Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2021 Vol.30 Issue.4 Published 2021-04-15

	Abdominal Tumors Thoracic Tumors Review Articles Guidelines Physics·Technique·Biology

Guidelines

	321	Guidelines for radiotherapy of breast cancer (Chinese Medical Doctor Association 2020 edition)
		Radiation Oncology Physicians Branch of Chinese Medical Doctor Association
		Breast cancer is a malignant tumor that seriously affects the physical and mental health of women. The morbidity and mortality rates rank the first and fifth among female malignant tumors in China, respectively. The multidisciplinary treatment strategies including surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy have significantly improved the prognoses of patients with breast cancer. Radiotherapy plays an important role in reducing the tumor recurrence and prolonging the survival of patients who have received breast-conserving surgery or mastectomy. Moreover, it also serves as an effective palliative therapy for inoperable locally advanced or metastatic breast cancer. At present, there is no consensus on the standard guideline for breast cancer radiotherapy in China. In 2020, Radiation Oncology Physicians Branch of Chinese Medical Doctor Association proposed the Radiotherapy Guidelines for Breast Cancer. The Guidelines were formulated based on the latest evidences in combination with national practice in China, aiming to guide the implementation of radiotherapy, and promote the standardization of radiotherapy in breast cancer; and ultimately achieve the goal of making progress in the practice of radiotherapy and improving the prognoses of breast cancer patients.
		2021 Vol. 30 (4): 321-342 [Abstract] ( 332 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	343	Long-term therapeutic effect of stereotactic ablative radiotherapy for pulmonary oligometastasis
		Zheng Xiaoli, Ni Peizan, Sun Yanan, Ye Ke, Fan Chengcheng, Song Shuai, Yang Yang, Wang Nan, Wang Xiaohui, Luo Hui, Ge Hong
		Objective To evaluate the efficacy and safety of stereotactic ablative radiotherapy (SABR) in patients with pulmonary oligometastases. Methods Clinical data of patients with pulmonary metastases treated with SABR from 2011 to 2018 were retrospectively analyzed. The local control rate (LCR) and overall survival (OS) were calculated by Kaplan-Meier method. log-rank test was used for univariate analysis and Cox's regression model for multivariate analysis. Results A total of 214 lung metastases were detected in 159 patients, and the median follow-up time was 43 months. The 1-, 3-and 5-year LCR were 90.1%, 73.9% and 65.8%, respectively. The 1-, 3-and 5-year OS were 73.8%, 43.6% and 11.9%, respectively. Univariate analysis showed that biological effective dose (BED)≥100 Gy was significantly correlated with LCR (P=0.033). Cox's multivariate analysis showed that BED and primary tumor source were the independent prognostic factors of LCR (P=0.023, P=0.043). No>grade 3 adverse events were observed in all patients during treatment. Conclusions SABR is a safe and effective treatment of lung oligometastases. SABR should be actively aDministered for pulmonary oligometastases, especially for those with lesions from lung cancer and the radiation dose should be selected as BED ≥100 Gy.
		2021 Vol. 30 (4): 343-347 [Abstract] ( 238 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	348	Effect of previous radiotherapy on the efficacy and pulmonary toxicity of PD-1 inhibitor in second-line or above treatment in patients with stage Ⅳ non-small cell lung cancer
		Chen Huijing, He Chunyu, Ge Hong, Nie Xin, Liu Ru, Wu Xiaoyuan, Jiao Shuyue, Ma Cong
		Objective To investigate whether radiotherapy should be delivered before the application of immune checkpoint inhibitor PD-1 in patients with advanced non-small cell lung cancer (NSCLC) and evaluate the effect of previous radiotherapy on the efficacy and pulmonary toxicity of PD-1 inhibitor. Methods Clinical data of patients with stage Ⅳ NSCLC who received immunotherapy in Henan Cancer Hospital from March 2015 to September 2019 were retrospectively analyzed. The baseline data of patients, the status of radiotherapy and immunotherapy and the pulmonary toxicity were collected. According to whether radiotherapy was given before PD-1 inhibitor application, all patients were divided into the previous radiotherapy and non-radiotherapy groups. Survival analysis was performed by Kaplan-Meier method. Results A total of 90 patients were enrolled including 39 cases in the previous radiotherapy group and 51 cases in the non-radiotherapy group. The median follow-up time was 22.9 months. The median progression-free survival (mPFS) in the previous radiotherapy group was 7.5 months (95%CI 5.4-9.5 months), significantly longer compared with 4.1 months (95%CI 3.1-5.1 months) in the non-radiotherapy group (P=0.003). The median overall survival (mOS) significantly differed between two groups[15.2 months (95%CI 12.3-18.1 months) vs. 9.3 months (95%CI 6.1-12.5 months)](P=0.040). The incidence of pulmonary toxicity showed no significant difference between two groups (P=0.154). Conclusions Patients with stage Ⅳ NSCLC patients in the previous radiotherapy group obtain significantly better mPFS and mOS and similar pulmonary toxicity compared with their counterparts in the non-radiotherapy group. Nevertheless, the findings remain to be validated by subsequent investigations with larger sample size.
