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.7 Published 2023-07-15

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

Head and Neck Tumor

	577	Study of application of 3D printed oral stents in radiotherapy for head and neck malignancies
		Meng Xue, Du Guobo, Wu Tingting, Tan Bangxian
		Objective To analyze the dosimetric differences between 3D printed oral stents and corked oral stents in the target area and perioral organ at risk (OAR) in radiotherapy for head and neck cancer, and the effectiveness in reducing acute adverse reactions associated with radiotherapy. Methods A total of 58 patients with head and neck cancer admitted to Department of Oncology of Affiliated Hospital of North Sichuan Medical College were selected and divided into experimental group (Group A, n=28, wearing 3D printed oral stents during radiotherapy) and control group (Group B, n=30, wearing corked oral stents during radiotherapy) in this retrospective cohort study. The incidence of radiotherapy - induced oral mucositis (RTOM), xerostomia and oropharyngeal mucosal pain was compared between two groups. Meanwhile, informed consent was obtained from 21 patients in Group A. Using the self control method, each patient wore a 3D printed oral stent (Group C) and a corked oral stent (Group D) to make two radiotherapy plans. The differences in the conformity index (CI), homogeneity index (HI) and exposure dose of OAR (D_max, D_mean) in the target area were analyzed between two groups. SPSS 25.0 statistical software was used for statistical analysis. Measurement data were expressed as Mean±SD. Comparison between two groups was conducted by paired t-test or repeated measurement analysis. Count data were expressed as ratio. Comparison between two groups was performed by Chi - square test or Fisher's exact test. P<0.05 was considered as statistically significant difference. Results The severity of RTOM (P<0.05), oropharyngeal mucosal pain (P=0.004) and xerostomia score (P<0.001) in Group A were significantly lower than those in Group B. There was no significant difference in the HI and CI of the target area between Group C and Group D (both P>0.05). The D_max(P=0.014, 0.009) and D_mean (P<0.001, P=0.033) of the upper lip and the affected buccal mucosa in Group C were significantly lower than those in Group D. Conclusion 3D printed oral stents obtain favorable HI and CI in radiotherapy for head and neck cancer, significantly reduce the irradiated dose to perioral OAR, and effectively lower the incidence and mitigate the severity of acute RTOM, xerostomia and oropharyngeal mucosal pain associated with radiotherapy.
		2023 Vol. 32 (7): 577-583 [Abstract] ( 63 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Thoracic Tumors

