Chinese Journal of Radiation Oncology

中华放射肿瘤学杂志

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Chinese Journal of Radiation Oncology

	2023 Vol.32 Issue.3 Published 2023-03-15

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

	189


		2023 Vol. 32 (3): 189-189 [Abstract] ( 43 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	190	Dosimetry standardization in radiobiological research
		Qian Jianjun, Tian Ye, Dai Jianrong
		In recent years, the issue of "reproducibility" of scientific research results has become more and more prominent. Radiobiology is a medical science that studies the biological effect of radiation on living organisms, and there is also a serious problem of "reproducibility of findings". Inaccuracy of physical dose or incomplete dosimetric reports is one of the main causes. Use of guidelines, specifications and recommendations for dosimetric measurement, such as the standardized scoring system for dosimetric reports, will help improving the standardization and accuracy of physical dose measurement in radiobiological research. In this article, multiple guidelines and recommends for improving collaboration between radiobiology and radiation physics, as well as for dose standardization of radiobiological research were evaluated, aiming to provide reference for improving the reproducibility of radiobiological research.
		2023 Vol. 32 (3): 190-193 [Abstract] ( 73 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Head and Neck Tumor

	194	Clinical characteristics and efficacy of second primary malignancies in hypopharyngeal carcinoma: an analysis of 216 real‐world cases
		Luo Xi, Wu Runye, Liu Shaoyan, Wang Xiaolei, Ni Xiaoguang, Zhang Ye, Huang Xiaodong, Wang Kai, Chen Xuesong, Wang Jingbo, Zhang Jianghu, Qu Yuan, Luo Jingwei, Yi Junlin
		Objective To evaluate the incidence, clinical characteristics and prognosis of second primary malignancies (SPMs) among patients with hypopharyngeal carcinoma (HPC) in real‐world analysis. Methods A total of 594 HPC patients admitted to Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from 2010 to 2018 were retrospectively analyzed.The incidence and clinical characteristics of HPC patients complicated with SPMs were analyzed. Clinical efficacy was compared among different groups. Results With a median follow‐up time of 66.9 months, SPMs were present in 36.4% (216/594) of HPC patients: 22.2% (132/594) were synchronous and 14.1% (84/594) were metachronous. The upper aerodigestive tract was the most common involved region. Compared with patients without SPMs, patients with synchronous and metachronous carcinoma in situ had similar 5‐year overall survival (OS) of 42.2% vs. 44.5% (P=0.958) and 62.2% vs. 44.5% (P=0.240), respectively. Patients with synchronous invasive SPMs had a worse 5‐year OS of 27.2% vs. 44.5% in their counterparts without SPMs (P=0.001). Patients with metachronous invasive SPMs had similar 5‐year OS of 50.2% vs. 44.5% in their counterparts without SPMs (P=0.587). SPMs accounted for 42.5% of total death in metachronous invasive SPMs group. Conclusions Patients with HPC have a high probability of developing SPMs. Moreover, the incidence of complicated with esophageal/gastric carcinoma in situ or metachronous SPMs exerts no effect on prognosis, while the occurrence of synchronous SPMs significantly affectes the prognosis of patients. However, the incidence of SPMs is still one of the main death causes in metachronous invasive SPMs group.
