Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2018 Vol.27 Issue.9 Published 2018-09-15

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

Head and Neck Tumors

	793	Clinical efficacy of CT-guided iodine-125 seed implantation for recurrent head and neck carcinoma after external beam radiotherapy
		Ji Zhe, Jiang Yuliang, Guo Fuxin, Peng Ran, Xu Fei, Sun Haitao, Fan Jinghong, Li Weiyan, Wang Junjie
		Objective To evaluate the clinical efficacy and safety of CT-guided ¹²⁵I seed implantation in the treatment of recurrent head and neck tumors after radiotherapy. Methods Clinical data of 101 patients who received CT-guided radioactive ¹²⁵I seed implantation for recurrent head and neck cancer after radiotherapy from 2007 to 2015 were retrospectively analyzed. The median accumulated dose of external radiotherapy was 66 Gy and the median dose after seed implantation(D₉₀) was 117 Gy. The local progression-free survival and overall survival were analyzed by Kaplan-Meier method. Univariate analysis was performed by log-rank test and multivariate analysis was conducted by using Cox regression model. Results The median follow-up time was 12.2 months. The 5-year local progression-free survival rate was 26.6%.The 5-year overall survival rate was 15.5%. Univariate analysis demonstrated that age,pathological type,implantation site,lesion volume,D₉₀and short-term efficacy were correlated with local control,and KPS score,lesion volume,D₉₀,and short-term efficacy were associated with survival (all P<0.05). Multivariate analysis revealed that pathological type,lesion volume,D₉₀ and short-term efficacy were independent factors related to local control (P=0.000,0.002,0.003 and 0.014).In terms of the adverse events,skin/mucosal ulceration was observed in 25.7% and pain occurred in 13.9% of all patients. No correlation was noted between the adverse events and dose. Conclusions CT-guided radioactive ¹²⁵I seed implantation is an efficacious and safe treatment of recurrent head and neck tumors after radiotherapy. Non-squamous carcinoma,small lesion volume and high dose(D₉₀) indicate excellent local control.
		2018 Vol. 27 (9): 793-797 [Abstract] ( 541 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	798	Radiological features of non-small-cell lung cancer with brain metastases in a single center:an implication for the HA-WBRT approach
		Han Yimin, Chai Weimin, Xu Cheng, Cao Lu, Ou Dan, Cai Gang, Chen Jiayi
		Objective Whole brain radiotherapy (WBRT) remains the primary treatment for patients with multiple brain metastases (BM).Hippocampal avoidance WBRT (HA-WBRT) offers the feasibility of less cognitive function impairment than conventional WBRT.WBRT yields better control rate of intracranial distant progression than stereotatic body radiotherapy (SBRT).This study aims to understand the distribution characteristics of BM within the cranial structures by analyzing imaging features and define the safe margin during HA-WBRT. Methods Clinical data of patients diagnosed with BM by enhanced MRI in Ruijin Hospital from July 2011 to July 2016 were retrospectively analyzed. The distance between the intracranial lesion closest to the hippocampus and the hippocampus was measured. Results A total of 146 patients (90 male and 56 female) with 630 BM lesions were reviewed. Sixty-four patients were diagnosed with non-small-cell lung cancer complicated with BM during the initial admission. In the other 82 patients,the average time from the initial diagnosis to the diagnosis of BM was (14.5±14.3) months. In total,486(77.1%) BM lesions were situated beyond the tentorium. The average diameter of the largest intracranial lesion was (12.5±10.3) mm (95%CI:10.8-14.2).All 630 BM lesions were distributed as follows:138(21.9%) in the cerebellum,182(28.9%) in the frontal lobe,114(18.1%) in the temporal lobe,78(12.4%) in the parietal lobe,87(12.7%) in the occipital lobe,28(4.4%) in the thalamus and 10(1.6%) in the brainstem. The frequency of hippocampal involvement was 3.4%(5 mm),4.8%(10 mm) and 8.2%(20 mm).The univariate and multivariate logistic analyses indicated that with the risk of hippocampal involvement in patients aged> 60 years was significantly increased (OR=11.576 P=0.042). Conclusions The probability of brain metastasis within 10 mm around the hippocampus is low. HA-WBRT can control the intracranial lesions and reduce cognitive impairment,which is a safe and feasible treatment method.
