Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2019 Vol.28 Issue.9 Published 2019-09-15

	641	Expert consensus on prevention and control strategy of radiotherapy-induced oral mucositis (2019) Chinese Society of Radiation Oncology of Chinese Medical Association

		Radiotherapy-induced oral mucositis (RTOM) is a category of oral mucosal injury caused by radiotherapy,which is the most common complication of radiotherapy in patients with head and neck tumors. Severe RTOM may interrupt the treatment and lower the clinical efficacy. In recent years,new accomplishment on the prevention and treatment of RTOM has been reported. Nevertheless,unified standards and guidelines are still lacking in China. This expert consensus refers to clinical practice guideline abroad,reviews and summarizes the prevention and management of RTOM at home and abroad,aiming to provide recommendations and suggestions for the prevention and treatment of RTOM in patients with head and neck tumors in China.
		2019 Vol. 28 (9): 641-647 [Abstract] ( 1814 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	648	Clinical characteristics,diagnosis and efficacy of primary lymphoepithelial carcinoma of the parotid gland
		Wang Huili,Huang Xiaodong,Qu Yuan,Wang Kai,Wu Runye,Zhang Ye,Liu Qingfeng,Zhang Shiping,Xiao Jianping,Yi Junlin,Xu Guozhen,Gao Li,Luo Jingwei
		Objective To analyze the clinical features,diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland. Methods Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed. The median follow-up time was 38.5 months. All patients received radiotherapy after operation. Results Of 13 patients,9 cases were male and 4 female. The median age was 33 years. At the initial diagnosis,9 cases had primary lesions limited to the parotid gland,and 4 cases of lymph node metastases located in Ⅰ b and Ⅱ regions of the neck. According to UICC2010 staging,1 case was classified as stage Ⅰ,1 as stage Ⅱ,6 as stage Ⅲ and 5 as stage Ⅳ, respectively. Eleven surgically pathological specimens were tested with EBER in-situ,and 10 cases were positive for EBER. No patient died in the whole group. The 3-year overall survival rate was 100%. The 3-year progression-free survival rate was 76%. The 3-year local control rate was 92%. The 3-year metastasis-free survival rate was 84%. Conclusions The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low. The pathological features are associated with EB virus. It is prone to present with cervical lymph node metastasis. The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment. At present, surgery combined with postoperative radiotherapy is the main treatment. The overall survival is favorable. Local recurrence and distant metastasis are the main causes of treatment failure.
		2019 Vol. 28 (9): 648-651 [Abstract] ( 300 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	652	The risk factors of parotid lymph node metastasis of nasopharyngeal carcinoma and the feasibility of local intensity-modulated radiotherapy for high-risk patients
		Zhang Yongqin,Zuo Yun,Wen Jing,Wang Lijun,Zhang Lanfang,Huang Shengfu
		Objective To investigate the high-risk factors for parotid lymph node (PLN) metastasis from nasopharyngeal carcinoma (NPC) and evaluate the feasibility of local intensity-modulated radiotherapy (IMRT) in patients with high-risk NPC. Methods Clinical data of 440 NPC patients admitted to Department of Radiotherapy of Jiangsu Cancer Hospital from May,2011 to March,2017 were collected. The imaging features,treatment strategies and clinical prognosis of PLN metastasis were retrospectively analyzed. The whole group adopts the technique of intensity modulated radiotherapy. Total parotid or partial parotid irradiation, selective PLN irradiation, X-Ray and/or electronic line supplementation, dose 45-60 Gy. The χ² test or Fisher's accurate probability method test and single factor analysis,Logistic regression model multi-factor analysis. Kaplan-Meier survival analysis,log-rank test differences. Results PLN was observed in the parotid of 230 cases. At the end of follow-up,11 patients (2.5%,11/440) were diagnosed with PLN metastases. Among 11 cases,9 patients (81.8%) had PLN size ≥5 mm. Multivariate analysis demonstrated that extracapsular spread of level Ⅱ was an independent risk factor for PLN metastasis. The patients with PLN size ≥5 mm or extracapsular spread of level Ⅱ were assigned into the high-risk PLN metastasis group. The patients in the high-risk group were further divided into the radiotherapy and non-radiotherapy subgroups. Survival analysis demonstrated that for 230 patients with PLN metastasis,the local recurrence-free survival (LRFS) significantly differed,whereas the overall survival (OS),disease metastasis-free survival (DMFS) and progression-free survival (PFS) did not considerably differ between the radiotherapy and non-radiotherapy subgroups in the high-risk PLN metastasis patients. Conclusions The PLN metastasis rate of NPC is low. Extracapsular spread of level Ⅱ is an independent risk factor. Radiotherapy of the parotid region is considered for patients with PLN size≥5 mm or those with PLN size<5 mm complicated with extracapsular spread of level Ⅱ.
