Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

中华放射肿瘤学杂志

Office

Journal

Archive

RSS

Download

Instruction

Template

Quick Search

Advanced Search

Chinese Journal of Radiation Oncology

	2013 Vol.22 Issue.4 Published 2013-06-28

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

Abdominal Tumors

	263	Analysis of therapeutic effects of radiochemotherapy and chemotherapy alone in patients with advanced gastric cancer after gastrectomy
		QIN Yu-e, ZHOU Fu-xiang, DAI Jing, XIE Cong-hua, YU Hai-jun, ZHOU Yun-feng
		Objective To investigate the therapeutic effects and toxic effects of radiochemotherapy versus chemotherapy alone in patients with advanced gastric cancer after gastrectomy. Methods A total of 183 patients with stage Ⅱ—Ⅳ(M₀) gastric cancer, who received treatment after gastrectomy from 2004 to 2010, were included in the study. Of the 183 patients, 64 received radiochemotherapy after gastrectomy, and 119 received chemotherapy alone after gastrectomy. The survival rates and hematological and gastrointestinal toxic effects were compared between the two groups;survival difference was also analyzed after the patients were stratified by TNM stage, number of metastatic lymph nodes, and extent of lymph node dissection (D₀, D₁, and D₂). The Kaplan-Meier method was used for calculating survival rates, and the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparing toxic effects between the two groups. Results The follow-up rate was 87.8%;72 patients were followed up for at least 3 years, and 29 patients for at least 5 years. The 1-, 3-, and 5-year survival rates for the radiochemotherapy group were 86%, 62%, and 55%, respectively, as compared with 77%, 53%, and 43% for the chemotherapy group (P=0.079). There were no significant differences in grade 3—4 hematological and gastrointestinal toxic effects between the two groups (P=0.363 and 0.617). The univariate analysis showed that radiochemotherapy had a significantly better survival benefit than chemotherapy alone in patients with stage Ⅲ_B—Ⅳ(M₀) gastric cancer, patients who underwent D₀ lymph node dissection, and patients with more than 6 metastatic lymph nodes (P=0.022, 0.025, and 0.021). Conclusions Compared with chemotherapy alone, radiochemotherapy tends to improve survival in patients with gastric cancer after gastrectomy, and its toxic effects are tolerable. The patients with stage Ⅲ_B—Ⅳ(M₀) gastric cancer, patients who undergo D₀ lymph node dissection, and patients with more than 6 metastatic lymph nodes can benefit from radiochemotherapy.
		2013 Vol. 22 (4): 263-265 [Abstract] ( 4107 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	266	Treatment outcome and prognostic factors in patients with carcinoma of the anal canal
		REN Hua, JING Hao, JIN Jing, LI Ye-xiong, WANG Wei-hu, WANG Shu-Lian, SONG Yong-wen, LIU Yue-ping, FANG Hui, LIU Xin-fan, YU Zi-hao
		Objective To retrospectively analyze the treatment outcome and prognostic factors in patients with primary carcinoma of the anal canal (CAC). Methods From January 2000 to December 2011, 31 patients with CAC were treated in our institution;of the 31 patients, 23 had squamous cell carcinoma, and 8 had adenocarcinoma. In the initial treatment for stage Ⅰ—Ⅲ patients, 16 were treated with radiotherapy-based modality, 11 with surgery-based modality, and 3 with chemotherapy. Results The follow-up rate was 90%;21 patients were followed up for at least 3 years. The 3-year overall survival (OS) rate and progression-free survival (PFS) rate were 76% and 56%, respectively. The univariate analysis showed that clinical stage and T stage were the prognostic factors for OS (χ²=12.11, P=0.001;χ²=4.64, P=0.031) and marginal prognostic factors for PFS (χ²=2.91, P=0.088;χ²=2.75, P=0.097). There were no significant differences in 3-year OS and PFS between the stage Ⅰ—Ⅲ patients with squamous cell carcinoma who received radiotherapy-based initial treatment and those who received surgery-based initial treatment (80% vs. 80%,χ²=0.08, P=0.776;78% vs. 67%,χ²=0.17, P=0.697). Of the patients treated with radiotherapy, 37% experienced grade 3 acute skin or mucosal toxicity, and 9% experienced impaired anal sensation or function as late toxicity. Conclusions Clinical stage and T stage are the most important prognostic factors in patients with CAC. Concurrent chemoradiotherapy should be the standard radical treatment for squamous cell carcinoma of the anal canal, and using intensity-modulated radiotherapy helps patients to complete the planned course of radiotherapy without severe adverse events.
