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.12 Published 2018-12-15

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

Head and Neck Tumors

	1035	Imaging diagnosis of the medial group of retropharyngeal lymph nodes and the exploration of the optimization of target volume for protecting the swallowing structure in nasopharyngeal carcinoma
		Zong Dan, Zhang Lanfang, Chen Cheng, Gu Dayong, He Xia, Huang Shengfu
		Objective To clarify the diagnostic value of diffusion-weighed imaging (DWI) in the medial group of retropharyngeal lymph nodes in nasopharyngeal carcinoma,understand the clinical characteristics of retropharyngeal lymph nodes and explore the feasibility of optimizing the target volume of CTV60. Methods Clinical data of 437 patients with clinical stage Ⅰ-IVa nasopharyngeal carcinoma admitted to Jiangsu Cancer Hospital from 2011 to 2017 were retrospectively analyzed. All patients underwent magnetic resonance imaging (MRI),DWI (1000 s/mm²) and enhanced CT scans to analyze the clinical characteristics of retropharyngeal lymph nodes and investigate the dosimetric advantage and safety of CTV60 lower margin on the upper margin of C2. Results The medial lymph nodes with a transverse diameter of 2.0-19.0 mm were detected 13 of 437 patients,and 53.8% of the lymph nodes were measured 2-5 mm in transverse diameter. The medial lymph nodes were distributed between the superior margin of C1 and 1/3 of C3.Its occurrence was related to N stage,double cervical lymph node metastases,especially the transverse diameter of cervical lymph node> 3 cm. The sensitivity of DWI,T2 and enhanced CT were 100%,61.5% and 23.1%.After the special cases were excluded,the lower margin of CTV60 on the superior margin of C2 was separated. The radiation dose and volume of the swallowing structures were significantly decreased. The 5-year survival rate was 80% without recurrence in the optimized region. Conclusions The incidence of the medial group of retropharyngeal lymph nodes is low with a diameter of less than 5 mm. DWI possesses advantages in displaying the medial group of retropharyngeal lymph nodes. Isolating the lower margin of CTV60 from the superior margin of C2 is safe and feasible and has dosimetric advantages for protecting swallowing structure.
		2018 Vol. 27 (12): 1035-1040 [Abstract] ( 408 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1041	Analysis of clinical efficacy,failure pattern and prognostic factors of comprehensive treatment for malignant mucosal melanoma of head and neck
		Sun Shiran, Yi Junlin, Gao Li, Huang Xiaodong, Luo Jingwei, Zhang Ye, Zhang Shiping, Wang Kai, Qu Yuan, Wu Runye, Liu Qingfeng, Chen Xuesong, Xiao Jianping, Xu Guozhen
		Objective To evaluate the clinical efficacy,failure pattern and prognostic factors of the malignant mucosal melanoma of the head and neck (MMHN) in a single center. Methods The treatment pattern,clinical efficacy,failure pattern and prognostic factors of 194 M0 MMHN patients admitted to our institution from 1982 to 2017 were retrospectively analyzed. Results The 5-year overall survival (OS),local recurrence-free survival (LRFS),regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) were 41.4%,57.8%,76.5% and 46.5%,respectively. The failure rate was calculated as 74.6%(141/189).Among them,40%(56/141) had distant metastasis as the first pattern of treatment failure,37%(52/141) had local relapse,15%(21/141) had regional relapse,5%(7/141) had concurrent distant metastasis and local/regional relapse and 3%(5/141) had concurrent local and regional relapse. Multivariate analysis demonstrated that surgical margins (P=0.001) and adjuvant radiotherapy (P=0.000) were the independent prognostic factors for LRFS. Conclusions Surgery combined with radiotherapy can yield relatively high LRFS in the comprehensive treatment of MMHN.Distant metastasis is the major failure pattern.