		2019 Vol. 28 (9): 652-656 [Abstract] ( 325 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	657	Preliminary analysis of the factors influencing the secondary externalauditory canal carcinomaof nasopharyngeal cancer
		Ma Shuang,Li Liting,Ma Yujia,Shi Juntian,Zhou Changfeng,Liu Yimin,Chen Jie
		Objective In order to investigate the clinical features and influence factors for incidence in patients with radiation-induced external auditory canal carcinoma (RIEACC). Methods The nasopharyngeal carcinoma (NPC) 16 patients who were diagnosised RIEACC after radiotherapy in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen UniversityfromJanuary 1990 to December 2017 wereretrospectively analysis. The influence factors analysis were used Logistic regression analysis. Results Univariate analysis showed that age,somking history,family history of cancer and NPC stage were the influencing factors. Multi-factor logistic regression analysis showed that age,family history of cancer and NPC stage were independent risk factors. Conclusions RIEACC is rare complication of NPC patients received radiotherapy,which is also a multifactorial outcome. Age,family history of cancer and NPC stage is preliminary the main influencing factor. Although RIEACC has a low incidence,its malignancy should be highly vigilant.
		2019 Vol. 28 (9): 657-659 [Abstract] ( 414 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	660	Influence of survival in primary tumor volume for stage IV non-small cell lung cancer on survival-re-analysis of phase II multicenter prospective clinical findings
		Luo Lan,Ouyang Weiwei,Su Shengfa,Ma Zhu,Li Qingsong,Yang Wengang,Fu Shimei,Lu Bing
		Objective To investigate the effect of primary tumor volume on the survival in the three-dimensional radiotherapy of primary tumors of stage Ⅳ non-small cell lung cancer (NSCLC). Methods Clinical data of 428 patients in a multicenter prospective clinical study from December 2002 to January 2017 were reanalyzed, and 423 of them were subject to survival analyses. Platinum-based doublet chemotherapy was adopted. The median number of chemotherapy cycle was 4, and the critical value of planning target volume (PTV) of primary tumors was 63 Gy. The critical value of gross tumor volume (GTV) of primary tumors was 150 cm³. Results Single factor Cox regression analysis demonstrated that female, KPS score, single organ metastasis,N0-N1 staging, adenocarcinoma, radiotherapy dose ≥63 Gy,4-6 cycles of chemotherapy, recent effectiveness, post-treatment progress in taking targeted drugs and GTV<150 cm³ were good prognostic factors for the patients with stage Ⅳ NSCLC (all P<0.05). According to the stratified analysis of different radiotherapy regimes, for the stage Ⅳ NSCLC patients with a GTV ≥150 cm³,the survival rate of the primary tumor radiotherapy dose ≥63 Gy on the basis of systemic chemotherapy was significantly better than that of the primary tumor radiotherapy dose <63 Gy (P<0.05). Conclusions Stage Ⅳ NSCLC patients with GTV≥150 cm³ in 4-6 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy and GTV<150 cm³ in 1-3 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy may prolong the overall survival of patients with stage Ⅳ NSCLC.