		2013 Vol. 22 (4): 266-269 [Abstract] ( 3986 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	270	Center displacement of surgical cavity delineated by metal clips and/or seroma on 4DCT in patients for external-beam partial breast irradiation:a comparative study
		DING Yun, LI Jian-bin, WANG Wei, FAN Ting-yong, XU Min, SHAO Qian, MA Zhi-fang, WANG Su-zhen
		Objective To conduct a comparative study on the center displacement of surgical cavity delineated by metal clips and/or seroma on four-dimensional computed tomography (4DCT) in patients for external-beam partial breast irradiation (EBPBI) during free breathing. Methods Fourteen breast cancer patients, who had underwent breast-conserving surgery and met the requirements of EBPBI and who underwent 4DCT simulation scans and had a seroma clarity score of ≥3, were included in the study. On the 10 phases of 4DCT images, GTV_s were delineated based on metal clips plus seroma, metal clips, and seroma to obtain GTV_c+s, GTV_c, and GTV_s, respectively, and all the metal clips at the boundaries of surgical cavity were marked to obtain the geometry. The three-dimensional center displacements of the geometry, GTV_c+s, GTV_c, and GTV_s as well as four selected metal clips were measured and compared. Results The center displacements of the geometry, GTV_c+s, GTV_c, and GTV_s were 2.20, 0.90, 0.90, and 0.90 mm, respectively, in the left-right (LR) direction, 1.80, 1.20, 1.05, and 1.05 mm, respectively, in the anterior-posterior (AP) direction, and 2.70, 1.40, 1.20, and 0.80 mm, respectively, in the superior-inferior (SI) direction. For each of the geometry, GTV_c+s, GTV_c, and GTV_s, there were no significant differences between the center displacements in the LR, AP and SI directions (χ²=2.05—3.84, P=0.147—0.359). In each of the LR, AP and SI directions, the geometry had a significantly larger displacement than GTV_c+s, GTV_c, GTV_s, and the four selected clips (χ²=15.38—21.022, P=0.000—0.002). The center displacement of GTV_c was larger than that of GTV_s in the SI direction (Z=－2.05, P=0.041). Conclusions During free breathing, the geometry consisted of all the metal clips has a larger center displacement than GTV_c+s, GTV_c, GTV_s, and the four selected metal clips in the LR, AP and SI directions, but there are no significant differences in center displacement between GTV_c+s, GTV_c, and GTV_s.
		2013 Vol. 22 (4): 270-273 [Abstract] ( 3813 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	274	Clinical effects of concurrent radiochemotherapy followed by radical surgery and radical radiotherapy with concurrent chemotherapy:a comparative study of 243 patients with FIGO stage Ⅱ_B cervical cancer
		WANG Ning, WEI Li-chun, SHI Mei, LI Wei-wei, Hu Jing, LIU Juan-yue, LI Jian-ping, ZHOU Yong-chun, ZHANG Ying
		Objective To compare concurrent radiochemotherapy (CRCT) followed by radical surgery and radical radiotherapy (RT) with concurrent weekly cisplatin in terms of survival rates and long-term toxicities in patients with FIGO stage Ⅱ_B cervical cancer. Methods A retrospective analysis was performed on 243 patients with FIGO stage Ⅱ_B cervical cancer who were admitted to our hospital from November 2004 to November 2011. Of the 243 patients, 121 patients received CRCT followed by radical surgery (group 1), and 122 received radical RT with concurrent chemotherapy (weekly cisplatin, 40 mg/m²)(group 2). The Kaplan-Meier method wasused to calculate survival rates, and the log-rank test wasused for survival difference analysis;the Cox model was used for multivariate prognostic analysis.ResultsThe follow-up rate was 100% in groups 1 and 2. 