		2018 Vol. 27 (12): 1041-1045 [Abstract] ( 369 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	1046	Final report of a prospective randomized study on thoracic radiotherapy target volumes for limited-stage small cell lung cancer
		Hu Xiao, Bao Yong, Xu Yujin, Zhang Li, Wang Jin, Ma Honglian, Jin Ying, Xu Xiaoling, Song Zhengbo, Peng Fang, Tang Huarong, Fang Min, Kong Yue, Chen Mengyuan, Dong Baiqiang, Yu Xinmin, Lu Hongyang, Zhang Yiping, Fan Yun, Chen Ming
		Objective In view of the controversy over radiotherapy target volume for patients with limited-stage small cell lung cancer (SCLC),a prospective randomized controlled trial was conducted to compare the impact of different radiotherapy target volumes on prognosis. Methods After 2 cycles of EP chemotherapy,patients without progressive disease were randomly assigned to receive thoracic radiotherapy (TRT) to either the post-or pre-chemotherapy primary tumour extent as study arm or control. Involved field radiotherapy (IFRT) to the entire metastatic lymph node regions was applied for both arms. TRT consisted of 45 Gy/30Fx/19 d administered concurrently with cycle 3 chemotherapy. Prophylactic cranial irradiation was administered to patients achieved complete or partial remission. Kaplan-Meier method was used for survival analysis. Results Between June 2002 and December 2017,159 and 150 patients were randomly assigned to study arm and control respectively. The 1-,2-,and 5-year local/regional control rates were 79.4%,61.5% and 60.1% respectively in the study arm versus 79.8%,66.5%,and 57.3% in the control arm (P=0.73).The median OS time was 22.1 months in the study arm (95%CI,18.2-26.0 months) and 26.9 months (95%CI,23.5-30.3 months) in the control arm,the 1-,3-,5-,and 7-year OS rates were 81.1%,31.6%,23.9% and 22.2% respectively in the study arm versus 85.3%,36.6%,26.1% and 20.0% in the control arm (P=0.51).Grade 2-3 acute esophagitis was developed in 32.9% and 43.2% of patients respectively in study arm and control arm (P=0.01),while grade 2-3 pulmonary fibrosis was observed in 2.0% and 10.9% of patients (P=0.01) respectively. Conclusions For patients with limited-stage SCLC who received induction chemotherapy,thoracic radiotherapy can be limited to post-chemotherapy tumour extent and IFRT can be routinely applied.
		2018 Vol. 27 (12): 1046-1050 [Abstract] ( 386 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1051	Recurrence risk stratification of esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy
		Wang Xiushen, Zhang Xiqian, Xi Mian, Bu Shanshan
		Objective To analyze the pattern of recurrence risk and investigate the association between pathological staging and recurrence risk in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (CRT). Methods Clinical data of 174 patients with advanced thoracic ESCC treated with neoadjuvant CRT between 2002 and 2015 were retrospectively analyzed. All patients received preoperative concurrent platinum-based chemotherapy with conformal radiotherapy (40-50.4 Gy,conventional fractionation) combined with surgery. Kaplan-Meier method was utilized to analyze the survival,the log-rank test was conducted to compare the differences between groups,and the Cox regression model was used for multivariate analysis. Results The median follow-up time was 53.9 months. A total of 44.8% of patients achieved pathological complete response,and 59 patients (33.9%) recurred after neoadjuvent CRT.The postoperative recurrence rate was 22.2% for patients with pathological stage 0/I,38.7% for stage Ⅱ and 68.2% for stage Ⅲ(P=0.000).The 5-year recurrence-free survival (RFS) rates were 74.7%,61.4% and 20.9% for patients with pathological stage 0/Ⅰ,Ⅱ and Ⅲ,respectively (P=0.000).In total,20.5% of patients with pathological stage 0/I or Ⅱ recurred after postoperative 3 years,whereas all patients with pathological stage Ⅲ recurred within postoperative 2 years. Multivariate analysis demonstrated that age,clinical TNM staging,chemotherapy regimen,and pathological response after CRT were independent prognostic factors affecting the RFS (P=0.027,0.047,0.010,0.005). Conclusions Pathological stage is significantly correlated with the recurrence risk in ESCC patients after neoadjuvant CRT.Risk-based surveillance strategies can be defined according to different pathologial staging.