		2023 Vol. 32 (3): 194-200 [Abstract] ( 87 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	201	Analysis of survival time and benefits of postoperative radiotherapy in resected small cell lung cancer patients
		Wang Yanyang, Ding Xiaolong, Bai Xuehong, Yu Liang, He Jinxi, Zhao Ren
		Objective To analyze the survival time, prognostic factors and the value of postoperative thoracic radiotherapy in resected small cell lung cancer (SCLC) patients. Methods Clinic opathological data of SCLC patients who received surgical treatment in Cancer Hospital & General Hospital of Ningxia Medical University from April 2014 to September 2021 were enrolled in this retrospective study. All patients were subject to follow-up. The survival time of SCLC patients was evaluated by Kaplan‐Meier method. Univariate and multivariate analyses of prognostic factors were performed by Cox proportional hazard model. Results A total of 64 patients with SCLC were enrolled in the study. The 5‐year overall survival (OS) rate was 43.5%. Univariate analysis showed that TNM staging (P=0.027), postoperative neutrophil‐lymphocyte ratio (NLR) (P=0.039) and adjuvant thoracic radiotherapy (P=0.041) were the prognostic factors. Multivariate analysis showed that TNM staging (P=0.038) and adjuvant thoracic radiotherapy (P=0.022) were the prognostic factors in patients with SCLC. The 5‐year OS rates of patients with and without adjuvant thoracic radiotherapy were 71.6% and 35.4% (P=0.028), respectively. There was a statistically significant difference in the 5‐year OS rates between pathological stage N₂ SCLC patients with or without adjuvant thoracic radiotherapy (75.0% vs. 0%, P=0.030). Conclusions TNM staging and postoperative adjuvant thoracic radiotherapy are prognostic factors in patients with SCLC undergoing surgical treatment. Pathological stage N₂ SCLC patients can benefit from adjuvant thoracic radiotherapy.
		2023 Vol. 32 (3): 201-206 [Abstract] ( 83 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	207	Prognosis and risk factors of brain metastases from limited‐stage small cell lung cancer after complete resection
		Zhou Jianxi, Sun Yunchuan, Xiao Li, Lu Hongling, Yin Xiaoming
		Objective To analyze the prognosis and risk factors for brain metastases (BM) in patients with limited‐stage small cell lung cancer (LS‐SCLC) after complete resection, aiming to identify those most likely to benefit from prophylactic cranial irradiation (PCI). Methods Clinical data of 94 patients with LS‐SCLC treated in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2005 to December 2018 who underwent complete resection were retrospectively analyzed, including 31 cases treated with PCI and 63 without PCI. Prognostic factors and risk factors of BM were analyzed by Kaplan‐Meier method. The differences between two groups were analyzed by log‐rank test. Independent risk factors of overall survival (OS) and BM were assessed by multivariate Cox regression model. Results The 2‐year and 5‐year OS rates were 80.6% and 61.3% in the PCI group, and 61.9% and 46.0% in the non‐PCI group, respectively (P=0.001). The 2‐year and 5‐year brain metastasis-free survival (BMFS) rates were 80.6% and 54.8% in the PCI group, and 57.1% and 42.9% in the non‐PCI group, respectively (P=0.045). The 2‐year and 5‐year progression-free survival (PFS) rates were 71.0% and 48.4% in the PCI group, and 49.2% and 34.9% in the non‐PCI group, respectively (P=0.016). PCI could improve OS in patients with pII/III stage LS‐SCLC (P=0.039, P=0.013), but the OS benefit in patients with pI stage LS‐SCLC was not significant (P=0.167). BM occurred in 3 patients (9.7%) in the PCI group, which was significantly lower than that in the non‐PCI group (n=17, 27.0%; P=0.044); there was no significant difference in the BM rate of patients with pI and pII stage LS‐SCLC between PCI and non‐PCI groups (P=0.285, P=0.468); and the BM rate of patients with pIII stage LS‐SCLC in the PCI group was significantly lower than that in the non‐PCI group (P=0.041). Multivariate analysis showed age ≥60 (HR=2.803, P=0.001), BM (HR=2.239, P=0.022), no PCI (HR=0.341, P=0.004) and pathological stage pII/III (HR=4.963, P=0.002) were the independent high‐risk factors affecting OS; and pathological stage pII/III (HR=11.665, P=0.007) was an independent high‐risk factor affecting BM. Conclusions LS‐SCLC patients with pII‐III stage have a higher risk of developing BM and poor prognosis after complete resection, and should receive PCI treatment. However, LS‐SCLC patients with pI stage may not benefit significantly.
