Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2015 Vol.24 Issue.6 Published 2015-10-30

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

Thoracic Tumors

	605	Predictive factors for acute symptomatic esophagitis in 256 patients with locally advanced non-small cell lung cancer treated with intensity-modulated radiation therapy
		Sun Shuai,Wang Jingbo,Ji Zhe,Chen Xinyuan,Bi Nan,Zhou Zongmei,Feng Qinfu,Hui Zhouguang,Liang Jun,Xiao Zhefen,Lyu Jima,Wang Xiaozhen,Zhang Fuquan,Yin Weibo,Wang Lyuhua
		Objective To explore the incidence and related predictive factors for acute symptomatic esophagitis in patients with locally advanced non-small cell lung cancer (NSCLC) treated with intensity-modulated radiation therapy (IMRT). Methods Data were collected retrospectively from 256 patients with inoperable or unresectable stage Ⅲ NSCLC treated in our hospital between January 2007 and December 2011.The radiotherapy target volume included primary lung cancer and lymphatic drainage area involved, with a median dose of 60 Gy in 30 fractions (50－70 Gy).Of all the patients, 109 patients (42.6%) received concurrent chemotherapy. Grade ≥2 acute esophagitis (AE)(symptomatic esophagitis) which occurred during radiotherapy and within 3 months after completion of radiotherapy served as the outcome event. National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0(NCI-CTCAE3.0) was used to evaluate the grade of AE.The logistic regression model was used to analyze the predictive factors. Results A total of 174 patients (68%) had treatment-related grade ≥2 AE;154 patients (60.2%) had grade 2 AE and 20 patients (7.8%) had grade 3 AE.The median dose when grade ≥2 AE occurred was 30 Gy (11-68 Gy).For grade ≥2 AE, multivariate analysis showed that esophageal V₅-V₆₀, mean dose, and age were independent predictive factors (P=0.021, 0, 0.010).For grade ≥3 AE, multivariate analysis showed that esophageal V₅₀-V₆₀, concurrent chemotherapy, and body mass index (BMI) were independentpredictivefactors (P=0.010, 0.003, 0.019).Old age and higher BMI were the protective factors for grade ≥2 and≥3 AE, respectively. Conclusions For patients with locally advanced NSCLC treated with IMRT, esophageal V₅₀—V₆₀ and concurrent chemotherapy are predictive factors for grade ≥3 AE, and esophageal V₅₀ has a high predictive value for both grade ≥2 and ≥3 AE.
		2015 Vol. 24 (6): 605-609 [Abstract] ( 2234 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	611	A prospective phase II study of consolidation chemotherapy after concurrent chemoradiotherapy for oligometastatic stage IV non-small cell lung cancer
		Lyu Jiahua,Li Tao,Liu Li,Li Fang,Li Churong,Song Yanqiong,Wang Qifeng,Wang Junchao
		Objective To evaluate the efficacy and safety of consolidation chemotherapy after thoracic radical concurrent chemoradiotherapy for patients with oligometastatic non-small cell lung cancer (NSCLC). Methods Sixty-six NSCLC patients with more than five metastases from 2008 to 2013 were enrolled, and image-guided radiotherapy with conventionally fractionated or hypofractionated doses were performed for these patients. Platinum-based doublets chemotherapy was applied for both concurrent chemoradiotherapy and consolidation chemotherapy. Short-term outcome, adverse reactions, and survival rate were assessed for the patients after treatment. Results Sixty-four patients completed the treatment. The median biologically equivalent dose for planning target volume of thoracic primary tumor lesions was 72 Gy, with a median number of chemotherapy cycles of 4. The Objective response rate for thoracic lesions was 70%. The follow-up rate was 97%. The 1-, 2-, and 3-year overall survival (OS) rates were 72%, 53%, and 31%, respectively, with a median OS time of 25 months;the 1-, 2-, and 3-year progression-free survival (PFS) rates were 56%, 26%, and 7%, respectively, with a median PFS time of 14 months. The incidence of grade 2-3 acute radiation pneumonitis and radiation esophagitis was 1% and 17%, respectively, and the incidence of grade 3-4 decreases in leukocytes, hemoglobin, and platelet count was 39%, 11%, and 16%, respectively. Conclusions Radical radiotherapy combined with concurrent and consolidation chemotherapy for oligometastatic NSCLC can achieve good short-term outcome and long-term survival, with tolerable adverse effects.
		2015 Vol. 24 (6): 611-614 [Abstract] ( 2951 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	615	A comparative study of different irradiation ranges in radical radiotherapy for early-stage esophageal cancer
		Zhu Shuchai,Dong Hui,Liu Zhikun,Shen Wenbin,Li Juan,Su Jingwei,Xu Jinrui
		Objective To compare the efficacy of elective nodal prophylactic irradiation (ENI) and involved-field irradiation (IFI) in radical radiotherapy for early-stage esophageal cancer and to determine the appropriate irradiation range for early-stage esophageal cancer. Methods The clinical data of 121 patients with early-stage esophageal cancer receiving radical radiotherapy in our hospital from January 2006 to December 2011 were collected and respectively analyzed. Sixty-one patients received ENI, and the other 60 patients received IFI. The Kaplan-Meier method was used to calculate local control (LC) and overall survival (OS) 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 1-, 3-, and 5-year LC rates in ENI group and IFI group were 81.1%, 60.1%, and 57.5% vs. 64.5%, 43.9%, and 27.2%, respectively (P=0.003). The 1-, 3-, and 5-year OS rates in ENI group and IFI group were 86.9%, 56.8%, and 34.8% vs. 86.7%, 34.3%, and 19.1%, respectively (P=0.019). The 1-, 3-, and 5-year overall failure rates in ENI group and IFI group were 22.3%, 53.8%, and 63.2% vs. 43.3%, 65.8%, and 78.8%, respectively (P=0.023). Multivariate analysis showed that irradiation range was the influencing factor for LC and OS. Conclusions As for the radical radiotherapy for early-stage esophageal cancer, ENI can significantly increase LC and reduce locoregional failure, and therefore improve long-term OS.