34 and 33 patients were followed up for at least 3 years in groups 1 and 2. The 3-year progression-free survival (PFS) rates, overall survival (OS) rates, and local control rates for groups 1 and 2 were 91.5% vs 82.0%(P=0.013), 95.5% vs 89.2%(P=0.085), and 96.7% vs 93.4%(P=0.375), respectively. In group 1, the patients with a tumor diameter of ≥6 cm and an age of ≤35 years had a significantly lower 3-year PFS rate than those with a tumor diameter of<6 cm and an age of>35 years (68.2% vs 93.8%, P=0.004;74.1% vs 93.2%, P=0.037). In group 2, the patients with non-squamous cell carcinoma and a tumor diameter of ≥6 cm had a significantly lower 3-year PFS rate than those with squamous cell carcinoma and a tumor diameter of<6 cm (50.0% vs 83.0%, P=0.013;25.0% vs 86.0%, P=0.002). In groups 1 and 2, the patients with a tumor diameter of ≥6 cm had a significantly lower 3-year OS rate than those with a tumor diameter of<6 cm (78.8% vs 97.0%, P=0.033;46.9% vs 92.6%, P=0.007). Leg edema occurred more frequently in group 1 than in group 2(33.1% vs 8.2%, P=0.000), while radiation enteritis more frequently in group 2 than in group 1(31.2% vs 5.0%, P=0.000). Conclusions CRCT followed by radical surgery may lead to better PFS than radical RT with weekly cisplatin in patients with FIGO stage Ⅱ_B cervical cancer. Tumor diameter is the common prognostic factor for PFS in patients who receive the two treatments.
		2013 Vol. 22 (4): 274-277 [Abstract] ( 3605 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	278	Pattern of lymph node metastasis in limited-stage primary esophageal small-cell carcinoma and its clinical significance:a preliminary study
		WU Gang, FU Xiao-long, GE Hui-juan, SHEN Lei, XIANG Jia-qing, ZHANG Ya-wei,ZHAO Wei-xin, CAI Xu-wei, YU Wen
		Objective To study the pattern of lymph node metastasis (LNM) in limited-stage primary esophageal small-cell carcinoma (PESC) and its guiding significance for clinical target volume delineation in radiotherapy. Methods A retrospective analysis was performed on the clinical data of 21 patients with limited-stage PESC who underwent esophagectomy in our hospital from January 2006 to July 2012 to analyze the rate and degree of LNM and distribution of metastatic lymph nodes. Results The mean number of dissected lymph nodes per patient was 27.9. There were 15 patients who had LNM;8 patients had dispersed distribution of metastatic lymph nodes, and 7 patients had aggregated distribution of metastatic lymph nodes. The LNM rate was 71.4%, and the LNM degree was 17.2%. The Logistic univariate analysis showed that advanced T stage and long PESC lesion were the risk factors for LNM (P=0.004,P=0.044) and that advanced T stage and angiolymphatic invasion were the risk factors for dispersed distribution of metastatic lymph nodes (P=0.007,P=0.005). Conclusions The rate and degree of LNM are higher in PESC than in esophageal squamous cell carcinoma. Among the patients with limited-stage PESC, 38% have dispersed LNM. More research is recommended to evaluate the distribution of metastatic lymph nodes according to T stage and angiolymphatic invasion and investigate the value of prophylactic irradiation to the lymphatic drainage area of PESC.
		2013 Vol. 22 (4): 278-281 [Abstract] ( 4232 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	282	Respiratory motion of GTV and its influential factors in patients with primary thoracic esophageal cancer
		WANG Wei, LI Jian-bin, QI Huan-peng, SHAO Qian, ZHANG Ying-jie, FAN Ting-yong, XU Min, Wang Jin-zhi
		Objective To investigate the three-dimensional (3D) motion of gross tumor volume (GTV) and its influential factors in patients with primary thoracic esophageal cancer based on four-dimensional CT (4DCT). Methods Sixty-five patients with thoracic esophageal cancer underwent 3DCT and 4DCT simulation scans during normal breathing to measure the centroid motions of GTV in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions. The distances from the upper and lower edges of GTV to the lower edges of the aortic arch and tracheal carina and the diaphragmatic dome at both sides were measured. The patients were grouped based on age, sex, and the location, pathological type, volume, and length of tumor. The impacts of the above factors on GTV motion and the correlation between the positions of tumor upper/lower edges and GTV motion were analyzed. Results The centroid motions of GTV in the LR, AP, and SI directions were 0.15 cm, 0.12 cm, and 0.34 cm, respectively. The patients with lower