abstract] ( 4755 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	468	Accuracy comparison of enhanced dynamic wedge modles among Pinnacle³ 9.0 ACA and Eclipse7.3 AAA,PBC algorithm
		XING Xiao-fen, CUI Tong, ZHENG Xu-liang, CHU Xue-gang, ZHENG Ya-qin
		Objective To compare the accuracy of enhanced dynamic wedge (EDW) models of adaptive convolution algorithm (ACA) in Pinnacle³ 9.0 and anisotropic analytical algorithm (AAA),and pencil beam convolution (PBC) algorithms in Eclipse7.3 treatment planning systems (TPS). Methods To evaluate the accuracy of the three algorithm models, we compared actual measurement values with TPS calculation values of EDW wedge factors under for different fields in which Varian-21EX 6 MV X-ray was applied, and also compared the actual dose distribution profile with that of TPS. Results The deviations of EDW wedge factors of symmetry fields and asymmetric fields are within 2.8% and 19.4% for ACA in Pinnacle³ 9.0. Meanwhile, the deviations are 1.0% and 2.0% for AAA, 1.2% and 3.0% for PBC in Eclipse7.3. The deviations between measurement and calculation of all fields′ profile for ACA is within 3% and within 2.7% for AAA within 4.0% for PBC in wedge direction. For the dose distributions, we evaluated the pass rates of three algorithms using gamma analysis. The gamma pass rates among all the three algorithms in symmetry and asymmetric fields are above 87% and 85% respectively. After the removal of the penumbra zone, the pass rates among all the three algorithms are above 96% in symmetry fields, and above 95% in asymmetric fields, respectively. Conclusions AAA and PBC algorithms in symmetric and asymmetric fields can meet the need of clinical applications. While, wedge factor of ACA should not be used in clinical due to its greater error in asymmetric fields.
		2012 Vol. 21 (5): 468-470 [Abstract] ( 4030 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	471	Commissioning of GyroKnife digital cobalt-60 system for stereotactic radiotherapy and radiosurgery in dosimetric aspects
		XU Yi-guo^*, XU Zhi-yong, CHEN Jun-chao, ZHAO Jian-dong, CHEN Gui-yuan, ZUO Deng-ke, HU Fan
		Objective To introduce and evaluate the dosimetric characteristics of a GyroKnife cobalt-60 system for radiosurgery. Methods 0.015 cm³ and 0.600 cm³ ionization chamber, EDR2 film and semiconductor dosimeter were used to measure the dose rate of center point for the four collimators. The diameter of the four collimators were 5 mm,12 mm,30 mm and 50 mm,respectively. 0.015 cm³ ionization chamber was used to test the dose-time linear relationship and dose stability. 0.015 cm³ ionization chamber and semiconductor was used to measure the dose error of phantom between treatment planning system (TPS) calculation and measurement. The film was used to measure the error of TPS calculation isodose lines width. Results The results from the four measurement methods have no significant difference for the collimator 50 mm. But for collimator 5 mm great discrepancy appeared. The error between calculation by TPS and the measurement by semiconductor was biggest and the value was 4.8%. Most of the error was within 3.0%.The error of the 50% isodose line along x-axis was biggest and the value was 4.9 mm,others are all within 2.0 mm. Conclusion The dosimetric character of this system is suitable for stereotactic radiotherapy.
		2012 Vol. 21 (5): 471-473 [Abstract] ( 4293 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	474	An experimental study of 10 cGy whole brain radiation induced cognitive dysfunction
		SUN Rui, ZHANG Li-yuan, JI Sheng-jun, CHEN Lie-song, JI Jian-feng, TIAN Ye
		Objective To investigate the relationship between 10 cGy whole brain radiation and cognitive dysfunction. Methods Thirty-two male Sprague-Dawley rats at age one month were randomized into irradiation and sham exposed groups. Behavioral and histopathological tests were performed 3 months after irradiation in the order of open field, Morris water maze, passive avoidance, and histopathological test. Comparison between the two groups was conducted using independent samples t-test. Results In the place navigation test of Morris water maze, irradiation group showed significantly longer latency than sham exposed group on day 3 and 4(t=2.91 and 2.65,all P<0.05). In the total latency of the place navigation, irradiation group also presented longer latency comparing with sham exposed group (t=2.63,P<0.05). In the spatial probe test of Morris water maze, the open field test and the passive avoidance test showed no significant difference between the two groups (t=0.92,0.59,0.83,all P>0.05).The histopathological examination had no significant difference either. Conclusion Whole brain radiation of 10 cGy could partly injury the cognitive function of the rat.
		2012 Vol. 21 (5): 474-476 [Abstract] ( 3957 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	477