		2015 Vol. 24 (6): 615-618 [Abstract] ( 3051 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	619	Radiotherapy following modified radical mastectomy significantly improves locoregional control in patients with Rec-/HER-2+ locally advanced breast cancer
		Zhang Jianghu,Wu Tao,Wang Shuya,JinJing,Liu Yueping,Wang Weihu,Song Yongwen,Yu Zihao,Liu Xinfan,Li Yexiong
		Objective To evaluate the risk of locoregional recurrence (LRR) and role of radiotherapy for patients with estrogen receptor-negative and human epidermal growth factor receptor 2-overexpressed (Rec-/HER-2+) locally advanced breast cancer (LABC). Methods A retrospective analysis was performed on the clinical data of 294 patients with Rec-/HER-2+ LABC from 1999 to 2011. All patients were treated with modified radical mastectomy (MRM). Of them, 239 patients received postmastectomy radiotherapy and 55 patients did not. Locoregional recurrence-free survival (LRRFS) and overall survival (OS), as well as LRR, were compared between the two groups. The Kaplan-Meier method was used to estimate survival and recurrence rates, and the log-rank test was used for survival difference analysis and univariate prognostic analysis. Multivariate prognostic analysis was performed using the Cox regression model. Results The 5-year sample size was 162. Fifty-six patients developed LRR. The 5-year LRRFS and OS rates were 79.7% and 70.0%, respectively. Postmastectomy radiotherapy significantly increased the 5-year LRRFS rate (85.1% vs. 56.0%, P=0.000), but did not significantly increase the 5-year OS rate (71.3% vs. 64.2%, P=0.441). Multivariate analysis indicated that postmastectomy radiotherapy was the only independent prognostic factor associated with increased LRRFS (RR=0.303, 95%CI:0.166-0.554, P=0.000). Conclusions Patients with Rec-/HER-2+ LABC treated with MRM alone appear to be at a significantly increased risk of LRR compared with those treated with MRM followed by radiotherapy.
		2015 Vol. 24 (6): 619-622 [Abstract] ( 2868 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	623	Optimization of radiotherapy target delineation after breast cancer surgery
		Li Dongqin,Peng Mingya,Cai Rong,Hu Lijun,Sun Zhiqiang,Ni Xinchu,Wang Jian,Nie Bin,Li Yi,Meng Qinghong,Sun Suping,Yu Jingping
		Objective To optimize the method for radiotherapy target delineation after breast cancer surgery, and to observe its advantage in raising work efficiency. Methods Ten physicians in our department were selected, and 20 patients who received breast-conserving surgery were randomly selected. The 10 physicians delineated the targets for these patients with the method in the control group and the method in the study group, and the time required for each delineation was recorded. The method in the control group was commonly used in daily practice and the method in the study group was optimized. The independent-samples t test was applied to compare the differences between the two groups. Results With the optimized method, the average time of delineation in the study group was less than that in the control group (51 min vs. 65 min, P=0.029). The time curves for delineation in the control group were relatively flat;the time curves for delineation in the study group were high at first, then decreased gradually, and finally became flat. The time for each physician to finish delineation skillfully was relatively stable, while in the study group, the time started to decrease after delineation for the first few patients, with an apparent learning process. Conclusions The optimized method for target delineation in breast cancer is feasible, reliable, and easy to master, and can increase work efficiency, which is more obvious in physicians with rich experience in delineation.
		2015 Vol. 24 (6): 623-626 [Abstract] ( 3350 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	627	Predictors of pathologic complete response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer
		Chen Yuangui, Xu Benhua, Lu Haijie, Chen Mingqiu, Li Xiaobo, Guo Yuyan, Li Jinluan, Wu Junxin
		Objective To evaluate the potential influencing factors associated with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC). Methods A retrospective analysis was performed on the clinical data 265 patients with stage Ⅱ and Ⅲ(the 7^th version of AJCC) rectal cancer admitted to our hospital from 2011 to 2013. All patients underwent neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery with/or without induction chemotherapy during the interval between the complete of CCRT and surgery. The predictors associated with pCR were analyzed by univariate and multivariate logistic regression analyses. With the use of the independent predictive variables for pCR from multivariate analysis, a clinical risk score model was established according to the following criteria:no-risk group (0 factor);low-risk group (1 factor);high-risk group (2 factors). Results Among these 265 patients, 50(18.9%) achieved pCR. The univariate analysis showed that carcinoembryonic antigen (CEA) level before CCRT (P=0.017), T stage before CCRT (P=0.001), interval between complete of CCRT and surgery (P=0.000), and the maximum tumor thickness before CCRT (P=0.040) were significantly associated with pCR. The multivariate analysis showed that pre-CCRT CEA level (P=0.021 or 0.446) and interval between the complete of CCRT and surgery (P=0.000 or 3.774) were significant predictors of pCR. When stratifying for smoking status, only low pre-CCRT CEA level was significantly associated with pCR in the non-smoking patients (P=0.044). For the prediction of pCR by the clinical risk score model, the sensitivity was 0.805, the specificity was 0.460, the area under the receiver operating curve was 0.690(95%CI=0.613-0.767), the positive predictive value was35.49%, the negative predictive value was 86.5%, and the predictive accuracy was 73.9%. ConclusionsFor locally advanced rectal cancer, pCR can be achieved in some patients after neoadjuvant therapy. Low pre-CCRT CEA level and long interval time between CCRT and surgery are independent factors associated with pCR, and only low pre-CCRT CEA level is an associated factor in the group of nonsmokers. The clinical risk score model based on pre-CCRT CEA level>5 ng/ml and time interval from CCRT completion to surgery ≤8 weeks can be used to predict pCR after neoadjuvant chemoradiotherapy for LARC.
