Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2020 Vol.29 Issue.11 Published 2020-11-15

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

Guidelines

	925	Guidelines on quality control of radiotherapy record and verification system
		National Cancer Center/National Cancer Quality Control Center
		Radiotherapy Record and Verification System (RVS) is a medical software control system applied to prevent wrong parameter settings in radiotherapy machines, such as medical linear accelerators, and to record all the execution parameters in the process of radiotherapy. To ensure the safety of patient treatment, necessary quality control measures must be taken for RVS. The guidelines cover the following topics:quality control in RVS installation and parameter setting, acceptance of RVS, quality control of RVS in clinical practice, typical error types encountered in RVS and examples of acceptance test of RVS.
		2020 Vol. 29 (11): 925-931 [Abstract] ( 179 ) [HTML 1KB] [ PDF 755KB] ( 0 )

Special Feature

	932	Recommendations on high-dose-rate rachytherapy for malignant tumors during COVID-19 epidemic
		Zhang Ning, Zhao Hongfu, Cheng Guanghui, Zhao Zhipeng, Mao Zhuang
		InChina, COVID-19 epidemic is currently showing a sporadic state, and the task of epidemic prevention is still arduous. Brachytherapy (BT) plays a critical role in the treatment of cancer. For some cancer receiving radiotherapy, use of BT can not be replaced or excessively delayed. Nevertheless, the recommendations or guidelines regarding the application of BT during COVID-19 epidemic have been rarely reported. In this article, a few recommendations on the application of BT during COVID-19 epidemic were retrieved and the work experience of Department of Radiation Oncology, China-Japan Union Hospital of Jilin University in the early epidemic period was summarized, aiming to provide relevant reference for the use of high-dose-rate BT for malignant tumor patients during COVID-19 epidemic.
		2020 Vol. 29 (11): 932-936 [Abstract] ( 172 ) [HTML 1KB] [ PDF 952KB] ( 0 )

Head and Neck Tumors

	937	Observation of the effect of organ displacement on target area of intensity-modulated radiotherapy during swallowing for head and neck cancer based on dynamic MRI images
		Sun Meng, Liu Xuan, Cao Ying, Zuo Lijing, Wang Kai, Qu Yuan, Yi Junlin, Xiao Jianping, Gao Li, Xu Guozhen, Huang Xiaodong, Luo Jingwei
		Objective Continuous acquisition of swallowing images of head and neck cancer patients by using MRI technique was performed to observe and measure the movement regularity and maximum displacement of the soft palate, tongue and larynx. Methods From July 2018 to October 2018, 20 patients with primary head and neck cancer were chosen randomly, 17 male and 3 female. The median age was 58.5 years (28 to 78 years). Among the 20 patients, 7 patients were diagnosed with nasopharyngeal carcinoma, 3 patients with oral cancer, 5 patients with oropharyngeal cancer, 3 patients with hypopharyngeal cancer, and 2 patients with nasal and paranasal sinuses cancer. Two patients were classified as stage Ⅰ-Ⅱ, 8 patients as stage Ⅲ and 10 patients as stage Ⅳ according to the eighth edition of AJCC. Results The displacement of the upward movement of the soft palate during swallowing was (1.06±0.31) cm and followed the pattern normal distribution. The displacement of backward movement of the soft palate was (0.83±0.24) cm, which also almost normally distributed. The displacement of backward tongue movement was (0.77±0.22) cm and followed the normal distribution pattern. The displacement of upward tongue movement was 0 in patients with tongue depressor for image acquisition. The mediandisplacement of upward tongue movement in patients without tongue depressor was 1.23 cm (0.59 to 1.41 cm). The displacement of upward laryngeal movement was (1.14±0.22) cm and followed the normal distribution pattern, and the median displacement of forward laryngeal movement was 0.4 cm (0.27 to 0.90 cm). Conclusions Swallowing movement may occur in head and neck cancer patients during radiotherapy. It can also cause the movement of gross tumor volume (GTV) and surrounding normal tissues. Therefore, extensive attention should be paid to the individual distance between GTV and planning gross tumor volume (PGTV) when making radiotherapy plans, aiming to ensure the prescription dose of cancer.
		2020 Vol. 29 (11): 937-940 [Abstract] ( 176 ) [HTML 1KB] [ PDF 720KB] ( 0 )

