Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2014 Vol.23 Issue.5 Published 2014-08-27

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

Abdominal Tumors

	373	Preliminary study on relationship between DVH parameters and late side effects of rectum in external-beam radiotherapy combined with CT-based brachytherapy for locally advanced cervical cancer
		An Jusheng, Huang Manni, Xu Yingjie, Xiong Suiyang, Wu Lingying, Dai Jianrong
		Objective To investigate the relationship between dose-volume histogram (DVH) parameters and the late side effects (LSE) of the rectum in external-beam radiotherapy combined with computed tomography (CT)-based brachytherapy for locally advanced cervical cancer. Methods From 2008 to 2011, 18 patients with stage II_B-III_B cervical cancer received external-beam radiotherapy and CT-based brachytherapy. The DVH parameters of high-risk clinical target volume (HR CTV) D₉₀, point A dose, and D_{1 cm³} and D_{2 cm³} of the rectum and bladder were calculated by Oncentra HDR treatment planning system. Survival outcomes were followed up and rectal LSE were evaluated by RTOG/EORTC grades. Results The point A dose and HR CTV D₉₀ were (93.0±5.5) Gy and (73.6±11.9) Gy, respectively. The median follow-up was 26 months. No recurrence was found during follow-up. Eight patients had mild and moderate rectal LSE, and their rectum D_{2 cm³} and D_{1 cm³} were significantly higher than those of patients without mild and moderate rectal LSE (D_{2 cm³} :(87.4±3.8) Gy vs. (75.8±7.4) Gy, P=0.004;D_{1 cm³} :(96.4±6.6) Gy vs. (80.5±7.1) Gy, P=0.001). Conclusions HR CTV D₉₀ in CT-based brachytherapy for locally advanced cervical cancer might be lower than that in the MRI-based plan. Rectum D_{2 cm³} is recommended to be less than 75 Gy.
		2014 Vol. 23 (5): 373-376 [Abstract] ( 3718 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	377	A clinical study of CT image-based 3D brachytherapy for cervical cancer
		Yan Junfang, Yu Lang, Sun Yuliang, Li Wenbo, Zhang Fuquan
		Objective To evaluate the feasibility and significance of CT image-based three-dimensional (3D) brachytherapy for cervical cancer. Methods Three-dimensional (3D) plan and two-dimensional (2D) plan were designed for 55 CT images of brachytherapy from 12 cervical cancer patients who received radical radiotherapy in 2013. Dosimetric comparison was performed between the 3D plan and 2D plan, and paired t-test, Wilcoxon signed rank test, Pearson correlation analysis, and Spearman correlation analysis were performed. Results A point dose, D₉₀, V₁₀₀, CI, and CI′ in 3D plan were higher than those in 2D plan (P=0.015,0.016,0.000,0.000,0.000). Bladder point dose, rectal point dose, and rectal D_{2 cm³} in 3D plan were slightly higher than those in 2D plan, but hot spot dose was significantly reduced in 3D plan (P=0.140,0.123,0.214). Bladder D_{2 cm³} was significantly higher than bladder point dose (P=0.000). Sigmoid colon D_{2 cm³} was more correlated with the average doses of the three highest rectal points than rectal D_{2 cm³}(r=0.314,0.630, P=0.000,0.000). V₁₀₀ showed a linear relationship with high-risk CTV (r=0.981, P=0.000). Bladder D_{2 cm³} was higher than 430 cGy when the bladder volume was more than 80 cm³;small intestinal D_{2 cm³} did not change significantly when the bladder volume was less than 115 cm³, but decreased significantly once the volume exceeded the value. Conclusions Compared with the traditional 2D plan, the 3D plan for CT image-based cervical cancer brachytherapy significantly increases the target coverage and conformity index, but does not significantly increase the doses to organs at risk. Point dose evaluation is confirmed to be inaccurate. The doses to the bladder, rectum, and small intestine can be adjusted by controlling the bladder volume.
