Objective To evaluate the tumor dose distribution of routine radiotherapy plan in esophageal cancer with 3D treatment planning system. Methods For the 19 esophageal cancer patients who were diagnosed, the thoracic CT were done and GTV, CTV and PTV were delineated on the image of CT. Then a routine 3 field radiotherapy planning was produced using the Cad Plan 6.4.7 treatment planning system. The dosimetric results of GTV, CTV and PTV, target conformity and the dosimetric uniformity of variant target volume gained from DVH were compared. Results The maximal dose of GTV, CTV and PTV was 51.64Gy, 51.94Gy, 51.48Gy, respectively; the minimal dose was 41.17 Gy, 25.31 Gy, 18.94 Gy, respectively; the mean dose was 49.5 Gy, 47.34 Gy, 42.92 Gy, respectively; the conformity index was 0.94, 0.69, 0.38, respectively; and the dose variability was 2.2 Gy, 7.57 Gy, 14.56 Gy. Conclusions The routine radiotherapy plan in esophageal cancer could not offer satisfactory dose distribution. The method of CT simulation and 3D treatment planning systems should be applied to decide treatment planning.

Objective To compare the dose distribution of mantle-field radiotherapy using conven-tional radiotherapy(CRT) and four intensity-modulated radiotherapy(IMRT) techniques in stage Ⅰ and Ⅱ Hodgkin's lymphoma(HL). Methods Ten patients with patholocally proved early stage HL underwent CT simulation. Then both CRT and IMRT planning performed using ECLIPS treatment planning system(TPS). The dosimetric parameters of different irradiation plans were analyzed, including conformal index (CI), homo-geneity index (HI), D95 and V95 of planning target volume (PTV), Dmax,Dmean,Dmin,V5,V10,V20 and V30 of the lung, as well as Dmax of the spinal cord. Results The isodose distribution and homogeneity of PTV were better in IMRT plans when compared with CRT plans. Target coverage, target dose conformity and homogene-ity were similar among all the four IMRT techniques. The V30 of the lung using IMRT was lower than using CRT,but the low-dose volume of the lung was higher. Among the four IMRT technique plans,the lung V20 and V30 were lower in plans with more-field technique,but the V5 and V10 were higher. The Dmax of the spinal cord using IMRT was all lower than that using CRT. Conclusions IMRT is better than CRT in target cov-erage, conformity, homogeneity and normal tissue sparing, especially in protecting the spinal cord and decrea-sing high-dose lung volume,though the low-dose lung volume is higher. Seven-field IMRT technique for man-de-field radiotherapy is recommanded.

Objective To compare.the therapeutic effect of claw-type bone plates and anatomical plates in fixation of traumatic multiple rib fractures.Methods Clinical data of 70 patients with traumatic multiple rib fractures between January 2016 and November 2017 was analyzed retrospectively.Based on the treatnents,patients were assigned to two groups:the claw-type bone plates fixation group (n0=33) and anatomical plates fixation group (n =37).The variables including operation time,intraoperative blooding,postoperative thoracic hemorrhage rate,wound drainage,plate loosening and breakage,postoperative chest pain were compared.Data were analyzed using SPSS17.0 statistical software.Student's t test and rank sum test were used to compare the measurement data,and x2test was used to compare the counting data.Results The operation time after the full exposure of fractures were recorded.Operation time for each fracture [(11.04± 1.81)min vs (12.30±0.47) min],intraoperative bleeding [(120.76±7.19) mL vs (110.00±7.45) mL] and wound drainage [(114.06±7.24) mL vs (107.98±7.23) mL] in the claw-type rib bone plates fixation group were statistically significant different compared with the anatomical plates fixation group (P＜0.05).There were lcase of screw abscission in the anatomical plates fixation group (suffering trom osteoporosis) and 2 cases in the claw-type bone plates fixation group (without osteoporosis and other complications).Two cases suffered from chest pain and 2 cases suffered from massive hemorrhage in the chest in the claw-type bone plates fixation group,with secondary operation removing internal fixations.Conclusions The two kinds of internal fixation have their own advantages and disadvantages.The claw-type bone plates fixation is cheaper,easier to shape and has shorter operation time,which is especially suitable for comminuted fracture.Although the anatomical plates fixation is more expensive than claw-type bone plates fixation,the anatomical plates fixation on multiple fractured ribs has less postoperative blood loss,lower postoperative thoracic hemorrhage rate,plate loosening,chest pain,which significantly reduces second operation and possesses a higher clinical application value.