Thoracic Tumors

	941	Clinical efficacy of dose escalation in 3-dimensional radiotherapy for patients with esophageal squamous cell carcinoma-multicenter retrospective analysis (3JECROG R-03)
		Zhao Jingjing, Zhang Wencheng, Zhang Hualei, Han Weiming, Wang Xin, Li Chen, Chen Junqiang, Wang Xiaomin, Zhao Yidian, Qiao Xueying, Zhou Zhiguo, Han Chun, Zhu Shuchai, Shen Wenbin, Wang Lan, Ge Xiaolin, Sun Xinchen, Zhang Kaixian, Hu Miaomiao, Li Ling, Hao Chongli, Li Gaofeng, Xu Yonggang, Wang Yadi, Lu Na, Liu Miaoling, Qie Shuai, Xiao Zefen, Pang Qingsong, Wang Ping
		Objective To evaluate the effect of definitive radiotherapy with different doses on overall survival (OS) and identify the prognostic factors of patients with non-metastatic esophageal squamous cell carcinoma (ESCC). Methods Clinical data of 2344 ESCC patients treated with definitive radiotherapy (RT) alone or chemoradiotherapy from 2002 to 2016 in 10 hospitals were collected and analyzed retrospectively. After the propensity score matching (PSM)(1 to 2 ratio), all patients were divided into the low-dose group (equivalent dose in 2Gy fractions,EQD2Gy<60 Gy;n=303) and high-dose group (EQD2Gy≥60 Gy;n=606) based on the dose of radiation. Survival analysis was conducted by Kaplan-Meier method. Multivariate prognostic analysis was performed by Cox′s regression model. Results The median follow-up time was 59.6 months. After the PSM, the 1-, 3- and 5-year overall survival (OS) rate was 66.5%,34.7%,27.2% in the low-dose group, 72.9%,41.7% and 34.7% in the high-dose group, respectively (P=0.018). The 1-, 3-and 5-year progression-free survival rate was 52.2%,27.2%,23.1% in the low-dose group, 58.3%,38.1% and 33.9% in the high-dose group, respectively (P=0.001). The outcomes of univariate analysis indicated that cervical/upper esophagus location, early (stage Ⅱ) AJCC clinical stage, node negative status, tumor length ≤5 cm, receiving intensity-modulated radiation therapy (IMRT), receiving concurrent chemotherapy and EQD2Gy≥60Gy were closely associated with better OS (all P<0.05). Multivariable analysis demonstrated that tumor location, regional lymph node metastasis, concurrent chemotherapy and EQD2Gy were the independent prognostic factors for OS (all P<0.05). Conclusion Three-dimensional conformal or IMRT with EQD2Gy≥60Gy yields favorable survival outcomes for patients with locally advanced ESCC.
		2020 Vol. 29 (11): 941-947 [Abstract] ( 184 ) [HTML 1KB] [ PDF 1202KB] ( 0 )