		2021 Vol. 30 (4): 348-352 [Abstract] ( 280 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	353	Preliminary clinical analysis of concurrent chemoradiotherapy combined with nituzumab for inoperable locally advanced esophageal cancer
		Zeng Cheng, Yang Dan, Du Rongxu, Jiang Leilei, Dong Xin, Li Dongming, Yu Rong, Yu Huiming, Shi Anhui
		Objective The standard treatment for inoperable locally advanced esophageal cancer is concurrent chemoradiotherapy, but the survival was not satisfied. Nituzumab is a humanized IgG monoclonal antibody against EGFR. The purpose of this study is to investigate the toxicity and efficacy of concurrent chemoradiotherapy combined with nituzumab for locally advanced esophageal cancer. Methods We retrospectively reviewed the clinical data of locally advanced esophageal cancer who were treated with concurrent chemoradiotherapy combined with nituzumab in Peking University Cancer Hospital from June 2015 to June 2020. Kaplan-Meier method was used for analysis. Results Thirty Patients were enrolled this study.After a median follow-up of 22.5 months, The objective response rate was 93%. The 1-year, 2-year, 3-year overall survival rates were 83%, 57% and 41%,with the progression-free survival rates 75%, 47% and 32%, with the local-recurrence free survival rates 83%, 53% and 37%, with the metastasis-free survival rates 75%, 51% and 36%, respectively.The incidence of grade≥3 hematological toxicity was 32%. There were 16% patients experiencing grade≥3 esophagitis. Conclusion The preliminary result of concurrent chemoradiotherapy combined with nituzumab is effective and safe for patients with locally advanced esophageal cancer.
		2021 Vol. 30 (4): 353-356 [Abstract] ( 252 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	357	Association between human papilloma virus 16 E6 and E7-specific T cell immune response and clinical prognosis of patients with cervical squamous cell carcinoma
		Cai Hongchao, Yuan Yuanliang, Mayinuer Alifu, Wang Ruozheng
		Objective To investigate the relationship between human papilloma virus (HPV)16 E6/7-specific T cell immune response in the periphral blood and clinical features and prognosis of patients with cervical squamous cell carcinoma (CSCC). Methods Seventy-two patients pathologically diagnosed with CSCC admitted to Affiliated Tumor Hospital of Xinjiang Medical University from June 2013 to October 2015, and 75 healthy controls were enrolled in this study. The special responses of peripheral blood T cells to E6 and E7 overlapping peptides before treatment were detected by enzyme-linked immunosorbent assay (ELISA). The differences of frequency and intensity expression of specific immune responses between two groups were analyzed by chi-square χ² test and nonparametric test. The correlation between antigen-specific immune response and T cell subsets was analyzed by Spearman test. Log-rank test and Cox's regression model were employed for univariate and multivariate prognostic analyses. Results The frequencies of HPV16 E6-ad E7-specific T cell responses in CSCC patients were significantly higher than those in healthy controls (51.39% vs. 29.33%,P=0.006 and 45.83% vs.25.33%,P=0.009), and the mean intensities were also considerably higher than those in healthy controls (20.00 SFC/10⁶ vs.10.76 SFC/10⁶,P<0.001 and 16.17 SFC/10⁶ vs.10.72 SFC/10⁶,P=0.017). The intensity of HPV16 E6-specific T cell immune response was positively correlated with the CD⁺₄/CD⁺₈ ratio in the peripheral blood of CSCC patients (r=0.279,P=0.018). And a strong correlation was noted between E7-specific T cell immune response intensity and increasing proportion of NK+ cells (r=0.274,P=0.020). Univariate and multivariate analyses showed that therapeutic mode (radiotherapy vs. concurrent chemoradiotherapy, HR=2.918, 95%CI 1.454-5.854, P=0.003) and E6-specific T cell response (response group vs. no response group, HR=0.491, 95%CI 0.243-0.99,P=0.047) were the independent prognostic factors influencing the clinical prognosis. The 5-year overall survival in patients with HPV16 E6-specific T cell responses was significantly higher than that in the no response group (64% vs.41%,P=0.041). Conclusions The intensity of HPV16 E6-specific T cell immune response is positively correlated with the CD⁺₄/CD⁺₈ ratio. No HPV16 E6-specific T cell response and radiotherapy alone are more likely to cause poor prognosis of CSCC patients.