		2015 Vol. 24 (6): 627-632 [Abstract] ( 3065 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	633	Analysis of efficacy and prognostic factors of postoperative intensity-modulated radiotherapy with or without chemotherapy in rectal cancer
		Hu Jing,Guo Qi,Yang Yongqiang,Zhu Yaqun,Tian Ye
		Objective To explore the efficacy and prognostic factors of postoperative intensity-modulated radiotherapy (IMRT) with or without chemotherapy in rectal cancer. Methods A retrospective analysis was performed on the clinical data of 218 patients with rectal cancer, who underwent postoperative IMRT in our hospital from January 2009 to December 2013.The Kaplan-Meier method was used to calculate survival rate;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 97.7%. The 1-and 3-year overall survival rates were 90.8% and 75.2%, respectively, the 1-and 3-year disease-free survival rates were 85.3% and 70.5%, respectively, and the 1-and 3-year locoregional recurrence-free survival rates were 96.7% and 88.1%, respectively. The incidence of grade 3-4 acute adverse reactions was 28.4%, mainly manifested as leukopenia (13.8%) and diarrhea (11.0%). Univariate prognostic analysis showed that preoperative carcinoembryonic antigen (CEA) and CA199 levels, maximum tumor diameter, tumor location, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM stage, perineural invasion, surgical procedure, total mesorectal excision, preoperative bowel obstruction, and preoperative anemia were the predictors of survival (P=0.006, 0.000, 0.000, 0.017, 0.000, 0.016, 0.000, 0.011, 0.001, 0.006, 0.037 and 0.010). Multivariate prognostic analysis showed that preoperative CEA level, tumor location, TNM stage, preoperative bowel obstruction, and preoperative anemia were the predictors of survival (P=0.000, 0.000, 0.000, 0.001 and 0.001). Conclusions Postoperative IMRT with or without chemotherapy is an effective method for rectal cancer with mild adverse reactions and high compliance. Preoperative CEA level, tumor position, TNM stage, preoperative bowel obstruction, and preoperative anemia are independent prognostic factors for the overall survival.
		2015 Vol. 24 (6): 633-637 [Abstract] ( 2853 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	638	Comparison of static intensity-modulated radiation therapy and volumetric modulated arc therapy in early-stage primary mediastinal B-cell lymphoma
		Xu Liming,Kang Minglei,Jiang Bo,Fang Hui,Jin Jing,Wang Weihu,Wang Shulian,Liu Yueping,Song Yongwen,Liu Qingfeng,Wang Qingxin,Dai Jianrong,Li Yexiong
		Objective To compare target dosimetric distribution and normal tissue radiation between different static intensity-modulated radiation therapy (IMRT) plans and volumetric modulated arc therapy (VMAT) and to identify the best IMRT plan for patients with primary mediastinal B-cell lymphoma (PMBCL). Methods A total of 16 patients (8 males and 8 females) with early-stage (Ann-Arbor stage Ⅰ) PMBCL were enrolled in this study, with doses of 45 Gy for primary gross tumor volume (PGTV) and 40 Gy for planning target volume (PTV).Four plans were designed for each patient, consisting of static IMRT (5F-IMRT, 7F-IMRT, 9F-IMRT) and VMAT, and the target dosimetric distribution, normal tissue radiation dose, and efficiency of each plan were evaluated. The difference of dose was analyzed by analysis of variance. Results The mean conformity index (CI) and homogeneity index (HI) for PGTV in 5F-, 7F-, 9F-IMRT and VMAT were 1.01 and 1.10, 1.01 and 1.10, 1.01 and 1.10, and 1.01 and 1.11(P=0.963 and 0.843), respectively, while these two indices for PTV were 1.04 and 1.22, 1.03 and 1.19, 1.03 and 1.17, and 1.08 and 1.14(P=0.964 and 0.969), respectively. The parameters of volume and dose were similar on normal tissue (P=0.192-1.000).The treatment time and number of monitor units in 9F-IMRT were significantly higher than those in other static IMRT plans and VMAT (P=0.000, 0.000), and among these plans, VMAT had the lowest number of monitor units (13 345.0 MU) and the shortest treatment time (5.9 min). Conclusions The target volume coverage of 7F-and 9F-IMRT is better than that of 5F-IMRT and VMAT.For early-stage PMBCL, VMAT is not superior to IMRT in terms of dosimetry, especially with a larger area of low-dose radiation to the breast, but it is highly efficient in practice.
		2015 Vol. 24 (6): 638-643 [Abstract] ( 3223 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	644	Effects of bladder and rectum management on dose distributions of target and organs at risk in intensity-modulated radiotherapy for prostate cancer
		Li Ming,Lin Hailei,Xiu Xia,Hou Xiuyu,Gao Hong,Xu Yonggang,Zhong Qiuzi,Zhao Ting,Li Gaofeng
		Objective To observe the motions of the rectum and bladder by image-guided radiotherapy (IGRT) and to analyze their impact on treatment. Methods Eighteen patients with prostate cancer undergoing intensity-modulated radiotherapy (IMRT) were enrolled in the study and 247 cone-beam computed tomography (CBCT) images were obtained from this study. The clinical target volume, bladder, and rectum were contoured on all simulated CT and CBCT to examine their volume and position changes. The dose distributions were recalculated based on the data of the x-, y-, and z-axis setup errors. The doses to planning target volume (PTV) and organs at risk were calculated in the replanning, and their impact on treatment was analyzed. Comparison of the planning and replanning Results was made by paired t-test. The effects of displacements and volumes of the bladder and rectum on target doses were analyzed by Pearson correlation method. Results Great changes in the volumes of the bladder and rectum were observed during the treatment. For the planning and replanning results, PTVD_95% was 7777.37 cGy vs. 7628.56 cGy (P=0.027), PTVD_min was 87.91 cGy vs. 83.35 cGy (P=0.000), and RVP was 5.89% vs. 8.31%(P=0.000). There were correlations between PTVD_95% and the motions of the bladder and rectum, with correlation coefficients of 0.296 and 0.177, respectively. The correlation coefficient between rectal volume and PTVD_95% was 0.115, indicating a certain correlation. There is a certain correlation between and PTVD_min and bladder volume, with a correlation coefficient of-0.128. Conclusions The recovery of the state during localization for the bladder and rectum, especially the latter, has great significance to ensure the target dose and reduce exposure of the rectum in the IMRT for prostate cancer.
		2015 Vol. 24 (6): 644-648 [Abstract] ( 3016 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	649	Correlation between the dose measured in the rectum and reference dose in three-dimensional brachytherapy for cervical cancer
		Liu Liqiong, Zhao Zhipeng, Cheng Guanghui,He Mingyuan, Zhao Hongfu,Zhu Yonggang,Shi Dan
		Objective To explore the correlation between the dose measured in the rectum and reference dose in three-dimensional brachytherapy (3DBT) for cervical cancer, and to evaluate the significance of the dose measured in the rectum. Methods Fifty patients receiving radiotherapy for cervical cancer were selected, and 3DBT was performed after pelvic external beam radiotherapy. According to the rectal monitoring method recommended in the report ICRU38, in vivo monitoring was applied to obtain the dose measured in the rectum, reference point dose (D_ICRU), and D_{2 cm³}, and the planned dose was obtained from the planning system. The differences in these values were determined by the paired t-test and correlation analysis was performed with Pearson test. Results The dose measured in the rectum was higher than the planned dose (3.48 vs. 3.25, P=0.000), and lower than D_ICRU (3.48 vs. 3.71, P=0.000) and D_{2 cm³}(3.48 vs. 3.87, P=0.002). A linear relationship existed between the dose measured in the rectum and the planned dose, with a deviation percentage of －20% to 40% and an average deviation of 8.16%;63% of the patients with cervical cancer had a deviation of<±10%;the maximum deviation was 60%. The dose measured in the rectum had a strong correlation with D_ICRU (r=0.722), but a weak correlation with D_{2 cm³}(r=0.284). Conclusions During 3DBT for cervical cancer, the dose measured in the rectum has certain deviations, but has a linear correlation with the planned dose. Both the dose measured and the planned dose underestimate the dose at the reference point in the rectum, and in vivo rectal monitoring may be an effective method for quality control.