		2012 Vol. 21 (5): 477-478 [Abstract] ( 3372 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	479


		2012 Vol. 21 (5): 479-480 [Abstract] ( 3388 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	481


		2012 Vol. 21 (5): 481-482 [Abstract] ( 3304 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	415


		2012 Vol. 21 (5): 415-416 [Abstract] ( 3459 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	439	Feasibility, efficacy and cosmetic effect of three-dimensional conformal external beam partial breast irradiation for the selected early stage breast cancer patients after breast-conserving surgery
		XU Min, LI Jian-bin, FAN Ting-yong, SHAO Qian, LU Jie, WANG Chun-xiang, XING Jun, ZHANG Ying-jie, WANG Yong-sheng, ZUO Wen-shu
		Objective To explore the feasibility, efficacy and cosmetic effect of three-dimensional conformal external beam partial breast irradiation (EB-PBI) after breast-conserving surgery for the selected Chinese early stage breast cancer patients. Methods From June 2003 to December 2010, Forty-four early stage breast cancer patients underwent EB-PBI after breast-conserving surgery. Twenty patients had CT simulation scan in moderate deep inspiration breathing hold, and twenty-four patients in free breathing. EB-PBI was planned and delivered by three-dimensional conformal radiotherapy (3DCRT) with four non-coplanar beams. The prescribed dose was 3.40 Gy per fraction in thirty-nine patients and 3.85 Gy per fraction in five patients, twice per day at an interval of at least six hours, in five consecutive days. Results The number of patients with follow up time of 2,3 and 5 years were 39, 31 and 16. Grade 1 acute radiation-induced dermatitis was observed in 17 patients (39%) at three months. Cosmesis was good or excellent in all cases at six months after radiotherapy and in 95% cases at two years after radiotherapy. The 2-, 3-and 5-year local control rates were 100%, 99% and 94%, respectively. The 2-, 3-, and 5-year survival rates were all 100% and no metastases occurred. Conclusions EB-PBI delivered by 3DCRT is feasible for selected Chinese early stage breast cancer patients after breast-conserving surgery. The cosmetic effect, local control rate and long-term survival rate are satisfactory, and acute radiation toxicity is very low.
		2012 Vol. 21 (5): 439-442 [Abstract] ( 4841 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	443	The effect of local excision and adjuvant radiotherapy for patients with stageⅠrectal cancer
		XIAO Qin, JIN Jing, LI Ye-xiong, WANG Shu-lian, WANG Wei-hu, SONG Yong-wen, LIU Yue-ping, REN Hua, FANG Hui, LIU Xin-fan, YU Zi-hao
		Objective To evaluate the long-term survival and treatment failure patterns for patients with stage Ⅰ adenocarcinoma in the lower rectum after local excision with or without adjuvant radiotherapy. Methods From Jan. 2000 to Dec. 2008,Seventy-seven patients with rectal cancer received local excision. Among them, 41 received adjuvant radiotherapy. Fifty-four patients were pathologically proven as T₁, the other 23 as T₂. Patients were classified into low-and high-risk groups according to tumor grade, the length of tumor, surgical margin, circumference ratio of tumor/rectum and T stage. Survival rates and prognosticfactors were estimated by Kaplan-Meier method, and comparisons were made by the Logrank test. ResultsFourty patients were followed up more than 5 years. The 5-year locoregional recurrence-free survival (LRFS) and overall survival (OS) rates were 83% and 82% for the whole group. There were no significant differences in 5-year LRFS and OS rates in low-risk patients between local excision alone and local excision followed by adjuvant radiotherapy (86%∶83%,χ²=0.29,P=0.588 and 100%∶100%,χ²=1.50,P=0.221). In high-risk patients, the 