		2014 Vol. 23 (5): 377-381 [Abstract] ( 3946 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	382	Impacts of bladder filling status on dosimetric parameters of target volume and OAR in intensity-modulated radiotherapy for prostate cancer
		Zhang Liang, Ju Yongjian, Wang Gaoren, Wu Dijun, Li Kexin, Cao Liyuan
		Objective To study the impacts of bladder filling status on the dosimetric parameters of the target volume and organs at risk (OAR) in intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods Ten localized prostate cancer patients without serious complications treated with IMRT were selected for this study. These patients underwent CT scans of the whole pelvic cavity three times in different bladder filling status (empty and injected with 150 ml and 300 ml of normal saline) to obtain three series of pelvic CT images. The three sets of CT images were transferred to the treatment planning system. The target volume and OAR such as the rectum, bladder, and femoral heads were contoured by the same doctor. The treatment planning was performed and optimized by the physicist. The dosimetric parameters of the target volume and OAR in three bladder filling status were subjected to analysis by paired t-test. Results If the bladder filling status was consistent in orientation and radiation, the bladder filling status was not associated with the dosimetric parameters of the target volume and femoral heads (P=0.077-0.998;P=0.219-0.969);it had significant impacts on the dosimetric parameters of the bladder (P=0.000-0.562) and some dosimetric parameters of the rectum (P=0.000-0.645), and bladder filling was favorable for the protection of the bladder and rectum. If the bladder filling status was not consistent in orientation and actual radiation, the calculated planning target volume, the dosimetric parameters of the bladder, and some dosimetric parameters of the rectum were different from those in actual treatment (P=0.000-0.913). Conclusions For the prostate cancer patients treated with IMRT, it is recommended to keep the bladder well and consistently filled.
		2014 Vol. 23 (5): 382-385 [Abstract] ( 3720 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	386	Safety of intraoperative electron radiation therapy for primary hepatocellular carcinoma:a cohort study
		Xu Cai, Feng Qinfu, Bi Xinyu, Fan Chengcheng, Zhui Yirui, Li Minghui, Cai Jianqiang
		Objective To investigate the safety of intraoperative electron radiation therapy (IOERT) for stage I hepatocellular carcinoma (HCC) by a cohort study. Methods From November 2010 to May 2012, 16 patients who were pathologically diagnosed with stage I HCC underwent IOERT after radical resection. With a cohort study, 87 patients with stage I HCC who underwent radical resection alone during the same period were qualified, and according to tumor size (>5 cm and ≤5 cm) and resection margin (close margin and negative margin), 32 of 87 patients made up the control group. The intraoperative and postoperative adverse events, liver function parameters, coagulogram, and routine blood parameters, as well as IOERT-related adverse reactions, were evaluated. Independent-samples t test was used for analyzing the differences between groups. Results Compared with the control group, the IOERT group had a significantly longer operative time ((275.4±71.55) min vs. (184.7±64.74) min, P=0.000), a slightly higher incidence of intraoperative adverse events (18.75% vs. 6.25%, P=1.000), a slightly lower incidence of operative complications (12.50% vs. 28.12%, P=0.460), and a lower perioperative mortality (0 vs. 6%, P=0.440). Liver function parameters showed no significant differences between the two groups (P>0.05). There were no significant differences between the two groups in postoperative time to grade 1 or normal liver function parameters, median length of postoperative hospital stay, length of hospital stay in the surgical department, time to incision healing, and level of incision healing (P>0.05). During follow-up, no radiation hepatitis was found in the IOERT group. Conclusions As an adjuvant therapy after radical resection for early HCC, IOERT has no significant side effects on postoperative recovery and liver function, and an intraoperative dose of 15-16 Gy is safe.
		2014 Vol. 23 (5): 386-389 [Abstract] ( 3246 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

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		2014 Vol. 23 (5): 390-391 [Abstract] ( 3033 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2014 Vol. 23 (5): 409-410 [Abstract] ( 2660 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	415	Analysis geometrical uncertainties of 220 cases in helical tomotherapy (HT)
		Wang Zhiwei, Duan Jimei, Yue Qi, Yang Xiumei, Gu Dan, Li Rongqing
		Objective To analyze geometrical uncertainties of the target and provide the margin enlarging from clinic target volume (CTV) to planning target volume (PTV) with HT. Methods Analysis set-up data of 220 cases include 97 cases of head and neck,45 cases of chest and 78 cases of abdomen and pelvic, calculating the systematic error (Σ) and the random error (σ) in the three-dimension and check whether the set-up data accord with the normal distribution or not, then acquire the values expand in the three directions based on formula 2.0Σ+0.7σand μ±2.58σ. Results The systematic error (Σ) and random error (σ) of head and neck, the chest and abdomen and pelvic were (0.7-1.9 mm,1.1-1.4 mm),(0.8-4.2 mm,1.5-3.2 mm),(1.1-4.1 mm,1.8-4.1 mm),respectively, and the margin that expand in the direction of x, y, z were (5.2,6.5,7.7 mm),(7.5,16.2,10.3 mm),(7.6,17.1,15.7 mm),respectively. Conclusions The curative effect of this task need prove with a large sample during HT, but other should establish data of margin by yourself.