		2015 Vol. 24 (6): 649-652 [Abstract] ( 3141 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	724


		2015 Vol. 24 (6): 724-725 [Abstract] ( 2154 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Head and Neck Tumors

	653	Comparison between the 7^th edition of International Union Against Cancer staging system and the Chinese 2008 staging system for nasopharyngeal carcinoma and suggestions for the updating of the staging system
		Liang Zhongguo,Lei Hao,Chen Zetan,Li Ling,Qu Song,Su Fang,Zhao Wei,Pei Su,Pan Xinbin,Zhu Xiaodong
		Objective To compare the 7^th edition of International Union Against Cancer (UICC) staging system with the Chinese 2008 staging system for nasopharyngeal carcinoma (NPC), and to provide evidence for further updating of the staging system. Methods A retrospective analysis was performed among 767 patients who were pathologically and newly diagnosed with non-metastatic NPC and treated with intensity-modulated radiotherapy from 2006 to 2012. Based on the main prognostic indices, overall survival (OS), locoregional failure-free survival(LFFS)local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates, the value of T stage, N stage, and clinical stage in prognostic prediction was compared between the two staging systems. The Kaplan-Meier method was used for calculating survival rates. The log-rank test was used for survival difference analysis. The Cox model was used for multivariate prognostic analysis. Results In terms of T stage, the Chinese 2008 staging system was a significantly better predictor of the OS and LRFS rates than the 7^th edition of UICC staging system. In terms of N stage, they were comparable in the prediction of the OS and DMFS rates. In terms of clinical stage, the 7^th edition of UICC staging system was a significantly better predictor of the OS rate than the Chinese 2008 staging system. For the new staging system proposed based on the statistical results, the T, N, and clinical staging gave significantly better prognostic prediction. Conclusions The 7^th edition of UICC staging system and the Chinese 2008 staging system for NPC have their own advantages in prognostic prediction. The new staging system proposed in this study could contribute to the updating of the current staging system for NPC.
		2015 Vol. 24 (6): 653-658 [Abstract] ( 3237 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	659	Long-term efficacy of intensity-modulated radiotherapy with or without chemotherapy in treatment of nasopharyngeal carcinoma and its influencing factors:an analysis of 454 patients
		Long Jinhua,Jin Feng,Wu Weili,Li Yuanyuan,Chen Xiaoxiao,Gong Xiuyun,Ma Faqiang,Qi Zhengjun
		Objective To analyze the long-term efficacy of intensity-modulated radiotherapy (IMRT) with or without chemotherapy in treatment of 454 patients with nasopharyngeal carcinoma (NPC) and its influencing factors. Methods A retrospective analysis was performed on the clinical data of 454 patients with non-metastatic NPC who received IMRT with or without chemotherapy in our center from 2007 to 2012. Prescribed doses of 69.96-73.92 Gy in 33 fractions, 69.96 Gy in 33 fractions, 60.06 Gy in 33 fractions, and 50.96 Gy in 28 fractions were applied to nasopharyngeal gross tumor volume, cervical metastatic lymph nodes, high-risk drainage area, and low-risk drainage area, respectively. In all patients, 438 received induction chemotherapy, 420 concurrent chemotherapy, and 216 adjuvant chemotherapy, most of which were based on cisplatin and taxol. 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 Cox model was used for the multivariate prognostic analysis. Results The 3-year sample size was 210. The 3-year overall survival (OS), local recurrence-free survival, nodal relapse-free survival, progression-free survival, and distant metastasis-free survival (DMFS) rates were 88.1%, 91.0%, 90.7%, 80.5%, and 85.1%, respectively. Age, T stage, and N stage were influencing factors for the OS rate (P=0.011;P=0.005;P=0.033);T stage and N stage were influencing factors for the disease progression-free survival (P=0.017;P=0.005) and DMFS (P=0.012;P=0.019). The grade ≥3 acute and late adverse reactionsincluded hematological toxicity, oral mucositis, xerostomia, dysphagia, and brain injury. Conclusions IMRT promotes the long-term survival rates in patients with NPC. The distant metastasis is the major reason for treatment failure. The adverse reactions induced by IMRT combined with chemotherapy are tolerable.
		2015 Vol. 24 (6): 659-661 [Abstract] ( 3182 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	662


		2015 Vol. 24 (6): 662-663 [Abstract] ( 2044 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	664	Influence of change in anatomical volume on dose distribution during intensity-modulated radiotherapy for different stages of nasopharyngeal carcinoma
		Hu Xuefeng,Liu Guichao,Lin Li,Huang Zeli,Huang Guosen,Zou Yuchao,Liang Shaobo,Su Jianchun
		Objective To explore the change in anatomical volume during intensity-modulated radiotherapy (IMRT) for different stages of nasopharyngeal carcinoma (NPC) and its influence on dose distribution, and to assess the necessity to modify the IMRT plan. Methods Twenty-four patients with newly diagnosed NPC who received IMRT and chemotherapy were enrolled in the study, and were divided into early-intermediate group (12 cases) and locally advanced group (12 cases) according to the 2008 staging system for NPC. Each patient had a repeated CT scan at week 5 of radiotherapy, and target volume and organs at risk (OAR) were contoured. The dose distribution of the original plan shown on CT was calculated. Changes in target volume, OAR anatomical volume, and dose distribution were analyzed, and paired t-test and Spearman correlation analysis were performed. Results In the early-intermediate group, gross target volume of neck positive lymph nodes (GTV_nd) was reduced during radiotherapy (P=0.059), and gross target volume of nasopharynx (GTV_nx), high-risk clinical target volume (CTV₁), and parotid volume were reduced significantly during radiotherapy (P=0.001, 0.012, 0.002, and 0.000, respectively). In locally advanced group, GTV_nx, GTV_nd, CTV₁, and parotid volume were significantly reduced during IMRT (P=0.000, 0.000, 0.003, 0.003, and 0.000, respectively). Compared with the values before radiotherapy, the parotid dose increased significantly in the two groups during IMRT (P=0.044, 0.026, 0.033, and 0.026, respectively;P=0.024, 0.016, 0.030, and 0.015, respectively), and the increase in GTV_nd dose was observed in the locally advanced group (P=0.029 and 0.049). Conclusions It is recommended to perform another CT scan for patients with locally advanced NPC at week 5 of radiotherapy and formulate a new IMRT plan to maintain target volume dose and guarantee a safe parotid dose.
