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.10 Published 2019-10-15

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

Special Feature

	721	Research progress on radiation-induced heart damage—basic mechanism
		Wang Jun, Wu Yajing
		At present, heart has become an important organ at risk during radiotherapy for thoracic, mediastinal and breast carcinoma. Heart is relatively sensitive to radiation because of its anatomical location and structure. The incidence of radiation-induced cardiac adverse events can affect the long-term survival of patients. In this article, the recent progress on the basic research of radiation-induced heart damage was described as follows.
		2019 Vol. 28 (10): 721-727 [Abstract] ( 251 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Head and Neck Tumors

	728	Observation of preliminary efficacy and nursing care of skin relief cream and Biafine for radiation-induced skin damage in patients with nasopharyngeal carcinoma
		Shi Kefu, Qi Liping, Zhou Dan, Feng Huixia
		Objective To compare the preliminary efficacy and nursing care of radioprotective agent skin relief cream and Biafine for the prevention and treatment of neck radiation-induced skin damage in patients with nasopharyngeal carcinoma. Methods Sixty-seven nasopharyngeal carcinoma patients initially treated with intensity-modulated radiotherapy in Sun Yat-sen University Cancer Prevention and Control Center from 2016 to 2017 were recruited and assigned into the control (n=36) and experimental groups (n=31). In the control group, Biafine was applied to the skin in the radiation field and radioprotective agent skin relief cream was applied in the experimental group. The degree of radiation skin injury and adverse reactions were statistically compared between two groups. Results No grade IV radiation-induced skin damage occurred in two groups. The incidence rates of grade 1, 2 and 3 radiation-induced skin damage in the experimental group were 45%,42% and 13%, and 17%,64% and 19% in the control group, respectively (P=0.04). Radioprotective agent skin relief cream could control the radiation-induced skin injury within grade Ⅱ and significantly increase the proportion of grade I skin injury. Conclusion Medical radioprotective agent is superior to Biafine in the prevention and treatment of radiation-induced skin damage in patients with nasopharyngeal carcinoma.
		2019 Vol. 28 (10): 728-730 [Abstract] ( 408 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	731	Early assessment of treatment response during radiotherapy for esophageal cancer based on CT radiomics analysis
		Li Dingjie, Li, Wu Hui, Liu Ru, Zhang Yougai, Guo Wei, Lou Zhaoyang, Ge Hong
		Objective To investigate the feasibility of assessing the treatment response using diagnostic-quality CT imaging features during radiotherapy for esophageal cancer. Methods Thirty-three patients with stage Ⅰ to IV esophageal cancer undergoing intensity-modulated radiotherapy were recruited in this study. CT images were acquired using a CT-on-rail imaging system. Imaging data of CT images including gross tumor volume (GTV), the volume of spinal cord and non-irradiated tissue (NIT), CT mean (MCTN),standard deviation ,and skewness were collected and analyzed by using MIM image processing system. Patients were divided into the effective group (complete remission and partial remission,n=24) and ineffective group (no change and progression, n=9) based on the outcomes of 3-month follow-up. The imaging data were statistically compared between two groups using the self-designed Matlab software. Results The tumor volume and MCTN of 33 patients were gradually decreased with the increase of radiotherapy dose. The tumor volume and MCTN were decreased by 42.46% and 5.76HU in the effective group, more significant compared with 21.76% and 3.66HU in the ineffective group (both P<0.005). The skewness in the ineffective group was decreased by 0.503 with the increasing radiation dose, whereas that in the effective group was increased by -0.450(P=0.034). Spinal cord and NIT did not significantly change with the increasing radiation dose. Conclusion Analysis of the characteristic data of CT images of patients with esophageal cancer during radiotherapy may early predict the clinical efficacy of radiotherapy.