thoracic esophageal cancer had lager centroid motions of GTV in the LR and AP directions than those with upper and middle thoracic esophageal cancer (P=0.036 and 0.014), but there was no significant difference in the centroid motion of GTV in the SI direction (P=0.123). There were no relationships between GTV motion and the sex, age, and body mass index (BMI) of patients (P_LR=0.464, 0.962, and 0.727, P_AP=0.924, 0.594, and 0.865, P_SI=0.955, 0.264, and 0.139). A significant difference was found between patients with different tumor lengths in terms of the GTV motion in the LR direction (P=0.014). GTV motions were not correlated with whether lymph node metastasis occurred (P=0.502, 0.665, and 0.815), but they were negatively correlated with the distances between the upper and lower edges of GTV and the tracheal carina (P=0.000—0.014). Conclusions The maximum GTV motion is seen in the SI direction among patients with thoracic esophageal cancer during normal breathing. Age, sex, BMI, and mediastinal lymph node metastasis have no impacts on target volume expansion, and appropriate site-specific internal target volume expansion should be determined in consideration of the tumor location and the distances between the upper and lower edges of GTV and the tracheal carina.
		2013 Vol. 22 (4): 282-285 [Abstract] ( 3898 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	286	A comparative study of target volumes based on three CT images in non-small cell lung cancer
		LI Feng-xiang, LI Jian-bin, SHAO Qian, FAN Ting-yong, XU Min, ZHANG Ying-jie, QI Huan-peng, SHANG Dong-ping, YU Ning-sha
		Objective To determine the positional and volumetric differences between the target volumes delineated based on three-dimensional computed tomography (3DCT), four-dimensional computed tomography (4DCT), and cone-beam computed tomography (CBCT) in non-small cell lung cancer (NSCLC). Methods Thirty-one patients with peripheral NSCLC sequentially underwent 3DCT and 4DCT simulation scans of the thorax during normal breathing. A 3D conformal treatment plan was created based on 3DCT. Before the first treatment, CBCT was performed and registered to the planning CT using bony anatomy registration. All contours were delineated by a radiation oncologist using the same contouring protocol. GTV_3D and GTV_4D50% were contoured based on 3DCT and end-expiration phase (50% phase) of 4DCT, respectively;internal GTVs (IGTV_MIP and IGTV_CBCT) were contoured based on maximum intensity projection (MIP) of 4DCT and CBCT, respectively. The differences in the position, size, and degree of inclusion (DI) between these volumes were determined by Wilcoxon rank-sum test and paired t-test. The Pearson test was used for the correlation analysis on 3D motion vector of GTV. Results The mean size ratio of GTV_3D, GTV_4D50%, and IGTV_MIP to IGTV_CBCT were 0.77, 0.84, and 1.10(z=－2.91, P=0.004;z=－2.79, P=0.005;z=－1.81, P=0.070) for tumors in the upper lobe of the lung and 0.67, 0.65, and1.17(z=－3.30, P=0.001;z=－3.30, P=0.001;z=－2.32, P=0.020) for tumors in the middle/lower lobe of the lung. GTV_4D50%/IGTV_CBCT ratio was negatively correlated with the 3D motion vector of GTV (r=－0.45, P=0.012) in all the patients. The mean DIs of GTV_3D, GTV_4D50%, and IGTV_MIP in IGTV_CBCT were 0.65, 0.65, and 0.62, respectively, and the DI of GTV_3D or GTV_4D50% in IGTV_CBCT showed no significant difference from that of IGTV_MIP in IGTV_CBCT (t=－0.90, P=0.375;t=－1.42, P=0.167);the mean DIs of IGTV_CBCT in GTV_3D, GTV_4D50%, and IGTV_MIP were 0.47, 0.49, and 0.67, respectively, and the DI of IGTV_CBCT in IGTV_MIP was significantly greater than that of IGTV_CBCT in GTV_3D or GTV_4D50%(t=－8.28, P=0.000;t=－5.70, P=0.000). Conclusions CBCT can help to acquire significantly more information on tumor motion than 3DCT and end-expiration phase of 4DCT, but with slightly less information than 4DCT MIP. The use of 3DCT or 4DCT registered to CBCT based on bony anatomy may still result in a serious target miss in radiotherapy, which should be focused on when we perform adaptive radiotherapy and rectify treatment planning based on CBCT.
		2013 Vol. 22 (4): 286-290 [Abstract] ( 3787 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Head and Neck Tumors