	584	Prognostic impacts of the estimated dose of radiation to immune cells (EDRIC) on limited-stage small-cell lung cancer with different tumor burdens
		Lai Jianian, Guan Song, Yan Meng, Meng Chunliu, Zhang Zhen, Zhang Jiaqi, Zhao Lujun
		Objective To investigate the effects of estimated dose of radiation to immune cells (EDRIC) on overall survival (OS), local progression-free survival (LPFS) and distant metastasis-free survival (DMFS) in limited-stage small-cell lung cancer (LS-SCLC) with different tumor burdens. Methods Clinical data of 216 patients with LS-SCLC who initially received conventional fractionated radiotherapy of the chest for radical treatment in Tianjin Medical University Cancer Institute and Hospital from 2013 to 2019 were retrospectively analyzed. EDRIC was calculated based on the model developed by Jin et al. and tumor burdens were assessed by gross tumor volume (GTV) or clinical stage. The study endpoints were OS, LPFS and DMFS, which were calculated from the date of diagnosis. The optimal cut-off value of EDRIC was calculated by R language. The correlation between EDRIC and tumor burdens was analyzed using Spearman's correlations. Survival analysis was performed by Cox proportional hazards regression model and Kaplan-Meier curve. Results The median follow-up time for the whole group was 47.8 months, and the median OS and DMFS was 34.6 months and 18.5 months, respectively, while the median LPFS did not reach. The optimal cut-off value of EDRIC was 6.8 Gy. Cox multivariate analysis showed that EDRIC was an independent prognostic factor affecting OS and DMFS. EDRIC was weakly correlated with GTV or clinical stage. Stratified by the median GTV, OS (P=0.021) and DMFS (P=0.030) were significantly shortened and LPFS had a tendency of shortening (P=0.107) when EDRIC>6.8 Gy compared with those when EDRIC ≤ 6.8 Gy in the GTV ≤ 34.6 cm³ group; EDRIC had little effect on OS, LPFS, and DMFS (P=0.133, 0.420, 0.374) in the GTV>34.6 cm³ group. Stratified by clinical stage, OS (P=0.003) and DMFS (P=0.032) were significantly shortened and LPFS (P=0.125) tended to shorten when EDRIC>6.8 Gy in stage I, II and IIIA groups; EDRIC exerted slight effect on OS, LPFS, and DMFS (P=0.377, 0.439, 0.484) in stage IIIB and IIIC groups. Conclusion EDRIC is an important factor affecting prognosis and exerts more significant impact on prognosis in patients with smaller tumor burden.
		2023 Vol. 32 (7): 584-591 [Abstract] ( 66 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	592	Preliminary analysis of immunotherapy combined with second-line treatment for esophageal squamous cell carcinoma patients
		Gao Hongmei, Zhao Xiaohan, Wen Jingyuan, Zhu Shuchai, Shen Wenbin
		Objective To investigate the efficacy of camrelizumab combined with second-line therapy in patients with recurrent or metastatic esophageal squamous cell carcinoma (ESCC) in the real-world settings. Methods Clinical data of 48 patients with esophageal cancer who met the inclusion criteria were retrospectively analyzed. The types of failure after first-line treatment, clinical efficacy, side effects and prognostic factors of second-line treatment were analyzed. SPSS 25.0 software was used for statistical analysis. Count data were expressed by composition ratio and analyzed by Chi-square test or Fisher's exact test. Survival analysis was conducted by Kaplan-Meier curve and log-rank test. Non-normally distributed data were recorded with the median, range and quartile. Results There were 26, 14, and 4 cases of combined chemoradiotherapy, chemotherapy and radiotherapy in the treatment of second-line camrelizumab, and 4 cases received immunotherapy alone. The median duration of immunotherapy was 6 cycles (range, 2-39 cycles). After second-line treatment, the short-term efficacy of 17, 27 and 4 cases was partial remission (PR), stable disease (SD) and progressive disease (PD), respectively. The overall response rate (ORR) was 35.4% and disease control rate (DCR) was 91.7%. The 1- and 2-year OS rates were 42.9% and 22.5%, and 1- and 2-year PFS rates were 29.0% and 5.8%. The median OS and PFS were 9.0 months (95%CI=6.4-11.7) and 8.5 months (95%CI=1.5-5.6), respectively. Multivariate analysis showed that combined immunotherapy mode, number of cycles of immunotherapy and short-term efficacy were the independent prognostic indicators affecting OS in this group of patients (HR=2.598, 0.222, 8.330, P=0.044, <0.001, <0.001). Lymphocyte count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), combined immunotherapy mode and short-term efficacy were the independent prognostic indicators affecting PFS in this group (HR=3.704, 3.598, 6.855, 2.159, 2.747, P=0.009, 0.008, <0.001, 0.049, 0.012). Conclusions Camrelizumab combined with second-line therapy can bring survival benefit to patients with recurrent or metastatic ESCC after first-line therapy, especially immunotherapy combined with chemoradiotherapy can significantly provide survival benefit. Peripheral blood inflammatory biomarkers are independent indicators affecting clinical prognosis of patients. Patients with better short-term efficacy also achieve better prognosis. The final conclusion remains to be validated by a large number of randomized controlled studies.
		2023 Vol. 32 (7): 592-598 [Abstract] ( 67 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Abdominal Tumors