		2023 Vol. 32 (3): 207-214 [Abstract] ( 70 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	215	Clinical report of two dose fractionation modes using carbon ion beam therapy in the lymph node drainage area for lung cancer
		Pan Xin, Zhang Yihe, Li Xiaojun, Ma Tong, Wang Xin, Yang Yuling, Chai Hongyu, Qin Tianyan, Lyu Caixia, Li Pengqing, Ye Yancheng, Zhang Yanshan
		Objective To compare the adverse reactions, efficacy and survival rate of carbon ion beam irradiation in the elective lymph node (ENI) drainage area of locally advanced non‐small cell lung cancer (LA‐NSCLC) with relative biological effect (RBE) dose of 48 Gy using 16 and 12 fractions. Methods A total of 72 patients with pathologically confirmed LA‐NSCLC admitted to Wuwei Heavy Ion Center of Gansu Wuwei Tumor Hospital from June 2020 to December 2021 were enrolled and simple randomly divided into groups A and B, with 36 patients in each group. Patients in groups A and B were treated with carbon ion beam irradiation to the lymph node drainage area with 48 Gy (RBE) using 16 and 12 fractions. The acute and chronic adverse reactions, efficacy and survival rate were observed. The survival curve was drawn by Kaplan‐Meier method. Difference test was conducted by log‐rank test. Results The median follow‐up time was 13.9 (8.8‐15.7) months in group A and 14.6 (6.3‐15.9) months in group B. Sixteen (44.4%) patients were effectively treated in group A and 9 (25%) patients in group B. Thirty‐four (94.4%) cases achieved disease control in group A and 30 (83.3%) cases in group B. Statistical analysis showed that the overall survival rate in group B was similar to that in group A (χ²=1.192, P=0.275). Comparison of planning parameters between two groups showed CTV volume, D_mean, V_{5 Gy(RBE)}, V_{20 Gy(RBE)} and V_{30 Gy(RBE)} of the affected lung, cardiac V_{20 Gy(RBE)}, V_{30 Gy(RBE)} and D_mean, esophageal V_{30 Gy(RBE)}, V_{50 Gy(RBE)}, D_max and D_mean, D_max of the trachea and spinal cord had no significant difference (all P>0.05). No grade 3 or 4 adverse reactions occurred in the enrolled patients during treatment and follow‐up. No statistical differences were observed in the acute radiation skin reaction (χ²=5.134, P=0.077), radiation esophagitis (χ²=1.984, P=0.371), and advanced radiation pneumonia (χ²=6.185, P=0.103) between two groups. Conclusions The two dose fractionation modes of carbon ion therapy system are equally safe in the mediastinal lymphatic drainage area of LA‐NSCLC, and the adverse reactions are controllable. The long‐term efficacy still needs further observation.
		2023 Vol. 32 (3): 215-221 [Abstract] ( 75 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	222	Automatic‐delineation model construction for prostate cancer target volume of postoperative radiotherapy based on artificial intelligence
		Wang Fang, Miao Dong, Shen Yali, Chen Zhebin, Yao Yu, Wang Xin
		Objective To explore the method of constructing automatic delineation model for clinical target volume (CTV) and partially organs at risk (OAR) of postoperative radiotherapy for prostate cancer based on convolutional neural network, aiming to improve the clinical work efficiency and the unity of target area delineation. Methods Postoperative CT data of 117 prostate cancer patients manually delineated by one experienced clinician were retrospectively analyzed. A multi‐class auto‐delineation model was designed based on 3D UNet. Dice similarity coefficient (DSC), 95% Hausdorf distance (95%HD), and average surface distance (ASD) were used to evaluate the segmentation ability of the model. In addition, the segmentation results in the test set were evaluated by two senior physicians. And the CT data of 78 patients treated by other physicians were also collected for external validation of the model. The automatic segmentation of these 78 patients by CTV‐UNet model was also evaluated by two physicians. Results The mean DSC for tumor bed area (CTV1), pelvic lymph node drainage area (CTV2), bladder and rectum of CVT‐UNet auto‐segmentation model in the test set were 0.74, 0.82, 0.94 and 0.79, respectively. Both physicians' scoring results of the test set and the external validation showed more consensus on the delineation of CTV2 and OAR. However, the consensus of CTV1 delineation was less. Conclusions The automatic delineation model based on convolutional neural network is feasible for CTV and related OAR of postoperative radiotherapy for prostate cancer. The automatic segmentation ability of tumor bed area still needs to be improved.