Abdominal Tumors

	948	Comparison of clinical efficacy between simultaneous integrated boostintensity-modulated radiotherapy (SIB-IMRT) and late-course boost intensity-modulated radiotherapy (LB-IMRT) for early-stage breast cancer after breast-conserving surgery
		Xu Min, Wang Suzhen, Wang Wei, Shao Qian, Zhang Yingjie, Li Fengxiang, Li Jianbin
		Subject To compare the irradiation-induced injury and clinical efficacy between SIB-IMRT and LB-IMRT for early-stage breast cancer after breast-conserving surgery. Methods From November 2002 to February 2012, 353 early breast cancer patients who underwent IMRT after breast-preserving surgery at Shandong Cancer Hospital were selected, of whom 218 patients receiving SIB-IMRT and 135 patients receiving LB-IMRT.The prescription dose of the SIB-IMRT group was the ipsilateral breast (PTVb )1.8-1.9 Gy, 27-28 times, and concurrent tumor bed (PTVt) 2.15-2.3 Gy, 27-28 times. In the LB-IMRT group, the prescription dose was PTVb 2.0 Gy, 25 times, followed by PTVt boost 2.0 Gy, 5-8 times. Results The median follow-up time was 92 months. The excellent, good, fair, and poor cosmetic results in the SIB-IMRT and LB-IMRT groups were 10.1% and 12.6%, 85.8% and 80.7%, 3.7% and 5.2%, 0.5%, and 0.7%, respectively (P=0.731). The 5-year locoregional recurrence rates (LRRs) in the SIB-IMRT and LB-IMRT groups were 3.21% and 5.93% and the 10-year LRRs were 4.13% and 6.67%, respectively (P=0.209, 0.280). The 3-, 5-, 8-, and 10-year overall survival rate in the SIB-IMRT and LB-IMRT groups were 97.7% and 97.8%, 96.3% and 95.2%, 94.9% and 92.0%, 93.6% and 90.3%, respectively (P=0.288). The 3-, 5-, 8-, and 10-year disease-free survival in the SIB-IMRT and LB-IMRT groups were 95.4% and 93.8%, 91.8% and 87.7%, 89.9% and 84.1%, 89.0% and 82.1%, respectively (P=0.160). Conclusion There is no significant difference in the cosmetic effect, local control rate, and survival rate between SIB-IMRT and LB-IMRT after breast-preserving surgery in patients with early-stage breast cancer. SIB-IMRT is a safe and feasible treatment.
		2020 Vol. 29 (11): 948-953 [Abstract] ( 181 ) [HTML 1KB] [ PDF 939KB] ( 0 )

	954	Preliminary clinical observation of neoadjuvant chemoradiotherapy for low and locally advanced rectal cancer
		Liu Lu, Feng Linchun, Liu Qiteng, Jia Baoqing, Du Xiaohui, Dai Guanghai, Chen Jing, Dai Xiangkun, Yang Tao
		Objective To evaluate the efficacy of preoperative neoadjuvant chemoradiotherapy for low and locally advanced rectal cancer. Methods Clinical data of 46 patients with low rectal tumors located within 6 cm from the edge of anal admitted to our hospital between February 2014 and December 2018 were retrospectively analyzed. SIB-IMRT technique was adopted for preoperative radiotherapy. Rectal tumors and positive lymph nodes were irradiated with a dose of 58.75 Gy in 25 fractions (2.35 Gy/fraction), and pelvic lymphatic drainage area was given with 50 Gy in 25 fractions (2.0 Gy/fraction). Oral administration of capecitabine was delivered for concurrent chemotherapy. Radical surgery for rectal cancer was performed at 6 to 12 weeks after the end of chemoradiotherapy. The overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), local recurrence-free survival (LRFS) and metastasis-free survival (MFS) were calculated by using Kaplan-Meier method. Univariate analysis was conducted by log-rank test, and multivariate analysis was performed by Cox’s regression model. Results After a median follow-up of 47 months, local recurrence occurred in 3 patients and distant metastasis in 6 patients. The ypCR rate was 26%(12/46), the sphincter-preservation rate was 74%(34/46), the R0 resection rate was 100%(44/44), the overall tumor response TN down staging rate was 87%(40/46), and the postoperative complication rate was 13%(6/46). The 3-year OS, DFS, and PFS were 93%,91% and 87%, respectively. In univariate analysis, ypN staging was an important factor affecting OS, DFS, PFS, LRFS and MFS (all P<0.05). In multivariate analysis, ypN staging was significantly correlated with DFS, PFS, LRFS and MFS (all P<0.05). Conclusions Preoperative SIB-IMRT 58.75 Gy in 25 fractions combined with capecitabine chemotherapy is a safe and efficacious treatment for patients with low and locally advanced rectal cancer, which improves the ypCR rate and quality of life, and yields tolerable adverse reactions. Nevertheless, the long-term survival benefits remain to be validated.
		2020 Vol. 29 (11): 954-958 [Abstract] ( 190 ) [HTML 1KB] [ PDF 769KB] ( 0 )