		2018 Vol. 27 (12): 1051-1055 [Abstract] ( 409 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1056	Survival analysis for patients with T4b squamous cell carcinoma of thoracic esophagus receiving concurrent chemoradiotherapy
		Hu Yonghong, Li Qiaoqiao, Xi Mian, Zhu Yujia, Liu Hui, Li Qun, Liu Mengzhong
		Objective We aimed to analyze the clinical efficacy and treatment-related complications in patients with T4b esophageal squamous cell carcinoma (SCC) who received concurrent CRT,and to explore the potential prognostic factors related to survival. Methods Between 2010 and 2015,143 patients with T4b esophageal SCC treated with CRT were analyzed,including 71% patients with trachea and/or bronchus invasion and 44% patients with aorta and/or large vessel invasion. The median radiation dose was 60 Gy (range,44-68 Gy) with conventional fractionation,including 69 patients (48%) treated with three-dimensional conformal radiotherapy and 74 patients (52%) treated with intensity-modulated radiotherapy. All patients received concurrent platinum-based chemotherapy during radiotherapy. Kaplan-Meier method was used to analyze the survival,the log-rank test was used to examine group differences,and the Cox regression model was used for multivariate analysis. Results The median overall survival (OS) time for the whole cohort was 12.2 months. The 2-and 3-year OS rates were 34% and 29%,respectively. A total of 51 patients experienced ≥2 severe non-hematological complications,including 42 esophageal fistula,6 pneumonia,and 3 esophageal hemorrhage. Patients with severe complications showed significantly worse survival than those without complications (6.9 months vs.20.4 months,P<0.01).Multivariate analysis revealed that TNM stage and severe complications were independent prognostic factors for OS. Conclusions Patients with T4b esophageal SCC who received CRT showed satisfactory survival but with high risk of severe complications. Therefore,prevention and treatment of severe complications is the key to improve efficacy.
		2018 Vol. 27 (12): 1056-1060 [Abstract] ( 489 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	1061	Hypofractionated radiotherapy for 45 cancer patients with hepatic metastasis
		Zhao Ruizhi, Xiao Jianping, Zhang Hongmei, Ma Yuchao, Yang Siran, Liu Qingfeng, Zhang Ye, Wang Kai, Deng Lei, Bi Nan, Wang Wenqing, Yi Junlin, Li Yexiong
		Objectives To evaluate the clinical efficacy and safety of hypofractionated radiotherapy for cancer patients with hepatic metastases. Methods From May 2007 to November 2016,45 patients (male:female=20:25) with inoperable hepatic metastases were enrolled in this investigation. The median age was 58 years old (range:25-83).The median Karnofsky performance score (KPS) was 80.Primary colorectal cancer was detected in 14 patients,primary breast cancer in 9 and primary lung cancer in 6 cases. Twenty-one patients had extrahepatic metastases. A total of 52 lesions were treated. Thirty-four cases received radiotherapy for one single lesion. The fractional dose was 45 Gy/3 fractions and 60 Gy/10-15 fractions. The median gross tumor volume (GTV) was 10.1 cm³(0.3-175.2 cm³) and 29.8 cm³(5.0-209.6 cm³) for planning target volume (PTV).Seventeen CT images were fused with MRI and IMRT was adopted in 43 cases. The median dose of PTV was 60 Gy (40-60 Gy) and 90 Gy (60-132 Gy) for bioequivalent dose (BED). Results The median follow-up time was 23.5 months and the median survival time was 26.0 months (95%CI:21.4-30.6 months).The 1-year local control (LC),disease-free survival (DFS) and overall survival (OS) were 94%,27% and 91%,respectively. Six cases died of liver metastases and abnormal liver function. Conclusion Hypofractionated radiotherapy is an efficacious and safe local treatment for inoperable hepatic metastases.