		2019 Vol. 28 (10): 731-734 [Abstract] ( 265 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	735	Analysis of risk factors of radiation-induced lung toxicity in non-small cell lung cancer patients treated with postoperative radiotherapy
		Fan Chengcheng, Zhao Lujun, Bi Nan, Hui Zhouguang, Liang Jun, Lyu Jima, Wang Xiaozhen, Ge Hong, Wang Luhua
		Objective To evaluate the incidence and risk factors of symptomatic radiation-induced lung toxicity (SRILT) in non-small cell lung cancer (NSCLC) patients treated with modern radiotherapy after surgery. Methods Clinical data of consecutive NSCLC patients treated with postoperative three-dimensional conformal or intensity-modulated radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences between November 2002 and December 2011 were retrospectively analyzed. According to the Common Terminology Criteria for Adverse Events (CTCAE, version 3.0), SRILT was defined as ≥grade 2 radiation-induced lung toxicity. Potential clinical risk factors and dosimetric parameters for SRILT were evaluated using logistic regression model. Results Among 227 enrolled patients, 190 cases underwent lobectomy and 37 patients received pneumonectomy. Twenty-three patients (10.1%) developed SRILT after lobectomy. Seventeen patients experienced grade 2 SRILT, 5 cases of grade 3 SRILT and 1 case of grade 4 SRILT. Univariate analysis showed that postoperative concurrent chemoradiotherapy, relatively large PTV, mean lung dose and V20- V40 were significantly correlated with the incidence of SRILT (P=0.015, 0.048 and<0.001). Multivariate analysis demonstrated that postoperative concurrent chemoradiotherapy and V20 were significantly associated with the incidence of SRILT (P=0.017 and P=0.009). Conclusions The incidence of SRILT is relatively low in NSCLC patients after postoperative radiotherapy. Concurrent chemoradiotherapy and V20 are risk factors of SRILT.
		2019 Vol. 28 (10): 735-740 [Abstract] ( 231 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	741	Effect of peripheral blood lymphocyte-to-monocyte ratio on prognosis of esophageal cancer patients treated with intensity-modulated radiotherapy
		Li Li, Li Shuguang, Yan Ke, Song Chunyang, Zhao Yan, Wang Xuan, Shi Hongyun, Zhu Shuchai
		Objective To observe the variation trend of the peripheral blood lymphocyte-to-monocyte ratio (LMR) during radiotherapy in patients with esophageal cancer and analyze the relationship between LMR and the radiation-induced injury, aiming to provide parameters for accurate evaluation of radiotherapy responses and clinical efficacy. Methods Clinical data of 248 eligible patients undergoing definitive radiotherapy in our department from January 2013 to December 2015,248 were retrospectively analyzed. The routine peripheral blood examination was performed weekly before, during and at the end of radiotherapy. The absolute number of lymphocyte and monocyte was recorded to calculate the LMR. The standard classification of LMR value was conducted based on the median value of each parameter. All data including the lesion length, lesion location, clinical stage and LMR were analyzed using the Kaplan-Meier, cox and logistic regression methods, respectively. Results LMR displayed an exponential decline during radiotherapy. Univariate analysis showed that the average LMR value was the influential factor of overall survival (P=0.011) and progression-free survival (P=0.017). The mean LMR value almost exerted significant effect upon local control rate (P=0.053). No significant correlation was observed between the mean LMR value and radioactive esophagitis and pneumonitis. Stratified analysis based on the results of multivariate analysis demonstrated that patients with higher average LMR value still had longer survival. Logistic regression model revealed that the length of esophageal lesion and irradiation pattern were the influential factors of the mean LMR value. Conclusions LMR value displays an exponential decline during radiotherapy. The greater amplitude prompts the worse prognosis. The wider the irradiation field and the greater decrease in LMR exert more obvious impact on the prognosis.
