1.Prediction for radiation pneumonia in patients with esophageal carcinoma or lung cancer
Zhonghua LU ; Juying ZHOU ; Xiyuan XU ; Jianhua WANG
Chinese Journal of Radiation Oncology 1992;0(04):-
Objective To prospectively study the relation between transforming growth factor beta-1 (TGF-?_1), V_(20) and lung function (PFTs) and radiation pneumonia (RP), as well as to set up a prediction model of RP. Methods From Jan 2004 to Dec 2005, 121 valid patients with esophageal carcinoma or lung cancer were treated with conventional thorax radiotherapy(RT) by 15 MV X-ray beams to a total D_T 60-68 Gy over 30-34 fractions in 42-46 days. All patients received chest CT scanning before RT. Dose volume his- togram(DVH) and V_(20) were obtained through 3-dimensional TPS. Serum TGF-?_1 and PFTs of the patients were measured both before and after RT as well as on the 20th day after the beginning of RT. RP was diag- nosed basing on contrasted CT and clinical symptoms. Results RP was diagnosed in 32 of all 121 pa- tients. The results of Logistic Regression Statistic showed that V_(20) and TGF-?_1 ratio (after RT/before RT) significantly influenced the incidence of RP. Patients with V_(20)≥30% had more RP than patients with V_(20)
2.Preliminary study on proteomic technique in radiobiological characteristics in nasopharyngeal carcinoma cell line
Hui WANG ; Yisong LIU ; Liang ZENG ; Xuping XI ; Bingqiang HU ; Songping LIANG
Chinese Journal of Radiation Oncology 1992;0(04):-
Objective To examine the variation of protein expression in nasopharyngeal carcinoma cell lines with different biological characteristics and to identify the radiobiological associated proteins. Methods Biological characteristics of 5-8F and 6-10B were compared by flow cytometry assay after irradia- tion. The total proteins of 5-8F and 6-10B were separated by immobilized pH gradient(IPG) IEF-SDS two- dimensional gel electrophoresis technique. The differentially expressed proteins were cut from the gel and di- gested into peptides for MALDI-TOF MS and the Q-TOF mass spectrometric analysis. Identification of pro- tein was made through searching in protein sequence database. Protein expressions were examined by western blot and immunohistochemistry method. Results Nine most differentially expressed proteins between 5-8F cell and 6-10B cell were identified, p73 and CK19 expression examined by western blot were conformal with that by proteomic method, p73 expression in 5-8F cell was higher than in 6-10B cell. CK19 expression in 6- 10B cell was higher than in 5-8F cell. Conclusion Differentially expression of proteins exist in nasopha- ryngeal carcinoma cell lines with different biological characteristics. These proteins may be associated with cell radiobiological characteristic with the p73 as a potential biomarker.
3.Dose-volummetrics in the prediction of pulmonary function changes after radiotherapy in patients with lung cancer
Ying LI ; Shuchai ZHU ; Yankun CAO
Chinese Journal of Radiation Oncology 1992;0(04):-
Objective To study the correlation between dose-volummetrics and changes of pulmona- ry function tests(PFTs), and to study the ability of standard dose-volummetrics to predict these changes after radiotherapy. Methods Pulmonary function was measured in 39 patients with inoperable lung cancer one week before and 2-4 months after radiotherapy. The pulmonary function parameters were the forced vital ca- pacity(FVC), forced expiratory volume in ls (FEV 1.0) and diffusion capacity of carbon monoxide(DL- CO). Dose-volumrnetrics were V_(10), V_(15), V_(20), V_(25), V_(30), V_(35), V_(40), CTV_(100), CTV_(95), CTV_(90), CTV_(80), lung D_(mean), V_(eff) and NTCP. Pearson and line regression analysis was performed to determine whether the correlation exis- ted between the metrics and the changes of PFTs. Results No correlation was found between the dose- volummetrics and the changes in PFTs. Excluding patients(n=15) with pretreatment atelectasis, signifi- cant correlation was found between the dose-volummetrics (V_(20), V_(25), V_(30), V_(35), V_(40), GTV, V_(eff) and D_(mean)) and the PFTs changes(r=0.469-0.695, P≤0.05). Therefore, the re-expansion may have jesperdized the proper data to the present record. Multivariate analysis showed that V_(30) was the risk factor to affect the chan- ges of FEV 1.0 and DLCO(P=0.046、0.041). The pulmonary function of patients with V_(30)≥18% was worse than patients with V_(30)
4.Late course accelerated hypofractionated three-dimensional conformal radiotherapy for stageⅢnon-small cell lung cancer
Zhongzhu TANG ; Yuan ZHU ; Qinghua DENG ; Jian WANG ; Shenglin MA
Chinese Journal of Radiation Oncology 1992;0(04):-