		2018 Vol. 27 (12): 1061-1065 [Abstract] ( 502 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1066	Clinical efficacy and prognostic factors of neoadjuvant chemoradiotherapy for locally advanced low and middle rectal cancer
		Liu Yan, Lyu Yin, Lu Yanrong, Xiao Nan, Wu Wanyan, Zhang Jinrong
		Objective To investigate the clinical efficacy of neoadjuvant chemoradiotherapy in the treatment of locally advanced low and middle rectal cancer,and evaluate the effect of related clinical factors upon the long-term survival. Methods Clinical data of 101 patients with locally advanced low and middle rectal cancer admitted to our hospital from January 1,2010 to December 31,2014 were collected. All patients completed the preoperative intensity-modulated radiation therapy DT45-50.4 Gy,synchronized with oxaliplatin+capecitabine/5-fluorouracil or single drug capecitabine chemotherapy,and total mesorectal excision) was performed 4-13 weeks after the end of the neoadjuvant therapy. The short-term efficacy and long-term prognosis of these patients were evaluated. Kaplan-Meier method was used for survival analysis,and Cox’s regression model for multivariate analysis. Results The total sphincter preservation rate was 53.5%.The decrease rates of T,N staging and TNM total staging were 73.26%,67.32% and 72.3%,respectively. The pathological complete response (pCR) rate was 16.8%.The median follow-up time was 41 months. The 3-year overall survival (OS), desease-free survival (DFS),local recurrence and distant metastases rates were 82.2%,80.7%,7.2% and 12.1%,respectively. The single factor analysis demonstrated that ypT and ypN stages were the risk factors affecting the 3-year OS,DFS anddistant metastases (all P<0.05).Multivariate analysis revealed that ypT stage was an independent factor affecting the 3-year OS,and ypT and ypN stages were the independent factors of the 3-year DFS (all P<0.05). Conclusions Neoadjuvant chemoradiotherapy combined with TME in the treatment of locally advanced middle and low rectal cancer can partially decrease the tumor staging,enhance the sphincter preservation rate and improve long-term clinical prognosis. Both ypT and ypN stages are correlated with the clinical prognosis of patients.
		2018 Vol. 27 (12): 1066-1071 [Abstract] ( 547 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

	1072	Comparative study of automatic and manual plans of intensity-modulated radiation therapy for nasopharyngeal carcinoma
		Xin Xin, Li Churong, Li Jie, Wang Pei
		Objective To compare the automatic and manual plans of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma and investigate whether the automatic plan possesses advantages over the manual plan. Methods Clinical data of 97 nasopharyngeal carcinoma patients were retrospectively analyzed. All patients received IMRT with Eclipse treatment planning system (Version 11.0) using manual optimization. The same plans were optimized successively in Pinnacle³(version 9.10) treatment planning system using automatic plan software package module (provided by Prof. Zhang XD from MD Anderson Cancer Center).The D95(dose in 95% of planning target volume,PTV),homogeneity index,conformal index and normal organ dose were statistically compared between two plans. Results The PTV coverage and homogeneity did not significantly differ between two plans. Compared with the manual plan,the automatic plan could more effectively protect the normal organs. Two plans significantly differed in a majority of organ at risk (OAR).The mean dose was decreased by 270-1870 cGy. Conclusions For nasopharyngeal carcinoma patients,IMRT via the automatic plan can meet the clinical requirement for target prescription dose and reduce the dose of normal organs.
		2018 Vol. 27 (12): 1072-1077 [Abstract] ( 470 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1078	Feasibility of integrated IMRT technique for craniospinal irradiation in a supine position
		Cai Xiaojun, Guo Jian, Zhou Juying, Jiang Hua, Zhang Ruting, Xu Wentao, Xu Xiaoting, Qin Songbing
		Objective To explore the feasibility and safety of integrated intensity-modulated radiation therapy (IMRT) technology applied in craniospinal irradiation in a supine position. Methods The patients were fixed in a supine position using thermoplastic mask and vacuum mat. Three isocenters with a fixed interval of 20-25 cm were adopted according to the height of patients. A total of 13 beams with a length of 2-3 cm in the overlapping region were included in the treatment plan. Fixed jaw technique was employed and overall calculation was performed by the inverse optimization method. The γ-passing rate and absolute point dose verification were performed for three isocenters and two overlapping regions. Cone-beam CT (CBCT) images were scanned for three isocenters before treatment. The setup error of each isocenter in the x,y and z directions of the same coordinate system was recorded and overall analysis was conducted. Results Among 28 patients,the γ-passing rate (%) of three isocenters and two overlapping regions was 99.36%,99.60%,99.75%,94.77% and 95.09%,whereas the absolute point dose verification error was 1.56%,-1.56%,0.52%,-0.76% and -1.68%,respectively. Twenty-eight patients received 162 groups of IGRT with 486 setup errors from the CBCT images. The average deviation in the x,y and z direction for three isocenters (neck,chest and abdomen) was 0.17 mm,0.10 mm,0.02 mm,0.06 mm,0.04 mm,0.46 mm,0.19 mm,0.26 mm and 0.41 mm,respectively. Conclusions The integrated IMRT techniques for craniospinal irradiation in a supine position is feasible and safe,which is worthy of clinical application.