		2019 Vol. 28 (10): 741-745 [Abstract] ( 254 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	746	Preliminary study of the relationship between the expression of NRAGE and the therapeutic effect of radiotherapy in patients with esophageal squamous cell carcinoma
		Tian Zhesen, Liu Huizhi, Zhou Huandi, Zhang Yufeng, Zhang Ge, Gai Xiaohui, Liu Chunmei, Xue Xiaoying
		Objective To detect the expression of NRAGE protein in esophageal squamous cell carcinoma and investigate the relationship between NRAGE and therapeutic effect of radiotherapy. Methods The expression level of NRAGE in 44 patients with esophageal squamous cell carcinoma was evaluated by immunohistochemistry and statistically analyzed along with clinical data by using multivariate analysis using Cox regression model. Results The overall expression level of NRAGE protein in esophageal squamous cell carcinoma (P=0.025) and the expression level of NRAGE nuclear protein (P=0.008) were negatively correlated with short-term efficacy. In terms of the overall expression level of NRAGE protein, the 3-year survival rates in the strongly positive group and the positive weakly positive group were 16% and 36%(P=0.198). As for the expression of NRAGE nuclear protein, the 3-year survival rates in the strongly positive group and the positive+ weakly positive group were 0% and 41%(P<0.001). Multivariate analysis using Cox regression model demonstrated that as for the expression of NRAGE nuclear protein, the risk of death in the strongly positive group was significantly higher than those in the positive+ weakly positive group (P=0.002). Conclusion The overall expression level of NRAGE protein in the esophageal cancer is negatively correlated with the short-term efficacy of radiotherapy, whereas it is not correlated with long-term survival rate. The strongly positive expression level of NRAGE nuclear protein is negatively correlated with the short-term efficacy of radiotherapy and the long-term survival rate, prompting that NRAGE may be a molecular indicator for predicting radiation resistance and even the efficacy of radiotherapy for esophageal squamous cell carcinoma
		2019 Vol. 28 (10): 746-748 [Abstract] ( 229 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	749	Observation of clinical efficacy of stereotactic body radiotherapy in 28 cases of large hepatocellular carcinoma
		Sun Jing, Zhang Aimin, Li Wengang, Wang Jia, Zhang Dan, Li Dong, Ding Junqiang, Duan Xuezhang
		Objective To observe the survival and side effects of stereotactic body radiotherapy (SBRT) in large hepatocellular carcinoma (HCC) patients. Methods Twenty-eight large HCC patients undergoing SBRT in 302 Military Hospital from November 1,2011 to January 31,2014 were observed. The prescribed dose was 39-61Gy/3-9f. Among them,20 patients simultaneously received transcatheter arterial embolization. The overall survival (OS), progression-free survival (PFS) and local control (LC) rates were calculated by using Kaplan-Meier method. The influencing factors of OS were analyzed by Cox regression model. The influencing factors of radiation-induced liver disease (RILD) were identified by using Logistic regression analysis. Results The 1-,2-,3-and 5-year OS rates were 75%,57%,54% and 22%, respectively. The 1-,2-,3-and 5-year PFS rates were 59%,47%,36% and 18%, respectively. The 1-,2-,3-and 5-year LC rates were 92%,86%,86% and 86%, respectively. Four patients suffered from RILD and none died from RILD. Child-Pugh classification was the influencing factor of OS and RILD. Conclusion It is preliminarily believed that SBRT is an alternative and safe treatment for patients with large HCC.