	959	Analysis of dosimetry and clinical efficacy of intracavitary/interstitial brachytherapy in locally advanced cervical cancer
		Teng Yun, Zou Lijuan, Zhang Haichen, Xu Xiaoying, Lei Hongwei, Xu Zhuang
		Objective To study the dosimetric differences and short-term efficacy between intracavitary/interstitial brachytherapy (IC/ISBT) and conventional intracavitary brachytherapy (ICBT). Methods Forty-five patients with locally advanced cervical cancer were treated with IC/ISBT and ICBT. Points A (A1,A2), D90%, D100%, organs at risk, and the doses of bladder, colon, rectum and small intestine were calculated and the short-term efficacy was observed between two groups. Results Point A dose was significantly improved in IC/ISBT compared with ICBT (P<0.05). The D90% and D100% in IC/ISBT were significantly higher than those in ICBT (both P<0.05). After brachytherapy, IC/ISBT could obtain a significantly larger increase in target dose when residual tumor diameter was ≥3 cm compared with ICBT (P<0.05). The D2cm³ and D0.1cm³ of bladder, rectum, colon and small intestine did not significantly differ between IC/ISBT and ICBT (all P>0.05). The 1-,3-and 6-month clinical efficacy did not significantly differ between two technologies (all P>0.05). Conclusion During brachytherapy for locally advanced cervical cancer (residual tumor diameter ≥3 cm), IC/ISBT significantly increases the doses of target area and point A without increasing the dose of organs at risk or lowering the short-term clinical efficacy, which has significant dosimetric advantages.
		2020 Vol. 29 (11): 959-962 [Abstract] ( 180 ) [HTML 1KB] [ PDF 1504KB] ( 0 )

Physics·Biology·Technique

	963	Dosimetric characteristics test of 1.5T magnetic resonance accelerator
		Li Minghui, Tian Yuan, Zhang Ke, Men Kuo, Dai Jianrong
		Objective The Lorentz force produced by magnetic field deflects the paths of secondary electrons. The X-ray beam dosimetry characteristics of the magnetic resonance accelerator (MR-Linac) are different from conventional accelerators. The purpose of this study was to measure and analyze the X-ray beam dosimetry characteristics of 1.5T MR-Linac. Methods In May 2019, our hospital installed a Unity 1.5T MR-Linac and measured it with magnetic field compatible tools. The measurement indexes include:surface dose, maximum dose point depth, beam quality, off-axis dose profile center, beam symmetry, penumbra width, output changes of different gantry angles. Results The average surface dose was 40.48%, and the average maximum dose depth was 1.25cm. The center of the 10cm×10cm beam field was offset by 1.47mm to the x₂ side and 0.3mm to the y₂ side. The x-axis symmetry was 101.33%, and the penumbra width on both sides was 6.86mm and 7.14mm, respectively. The y-axis symmetry was 100.85%, and the penumbra width on both sides was 5.92mm and 5.95mm, respectively. The maximum deviation of output dose with different gantry angles reached 1.50%. Conclusions The surface dose of MR-Linac tend to be consistent, and the depth of the maximum dose point became shallower. The off-axis in the x-axis direction was shifted to the x₂ side, which resulting in worse symmetry and penumbra asymmetry. The output dose at different angles has obvious variation and needs correction.
		2020 Vol. 29 (11): 963-967 [Abstract] ( 203 ) [HTML 1KB] [ PDF 2437KB] ( 0 )

	968	Study of automatic planning of multi-disease and multi-plan type based on Raystation planning system
		Lou Zhaoyang, Mao Ronghu, Li Dingjie, Tian Lingling, Li Bing, Ge Hong
		Objective To propose an automatic planning platform of the Raystation planning system suitable for multi-disease and multi-plan technique by using the Raystation built-in script function. Methods IronPython and WPF user interface framework were utilized for programming and resolving the differences in the design of different types of plans for different diseases. The program was designed from prescription identification, visual plan parameter input and cost-function setting. The efficiency of automatic planning and manual planning was compared when applied in whole brain irradiation, nasopharyngeal carcinoma, cervical cancer, esophageal cancer and breast cancer, including IMRT and VMAT. The dosimetric parameters of the whole brain irradiation were chosen. Results Physicists were only required to enter and select the necessary parameters to achieve the plan design by using the program. Compared with the five types of diseases, the maximum efficiency of automatic planning was 1.4 times higher than that of manual planning. In the dosimetric evaluation of the whole brain irradiation plan, both manual and automatic planning could meet the clinical needs, and the D2%, CI and HI of the target area did not significantly differ (all P>0.05). The mean D98% of the target area and the Dmax of lens in the manual plan were significantly higher than those in the automatic plan by 0.4% and 7.1%(both P<0.05). Conclusion The developed program has the function of automatic planning system, which can realize the automatic planning of multi-disease and multi-type radiotherapy, significantly improve the efficiency of plan design and has important clinical application value.
		2020 Vol. 29 (11): 968-972 [Abstract] ( 178 ) [HTML 1KB] [ PDF 1011KB] ( 0 )