		2018 Vol. 27 (12): 1078-1082 [Abstract] ( 465 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1083	Effect of the discrepancy of the dose calculation results of different algorithms on CyberKnife lung tumor treatment plan
		Yang Jing, Liu Hongyuan, Cao Ting, Nie Xin, Liu Gang, Liang Zhiwen, Han Jun, Li Qin
		Objective To evaluate the effect of the discrepancy of the dose calculation results of different algorithms upon the CyberKnife lung tumor treatment plan,and assess the impact of tumor volume and location on the dose calculation results. Methods Thirty-two cases of lung tumors were treated with MultiPlan 5.2.1 planning system of CyberKnife VSI.Ray Tracing and Monte Carlo algorithms were adopted to calculate the dose distribution,and then the calculation results were statistically compared between two algorithms. Results For the enrolled cases,the calculation results of these two algorithms demonstrated that the deviation range of prescription dose coverage of planning target volume (PTV),conformal index,new conformal index and uniformity index were 0.93%~68.80%,0.87%~17.21%,-212.38%~8.27% and 0%~15.17%,respectively. Conclusions In the CyberKnife treatment of lung tumors,the volume and location of tumors exert significant impact on the discrepancies of the dose calculation results of different algorithms. The smaller tumor volume and longer beam heterogeneity path are likely to generate a greater discrepancy. It is recommended to adopt or refer to the calculation results of Monte Carlo algorithm to deliver corresponding treatment.
		2018 Vol. 27 (12): 1083-1087 [Abstract] ( 415 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1088	A method of measuring the field output factor based on daisy–chaining
		Li Minghui, Ma Pan, Tian Yuan, Miao Junjie, Men Kuo, Zhang Ke, Niu Chuanmeng, Dai Jianrong
		Objective improve the accuracy of the measurement results by using the field output factor measurement method based on daisy-chaining. Methods The Varian Edge Accelerator 6 MV X-ray data were measured using the IBA CC13 ionization chamber,IBA CC01 ionization chamber,IBA Razorsemiconductor detector,IBA EFD semiconductor detector and Gafchromic EBT3 film,respectively. Results Compared with the daisy-chaining measurement method,the results obtained by the conventional measurement method using CC13 were smaller. The deviation value was 16.71% in the 1 cm × 1 cm field. The measurement results in a larger field via CC01 were bigger with a deviation of 8.39% in the 40 cm × 40 cm filed. The measurement results via Razor in a larger field were larger with a deviation of 9.40% in the 40 cm × 40 cm field. The measurement results were similar between EFD and Razor with a deviation of 9.14% in the 40 cm × 40 cm field. The results of the film measurement were equivalent to those obtained from the daisy-chaining method in a field of> 1 cm × 1 cm with a deviation within 1.60%,whereas the deviation was increased to 3.13% in the 1 cm × 1 cm field. The results were consistent with daisy-chaining measurement if the 3 cm × 3 cm or 4 cm × 4 cm fields were selected as the intermediate fields with the maximum deviation of 0.29%. Conclusions For the detectors with changing response along with the field size,daisy-chaining measurement method can be utilized to extend the measurement range and improve the accuracy of the measurement results.
		2018 Vol. 27 (12): 1088-1092 [Abstract] ( 401 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1093	Application of virtual reality technology in teaching course of radiotherapy technology
		Li Xiaobo, Dong Fangfen, Song Wenfang, Chen Lifang, Zhang Dongdong, Yao Jianmin, Xu Benhua
		Objective To discuss the necessity and feasibility of application of virtual reality (VR) technology in the teaching course of radiotherapy technology based on the contradictions between the theory and practice of current teaching mode. Methods After in-depth analysis of the characteristics of the existing disciplinary teaching mode,VR technology was introduced to design software,glasses,operating handles and establish a special interactive platform. The teaching courses could be delivered via mobile phone side AR,helmet and AR,touch screen and PC virtual simulation with VR virtual simulation,etc. Six processes of radiotherapy were tested through online courses and offline groups to analyze the feasibility of this technology applied in the training of radiotherapy professionals. Results After the design of software and hardware and the analysis of test results,the online teaching could be utilized to write interactive programs,build virtual experience scenes,create course resource database and construct practical training courses and teaching system. The offline practice test could be applied to the simulation learning of feedback of the whole process,which possessed feasibility and development value. It could be applied to the theory and practice teaching of radiation therapy technology,making the teaching more convenient,vivid and intuitive. Conclusions VR technique combined with radiotherapy technology training can be delivered through online and offline teaching courses of theory and practice by using the plane and virtual simulation technology,which is convenient,quick and highly efficient and deserves widespread application.