		2023 Vol. 32 (3): 222-228 [Abstract] ( 67 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	229	Radical therapy with or without chemotherapy in highly malignant non‐metastatic prostate cancer: interim analysis of a prospective non-randomized controlled study
		Ma Mingwei, Tang Qi, Gao Xianshu, Yu Wei, Li Hongzhen, Sun Mingxia, Yang Kaiwei, Li Xiaoying, Qi Xin, Chen Jiayan, Ren Xueying
		Objective To compare the efficacy and safety of standard treatment with or without adjuvant chemotherapy in patients with highly malignant non‐metastatic prostate cancer. Methods In this prospective non-randomized controlled study, consecutive non‐metastatic prostate cancer patients with pathologically proven Gleason score of 9‐10 or Gleason score of 5 admitted to Peking University First Hospital were enrolled. Four to six cycles of chemotherapy using docetaxel ± carboplatin regimen were added or not after standard radical therapy. The primary end point was 5‐year event‐free survival (EFS), and the secondary end points were distant metastasis‐free survival (MFS), overall survival (OS), and treatment‐related adverse events. The survival curve was drawn by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test. Results A total of 176 patients were consecutively enrolled from November 2019 to January 2022 of which 138 patients received only standard radical therapy (control group), and 38 patients received adjuvant chemotherapy after standard radical therapy (chemotherapy group). The median follow‐up time was 13.4 (2.0‐34.0) months. All patients survived. The 30‐month EFS rates in the chemotherapy and control groups were 100% and 85.6%, respectively (P=0.064). There were no events in the chemotherapy group, while there were 12 cases of events in the control group, including 6 cases of biochemical recurrence and 6 cases of imaging progression. The 30‐month MFS rates in two groups were 100% and 91.9%, respectively (P=0.205). After the 1 vs. 2 propensity score matching, the EFS and MFS rates in two groups were 100% vs. 85.7% (P=0.056), and 100% vs. 92.2% (P=0.209), respectively. The incidence rates of grade 2 and above urinary toxicity in the chemotherapy and control groups were 2.6% and 7.2% (P=0.354), respectively. The incidence rates of grade 2 and above rectal toxicity were 5.3% and 5.1% (P=0.711), respectively. Grade 3 and above chemotherapy‐related toxicity in the chemotherapy group were leukopenia (31.6%), thrombocytopenia (2.6%) and alopecia (13.2%). Conclusion The addition of adjuvant chemotherapy after standard radical therapy tends to improve the overall EFS of patients with highly malignant prostate cancer, and the adverse effects are tolerable, which should be confirmed by long‐term follow‐up results.
		2023 Vol. 32 (3): 229-234 [Abstract] ( 81 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	235	Correlation between acute intestinal toxicity and dose-volume parameters in patients with cervical cancer receiving postoperative adjuvant radiotherapy
		Xu Bichun, Guo Qi, Qian Jianjun, Cai Shang, Tian Ye
		Objective To identify dose‐volume parameters to predict the incidence of acute intestinal toxicity in cervical cancer patients after postoperative adjuvant radiotherapy. Methods Clinical data of 93 cervical cancer patients who underwent postoperative adjuvant intensity‐modulated radiotherapy (IMRT) were retrospectively evaluated. The dose‐volume parameters comprised the absolute volume of the bowel receiving 5‐45 Gy (5 Gy interval) radiation dose and the total volume of the bowel. The acute radiation-induced intestinal toxicity was evaluated by Radiation Therapy Oncology Group (RTOG) criteria. The association between the irradiated bowel volume and acute intestinal toxicity was analyzed. Results A total of 26 (28%) patients experienced grade ≥2 acute intestinal toxicity. A strong relationship between grade ≥2 acute intestinal toxicity and the irradiated small bowel volume was observed at the total volume of small bowel, small bowel V_{5 Gy}, V_{10 Gy} and V_{15 Gy} (all P<0.05). Small bowel V_{10 Gy} (HR=1.028, 95%CI, 0.993‐1.062, P=0.029) and small bowel V_{15 Gy}(HR=0.991, 95%CI, 0.969‐1.013, P=0.034)were the independent risk factors for evident acute intestinal toxicity. Conclusion Dose‐volume parameters of the small bowel can be used as predictors for the occurrence of grade ≥2 acute intestinal toxicity in cervical cancer patients undergoing postoperative adjuvant radiotherapy.