		2014 Vol. 23 (5): 415-417 [Abstract] ( 3689 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	418	Simulafion of respiratory motion effect on dose distributions in three-dimensional radiotherapy of tumor
		Ruan Changli, Song Qibin, Xu Liming,Li Xiangpan, Zhu Yuxin, Fu Jingguo, Wang Luzhou, Wu Bing, Zhang Jun
		Objective To evaluate the effects of respiratory on dose distributions in three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT). MethodsThe dose distributions were measured with a Sun Nuclear Mapcheck 2D-ARRAY placed on a moving platform home-made to simulate the respiratory. The periodic motion of the moving platform was 3.5 s. The rang of the moving platform was ±3 mm,±5 mm,±10 mm,±15 mm. Dosimetric comparisions for 3DCRT and IMRT plans were performed by means of Gamma analysis with 3% and 3 mm, respectively. Dates of two groups were used by paired t-test. Results The respiratory could reduce the target dose and conformal index, blurring effect of dose distribution. The pass rate (3%/3 mm) in 3DCRT was greater than it in IMRT of the 11 cases, and P<0.05;The failed points were mainly near the field edge for 3DCRT plans, but located in the whole target volumes for IMRT plans. Conclusions Respiratory motion blurred the dose distribution of 3DCRT and IMRT, yet the influence on IMRT was much more striking. As for tumors with large motion amplitude, it is advisable to use 3DCRT rather than IMRT techniques. 3DCRT may deliver a more reliable dose distribution by cautiously delineating the PTV margin.
		2014 Vol. 23 (5): 418-421 [Abstract] ( 3574 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	422	Evaluation of PTW Seven29 combining Octavius phantom for tomotherapy patient-specific quality assurance
		Zhang Fuli, Wang Yadi, Liu Qingzhi, Zhang Weichao,Wang Ping
		Objective To investigate the feasibility of dose verification of helical tomotherapy (HT) using the PTW Seven29 2D-ARRAY with Octavius phantom. Methods The 12 patients HT plan were verified with the PTW Seven29 2D-ARRAY combining Octavius phantom. The detector array was guided and registered by MVCT imaging, and measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system (TPS). Based on several different Gamma criteria, the Gamma analysis method was utilized to evaluate the dose verification. Results According to the different acceptance criteria combination of dose difference/ 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, the mean passing rates with γparameter ≤1 were all above 91.7% and 93.9% when PTW Seven29 2D-ARRAY was horizontal and vertical. The dose distribution measured by the 2D-ARRAY combining Octavius phantom was well consistent with that calculated by the TPS. Conclusions 2D-ARRAY with Octavius phantom 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.