		2015 Vol. 24 (6): 664-667 [Abstract] ( 2816 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	668	Movement of the hyoid bone and ventriculus laryngis in normal swallowing
		Deng Chong, LIN Qin, Wu Qiong,Zhou Yufei, Rao Mingyue,Wang Lichen, Tian Ye
		Objective To measure the maximum movement of the hyoid bone and ventriculus laryngis during normal swallowing. Methods Forty volunteers were selected as subjects, and an X-ray simulator was used to collect the videos of normal swallowing. Video analysis software was used to capture continuous and quick screenshots of these videos, and the maximum movement of the hyoid bone and ventriculus laryngis was measured. The difference in movement was analyzed by one-way analysis of variance. Results The mean time for swallowing in 40 volunteers was 1.13±0.28 s. During the process of swallowing, the hyoid bone and ventriculus laryngis moved upward first, then outward, and finally returned to the resting position. The maximum movement of the hyoid bone forward and backward was 0.90±0.30 cm;the maximum vertical movement of the hyoid bone was 0.93±0.36 cm. The maximum movement of the ventriculus laryngis forward and backward was 0.69±0.25 cm;the maximum vertical movement of the ventriculus laryngis was 1.04±0.45 cm. Further studies showed the effect of age on the time for swallowing (P=0.03), with similar Results for the male and female (P=0.13). Sex and age had no effects on movement of the hyoid bone and ventriculus laryngis (P=0.28-0.81 and 0.20-0.88). Conclusions During normal swallowing, the hyoid bone and the ventriculus laryngis move first upward and then forward. These movements should be considered during the development of radiotherapy plan for head and neck cancer.
		2015 Vol. 24 (6): 668-670 [Abstract] ( 2851 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	671	Treatment of primary sphenoid sinus malignancies:an analysis of 16 patients
		Liu Zhiping,Luo Jingwei,Xu Guozhen,Gao Li,Yi Junlin,Huang Xiaodong,Wang Kai,Zhang Shiping,Qu Yuan,Xiao Jianping
		Objective To analyze the treatment outcomes of patients with primary sphenoid sinus malignancies. Methods Sixteen patients with primary sphenoid sinus malignancies admitted to our hospital from 2000 to 2013 were analyzed retrospectively. No patients were newly diagnosed with cervical lymph node metastasis. One patient had stage Ⅳ_A disease, while fifteen had stage Ⅳ_B disease. Eleven patients received surgery followed by radiotherapy, one surgery alone, three radiotherapy alone, and one chemotherapy alone.All surgeries were cytoreductive. The median dose of radiotherapy was 69.96 Gy (56.00-80.56 Gy). Results The 3-year local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 67%, 69%, 44%, and 58%, respectively, in all patients, and 67%, 55%, 30%, and 41%, respectively, in patients treated with cytoreductive surgery followed by radiotherapy. All orbital contents and skull base were preserved. In all patients, the local recurrence, distant metastasis, and lymph node recurrence rates were 25%, 37%, and 6%, respectively. There were no independent predictors for the LC and DSS rates based on the prognostic analysis. Conclusions With the orbital contents and skull base preserved, the cytoreductive surgery followed by radiotherapy yields satisfactory outcomes and a low lymph node recurrence rate in the treatment of sphenoid sinus malignancies. The prophylactic irradiation of cervical lymph nodes is not recommended in clinical practice.
		2015 Vol. 24 (6): 671-674 [Abstract] ( 2763 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	675	A dosimetric study of hippocampal-avoidance prophylactic cranial irradiation in intensity-modulated radiotherapy and volumetric modulated arc therapy for patients with localized small cell lung cancer achieving complete response after chemoradiotherapy
		Zhang Mao,Sun Tao,Bu Mingwei,Guo Xiao,Zhang Jin
		Objective To investigate the dosimetric characteristics of hippocampal-avoidance prophylactic cranial irradiation (HA-PCI) in fixed-field intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) and the feasibility and risks of hippocampal avoidance. Methods Prophylactic cranial irradiation (PCI) was performed for 16 patients with localized small cell lung cancer (SCLC) who were treated in our hospital from January to August, 2014, and achieved complete response (CR) after chemoradiotherapy, with a prescribed dose of 25 Gy in 10 fractions. CT localization image was fused with brain MRI image to contour the hippocampus on the fused image, and the boundary of the hippocampus was extended 5 mm outward to form the area for reduced dose. IMRT and VMAT plans with hippocampal avoidance were developed separately, and the dose distribution in the whole brain, the hippocampus, and the 5-mm area outside the hippocampus was evaluated for these two plans. Independent-samples t test was applied to evaluate the difference between the two groups. Results The mean hippocampal volume in the 16 patients was 2.76 cm³(range 2.56-3.01 cm³). The mean radiation dose (D_mean) in the hippocampus during IMRT and VMAT was 9.04±0.20 Gy and 10.32±0.28 Gy, respectively, reduced by 66.0% and 61.2%, respectively, compared with the prescribed dose (P=0.55);D_mean in the area for reduced dose during IMRT and VMAT was 13.57±0.90 Gy and 14.86±0.60 Gy, respectively, reduced by 49.0% and 44.1%, respectively, compared with the prescribed dose (P=0.88). Conclusions HA-PCI in IMRT and VMAT meets the clinical requirements, and can reduce the dose in the hippocampus while ensuring the whole-brain radiation dose, and therefore can be applied in PCI and provide a technical support to protect the patient’s neurocognitive function.