		2023 Vol. 32 (3): 235-240 [Abstract] ( 66 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Technique·Biology

	241	Comprehensive comparison between Halcyon 2.0 and Truebeam VMAT plans for different treatment sites: dosimetric quality and plan complexity
		Zhu Qizhen, Yang Bo, Wang Zhiqun, Liang Yongguang, Zhang Wenjun, Gao Yuan, Qiu Jie
		Objective To analyze the differences in dosimetric quality and plan complexity of volumetric modulated arc therapy (VMAT) plans based on Halcyon 2.0 and Truebeam for different treatment sites of the patients. Methods Halcyon 2.0 VMAT plans in head & neck, chest, abdomen, and pelvis treatment sites of 49 cases were retrospectively selected and the VMAT plans were re‐designed based on Truebeam with the same optimization parameters. The differences in dosimetric metrics and plan complexity between the two types of plans were compared and analyzed. P<0.05 was considered as statistically significant. Results In terms of PTV, Halcyon 2.0 plans showed better homogeneity index (HI), conformal index (CI) in the head & neck and chest. Besides, Halcyon 2.0 plans yielded better D_98% and CI in the abdomen and better D_2% in the pelvis. For organs at risk (OAR), the D_20% and D_mean of bilateral lungs, and D_meanof heart for Halcyon 2.0 plans in the chest were lower than those for Truebeam plans (all P<0.05). For the complexity metrics, the median average aperture area variability (AAV) of Halcyon 2.0 plans in the head & neck, abdomen and pelvis were 0.414, 0.425 and 0.432, which were better than 0.385, 0.368 and 0.361 of Truebeam plans in the corresponding sites, respectively. In the abdomen and pelvis, Halcyon 2.0 plans showed better median modulation complexity score (MCS) than Truebeam plans (0.320 vs. 0.268, 0.303 vs. 0.282; both P<0.05). The median small aperture score (SAS) for all plans of Halcyon 2.0 were better than that of Truebeam plans (all P<0.05), and the median plan average beam area (PA) of all plans of Halcyon 2.0 were larger than that of Truebeam plans (all P<0.05). Conclusions Compared with conventional fractionated VMAT plans based on Halcyon 2.0 and Truebeam, Halcyon 2.0 plans have similar or even better dosimetric quality. However, Halcyon 2.0 plans have lower plan complexity, which makes it an advantage in clinical application.
		2023 Vol. 32 (3): 241-247 [Abstract] ( 48 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	248	The remote training system for quality assurance of medical electronic linear accelerators based on extended reality technology
		Chen Jing, Weng Xing, Jiang Liuqing, Dong Fangfen, Zheng Fen, Guo Lanyan, Yao Jianmin, Li Xiaobo
		Objective To improve the quality assurance (QA) skills of radiotherapy personnel and medical students and reduce the radiation risk of training by developing a remote training system for QA of medical electronic linear accelerators. Methods This training system was built based on radiotherapy technology and quality control contents of medical electronic linear accelerators, and a virtual reality interactive software was developed using extended reality (XR) technology Unity 3D. A remote control module of multi‐terminal platform was also developed. A multi‐perspective evaluation system was adopted and a questionnaire was designed to analyze the application value of this system. Results The training system reproduced the live environment and physical objects of medical electronic linear accelerator treatment room. It built a multi‐terminal virtual simulation training system with radiotherapy technology as well as QA knowledge system. This system could provide 5G remote control of medical electronic linear accelerator for off‐site quality control demonstration and guidance. By March 1, 2022, a total number of 133 people had been trained using this system, 76 valid questionnaires had been taken, of which 90.79% (69/76) of the respondents trusted the experimental results shown by the system and 88.16% (67/76) of the respondents considered the training system necessary. Conclusions The training effect of this system is widely recognized. It fundamentally reduces the training radiation hazard and provides reference for the reform and progress of QA training mode of medical electronic linear accelerators.