5-year LRFS were similar (80%∶82%,χ²=0.27,P=0.600),but the OS were significantly different (92%∶66%,χ²=4.64,P=0.031) between local excision alone and local excision followed by adjuvant radiotherapy. By univariate analysis, large tumor size, positive margin, poor differentiation, tumor located less than 5 cm from anal verge and pT₂ stage were poor prognostic factors for OS. The overall relapse rate for the whole group was 29%, and 70% of them were locoregional relapse. The 5-year OS for patients treated with radical salvage surgery after local relapse was 69%. Conclusions For stage Ⅰ lower-sited rectal cancer,low-risk patients can achieve good result after local excision alone. The role of adjuvant radiotherapy in high-risk patients needs further evaluation. Local relapse is the main cause of failure, and salvage surgery after local relapse can provide long-term survival.
		2012 Vol. 21 (5): 443-447 [Abstract] ( 4474 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	448	Clinical results and prognostic factors of patients with locally advanced cervical carcinoma treatedwith neoadjuvant therapy followed by radical hysterectomy:a retrospective study of 182 patients
		WANG Ning^*, WEI Li-chun, SHI Mei, LIU Juan-yue, LI Wei-wei, LI Jian-ping, ZHANG Ying, LI Xia, HUANG Yan-hong
		Objective To analyze the clinical outcome and prognostic factors of concurrent radiochemotherapy (CRCT) or radiotherapy (RT) alone followed by radical hysterectomy in cervical cancer. Methods Between April 2006 and June 2011, 182 patients with FIGO Ⅰ_B2-Ⅲ_B cervical carcinoma were treated with preoperative CRCT (123 patients) or RT alone (59 patients) followed by radical surgery. Weekly cisplatin (40 mg/m²) were administered during radiotherapy for patients treated with CRCT. Preoperative RT doses were 40－50 Gy in 20－25 fractions. Total hysterosalpingo-oophorectomy and pelvic lymph node dissection was performed 2－3 weeks after neoadjuvant therapy. The prognostic factors were analyzed by Cox-regression method. Results Sixty-nine patients were followed up for 3 years. For patients with tumor ≥4.5 cm, there were no significant differences in the 3-year progression-free survival (PFS) and overall survival (OS) rates between CRCT and RT alone (χ²=1.84 and 1.56, P=0.176 and 0.221). For patients with tumor<4.5 cm, CRCT group had higher PFS and OS rates than RT alone (χ²=5.22 and 4.81,P=0.022 and 0.018). The 3-year PFS and OS rates were 92.0% and 93.8%. By multivariate analysis, tumor diameter (≥6 cm vs.<6 cm) was significant prognostic factor for PFS and OS (χ²=2.56,P=0.011;χ²=4.06,P=0.007), age (<48 vs. ≥48 years) was significant prognostic factor for OS (χ²=4.86,P=0.046), and postoperative lymph node status (positive vs. negative) was significant prognostic factor for PFS (χ²=1.04,P=0.010). Conclusions Treatment with CRCT or RT followed by radical surgery has achieved good OS and PFS for patients with FIGO Ⅰ_B2-Ⅲ_B cervical cancer. Tumor diameter, age and postoperative lymph node status are important prognostic factors for survival.
		2012 Vol. 21 (5): 448-451 [Abstract] ( 4431 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	452	Clinical observation on the therapeutic efficacy of cyberknife for primary or metastastic retroperitoneal tumors
		ZHUANG Hong-qing, YUAN Zhi-yong, WANG Ping