	973	Application of 3D printed head film fixation technology in radiotherapy for head tumors
		Wang Bin, Sun Yunchuan, Liu Guangbo, Xue Tao, Liu Zhikun, Yan Huijuan, Zhou Lixia, Wang Peiye, Zhao Jianyong, Wang Hongfei
		Objective To customize the individualized 3D printed head film for patients with head tumors undergoing radiotherapy, and to evaluate the physical properties of the material and the precision of this technology compared with the thermoplastic head film. Methods The 3D printed head film and thermoplastic head film were placed on the solid water surface, and the depth and surface dose were measured at 5 cm by ionization chamber and film, respectively. Thirty patients with head tumors receiving radiotherapy were randomly divided into the control and experimental groups. The patients were fixed with thermoplastic head film and 3D printed head film. The translational and rotational errors in the x, y and z direction were obtained by CBCT. Results The radiation attenuation rate of two materials at the depth of 5 cm was less than 1%. The dose of thermoplastic head film in the surface position was increased by 27%, and increased by 18% in the 3D printed head film. In two groups, 116 sets of setup errors were collected. The average translational setup errors in the control and experimental groups were 1.29 mm and 1.16 mm, 1.42 mm and 1.24 mm, 1.38 mm and 1.16 mm, respectively, and the average rotational setup errors were 1.29°and 1.08°, 1.02°and 0.96°, 1.01°and 1.00°, respectively. The translational setup errors in the y and z direction and rotational setup errors in the x direction significantly differed between the control and experimental groups (all P<0.05), but no statistical significance was found in the other direction (all P>0.05). Conclusion The 3D printed head film fixation meets the precise setup requirements of modern radiotherapy, which deserves further application in clinical trials.
		2020 Vol. 29 (11): 973-977 [Abstract] ( 175 ) [HTML 1KB] [ PDF 1633KB] ( 0 )

	978	Dosimetric comparison between IMRT and VMAT in patients undergoing internal mammary lymph node radiotherapy after modified radical mastectomy
		Yu Jie, Li Qing, Zeng Daolin, Yi Hanjie, Liu Guangjin, Lan Qiongyu
		Objective To investigate the dosimetric differences in volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) in patients receiving adjuvant radiotherapy and internal lymph node irradiation after left-sided modified radical mastectomy. Methods VMAT and IMRT radiotherapy plans were established for 20 patients undergoing left-sided modified radical mastectomy. The dosimetric parameters of the target area and organs at risk were calculated by the dose volume histogram. The categorical variables were tested by χ² or Fisher′s exact probability test. The continuous variables with normal distribution were analyzed by paired-t test or rank-sum test. Results Among the two radiotherapy techniques, the homogeneity index of IMRT was significantly higher than that of VMAT (P<0.05). The time of VMAT treatment was significantly shorter than that of IMRT (P<0.01). VMAT was superior to IMRT in V20Gy and V30Gy of the affected lung (both P<0.05). VMAT was superior to IMRT in the left anterior descending coronary artery Dmean, Dmax, and heart V30Gy, V40Gy, Dmean and Dmax(all P<0.01). The esophageal Dmean in the VMAT group was superior to that in the IMRT group (P<0.05). The V5Gy and V10Gy of the contralateral lung and the Dmax of the esophagus in the IMRT group were significantly better compared with those in the VMAT group (all P<0.05). Conclusions VMAT can significantly reduce the dose of the heart, contralateral lung, spinal cord, esophagus and other vital organs, and shorten the treatment time. For patients who need adjuvant radiotherapy and internal mammary lymph node irradiation after left-sided modified radical mastectomy, VMAT technology can better protect normal tissues than IMRT.
		2020 Vol. 29 (11): 978-981 [Abstract] ( 187 ) [HTML 1KB] [ PDF 740KB] ( 0 )