		2021 Vol. 30 (4): 357-362 [Abstract] ( 261 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	363	The predicting value of pretreatment neutrophil count and lymphocyte-to-monocyte ratio in peripheral blood for the pathological tumor responses in patients with locally advanced gastric adenocarcinoma after preoperative therapy
		Li Nai, Zhang Yujing, Fang Yi, Zhang Li, Huang Shaomin, Zhou Zhiwei
		Objective To analyze the predicting values of hematological indicators for the pathological response in patients with gastric adenocarcinoma after preoperative neoadjuvant therapy and radical surgery. Methods The absolute count of neutrophils (NE), lymphocytes (LY) and monocytes (MO) of 102 patients with locally advanced gastric adenocarcinoma in a multi-center randomized phase Ⅲ clinical trial (NCT01815853) from June 2013 to Feburary 2019 were retrospectively analyzed. Patients were divided into the chemotherapy alone group (ChT, 3 cycles of XELOX regimen) and the chemoradiation group (CRT, 1 cycle of induced XELOX regimen and 4500 cGy/25f radiotherapy plus concurrent extenuated 2 cycles of XELOX regimen), 51 cases in each group. The pathological response indicators of tumors after radical surgery included tumor regression grade, pathological complete regression, pathological T stage (ypT), N stage (ypN) and TNM stage (ypTNM). Results Univariate regression analysis and ROC curves demonstrated a significant association between the absolute neutrophil count (NE) and ypT, lymphocyte-to-monocyte ratio (LMR) and ypN0, and LMR and ypTNM reduction in the entire cohort of patients. Multivariate regression analysis showed that higher NE (>4.10×10⁹/L) was significantly associated with higher probability of ypT reduction (OR=3.308, P=0.007). Higher LMR (>3.46) was significantly associated with higher ypN0 probability (OR=4.276, P=0.005) and better ypTNM reduction (OR=2.805, P=0.019). In subgroup analysis, higher NE (>4.10) was significantly correlated with higher probability of ypT reduction (OR=3.750, P=0.030) in the CRT group, and higher LMR (>3.46) was significantly associated with higher ypN0 probability (OR=8.500, P=0.050) and the probability of ypTNM stage reduction (OR=4.000, P=0.026) in the ChT group. Conclusions Pretreatment NE and LMR in the peripheral blood serve as independent predictors for tumor pathological responses after preoperative treatment, and immune condition is correlated with tumor regression after radical surgery in patients with locally advanced gastric cancer.
		2021 Vol. 30 (4): 363-367 [Abstract] ( 182 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	368	Preliminary observation of clinical efficacy of microwave hyperthermia combined with radiochemotherapy for locally advanced gastric cancer
		Qi Qing, Lu Yongchang, Huo Zhongchao, Wang Li, Su Ying, He Xiaolei, Li Zhijia, Wang Wenling, Lyu Linlin, Zhou Yongle, Xu Fei, Zhao Liwei
		Objective To preliminarily observe the clinical efficacy of microwave hyperthermia combined with intensity-modulated radiotherapy (IMRT) and chemotherapy for patients with locally advanced gastric cancer. Methods Forty patients who could not been operated or refused operation were enrolled in this clinical trial, who were confirmed as locally advanced proximal or distal gastric cancer by gastroscopy pathology and imaging. Radiotherapy was delivered by IMRT technology for 5 times per week with a total dose of 46 to 56Gy (median dose of 50Gy) in 25 to 28 fractions. Synchronous hyperthermia was given at 42 to 44℃ twice a week, 45 min/time. S-1 or capecitabine-based synchronous chemotherapy was performed, d1-14/3 weeks. The symptom remission rate, adverse reactions, objective remission rate (complete and partial remission) and survival were observed. Results A total of 40 patients, aged between 56 and 83 years (median age of 71 years), were enrolled in this study. The male-to-female ratio was 7:1. Among them, 38 cases (95%) showed symptom remission. The most common adverse reactions were grade 1-2 gastrointestinal reactions and leukopenia. The objective remission rate was 87.5%, the 2-year progression-free survival and overall survival rates were 68.6% and 70.5%, respectively. Conclusion Preliminary findings demonstrate that microwave hyperthermia combined with chemoradiotherapy achieve satisfactory outcomes and yield tolerable toxicity in patients with locally advanced gastric cancer.
