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

	2016 Vol.25 Issue.1 Published 2016-01-15

	Head and Neck Tumors Thoracic Tumors Physics·Biology·Technique Review Articles Investigation Report

Investigation Report

	1	The brief history of radiation oncology in Hong Kong
		Cheung KY,Choi DKY,Lee AWM,Tung Y,Law CK
		This article gives a brief review on the historical development and current status of radiation oncology in Hong Kong from the perspectives of equipment technology, manpower and treatment modality. The aims are to enhance understanding between Mainland China and Hong Kong, to show the messages learnt during our development, and to express our tribute to our predecessors for their contribution in the development of our specialty.
		2016 Vol. 25 (1): 1-3 [Abstract] ( 2528 ) [HTML 1KB] [ PDF 334KB] ( 0 )

Head and Neck Tumors

	4	Role of large-diameter MRI simulation in target volume delineation in radiotherapy for nasopharyngeal carcinoma
		Dong Wei,Sun Yan,Hu Qiaoqiao,Zheng Baomin,Xiao Shaowen,Zhu Guangying
		Objective To investigate the role of large-diameter magnetic resonance imaging (MRI)simulation in target volume delineation in radiotherapy for nasopharyngeal carcinoma (NPC). MethodsEighteen patients with NPC underwent computed tomography (CT) simulation and MRI simulation scans and localization in the same body position, with SOMATOM Sensation Open 40-row 82-cm large-diameter CT simulator and Siemens 3T MRI MAGNETOM Skyra 70-cm large-diameter simulator, respectively. The gross tumor volume (GTV) and parotid glands were delineated on all images according to the ICRU Report 50/62, and MRI was applied to observe the changes in GTV and parotid volume during radiotherapy. Paired t-test was applied to analyze the differences between GTV_CT and GTV_MRI and between GTV_nx-CT and GTV_nx-MRI. Results GTV_MRI decreased significantly compared with GTV_CT, and the average volume decreased from (213.64±84.59) cm³ to (199.68±84.69) cm³(P=0.006). As for the volume of primary lesions in the nasopharynx, GTV_nx-MRI was significantly smaller than GTV_nx-CT, and the volume decreased from (95.75±24.76) cm³ to (88.12±26.25) cm³(P=0.001);as for the volume of cervical lymph nodes, GTV_nd-MRI was significantly smaller than GTV_nd-CT, and the volume decreased from (117.89±72.69) cm³ to (111.56±70.69) cm³(P=0.018). The targets delineated by CT and MRI did not overlap completely, with major differences in skull base bone and cervical soft tissue. The volume of both parotid glands delineated on MRI image was higher than that delineated on CT image, with a major difference in the deep lobe. MRI showed that GTV was reduced by 82.64±16.87% during radiotherapy, and the volumes of the left and right parotid glands were reduced by (32.7±23.95)% and (34.7±21.72)%, respectively. Conclusions The delineation of target volume based on MRI simulation is more accurate than that based on CT simulation and can achieve a smaller volume range, which helps to guide target volume delineation in radiotherapy for NPC accurately.
		2016 Vol. 25 (1): 4-8 [Abstract] ( 3066 ) [HTML 1KB] [ PDF 971KB] ( 0 )

	9	The prognostic value of paranasal sinus involvement based on MRI in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy
		Fang Yanhong,Chen Yunbin,Xiao Youping,Lin Shaojun,Zong Jingfeng,Pan Jianji
		Objective To identify the prognostic value of paranasal sinus involvement based on magnetic resonance imaging (MRI) findings in the staging of nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Methods The clinical data of 1179 patients who were initially diagnosed with NPC by MRI and received IMRT from 2005 to 2010 were analyzed retrospectively, and staging was performed for these patients again according to the American Joint Committee on Cancer (AJCC) staging system. Paranasal sinus involvement was classified into T₃ stage with paranasal sinus involvement and T₄ stage with paranasal sinus involvement. Overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated by the Kaplan-Meier method, and the log-rank test was used for survival difference analysis. The Cox regression model was used to investigate the independent prognostic factors and the hazard ratios for local relapse in each T group. Results The rate of paranasal sinus involvement was 14.2%, and paranasal sinus involvement was not an independent prognostic factor for OS, LRFS, or DMFS of NPC patients (P=0.677,0.485,0.211). The patients in T₂ stage, T₃ stage with paranasal sinuses involvement, and T₃ stage without paranasal sinuses involvement had similar hazard ratios for local relapse (HR=1.927,2.030,2.283), and the three groups of patients also had similar LRFS and OS curves (P>0.05), which were significantly different from those of the patients in T₄ stage with paranasal sinus involvement and T₄ stage without paranasal sinus involvement (P<0.05). Conclusions Paranasal sinus involvement is not an independent prognostic factor for OS, LRFS, or DMFS in NPC treated with IMRT;however, the patients in T₃ stage with paranasal sinus involvement have similar LRFS and OS as those in T₂ and T₃ stages, and have better prognosis than those in T₄ stage.
		2016 Vol. 25 (1): 9-13 [Abstract] ( 2752 ) [HTML 1KB] [ PDF 1401KB] ( 0 )

