The use of adjuvant extemal-beam RT is well established in the postoperative treatment of glioblastoma multiforme (CBM).It is consensus that target volume should be determined based on the fusion images of MRI and CT,but the inclusion of peritumoural edematous is controversial.The vast majority of recurrences occur within 2 cm of the original tumor site orin radiation field.There is no inevitable relation between the degree of peritumoral edema and recurrence model.The clinical and pathological characteristics may be as predictive and prognostic factors for the treatment of GBM.Target volume delineation for CBM tend to individual,which can maintain known outcomes and reduce treatment toxicity.

Objective:To develop an experimental three-dimensional model by ECV304 cells(human umbilical vein endothelial cell line) for investigating the mechanisms of angiogenesis in vitro.Methods:ECV304 cells were seeded onto three-dimensional collagen gels made of rat-tail collagen.When the endothelial cells were cultured and grown to near confluence,treated with bFGF for 3 to 12 days,and then assessed with inverted phase contrast microscope.Results:The endothelial cells migrated into the gels,formed complex networks by cell cords at different levels through the bottom view,and sprouted capillary-like structures through the side view.Conclusion:ECV304 cells are capable of expressing some early events of angiogenesis in the three-dimensional collagen gels:proliferating,migrating and sprouting and so on.It should be useful for studying angiogenesis in vitro.

Objective To determine the effect of Leptospira interrogans lipopolysaccharide (L-LPS) inducing apoptosis of murine mononuclear-macrophage cell line( J774A. 1 ), and apoptotic regulation of Toll-like receptor(TLR) and associated intracellular signaling pathways. Methods Lipopolysaccharide (L-LPS) of L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai 56601 was prepared using phenol-water method. The effects of L-LPS inducing J774A. 1 cell apoptosis and the apoptosis-blocking with FasL neutralizing antibody were detected by flow cytometry. Real-time fluorescent quantitative RT-PCR (qPCR) and flow cytometry were performed to measure the changes of Fas/FasL mRNA and protein expression levels in J774A. 1 cells before and after L-LPS treatment. The regulations in L-LPS-induced cell apoptosis by TLR2 and TLR4 as well as p38MAPK, JNK, ERK pathways were determined by either TLR2 or TLR4 antibody blocking test, signaling pathway blocking test and flow cytometry. Results 56.50%, 69.28% and 24.35% of the J774A. 1 cells after treatment with 100 ng/ml L-LPS for4, 12 and 24 h were apoptotic,while the apoptosis rates were decreased to 11.21%, 21.58% and 12.70% after the cells blocked by FasL neutralizing antibody(P ＜0.05). The levels of FasL and Fas mRNAs in J774A. 1 cells treated with L-LPS for 4, 12 and 24 h were elevated with 1.34, 2.12, 2.10 times and 2.45, 3.87, 3.12 times compared to those in the L-LPS untreated cells (P ＜ 0. 05 ), respectively, while the expression rates of FasL and Fas proteins were upregulated to 18.61%, 60.13%, 42.75% and 76.34%, 85.70%, 77.92% from 4.82% and 15.32% apoptotic rates in the L-LPS untreated cells, respectively( P ＜0.05 ). The L-LPS-induced apoptosis rate( 11.54% ) of TLR2 antibody blocked J774A. 1 cells was significantly lower than that(66.56% ) of the J774A. 1 cells without TLR2 antibody blocking( P ＜0.05 ), but L-LPS-induced apoptosis rate of TLR4 antibody blocked J774A. 1 cells was as high as 55.27% ( P ＞ 0.05 ). Compared to the apoptosis rate (62.17%) in the p38MAPK and JNK pathway-free J774A. 1 cells, the L-LPS-induced apoptosis rates in p38MAPK blocked cells(20.54% ) and JNK blocked cells(47.98% ) were significantly lower( P ＜0.05 ),and the apoptosis rate in ERK blocked cells was as high as 61.72% ( P ＞ 0.05 ). Conclusion L-LPS was recognized by TLR2 and upregulates both Fas and FasL expression via p38MAPK and JNK pathways, which involving in the process of the L-LPS-induced cell apoptosis.