	291	Long-term outcomes of patients with nasopharyngeal carcinoma in different stages treated by intensity-modulated radiotherapy and their treatment strategies
		SU Sheng-fa, ZHAO Chong, HAH Fei, CHEN Chun-yan, XIAO Wei-wei, SUN Xue-ming, LU Tai-xiang
		Objective To investigate the long-term outcomes of patients with nasopharyngeal carcinoma (NPC) in different stages treated by intensity-modulated radiotherapy (IMRT) and explore their treatment strategies. Methods A retrospective analysis was performed on the clinical data of 868 NPC patients without distant metastasis who received radical IMRT from May 2001 to October 2008. These patients were divided into early N₀(T_1－2N₀) group (n=137), early N₁(T_1－2N₁) group (n=129), locally advanced (T_3－4N_0－1) group (n=322), regionally advanced (T_1－2N_2－3) group (n=107), and locoregionally advanced (T_3－4N_2－3) group (n=173). There groups were compared in terms of treatment outcome and treatment strategy. Results The follow-up rate was 91.4%, and 314 patients completed 5-years follow-up. The 5-year overall survival rate, local recurrence-free rate, and distant metastasis-free rate (DMFR) were 83.5%, 91.8%, and 84.6%, respectively. The early N₀ group had the best treatment outcome, with a 5-year disease-specific survival (DSS) rate up to 99.1%. Each group had a similar outcome after receiving either IMRT alone or IMRT combined with chemotherapy. The locally advanced group and regionally advanced group had similar failure patterns and treatment outcomes. The locoregionally advanced group had the worst treatment outcome, with a 5-year DMFR of 67.2% and a DSS of 68.0%. The regionally advanced group and locoregionally advanced group had a similar treatment outcome after receivingIMRT alone, induction chemotherapy plus IMRT, or concurrent chemotherapy and IMRT. ConclusionsPatients with NPC in different stages have different survival outcomes. It is recommended that different treatment strategies should be adopted according to the T and N stages of NPC. IMRT alone can produce satisfactory results in patients with T_1－2N₀ NPC, but a more effective medication should be added to IMRT in patients with advanced NPC, particularly those with T_3－4N_2－3 NPC who have a relatively low DMFR.
		2013 Vol. 22 (4): 291-294 [Abstract] ( 4274 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	295	Prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma
		LI Shao-en, LIANG Shao-bo, ZHANG Ning, LU Rui-liang, ZHAO Hai, ZHENG Zhen-he
		Objective To evaluate the prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma (NPC) treated with radiotherapy and chemotherapy. Methods A retrospective analysis was performed on the clinical data of 333 patients who had newly diagnosed biopsy-proven NPC without distant metastasis from 2005 to 2007. All patients underwent MRI scans of the nasopharynx and neck and were treated with two-and three-dimensional radiotherapy without or without chemotherapy. The Kaplan-Meier method was used to calculate overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS), and the log-rank test was used for survival difference analysis;the Cox proportional hazards regression analysis was used to assess the prognostic value of prevertebral space involvement. Results The follow-up rate was 95.2%. Prevertebral space involvement was seen in 139(41.7%) of these patients. The patients with prevertebral space involvement had significantly higher T stage and clinical stage than those without prevertebral space involvement (χ²=90.41, P=0.000;χ²=54.03,P=0.000). The 5-year OS, DMFS, and LRFS for NPC patients with and without prevertebral space involvement were 58.8% vs. 77.5%(χ²=11.95, P=0.000), 77.8% vs. 85.0%(χ²=2.56, P=0.110), and 88.3% vs. 91.8%(χ²=1.51, P=0.220), respectively. After adjusting for N stage, a significant difference was still seen between the two groups with regard to 5-year OS (χ²=9.93, P=0.002). The multivariate analysis showed that prevertebral space involvement was not the independent prognostic factor for OS, DMFS, and LRFS (χ²=0.43, P=0.512;χ²=0.08, P=0.783;χ²=0.00, P=0.971). Conclusions The frequency of prevertebral space involvement is very high in NPC. The OS for the patients with prevertebral space involvement is significantly lower than those without prevertebral space involvement. But prevertebral space involvement is not the independent prognostic factor in NPC patients.
		2013 Vol. 22 (4): 295-298 [Abstract] ( 4028 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	299	Prognostic impact of degree of bone metastasis in patients with nasopharyngeal carcinoma after radiochemotherapy
		ZHU Yan-fe, DING Yi, CHEN Bin, CHEN Long-hua
		Objective To analyze the prognostic impact of degree of bone metastasis in patients with nasopharyngeal carcinoma (NPC) after radiochemotherapy. Methods A retrospective analysis was performed on the prognosis of 109 NPC patients who had bone metastases after radiochemotherapy in Nanfang Hospital from June 1997 to December 2007. The Kaplan-Meier method was used to calculate survival rates;the log-rank test was used for univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The 5-year follow-up rate was 97.2%. The 1-, 2-, 3-, and 5-year overall survival rates for all patients were 67.9%, 48.6%, 32.9%, and 17.4%, respectively. The 1-, 2-, 3-, and 5-year survival rates for the 43 patients with not more than 3 bone metastases and the 66 patients with more than 3 bone metastases were 90.7% vs. 53.0%, 81.4% vs. 27.3%, 72.1% vs. 6.2%, and 34.9% vs. 4.2%, respectively (P=0.000). In the patients with more than 3 bone metastases, the 1-, 2-, 3-, and 5-year survival rates for those with and without other metastatic sites were 56.5% vs. 72.1%, 21.7% vs. 30.2%, 3.1% vs. 13.0%, and 0.0% vs. 6.5%, respectively (P=0.866). The multivariate analysis showed that more than 3 bone metastases were an adverse prognostic factor in the patients (P=0.000). Conclusions The number of bone metastases is an important prognostic factor in NPC patients after radiochemotherapy. Patients with not more than 3 bone metastases have better survival than those with more than 3 bone metastases, and aggressive treatment should be considered. In addition, the staging system of NPC needs to be improved.
		2013 Vol. 22 (4): 299-301 [Abstract] ( 4014 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review