	982	X-ray irradiation increases production of IL-8 in lung cancer cell line A549
		Song Yinghui, Wang Nila, Hu Jinyue, Chai Qin, Yang Fanfan, Wang Guihua
		Objective To observe the effect of irradiation on the production of IL-8 in lung cancer cell line A549 and explore its possible mechanism. Methods A549 cells irradiated with different doses of X-rays were used to collect cell supernatant, cellular RNA and protein at different time points after irradiation. The expression level of IL-8 mRNA in A549 cells after irradiation was detected by RT-PCR, which was further validated by real-time quantitative PCR. The expression level of IL-8 in the cell supernatant was quantitatively measured by ELISA. The expression levels of cellular signaling pathway molecules in A549 cells after irradiation were detected byWestern Blot. The A549 cells were pretreated with p38 MAPK inhibitor, NF-κB inhibitor and ROS scavenger. The effect of these inhibitors on the expression of IL-8 in A549 cells induced by irradiation was evaluated by ELISA. Results Irradiation up-regulated the expression of IL-8 in A549 cells in a dose-and time-dependent manner. Irradiation activated the p38 MAPK and NF-κB signaling pathway in A549 cells. p38 MAPK and NF-κB inhibitors blocked the induction of IL-8 of A549 cells by irradiation. Inhibition of ROS failed to inhibit the induction of IL-8 of A549 cells by irradiation. Conclusion Irradiation can increase the production of IL-8 in lung cancer cells A549, possibly through the activation of p38 MAPK and NF-κB signaling pathways in a ROS-independent pattern.
		2020 Vol. 29 (11): 982-985 [Abstract] ( 178 ) [HTML 1KB] [ PDF 1200KB] ( 0 )

	986	lncRNA MEG3 increases the radiosensitivity of lung cancer cells by regulating miR-21
		Xue Mingqiang, Liu Mingbo, Xu Guanghui, Wang Wenguang
		Objective To investigate the regulatory mechanism of long-chain non-coding RNA (lncRNA) MEG3 on the sensitivity of lung cancer cell line H1299 to irradiation. Methods The expression of MEG3 and miR-21-5p in lung cancer cell line H1299 was detected by qRT-PCR. Overexpression control group (transfected with pcDNA3.1), MEG3 overexpression group (transfected with pcDNA3.1-MEG3), miR-NC inhibition group (transfected anti-miR-NC), miR-21-5p inhibition group (transfected with anti-miR-21-5p), MEG3 overexpression+miR-NC overexpression group (co-transfected with pcDNA3.1-MEG3 and miR-NC), MEG3 overexpression+miR-21-5p overexpression group (co-transfected with pcDNA3.1-MEG3 and miR-21-5p mimics) were all transfected into H1299 cells by liposome method treated with 4Gy irradiation. Cell survival fraction was detected by colony formation assay. Cell apoptosis was detected by flow cytometry. The binding of MEG3 to miR-21-5p in cells was assessed by dual luciferase reporter assay. Results Compared with normal lung epithelial cells, the expression of MEG3 was significantly decreased, whereas the expression of miR-21-5p was significantly increased in the radioresistant lung cancer cells H1299. Overexpression of MEG3 or inhibition of miR-21-5p could promote the apoptosis and enhance the radiosensitivity of H1299 cells. MEG3 could targetedly regulate the expression of miR-21-5p. Overexpression of miR-21-5p could reverse the enhanced radiosensitivity of MEG3 to H1299 cells. Conclusion LncRNA MEG3 can enhance the sensitivity of lung cancer cells H1299 to irradiation. The mechanism may be related to targeting miR-21-5p.
		2020 Vol. 29 (11): 986-990 [Abstract] ( 188 ) [HTML 1KB] [ PDF 1793KB] ( 0 )