		2015 Vol. 24 (6): 675-679 [Abstract] ( 3045 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

	680	The development and application of the radiotherapy information management system
		Wu Zhili,Zhang Jiutang,Ni Qianxi,Zeng Biao
		Objective To develop information system for radiotherapy. Methods The radiotherapy information the system adopts B/S structure mode, ACCESS 2010 as the database Server at the front desk, running on the hospital local network, background database is called Oncentra TPS and SQL Server 2008 in Mosaiq system, using ASP programming language network, the system is in Macromedia Dreamweaver 8 platform development. Based on the Internet information services (IIS) 6.0 6.0 build system server service components, IE browser is used to implement the client access server capabilities. Results The information system including system Settings module, physics teacher module, the doctor module, technician module, data statistics and analysis, data download, seven modules such as video teaching. Conclusions The Radiotherapy information system is real-time performance, data security, stable operation, is the key construction for efficient utilization of resources in radiotherapy.
		2015 Vol. 24 (6): 680-683 [Abstract] ( 2578 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	684	The quantitative method to evaluate the plan complexity of volumetric-modulated arc therapy
		Li Guangjun,Li Yanlong,Wang Xuetao,Xiao Jianghong,Zhong Renming,Bai Sen
		Objective To study a new quantitative method—arc-beam modulation complexity score (AMCS) to evaluate the plan complexity of volumetric-modulated arc therapy (VMAT), and the effect of the six metrics on VMAT dosimetric verification. Methods The six metrics, which contain the average of beam area (ABA), the average of leaf travel (ALT), the average of beam width (ABW), the modulation complexity score (MCS), the leaf travel and modulation complexity score (LTMCS) and AMCS, was calculated to quantify the plan complexity of VMAT for 127 selected patients. Delta⁴ system was used for verifying the VMAT plans and the γ pass rate was calculated. The relativity between the six metrics and the pass rates or between the 6 parameters were analyzed with Pearson method. Results The average of ABA, ALT, ABW, MCS, LTMCS and AMCS were (73.5±24.1) cm², (69.6±9.8) cm, (3.63±1.03) cm, 0.33±0.05, 0.14±0.04 and 0.16±0.05, respectively. A negative correlation was observed for ALT and the pass rate, and the other metrics had a positive correlation with it (P=0.000).The correlation between AMCS and the pass rate was the strongest with Pearson’s (r=0.637) in the six metrics. The percentage of arcs with a pass rate lower the 95% was 60.7 when AMCS is lower than the average, while it was 9.9% when AMCS is higher than the average. Both ABA and ABW had no significant correlation with ALT (P=0.720, 0.073), and the other metrics had significant correlations (P=0.000-0.003). Conclusions AMCS is a suitable quantitative metric to evaluate the plan complexity of VMAT, and could be used to forecast the result of dosimetric verification of VMAT plans. It could be also use to compare the multiple VMAT plans complexity and help us to choose the best plan.
		2015 Vol. 24 (6): 684-687 [Abstract] ( 2004 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	688	Research on the geometric difference between different ITV generation methods in non-small cell lung cancer treated with stereotactic radiotherapy
		Li Xiadong,Deng Qinghua,Zhang Lidan,Ren Yao,Gu Jiale, Ma Shenglin,Wu Zhibing,Wang Jiahao,Li Gang
		Objective To study the geometric difference between six different ITV generation Methods from 4DCT for patients with non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy technique (SABR). Methods Between Dec. 2013 and Mar. 2014, 16 patients were enrolled in this retrospective study. All patients underwent imaging with 4DCT scans. The MI and DI index were evaluated between six ITV generation methods:combining GTV from all 10 respiratory phases (ITV₁₀);combining GTV from four respiratory phases, including two extreme phases (0% and 50%) plus two intermediate phases (20% and 70%)(ITV_Yeo) which was proposed by Seung-Gu Yeo of Soonchunhyang University;combining GTV from two extreme phases (ITV_EI+EE).And combining GTV from five odd phases (10%, 30%, 50%, 70%, 90%)(ITV_odd).Accordingly the ITV_EVEN which was combined from the remaining five even phases (20%, 40%, 60%, 80%, 0%), and ITV_AVG, ITV_MIP were contoured from two reconstructed 4DCT sequences, finally, a method which was not sensitive to the tumor volume and motion characteristic was selected for clinical use. Data were compared using a variance analysis followed by Student-Newman-Keuls^a test both in same group or between groups. At the same time, the volume and the three dimensional movements of the tumor, the relativity of MI and DI were analyzed by Multi-parameter regression analysis. Results The mean (range) tumor motion (R_LR, R_AP, R_CC, and R_3D) are 3.5 mm (1.4-8.4 mm), 4.5 mm (1.1-8.6 mm), 9.5 mm (0-10 mm), 12.3 mm (2.5-55.3 mm) respectively. The IGTV_x volume are Underestimated by 25.7%, 35.6%, 17.9%, 12.8%, 3.6%, 4.8%(P=0.000) respectively. The MI index comparisons between six ITV generation Methods and ITV₁₀ showed statistical significance:0.69, 0.62, 0.80, 0.86, 0.93, 0.91(P=0.006).The DI index showed no statistical significance:0.98, 0.98, 0.97, 0.97, 0.99, 0.98(P=0.130).The tumor size and motion amplitude were certified not the independent factors for the MI index of ITV_odd and ITV_EVEN. Conclusions IGTV_ODD/EVEN based on odd or even 4DCT phases is not sensitive to the tumor size or motion characteristic and is proved to have a good marching with ITV₁₀ meanwhile maintaining a reasonable contouring efficiency, it can be recommend to the institutions which was not equipped with the deformable registration systems.