Thoracic Tumors

	14	Clinical outcomes of extensive stage small cell lung cancer patients treated with intensive modified radiotherapy
		Zhang Wenjue,Zhou Zongmei,Chen Dongfu,Xiao Zefen,Feng Qinfu,Lyu Jima,Liang Jun,Dong Xin,Hui Zhouguang,Wang Xiaozhen,Zhang Hongxing,Wang Lyuhua,Yin Weibo
		Objective To determine the effect and the patterns of failure in extensive small cell lung cancer (SCLC) patients treated with thoracic intensive modified radiotherapy (IMRT). Methods A retrospective review was conducted on 130 extensive stage SCLC patients received thoracic IMRT from January 2007 to December 2012.Most patients received initial chemotherapy with carboplatin plus etoposide or chemotherapy with cisplatin plus etoposide and 35 patients received PCI.The median thoracic radiation dose was 56 Gy (3267 Gy) with 1823 Gy per fractions. The KaplanMeirer and logrank test, Cox regression were used for survival analysis and to identify prognostic factors.
		2016 Vol. 25 (1): 14-17 [Abstract] ( 2790 ) [HTML 1KB] [ PDF 357KB] ( 0 )

	20	Failure patterns and oligometastasis after concurrent chemoradiotherapy for stage III-IV non-small cell lung cancer
		Liu Hui,Su Shengfa,Ouyang Weiwei,Ma Zhu,Li Qingsong,Wang Yu,Li Huiqin,He Zhixu,Lu Bing
		Objective To investigate the failure patterns and oligometastasis after concurrent chemoradiotherapy for stage III-IV non-small cell lung cancer (NSCLC),and to discuss the significance of local radiotherapy. Methods The patterns of failure including oligometastasis were analyzed in 299 previously untreated patients with stage III-IV NSCLC who underwent concurrent chemoradiotherapy from 2007 to 2014. Results Of all the patients with NSCLC,88 patients with stage III NSCLC failed,among whom 22(22.7%) experienced primary tumor recurrence with or without distant metastasis and 27(30.7%) experienced oligometastasis,and brain metastasis was the most common failure pattern. A total of 211 patients with stage IV NSCLC failed,among whom 11.4% experienced primary tumor recurrence with or without distant metastasis,10.0% experienced recurrence of the primary metastatic lesions,and 9.0% experienced new lesions in the organs with metastasis;9 out of 94 patients with oligometastasis and 12 out of 117 patients without oligometastasis,respectively,experienced recurrence of the primary metastatic lesions. Brain metastasis had the highest incidence rate (38.2%). Conclusions After concurrent chemoradiotherapy,nearly 1/3 patients with stage III NSCLC and 10% patients with stage Ⅳ NSCLC experience the failure of oligometastasis,and brain metastasis is the most common pattern of failure. Radical radiotherapy for primary tumors in stage IV NSCLC can reduce local recurrence.
		2016 Vol. 25 (1): 20-23 [Abstract] ( 2902 ) [HTML 1KB] [ PDF 337KB] ( 0 )

