Objective To acquire,evaluate and integrate the best evidence of perioperative exercise interventions in patients with liver cancer and provide evidence-based references for clinical medical staff.Methods Following the"6S"Evidence Resource Pyramid model,literatures in perioperative exercise interventions published between January 2010 and June 2022 were retrieved from various databases,including BMJ Best Practice,UpToDate,Guidelines International Network,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Medlive,Cochrane Library,JBI,Web of Science,PubMed,Embase,CINAHL,CNKI,SinoMed,Wanfang Data,American Cancer Society,American College of Sports Medicine and International Liver Cancer Association from January 2010 to June 2022.Two researchers evaluated the quality of the retrieved literatures and extracted evidences that met the inclusion criteria.Results A total of 22 articles were included,yielding 26 pieces of evidence across seven themes:the necessity of exercise,evaluation before exercise,preoperative exercise program,postoperative exercise program,exercise monitoring,health education and effect evaluation.Conclusions This study provides a summary of the best evidence regarding perioperative exercise interventions in the patients with liver cancer.The findings offer valuable references for clinical healthcare providers to deliver evidence-based care for the patients with liver cancer.

Objective:To provide a basis for selecting the optimization method for intracavitary/interstitial brachytherapy (IC/ISBT) of cervical cancer by comparing graphical optimization (GO), inverse planning simulated annealing (IPSA), and hybrid inverse planning optimization (HIPO) using dosimetric and radiobiological models.Methods:This study selected 65 patients with cervical cancer who were treated with image-guided IC/ISBT. The afterloading therapy plans for these patients were optimized using GO, IPSA, and HIPO individually, with a prescription dose high-risk clinical target volume (HRCTV) D90 of 6 Gy. The non-parametric Friedman test and the non-parametric Wilcoxon rank test were employed to analyze the differences in duration, dose-volume parameters, and radiobiology between the three types of optimized plans. Results:Inverse planning optimization (IPSA: 46.53 s; HIPO: 98.36 s) took less time than GO (135.03 s). In terms of gross target volume (GTV) dose, the high-dose irradiation V150% (53.66%) was slightly higher in the HIPO-optimized plans, while the V200% (30.29%) was higher in the GO-optimized plans. The GO-optimized plans had a higher conformity index (CI; 0.91) than other plans, showing statistically significant differences. Compared with other plans, the HIPO-optimized plans showed the lowest doses of D1 cm 3 and D2 cm 3 at bladders and rectums and non-statistically significant doses at small intestines ( P > 0.05). In terms of the equivalent uniform biologically effective dose (EUBED) for HRCTV, the HIPO-optimized plans showed a higher value (12.35 Gy) than the GO-optimized plans (12.23 Gy) and the IPSA-optimized plans (12.13 Gy). Moreover, the EUBED at bladders was the lowest (2.38 Gy) in the GO-optimized plans, the EUBED at rectums was the lowest (3.74 Gy) in the HIPO-optimized plans, and the EUBED at small intestines was non-significantly different among the three types of optimized plans ( P = 0.055). There was no significant difference in the tumor control probability (TCP) predicted using the three types of optimized plans ( P > 0.05). The normal tissue complication probabilities (NTCPs) of bladders and rectums predicted using the HIPO-optimized plans were lower than those predicted using the GO- and IPSA-optimized plans( χ2 = 12.95-38.43, P < 0.01), and the NTCP of small intestines did not show significant differences ( P > 0.05). Conclusions:Among the three types of optimization algorithms, inverse optimization takes less time than GO. GO-optimized plans are more conformal than IPSA- and HIPO-optimized plans. HIPO-optimized plans can increase the biological coverage dose of the target volume and reduce the maximum physical/biological exposure and NTCP at bladders and rectums. Therefore, HIPO is recommended preferentially as an optimization algorithm for IC/ISBT for cervical cancer.

