Objective To investigate the patterns of intrathoracic lymph node metastasis in nonsmall cell lung cancer (NSCLC) and to provide a theoretical basis for the delineation of radiotherapy target volume.Methods A retrospective analysis was performed on the clinical data of 314 NSCLC patients after operation.Our focus was to investigate the distribution characteristics and metastatic extent of intrathoracic lymph nodes and their relationship with tumor size,pathological type,and primary site.Comparisons between groups were made by one-way analysis of variance.Results The frequencies of metastases to lymph nodes at stations 4,5,7,10,and 11 were all above 12％,while those at stations 1,2,3,6,8,and 9 were all below 12％.The lymph node metastasis rate was similar on the primary tumor site (P =0.102).The patients with T3 and T4 NSCLC had a significantly higher frequency of N2 lymph node metastasis than those with T1 and T2 NSCLC (17.0％ vs.11.6％,P =0.002) ;the patients with adenocarcinoma had a significantly higher frequency of N2 lymph node metastasis than those with squamous cell carcinoma (34.5 ％ vs.23.2％,P =0.008).Conclusions For patients with T3 and T4 NSCLC of adenocarcinoma subtype,we should highlight the lymph nodes at stations 4,5,7,10,and 11 when delineating the radiotherapy target volume after operation.

Objective To evaluate the feasibility of 153　Sm-EDTMP for multiple bone metastasis.Methods 32 patients with multiple bone metastases were treated with 153　Sm-EDTMP injected into the veins,0.4～1.0 mci/kg,of which 7 cases received therapy for 2～3 times.Results 53.1%(17/32)was relieved completely,25.0%(8/32)was relieved partially and 9.4%(3/32)was relieved slightly.No effects were found in 12.5%(4/32).The overall effective rate was 78.1%.Side effects that were the decreasing of WBC and PLT were found in 15.6%(5/32),which rose to the preoperative levels within 6～8 weeks.Conclusion Internal radiotherapy with 153　Sm-EDTMP is safe and effective in the treatment of multiple bone metastases.

Objective To evaluate the feasibility of 153 Sm EDTMP for multiple bone metastasis.Methods 32 patients with multiple bone metastases were treated with 153 Sm EDTMP injected into the veins,0.4～1.0 mci/kg,of which 7 cases received therapy for 2～3 times.Results 53.1%(17/32)was relieved completely,25.0%(8/32)was relieved partially and 9.4%(3/32)was relieved slightly.No effects were found in 12.5%(4/32).The overall effective rate was 78.1%.Side effects that were the decreasing of WBC and PLT were found in 15.6%(5/32),which rose to the preoperative levels within 6～8 weeks.Conclusion Internal radiotherapy with 153 Sm EDTMP is safe and effective in the treatment of multiple bone metastases.

Objective This study was to investigate the lymph node metastasis pattern in thoracic esophageal squamous cell carcinoma (ESCC),and analyze the risk factors to provide reference for the delineation of radiotherapy target.Methods A total of 319 patients with thoracic ESCC who underwent surgical treatment at the second hospital of Dalian medical university were analyzed retrospectively.The lymph nodes around esophageal were divided into 20 groups according to the mapping scheme of the American Thoracic Society (ATS) modified by Casson et al.Analyzed the pattern of lymph node metastasis and its relationship with tumor location,tumor length,depth of invasion,pathological grade,and vessel invasion.Results The lymph node metastatic rate was 48.90％ (156/319),while the metastatic ratio of lymph node (LMR) was 15.70％ (562/3 581).The lymph node metastatic rates had gradually increasing trend with tumor sites descending (upper ESCC 35.48％,middle ESCC 47.06％ and lower ESCC 56.43％),but no statistically significance (P ＞ 0.05) was observed.In the whole 20 groups,the higher node metastasis stations of upper thoracic ESCC LMR were 1,2,4,5,7,9 (x2 =27.38,P ＜ 0.05),while the middle thoracic ESCC LMR were 2,4,5,7,8M (x2 =57.77,P ＜ 0.05),and the lower thoracic ESCC LMR were 4,5,7,8L,16,17,20 (x2 =28.88,P ＜ 0.05),with statistically significance.So the main lymph node metastasis stations were paraesophageal nodes,tracheobronchial nodes,paratracheal nodes,aroticopumonary nodes,left gastric nodes,subcarinalnodes and celiac nodes.The univariate analysis revealed that lymph node metastasis was correlated with the tumor length,depth of invasion,pathological grade,and presence of vascular invasion (x2 =6.82,26.04,36.26,4.56respectivcly,P ＜ 0.05).The muhi-variate regression analysis showed that tumor length and depth of tumor invasion were independent risk factors for lymph node metastasis (OR =2.212,2.123,P ＜ 0.05).Conclusions The factors influencing lymph node metastasis in thoracic ESCC include tumor length,depth of invasion,pathological grade,and presence of vascular invasion,which should be carefully considered during the target delineation of radiotherapy for esophageal carcinoma.

Breast cancer is a malignant tumor with strong invasiveness, strong metastasis and high recurrence rate. Breast cancer cells can be transferred to different tissues in a variety of ways. Breast cancer cells can spread because of the tumor microenvironment created by tumor interaction with surrounding cells. This review examines the role and mechanisms of the tumor microenvironment in breast cancer cell metastasis in recent years, including adipocytes, fibroblasts, neuroendocrine cells, immune and inflammatory cells, blood and lymphatic network, and extracellular matrix, as well as how to treat breast cancer metastasis.

Objective To study the short-term efficacy of computed tomography (CT)-guided iodine-125(125I) radioactive seed implantation in the treatment of hypoxic tumors.Methods Twenty-two patients treated with 125I radioactive seed implantation in our department from 2014 to 2016 were divided into hypovascular tumor group (hypoxic group,n =12) and hypervascular tumor group (non-hypoxic group,n=10) based on the hemodynamics of solid tumor evaluated by color Doppler ultrasound.The enhanced CT images were loaded to the three-dimensional particle implantation planning system for preoperative planning.After 125I radioactive seed implantation,the D90 for target volume was verified to be 106-128 cGy.Treatment outcomes were evaluated according to the World Health Organization criteria at 1-3 months after surgery.Results In all the patients,the overall response rate was 82％ at 3 months after surgery.There were no significant differences in response (complete response + partial response) rates at 1,2,or 3 months after surgery between the hypoxic group and the non-hypoxic group (P=0.840,0.696,0.840).Conclusions In the treatment of solid malignant tumor,125I radioactive seed implantation can overcome the resistance of hypoxic tumor to radiotherapy in vitro and achieve satisfactory short-term efficacy.