		2018 Vol. 27 (9): 798-804 [Abstract] ( 735 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	805	BRAF/KRAS and PIK3CA mutation characteristics and clinical significance in primary small cell lung caner
		Tang Huarong, Yang Shifeng, Hu Xiao, Xu Yujin, Dong Baiqiang, Wang Jin, Kong Yue, Ma Honglian, Zhang Xiaoqian, Xu Qiang, Zhang Jianjun, Chen Ming
		Objective To detect the frequency of BRAF/KRAS and PIK3CA mutations in the small cell lung cancer (SCLC) specimens from a large population of Chinese patients and to analyze the gene mutation and clinical characteristics. Methods A total of 557 samples were collected from SCLC patients from 2009 to 2014.BRAF,KRAS,PIK3CA,NRAS and MEK1 gene mutations were detected by the dideoxy sequencing. Chi-square test was adopted to analyze the correlation between clinical factors and gene mutation. Kaplan-Meier method was utilized for survival analysis. Cox model was used for multivariate prognostic analysis. Results BRAF mutations were detected in 13 out of 557 specimens. The mutation types included V600E (n=5),V600A (n=2),V600M (n=1),D594G (n=1),G464E (n=1),K601R (n=2) and S605N (n=1).KRAS mutation was detected in 6 cases including G12C (n=3),G12A (n=1),G12D (n=1) andG13D (n=1).PIK3CA mutation was observed in 4 samples including E545G (n=2) and H1047R (n=2).Besides,NRAS mutation (Q61R) was detected in 1 case and MEK1 mutation(D61Y) was noted in 1 case. These gene mutations were not significantly correlated with the age,gender,smoking status and clinical staging of the patients. Univariate survival analysis demonstrated the median survival time of patients with gene mutation was (10.30±0.751) months (95%CI:8.829-11.771 months),significantly shorter than (12.80±0.543) months (95%CI:11.736-13.864 months) of their counterparts without gene mutation (P=0.011). Conclusions BRAF/KRAS and PIK3CA gene mutation is detected in a small proportion of SCLC patients. These gene mutations are not significantly correlated with the clinical characteristics. Univariate survival analysis demonstrates that negative these gene mutations are negatively correlated with the clinical prognosis of SCLC patients.
		2018 Vol. 27 (9): 805-808 [Abstract] ( 507 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	809	Effect of nutritional intervention on clinical efficacy of chemoradiotherapy for esophageal carcinoma patients
		Yang Liping, Gao Jin, Zhou Yan, Tao Zhenchao, He Jian, Yang Jing, Wang Ru, Zhang Yangyang, Huang Yifan
		Objective To investigate the effect of nutritional intervention upon the clinical efficacy of chemoradiotherapy in patients diagnosed with esophageal carcinoma. Methods A total of 46 patients who were diagnosed with esophageal cancer in Anhui Cancer Hospital from November 2016 to August 2017 were enrolled in this prospective study. All patients were randomly and evenly divided into the nutritional intervention (NI) and routine treatment (RT) groups. The changes in body mass index (BMI),PG-SGA,serum albumin (ALB),hemoglobin (HB),white blood cell (WBC) and other Objective nutritional parameters and the incidence of chemoradiotherapy-induced complications were recorded before and after chemoradiotherapy. Results Prior to chemoradiotherapy,age,sex,BMI,ALB,PLT and clinical staging did not significantly differ between two groups (all P>0.05).In the NI group,the BMI was (21.52±2.67) after chemoradiotherapy,significantly higher than (21.13±2.73) before radiotherapy (P=0.000).Moreover,the PG-SGA score after chemoradiotherapy was significantly lower compared with that before chemoradiotherapy (P=0.000).In the RT group,the BMI,Hb,ALB,PLT and WBC after chemoradiotherapy were significantly lower than those before radiotherapy,and thePG-SGA score was worse after chemoradiotherapy (all P<0.05).In the NI group,the incidence of grade 3 myelosuppression was 4.34%,significantly lower than 8.68% in the RT group (P=0.000). Conclusions Patients with esophageal cancer treated with chemoradiotherapy have a high nutritional risk. Nutritional intervention can improve the nutritional status,reduce the incidence of chemoradiotherapy-induced complications,and probably improve the quality of life and clinical prognosis.