		2019 Vol. 28 (9): 660-664 [Abstract] ( 307 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	665	Preliminary observation of the safety of template-assisted ¹⁹²Ir source hypofractionated stereotactic ablative brachytherapy for locally advanced non-small cell lung cancer
		Shi Xiangxiang,Tang Tao,Pang Haowen,Sun Xiaoyang,Wu Jingbo,Lin Sheng
		Objective To preliminarily evaluate the safety of the coplanar template-assisted ¹⁹²Ir hypofractionated stereotactic ablative brachytherapy (SABT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC),and assess the effect of template-assisted technology upon the accuracy of SABTby comparing the consistency of dosimetric parameters between preoperative and operative plans. Methods Fifteen patients histologically confirmed with LA-NSCLC (stage ⅡB-ⅢA) were recruited and received the template-assisted SABT delivered in a risk-adapted fractionation (30Gy/1F). Preoperative planning, template-assisted needle implantation, operative planning and implementation were performed in all patients. Dosimetric results of preoperative and operative plans were statistically compared by assessing the dosimetric parameters of gross tumor volume (HI,CI,D90,V100 and V150) and organ at risk(V5,V20 and mean dose of bilateral lung,D2cc of spinal cord. The incidence of perioperative complications of SABT was recorded. The safety and feasibility of SABT were evaluated. Results Slight changes were noted in terms of target dose and irradiated dose to the lung between preoperative and operative plans without statistical significance (both P>0.05). No severe adverse events, such as severe pneumothorax, hemothorax and hemoptysis were observed. Conclusions Application of the template-assisted SABT can enhance the accuracy of implantation, maintain the consistency of the dosimetric parameters between the preoperative and operative plans and guarantee the clinical efficacy.
		2019 Vol. 28 (9): 665-668 [Abstract] ( 280 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	669	Predictive value of prognostic nutritional index for radiotherapy and prognosis of elderly patients with esophageal squamous cell carcinoma
		Xu Yingying,Guo Xinwei,Ji Shengjun,Chen Qingqing,Gu Ke,Tian Ye
		Objective To evaluate the role of prognostic nutritional index (PNI) in the radiotherapy for elderly patients with esophageal squamous cell carcinoma. Methods Clinical data of 108 elderly patients (aged>65 years) with esophageal squamous cell carcinoma who underwent radical radiotherapy were retrospectively analyzed. The PNI value of each patient was calculated, and the optimal cutoff value of PNI before treatment was determined by establishing the receiver operating characteristic curve (ROC curve). All patients were divided into the low and high PNI value groups. The overall survival rate was calculated by Kaplan-Meier method. Log-rank test, univariate and Cox’s multivariate prognosis analyses were performed. Results The ROC curve demonstrated that the optimal cutoff value of PNI was 50.1(n=52 in high PNI group and n=56 in low PNI group). Age, gender and treatment did not significantly differ between two groups, whereas the TNM staging significantly differed (P=0.022). The effective rate of radiotherapy in the high PNI group was 96%, significantly higher than 73% in the low PNI group (P=0.001). In the high PNI group, the 1-,2-,and 3-year overall survival rates were 94%,69%,and 62%,significantly higher compared with 70%, 32% and 27% in the low PNI group (all P<0.001). Univariate analysis showed that PNI,T staging, N staging and TNM staging were significantly correlated the overall survival of patients (all P<0.01).Cox’s multivariate analysis revealed that N staging (RR=1.94,95%CI=1.29-2.94,P=0.002) and PNI (RR=0.83,95%CI=0.77-0.90,P<0.001) were independent risk factors affecting overall survival. Conclusions PNI before treatment has a good correlation with the prognosis and radiotherapy efficacy of patients, which can be used as a pivotal index to predict the clinical benefit of radiotherapy for elderly patients with esophageal squamous cell carcinoma.