	599	Meta-analysis of the efficacy and adverse reactions of fractionated high dose rate brachytherapy as monotherapy for localized prostate cancer
		Guo Wei, Sun Yunchuan, Lu Hongling, Yin Xiaoming, He Xinying, Zhang Yiran, Fan Kui
		Objective To conduct a meta-analysis to analyze the efficacy and adverse reactions of fractionated high dose rate brachytherapy (HDR-BT) as monotherapy for localized prostate cancer. Methods Relevant databases were searched to collect the clinical trials on HDR-BT as monotherapy in patients with localized prostate cancer. Included studies were limited to full-text publications of fractionated HDR-BT as monotherapy with a median follow-up of at least 5 years, and adequate reporting of treatment outcomes and adverse reactions data. Stata 12.0 was used for data analysis. Results According to the inclusion and exclusion criteria, a total of 11 clinical trials involving 2 683 patients with prostate cancer were included in this meta-analysis. The results of the meta-analysis showed that 5-year biochemical recurrence-free survival (bRFS) rate and overall survival (OS) rate were 94% (95%CI: 93% - 96%) and 96% (95%CI: 94% - 98%), respectively. Long-term (≥5 years) cancer-specific survival (CSS) rate and distant metastasis-free survival (DMFS) rate were 99% (95%CI: 98% - 100%) and 98% (95%CI: 98% - 99%), respectively. Long-term (≥5 years) late grade ≥3 grade gastrointestinal and genitourinary adverse reactions rates were 2% (95%CI: 1% - 3%) and 9% (95%CI: 6% - 13%), respectively. Conclusions Fractionated HDR-BT as monotherapy is an effective treatment for patients with localized prostate cancer. Its long-term efficacy is encouraging, and the treatment is well tolerated and safe.
		2023 Vol. 32 (7): 599-605 [Abstract] ( 52 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	606	Prognostic value of diffusion kurtosis imaging histogram based nomogram model for cervical cancer
		He Bin, Chen Wubiao, Wu Yongjun, Chen Xiaodong, Ye Ling
		Objective To analyze the prognostic value of nomogram model for cervical cancer based on the imaging features of diffusion kurtosis imaging (DKI) histogram. Methods The DKI and clinical data of 272 patients with cervical cancer who were admitted to Affiliated Hospital of Guangdong Medical University from March 2015 to February 2022 were collected and retrospectively analyzed. All patients were randomly divided into the training group (n=190) and validation group (n=82) at a ratio of 7 vs. 3. The parameters of DKI histogram were obtained by GE AW 4.2 MRI software. The best prognostic imaging features were screened by LASSO regression. The DKI radiomics score was calculated by linear combination. The independent risk factors of prognosis were identified by univariate and multivariate regression analyses, and a nomogram model was constructed. The model discrimination was assessed by the area under the receiver operating characteristic (ROC) curve (AUC). The internal consistency of the model was evaluated by the calibration map. Results Adenocarcinoma (HR=2.496, 95%CI=1.312-4.749, P=0.005), DKI score (HR=24.087, 95%CI=6.062-95.711, P<0.001), depth of invasion ≥ 1/2 muscular layer (HR=2.277, 95%CI=1.156-4.487, P=0.017) and neutrophil to lymphocyte ratio (NLR) (HR=1.800, 95%CI=1.313-2.468, P<0.001) were the independent risk factors for prognosis of cervical cancer. The AUC of the nomogram model in the training and validation groups were 0.860 and 0.757, respectively. The calibration curve was well fitted with the 45° diagonal. The prediction results of long-term prognosis of this model were in good agreement with the actual situation. Conclusions Adenocarcinoma, NLR, DKI score and depth of invasion ≥ 1/2 muscular layer are the independent risk factors for the prognosis of patients with cervical cancer. The constructed nomogram model could reliably predict the 3-year survival rate of patients with cervical cancer.
		2023 Vol. 32 (7): 606-611 [Abstract] ( 65 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Physics·Technique·Biology