	24


		2016 Vol. 25 (1): 24-25 [Abstract] ( 1986 ) [HTML 1KB] [ PDF 233KB] ( 0 )

	26	Postoperative prophylactic concurrent radiochemotherapy for node-positive esophageal squamous cell carcinoma:a phase Ⅰ clinical study
		Yu Shufei,Zhang Wencheng,Wang Qifeng,Xiao Zefen,Zhou Zongmei,Feng Qinfu,Chen Dongfu,Zhang Hongxing,Liang Jun,Hui Zhouguang,Lyu Jima
		Objective To investigate the maximum-tolerated dose (MTD) and target volume of postoperative prophylactic concurrent radiochemotherapy for lymph node-positive esophageal squamous cell carcinoma. Methods In this phase Ⅰ clinical study,the 33 patients who had middle-lower thoracic esophageal squamous cell carcinoma with lymph node metastasis and received radical surgery in our hospital from July 25,2007 to December 31,2011 were enrolled. The median age was 52 years. The patients of T₃+T₄ stage were 76%.The 33 patients were randomly divided into 60 Gy/2.0 Gy/30f (n=18) and 54 Gy/1.8 Gy/30f (n=15) for radiotherapy,and cis-platinum 20 mg/m² per week+Taxol 20,30,40,50 mg/m² per week (1 weeks and 3 patients,respectively) were used in 5-6 consecutive weeks for concurrent chemotherapy. MTD was determined when grade 4 leucopenia,grade ≥3 reduction in hemoglobin and platelet,or grade ≥3 non-hematological toxicities occurred with CTCAE3.0 standard. Results In the group with a dose of 60 Gy/2.0 Gy/30f for radiotherapy,the initial dose of paclitaxel was 20 mg/m² per week for concurrent chemotherapy,one patient experienced a dose-limiting toxicity (DLT) of grade 3 loss of body weight,and then another three patients experienced the same toxicity,among whom one experienced grade 4 leucopenia;thus,the dose escalation study failed. In the group with a dose of 54 Gy/1.8 Gy/30 f for radiotherapy,one patient experienced paclitaxel allergy and discontinued chemotherapy,and the dose of 20-40 mg/m² per week escalation study was successful for each dose group;however,a paclitaxel dose of 50 mg/m² per week,2 out of 3 patients experienced grade 4 leucopenia and grade 3 decrease in platelet,and therefore,the dose escalation study was terminated;MTD was determined as paclitaxel 40 mg/m² per week plus cisplatin 20 mg/m² per week for 5-6 consecutive weeks. CTV was also reduced,with the superior border of the thoracic vertebra T₁ as the upper boundary and 3 cm below the tumor bed as the lower boundary,and the radiotherapy dose was 60 Gy/2.0 Gy/30f;none of the 12 patients in dose escalation study experienced DLT,and the dose escalation study was successfully completed. The average planning target volume and the mean dose to the remnant stomach were reduced significantly after adjustment of the radiation field (P=0.006 and 0.013,respectively). Conclusions The regimen of paclitaxel plus cisplatin in the postoperative prophylactic concurrent radiochemotherapy for middle-lower thoracic esophageal squamous cell carcinoma is safe and effective when CTV is reduced reasonably.
		2016 Vol. 25 (1): 26-31 [Abstract] ( 2671 ) [HTML 1KB] [ PDF 670KB] ( 0 )

	32	Analysis of influencing factors for cardiac death after radiotherapy with or without chemotherapy for middle-or lower-thoracic esophageal cancer
		Shen Wenbin,Gao Hongmei,Zhu Shuchai,Li Youmei,Cao Yankun,Liu Zhikun,Li Shuguang,Su Jingwei,Li Juan
		Objective To analyze the influencing factors for cardiac death (CD) after radical radiotherapy with or without chemotherapy in patients with middle-or lower-thoracic esophageal cancer. Methods The clinical data of 140 patients who met the inclusion criteria were analyzed retrospectively, as well as the effect of cardiac dose-volume factors suggested by dose-volume histogram in the therapeutic regimen on CD. Chi-square test was applied for comparison of categorical data between groups, and independent-samples t-test was applied for comparison of continuous data between groups;logistic regression analysis was applied to analyze the association of cardiac dose-volume and clinical factors with CD. Results A total of 103 patients died, including 8 patients with CD (7.8%). The univariate analysis of CD showed that age ≥70 years (P=0.033), a history of diabetes (P=0.043), lower-thoracic esophageal cancer (P=0.017), and the length of esophageal lesions>5 cm on esophagography (P=0.013) were risk factors for CD, and heart D_mean(P=0.032) and heart V₅₀(P=0.045) were influencing factors. The results of ROC curve analysis showed that heart D_mean could effectively predict CD (P=0.044), with a cut-off value of 3325 cGy. The results of multivariate logistic analysis showed that the length of esophageal lesions on esophagography (P=0.013) and heart D_mean(P=0.034) were independent prognostic factors for CD. Conclusions The length of esophageal lesions on esophagography and heart D_mean were independent prognostic factors for CD, and the value of heart D_mean can effectively predict CD;therefore, it is suggested that the value of heart D_mean be controlled during the development of therapeutic regimens.
		2016 Vol. 25 (1): 32-36 [Abstract] ( 2750 ) [HTML 1KB] [ PDF 359KB] ( 0 )