		2021 Vol. 30 (4): 368-371 [Abstract] ( 196 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	372	Preliminary study of neoadjuvant plus chemotherapy combined with concurrent chemoradiotherapy for locally advanced giant cervical cancer
		Yang Hua, Wei Lichun, Zhang Ying, Zhang Jianjun, Yin Yutian, Zhou Yan, Shi Mei
		Objective To preliminarily investigate the efficacy and safety of bevacizumab plus neoadjuvant chemotherapy combined with concurrent chemoradiotherapy in the treatment of locally advanced giant cervical cancer (LACC). Methods Twenty-four patients with LACC who were treated with bevacizumab combined with neoadjuvant chemotherapy were assigned into the study group, and 30 patients receiving neoadjuvant chemotherapy in phase Ⅱ clinical trial (ChiCTR-TRC-11001832) were allocated in the control group. The survival rate was calculated by the Kaplan-Meier method, and the significance of differences between the variables was determined by the log-rank test. Results The tumor volumes were (1.64±23.15) cm³ and (12.83±15.08)(P=0.037), and the complete remission (CR) rates were calculated as 45.8% and 13.3%(P=0.004) in the study and control groups after neoadjuvant chemotherapy. The tumor volumes were (0±1.5) cm³ and (1.00±10.63) cm³(P=0.022) and the CR rates were 70% and 50%(P=0.009) in the study and control groups before afterloading treatment. The median follow-up was 24.6(9.3-101.7) months. The 1-and 2-year overall survival rates were 96%,96% and 90%,71%(P=0.110),the recurrence-free survival rates was 96%,96% and 97%,89%(P=0.512),and the distant metastasis-free survival rates were 96%, 88% and 83%,80%(P=0.297) in the study and control groups, respectively. Adverse reactions were acceptable in both groups. Conclusion Bevacizumab combined with neoadjuvant chemotherapy can significantly reduce the tumor volume, improve the tumor CR rate and yield tolerable adverse reactions.
		2021 Vol. 30 (4): 372-375 [Abstract] ( 254 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Technique·Biology

	376	Study on radiation dose distribution based on generative adversarial network
		Liao Wentao, Pu Yuehu
		Objective To investigate whether the combination of the advantages of deep learining in image processing and radiotherapy will make the radiotherapy process more intelligent. Methods The generative adversarial network (GAN) is a generation model using neural network. High-quality dose distribution images can be generated by inputting relevant features. Firstly, random unconditional GAN was utilized to verify the ideal data, then conditional GAN (cGAN) was employed to train DICOMRT data of tumor patients, and the target contour information was used to directly generate dose distribution images. Results For the verification of ideal data, the generation of ideal distribution yielded good effect. By extracting target contour and real dose slice data and using cGAN training, the dose distribution maps of planning target volume (PTV) and organs at risk (OAR) of tumor patients could be obtained. The absolute error evaluation of the maximum and average values between the predicted value and the real dose was shown as[3.57%, 3.37%](PTV),[2.63%, 2.87%](brain),[1.50%, 2.70%](CTV),[3.87%, 1.79%](GTV),[3.60%, 3.23%](OAR1) and[4.40%, 3.13%](OAR2), respectively. Conclusions GAN model can be used to generate ideal dose distribution data, and cGAN model with prior knowledge can be employed to establish the relationship between target information and dose distribution. Directly generating the corresponding dose distribution image by inputting the target contour information is an effective attempt for dose prediction.