		Objective To evaluate the early response rate and radiation toxicity of cyberknife in the treatment of primary or metastastic retroperitoneal tumors. Methods Twenty-eight patients with retroperitoneal tumors were treated with cyberknife. The total doses were 2000－6000 cGy (median 4500 cGy) and biological effective doses were 3750－10080 cGy (median 7680 cGy) in 2－10 fractions (median 5). Of all patients, 3 received three dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) boost, 1 was treated as second-course radiotherapy, and others were treated with cyberknife only. The survival rates were calculated by Kaplan-Meier method and compared with Logrank test. Results The complete response, partial response, stable disease and progression disease rates were 43%(12/28),6%(10/28),18%(5/28),4%(1/28), respectively. The overall response rate was 96%. The number of patients who were followed up more than 1,2,3 years were 17,9,7, respectively. The 1-, 2-and 3-year local control rates were 92%,86% and 86%, respectively. The 1-, 2-and 3-year overall survival rates were 60%,49% and 49%, respectively. The difference between local progression-free survival and overall survival was not significant (median 9.5 and 12.0 months,χ²=0.17,P=0.680). Moreover, if the patients did not have metastasis elsewhere and local treatment was effective, there was no significant difference between local progression-free survival and progression free survival (median 17 and 11 months,χ²=0.13,P=0.720). Acute radiation-induced side effects (≥2 grade) such as fatigue, anorexia, nausea, vomiting and epigastric discomfort occurred in 9, 9, 7, 7 and 2 patients, respectively. Intestinal stenosis of 1 grade occurred in 1 patient. Conclusions Radiotherapy for retroperitoneal tumors with cyberknife has provided a high response rate with minimal side effects. It is a safe and effective local treatment method for retroperitoneal tumors.
		2012 Vol. 21 (5): 452-454 [Abstract] ( 4329 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	421	Treatment outcomes of 792 cases of esophageal carcinoma patients treated with three-dimensional radiotherapy
		KONG Jie, LI Xiao-ning,HAN Chun,WANG Lan, GAO Chao, ZHANG Jing, TIAN Hua, XIAO Ai-qin, MA Guo-xin
		Objective To investigate the long term clinical result of three-dimensional radiotherapyfor esophageal carcinoma, discuss the effect of correlative factors to survival and local control. MethodsFrom July 2003 to December 2008, 792 patients with esophageal cancer were eligible. Patients were treated with three-dimensional radiotherapy (672 patients) or intensity-modulated (120 patients) radiotherapy. The radiotherapy was delivered in 1.8－2.0 Gy per fraction, 5 fractions per week, total dose of 50－70 Gy,(median, 60 Gy). 142 patients were treated by concurrent radiochemotherapy, and the other 650 patients radiotherapy alone. The local control rate and survival rate were calculated by Kaplan-Meier method. Logrank method was used for univariate analyses. Cox regression model was used for multivariate analyses. Results The follow-up rate was 95.8%.The number of patients with 5 years time followed-up was 133.The 1-year, 3-year and 5-year local control rates were 76.6%, 53.2%, 48.6%, and the 1-year, 3-year and 5-year overall survival rates were 70.1%, 36.7% and 28.0%, respectively. There were significant influence on the prognosis of T stage, N stage, TNM stage, tumor volume (χ²=20.58－55.60,all P=0.000). The Cox multivariate model showed that N stage and tumor volume were independent prognostic factors (χ²=6.35,29.23,P=0.012,0.000). For the two groups of concurrent chemo-radiotherapy and radiotherapy alone, 5-year local control rates were 57.0% and 46.8%(χ²=7.34,P=0.007),the 5-year overall survival rate 32.8% and 27.6%(χ²=3.42,P=0.064. Conclusions Three-dimensional radiotherapy is effective for esophageal carcinoma. It might improve the local control rate and overall survival rate to some extent. T staging, N staging, TNM staging and tumor volume were important prognostic factors for long-term survival. The addition of concurrent radiochemotherapy could improve local control rates.
		2012 Vol. 21 (5): 421-422 [Abstract] ( 4434 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	424