	612	Feasibility study of automatic uARC planning for esophageal cancer using simultaneous integrated boost radiotherapy
		Liang Hengpo, Tao Jinzhu, Han Qian
		Objective To compare dosimetric and radiobiological parameters between automatic and manual uARC plans in the treatment of esophageal cancer patients, aiming to provide reference for clinical application. Methods High-quality uARC plans of 100 patients with esophageal cancer were selected, and the mean values of the dosimetric parameters in the target area and organs at risk (OAR) were counted, and the goal table of uRT-TPOIS intelligent plan was established. Automatic and manual uARC plans were generated with UIH (United Imaging) treatment planning system (TPS) for 21 esophageal cancer patients. The differences in mean dose (D_mean), approximate minimum (D_98%) and maximum (D_2%) dose of planning target volume (PTV), homogeneity index (HI) and conformity index (CI), dose of OAR, mean planning time, monitor unit (MU), tumor control probability (TCP) and normal tissue complication probability (NTCP) were compared between automatic and manual uARC plans. Normally distributed data between two groups were compared by paired t-test, and non-normally distributed data were assessed by nonparametric Wilcoxon test. Results The D_98%(PTV_{60 Gy}: P<0.001, PTV_{54 Gy}: P=0.001) , CI (PTV_{60 Gy}: P<0.001, PTV_{54 Gy}: P=0.002) and target volume of area covered by prescription dose (V_{54 Gy}: P<0.001) of the automatic uARC plans were better than those of manual uARC plans (all P<0.05). There was no significant difference in D_mean or HI between the two plans [PTV_{54 Gy} (59.32±1.87) Gy vs. (59.13±1.64) Gy, (0.19±0.02) vs. (0.18±0.02), all P>0.05]. The D_mean and D_max of spinal cord of the automatic plan were better than those of the manual plan [(13.22±4.27) Gy vs. (13.75±4.44) Gy, P=0.020 and (36.99±1.67) Gy vs. (38.14±1.31) Gy, P=0.011]. There was no significant difference in the mean dose of V_{20 Gy} of the lung between two plans (P>0.05), whereas the mean doses of V_{5 Gy}and V_{10 Gy} of the lung of the manual plan were less than those of the automatic plan ( both P<0. 001). Automatic uARC plan had a significantly shorter mean planning time than manual uARC plan [(11.79±1.71) min vs. (53.36±8.23) min, P<0.001]. MU did not significantly differ between two plans [(762.84±74.83) MU vs. (767.41±80.63) MU, P>0.05]. The TCP of the automatic plan was higher than that of the manual plan (PTV_{60 Gy} 89.15%±0.49% vs. 86.75%±6.46%, P=0.004 and PTV_{54 Gy} 79.79%±3.48% vs. 77.51%±5.04%, P=0.006). However, manual plan had a lower NTCP of the lung than automatic uARC plan (0.46%±0.40% vs. 0.35%±0.32%, P<0.001). There was no significant difference in NTCP of heart and spinal cord between two plans (all P>0.05). Conclusion It is feasible to generate automatic uARC plan with uRT-TPOIS TPS for esophageal cancer patients, which can increase the target CI and shorten the plan design time.
		2023 Vol. 32 (7): 612-619 [Abstract] ( 56 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	620	Prediction model of radiation pneumonitis after chemoradiotherapy for esophageal cancer based on dosiomics
		Bai Xue, Yang Jing, Zhuang Lei, Zhang Danhong, Chen Ying, Du Xianghui, Sheng Liming
		Objective To study the risk factors and prediction model of radiation pneumonitis (RP) after radical chemoradiotherapy for locally advanced esophageal cancer based on dosiomics. Methods Clinical data of 105 patients with esophageal cancer undergoing radical chemoradiotherapy at Zhejiang Cancer Hospital between January 2020 and August 2021 were retrospectively analyzed. RP was scored using the National Cancer Institute's Common Terminology Criteria for Adverse Events version 5.0 (CTCAE 5.0). Clinical factors, traditional dosimetric features and dosiomics features were collected, respectively. The features for predicting PR were analyzed by limma package. Support vector machine, k-nearest neighbor, decision tree, random forest and extreme gradient boosting were used to establish the prediction model, and the ten-fold cross-validation method was employed to evaluate the performance of the model. The differences of this model when different features