		2014 Vol. 23 (5): 422-425 [Abstract] ( 3875 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	426	Analysis of accuracy of bladder volume by simulating water mold based on Computed Tomography and kilovoltage cone-beam computed tomography images
		Hu Jian, Xu Liming, Li Changhu, Zhang Aihua, Xu Ximing, Ge Wei, Peng Zhoufeng, Yang Renjie
		Objective To study accuracy and stability of bladder mold volume using fan beam CT (FBCT) and kilovoltage cone-beam CT (CBCT). Methods The water bladder molds in 2 categories:hard and soft water wall molds (1 group and 3groups), scanned by FBCT and CBCT. FBCT was scanned by 2 rows of Hispeed dual and 64 rows of Lightspeed VCT spiral scan, then it was divided into two groups according to the pitch/speed of bed. CBCT was scanned by pelvis, pelvis spotlight and high quality head scan. Every scan repeated 5 times, then compared reconstruction volume with the real volume, analyzing stability and repetition by treatment planning system and the results of two phantoms by using independent sample t test. Results The deviation which compared the hard wall phantom with the real value was FBCT:－(1.5-0.2)%, CBCT:－(5.1-2.9)%.The deviation of soft wall molds, FBCT:－(4.2-0.1)%, CBCT:－(4.0-0.3)%.Reconstruction volume of FBCT decreases with the increase of motion speed and pitch of bed,the volume of Hispeed was greater than the Lightspeed (hard wall molds, P=0.010 and soft wall molds, P=0.004).Among CBCT modes, the pelvis one had the smallest reconstruction volume (hard wall molds:CBCTH vs. CBCTP,P=0.020, CBCTP vs. CBCTPS P=0.013 and soft wall molds:CBCTH vs. CBCTP,P=0.006, CBCTP vs. CBCTPS P=0.008.). Conclusions Reconstruction volume of FBCT and CBCT have no statistical difference, and both of them have a good repeatability. Slow scan mode is recommended when using FBCT for active organ (respiration, filling and so on). Pelvis spotlight and high quality head protocols are recommended when using CBCT scanning.
		2014 Vol. 23 (5): 426-428 [Abstract] ( 5984 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	433	The study of error in the head and neck phantom using the X-ray volumetric image system of Elekta Synergy accelerator with CBCT
		Xu Senkui,Yao Wenyan,Lin Chengguang
		Objective To investigate the accuracy and reliability of the image automatic matching using X-ray volumetric image (XVI) system with the accelerator Elekta Synergy and to compare the matches with different methods and area. Methods A simulation plan using the head and neck phantom was designed and sent to XVI system for CBCT scanning. During the scanning,the couch for certain distance was moved and the data of XVI image automatic Matching in different matching methods and area was collected. Results The result of XVI image automatic matching is consistent and correct to direction and distance which the couch had been moved (x:(0.11 ± 0.41) mm, y:(－0.04± 2.6) mm, z:(0.28 ± 0.74 mm)).There are not significant differences between the results that matching in different matching methods and different matching area. Conclusions The automatic image Matching of XVI is accuracy and high reliability in recognition of offset error. But there are some significant differences on the automatic image Matching in different matching methods and different matching area.
		2014 Vol. 23 (5): 433-436 [Abstract] ( 3690 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	437	Dosimetry influence of different radiotherapy technologies caused by cavity and inhomogeneous tissues
		Li Jian, Kang Shengwei, Qi Guohai, Wu Dake, Zhong Hailuo,Wang Pei
		Objective To investigate influence on dose distribution due to cavity andinhomogeneous structures using thermoluminescence dosimeters (TLD) and Chengdu phantoms. Methods A cavity 4 cm×4 cm×3 cm was made by a head and neck phantom and a lung phantom was cut into slices which were got a CT scanning and setup in a digital simulator. The TLD were pasted on edge and in the center of cavity structure and inhomogeneous structures. Treatment plans of different radiotherapy technologies were made generated and delivered on a linear accelerator. Then the TLD were read and analyzed. Results There were remarkable cavity effects of conventional single field, opposite fields and IMRT plans with 7 fields for head and neck phantom. There is similar effect in lung phantom. The more complexity the radiotherapy technology was the less cavity effect. Conclusions It is necessary to consider using more advanced radiotherapy technology or applying more fields to make treatment plans in order to decrease the cavity effect or similar effect when there are inhomogeneous structures.
		2014 Vol. 23 (5): 437-439 [Abstract] ( 3015 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	444	Probabilistic safety assessment method in the application of external beam radiotherapy process control management study
		Hu Rui, Wang Shi, Wu Jinchang, Shen Danqing, Wu Zhaoxia
		Objective To study the probability safety assessment to analyze and evaluate radiation error risk in the external beam radiotherapy, so as to establish and strengthen the control and management of the radiotherapy process, continuous improvement of quality control and quality management. Methods To build the whole of radiotherapy flow chart and process tree, using the decision tree model to determine critical control points in the whole process, making risk assessment chart and analyzing 4 patients with potential safety hazards error. Results The whole process is divided into 22 missions in 3 functional areas, the entire cover 15 branches and 59 key and 11 key control point. The enumeration of error as risks and critical control points has certain correlation. Conclusions Probabilistic safety assessment method have strengthened manage, analyze and control to risk, and all these provide the basis for developing and improving radiotherapy process control management. Radiotherapy quality management for future multidisciplinary and high-level management personnel who take up provides a prospective study.