		2018 Vol. 27 (9): 809-813 [Abstract] ( 692 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	814	Consistency of bladder filling during intensity-modulated radiotherapy for cervical cancer
		Lu Ying, Zhang Hailiang, An Junxuan, Jin Xiaoli, Song Jianbo
		Objective To evaluate the effect of the bladder scanner upon maintaining the consistency of bladder filling in cervical cancer patients during the intensity-modulated radiotherapy. Methods The bladder volume change of 20 patients diagnosed with cervical cancer throughout radiotherapy were retrospectively analyzed to determine the timing of introducing the bladder scanner. Ten patients undergoing cervical cancer radiotherapy were selected to analyze the consistency between the bladder volume measured by bladder scanner and cone-beam CT (CBCT).The changes of bladder volume before and after the intervention of bladder scanner were statistically compared. Results In total,100 CBCT images of 20 patients were retrospectively analyzed. Nonparametric test demonstrated that the bladder volume significantly differed compared with the planning volume (P<0.05).Bland-Altman plot illustrated high consistency between the bladder volume measured by the bladder scanner and CBCT images with a mean difference of-6.66 cm³(95%CI:-53.1-39.83 cm³).Paired-t test showed there was statistical difference between the bladder volume before intervention and the planning bladder volume (P=0.000).The bladder volume after intervention did not significantly differ from the planning bladder volume (P=0.745). Conclusions The bladder volume significantly varies throughout the treatment process. Bladder scanner should be utilized prior to treatment. The bladder volume measured by the portable bladder scanner is consistent with the planning bladder volume.
		2018 Vol. 27 (9): 814-817 [Abstract] ( 510 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	818	Clinical effect of medical radiation protective ointment compared with trolamine cream to prevent acute radiation-induced skin injury in breast cancer patients undergoing radiotherapy after modified radical mastectomy
		Lan Xiaowen, Lin Xiao, He Haiyan, Chen Jie, Zhu Xiaohua, Tan Yuting, Xue Weiping, Huang Xiaobo
		Objective To access the clinical effect of medical radiation protective ointment compared with trolamine cream to prevent acute radiation-induced skin injury in breast cancer patients undergoing radiotherapy after modified radical mastectomy. Methods Between February 2017 and February 2018,a total of 120 stage T1-4N1-3M0 eligible patients received intensity modulated radiation therapy were enrolled and matches into two groups:study group (60 cases) was administered medical radiation protective ointment from the first irradiation fraction,and control group (60 cases) received trolamine cream. When 3 grade reaction was observed,patients in control group start to administer medical radiation protective ointment until a month after radiation. Results The occurrence rate of acute breast dermal radiation reaction was 100%.Most patients in study group only underwent 1 grade radiation reaction (82%),while 2 and 3 grade radiation reaction (47% and 13%) in control group were common (P=0.000).Both pruritic degree and pain degree were higher in control group compared with study group (both P=0.000).In study group,the occurrence of 2 grade acute radiation-induced skin injury was obviously later than in control group with significant difference (P=0.000).Patients observed with 3 grade reaction relieved to certain reaction after administering medical radiation protective ointment. Conclusions Medical radiation protective ointment can effectively both alleviate and delay acute radiation-induced skin injury compared with trolamine cream. It also has therapeutic effect on 3 grade radiation reaction.