		2019 Vol. 28 (9): 669-672 [Abstract] ( 384 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	673	Postoperative recurrent pattern and the lymph node metastatic stations of the thoracic esophageal squamous cell carcinoma
		Li Chunyang,Yu Jing,Shen Jiuling,Ouyang Wen,Xu Yu,Zhang Junhong,Xie Conghua
		Objective To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC),aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC. Methods Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed. According to the AJCC 8^th edition-defined classification of esophageal carcinoma, regional lymph node stations 1 to 8M were defined as the upper-middle mediastinum region (UMMR),and stations 8Lo,9 and 15 were defined as the inferior mediastinum region (IMR),stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR). Results Among all 66 patients,41 cases (62%) experienced loco-regional recurrence alone,25 cases (38%) presented with distant metastasis alone. A total of 54 patients with 148 lymph node recurred after treatment. The highest risk region of lymph node recurrence was UMMR (118/148,80%),after that,followed by UAR (24/148,17%). With regard to 9 cases of UAR, 6 patients had lower TESCC,and 8 patients (89%) were graded as ≥ pathological stage Ⅲ. Conclusions The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy, which should be considered as the target volume in postoperative radiotherapy. For patients with lower TESCC ≥ pathological stage Ⅲ,UAR might be the target volume with cautions. Anastomosis and IMR are probably not the routine treatment volumes.
		2019 Vol. 28 (9): 673-676 [Abstract] ( 320 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	677	Isocenter bilateral tangential fields combined with intensity-modulated radiotherapy for synchronous bilateral whole breast irradiation
		Ma Mingwei,Wang Shulian,Miao Junjie,Tang Yu,Zhao Bo,Qin Shirui,Zhang Jianghu,Qi Shunan,Chen Siye,Ma Yuchao,Liu Xin,Li Yexiong
		Objective To investigate the dose characteristics and outcomes of a single isocenter bilateral tangential fields (IBTF) combined with intensity-modulated radiotherapy (IMRT) in bilateral breast radiotherapy (BBR). Methods Fourteen female patients with synchronous bilateral breast cancer (SBBC) after breast-conserving surgery (BCS) were enrolled in this study. All patients received BBR using IBTF combined with IMRT at a conventional (50Gy/25f) or hypofractionated (43.5Gy/15f) dose. For patients with invasive cancer,the additional tumor bed boost was given with sequential electron radiation or simultaneously photon IMRT. The coverage, uniformity and short-term clinical efficacy were evaluated. Results The number of the irradiation field was 8-11,including 4-7 intensity-modulated fields. The bilateral breast PTV dose coverage reached 95% in all plans. For the tumor bed, the mean dose coverage was (95.54±1.33)%(left) and (94.19±1.03)%(right) using photon, and (90.25±8.79)%(left) and (85.28±8.35)%(right) using electron. The average V20 of bilateral lungs was (16.69±3.90)%. The cardiac Dmean was 5.48 Gy. Three patients presented with grade Ⅱ acute skin toxicities. No ≥ grade Ⅱ pneumonitis was observed. No recurrence occurred with the median follow-up time of 30.1 months. Eleven patients showed excellent cosmetic results. Conclusion BBR using IBTF combined with IMRT is efficacious and safe for patients with SBBC after BCS.
		2019 Vol. 28 (9): 677-681 [Abstract] ( 291 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	682	A meta-analysis of comparing hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer
		Liu Lei,Ren Bixin,Yang Yongqiang,Zou Li,Guo Qi,Zhu Yaqun,Tian Ye
		Objective To compare the efficacy between hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer by a meta-analysis. Methods The controlled clinical trials of comparing hypofractionated radiotherapy versus conventionally fractionated radiotherapy in post-mastectomy breast cancer were searched from PubMed,EMbase,Cochrane Library,Wanfang database,VIP,CNKI,and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 software. The differences between two groups were estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results A total of 19 controlled clinical trials involving 2652 post-mastectomy breast cancer patients were selected in this meta-analysis according to the inclusion and exclusion criteria. The meta-analysis results demonstrated that no statistical significance was observed in the tumor-free survival (OR=1.10,95%CI:0.78-1.56,P=0.59), overall survival (OR=1.18,95%CI:0.92-1.53,P=0.19), locoregional recurrence (OR=1.01,95%CI:0.68-1.51,P=0.96), distant metastasis (OR=1.14,95%CI:0.82-1.59,P=0.43), skin toxicity (OR=1.01,95%CI=0.80-2.16,P=0.96), cardiac toxicity (OR=1.17,95%CI:0.71-1.93,P=0.53) and pulmonary toxicity (OR=0.78,95%CI:0.44-1.37,P=0.38) between two groups. Conclusions Hypofractionated radiotherapy and conventionally fractionated radiotherapy post-mastectomy yield similar clinical efficacy, both of which are safe and efficacious radiotherapy patterns. However, the findings remain to be validated by large-scale randomized clinical trials with long-term follow-up of the advanced stage complications.