Objective Objective To evaluate the efficacy and comphcations of late course acceler- ated hypofractionated three dimensional conformal radiation therapy (3DCRT) for patients with stageⅢnon small cell lung cancer (NSCLC). Methods Sixty patients with stageⅢNSCLC were randomized into 2 groups: Late course accelerated hypofractionated 3DCRT group(group A—30 patients) and conventional fractionated radiation therapy group (group B—30 patients). In group A, 30 patients, at first, received a dose of 40 Gy at 2 Gy per fraction, 5 times a week, which followed by late course accelerated hypofractionat- ed 3DCRT with a dose of 16-20 Gy at 4 Gy per fraction, 3 times a week. In group B, 30 patients received a dose of 60-66 Gy at 2 Gy per fraction, 5 times a week. Chemotherapy, including vinorelbine and cisplatin, was given one cycle during radiotherapy and 3 cycles after radiotherapy for all patients. Results Group A had a higher complete response rate (47% vs 20%, P
5.Impact of lymph node micrometastasis for the UICC stage in non-small cell lung carcinoma
Weiwei OUYANG ; Bing LU ; Chang HE ; Yiguo LONG ; Ping WANG
Chinese Journal of Radiation Oncology 1992;0(04):-
Objective To detect cytokeratin in routine pathology negative regional lymph nodes postoperatively in non-small cell lung carcinoma (NSCLC). To investigate the relationship of lymph node micrometastasis in P-TNM stages NSCLC and survival rates. Methods From Jan. 1996 to Dec. 2003, 107 paraffin-embedded specimens of T1-T4N0-N1M0 NSCLC patients were collected. Anti-cytokeratin(CK) an- tibody AE1/AE3 was applied to detect cytokeratin with Envision~(TM) method in routine pathological negative re- gion lymph nodes in NSCLC, and selected negative control, positive control and blank control. The pulmo- nary hilar lymph node micrometastasis was upward regulated with stage pCK-N1, mediastinal lymph node mi- crometastatsis was upward regulated with stage pCK-N2. The result applied to SPSS11.0 software to process. Results The CK positive rate was 29.9% in all the patients. The CK positive rate was 27% (21/78), 30% (7/23), 67% (4/6)in stage p-Ⅰ, p-Ⅱand p-Ⅲ, respectively. All these data showed the tendency by which detectable rate increased and was accompanied by disease progress. Comparing the annual survival rate and median survival time of the non-micrometastasis group with the mierometastasis group in two groups, the survival rate difference was statistically significant. Comparing the annual survival rate and median sur- vival time in pCK-ⅢA stage with p-Ⅰ-Ⅱstage, pCK-ⅢA stage annual survival rate and median survival time was significantly different (P=0.020). Similarly, comparing the survival rate in pCK-ⅡB stage with p-ⅠB stage, pCK-ⅡB stage survival rate was significantly different(P=0.059). Comparing the survival time of pCK-ⅢA stage with p-Ⅲstage, pCK-ⅡB stage, with p-ⅡB stage, euther survival time difference was statistically significant (P=0.838, 0.518). Conclusions The rate of positive cytokeratin increase is ac- companied by the disease progress in NSCLC. Positive cytokeratin has disadvantagious prognosis. It is showed that pCK-N1 may be equal to p-N1 and pCK-N2 which also may be equal to p-N2. Micrometastasis may affect the UICC staging currently in use.
6.Value of ~(18)FDG PET-CT after radiotherapy in nasopharyngeai carcinoma
Qingsong PANG ; Jing WANG ; Dong DAI ; Yanjia ZHU ; Ping WANG
Chinese Journal of Radiation Oncology 2005;0(06):-
Objective To evaluate the role of 18F fluorodeoxyglucose positron emission tomography computed tomography (PET-CT) in nasopharyngeal carcinoma (NPC) after radiotherapy. Methods A total of 27 NPC patients received 18FDG PET-CT 8-32 weeks after radiotherapy. All the patients were followed up for about 12 months after the examination. Metastasis and residual were evaluated by PET-CT. The correlation between SUV and prognosis was analyzed. Results Of these 27 patients, metastasis was found in 2 patients by PET-CT. Local persistence was diagnosed as for SUV≥2. 5 by PET-CT in 20 patients, among whom 18 were confirmed by biopsy and then received brachytherapy or conformal radiotherapy. One year local control and survival rates were 70% and 81%. Based on SUV, the patients were divided into group one for SUV between 2. 5 and 5(9 patients) or group two for SUV≥5 (11 patients). In group one and group two, the one year local control rate, survival rate and metastasis rate were 67% , 55% (P=0.670) , 64% ,89%(P=0.319), and 22% , 82% (P =0. 022) , respectively. Conclusions PET-CT is valuable for the identification of residual nasopharyngeal carcinoma. SUV of residual tumor is related to metastasis.