	302


		2013 Vol. 22 (4): 302-304 [Abstract] ( 3872 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	329


		2013 Vol. 22 (4): 329-332 [Abstract] ( 3752 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	335


		2013 Vol. 22 (4): 335-337 [Abstract] ( 3631 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	338


		2013 Vol. 22 (4): 338-339 [Abstract] ( 3644 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

	305	Study on multicriteria optimization of intensity-modulated radiotherapy planning comparing with direct machine parameter optimization
		LIAO Xiong-fei, Jack Yang, Yie Chen, LI jie, XIAO Ming-yong, WANG Pei
		Objective The aim of this study was to evaluate the role of multicriteria optimization (MCO) in planning of intensity-modulated radiotherapy (IMRT). Methods Twenty IMRT patients (ten with prostate and ten with lung cancers) were randomly selected. For these patients, the treatment plans were designed with direct machine parameter optimization (DMPO). Based on these plans, new plans were designed with MCO, while keeping the setting conditions unchanged. Comparison was made between the two plans including the dose distribution, the dose volume histogram, the time of optimization and number of monitor unit (MU),but were play by pairing-t test. Results The plan designed in both optimizations satisfied all clinical requirements. For the same or better target coverage, rectum, bladder and small bowel were better with MCO compared with DMPO, MCO reduced 58% of the time for optimization by average while MU increased 32% by average for prostate cancer. For lung cancer, the whole lung, heart and spinal cord were better with MCO compared with DMPO,MCO reduced 59% of the time for optimization by average while MU increased 11% by average. Conclusions In comparison with DMPO, MCO reduces the dose of organs at risk, shorten the time of optimization.
		2013 Vol. 22 (4): 305-308 [Abstract] ( 5129 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	309	Delta three-dimensional semiconductor array verification for intensity modulated planning of helical tomotherapy
		ZHANG Fu-li,WANG Ya-di, LIU Qing-zhi, ZHANG Yong-qian
		Objective To investigate the feasibility of dose verification of intensity modulated planning of helical tomotherapy (HT) using three-dimensional semiconductor array (Delta4) and find a more time-consuming and accurate method to validate the delivery dose. Methods Delta4 detector array was used to verify the HT plan dose distribution of 10 patients. The precise setup of detector array was guided and registered by MVCT imaging. After the implementation of delivery, the measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system (TPS). According to the different acceptance criteria combination of dose difference or distance to agreement at different threshold level including 3%/2 mm, 3%/3 mm, 3%/4 mm, 3%/5 mm at TH5, TH10, TH20, TH30, TH70, TH90, the γ analysis method was utilized to evaluate the dose verification. Results The dose distribution measured by the Delta4 was well consistent with that calculated by the TPS. The mean γpassing rates were all above 94.89%. Conclusions Delta4 detector array can get satisfying results when used in HT plan dose verification and is a viable tool to replace traditional film dosimetry system in clinical quality assurance work.
		2013 Vol. 22 (4): 309-311 [Abstract] ( 4137 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	312	Analyse two kinds of intensity-modulated radiotherapy verification methods comparatively by using the MatriXX
		DAI Yue,HU Chun-hong,LI Xiao-dong,GUO Yan-yan
		Objective To explore the MatriXX measurements the dose distributions for each beam in intensity-modulated radiotherapy (IMRT) plans were measured with 0 degree gantry angle and actual gantry position respectively. To discuss whether the two multi-angle synthetic pass rate from the two methods has statistics differences. Methods The dose distributions for each beam in IMRT plans were measured with 0 degree gantry angle and actual gantry position for twelve patients with head and neck tumor respectively. The γ pass rates (according to 3%/3 mm) for each beam under each angle condition was obtained by the comparison between the measured and the calculated dose distributions from the treatment planning system which was treated as the reference distribution. Use the t-test to analyse the actual gantry angle method and use the one factor analysis of variance to analyze the two multi-angle synthetic pass rate from the two methods. Results The γ pass rates of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle, but differentγ pass rates showed only in 80 °, 120°and 240° with 98.71%, 93.59%(t=2.10,P=0.000),98.15%,93.17%(t=2.10,P=0.000) and 98.94%,92.85%(t=2.10,P=0.000) respectively. The γ pass rate of multi-angle synthetic was seemingly between methods (98.27%,94.63%,F=0.50,P=0.134). Conclusions Two kinds of IMRT verification mode are from two position to validated the IMRT plans dose accuracy,comparatively analysing the conclusions drawn from the two methods can protect accuracy of IMRT plans more comprehensively.