	991	miR-106b enhances cell radioresistance by targeting PTEN in colorectal carcinoma
		Zhang Yuqin, Zheng Lin, Ding Yi
		Objective To investigate the role of miR-106b in the cell radioresistance in colorectal carcinoma (CRC), and unravel the underlying mechanism. Methods The CRC cell lines stably overexpressing and interfering miR-106b were established. The effect of miR-106b upon the CRC cell radiosensitivity was evaluated by cell radiation, immunofluorescence and colony formation assay. The expression levels of Caspase-3 and γ-H2AX were detected by Western blot. The target genes of miR-106b were identified by bioinformatics prediction, which were further validated by dual luciferase assay, fluorescence quantitative PCR and Western blot. The CRC cell lines stably overexpressing miR-106b were transfected with pCDNA3.0-PTEN. The changes of CRC cell radiosensitivity were investigated. Whether miR-106b could increase the radioresistance of CRC cells by targeting PTEN was clarified. Results Compared with the control group (miR-ctr group), the cell surviving fraction was significantly elevated (P<0.05), the radioresistance (P<0.05) was considerably enhanced and the expression levels of Caspase-3 and γ-H2AX were significantly down-regulated (both P<0.05) in the miR-106b overexpression group. PTEN up-regulation in CRC cell lines stably overexpressing miR-106b could reverse the radioresistance induced by miR-106b. Conclusion miR-106b can induce CRC cell radioresistance by inhibiting PTEN, prompting that miR-106b-PTEN might provide theoretical evidence for relevant targets which can enhance the clinical efficacy of radiotherapy.
		2020 Vol. 29 (11): 991-995 [Abstract] ( 176 ) [HTML 1KB] [ PDF 2616KB] ( 0 )

	996	A theoretical investigation on improving the treatment efficiency based on timing characteristics for a proton-and-carbon ion treatment facility
		Zhao Jun, Li Yongqiang, Wu Xianwei, Xing Ying
		Objective To identify the key factors affecting the time of proton and carbon ion radiotherapy by analyzing the timing characteristics of the accelerator system and to find out potential solutions to enhance treatment efficiency. Methods The log files for 47 patients with different types of tumors treated with proton beams and carbon ion beams were analyzed. Lung cancer patients were treated with the gating technology.The timing characteristics of beam delivery were analyzed and potential solutions to enhance treatment efficiency were explored. Results The mean spill time and mean cycle time per iso-energy slice (IES) for proton radiotherapy with beam gating technology were (2.98±1.98) s and (5.71±4.51) s, which were longer than the radiotherapy without using gating technology. The mean total cycle time for treatment without using gating technology was approximately 7 min for both proton and carbon ion beams. The mean total cycle time for lung cancer treatment using gating technology was approximately 15 min. Conclusion Application of mini-ridge filter or ripple filter to reduce per IES numbers and use of passive breath hold technology to eliminate interruptions during beam delivery in each IES for gating radiotherapy are two feasible approaches to improve treatment efficiency for this specific machine.
		2020 Vol. 29 (11): 996-999 [Abstract] ( 162 ) [HTML 1KB] [ PDF 1234KB] ( 0 )

Symposium

	1000	The six-year operation faults statistics analysis and prediction of Philips Brilliance big bore CT
		Wang Shouyu, Wang Xiaochun, Huo Xiaoqing, Wu Peng, Liu Bo, Miao Zhanhui, Lu Ping
		Objective To analyze the 6-year operation faults of PHILIPS Brilliance big bore CT, identify the common problems, make corresponding maintenance plans, reduce the incidence of failures, and carry out simulation prediction of the occurrence rate of failures in the next few years. Methods The failure data of Brilliance big bore CT from June 2012 to June 2018 were collected, and the curve estimation function in SPASS 19.0 software and the pareto diagram were used to analyze the relationship between the number of failures, time and failure types, and the prediction was made. Results A total of 28 faults occurred during the 6-year opeation of Brilliance big bore CT. During the first half year, five times of faults occurred with the highest fault rate and then tended to stabilize. The linear function model was obtained using the curve estimation:y=-0.033x+2.099(y for the number of fault, unit for times, x for the unit of time for half a year), the model of R²=0.003. In the next three years, approximately twice faults occurred within half year. The pareto chart showed that 16 faults occurred during data collection, including 3 faults in the treatment bed and 3 faults in the power supply system, respectively. The accumulative ratio of the above three faults was 71.4%, which were the main fault sources. Conclusion The fault statistical analysis of Brilliance big bore CT is helpful for department maintenance personnel to better understand CT, develop effective maintenance programs, reduce the occurrence of faults, and predict the incidence of faults in the future.
		2020 Vol. 29 (11): 1000-1002 [Abstract] ( 208 ) [HTML 1KB] [ PDF 874KB] ( 0 )