	37	Clinical features and prognosis of thymoma with myasthenia gravis:an analysis of 126 patients
		Wang Lihuan,Wang Wei,Chen Yuping,Zhang Yuhai,Meng Shaolin,Li Yang,Li Yuemin
		Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG). Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively. The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis. Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45, respectively (the patients who were admitted before the end of October 2011 and the end of October 2009). The 3-and 5-year survival rates were 97.9% and 91.8%, respectively. The 3-and 5-year survival rates for patients with WHO types A+AB+B1+B2 and B3 were 98.6%/95.2% and 90.6%/92.9%, respectively (P=0.764), and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-IV were 98.6%/95.2% and 97.4%/72.7%, respectively (P=0.791). The 3-and 5-year survival rates for patients with complete and partial resection were 97.8%/91.7% and 100.0%/50.0%, respectively (P=0.964), and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8%/93.1% and 100.0%/94.7%, respectively (P=1.000). Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery. Complete resection, postoperative radiotherapy, WHO type, and Masaoka stage may be associated with prognosis.
		2016 Vol. 25 (1): 37-41 [Abstract] ( 3009 ) [HTML 1KB] [ PDF 2006KB] ( 0 )

	42	Distance between brain metastases of non-small cell lung cancer and the hippocampus and its correlation with PTV low-dose regions in prophylactic cranial irradiation with hippocampal avoidance:an analysis of 56 patients
		Chen Yuan,Gu Wendong,Tian Ye,Mu Jinming,Mo Junchong,Pei Honglei
		Objective To investigate the feasibility of prophylactic cranial irradiation with hippocampal avoidance (HA-PCI) in non-small cell lung cancer (NSCLC). Methods The clinical data of 56 patients with brain metastases of NSCLC who were treated from 2011 to 2014 were collected. Brain metastases and the hippocampus were delineated on T₁W1 contrast-enhanced MRI, and the distance between brain metastases and the hippocampus was analyzed;an HA-PCI regimen was also developed, and the distribution of the metastases in planning target volume (PTV) low-dose regions around the hippocampus was analyzed. Results None of the 139 metastases involved the hippocampus. There were 6(4.3%) and 18(12.9%) metastases within 5 mm and 10 mm, respectively, outside the hippocampus. In the HA-PCI regimen, the D_50% and D_2% of PTV were 25.6 Gy and 27.1 Gy, respectively. D_mean and D_2% for the hippocampus were 7.4 Gy and 9.9 Gy, respectively;D_50% within 0-5.0 mm, 5.1-10.0 mm, and 10.1-15.0 mm outside the hippocampus was 10.3 Gy, 15.1 Gy, and 20.5 Gy, respectively. Conclusions HA-PCI may be feasible theoretically, but this needs to be confirmed by the intracranial failure pattern in patients with long-term survival.
		2016 Vol. 25 (1): 42-45 [Abstract] ( 2719 ) [HTML 1KB] [ PDF 1089KB] ( 0 )

	46	Therapeutic effect of postoperative intensity-modulated radiotherapy in patients with soft tissue sarcomas of the extremities and trunk wall
		Wang Jianyang,Wang Shulian,Song Yongwen,Liu Xinfan,Jin Jing,Wang Weihu,Yu Zihao,Liu Yueping,Li Yexiong
		Objective To investigate the therapeutic effect of postoperative intensity-modulated radiotherapy (IMRT) in patients with soft tissue sarcomas (STSs) of the extremities and trunk wall. Methods The clinical data of 80 patients with STSs of the extremities and trunk wall who were admitted and treated from 2005 to 2011 were analyzed retrospectively. All the patients received postoperative IMRT after conservation surgery, among whom 51 patients had primary lesions in the extremities and 29 had primary lesions in the trunk wall. Seventy-one patients achieved negative resection margin. The median dose of IMRT was 64 Gy. The Kaplan-Meier method was applied to calculate survival rates, the log-rank test was used for survival difference analysis, and the Cox proportional hazards model was applied for multivariate prognostic analysis. Results The 5-year sample size was 43. The 5-year local control (LC) rate, distant metastasis-free survival rate, progression-free survival rate, and 5-year overall survival (OS) rate were 88%, 75%, 73%, and 84%, respectively. The patients with negative resection margin had a significantly higher 5-year LC rate than those with positive resection margin (90% vs. 65%, P=0.023). The patients with primary tumor ≤5 cm had a significantly higher 5-year OS rate than those with primary tumor>5 cm (95% vs. 69%, P=0.041). Multivariate analysis revealed that positive resection margin was an independent risk factor for LC rate (HR=5.33, 95%CI 1.19-23.86, P=0.029). During follow-up, the overall incidence rates of edema and joint stiffness were 18% and 10%, respectively. Conclusions Patients with STSs of the extremities and trunk wall can achieve a high LC rate after postoperative IMRT, with low incidence rates of long-term adverse events.
		2016 Vol. 25 (1): 46-49 [Abstract] ( 2751 ) [HTML 1KB] [ PDF 318KB] ( 0 )