		2018 Vol. 27 (9): 818-821 [Abstract] ( 652 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	822	Assessment of anxiety and analysis risk factors in 646 patients receiving radiotherapy and their relatives
		Sun Xiansong, Yang Zhiwei, Shen Jing, Miao Zheng, Zhang Yu, Yu Lang, Hu Ke, Qiu Jie, Zhang Fuquan
		Objective To evaluate the anxiety and explore relevant risk factors in patients receiving radiotherapy and their relatives,aiming to provide evidence for improving the quality of life. Methods Before radiotherapy,the self-rating anxiety scale (SAS) was utilized to evaluate the anxiety of patients and their relatives. The incidence rate of anxiety was analyzed under the influence from different risk factors. Results A total of 646 participants (463 patients and 183 relatives) were included in this study. The average SAS scores of all participants,patients and family relatives were 41.52±10.08,41.02±1 9.37 and 42.79±11.56,significantly higher than 37.23±12.58 for the healthy population in China (P=0.000.0.000,0.000).For patients aged 11-30,31-50 and 51-90 years,the incidence rate of anxiety was 26%(7/26),11.0%(20/182) and 19.1%(47/246),respectively (P=0.026).The incidence rate of anxiety for patients with and without tumor recurrence was 27%(13/48) and 15.4%(64/415)(P=0.040).Seventeen of 63 patients (27%) with metastases experienced anxiety,whereas 60 of 396 patients (15.2%) without metastases suffered from anxiety (P=0.020).The incidence rate of anxiety in patients with three or more chronic diseases was 26%(19/74),significantly higher compared with 15.0%(58/387) in those with less comorbidities (P=0.024).Multivariate binary logistic regression analysis demonstrated that three or more chronic diseases or serious diseases were high risk factors of anxiety (OR=1.92,95%CI:1.03-3.567). Conclusions Patients who receive radiotherapy and their relatives are prone to anxiety. Young age,tumor recurrence or metastasis and ≥ three comorbidities or severe diseases are the high risk factors of anxiety. It is necessary to evaluate the anxiety of patients and their family relatives before radiotherapy and deliver psychological counseling
		2018 Vol. 27 (9): 822-824 [Abstract] ( 506 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

	825	Application of deformable image registration in adaptive radiotherapy for lung cancer
		Bai Xue, Hou Qing, Wang Binbing, Feng Wei, Wang Shengye
		Objective To evaluate the effect of different Methodsof deformable image registration on the dose evaluation in adaptive radiotherapy for lung cancer. Methods By using Raystation Ver4.5 treatment planning system platform,two algorithms (Hybrid-and Biomechanics-based deformable image registration) and two orders (CT images before and during radiotherapy as reference images) were adopted. Four deformable image registration methods were utilized to calculate the accumulative dose. Eleven patients of lung cancer received adaptive radiotherapy for 35.0-61.6 Gy were recruited. The mean doses of lung,heart and GTV and the D₉₈ and D₂ of GTV were statistically compared using four methods. Results With the four deformable image registration methods,the standard deviation of the mean lung dose of 11 lung cancer patients was ranged from 0.07 to 0.70 Gy,0.01 to 0.79 Gy for the mean heart dose,0.01 to 2.23 Gy for the mean GTV dose,0.02 to 6.51 Gy for the D₉₈ of GTV and 0.01 to 0.97 Gy for the D₂ of GTV,respectively. Conclusion The selection of deformable image registration method causes uncertainty to the calculation of accumulative dose during adaptive radiotherapy for lung cancer.