		2019 Vol. 28 (10): 749-752 [Abstract] ( 224 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	753	Effect of radiotherapy on ovarian function in patients undergoing radical surgery for cervical cancer
		An Jusheng, Du Xiaomeng, Zhang Feng, Chen Jiayun, Dai Jianrong, Huang Manni, Wu Lingying
		Objective The correlation between dosimetric parameters of transposed ovary and different clinical ovarian functional status was assessed in young patients with cervical cancer who needed adjuvant radiotherapy after radical resection of the ⅠB1-ⅡA2 phase of preserved and transposed ovaries. Methods The function of transposed ovary and relevant clinical symptoms in 86 patients before and 2 years after treatment between 2015 and 2017 were retrospectively analyzed, and the correlation between the dosimetric parameters and functional status of transposed ovaries during radiotherapy was evaluated. Different in vitro measures were adopted to protect the transposed ovaries during postoperative radiotherapy including 68 cases of IMRT or VMAT and 18 cases of two-dimensional and other central radiotherapy. Results The nearest distance between ovary and PTV was negatively correlated with the ovarian dose ≥V5Gy (P=0.025). V8 Gy and Dmean were positively correlated with FSH after treatment (P=0.011, 0.020). The larger the volume of V8Gy and the large Dmean, the higher the FSH, the worse the ovarian function. In two-dimensional technology, the ovarian dose ≥V5Gy was significantly lower than that in three-dimensional technique. The average age of those with normal ovarian function after treatment was 33.4 years, whereas the average age of women with ovarian failure was 39.6 years (P=0.007). The number of preserved ovaries and whether synchronous chemotherapy was delivered were similar in patients with different ovarian status, which were correlated with the levels of FSH and E2 (Estradiol) before treatment, that is, the higher the level of FSH before treatment, the lower the E2 of ovarian FSH after treatment, and the higher the level of FSH after treatment, the lower the level of ovarian E2. Patients who retained their ovaries before treatment but suffered from ovarian failure received neoadjuvant chemotherapy with a slightly higher age. Conclusions Age, V8Gy and Dmean of the transposed ovary, the shortest distance between transposed ovary and PTV, whether neoadjuvant chemotherapy was delivered before surgery and radiotherapy technique affect the protection of the function of transposed ovary.
		2019 Vol. 28 (10): 753-757 [Abstract] ( 205 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	758	Influential factors and evaluation of psychological distress in cancer patients treated with radiotherapy
		Chen Jie, Chen Jinmei, Zhao Xiaohui, Chen Canglong, Ma Yujia
		Objective To evaluate the degree of psychological distress and analyze the influential factors of cancer patients receiving radiotherapy, aiming to provide theoretical basis for individualized psychological interventions. Methods A cross-sectional survey of 157 cancer patients treated with radiotherapy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University in the previous year was conducted in terms of data collection and mean score of NCCN distress thermometer by using the convenience sampling method. Tumor types included nasopharyngeal cancer,breast cancer and cervical cancer,etc. The influential factors were analyzed by using logistic regression method. Results The mean score of NCCN distress thermometer in 157 cancer patients was 4.07±0.19. Among them, 87 cases (55.41%) experienced significant psychological distress (NCCN distress thermometer score≥4). The main influential factors of psychological distress consisted of depression, loneliness, fear, appearance changes, urination changes, nausea, poor appetite, eating trouble,diarrhoea, constipation, pain and radiodermatitis. Logistic regression analysis demonstrated that nausea and urination changes were the independent influential factors of psychological distress. Conclusions Over half of cancer patients undergoing radiotherapy present with evident psychological distress. Somatic problems and emotional situations are the main factors of psychological pain. Consequently, it is highly necessary to emphasize the psychological health and actively resolve the somatic and emotional symptoms of cancer patients receiving radiotherapy.