Cancer-associated fibroblasts (CAF) represent a crucial and abundant group of stromal cells in the tumor microenvironment (TME) and are effective targets for anti-tumor therapy. CAFs exhibit high heterogeneity and plasticity, which play a pivotal role in tumor initiation, progression, immune evasion, and therapy resistance. Radiotherapy (RT) is a fundamental treatment modality for malignant tumors that can reshape the TME through various mechanisms. Following RT, CAFs undergo a series of phenotypic changes and interact with multiple cells in the TME, promoting radioresistance and immune evasion through multiple pathways, such as enhancing tumor cell proliferation, modulating immune response, inducing angiogenesis, remodeling extracellular matrix, and reprogramming metabolism, etc., thereby affecting therapeutic effect. Targeting CAFs in combination with RT can improve anti-tumor efficacy and prognosis. In this article, research progress in CAFs in tumor RT was reviewed.

Brain metastasis is the most common intracranial tumor in adults. Radiotherapy is one of the most important treatments, in addition to drugs, surgery, and other treatments. In recent years, rapid development of targeted therapy and radiosurgical technology has transformed the treatment mode of brain metastases, with increasing emphasis on individualized treatment. However, the mode of radiotherapy in patients with driver gene-positive remains controversial. In this article, the advances in the timing of radiotherapy for brain metastases were reviewed.

Objective:To investigate the manpower allocation and scientific research level of radiotherapists in radiotherapy units in mainland China, aiming to provide reference for the construction of radiotherapist teams.Methods:The questionnaire was designed and produced by the organizer, released in the professional committee, professional group and other channels of the radiotherapist industry, and filled out by the technical person in charge of the radiotherapy unit through the online questionnaire survey. The collection time started from mid-May 2021 to mid-June 2021.Results:A total of 558 effective questionnaires filled out by radiotherapy units. The radiotherapy institutions participating in the survey had a total of 5500 radiotherapists, including 3702 males and 1798 females, 3754 with a bachelor's degree, 371 who are currently studying or have obtained a master's degree, 21 who are currently studying or have already obtained a doctoral degree, 3642 with junior or lower titles, 1580 with intermediate titles, and 278 with senior titles. In 2020, radiotherapists from 193 units published articles, those from 81 units received project funding, and those from 56 units obtained patent authorization, and those from 15 units had scientific research transformation. The participating units had a total of 1080 large-scale radiation therapy equipment. In 2020, the daily average number of radiotherapy patients was 47 900, the average daily load of accelerator patients was 44.35, and the average workload index per capita was 8.71. The average daily radiotherapy patients in county-level or below, city-level, and provincial-level institutions were 25.78, 65.68, and 173.76, respectively, and the per capita workload index was 5.22, 8.09, and 10.11.Conclusions:Compared with the 2019 survey, the educational background of radiotherapists in mainland China has been improved, and the title structure has been optimized to a certain extent, and the workload of large-scale radiotherapy units is larger than that of grass-roots units.

Objective To explore the association between prognostic nutritional index(PNI) and prognosis of nasopharyngeal carcinoma (NPC) patients before radiochemotherapy.Methods A total of 153 newly diagnosed NPC patients in Sichuan Cancer Hospital were retrospectively reviewed.The hematological parameters and clinical characteristics before radiochemotherapy were collected,and the follow up for these patients was conducted.The effects of pretreatment hematological parameters and PNI on overall survival were analyzed with Kaplan-Meier method.The variables identified as statistically significant differences were further analyzed with multivariate Cox regression analysis.Results The 3,5 and 10-year overall survival were 89.54％,83％ and 75.16％.Both PNI and white blood cell count (WBC) before radiochemotherapy were the independent prognostic indicators for NPC in Cox regression analysis.The 3,5 and 10-year overall survival of NPC in PNI ≤49.45 group were lower than those of PNI ＞ 49.45 group.Conclusion PNI and WBC should be the independent prognostic indicators for NPC and closely relate to overall survival of NPC patients.