		2018 Vol. 27 (9): 825-829 [Abstract] ( 526 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	830	Analysis of the evaluation errors of dose-volume parameters for left ventricular myocardium in esophageal cancer radiotherapy
		Tong Ying, Yin Yong, Lu Jie, Chen Jinhu, Liu Tonghai, Cheng Pinjing, Gong Guanzhong
		Objective To evaluate the dynamic variation of the dose-volume parameters of the left ventricular myocardium following heart beat in radiotherapy for esophageal cancer. Methods The left ventricular myocardium of 22 patients was contoured on 20 phases (0%-95%) of electrocardiography (ECG) gated heart 4DCT images. The radiotherapy plan was designed on the simulation CT images,and then the dose distribution of radiotherapy plan was imported into MIM Maestro system and 4D dose-volume histogram (DVH) was reconstructed. The variations of position,volume and dice similarity coefficient (DSC) of the left ventricular myocardium were analyzed. The changing ranges of Dmean,V₁₀,V₂₀,V₃₀ and V₄₀ of the left ventricular myocardium during different phases were statistically compared. Results (1) The biggest displacement of the left ventricular myocardium was in Y axes. The maximum variation rate of volume and DSC of the left ventricular myocardium were (24.23±11.35)% and (184.33±128.61)% in different phases with statistical significance (both P<0.05).(2) The maximum variation rate of Dmean of the left ventricular myocardium was (87.05±38.34)% in different phases with the highest rate of 163.52% with statistical significance (P<0.05).(3) The maximum variation values of V₁₀,V₂₀,V₃₀ and V40 of the left ventricular myocardium were (13.64±4.33)%,(12.84±4.55)%,(11.62±4.85)% and (3.63±2.56)% with statistical significance (all P<0.05). Conclusions The impact of heart beat on the dose-volume parameters of the left ventricular myocardium should be considered during esophageal cancer radiotherapy. Traditional static 3DCT-based assessment of the dose-volume parameters of the left ventricular myocardium can yield relatively large errors,which is probably reduces the prediction efficiency of the dose-volume parameters for radiation-induced heart injury.
		2018 Vol. 27 (9): 830-834 [Abstract] ( 464 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	835	Fabrication and pre-clinical application of patient-specific 3D silicone rubber bolus for chest wall
		Hou Yanjie, Yu Jiangping, Wang Yongqiang, Liu Huanru, Li Da, Xu Jingjing, Zhou Juntao, Meng Ruijuan, Qin Zhixin, Li Xianfeng
		Objective To apply 3D printing technology to fabricate patient-specific silicone tissue compensators for the chest wall and compare the advantages and clinical characteristics between conventional bolus and 3D-printed PLA materials. Methods The chest wall data of two breast cancer patients undergoing mastectomy were obtained based upon the CT images. A patient-specific 3D printing silicone rubber bolus (3D-SRB) was designed and fabricated. The conformability of 3D-SRB,3D-PLA and conventional bolus to the chest wall were validated. Ecipse8.6 planning system was adopted to statistically compare the dosimetric parameters of virtual plan with those after using three tissue compensators. Results The 3D-SRB was successfully designed and fabricated with a similar hardness to conventional bolus. During the process of validating conformability and radiotherapy planning,3D-SRB and 3D-PLA were superior to conventional bolus in terms of conformability to chest wall and planning dosimetric distribution.3D-SRB was advantageous in repeatability,conformability and comfortable experience compared with 3D-PLA.Regarding dosimetric parameters,3D-SRB yielded the highest repeatability with the virtual plan,followed by 3D-PLA and conventional bolus. Conclusion It is applicable to utilize 3D-SRB as the patient-specific compensators for the chest wall,which is of significance in clinical practice.
		2018 Vol. 27 (9): 835-838 [Abstract] ( 543 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	839	A preliminary study of template library-based auto-planning of volume modulated arc therapy
		Wang Xiaoshen, Yang Tao, Cong Xiaohu, Qu Baolin, Dai Xiangkun, Xu Shouping
		Objective To explore the feasibility of the volume modulated arc therapy (VMAT) auto-planning based on template library (TL). Methods VMAT plans of 68 patients diagnosed with postoperative rectal cancer in Eclipse system were retrospectively selected. The prescription dose was 50 Gy/25F. In 19 patients, the feature values of target and organs at risk were extracted as the vectors. The final optimized restricted conditions were saved as the TL. Then, the plans of 15 rectal cancer patients (10 cases from TL and 5 outside TL) were automatically optimized. According to the multi-dimensional vector similarity principle, the similarity parameter αwas defined. The designed program automatically selected the optimal-object template in an in-house software developed with Matlab. The dosimetric parameters of the auto-optimized plans with the optimal-object template (ATP) and the clinical plan (CP) were compared by the paired t-test. The changes in the dosimetric parameters and similarity parameter α were statistically compared by Pearson′s correlation analysis. The linear fitting of the dosimetric parameters with α was used by least squares method to explore the tendency of the ATP dosimetric parameters relative to CP. Results The dosimetric parameters of ATP for 13 cases were slightly worse than those of CP. The conformal index (P=0.004), heterogeneous index (P=0.015), V40(P=0.003) and mean dose (P=0.022) of the intestine significantly differed. The α values of these 13 cases were 2.67,2.60,2.60,2.49,2.67,2.74,2.72,2.48,2.53,2.86,2.68,2.56 and 2.63. The α value was significantly correlated with the V40 or mean dose of the bladder (r=0.649 and 0.603,P=0.016 and 0.029).Along with the increase of α value,V40 and meandose of the intestine for ATP were gradually deteriorated than those of CP. The remaining dosimetric para-meters of ATP were close to or superior to those of CP. Conclusions The results of ATP are slightly worse than those of CP, whereas can satisfy the clinical requirements. The TL, the quality of TL and ATP remain to be further optimized.