		2019 Vol. 28 (9): 682-686 [Abstract] ( 454 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	687	Preliminary study of efficacy and safety of Pembrolizumab and Nivolumab in treatment of advanced malignant tumors
		Hou Lina,Dina·Suolitiken,Ren Hua
		Objective To preliminarily compare the efficacy and safety of Pembrolizumab and Nivolumab in the treatment of advanced malignant tumors. Methods Clinical data of 50 patients diagnosed with advanced malignant tumors treated with Pembrolizumab and Nivolumab from January 2017 to August 2018 in our hospital were retrospectively analyzed. All patients were divided into the Pembrolizumab (n=26) and Nivolumab groups (n=24). The incidence of adverse reactions was statistically compared between two groups by using χ² test. The survival analysis was performed by using Kaplan-Meier method. Results The median progression-free survival in the Pembrolizumab group was 213 d, and 146 d in the Nivolumab group (P>0.05). The incidence of aminotransferase elevation and hypothyroidism in the Nivolumab group was significantly higher than that in the Pembrolizumab group (63% vs. 23%,12% vs. 0%, both P<0.05), whereas the incidence of oral mucositis in the Nivolumab group was 0%, significantly lower than 15% in the Pembrolizumab group (P<0.05). The median overall survival time in the Pembrolizumab group was 579d, and 238 d in the Nivolumab group (P>0.05). Conclusion Clinical efficacy does not significantly differ, whereas the incidence of adverse reactions slightly differs between the Pembrolizumab and Nivolumab groups.
		2019 Vol. 28 (9): 687-691 [Abstract] ( 376 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	692	Influence of head position on radiation dose distribution in whole brain volume-modulated arc therapy
		Zhou Yang,Qian Yuecheng,Liu Gen
		Objective To explore the intensity of coplanar arc-adjusted radiotherapy with volume-modulated arc therapy (VMAT) and whether the position of the head tilt influences the distribution of radiotherapy dose. Methods From 2015 to 2017,500 patients underwent radiotherapy of the head and kept their head tilted. The simulated non-inclined CT images were obtained by rotating the original CT images. The protocol of the coplanar VMAT whole brain irradiation was 30 Gy and the maximum dose of planning target volume in the hippocampus was limited to 16 Gy. The doses of the optic nerve, optic chiasm and eyeball were lower than 37.5 Gy. The dosimetric parameters of two different protocols were statistically compared by paired t-test. Results The average head tilt angle was (11.12°±0.68°). The homogeneity and the conformal index in the tilted and non-tilted positions were decreased by (8.3±9.6)%(P=0.033) and (5.2±4.1)%(P=0.009). The dose of hippocampus in the tilted position of the head was decreased by (13.6±6.2)% on average compared with that in the non-inclined position (P=0.004). The dose of the lenses was decreased by (15.5±11.1)%(P=0.008) on average. The doses of optic nerve and eyeball were declined by (6.8±5.6)%(P=0.013) and (8.6±6.5)%(P=0.016). Conclusions By tilting the head at an appropriate angle during VMAT whole-brain radiotherapy, the radiation dose distribution of the target volume can be significantly improved and the radiation dose in the hippocampus and visual system can be reduced simultaneously to maintain the therapeutic effect and minimize the effect upon the cognitive and memory function of patients.