		2013 Vol. 22 (4): 312-314 [Abstract] ( 4093 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	315	The clinical effect of Body-Fix device in improving the positioning accuracy of the hypofractionated radiotherapy in the vertebral metastatic patients
		ZHANG Ya-qin, LIU Yu-jie, XU Qing, ZHU Guo-pei, ZHANG Zhen
		Objective To study the immobilization effect and keep the accurate treating position of Body-Fix device in the patients with vertebral metastatic tumor treated by hypofractionated intensity-modulated radiotherapy. Methods From October 2008 to February 2010, six nasopharyngeal carcinoma patients with 10 treated lesion with vertebral metastasis who were treated by hypofractionated intensity-modulated radiotherapy and immobilized by the Body-Fix device were enrolled in this study. Three sets cone beam CT images were taken and recorded when patient was underway the initial setup, position correction and after radiation delivery. Comparing these images with the planning CT images to get the setup errors and the intrafractional position shifting, and the immobilization effect of Body-Fix device was analyzed. Results In the upper, middle and lower sections of the vertebrae, the intrafractional setup errors in the left-right direction were (－0.6±0.5) mm,(－0.1±1.0) mm,(0.0±0.4) mm, with in the superior-inferior direction (1.0±1.4) mm,(4.8±5.7) mm,(0.0±0.3) mm and in the anterior-posterior direction (1.2±5.2) mm,(－0.3±0.3) mm,(0.0±0.5) mm, respectively. Conclusions With Body-Fix device, the intrafractional setup errors can be minimized within 2 mm which make the accurate spinal radiosurgery technique possible.
		2013 Vol. 22 (4): 315-317 [Abstract] ( 4033 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	318	The investigation into measuring the accuracy of γ knife treatment
		LI Sheng-yuan,LI Xiao-yang, GAO Li, ZHOU Xuan, HUI Lu-lu, WANG Lei, TANG Xin, ZHOU Long-xing, HE Xin-bin, YAN Zheng
		Objective To study the feasibility of measuring the accuracy of whole process of the head γ knife treatment by the self-designed water phantom. Methods To make the treatment plan on the CT and MRI images of the water phantom and get the coordinates of exposed spots at x, y, z axis through the film frame with a view to detectingγ knife treatment accuracy in our hospital and the other five hospitals.Results Except localization by the computed tomography of our hospital, the accuracy ofγ knife treatment with localization by the imaging equipments (CT or MRI) in other hospitals all fail to get the technical request that the deviation is supposed to be within 0.5 mm. Deviation is mainly at y axis. After the correction of treatment plan parameters according to the deviation, we can make the deviation within 0.5 mm, thus we can ensure the accuracy of γ knife treatment. Conclusions It is necessary and feasible for our hospital to detect and correct the errors on the accuracy of γ knife treatment. The existing deviation can be diminished through the correction of treatment plan parameters to ensure the accuracy of case treatment and to provide reference and evidence for manufactures.
		2013 Vol. 22 (4): 318-321 [Abstract] ( 3424 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	322	Implement of the radiation therapy case study multi-media system based on windows remote desktop feature
		WU Qin-hong, LI Gao-feng, XIU Xia, ZHONG Qiu-zi, XU Yong-gang, LI Ming
		Objective To explore a method of using a computer system for multi-media cases study in radiation oncology clinical work, in order to replace the traditional use of film images and paper. MethodsWe use a dedicated networked computer′s Windows XP′s Remote Desktop feature to remote access an Eclipse TPS and the radiation therapy information management system. Then we can online read the patient′s information of CT images, target volumes, treatment plans, plan application forms and electronic medical records, and use a projector to project it on the screen. Results There has been half a year since we successfully set up a radiation therapy case study multi-media system in the department. It′s convenient and effective to achieve the department conducted a collective case discussion. Conclusions The equipment required is simple, and it′s a safe and reliable technology, greatly improving the clinical efficiency and quality of medical care.
		2013 Vol. 22 (4): 322-323 [Abstract] ( 3897 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	324