		2019 Vol. 28 (10): 758-761 [Abstract] ( 245 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Biology·Technique

	762	Interobserver variations in the delineation of planning target volume and with orgagans at risk different contouring methods in intensity-modulated radiation therapy for nasopharyngeal carcinoma
		Peng Yinglin, Sun Wenzhao, Cheng Wanqin, Xia Haiqun, Yao Jijin, Xiao Weiwei, Shen Guanzhu, Yang Lin, Zhou Shu, Li Jiaxin, Guan Ying, Liu Shuai, Deng Xiaowu
		Objective To assess the interobserver variations in delineating the planning target volume (PTV) and organs at risk (OAR) using different contouring methods during intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC), aiming to provide references for the quality control of multi-center clinical trials. Methods The PTV and OAR of CT image of 1 NPC patient manually delineated by 10 physicians from 8 different radiation centers were defined as the "manual contour group", and the OAR auto-contoured using the ABAS software and modified by the physicians were defined as the "auto+manual contour group". The maximum/minimum ratio (MMR) of the PTV and OAR volumes, and the coefficient of variation (CV) for different delineated contours were comparatively evaluated. Results Large variation was observed in the PTV and OAR volumes in the manual contour group. The MMR and CV of the PTV were 1.72-3.41 and 0.16-0.39, with the most significant variation in the PTVnd (MMR=3.41 and CV=0.39 for the PTVnd-L). The MMRand CV of the manually contoured OAR were 1.30-7.89 and 0.07-0.67. The MMR of the temporal lobe, spinal cord, temporomandibular joint, optic nerve and pituitary gland exceeded 2.0. Compared with the manual contour group, the average contouring time in the auto+ manual group was shortened by 68% and the interobserver variation of the OAR volume was reduced with an MMR of 1.04-2.44 and CV of 0.01-0.37. Conclusions Large variation may occur in the PTV and OAR contours during IMRT plans for NPC delineated by different clinicians from multiple medical centers. Auto-contouring+ manually modification can reduce the interobserver variation of OAR delineation, whereas the variation in the delineation of small organs remains above 1.5 times. The consistency of the PTV and OAR delineation and the possible impact upon clinical outcomes should be reviewed and evaluated in multi-center clinical trials.
		2019 Vol. 28 (10): 762-766 [Abstract] ( 269 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	767	Effect of different expression levels of USP28 on apoptosis and related protein expression in esophageal cancer cell ECA109 after irradiation
		Zhang Weili, Liu Zhikun, Zhang Jun, Niu Yujie, Song Bo
		Objective To observe the effect of different expression levels of USP28 on the radiosensitivity of ECA109 cells by gene transfection method,aiming to provide theoretical basis for comprehensive treatment of esophageal cancer. Methods The expression levels of USP28 and c-Myc in the esophageal epithelial cells Het-1A,ECA109 and ECA109R were quantitatively measured by qRT-PCR. The specific siRNA sequences were designed according to the USP28 and c-Myc genes. The pcDNA-USP28 and pcDNA-c-Myc plasmids were constructed. The esophageal cancer cell ECA109 was transfected with Lipofectamine 2000 to observe the transfection effect and related protein expression. ECA109 and ECA109R cells were exposed to 6Gy X-ray radiation. The cell apoptosis in each group was detected by flow cytometry. The radiosensitivity was evaluated by clone formation assay. Results The expression levels of USP28 and c-Myc in ECA109 were significantly higher than those in Het-1A (both P<0.05),and the expression levels of USP28 and c-Myc in ECA109R were remarkably higher than those in ECA109(both P<0.05). The pcDNA-USP28 and pcDNA-c-Myc recombinant plasmids were successfully constructed. Compared with the negative control group, the expression of USP28 at the protein and mRNA levels in the si-USP28 group was significantly down-regulated, whereas those in the pcDNA-USP28 group were remarkably up-regulated. Similar results were obtained in terms of c-Myc. Compared with the control group, the expression level of c-Myc protein was significantly up-regulated in the pcDNA-USP28 group, whereas considerably down-regulated in the si-USP28 group. After 6Gy irradiation, the apoptosis rate and radiosensitivity of ECA109 cells were significantly declined. The apoptosis rate and radiosensitivity of ECA109R cells were increased in the si-USP28 group. Conclusions The expression of USP28 protein is closely correlated with the radiosensitivity of esophageal cancer cells. The underlying mechanism may be related to the regulation of c-Myc expression by USP28.