7.Iodine-125 seed implantational radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma
Kaiyun CHEN ; Guoan XIANG ; Hanning WANG ; Fanghan XIAO
Chinese Journal of Radiation Oncology 2005;0(06):-
90 Gy . Tumor irradiation dose, the umber of tumor and liver cirrhosis were identified by Cox-regression analysis as independent predictors for survival. Two patients experienced CTC grade 1 acute hepatic toxicity and three patients experienced grade 3 acute hepatic toxicity. Two patients developed RILD. Nine patients experienced RTOG grade 1 acute gastrointestinal complication and one patient experienced acute gastrointestinal bleeding. Five patients experienced RTOG grade 1 leucopenia and five patients experienced grade 2 leucopenia. Conclusion Iodine-125 seed local radiotherapy combined with TACE is safe and effective for HCC. It is worth of further dose escalation study.
8.Cosmetic outcome and curative effect of radiotherapy for early breast cancer after conservative surgery
Changuo MA ; Yuanyuan MA ; Shuhong ZHAO ; Hong WANG
Chinese Journal of Radiation Oncology 2005;0(06):-
93% at 36 months. The local control rate was 100%. The 1- and 3-year survival rates was 100% and 98% , respectively. Conclusions Tangential field radiotherapy for early breast cancer after conservative surgery has a satisfied result in both tumor control and cosmetic outcome, which can definitely improve the life quality of the patients.
9.Three-dimensional conformal partial breast external-beam irradiation after conservative surgery of the breast
Jianbin LI ; Tingyong FAN ; Jie LU ; Zhifang MA ; Yongsheng WANG ; Qian SHAO ; Juan LIU ; Jun XIN ; Tong BAI
Chinese Journal of Radiation Oncology 2005;0(06):-
Objective To explore the methods, dosimetric features and short-term effects of partial breast irradiation carried out by three-dimensional external-beam irradiation (3DCPBI) assisted by active breathing control (ABC) . Methods Computed tomography (CT) simulation assisted by active breathing control (ABC) was carried out for each patient and intended to get CT images in condition of 75% deepest inspiration named moderate deep inspiration breath hold (mDIBH). The extent labeled by the silver slips located in the cavity was delineated as gross target volume (GTV) , GTV plus the margin of 15 mm was defined as planning target volume (PTV). 6 MV X-ray was selected as the radiation source and noncoplanar radiation with four three-dimensional conformal fields was used, the described dose was 34 Gy /10f/5d. The volume of GTV, PTV, the affected whole breast, and the percentage of PTV accounted for the affected whole breast , the percentages of PTV included by 100% , 95% and 90% isodose curve, the percentage of volume of the affected breast irradiated by 34. 0, 27. 2, 20. 4, 13. 6 and 6. 8 Gy , and Dmean,D5,V20 of the lungs and heart were calculated respectively. Acute radiation skin response was recorded and the cosmetic effect of the breast after radiotherapy were appraised, with the local tumor control and survival rate followed. Results The mean of volume ratio of PTV and affected whole breast was 14. 88% ; the mean of the volume covered by 90% isodose curve accounted for 92. 54% of the PTV; the volume irradiated by 34 Gy (100% of described dose) accounted for 17. 23% (mean) of the whole breast and 6. 8 Gy (20% of described dose) for 46. 11% , in other words, the volume covered by 20% of described dose was less than 50% of the whole breast. The Dmean, D5, V20 for the affected lateral lung were 1.97, 9. 25 Gy and 1. 58% , it was 0.20, 0. 87 Gy , and 0% for the unaffected lateral lung. The Dmean,D5, V20 for the heart was 0.65 Gy , 2. 82 Gy , and 0. 85%. Zero grade of acute radiation skin reaction was seen in 14 patients and gradel in 3 patients and there was not equal to or more than grade 2 of skin reaction for all the patients. Cosmetic effect were appeci-ated and satisfaction defined as excellent or good appearance of the irradiated breasts for all the patients. No recurrence of local tumor for all of the patients followed for one year. Therefore, the cosmetic result of 1 yr. follow - up was 100% and no recurence was found after 1 yr. follow - up. The 1-year tumor-free survival rate were all 100%. Conclusions For selected patients with early breast cancer after breast-conservative surgery, 3DCPBI assisted by ABC is feasible, however, the selection criteria for the patients, technique protocol and dose fractionation of 3DCPBI and its influence on late cosmetic effect, local tumor control and survival need to be continuously explored and observed in the future.
10.Concurrent three dimension conformal radiation therapy and chemotherapy followed by consolidation chemotherapy for locally advanced non-small cell lung cancer
Shuhong HAN ; Xiaotao ZHANG ; Zhen ZHANG ; Xuezhen MA ; Minghuan LI
Chinese Journal of Radiation Oncology 2005;0(06):-
0.05). Conclusions For patients with locally advanced non-small cell lung cancer, concurrent conformal radiotherapy and chemotherapy followed by consolidation chemotherapy can improve the progression-free survival, but have few effects on overall survival and toxicity. Multicenter clinical trial with more patients should be carried out to confirm the benefit from the additional consolidation chemotherapy.