		2021 Vol. 30 (4): 376-381 [Abstract] ( 286 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	382	Comparison of validation results and leaf open time before and after upgrading of helix tomotherapy planning system
		Yue Qi, Duan Jimei, Wang Zhiwei, Zhang Yue, Yang Xiumei, Gu Dan
		Objective To compare the leaf open time (LOT) parameters and γ passing rates between the 4.0.4 and 4.2.3 helix Tomotherapy planning systems and evaluate the improvement. Methods Retrospective comparison of the treatment plans of 345 cases selected by 4.0.4 and 4.2.3 versions was performed. The Machine Specific Sinogram of each plan was extracted from the archived plan file to calculate the LOT. The evaluated LOT parameters included the projection time, the maximum LOT, the mean non-zeros time, the time difference between the projection time and the maximum LOT, the relative count of leaves with LOT greater than maximum LOT minus 5ms, the relative count of leaves with LOT lower than 100ms and the beam on time. The γ passing rate (criteria:3mm/3%, 10% threshold and global error) and the LOT parameters between two version systems were evaluated with the independent t-test. The relationship between the LOT parameters and γ passing rate was analyzed by the multiple linear regression method. Results The γ passing rate of the Ver 4.0.4 system was 97.86%, significantly lower than 98.6% of the Ver 4.2.3 system (P<0.001). The time gap between the projection time and the maximum LOT of the Ver 4.2.3 system was significantly less than that of the Ver 4.0.4 system (1 ms vs. 11 ms, P<0.001). For the Ver 4.0.4 system, the multiple linear regression method showed that the maximum LOT ratio and the beam on time were negatively correlated with the γ passing rate (both P<0.001). However, for the Ver 4.2.3 system, only the beam on time showed a negative correlation with the γ passing rate (P<0.001). Conclusion The γ passing rate of the Ver 4.2.3 system is significantly higher than that of the Ver 4.0.4 system. The decrease of γ passing rate caused by the leaves near the maximum LOT is properly resolved in the new version system.
		2021 Vol. 30 (4): 382-386 [Abstract] ( 232 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	387	Study of robust optimization in brachytherapy
		Wang Xianliang, Wang Pei, Kang Shengwei, Tang Bin, Yang Feng, Tang Ting, Li Jie
		Objective To evaluate the application value of robost optimization of brachytherapy for cervical cancer. Methods Twenty patients who completed radical treatment were recruited in this study. The dose volume histogram (DVH) parameters were statistically compared between the conventional and robust optimization plans, and the robustness between the conventional and robust optimization plans was evaluated using DVH and DVH bands. The robust optimization method utilized the worst dose distribution to consider the dose in the presence of uncertainties. In each optimization iteration, the dose distributin when the radioactive source shifted along the X, Y, and Z directions (±2 mm), and the dose distribution when the radioactive source was not shifted were calculated. The worst dose distribution for each voxel was the lowest dose in the target and the highest dose outside the target under all circumstances. The iterative objective function was calculated by the worst dose distribution. Results In the scenario of no shifting of radioactive source position, the mean value of robust optimization was significantly lower and that of V150% was significantly higher than those of conventional optimization (both P<0.05). When considering the shifting of radioactive source position, the worst dosimetric parameters of multiple dose distributions were statistically compared. The mean HR-CTV D100% values did not significantly differ between the robust and conventional optimization plans, whereas the mean D90% value (range:0.02-0.03Gy) of robust optimization was significantly higher than that of conventional optimization (P<0.05). Robust optimization increased the D2cm³ of the bladder and small intestine, and the rectum dose was increased with the shifting of the radioactive source position in the robust optimization. The DVH bands did not significantly differ between the conventional and robust optimization plans for all patients. Conclusions Robust optimization based on the worst dose distribution fails to significantly improve the robustness of brachytherapy for cervical cancer. Alternative methods are required to minimize the dosimetric effect of uncertainties in brachytherapy.