Objective To investigate the application value of a transmission reference stealth ionization chamber in the relative dosimetry of stereotactic radiotherapy.Methods The relative dosage of Varian (R) Novalis 6 MV photon rays equipped with Brainlab (R) conical applicators was determined by two different approaches in the IBA (R) Blue Phantom.One approach was designed to utilize IBA (R) SFD3G semiconductor ionization chamber alone in the "step by step" measurement mode,whereas the other method was to utilize IBA (R) SFD as the field detector combined with stealth ionization chamber as the reference detector in the "continuous" measurement mode.The central axial percentage depth dose (PDD) and off axis ratio (OAR) in a diameter of 4 and 15 mm were measured and the time spent on each measurement was recorded.Results The PDDs at the central axis and OARs at a depth of 10 cm for both conical applicators were in good agreement between the two measurement approaches with a dose difference of＜ 1％.The time spent on PDDs and OARs measurement with stealth ionization chamber was shortened by 13.1％ and 20.7％ compared with those without Stealth ionization chamber.Conclusion Stealth ionization chamber can be applied in the retative dosimetry of stereotactic radiotherapy with high dose accuracy and high efficiency.

Objective To study the patient movements features during radiotherapy . Methods Randomly selected 120 patients treated in our hospital from February to July on 2016,including 60 thorax treatment and 60 abdomen treatment. The movement data of patient treatment location during radiotherapy treatment was real time monitored by using Sentinel system,movement features of patient′s location during radiotherapy was analyzed. Paired t-test difference. Results During radiotherapy,patient′s treatment location movement types and proportion were motionless type 14. 0%,Moving stable type 64. 0%,Jumping type 8. 7%,increasing type 13. 3%.Patients with thoracic and abdominal radiotherapy,the maximum deviation of IMRT and VMAT treatment were (6.55±2. 34) mm and (4.97±1. 24) mm (P = 0. 002),(3.97±1. 80) mm and (2.69± 1. 42) mm (P = 0. 004).In single treatment,the deviation value of the patient′s treatment location increased gradually with the treatment time increasing and the deviant of thoracic is greater than abdominal at the same time after the treatment beginning. Conclusions Patient′s treatment location movement during radiotherapy is commonly exist,using the technology of VMAT treatment can effectively reduce the treatment site movement of the patient during the treatment and ensure the accuracy of dose.

Objective To prepare PLGA microparticles loaded with Iron oxide (PLGA/IO MPs) and explore their feasibility of the rat tendon stem cells (TSCs) labeled with the particles and the multimodal imaging of Ultrasonic (US)/Photoacoustic (PA)/Magnetic resonance (MR) in vitro. Methods The PLGA/IO MPs were prepared using double emulsification,and physical and chemical properties were tested and US/PA/MRI imaging was performed.The TSCs were labeled with PLGA/IO MPs,and transmission electron microscopy (TEM) and prussian blue staining were performed to test labeling effects,then the US, PA and MRI imaging of labeled TSCs were performed. Results The diameter and Zeta potential of prepared PLGA/IO MPs were ( 801.5 ± 165.6) nm and (6.36 ± 3.36) mV [the Zeta potential of microparticles which including poly-L-Lysine(PLL) was about (3.16 ± 3.69)mV],respectively.PLGA/IO MPs could be imaged by US/PA/MRI multimodal imaging. After labeling,the PLGA/IO MPs were distributed in cytoplasm of labeled TSCs which could be imaged by US,PA,MRI simultaneously. Conclusions The TSCs can be labeled with PLGA/IO MPs effectively,and imaged by using multimodal US/PA/MRI imaging in vitro,which will lay foundation for noninvasive and multimodal tracking of transplanted TSCs in vivo.

The TNM staging system is an essential standard for cancer treatment and evaluation, and is used to assess a patient''s prog-nosis. Therefore, every update made to the system is of great significance. According to the recently released edition of the American Joint Committee on Cancer (AJCC) Staging Manual, several major changes to head and neck cancer staging have been made. In this pa-per, we analyze the advantages and disadvantages of these amendments and offer a direction for making future amendments. Our goal is to provide a brief introduction of recent research on head and neck cancers, which can be used as a reference by clinicians.