		2018 Vol. 27 (9): 839-844 [Abstract] ( 479 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	845	Margin expansion for treatment field of volumetric modulated arc therapy for breast cancer
		Guo Chenlei, Xu Yingjie, Dai Jianrong
		Objective We developed a method to expand margin of beam aperture for VMAT treatment planning of breast cancer and evaluated its effectiveness in clinic. Methods An expanded VMAT (E-VMAT) plan for breast cancer using Pinnacle³ 9.10 planning system was made. A small tissue-equivalent bolus was added at the middle of the breast surface as part of the target and the VMAT plan was generated with beam aperture automatically expanded. Then the tissue-equivalent bolus was removed and the final dose distribution was calculated. Ten patients with breast cancer undergoing breast conserving surgery were tested. The dosimetrical metrics and delivery efficiency were compared between the E-VMAT plans and the routine VMAT plans. Results On the BEV view, it was observed that in E-VMAT plans the collimator and MLC leaf positions was extended outside the skin along the anterior-posterior direction of the thorax. There were no significant differences in conformity index and homogeneity index of target volume between the two types of plans and the planned delivery efficiency was consistent (P>0.05). Conclusions The method established in this study can automatically generate expansion of VMAT beam apertures and prevent missing of target volume due to respiratory motion and/or setup error of the patient. The method does not require programming skill and available for different treatment planning systems.
		2018 Vol. 27 (9): 845-849 [Abstract] ( 548 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	850	miR-20a induces cell radioresistance by targeting PTEN in hepatocellular carcinoma
		Zhang Yuqin, Chen Longhua, Ding Yi, Zheng Lin
		Objective To explore the role and mechanism of miR-20a in the radiosensitivity of hepatocellular carcinoma (HCC). Methods The expression level of miR-20a in HCC cell lines and tissue specimens was detected by real-time fluorescent quantitative PCR.HCC cell line stably over-expressing miR-20a was constructed. The effect of miR-20a on HCC cell radiosensitivity was evaluate by cloning assay. The expression levels of Bcl-2,Caspase-3 and γ-H2AX proteins were quantitatively detected by Western blot. The target gene of the downstream regulation of miR-20a was predicted by bioinformatics analysis,which was further verified by dual luciferase reporter assay,real-time fluorescent quantitative PCR and Western blot. HCC cell line stably overexpressing miR-20a was transfected with pCDNA3.0-PTEN to investigate the changes in the radiosensitivity of cells and to determine whether PTEN is a functional target gene for miR-20a-induced radioresistance of HCC. Results The expression levels of miR-20a was significantly up-regulated in HCC cell line and tissue specimens (both P<0.05).After identical radiotherapy,the cell survival rate,the radioresistance was strengthened (P<0.05),the expression of Bcl-2 was up-regulated,whereas the expression levels of Caspase-3 and γ-H2AX were down-regulated in the LV-miR-20a group compared with those in the blank and control groups (WT and LV-con groups).Overexpression of PTEN could reverse the miR-20a-induced radioresistance. Conclusion miR-20a is up-regulated in the HCC cell lines and tissue specimens. Overexpression of miR-20a can promote the radioresistance of HCC cells. PTEN is a functional target gene for miR-20a-induced radioresistance of HCC,indicating that miR-20a/PTEN site may be an effective molecular target associated with clinical radiotherapy for liver cancer.