	50	The significance of postoperative radiotherapy in uterine sarcoma
		Chen Xiuli,Hou Hailing,Zhao Lujun,Zhu Li,Zhang Bailin,Wang Ping
		Objective To evaluated the role of postoperative radiotherapy (PR) after surgery in patients with uterine sarcoma,and analyzed the prognostic factors. Methods A total of 182 patients with uterine sarcoma were included between June 1994 and October 2014. Radiotherapy dose were 30-50 Gy/10-25 fractions/5 fractions/week. The LRFFS and OS were calculated with Kaplan-Meier method, and difference was analyzed with log-rank method. Cox regression analyses were used to determine prognosticators. Results There were 114 patients which survived more than 5-years in this whole group, including PR 24 cases and no PR 90 cases. The 5-year LRRFS and OS were 62.1% and 56.2%,respectively. The 5-year LRRFS were 78.0% and 55.3% on PR and no PR (P=0.013);with OS 64.1% and 51.7% on PR and no PR (P=0.070).A multivariate analysis showed that pathological types, histological grade and clinical stage were associated with LRRFS and OS (P=0.032,0.008, 0.000 and 0.046,0.000,0.000). PR was significant influencing factor for OS (P=0.013). Conclusions Uterine sarcoma patients treated with PR after surgery had an improved LRRFS compared to those treated with surgery,especially those with leiomyosarcoma. The role of PR personalized radiation for uterine sarcoma still needs to be further discussed.
		2016 Vol. 25 (1): 50-53 [Abstract] ( 2724 ) [HTML 1KB] [ PDF 570KB] ( 0 )

	54	A study on clinical target volume of pancreatic cancer under the scope of ct scanning and patholog
		Dong Meng,Chang Dongshu,Hu Qilu,Zheng Jichun,Ren Li,Shi Huaiyin,Xia Tingyi
		Objective To compare the tumor sizes of primary lesions in pancreatic cancer based on CT scan and postoperative pathological analysis and measure the extent of filtration under a microscope, and to determine the CTV in radiotherapy target delineation. Methods A total of 19 patients with pancreatic cancer who were admitted to PLA General Hospital and Air Force General Hospital, PLA from 2013 to 2014 were analyzed. In 15 patients, the maximum diameters of tumor cross-section were measured based on the images of preoperative multi-slice spiral CT and postoperative gross samples, respectively. In 19 patients, the extent of tumor infiltration was measured on pathological sections under a microscope and the actual extent of infiltration was calculated. The paired t-test was applied to analyze the differences in the results of different measurement methods. Results In the 15 patients, the maximum tumor diameters measured with gross samples and CT scan were 33.6 mm and 30.1 mm, respectively (P=0.000), and the median and mean of the differences were 3.1 mm (1.2-8.0 mm) and 3.6±2.0 mm, respectively (95%CI 1.2-6.0). In the 19 patients, the maximum actual infiltration distance and the maximum distance measured were 3.50 mm and 3.19 mm, respectively (P=0.000), and the median and mean of the differences were 0.31 mm (0.15-0.50 mm) and 0.30±0.09 mm, respectively. The maximum distance between the margin of primary lesions and the infiltrating lesions was 5.21 mm, with a median of 3.34 mm (2.19-5.21 mm) and a mean of 3.50±0.88 mm (95%CI 2.19-5.06). Conclusions Contrast-enhanced CT scan underestimates the actual size of primary lesions in pancreatic cancer, and an extension of 5 mm outside gross tumor volume (GTV) as CTV may not be sufficient. It is recommended to extend another 1-3 mm outside GTV as CTV.
		2016 Vol. 25 (1): 54-58 [Abstract] ( 2714 ) [HTML 1KB] [ PDF 2554KB] ( 0 )