		2015 Vol. 24 (6): 688-691 [Abstract] ( 2712 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	695	DVH Obejective informed Planning in volume modulated arc therapy
		Jin Jianhua,Chu Kaijue,Shan Haijiao,Liu Haitao,Wu Jianting,Zhao Yongliang,Cao Gufei
		Objective To study the novel Methods of VMAT planning based dose volume histogram (DVH) optimization, evaluated the dosimetry and planning efficiency in VMAT planning for Esophageal Carcinoma. Methods Twelve Esophageal carcinoma patients were enrolled in this study. The conventional VMAT planning as the reference, using multi-criterion optimization DVH (MCO-DVH) and overlapping volume histogram prediction DVH (OVH-DVH) two different Methods to get ideal objectives function for informing VMAT plans, Then evaluate the dosimetric, planning efficiency for all new VMAT plans. The difference between the paired t-test groups. Results The two VMAT plans based DVH Objective function can meet the clinical needs. Compared with the conventional VMAT plan, Conformity index (CI) and Homogeneity index (0.77 vs.0.72, P=0.017 and 0.10 vs.0.12, P=0.047) is better in DVH informed plans;lung V₅ and spinal cord V₅₀ are better in MCO-DVH informed plan (54.66 vs.60.23, P=0.013 and 0.98 vs.0.49, P=0.037).Furthermore, the DVH informed plans had higher planning efficiency (8.2 vs.19.5, P=0.023).Conclusions DVH Objective informed VMAT Planning can achieve clinical needs with much uniform dose to target, lower OAR dose and higher planning efficiency.
		2015 Vol. 24 (6): 695-698 [Abstract] ( 2827 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	699	Physical characteristics research of OPEN stereotactic body gamma knife
		Cao Hongbin,Wu Xudong,Liu Guoqiang,Bai Yongrui
		Objective To study the physical characteristics of the OPEN stereotactic body radiotherapy system for the clinical application. Methods The 0.125cc ioniztion chamber, 160 mm polystyrene sphere model, Gafchromic EBT₂ films and IBA film analysis software were used to evaluated the focus position tolerance, dose rate, repeatability, linear relation, penumbra and composite error of the OPEN stereotactic body gamma knife. We used the DTA method to verify the accuracy of dose distribution between the plans and measured value. Resualts The focus error was 0.36 mm, max dose rate tolerance 3%, linear relation error 2%, repeatability error 0.3%, composited error 2.5 mm. There was 90% pass rate when thedistance away from test point was less than 2 mm and the dose error was set less than 5%. Conclusions Parts of the test resualts were similar to the head gamma knife national protocal of OPEN stereotatic body gamma knife. The deliver dose distribution can meet the clinic need.
		2015 Vol. 24 (6): 699-702 [Abstract] ( 2903 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	703	Establishment and biological characterization of radiation-resistant lung carcinoma cell lines
		Qiu Xiangnan,Zhang Wei,Li Hao,Qin Zhaohui,Wang Xia,Zhang Longzhen,Yao Yuanhu
		Objective To establish radiation-resistant lung carcinoma cell lines, and to investigate the changes in morphology, apoptosis, invasive migration, and epithelial-mesenchymal transition (EMT) in cells. Methods The radiation-resistant lung carcinoma cell lines were obtained by exposure of lung carcinoma cell lines, A549 and H1299, to radiation with a low dose in fractions, a sublethal dose, or a gradually increasing dose. The morphological changes in cells, radiosensitivity, survival rates after exposure, apoptosis rates, changes in invasive migration, and expression of EMT marker proteins were evaluated using microscopy, colony formation assay, CCK-8 assay, flow cytometry, transwell migration assay, and Western blot, respectively. Results Radiation with a gradually increasing dose successfully induced the radiation-resistant cell lines, A549R and H1299R. The morphological study showed that the morphology of radiation-resistant cells was converted to the morphology of mesenchymal cells. Compared with A549 and H1299 cells, the values of D₀, D_q, and SF₂ were significantly increased in A549R (P=0.017, P=0.001, P=0.000) and H1299R (P=0.033, P=0.000, P=0.008) cells, respectively;the values of α and α/β were significantly reduced in A549R (P=0.018;P=0.007) and H1299R (P=0.001;P=0.009) cells, respectively. The survival rates in A549R and H1299R cells after exposure to radiation with various doses were significantly higher than those in the control groups (all P<0.05). After exposure, the apoptosis rates were significantly reduced in A549R and H1299R cells (P=0.02, P=0.01);the invasion and migration rates were significantly increased in A549R (P=0.000;P=0.001) and H1299R (P=0.001, P=0.002) cells;the expression of E-cadherin was significantly down-regulated in A549R and H1299R cells (P=0.00, P=0.01), while the expression of vimentin was significantly elevated in A549R and H1299R cells (P=0.02, P=0.01). Conclusions The radiation-resistant lung carcinoma cell lines are successfully established. Both cell lines show enhanced invasion and migration, which may be associated with EMT.
		2015 Vol. 24 (6): 703-707 [Abstract] ( 2927 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	708	Effect of RNA interference for MDC1 gene on cell cycle and expression of related proteins in esophageal carcinoma cells after X-ray radiation
		Liu Zhikun,Zhu Shuchai,Su Jingwei,Li Juan,Shen Wenbin
		Objective To apply RNA interference technique for reducing the expression of MDC1 gene in esophageal carcinoma cell line ECA109, observe the changes in cell cycle and radiosensitivity after radiation, and discuss related mechanisms. Methods Three pairs of effective interference sequences and negative control sequences were synthesized for MDC1 mRNA sequence, and a recombinant plasmid was constructed with the vector pSIH1-H1-copGFP. RT-PCR and Western blot were used to determine the expression levels of MDC1 mRNA and protein. Colony-forming assay was applied to measure radiosensitivity, flow cytometry to determine cell cycle, Western blot to determine the expression of CHK1 and CHK2 proteins, and laser scanning confocal microscope to observe the number of MDC1 blotches inside the nucleus. One-way analysis of variance was used to analyze the differences between groups. Results The pSIH1-H1-copGFP plasmid was constructed successfully and ECA109 cells were infected to obtain ECA109M cells with stable transfection. The expression levels of MDC1 mRNA and protein in ECA109M cells were lower than those in ECA109N and ECA109 cells (P=0.032 and 0.041, respectively). After 5-Gy radiation, ECA109M cells had a lower proportion of G₂+M cells than ECA109N and ECA109 cells (P=0.026). After 5-Gy radiation, ECA109, ECA109N, and ECA109M cells had similar expression levels of CHK1 and CHK2 proteins (P=0.345 and 0.451, respectively), and ECA109M cells had a lower expression level of CHK2 T68 protein than ECA109 and ECA109N cells (P=0.012). ECA109 cells had a D₀ value of 3.06 Gy and an SF₂ value of 0.91;the D₀ values for ECA109N and ECA109M cells were 2.90 Gy and 1.88 Gy, respectively, and the SF₂ values for them were 0.89 and 0.84, respectively (P=0.021 and 0.037, respectively). Conclusions RNA interference can reduce the expression levels of MDC1 protein and cell cycle-related proteins, release cell cycle arrest, and enhance radiosensitivity in esophageal carcinoma ECA109 cells.