		2023 Vol. 32 (3): 248-253 [Abstract] ( 59 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	254	Establishment of a rat model of acute radiation esophagitis
		Li Kaixuan, Wen Yanping, Zheng Jiabin, Teng Feng, Jia Liqun
		Objective To establish Wistar rat models of acute radiation esophagitis, and observe the histopathological changes at different time points after modeling. Methods Wistar rats were locally irradiated with different doses of 6 MV X‐rays, and the rats were sacrificed on the 3^rd, 5^th, 7^th, and 14^th days after irradiation. The full‐length esophagus tissue was taken for paraffin embedding, sectioning, and hematoxylin and eosin (HE) staining for pathological assessment. The pathological changes of the esophagus of the rats were observed at the 3^rd, 5^th, 7^th, and 14^th days after 25 Gy and 30 Gy irradiation. The changes of daily dietary intake of rats in different irradiation groups within 1‐2 weeks after radiation exposure were observed. Results No rat died in two groups after being irradiated with 25 Gy and 30 Gy rays. All the rats in the 30 Gy group had esophagus injury. On the 7^th day, the degree of injury was the most serious, with a pathological score of 5.00±0.75 and a food intake of 0 g. On the 14^th day, the degree of injury was relieved, and the food intake was restored to the level before irradiation. Conclusions The Wistar rat model of acute radiation esophagitis can be established by a single dose of 6 MV X‐ray 30 Gy irradiation to the esophagus. The 7^th day after irradiation is an ideal observation time for the acute injury phase, which is gradually alleviated after the 7^th day. The time can be chosen from 7‐14 days after irradiation as the observation point for the healing repair phase.
		2023 Vol. 32 (3): 254-259 [Abstract] ( 62 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	260	Effect of hyperthermia on biological behavior of squamous cell carcinoma of the tongue by regulating ferroptosis pathway
		Shen Pei, Hao Yuli, Zhou Xuexiao, Cong yuan, Wang Shengzhi, Shao yun, Xu Ting, Li Shouyi
		Objective To investigate the regulation and possible mechanism of hyperthermia (HT) on the ferroptosis of squamous cell carcinoma of the tongue cell line CAL‐27. Methods Half maximal inhibitory concentration (IC₅₀) of Fer‐1, an inhibitor of ferroptosis, was detected by CCK‐8 assay and used for subsequent experiments. CAL‐27 cells were divided into the HT, control, Fer‐1 and HT+ Fer‐1 groups according to experimental design. Reactive oxygen species (ROS) levels and iron ion concentration were determined by corresponding detection kits. The p53 and TfR1 mRNA levels were detected by real‐time reverse transcription PCR. Cell migration was detected by cell scratch test and cell apoptosis was detected by flow cytometry. Results HT significantly up‐regulated the ROS levels (P<0.01) and iron ion concentration (P<0.001), and significantly increased the expression levels of p53 and TfR1 mRNA (both P<0.01). The cell migration ability was decreased (P<0.001), whereas cell apoptosis rate was increased by HT (P<0.01). In the HT+Fer‐1 group, the ROS levels (P<0.001), iron ion concentration (P<0.001), expression levels of p53 and TfR1 mRNA (both P<0.01) were significantly down‐regulated, the cell migration ability was recovered (P<0.01), and cell apoptosis rate was decreased (P<0.01) compared with those in the HT group, respectively. Conclusions HT may induce the ferroptosis of CAL‐27 cell line, inhibit cell migration ability and promote cell apoptosis by activating the p53/TfR1 pathway.