		2012 Vol. 21 (5): 424-425 [Abstract] ( 3216 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	426	A phase Ⅲ multicenter trial of radiosensitizing effect and safety of sodium glycididazole in thoracic esophegeal squamous carcinoma
		QIN Shang-bin^*, WANG Ya-di, YANG Jun-quan, WANG Xiao-hu, LI Hai-bin, YANG Zhi-yong, YU Hong, LI Xue-ying, GAO Xian-shu
		Objective To evaluate the efficacy and clinical safety of sodium glycididazole (CMNa) in thoracic esophageal squamous carcinoma. Methods From June 1, 2008 to October 13, 2009, 66 pathologically proved thoracic esophageal squamous carcinoma (stage Ⅱ_a-Ⅲ, stage Ⅳ with metastases only in supraclavicular lymph nodes,by AJCC 6^th ed) were randomized into radiotherapy plus CMNa (A) or radiotherapy plus placebo (B) group. Radiotherapy was given by conventional schedule:1.8－2.0 Gy per fraction, 5 times per week to a total dose of 66 Gy/6.6－7.2w. CMNa was given intravenously 800 mg/m² 3 times a week in solution of 100 ml saline within 30 minutes. Radiotherapy was started 30－60 minutes after completion of infusion. Patients of Group B received placebo in saline solution. A total of 66 patients were enrolled (Group A:32;Group B:34), and four patients were unanalyzable, remaining 31 patients in each Group. Baseline factors were balanced. Results Follow-up rate was 97%. Group A vs. Group B:the overall response rate was 93.5% vs. 67.7%(χ²=6.61,P=0.01), 2-year overall survival was 39.9% vs.29.9%(χ²=0.62,P=0.433), 2-year cancer specific survival was 43.1% vs.26.8%(χ²=0.30,P=0.878), and 2-year progression-free survival was 30.1% vs. 27.9%(χ²=0.02,P=0.586). No severe side effects observed. All patients tolerated CMNa infusion well. Conclusions CMNa is tolerable and effective as a hypoxic radiosensitizer, and its combination with radiotherapy can improve short term effect. However, survival is not improved within our follow-up period.
		2012 Vol. 21 (5): 426-428 [Abstract] ( 4669 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	432	Prophylactic cranial irradiation for non-small cell lung cancer:a systematic review
		BAI Ge^*, GULIBIYE·Shabier, ZHANG Jian-qing, YANG Mei, BAO Yong-xing, ZHANG Li
		Objective To determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC) treated with radical intent. Methods We searched The Cochrane Library, MEDLINE, EMbase, CBM, CNKI and VIP. The quality of the included studies was critically evaluated. Data analyses were performed using the Cochrane Collaboration′s RevMan 5.1 software. Results Four randomized controlled trials involving 905 patients met the inclusion criteria. The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group (χ²=1.98,P=0.000);but there is no evidence of 1-year overall survival (OS) benefit (χ²=1.12,P=0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P=0.600) or ADL (P=0.880) after PCI, but there was a significant decline in immediate recall (P=0.030) and delayed recall (P=0.008) at 1 year. At 1 year, there was no significant differences in QOL after PCI (P=0.050). Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation. There is insufficient evidence to support the use of PCI in clinical practice. Where possible, patients should be offered entry into a clinical trial.
		2012 Vol. 21 (5): 432-434 [Abstract] ( 4146 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	436	A comparison of the different CT scanning modes on the GTV delineation of the solitary pulmonary lesion
		SHANG Dong-ping, WANG Wei, LI Jian-bin, WANG Yun-gang, ZHANG Ying-jie, LI Yan-chi, DU Jun
		Objective To explore the influence of the CT scanning mode on the gross tumor volume (GTV) delineation of solitary pulmonary lesion (SPL), and to evaluate the feasibility of the spiral CT scan in CT simulation. Methods Sixteen patients with SPL underwent axial scan, spiral scan during free breathing. Compare the target position, volume between GTV_s and GTV_A (paired t-test). The matching index (MI) between GTV_s and GTV_A and correlations between MI and the tumor volume were calculated (bivariate correlation analysis). Results GTV_s and GTV_A volume was 8.95 cm³ and 9.38 cm³(t=0.43,P=0.667), respectively. The centroid position for GTV_s and GTV_A in x,y and z axises were 6.80 cm and 6.81 cm (t=0.27,P=0.794), 36.19 cm and 36.05 cm (t=0.37,P=0.717), and 4.99 cm and 4.96 cm (t=0.65,P=0.526),respectively. There were also no statistically significant difference in the distance between the centroidal position and origin of coordinates for GTV_s and GTV_A (38.31 cm∶38.23 cm,t=0.47,P=0.646). MI between GTV_s and GTV_A was 0.36(range 0－0.77), correlated with the tumor volume (r=0.587, P=0.017). Conclusions There was no significant difference between the axial scan and spiral scan in the GTV volume and position for SPL, but MI between GTV_s and GTV_A were small. A correlation was found for the MI between GTV_s and GTV_A with the tumor volume. Spiral CT scan was more timesaving, and was feasible in CT simulation scan.
		2012 Vol. 21 (5): 436-438 [Abstract] ( 4335 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review

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		2012 Vol. 21 (5): 429-431 [Abstract] ( 3579 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2012 Vol. 21 (5): 483-420 [Abstract] ( 3325 ) [HTML 1KB] [ PDF 0KB] ( 0 )

中华放射肿瘤学杂志

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China Association for
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Chinese Medical Association

Cancer Hospital of Chinese
　Academy of Medical
　Sciences Department of
　Radiation Oncology

Chinese Anti-Cancer
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Chinese Journal of Lung
　Cancer

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