		2019 Vol. 28 (10): 767-767 [Abstract] ( 236 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	772	Comparison of setup accuracy between Catalyst HD and skin markers in stereotactic body radiotherapy of lung cancer
		Yu Songmao, Zhou Shun, Du Yi, Li Junyu, Sheng Pengfei, Wu Hao, Yue Haizhen
		Objective To compare the setup accuracy between Catalyst HD and skin markers in stereotactic body radiotherapy (SBRT) of lung cancer. Methods A total of 24 cases treated with SBRT were selected and all patients were fixed with vacuum pad in the supine position. Patients in group A were positioned by Catalyst HD and those in group B were positioned by shin markers. All patients were matched with the CT images after CBCT scan by rigid registration and the setup errors in six directions (x-, y-, z-axis, Rtn, Pitch and Roll) were obtained. Results The mean±SD in group A and B in the six directions were as follows:(0.13±0.12) cm,(0.25± 0.19) cm;(0.26±0.15) cm,(0.13±0.11) cm;(0.23±0.19) cm,(0.35±0.29) cm;(0.43°±0.40°),(0.80°±0.69°);(0.48°±0.47°),(0.79°±0.64°);(0.62°±0.60°) and (0.88°±0.70°), respectively. Except the x-axis data in group B, all the data in the six directions were not normally distributed. The obtained data significantly differed between two groups (all P<0.05). The out-of-tolerance errors (>0.5 cm/2°) also significantly differed between two groups (P<0.05). Conclusions The setup errors of Catalyst HD are less than those of the skin markers (except the y-axis). The setup accuracy of Catalyst HD is superior to that of traditional skin markers, which is worthy of application in clinical practice.
		2019 Vol. 28 (10): 772-775 [Abstract] ( 267 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	776	Preliminary study of accurate position fixation between polyurethane styrofoam and vacuum negative pressure pad in IMRT after radical mastectomy for breast cancer
		Zhou Changfeng, Fang Jiannan, Huang Xiaobo, Shi Juntian, Ma Yujia
		Objective To preliminarily investigate the difference of position fixation accuracy between polyurethane styrofoam and vacuum negative pressure pad in intensity-modulated radiation therapy (IMRT) after radical mastectomy for breast cancer. Methods Forty breast cancer patients,who received breast-conserving surgery followed by hyper-fractionated IMRT of the whole breast (42.56 Gy for 16 times) in our hospital between 2017 and 2018 were recruited and randomly divided into the polyurethane styrofoam group and vacuum negative pressure pad group. Before IMRT treatment,the anterior and lateral films of patients were taken with kilovoltage digital radiographs (KVDRs) by Varian Trilogy machine-borne OBI KV image verification system. The KVDRs images were matched with the DRR images reconstructed by the planned system to obtain the setup errors in the left and right,head and foot,and ventral and back directions between two groups. Each patient was verified for 10 times to obtain 400 sets of data. The independent sample t-test was adopted to analyze the setup errors between two groups. The external expansion value of graded setup errors from clinical target volume (CTV) and planned target volume (PTV) was calculated. Results The setup errors in the left and right,head and foot,ventral and back directions between the styrofoam fixation and vacuum pad groups were (1.63±1.29) mm and (1.83 ±1.61) mm (P=0.18),(1.46±1.51) mm and (2.26±2.03) mm (P=0.00),and (1.30±1.35) mm and (1.91±1.67) mm (P=0.00), respectively. The external expansion values of setup errors from CTV to PTV were 2.19 mm,2.51 mm,1.57 mm and 2.40 mm,3.97 mm and 2.63mm,respectively. Conclusion Both two fixation methods meet the clinical requirements. However, the setup accuracy and reproducibility in the polyurethane styrofoam group are better than those in the vacuum negative pressure pad group.
		2019 Vol. 28 (10): 776-779 [Abstract] ( 232 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review Articles

	780	Current status of treatment for osteosarcoma of head and neck
		Liu Zhiping, Zhang Daxin, Pan Jie, Zhang Yisi
		Head and neck osteosarcoma is a rare tumor. Its clinical features and recurrence pattern are different from those of osteosarcoma in other parts. Osteosarcoma of the head and neck occurs late with a high local recurrence rate and a low distant metastasis rate. Local recurrence is the main cause of death. Surgery is the main treatment. Postoperative radiotherapy is recommended for patients with positive surgical margin,proximal incisional margin and uncertain surgical margin. The role of chemotherapy remains controversial. Effective molecular targeted therapeutics need to be further explored for recurrent, metastatic and unresectable osteosarcoma,.