		2013 Vol. 22 (4): 324-325 [Abstract] ( 3522 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	326	UHRF₁ expression inhibition by RNA interference enhances the radiosensitivity of esophageal cancer cells
		YANG Cong-rong, WANG Ya-di, LI Cheng-lin, JING Shao-wu, SUN GUO-gui
		Objective To study the effect of UHRF₁ expression inhibition by RNA interference on the radiosensitivity of esophageal cancer cell line TE-1 and its mechanism. Methods Short hairpin RNA (shRNA) targeting UHRF₁ gene was introduced into TE-1 cells by lentivector-mediated transfer. The cells were divided into three groups:non-transfected group, negative control (NC)-shRNA-transfected group, and UHRF₁-shRNA-transfected group. The mRNA and protein expression levels of UHRF₁ in TE-1 cells were measured by RT-PCR and Western blot before and after transfection. After transfection and X-ray radiation, the radiosensitivity of TE-1 cells was evaluated by colony formation assay;the cell cycle and cell apoptosis were determined by flow cytometry;the γ-H₂AX (as a marker of DNA damage) level was measured by Western blot. Results After transfection with UHRF₁-shRNA, the mRNA and protein expression levels of UHRF₁ were significantly decreased in TE-1 cells, as compared with those in the NC-shRNA-transfected group and non-transfected group (0.11 vs 0.96 and 0.98, F=124.21, P=0.000;0.10 vs 0.89 and 0.94, F=125.25, P=0.000). The UHRF₁-shRNA-transfected group had sensitization enhancement ratios of 1.53(D₀ ratio) and 1.95(D_q ratio). X-ray radiation could cause G₂/M arrest and increase apoptotic rate and γ-H₂AX expression in TE-1 cells. Compared with the two control groups, the UHRF₁-shRNA-transfected group showed significantly less G₂/M arrest (F=500.15, P=0.000), a significantly higher apoptotic rate (F=100.10,P=0.000), and significantly higher residual γ-H₂AX expression (F=61.00,P=0.000) at 24 hours after X-ray radiation. Conclusions RNA interference can effectively inhibit the UHRF₁ expression and enhance the radiosensitivity of TE-1 cells. The mechanism may be related to cell cycle regulation, cell apoptosis, and DNA damage repair.
		2013 Vol. 22 (4): 326-328 [Abstract] ( 6347 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	333


		2013 Vol. 22 (4): 333-334 [Abstract] ( 3428 ) [HTML 1KB] [ PDF 0KB] ( 0 )

中华放射肿瘤学杂志

News

More.....

Cooperation unit

友情链接

China Association for
　Science and Technology

Chinese Medical Association

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

Chinese Anti-Cancer
　Association

Chinese Journal of Lung
　Cancer

Cqvp

CNKI

Wanfang Data

More....