		2019 Vol. 28 (9): 692-695 [Abstract] ( 922 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	696	Dosimetric evaluation of conventional two-dimensional radiotherapy after modified mastectomy for breast cancer patients
		Zhai Yirui,Wang Shulian,Tang Yu,Dai Jianrong,Chen Bo,Fang Hui,Ren Hua,Qi Shunan,Lu Ningning,Tang Yuan,Li Ning,Liu Yueping,Song Yongwen,Yu Zihao,Jin Jing,Li Yexiong
		Objective To investigate the dosimetric characteristics of conventional two-dimensional radiotherapy of the chest wall,supra-and infra-clavicular regions,and the incidental irradiation dosage of the internal mammary region after modified mastectomy in breast cancer patients. Methods Clinical data of 20 breast cancer patients including 10 left and 10 right cases who received radiotherapy after modified mastectomy between 2015 and 2016 were retrospectively analyzed. All patients received irradiation to the chest wall,supra-and infraclavicular regions at a prescription dose of 43.5 Gy in 15 fractions with conventional technique. One anterior-posterior (AP) photon field irradiation was delivered for the supra-and infra-clavicular regions,and one electron field for the chest wall. The supra-and infraclavicular regions were re-planned by using two AP/PA fields and the doses of organ at risk were evaluated. Results With conventional radiotherapy,the D90 of the supra-and infra-clavicular regions were more than 39.15 Gy (EQD2≥45Gy) in 17 patients (85%),and the median D90 of the chest wall was 35.38 Gy. The median dose of incidental internal mammary region was 13.65 Gy. Patients with lower body mass index (BMI) received higher D90 in both supra-and infra-clavicular and chest wall irradiation (P=0.039,0.347). Conclusions Irradiation at D90 of 39.15Gy to the supra-and infra-clavicular regions with AP/PA fields can meet the prescription dose requirement of ≥90% in most cases and does not increase the irradiation dose to normal tissues. The dose distribution of one electron field of the chest wall is poor. Incidental internal mammary region can be irradiated at a limited dosage. BMI is an influencing factor for dose distribution.
		2019 Vol. 28 (9): 696-700 [Abstract] ( 370 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	701	Development and application of a simple radiotherapy information system with multi-technology integration
		Chen Jinshu,Ma Yujia,Shi Juntian
		Objective To develop a simple radiotherapy information system for the developments of multiple hospital areas. Methods Using C/S+B/S dual technology architecture, Visual Studio 2015+C#+HTML5+JavaScript+PostgreSQL9.5 were utilized as the programming tools selected for development. The two-dimensional barcode, intelligent IC card, identity card recognition, face recognition, speech synthesis and other technologies were integrated and applied in the radiotherapy process management. The normal business processes were designed by default automatic processing. Previous multi-step operation was simplified to single-key operation. Results System development was completed and implemented at the end of 2017, which connected the south and north hospital areas. The system not only resolved the problem that required the doctors to manually input or make telephone call for consulting patients’ data, but also achieved paperless business process in different departments. The outstanding advantage was reflected in the aspects of intelligence and optimization. Approximately 95% of the normal flows could be completed by single-key automatic processing, and the remaining 5% requiring special operations (such as, modification or deletion, etc.) were prompted and restricted to ensure data security and system stability. Conclusion The application of this system improves the level of information management in the departments and saves the cost of supplies and human resources.