Physics·Biology·Technique

	18

		Objective To investigate the maximum-tolerated dose (MTD) and target volume of postoperative prophylactic concurrent radiochemotherapy for lymph node-positive esophageal squamous cell carcinoma. Methods In this phase Ⅰ clinical study,the 33 patients who had middle-lower thoracic esophageal squamous cell carcinoma with lymph node metastasis and received radical surgery in our hospital from July 25,2007 to December 31,2011 were enrolled. The median age was 52 years. The patients of T₃+T₄ stage were 76%.The 33 patients were randomly divided into 60 Gy/2.0 Gy/30f (n=18) and 54 Gy/1.8 Gy/30f (n=15) for radiotherapy,and cis-platinum 20 mg/m² per week+Taxol 20,30,40,50 mg/m² per week (1 weeks and 3 patients,respectively) were used in 5-6 consecutive weeks for concurrent chemotherapy. MTD was determined when grade 4 leucopenia,grade ≥3 reduction in hemoglobin and platelet,or grade ≥3 non-hematological toxicities occurred with CTCAE3.0 standard. Results In the group with a dose of 60 Gy/2.0 Gy/30f for radiotherapy,the initial dose of paclitaxel was 20 mg/m² per week for concurrent chemotherapy,one patient experienced a dose-limiting toxicity (DLT) of grade 3 loss of body weight,and then another three patients experienced the same toxicit+T6y,among whom one experienced grade 4 leucopenia;thus,the dose escalation study failed. In the group with a dose of 54 Gy/1.8 Gy/30 f for radiotherapy,one patient experienced paclitaxel allergy and discontinued chemotherapy,and the dose of 20-40 mg/m² per week escalation study was successful for each dose group;however,a paclitaxel dose of 50 mg/m² per week,2 out of 3 patients experienced grade 4 leucopenia and grade 3 decrease in platelet,and therefore,the dose escalation study was terminated;MTD was determined as paclitaxel 40 mg/m² per week plus cisplatin 20 mg/m² per week for 5-6 consecutive weeks. CTV was also reduced,with the superior border of the thoracic vertebra T₁ as the upper boundary and 3 cm below the tumor bed as the lower boundary,and the radiotherapy dose was 60 Gy/2.0 Gy/30f;none of the 12 patients in dose escalation study experienced DLT,and the dose escalation study was successfully completed. The average planning target volume and the mean dose to the remnant stomach were reduced significantly after adjustment of the radiation field (P=0.006 and 0.013,respectively). Conclusions The regimen of paclitaxel plus cisplatin in the postoperative prophylactic concurrent radiochemotherapy for middle-lower thoracic esophageal squamous cell carcinoma is safe and effective when CTV is reduced reasonably.
		2016 Vol. 25 (1): 18-19 [Abstract] ( 2840 ) [HTML 1KB] [ PDF 450KB] ( 0 )

	59	Research on the respiratory frequency changes of 4DCT reconstructed image
		Li Lintao,Wang Shoulong,Pei Jiao,Zhang Dekang
		Objective To study the impact of respiratory frequency and amplitude of patients with the thoracic or abdomen tumor on 4DCT’s reconstructed image. Methods 75 thoracic or abdomen tumor patients who performed a scanning with belly belt-type respiratory gating on 4DCT between November 2012 to March 2013 in our hospital were retrieved. Reviewed their respiratory frequency,amplitude and fault distance of 4DCT’s reconstructed image and analyzed the correlation fault distance of the reconstructed image. The correlation analysis was used by bivariate Spearman method. Results Among these reconstructed images,fault distance more than 6 mm could be seen in 11 cases,fault distance ranging from 3 mm to 6 mm could be found in 46 cases,and distance less than 3 mm could be detected in 18 case. Respiratory frequency correlated significantly with the amplitude (r_s=0.369,P=0.000);the respiratory rate had a tight association with the fault distance of the reconstructed image (r_s=0.273,P=0.018);and respiratory amplitude was associated obviously with the fault distance of the reconstructed image (r_s=0.696,P=0.000). Conclusions Both 4DCT reconstructed image and respiratory amplitude are significantly correlated to the continuity of the respiratory frequency. The smaller the respiratory frequence and amplitude change are,the better continuity will be.
		2016 Vol. 25 (1): 59-61 [Abstract] ( 2700 ) [HTML 1KB] [ PDF 564KB] ( 0 )