		2021 Vol. 30 (4): 387-391 [Abstract] ( 223 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	392	Film analysis algorithm of isocenter error based on Hough transform for the CyberKnife system
		Li Wuzhou, Dai Zhitao, Wan Fuying, Shi Qijie, Zhao Man, Quan Hong
		Objective A new algorithm based on Hough transform (HT) was proposed to improve the accuracy and stability of the film image analysis of Automatic Quality Assurance (AQA) test, and to explore the influence of the resolution of film image on the test results. Methods Nine pairs of films were obtained for AQA modules in this study. Firstly, the median filter was used to preprocess the grayed-out film image to remove noise interference. Then, a global threshold was utilized to binarize the image. The images were edge-detected and the film edge line was extracted by Hough transform. The film image was transformed to the correct position. Finally, the edge of the field shadow circle and the shadow circle of the tungsten ball were extracted by the edge detection method and Hough transform. The radial error was finally obtained by analyzing the concentricity. Results There was no significant difference in the accuracy between the test results yielded by the HT method and the AQA software (P>0.05). The difference in the standard deviation of the test results was statistically significant (P=0.027),indicating that the algorithm increased the stability while ensuring the accuracy of film analysis. Increasing the resolution of film scanning failed to significantly improve the accuracy and stability of film analysis in both two methods. Conclusions The algorithm used in this study can eliminate the human error caused by film scanning placement while ensuring the accuracy of film analysis, providing a more stable way for the AQA test of the CyberKnife system.
		2021 Vol. 30 (4): 392-396 [Abstract] ( 256 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	397	Study of effect of silencing RACK1 expression by shRNA on enhancing radiosensitivity of oral squamous cell carcinoma cells
		Liu Dongmei, Liu Xinju, Wang Wen, Qiu Rongliang
		Objective To evaluate the effect of down-regulation of RACK1 expression on growth and radiosensitivity of oral squamous cell carcinoma cells. Methods The shRNA vector for RACK1 gene was constructed and transfected into HSC-3 cells by lipofectamine. The stably-transfected cell line was obtained by constructing G418. The expression levels of RACK1 mRNA and protein were detected by RT-PCR and Western blot. The cell proliferation was detected by CCK8 assay. Cell apoptosis was examined by flow cytometry. The invasive and metastatic capabilities of cancer cells were assessed by cell invasion assay in vitro.The effect of X-ray irradiation combined with down-regulation of RACK1 expression upon cell proliferation was assessed by clone formation assay. The xenograft tumor nude mouse model was established to observe the inhibitory effect of down-regulating RACK1 gene expression combined with X-ray irradiation on oral squamous cell carcinoma. Results RT-PCR revealed that the expression level of RACK1 mRNA of transfected HSC-3 cells was significantly down-regulated (P<0.05). Western blot showed that the expression level of RACK1 protein was significantly down-regulated (P<0.05). CCK8 assay demonstrated that down-regulation of RACK1 expression could remarkably inhibit the growth of HSC-3 cells (P<0.05). RACK1 gene shRNA interference combined with X-ray irradiation significantly enhanced the apoptosis rate of HSC-3 cells (P<0.05). The number of invasion cells in vitro in the RACK1 silencing group was evidently decreased (P<0.05). Clone formation assay showed that the survival fraction in the shRACK1 group was significantly lower than that in the control group. The sensitization enhancement ratio was 1.37(ratio of D0 value). Xenograft tumor experiment in nude mice showed that tumor growth was significantly inhibited in the shRACK1 group, the tumor volume was significantly decreased and the tumor mass was significantly lower than those in the control group (all P<0.05). Conclusion Down-regulating RACK1 expression can enhance the radiosensitivity of oral squamous cell carcinoma cells, providing novel thinking to improve the radiosensitivity of oral squamous cell carcinoma.