		2018 Vol. 27 (12): 1093-1096 [Abstract] ( 411 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1097	Effect of silencing of long non-coding RNA HOTAIR on radiosensitivity of rectal adenocarcinoma cell lines
		Li Minghe, Li Shoumiao, Zhang Wei, Zhang Zhizhong, Liu Zhiqiang, Li Baozhong
		Objective To investigate the effect of long non-coding RNA HOX transcript antisense RNA (lncRNA HOTAIR) on the cell proliferation,radiosensitivity and apoptosis of the rectal adenocarcinoma cell lines SW480 and HCT116 in vitro. Methods The expression levels of lncRNA HOTAIR in the rectal adenocarcinoma cell lines (SW480 and HCT116) were assessed by real-time quantitative PCR (RT-qPCR).Silencing of HOTAIR by RNA interference was performed to explore its roles in cell proliferation,radiosensitivity and apoptosis. After treatment with irradiation at a gradient dose,the cell viability was measured and the rate of cell apoptosis was tested. Results Compared with the human rectal epithelial cell lines,the expression of lncRNA HOTAIR was significantly higher in the rectal adenocarcinoma cell lines. The colonic assay demonstrated that the sensitizing enhancement ratios (SERs) were 1.58 and 1.33 for the cells transfected with HOTAIR siRNA in SW480 and HCT116 cell line compared with the control isRNA transfection group. In vitro silencing of lncRNA HOTAIR could enhance the apotosis rate and radiosensitivity of the rectal adenocarcinoma cell line SW480. Conclusion The expression level of lncRNA HOTAIR is correlated with the cellular radiosensitivity,which is probably a parameter for predicting the radiosensitivity of rectal adenocarcinoma cells. Radiotherapy combined with HOTAIR-siRNA can significantly inhibit the cell proliferation,induce cell apoptosis and enhance the radiosensitivity.
		2018 Vol. 27 (12): 1097-1100 [Abstract] ( 413 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review Articles

	1101	The effect of microwave radiation on the permeability change of blood brain barrier
		Wu Zhibing, Wu Kan, Wu Yajun, Ma Shenglin
		Microwave radiation plays an important role in the diagnosis and treatment of malignant tumors. Whether microwave radiation can improve the effect of chemotherapy on intracranial carcinoma through improving the permeability of blood brain barrier is a hot topic at present. Blood-brain barrier permeability can be increased by microwave radiation though thermal effect and non thermal effect,and the mechanism may be related to the regulation of vascular endothelial growth factor,Occludin,aquaporin 4 and adhesion molecule-1.However,there are still questions on the physical parameters,include temperature,microwave frequency,specific absorption rate and exposure time.
		2018 Vol. 27 (12): 1101-1105 [Abstract] ( 375 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1106	Effect and research progress of respiratory motion on intensity-modulated proton therapy
		Wang Xianliang, X.Ronald Zhu, Hou Qing
		Compared with intensity-modulated photon therapy,intensity-modulated proton therapy has significant dose advantages. However,the dose gradient of proton Bragg peak is relatively high,and the proton therapy is likely to be affected by range uncertainties,setup uncertainties and antonymic changes,etc. The difference between the planning dose and actual dose caused by respiratory motion hinders the widespread use of intensity-modulated proton therapy in thoracic cancers. In this paper,research progress on the effect of respiratory motion on intensity-modulated proton therapy and how to reduce the effect were summarized,aiming to provide reference for clinicians and researchers.
		2018 Vol. 27 (12): 1106-1109 [Abstract] ( 422 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	1110	Research progress in radiation-induced brachial plexopathy in breast cancer
		Xia Qing, Zhu Yaqun
		Radiotherapy is an important part of the postoperative adjuvant therapy of breast cancer. Radiation-induced brachial plexopathy (RIBP) of postoperative radiotherapy severely reduces the quality of life of breast cancer patients. In this article,the general situation,mechanism,diagnosis,risk factors,treatment and preventive measures of RIBP were reviewed.
		2018 Vol. 27 (12): 1110-1114 [Abstract] ( 403 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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