		2023 Vol. 32 (3): 260-264 [Abstract] ( 53 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review Articles

	265	Application and research progress on PET‐CT in radiotherapy and follow‐up for glioma
		Zhang Shuang, Yin Jun, Yao Yutang, Wang Shaolong
		Glioma is the most common primary intracranial central nervous system tumor, and postoperative radiotherapy is an important treatment for glioma. At present, computed tomography (CT) and magnetic resonance imaging (MRI) are widely applied in the delineation of radiotherapy targets for glioma. However, there are still some deficiencies in evaluating tumor scope, recurrence, radiation necrosis and prognosis, etc. Positron emission tomography (PET)/computed tomography (PET‐CT) combines the molecular images of PET with the anatomical images of CT, which plays an important role in the diagnosis and differential diagnosis of glioma. With the popularization and application of multimodal imaging technology in radiotherapy, PET‐CT molecular imaging, as an important supplement, contributes to the delineation of glioma target volume and the development of accurate radiotherapy, and brings benefits to the prognosis and follow‐up of glioma patients. In this article, the application and research progress on PET‐CT in the diagnosis, treatment and follow‐up for glioma were reviewed.
		2023 Vol. 32 (3): 265-269 [Abstract] ( 57 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	270	Research progress on pelvic insufficiency fracture after radiotherapy for pelvic malignancies
		Huang Yuanqiong, Chen Hongbo, Wu Chenwang, Xiao Lin
		After radiotherapy for pelvic malignancies, pelvic insufficiency fracture (PIF), as a type of late injury event for pelvic bones, cannot be ignored, because it can exert a detrimental effect on patients' quality of life, and might make patients disabled and threaten their lives. Meanwhile, PIF is likely to be misdiagnosed with bone metastases. In this article, research progresses on potential pathogenesis, general characteristics, risk factors, diagnosis and treatment for PIF were reviewed.
		2023 Vol. 32 (3): 270-275 [Abstract] ( 60 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	276	Research progress on cancer‐related fatigue induced by radiotherapy
		Mao Yuxin, Huang Xu, Wang Chunbo
		Cancer‐related fatigue (CRF) is a symptom associated with cancer and cancer treatment. The incidence of CRF during radiotherapy is extremely high and severely affects the quality of life and treatment compliance of patients. Although more and more studies on CRF have been carried out, the pathogenesis of CRF caused by radiotherapy is still not well understood, and systemic interventions remain to be improved. In this article, the pathogenesis, influencing factors, and interventions of CRF caused by radiotherapy were reviewed, aiming to provide reference for optimizing treatment options in clinical practice.
		2023 Vol. 32 (3): 276-280 [Abstract] ( 46 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	281	Research progress on radio‐resistance mechanism of nasopharyngeal carcinoma
		Yan Zhenyu, Cao Xiang, Hu Xinyu, Ge Yizhi, Zong Dan, He Xia
		Nasopharyngeal carcinoma is one of the most common malignant head and neck tumors, and radiotherapy is the main treatment. However, radio‐resistance is a key cause of local recurrence of nasopharyngeal carcinoma. Therefore, overcoming the radio‐resistance of nasopharyngeal carcinoma and enhancing the radiosensitivity have become urgent problems in the treatment of nasopharyngeal carcinoma, which also play a key role in improving the overall survival rate of patients. In this article, recent studies on DNA, non‐coding RNA (ncRNA), protein and cell behaviors related to radio‐resistance of nasopharyngeal carcinoma were reviewed, aiming to provide valuable ideas for clinical treatment of nasopharyngeal carcinoma.
		2023 Vol. 32 (3): 281-286 [Abstract] ( 76 ) [HTML 1KB] [ PDF 0KB] ( 0 )

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