were chosen were analyzed by delong test. Results The incidence of RP in the whole group was 21.9%. One clinical factor, 6 traditional dosimetric features and 42 dosiomics features were significantly correlated with the occurrence of RP (all P<0.05). Support vector machine using linear kernel function yielded the optimal prediction performance, and the area under the receiver operating characteristic (ROC) without and with dosiomics features was 0.72 and 0.75, respectively. The models established by support vector machine, random forest and extreme gradient boosting were significantly different with and without dosiomics features (all P<0.05). Conclusion The addition of dosiomics features can effectively improve the performance of the prediction model of RP after radiotherapy for esophageal cancer.
		2023 Vol. 32 (7): 620-625 [Abstract] ( 51 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	626	Effect and mechanism of ionizing radiation on ferroptosis in mouse hepatocytes
		Zhou Yali, Xu Jie, Li Ming, He Yang
		Objective To investigate the effect and mechanism of ionizing radiation on ferroptosis in mouse hepatocytes. Methods Twenty-four C57BL/6J mice were divided into two groups by random number table method: healthy control group (control group, n=6) and irradiation group (whole liver was irradiated with a single dose of 30 Gy X-ray, n=18). Mice were sacrificed at 6, 24 and 72 h (6 mice per time point) after irradiation to obtain liver tissue and plasma samples. The contents of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in plasma were measured by automatic biochemical analyzer. The prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured by automatic biochemical analyzer. Pathological changes of liver tissues were observed by hematoxylin-eosin (HE) staining. The iron deposition in liver tissues was detected by Prussian blue staining. The expression levels of 4-Hydroxynonenal (4HNE) and hepcidin in the liver were determined by immunohistochemical staining, and quantitative analysis was performed. Plasma malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, total antioxidant capacity (T-AOC) and glutathione (GSH) content were determined by microplate reader analysis according to the kit instructions. The expression levels of transferrin receptor 1 (TfR1), p53, solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) in the liver were measured by Western blot. Results Compared with the control group, the plasma contents of ALT (t=5.15, 5.47, both P<0.001) , AST at 6 and 24 h after irradiation were increased (t=8.42, 2.50, both P<0.001), the plasma PT was prolonged (t=3.12, P=0.011) and the APTT was shortened (t=3.26, P=0.009) at 72 h after radiation in the irradiation group. Histopathological results showed that evident liver edema was observed at 6, 24 and 72 h after irradiation (t=9.58, 10.09, 18.70, all P<0.001). Different degrees of iron deposition were observed (t=8.57, 15.31, 32.11, all P<0.001). The infiltration of hepcidin positive cells was significantly increased after irradiation (t=5.36, 13.17, 17.11, all P<0.001). The number of 4HNE positive cells was significantly increased (t=18.86, 22.67, 9.12, all P<0.001). At the same time, ionizing radiation induced a significant increase in plasma MDA content (t=4.36, 7.47, 8.22, all P<0.001), and a decrease in SOD (t=4.52, 5.80, 7.60, all P<0.001), T-AOC (t=13.24, 20.49, 24.96, all P<0.001) and GSH (t=2.78, 6.07, 11.25, P=0.020, <0.001, <0.001), respectively. The expression level of TfR1 protein was significantly up-regulated (t=3.46, 5.40, P=0.026, 0.006), whereas that of GPX4 protein was significantly down-regulated (t=11.88, 30.63, both P<0.001) at 24 and 72 h after irradiation. At 6, 24 and 72 h after irradiation, the expression level of p53 protein was significantly up-regulated and maintained at a high level (t=7.84, 4.25, 8.22, P=0.001, 0.013, 0.001), while that of SLC7A11 protein was significantly down-regulated (t=9.29, 19.96, 9.09, all P<0.001). Conclusion Ionizing radiation induces the ferroptosis in hepatocytes, and its mechanism may be related to the activation of p53-SLC7A11-GPX4 pathway.
		2023 Vol. 32 (7): 626-632 [Abstract] ( 47 ) [HTML 1KB] [ PDF 0KB] ( 0 )