	62	A clinical study of lung cancer dose calculation accuracy by using Monte Carlo simulation
		Zhao Yanqun,Yin Gang,Wang Xianliang,Wang Pei,Qi Guohai,Wu Daka,Xiao Mingyong,Li Jie,Kang Shengwei
		Objective To study the evaluate the PBC and CCC algorithms for lung cancer radiotherapy with the Monte Carlo (MC). Methods From 2012 to 2013 years,24 patients with lung cancer were studied. For each patient was designed four plans wiht Oncentra Masterplan TPS.Two IMRT plans and two 3DCRT plans were developed with the PBC and CCC algorithms. Then the DICOM-RT files of the plans were exported to the MC system for recalculate. The differences of results were analyzed by paired-t test. Results For 3DCRT and IMRT plans, the mean dose differences for GTV between CCC and MC, PBC and MC increased with the GTV volume decreasing (P=0.00,0.00,0.00,0.00),for IMRT plans the mean dose differences were found to be higher than that of 3DCRT plans (P=0.00,0.01).Comparison of DVHs, the differences became smaller gradually from D₉₈,D₉₅,D₉₀,D₅₀ to D₂(P=0.00,0.00,0.00,0.00,0.00), but the effect is not obvious in 3DCRT plans (P=0.18,0.08,0.62,0.08,0.97),similarly, the same effect was found in the differences between PBC and MC for IMRT plans, and the differences of dose volume are lager than that of CCC and MC. For the dose of ipsilateral lung, CCC algorithm overestimated dose for all lung, PBC algorithm overestimated V₂₀(P=0.00, 0.00),but underestimated V₅(P=0.00,0.00), the difference of V₁₀ have no statistical significant (P=0.47). Conclusions It is recommended that the treatment plan of lung cancer should be calculated by an advanced algorithm other than PBC. MC can calculate dose distribution of lung cancer accurately and can provide a very good tool for benchmarking the performance of other dose calculation algorithms.
		2016 Vol. 25 (1): 62-66 [Abstract] ( 2754 ) [HTML 1KB] [ PDF 1062KB] ( 0 )

	67	The comparison of three bowel delineation strategies in the radiation therapy of cervical cancer
		Sun Yanze,Zhou Gang,Qian Jianjun,Lu Xueguan,Tian Ye
		Objective To study three contouring approaches of the bowel and evaluate the bowel dose volume with cervical cancer patient. Methods Twelve patients were selected,prescribed dose 45 Gy/25f. For each patient we contoured the bowel according to three different definitions:bowel loops,bowel bag and peritoneal space. Then we generated three rival plans each considering a different bowel definition and to evaluate dose differences of the HI,CI of PTV and D_max,D_mean,V₅-V₄₅ of bowel loops with paired t-test. Results Comparison between BL and BB plan,D_max,HI and CI of PTV,V₅-V₄₅ of bowel loops were not significantly different (P=0.171,0.076,0.192,P=0.315-0.855),D_mean of PTV and D_max of bowel loops had difference (P=0.017,0.038).Comparison between BL and PS plan,D_max, D_mean,HI and CI of PTV and D_max of bowel loops had differences (P=0.033,0.044,0.046,0.041,0.013),V₅-V₄₅ of bowel loops were not significantly different (P=0.416-0.977).If the bowel loops V₄₀≤15%,and bowel bag and peritoneal space V₄₀≤20%. Conclusions All definitions provided a very similar dose volume of bowel loops. Taking into account HI and CI of PTV and max dose of bowel loops,BB seems better than PS.
		2016 Vol. 25 (1): 67-70 [Abstract] ( 2191 ) [HTML 1KB] [ PDF 1377KB] ( 0 )

	71	The application research about registration methods of 4D-CBCT in non-small cell lung cancer with SBRT
		Wang Jiahao,Li Xiadong,Xia Bing,Deng Qinghua,Xu Lixia,Ren Yao,Lai Jianjun,Tang Rongjun
		Objective To investigate the artificial and gray T+R 4D-CBCT image registration for non-small cell lung cancer (NSCLC) with SBRT. Methods 2D SBRT 10 patients with NSCLC,their 4D-CBCT scan images and reference CT images were registered by the methods of artificial and gray T+R registration. The maximum mutual information (MI),Haunsdorff distance and average symmetry distance (ASD) were calculated and were analyzed by paired-t test. Results In 1-3 fraction SBRT,the maximum MI for Gray T+R registration was averaged improved 8.8%(P=0.003,0.000,0.008),Haunsdorff distance and ASD were averaged reduced 21.1%(P=0.000,0.000,0.000) and 13.4%(P=0.000,0.002,0.018) respectively,and they all had the statistical significance compared with artificial registration in the early period of treatment;in 6-8 fraction SBRT,compared with gray T+R registration the maximum MI for artificial registration was averaged improved 19.3%(P=0.014,0.000,0.000),Haunsdorff distance and ASD were averaged reduced 17.6%(P=0.000,0.000,0.000) and 19.6%(P=0.001,0.000,0.000) respectively,and they also had the statistical significance. Conclusions Gray T+R image registration was reasonable in early period of treatment and artificial image registration was available in later period of treatment.
		2016 Vol. 25 (1): 71-75 [Abstract] ( 2754 ) [HTML 1KB] [ PDF 5788KB] ( 0 )