Review Articles

	1003	Delineation of prophylactic cervical target volumes in radical radiotherapy for supraglottic laryngeal carcinoma
		Xu Yi, Zhang Ye, Yi Junlin
		Intensity-modulated radiotherapy (IMRT) is one of the primary treatments for laryngeal cancer. According to the latest international guidelines, the delineation of lymphatic clinical target volumes (CTV) is performed only on the basis of N stage without considering other impact factors, such as tumor subsite, clinical stage and histopathological differentiation. Besides, the detailed lymph node regions that should be included in CTV are still controversial. In this article, clinical data of cervical surgery were retrospectively analyzed, clinical trials associated with lymph node metastases of supraglottic laryngeal carcinoma were reviewed,the distribution characteristics and risk factors of positive lymph nodes were summarized, aiming to provide reference for the precise delineation of prophylactic CTV in radical radiotherapy for supraglottic laryngeal carcinoma.
		2020 Vol. 29 (11): 1003-1007 [Abstract] ( 177 ) [HTML 1KB] [ PDF 794KB] ( 0 )

	1008	Research progress on radiotherapy-induced hippocampal damage and cognitive dysfunction in nasopharyngeal carcinoma
		Zhou Ling, Tao Changjuan, Chen Ming, Yu Zhonghua, Chen Yuanyuan
		Radiation-induced cognitive dysfunction is a common complication in patients with nasopharyngeal carcinoma after undergoing radiotherapy, which has been proven to be associated with neurogenesis dysfunction, oligodendrocyte loss, vascular damage and abnormal cytokine expression. With the development of medicine, functional magnetic resonance image (fMRI) can detect the early lesions of cognitive dysfunction. Hippocampus-sparing technology and drug therapy (memantine, donepezil and bevacizumab) can mitigate radiation-induced cognitive dysfunction. In this article, the pathogenesis, neuroimaging, radiodosimetry and therapies of radiotherapy-induced cognitive dysfunction in nasopharynal carcinoma patients were reviewed.
		2020 Vol. 29 (11): 1008-1011 [Abstract] ( 185 ) [HTML 1KB] [ PDF 766KB] ( 0 )

	1012	Research progress on diagnosis and treatment of HPV-positive oropharyngeal cancer
		Mao Guangmin, Xu Tingting, Lu Xueguan
		The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer is growing year by year. Compared with the other head and neck squamous cell carcinoma, HPV-positive oropharyngeal cancer has unique biological characteristics and better prognosis. According to the 8^th edition TNM staging of UICC/AJCC, HPV-positive and HPV-negative oropharyngeal cancer have been classified separately. In 2018, College of American Pathologists and American Society of Clinical Oncology released the guidelines on the HPV testing in head and neck cancer. Several published clinical trials have demonstrated that de-intensified chemoradiation might be efficacious treatment of HPV-positive oropharyngeal cancer.
		2020 Vol. 29 (11): 1012-1016 [Abstract] ( 170 ) [HTML 1KB] [ PDF 785KB] ( 0 )

	1017	Current status and controversy of adjuvant radiotherapy after radical resection of esophageal squamous cell carcinoma
		Li Bingxu, Wang Kunlun, Yang Hui, Li Mengxi, Yuan Ling
		Currently, the value of adjuvant therapy after radical resection of esophageal squamous cell carcinoma remains elusive. Some studies have reported that radiotherapy can improve the locoregional control rate and overall survival of patients. However, the design of radiotherapy target area, intervention time and dose of radiotherapy are controversial. In this article, literature review was conducted and the current status and controversy of adjuvant radiotherapy after radical resection of esophageal squamous cell carcinoma were reviewed.
		2020 Vol. 29 (11): 1017-1020 [Abstract] ( 179 ) [HTML 1KB] [ PDF 754KB] ( 0 )

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友情链接

China Association for
　Science and Technology

Chinese Medical Association

Cancer Hospital of Chinese
　Academy of Medical
　Sciences Department of
　Radiation Oncology

Chinese Anti-Cancer
　Association

Chinese Journal of Lung
　Cancer

Cqvp

CNKI

Wanfang Data

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