Review Articles

	633	Clinical application and prospect of SBRT in treatment of oligo-metastatic NSCLC
		Fang Min, Du Xianghui, Lai Xiaojing
		The rapid progress on immunotherapy and targeted therapy has brought long-term survival benefits for locally advanced non-small cell lung cancer (NSCLC). The oncology community has also paid more attention to the local treatment for advanced NSCLC, especially for patients with limited metastatic lesions, also known as oligo-metastasis. Many studies have reported that oligo-metastatic NSCLC patients could benefit from the combination of local and systematic treatment, and even to be cured. In recent years, with the advances in radiation technology, stereotactic body radiation therapy (SBRT) has achieved precise high-dose radiotherapy for small target tumors. Currently, SBRT has been widely applied in the treatment of inoperable early lung cancer, and its application value and safety in patients with advanced lung cancer are also being actively explored. In this article, the research status, progress and future development direction of SBRT in the treatment of oligo-metastatic NSCLC were discussed.
		2023 Vol. 32 (7): 633-637 [Abstract] ( 90 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	638	Research progress on neoadjuvant immunotherapy for esophageal cancer
		Yi Liang, Huang Hui, Yuan Zhiyong, Zhang Wencheng
		Neoadjuvant therapy, especially neoadjuvant chemoradiotherapy, has become the standard preoperative treatment for locally advanced resectable esophageal cancer, whereas the recurrence and distant metastasis rates after surgery remain high. In recent years, programmed cell death protein 1 (PD-1) / programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors have been widely adopted in immunotherapy for cancer. Whether PD-1/PD-L1 immune checkpoint inhibitors combined with neoadjuvant chemotherapy / neoadjuvant chemoradiotherapy could further improve clinical efficacy, increase the complete surgical resection rate and safety are current research hotspots. In this article, neoadjuvant immunotherapy combined with chemotherapy / radiochemotherapy for esophageal cancer was reviewed.
		2023 Vol. 32 (7): 638-643 [Abstract] ( 59 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	644	Radiotherapy strategy for advanced esophageal cancer
		Tian Yuanyuan, Lei Jun, Chen Yongshun
		Advanced esophageal cancer accounts for a large proportion of all esophageal cancer cases, and the treatment modality recommended by the current guidelines is systemic treatment. Radiotherapy is an important treatment option for malignant tumors, which is widely applied in clinical practice. Retrospective analysis and small-sample prospective studies have shown that combination of radiotherapy with chemotherapy, targeted therapy, and immunotherapy has the advantages of improving disease control rate, symptom remission rate and prolonging survival of advanced esophageal cancer patients. Therefore, it is an important clinical topic issue to make better use of the advantages of radiotherapy for esophageal cancer, such as rapid relief of symptoms, durable efficacy, and stimulation of immune neoantigens, etc. To optimize the treatment strategy of advanced esophageal cancer, the radiotherapy strategy for esophageal cancer with oligometastases or multiple metastases, and the screening method for the eligible population for radiotherapy were reviewed, aiming to provide reference for improving the status of radiotherapy in comprehensive treatment of advanced esophageal cancer.
		2023 Vol. 32 (7): 644-650 [Abstract] ( 58 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	651	Advances in synergistic treatment of radiotherapy and chimeric antigen receptor T cell therapy for refractory / relapsed diffuse large B-cell lymphoma
		Yang Yun, Sun Weikai
		Chimeric antigen receptor T (CAR-T) cell therapy is one of the most significant advances in cancer treatment in the last few decades, revolutionizing the treatment paradigm for patients with refractory / recurrent diffuse large B-cell lymphoma (R/R DLBCL) and effectively improving the survival rate of these patients. However, due to the high incidence of grade III-IV side effects of CAR-T cell therapy and the fact that some patients did not obtain remission after CAR-T cell therapy or developed rapid disease progression within a short period of time, researchers are attempting to explore combined therapies, such as chemotherapy, radiotherapy and immunotherapy, to reduce the incidence of side effects and prolong the duration of persistent remission in patients. Among these options, radiotherapy in combination with CAR-T cell therapy have been proven to improve clinical prognosis. In this article, the theoretical basis of synergistic treatment of radiotherapy and CAR-T cell therapy in patients with R/R DLBCL, the safety and efficacy of radiotherapy, the sequence of radiotherapy and CAR-T cell therapy, and the dose of the target area of radiotherapy were reviewed, aiming to provide more evidence for the application and optimization of radiotherapy combined with CAR-T cell therapy for R/R DLBCL.
		2023 Vol. 32 (7): 651-656 [Abstract] ( 51 ) [HTML 1KB] [ PDF 0KB] ( 0 )

	657	Mechanism of the effect of arginine on radiosensitization of metastatic brain tumors
		Liu Xueping, Jiang Yu, Wang Ruisi, Li Xiaochun, Tan Bangxian
		Brain metastases are the most common intracranial malignancies, and radiotherapy is an effective treatment of controlling the localized lesions. However, conventional radiotherapy techniques have their own shortcomings that limit the effectiveness of radiotherapy. Metastatic brain tumors are highly likely to recur or progress after treatment. Clinical studies have shown that arginine can penetrate the blood-brain barrier and subsequently improve the radiosensitization of metastatic brain tumors. In this article, the mechanisms underlying the effect of arginine on the radiosensitization of metastatic brain tumors by inhibition of tumor glycolytic metabolism, reduction of DNA damage repair and alteration of tumor hemodynamic parameters were reviewed, aiming to provide new ideas for clinical research and treatment of brain metastases.
		2023 Vol. 32 (7): 657-662 [Abstract] ( 49 ) [HTML 1KB] [ PDF 0KB] ( 0 )

中华放射肿瘤学杂志

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