	76	Effect of siRNA interference in EGFR expression on radiosensitivity of human Eca-109 and OE-19 cell lines
		Li Jiancheng,Qiu Zidan,Pan Dinglong,Zhuang Lizhen,Cai Lyujuan,Su Ying,Zou Changyan
		Objective To investigate the effect of small interfering RNA (siRNA) interference in the expression of epidermal growth factor receptor (EGFR) on the radiosensitivity of esophageal squamous carcinoma (Eca-109) and esophageal adenocarcinoma (OE-19) cell lines. Methods Human Eca-109 and OE-19 cell lines were selected as study subjects. Various EGFR-siRNA and negative siRNA were synthesized chemically through lipofection. Reverse transcription-polymerase chain reaction and Western blot were applied to measure the expression of EGFR before and after transfection, and the CCK8 assay was applied to analyze the influence of transfection on cell proliferation. Blank control groups of Eca-109 and OE-19 cells (O1 and O2 groups), simple irradiation groups (R1 and R2 groups), and EGFR-siRNA irradiation groups (E-R1 and E-R2 groups) were set, and the doses for single irradiation were 0, 2, 4, 6, and 8 Gy. The colony-forming assay was applied to calculate survival fraction (SF) and sensitization enhancement ratio (SER_{D0 ratio}), and flow cytometry was applied to evaluate the influence of EGFR-siRNA combined with radiotherapy on cell cycle distribution and apoptosis rate, and the dose for single irradiation was 6 Gy. Results The expression of EGFR in both cell lines was significantly down-regulated by EGFR-siRNA, and the inhibition rate of cell proliferation by transfection was<5%(4.9% and 4.5%, respectively). The results of colony-forming assay showed that the cells in the E-R1 and E-R2 groups had a lower SF than those in the O1 and O2 groups, with an SER_{D0 ratio} of 1.40 and 1.01, respectively. The results from flow cytometry showed that compared with the E-R2 group, the E-R1 group had a higher proportion of cells in G₂/M phase and a lower proportion of cells in S phase after irradiation (P=0.016 and 0.028), as well as a higher apoptosis rate (P=0.007). Conclusions Compared with the cell line OE-19, the cell line Eca-109 has a significantly increased radiosensitivity when treated with siRNA interference in EGFR expression.
		2016 Vol. 25 (1): 76-80 [Abstract] ( 2665 ) [HTML 1KB] [ PDF 804KB] ( 0 )

Review Articles

	81	Research status of postoperative radiotherapy for non-small cell lung cancer
		Zhang Rui,Qiao Xueying
		A considerable proportion of patients with non small cell lung cancer (NSCLC) require postoperative adjuvant therapy, postoperative radiotherapy is an important part of the treatment, this article review the role and value of postoperative radiotherapy for NSCLC patients in recent years.
		2016 Vol. 25 (1): 81-84 [Abstract] ( 2799 ) [HTML 1KB] [ PDF 349KB] ( 0 )

	85	Research progress in palliative radiotherapy for advanced gastric cancer
		Wang Xin,Jin Jing
		According to the medical history, imaging and pathological diagnosis, the advanced gastric cancer patients able to tolerate radiotherapy can be divided into the following three groups:(1) unresectable locally advanced or locally recurrent disease;(2) metastatic disease at primary diagnosis with stage Ⅳ;(3) patients experiencing severe tumor-related clinical symptoms. The role of palliative radiotherapy in patients with advanced gastric cancer would be discussed by reviewing 33 articles (8 in last five years, 13 in ten years).
		2016 Vol. 25 (1): 85-89 [Abstract] ( 2408 ) [HTML 1KB] [ PDF 359KB] ( 0 )

	90


		2016 Vol. 25 (1): 90-95 [Abstract] ( 1527 ) [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....