		2014 Vol. 23 (5): 444-447 [Abstract] ( 3367 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	448	Pigment epithelium-derived factor enhances radiation response by inducing vascular normalization in Lewis lung carcinoma
		Xu Zumin, Peng Fang, Dong Yong, Yu Zhonghua, Zuo Yufang, Chen Yuanyuan, Wang Jin, Hu Xiao, Zhou Qichao, Ma Honglian, Bao Yong, Gao Guoquan, Chen Ming
		Objective To observe the effects of pigment epithelium-derived factor (PEDF) on vascular normalization in lung cancer and further investigate the combined effects of PEDF and radiation on the growth of lung cancer. Methods Immunofluorescent staining was used to observe the effects of PEDF on vascular normalization in lung cancer and determine the time window of vascular normalization. C₅₇BL/6 mice bearing Lewis lung carcinoma xenografts were prepared and divided into control group, PEDF group,radiation group, and PEDF+radiation groups. The growth of tumor xenografts was evaluated. ResultsPEDF reduced the vascular density and basement membrane thickness of Lewis lung carcinoma xenografts, increased the pericyte coverage of blood vessels, and reduced the hypoxic fraction of tumor xenografts. On days 3-7 of PEDF treatment, the PEDF group had a reduced fraction of hypoxic tumor cells compared with the control group (33.73%), and the lowest value for PEDF group was seen on day 3(20.79%). The time window of vascular normalization induced by PEDF was days 3-7. PEDF combined with radiation delivered on day 5 of PEDF treatment had a stronger inhibitory effect on tumor xenografts than radiation alone and PEDF combined with radiation delivered on day 1 of PEDF treatment. Conclusions PEDF can promote the vascular normalization in lung cancer and enhance the anti-lung cancer effect of radiation.
		2014 Vol. 23 (5): 448-453 [Abstract] ( 3194 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	392	Analysis of age and prognosis in patients with esophageal squamous cell carcinoma after 3DCRT
		Zhang Andu, Han Chun, Lan Kuntian, Wang Lan, Kong Jie, Gao Chao, Li Xiaoning
		Objective To investigate the long-term survival of esophageal squamous cell carcinoma(ESCC) patients of different ages after three-dimensional conformal radiotherapy (3DCRT). MethodsFrom July 2003 to September 2008, 769 patients with stage I-III ESCC were eligible for the analysis. All patients were treated with 3DCRT. The prescribed dose was 50-70 Gy (median, 60 Gy), 1.8-2.0 Gy per fraction, 5 fractions per week. The Kaplan-Meier method was used to calculate overall survival (OS) and local control (LC) rates;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow-up rate was 98.3%. For all patients, the 1-, 3-, and 5-year LC rates were 76.3%, 52.8%, and 48.5%, respectively, and the 1-, 3-, and 5-year OS rates were 70.1%, 36.2%, and 23.0%, respectively. The 1-, 3-, and 5-year OS rates were 71.2%, 38.8%, and 24.9%, respectively, for patients aged 45-74 years, versus 69.6%, 26.6%, and 15.4% for patients aged 75-89 years (P=0.008). Multivariate prognostic analysis showed that age was also a prognostic factor in ESCC patients after 3DCRT. A total of 620 patients died. Patients aged 45-74 years had a significantly higher proportion of individuals that died of distant metastasis (23.9% vs. 14.2%, P=0.009), while patients aged 75-89 years had a significantly higher proportion of individuals that died of non-cancer diseases (14.1% vs. 4.9%, P=0.000). Conclusions Survival varies between ESCC patients of different ages after 3DCRT. The survival of elderly ESCC patients is poor, and the relatively high mortality from non-cancer diseases may be an important reason for poor survival.