		2015 Vol. 24 (6): 708-711 [Abstract] ( 2948 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	712	The quantitative method to evaluate the plan complexity of volumetric-modulated arc therapy
		Li Guangjun,Li Yanlong,Wang Xuetao,Xiao Jianghong,Zhong Renming,Bai Sen
		Objective To study a new quantitative method—arc-beam modulation complexity score (AMCS) to evaluate the plan complexity of volumetric-modulated arc therapy (VMAT), and the effect of the six metrics on VMAT dosimetric verification. Methods The six metrics, which contain the average of beam area (ABA), the average of leaf travel (ALT), the average of beam width (ABW), the modulation complexity score (MCS), the leaf travel and modulation complexity score (LTMCS) and AMCS, was calculated to quantify the plan complexity of VMAT for 127 selected patients. Delta4 system was used for verifying the VMAT plans and the γ pass rate was calculated. The relativity between the six metrics and the pass rates or between the 6 parameters were analyzed with Pearson method. Results The average of ABA, ALT, ABW, MCS, LTMCS and AMCS were (73.5±24.1) cm², (69.6±9.8) cm, (3.63±1.03) cm, 0.33±0.05, 0.14±0.04 and 0.16±0.05, respectively. A negative correlation was observed for ALT and the pass rate, and the other metrics had a positive correlation with it (P=0.000).The correlation between AMCS and the pass rate was the strongest with Pearson’s (r=0.637) in the six metrics. The percentage of arcs with a pass rate lower the 95% was 60.7 when AMCS is lower than the average, while it was 9.9% when AMCS is higher than the average. Both ABA and ABW had no significant correlation with ALT (P=0.720, 0.073), and the other metrics had significant correlations (P=0.000-0.003). Conclusions AMCS is a suitable quantitative metric to evaluate the plan complexity of VMAT, and could be used to forecast the result of dosimetric verification of VMAT plans. It could be also use to compare the multiple VMAT plans complexity and help us to choose the best plan.
		2015 Vol. 24 (6): 712-713 [Abstract] ( 2786 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	714	Effects of RNA interference-mediated silencing of vascular endothelial growth factor receptor-2 on proliferation, migration, invasion, and radiation-induced effects in Calu-1 cells
		Liu Yi, Liu Liang, Hu Chenxi, Zhou Lihua, Qiao Yun, Wang Lei, Liu Bin, Chen Hui, Jiang Xiaodong
		Objective To investigate the effects of vascular endothelial growth factor receptor-2(VEGFR-2) on proliferation, migration, invasion, and apoptosis after radiotherapy in lung cancer cell line Calu-1, and to explore the probable mechanisms. Methods Small interference RNA (siRNA)-mediated silencing of VEGFR-2 gene was performed on Calu-1 cells, and the mRNA and protein expression of VEGFR-2 was determined by quantitative real-time PCR and Western blot, respectively. The cells were divided into control group, vascular endothelial growth factor (VEGF) group, VEGFR-2 specific siRNA (siKDR) group, and siKDR+VEGF group. The changes in proliferation, migration, and invasion were evaluated by the CCK8 assay, cell scratch wound-healing assay, and transwell migration assay, respectively. The protein expression of VEGFR-2 and proteins in the related downstream signaling pathway was measured by Western blot. Apoptosis in each group was determined after radiotherapy. Results After RNA interference-mediated silencing of VEGFR-2, the mRNA and protein expression of VEGFR-2 was significantly reduced (P=0.001, P=0.000);the proliferation, migration, and invasion of Calu-1 cells were also significantly reduced (P=0.000, P=0.000, P=0.000);the phosphorylation levels of AKT, ERK1/2, and p38 were significantly reduced in Calu-1 cells (P=0.336, P=0.986, P=0.553);the apoptosis in Calu-1 cells was significantly elevated (P=0.0012);the protein expression of HIF-1α was significantly inhibited (P=0.016). Conclusions The VEGFR-2 gene silencing significantly inhibits several physiological functions of Calu-1 cells and elevates the apoptosis rate after radiotherapy.
		2015 Vol. 24 (6): 714-718 [Abstract] ( 2654 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	719	Effect of an inhibitor of protein kinase CK2 on radiosensitivity of human lung cancer cells
		Li Qianwen,Li Ke,Zhang Sheng,Yang Tianyang,Zhou Yu,Li Zhenyu,Zhou Fangzheng,Ma Hu,Dong Xiaorong,Liu Li,Wu Gang,Meng Rui
		Objective To evaluate the effect of an inhibitor of protein kinase CK2 on the radiosensitivity of human lung cancer cells. Methods The protein levels of CK2 α and β subunits in different lung cancer cell lines were measured by Western blot. Clonogenic assays were performed to assess the effect of a CK2 inhibitor, quinalizarin, on the radiosensitivity of lung adenocarcinoma A549 cells and large cell lung cancer H460 cells. The effects of the combination of quinalizarin and X-ray irradiation on the apoptosis and cell cycle of A549 and H460 cells were measured by flow cytometry. The differences between two groups were analyzed by analysis of variance and t-test. Results Western blot revealed that the α and β subunits of CK2 were overexpressed in non-small cell lung cancer cells (A549, H460, and H1650 cells), which were considered insensitive to X-ray irradiation, whereas a lower expression of these two subunits were found in small cell lung cancer cells (H446 cells), which were sensitive to X-ray irradiation. The clonogenic assays showed that A549 and H460 cells pre-exposed to quinalizarin had a significantly lower survival fraction compared with the control group and had a sensitization enhancement ratio greater than 1.0(D₀ were 2.771 and 2.463 respectively). The combination of quinalizarin and X-ray irradiation did not increase the apoptosis of A549 and H460 cells (X-ray+Quinalizarin vs. Quinalizarin, A549, P=0.487 and H460, P=0.254), but caused significant G₂/M arrest compared with under X-ray irradiation only (X-ray+Quinalizarin:X-ray, A549, P=0.000;H460, P=0.002 and X-ray+Quinalizarin:Quinalizarin, A549, P=0.000;H460, P=0.000). Conclusions Quinalizarin, as a CK2 inhibitor, can increase the radiosensitivity of non-small cell lung cancer cells.
		2015 Vol. 24 (6): 719-723 [Abstract] ( 3193 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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