		2018 Vol. 27 (9): 850-854 [Abstract] ( 359 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review Articles

	855	Quality of life of patients with non-small-cell lung cancer
		Ran Juntao, Wang Jingbo, Wang Lvhua
		Along with the development of modern medical modality and health awareness, the maintenance of favorable quality of life (QoL) has become one of the most important goals for cancer survivors. Non-small-cell lung cancer (NSCLC) survivors may suffer from substantial impairment on the overall QoL due to surgical treatment, radiotherapy and chemotherapy, etc. Evaluating the effect of NSCLC treatment upon the QoL of NSCLC patients contributes to understanding and enhancing the QoL through relevant interventions, improving life-cycle surveillance and subsequently obtaining the optimal therapeutic option. In this paper, recent researches on the QoL of NSCLC patients were summarized and reviewed.
		2018 Vol. 27 (9): 855-858 [Abstract] ( 500 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	859	Research progress on linear quadratic and biological equivalent dose models for high-dose-per-fraction radiotherapy
		Zhu Jian, Yue Chenxi, Yin Yong, Li Baosheng, Yang Bo
		The linear quadratic (LQ) model and deduced biological equivalent dose (BED) model are widely applied in the radiobiological studies and the mathematic models of radiation oncology in clinical practice. However, the LQ model cannot accurately fit the experimental and clinical data in the high-dose region under the high-dose-per-fraction treatment mode. To resolve this issue, researchers have made modifications to the LQ models since 2008. In the paper, first, the theoretical basis and the application scope of LQ and BED models were introduced and the debate on whether LQ model is applicable to the high-dose-per-fraction radiotherapy was reviewed. Second, five modified models were introduced in two categories and their characteristics were summarized. Finally, current research situation and existing problems of radiotherapy using biological equivalent dose (BED) models were briefly summarized and the development trend of models was predicted.
		2018 Vol. 27 (9): 859-863 [Abstract] ( 576 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	864	Hotspots of stereotactic body radiotherapy in radiobiology
		Le Ziyu, Liu Yong
		Stereotactic body radiotherapy (SBRT) has been gradually proven to be effective in treating multiple solid tumors. Along with the development of image-guided radiotherapy (IGRT) system and radiotherapy,SBRT can form a high-dose region in the target area,whereas the dose gradient outside the target area declines rapidly. It not only delivers large-dose irradiation to the tumors,but also protects the surrounding normal tissues as possible,thereby implementing safe"big fractionated radiotherapy".At present,regular understanding of the radiobiology underlying SBRT is still lacking. Multiple issues,such as applicability of linear quadratic (LQ) model,weakening of re-oxygenation,additional cell killing effect different from conventional fractionated radiotherapy and immune enhancement effect are still controversial. In this article,the above controversial hotspots were discussed and analyzed,aiming to deepen the understanding of the radiobiological characteristics of SBRT and contribute to promoting the application of SBRT in clinical practice.
		2018 Vol. 27 (9): 864-868 [Abstract] ( 714 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	869	Research progress of oral mucositis during the treatment of tumor
		Liu Mingzhu, Han Fei
		During the treatment of tumor,especially in head and neck cancer,oral mucositis is one of the common complications. The incidence of oral mucositis have relations with chemotherapy,targeted therapy,radiotherapy dose,radiotherapy technology and risk factors of patient. Severe oral mucositis may bring about treatment interrupted,decrease of tumor control rate,affect quality of life and so on. In general,what is very important during the treatment of tumor is to explore the prevention and treatment of oral mucositis.
		2018 Vol. 27 (9): 869-872 [Abstract] ( 574 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2018 Vol. 27 (9): 873-873 [Abstract] ( 433 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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		2018 Vol. 27 (9): 874-874 [Abstract] ( 379 ) [HTML 1KB] [ PDF 0KB] ( 0 )

中华放射肿瘤学杂志

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