		2014 Vol. 23 (5): 392-395 [Abstract] ( 3671 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	396	Differences and radiation pneumonitis prediction of lung dosimetric parameters based on three normal lung definitions in 3DCRT treatment planning
		Wang Jin,Bao Yon, Zhuang Tingting, Zhang Li, He Zhichun, Xu Yujin, Ma Honglian, Hu Xiao, Zhou Qichao, Peng Fang, Deng Xiaowu, Chen Ming
		Objective To compare lung dose-volume histogram (DVH) parameters based on commonly used normal lung definitions, i.e., lungs-gross tumor volume (GTV), lungs-clinical target volume (CTV), and lungs-planning target volume (PTV), in three-dimensional conformal radiotherapy(3DCRT) and to determine to what extent they differ in predicting radiation pneumonitis (RP). MethodsA total of 147 non-small cell lung cancer patients treated with concurrent chemotherapy and 3DCRT from 2006 to 2010 were collected. RP was diagnosed according to RTOG criteria. Lung DVHs were generated with exclusion of GTV, CTV, or PTV. Independent-samples t test was used to compare DVH parameters based on different normal lung definitions, and the predictive values of these parameters for RP were evaluated with the receiver operating characteristic (ROC) curve. Results There were significant differences in minimum lethal dose (MLD) between lungs-GTV and lungs-CTV/lungs-PTV ((1.16±0.96) Gy vs. (3.45±1.43) Gy). The biggest difference in MLD for the same patient based on different definitions was 8.73 Gy. MLD based on lungs-GTV had a better predictive value for grades ≥2 and ≥3 RP than MLD based on lungs-CTV and lungs-PTV, with larger areas under the ROC curve (lungs-GTV:area=0.614, P=0.024;area=0.678, P=0.056;lungs-CTV:area=0.556, P=0.269;area=0.602, P=0.226;lungs-PTV:area=0.551, P=0.317;area=0.616, P=0.167). We drew a similar conclusion when analyzing lung V₅-V₅₀. Conclusions There are significant differences between DVH parameters based on various normal lung definitions, which cannot be neglected in the clinical setting. DVH parameters based on lungs-GTV may be the most accurate in predicting RP.
		2014 Vol. 23 (5): 396-399 [Abstract] ( 3603 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	400


		2014 Vol. 23 (5): 400-400 [Abstract] ( 2422 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	401	Role of thoracic conformal radiotherapy in patients with extensive-stage small cell lung cancer
		Luan Zupeng, Wang Zhiwu, Huang Wei,Zhang Jian, Dong Wei, Zhang Wei, Li Baosheng
		Objective To evaluate the role of thoracic three-dimensional conformal radiotherapy (3DCRT) in patients with extensive-stage small cell lung cancer (ES-SCLC). Methods A total of 171 patients with ES-SCLC admitted from 2004 to 2009 were included in the study. Eighty-six patients received thoracic 3DCRT and systemic chemotherapy (CT), while 85 patients received systemic CT alone. 3DCRT was delivered at 1.5 Gy/fraction twice daily or 2.0 Gy/fraction once daily, with a total dose ranging from 40 to 62 Gy. The CT regimen consisted of carboplatin/cisplatin and etoposide. The survival time and survival rate were calculated by the Kaplan-Meier method, and the log-rank test was used for univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis. Results The follow-up rate was 100%. The median overall survival (OS) time and the 2- and 5-year OS rates were 15 months, 31.5%, and 2.4%, respectively, for all patients;they were 18 months, 35.3%, and 2.4%, respectively, for the CT/3DCRT group, versus 12 months, 14.5%, and 2.4% for the CT group (P=0.023). The median progression-free survival (PFS) time and the 1-and 2-year PFS rates were 8 months, 27.5%, and 2.4%, respectively, for all patients;they were 9 months, 35.4%, and 6.0%, respectively, for the CT/3DCRT group, versus 6 months, 20.5%, and 6.0% for the CT group (P=0.004). In the CT/3DCRT group, the 22 patients who received 45 Gy at 1.5 Gy/fraction twice daily had a median PFS time of 11 months, versus 9 months for the 26 patients who received 60 Gy at 2.0 Gy/fraction once daily (P=0.037). Multivariate analysis revealed that receiving ≥4 cycles of CT (P=0.001) and 3DCRT (P=0.008) were favorable prognostic factors for OS. Conclusions Thoracic 3DCRT can improve the OS and PFS in patients with ED-SCLC, and it has good efficacy when delivered with a total dose of 45 Gy at 1.5 Gy/fraction twice daily. Thoracic 3DCRT and receiving ≥4 cycles of CT are independent favorable prognostic factors for OS.