		2021 Vol. 30 (4): 397-402 [Abstract] ( 240 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	403	Effect of miR-133b on radiosensitivity of colon cancer SW620 cells by targeting HER-2
		Zhao Lei, Wang Tianyu, Wang Xiaomin, Liu Junzhong, Yi Shanyong
		Objective To evaluate the effect of miR-133b on the apoptosis and radiosensitivity of colon cancer cell line (SW620 cells), and to explore its mechanism. Methods SW620 cells were transfected with miR-con (miR-con group), miR-133b mimics (miR-133b group), si-con (si-con group) and si-HER-2(si-HER-2 group) by the liposome method, and then irradiated with 0, 2, 4, 6, 8 Gy. The miR-133b protein expression, HER-2 protein expression, apoptosis, cell survival fraction and cytofluoroactivity in each group were evaluated by qRT-PCR, Western blot, flow cytometry, colony formation assay and dual luciferase reporter gene assay, respectively. Results Compared with the pre-irradiation group, the expression level of miR-133b was significantly down-regulated (P<0.05), whereas that of HER-2 was significantly up-regulated in SW620 cells after irradiation (P<0.05). Overexpression of miR-133b and knockdown of HER-2 remarkably reduced the survival fraction (both P<0.05),and significantly promoted the apoptosis of SW620 cells (P<0.05). miR-133b could considerably inhibit the fluorescent activity of wild-type HER-2 cells (P<0.05) and negatively regulate the expression of HER-2 protein. Conclusion miR-133b can inhibit the survival of colon cancer cells, promote the apoptosis and enhance the sensitivity of radiotherapy probably via the mechanism of targeting HER-2.
		2021 Vol. 30 (4): 403-406 [Abstract] ( 270 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review Articles

	407	Research progress on immunotherapy for nasopharyngeal carcinoma
		Zhou Fengge, Yi Junlin
		Nasopharyngeal carcinoma (NPC) is a malignant carcinoma that is closely associated with Epstein Barr virus (EBV) infection. After the comprehensive treatment based on modern intensity-modulated radiation therapy, the oncological outcomes can be further improved. The main target of treatment is to increase the efficacy ofpatients with high risk and recurrent/metastatic (R/M) NPC.Recently, continuous progress has been made in the application of immunotherapy in the field of cancer treatment. Based on the accumulated knowledge on EBV antigen and immune checkpoint inhibitors, significant progress has been made in use of immunotherapy in treating R/M-NPC. Immunotherapy combined with radiotherapy or chemoradiotherapy will become the hot spot in the clinical management of patients with newly-diagnosed high-risk NPC.
		2021 Vol. 30 (4): 407-412 [Abstract] ( 278 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	413	Research progress on dosimetry-related long-term complications of pediatric cancer radiotherapy
		Qiu Wenlong, Shi Pengyue, Wang Jingfu, Zhu Jian, Yu Jinming
		Children with pediatric tumors have better prognosis and longer survival than adults, suggesting that attention should be paid to the long-term complications induced by radiotherapy. In this article, the data from more than 40 clinical studies of pediatric tumor radiotherapy published in the recent decade were retrospectively analyzed. Long-term complications of nervous system, cardio-cerebrovascular system, respiratory system, endocrine system, urinary system, reproductive system, skeletal development, long-term secondary tumors were considered and the corresponding radiation dose-volume parameters were summarized, aiming to guide radiation oncology physicians and physicists to optimize radiotherapy plans for children with pediatric tumors.
		2021 Vol. 30 (4): 413-418 [Abstract] ( 264 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	419	Research progress on radiosensitivity-related genes and biomarkers in esophageal carcinoma
		Wang Xiaofeng, Liang Jun
		Radiotherapy is one of the most important treatment methods for esophageal carcinoma. However, radiation resistance is the biggest problem and obstacle for patients with esophageal carcinoma treated with radiotherapy. Radiosensitivity is the focus and difficulty in the study of tumor radiobiology. A variety of genes and their expression products affect the radiosensitivity of esophageal carcinoma. Consequently, if the genes and biomarkers that determine radiosensitivity can be detected before radiotherapy, it will play a vital role in investigating the mechanism of radiotherapy sensitization, targeted therapy and radiotherapy efficacy prediction to guide individual therapy. In this article, major genes and biomarkers associated with esophageal carcinoma radiosensitivity in recent years were reviewed from different signal transduction pathways.
		2021 Vol. 30 (4): 419-423 [Abstract] ( 166 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	424	Research progress on radiotherapy combined with PD-1/PD-L1 inhibitors in the treatment of breast cancer
		Jiang Jie, Huang Wei
		Radiotherapy has been proven to enhance tumor-specific immune response and provide targets for immune drugs. Immune checkpoint inhibitors represented by PD-1/PD-L1 combined with radiotherapy can enhance anti-tumor activity and exert abscopal effect. In this article, research progress on the basic study and clinical trials and challenges of radiotherapy combined with PD-1/PD-L1 inhibitors in the treatment of breast cancer were reviewed.
		2021 Vol. 30 (4): 424-428 [Abstract] ( 238 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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