		2019 Vol. 28 (9): 701-705 [Abstract] ( 285 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	706	Effect of SALL4 on radiosensitivity of leukemia cell line HL-60
		Li Lin,Wu Guangyin,Li Xiaoke,Tian Lixiao,Chen Yuqing,Li Yan
		Objective To evaluate the effect of down-regulating SALL4 on the radiosensitivity of leukemia cells, aiming to provide new ideas for improving radiosensitivity of leukemia patients. Methods Human acute myeloid leukemia cell line HL-60 infected with shRNA SALL4 and shRNA control lentivirus was classified into the Lv-shSALL4 group and Lv-shNC group. The levels of SALL4 mRNA and protein in cells were detected by RT-PCR and Western blot. The infected cells treated with 8 Gy dose irradiation were assigned into the Lv-shSALL4＋radiation and Lv-shNC＋radiation groups. The cell apoptosis was detected by flow cytometry. The levels of cleaved Caspase-3, cleaved Caspase-9 and Bax proteins in cells were determined by Western blot. The cells in the Lv-shSALL4 and Lv-shNC groups were exposed to 0, 2, 4, 6 and 8 Gy irradiation. The radiosensitivity ratio was determined by cell clone test. Results The level of SALL4 in the Lv-shSALL4 group was significantly lower than that in the Lv-shNC group (P<0.05). The cell apoptosis rate was significantly increased, the levels of cleaved Caspase-3, cleaved Caspase-9 and Bax proteins were remarkably up-regulated in cells compared with those in the Lv-shNC group (all P<0.05). The cell proliferation ability in the Lv-shSALL4＋radiation was significantly reduced, the cell apoptosis rate was considerably increased, the levels of cleaved Caspase-3, cleaved Caspase-9 and Bax proteins were significantly up-regulated compared with those in the Lv-shSALL4 and Lv-shNC+ radiation groups (all P<0.05). The cell radiosensitization ratio in the Lv-shSALL4 group was 1.323. Conclusion Down-regulating SALL4 can increase the radiosensitivity of leukemic cells, inhibit the cell proliferation and induce the apoptosis of leukemic cells.
		2019 Vol. 28 (9): 706-708 [Abstract] ( 296 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	709	Treatment options of early-stage lung cancer:surgery or stereotactic body radiotherapy
		Wu Yanling,Feng Qingfu,Wang Xiaodan,Zeng Qiang
		For the treatment of early non-small cell lung cancer,surgery is still one of the most important curative treatments. Lung segment or subsegment resection under video-assisted thoracoscopic surgery is becoming more and more popular. With the development of radiotherapy technology, Stereotactic Body Radiotherapy (SBRT) has achieved the similar or the same curative effect as surgery. It has become an indisputable curative treatment for patients who can not or refuse surgery,and there are still some disputes among those who can operate. Therefore,this review will elaborate on these treatment methods in order to help update the concept and provide more treatment methods and obtain more benefits for patients. Although it is no randomized clinical trial to compare SBRT with surgery,we suggest that SBRT is the curative treatment for patients who can not or refuse surgery. Especially for the elderly,or patients with cardiopulmonary diseases,diabetes and other high-risks. SBRT should become the main treatment methods,because its curative effect is not inferior to surgery and its complications are fewer and lighter. Therefore,for the treatment of non-small cell lung cancer in the early stage,it is more importent to choose individualized treatment methods so as to more benefit.
		2019 Vol. 28 (9): 709-712 [Abstract] ( 319 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	713	Research progress on treatment of esophageal perforation in esophageal carcinoma
		Qi Xinrui,Liang Jun
		Esophageal cancer is one of the common tumors in China. Esophageal perforation is a common complication of esophageal carcinoma. Currently,there is no consensus on the treatment of esophageal perforation of esophageal carcinoma at home and abroad. Twenty-seven articles were selected from PubMed,CNKI and Wanfang database between 1997 to December 2017. The mechanism of esophageal perforation and clinical characteristics in these 27 articles were analyzed. Surgery can improve the survival rate, but the risk of perioperative complications may be increased. Concurrent chemoradiotherapy with nutritional support can significantly improve the survival rate.
		2019 Vol. 28 (9): 713-716 [Abstract] ( 446 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	717	Research progress inpostoperative brachytherapy for cervical cancer
		Qu Hongda,Shi Dan,Zhang Ning,Cheng Guanghui,Tang Yuhuan
		Radiotherapy is an important part of the postoperative adjuvant therapy of cervical cancer. Along with the persistent development of radiotherapy techniques,the application of brachytherapy has been more and more used as a boost to external beam radiotherapy. In this artical,the indications of postoperative radiotherapy and the application of brachytherapy were reviewed.
		2019 Vol. 28 (9): 717-720 [Abstract] ( 348 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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