		2014 Vol. 23 (5): 401-405 [Abstract] ( 3363 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Head and Neck Tumors

	406	Characteristics and prognosis of primary mucosal melanoma of nasal cavity and paranasal sinuses:a clinical analysis of 94 patients
		Yuan Wei, Wang Weifang, Wang Shengzi, Ding Hao, Chen Fu, Zhang Haiyan, Zou Lifen
		Objective To investigate the clinical features and survival status of mucosal melanoma of the nasal cavity and paranasal sinuses and to analyze the prognostic factors. Methods A retrospective analysis was performed on the clinical data of 94 patients with mucosal melanoma of the nasal cavity and paranasal sinuses treated from January 2000 to December 2012. Of the 94 patients, 50 were male, and 44 were female. The median age of onset was 60 years (range, 26-85 years). The primary sites were nasal cavity (86 patients), maxillary sinus (7 patients), and nasopharynx (1 patient). Cervical lymph node metastasis was observed in 10 patients (7 patients before treatment, 2 patients during treatment, and 1 patient after treatment).No patient had distant metastasis.Patients were treated with surgery ± radiotherapy. The Kaplan-Meier method was used to calculate survival rates, and the logrank test was used for univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The 1-, 3-, and 5-year sample sizes were 80, 54, and 50, respectively. The 1-, 3-, and 5-year disease-related survival rates were 71%, 33%, and 22%, respectively. Univariate analysis showed that the prognostic factors were age over 55 years (P=0.034), involvement of the posterior naris (P=0.011), involvement of the maxillary sinus (P=0.009), involvement of the hard palate (P=0.003), cervical lymph node metastasis (P=0.001), and therapeutic method (P=0.038). Multivariate analysis showed that the prognostic factors were involvement of the posterior naris (P=0.027), involvement of the orbit (P=0.005), and involvement of the hard palate (P=0.003). Conclusions The distant metastasis and local recurrence rates are high among patients with mucosal melanoma of the nasal cavity and paranasal sinuses, so combination therapy is imperative. Cervical lymph node metastasis rate is low. Rational clinical staging needs to be further explored.
		2014 Vol. 23 (5): 406-408 [Abstract] ( 3419 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	411	The characteristics and prognosis of meteastases to the breast from nasal cavity tumors
		Qu Yuan, Yi Junlin, Huang Xiaodong, Wang Kai, Gao Li
		Objective To detect the clinical features and prognostic factors of nasal cavity malignancy with breast metastasis. Methods 846 Patients with nasal cavity malignancy from January 1999 to December 2011 were enrolled, the clinical and pathological features, clinical diagnostic methods and prognostic factors for breast metastasis patients were analyzed. Results Six female cases (median age 25) were diagnosed with breast metastasis, including 3 rhabdomyosarcoma and 3 olfactory neuroblastoma;consisting 0.7% of the total 846 cases of primary nasal malignancy group. The metastasis were more likely to be multiple breast lesions with/without metastasis in other site. For the primary tumor, five patients received 66-72 Gy/30-33f of radical radiotherapy, one patient with rest rhabdomyosarcoma received 58 Gy of palliative radiation since breast metastasis was found after 14 Gy of radiation and breast mass resection were performed right after. For the breast metastasis, five of 6 patients received breast surgery, one patients with olfactory neuroblastoma received 6 cycles cyclophosphamide+adriamycin+vincristine chemotherapy. Median survival was 12.7 months. Conclusions For nasal cavity malignancy, breast metastasis more likely occur in younger female patients. Ultrasound may provide useful information in evaluating breast metastasis. Cases combined with metastasis except breast have unfavorable prognosis.
		2014 Vol. 23 (5): 411-414 [Abstract] ( 3359 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review

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		2014 Vol. 23 (5): 429-432 [Abstract] ( 3012 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2014 Vol. 23 (5): 440-443 [Abstract] ( 3282 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2014 Vol. 23 (5): 454-456 [Abstract] ( 2796 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2014 Vol. 23 (5): 458-460 [Abstract] ( 2984 ) [HTML 1KB] [ PDF 0KB] ( 0 )

News

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		2014 Vol. 23 (5): 457-457 [Abstract] ( 2678 ) [HTML 1KB] [ PDF 0KB] ( 0 )

中华放射肿瘤学杂志

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