		2019 Vol. 28 (10): 780-783 [Abstract] ( 201 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	784	The application of whole-brain radiotherapy for non-small cell lung cancer with brain metastases:evolution and revolution
		Yang Siran, Xiao Jianping
		Whole brain radiotherapy (WBRT) was widely used clinically as the standard therapy for brain metastases (BM). With the development of radiotherapy technology and systemic therapies,the non-small cell lung cancer (NSCLC) patients have prolonged local control rate and median survival time,meanwhile post-radiotherapy intracranial toxicities often lead to serious impacts on the quality of life and neurocognitive function. Therefore,the role WBRT played should have been reevaluated. The purpose of this review is to analyze the clinical application value of WBRT in the context of new treatments for NSCLC with BM,and to predict the main developing directions of WBRT in the future.
		2019 Vol. 28 (10): 784-791 [Abstract] ( 249 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	788	Research progress on radiation dose escalation for locally advanced non-small cell lung cancer
		Wang Daquan, Bi Nan, Wang Lvhua
		RTOG0617 trial has indicated that no benefit can be obtained in the overall survival of locally advanced non-small cell lung cancer patients by improving the prescribed dose, which promotes the adjustments to the strategies of dose escalation. Currently, multiple studies have been designed to explore more effective approaches to boost dose, such as dose boosts based on increased ¹⁸FDG-uptake regions, simultaneous integrated boost intensity-modulated radiotherapy and modulation of dose fractions, which have achieved a series of progress. The widespread application of PET-CT and intensity-modulated radiotherapy offers broad space for the dose escalation and optimization.
		2019 Vol. 28 (10): 788-791 [Abstract] ( 244 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	792	Progress in comprehensive treatment of pulmonary large cell neuroendocrine carcinoma
		Liu Ningbo, Luo Jing, Zhao Lujun, Wang Ping
		Large cell neuroendocrine carcinoma is not very common,and it has a high degree of malignancy and invasion,outcome is also poor. Even LCLC is defined as non-small cell lung cancer,its biological and clinical characteristics,prognostic factors are similar to small cell lung cancer. The treatment for LCLC is still controversial. The research progress on comprehensive treatment of lung large cell neuroendocrine carcinoma was reviewed.
		2019 Vol. 28 (10): 792-795 [Abstract] ( 226 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Symposium

	796	Practice and thinking on precise quality control management of radiotherapy of cancer hospital based on patient safety
		Huang Pei, He Xia
		Patient safety is the foundation of the hospital management. In recent years, Department of Radiation Oncology of Jiangsu Cancer Hospital has attached great importance to patient safety by introducing the precise concept to the quality control and management of radiotherapy, which includes pursuing standardized construction of quality control, accurately identifying the patients, combination of process reengineering and informatization, departmental learning and multi-disciplinary integration and paying attention to performance assessment. All these measures significantly elevate the medical quality and patient safety.
		2019 Vol. 28 (10): 796-798 [Abstract] ( 293 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	799	Quantitative evaluation and feasibility analysis of cone-beam computed tomography (CBCT) image quality based on three-dimensional parameters
		Qi Xinyu, Lu Shipei, Yang Xin, Lin Chengguang
		Cone-beam computed tomography (CBCT) image based on a single layer of image and the choice of regions of interest (ROI) is affected by individual subjectivity, making it difficult to compare the image quality. In this article, a quantitative evaluation method of CBCT image quality based on three-dimensional parameters was proposed, which was extended from single layer to multi-layer and from pixel to voxel. The selection range of ROI was discussed to reduce the error of artificial selection and realize the quantitative evaluation of image quality by three-dimensional parameters.
		2019 Vol. 28 (10): 799-800 [Abstract] ( 230 ) [HTML 1KB] [ PDF 0KB] ( 0 )

中华放射肿瘤学杂志

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