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.

Objective To explore the influence of different reconstruction modes with time?weighted respiratory phases on the internal tumor volume ( ITV) of solitary pulmonary lesion ( SPL) , and to evaluate the feasibilities of 8 and 4 equal time?weighted respiratory phases in 4DCT simulation. Methods 24 patients with SPL underwent 4D scanning. Images were reconstructed with 10, 8 and 4 equal time?weighted phases of the respiratory cycles, respectively. Gross tumor volumes ( GTVs ) were delineated on the three sets of reconstructed images and fused into ITVs, which were ITV10 , ITV8 and ITV4 respectively. The differences of volumes, centroid of the ITVs and motions of GTV centroids in three?dimensional directions were compared. Statistical analysis was performed using the Friedman M test. Results The volumes of ITV10 , ITV8 and ITV4 were (9.09±12?29) cm3,(9.10±12?47) cm3 and (8.98±12?61) cm3(P=0?001), respectively. There were no differences between the volumes of ITV10 and ITV8 after the Bonferroni correction ( P=0?721) , while the opposite between those of ITV10 and ITV4 ( P=0?002 ) . The differences of centroid positions of ITV10, ITV8 and ITV4 in x?, y?and z?axes were all less than 1 mm ((12.22±7?71),(12.23± 7?71),(12.22±7?71),Px =0?668);(43.30±29?38),(43.30±29?40),(43.31±29?39),Py =0?643;(5.66±3?67),(5.66±3?67),(5.66±3?67),Pz=0?878), similar to the motions of GTV centroids in three reconstructed modes ((0.69±0?56),(0.69±0?68),(0.79±0?51) mm,Px=0?356;(3.13±3?78),(3.13± 4?05),(3.19±4?06) mm,Py =0?978;(1.18±1?31),(1.03±1?32),(1.16±1?34) mm,Pz=0?302). Conclusions There were no differences in volumes, centroid positions and motions between ITV10 and ITV8 . The quantity of reconstruction images and GTV delineations according to 8 time?weighted phases were both less than conventional 10 phases. 8 time?weighted respiratory phases mode was feasible in 4DCT simulation for SPL.

Surgery remains an important therapeutic method for localized esophageal cancer, but the 5?year survival rate of patients undergoing surgical resection alone is only 20%?25%. Early studies show that postoperative radiotherapy reduced regional recurrence rate, but did not increase the survival rate. Most recent studies show that stage Ⅲ or lymph node?positive patients can obtain survival benefit from postoperative radiotherapy, and patients in pT2?3 N0 M0 stage may also benefit from postoperative radiotherapy. The recommended radiotherapy target volumes include bilateral supraclavicular areas, superior mediastinum, subcarinal area, and tumor bed. It is recommended in most studies that regional lymph nodes in the upper abdomen should be included in patients with lower?segment lesions. The locally advanced patients may benefit more from postoperative radiotherapy combined with chemotherapy. The significance of postoperative radiotherapy for esophageal squamous cell carcinoma, target volume design, and combined chemotherapy need individualized consideration and more clinical evidence.

Chemoradiotherapy is a major treatment for inoperable esophageal carcinoma (EC).However, there is still controversy over the target volume for radiation, particularly nodal target volume.EC is characterized by a high rate of lymph node metastasis, and its metastatic pattern is not always predictable.Elective nodal irradiation (ENI) will increase the radiation field, which may increase the incidence of adverse events.Some investigators used involved-field irradiation (IFI) to reduce treatment-related toxicities without compromising survival.Studies have demonstrated that regional and distant micrometastases can be controlled, to some extent, by chemotherapy, incidental irradiation, and the abscopal effects of radiation.With either ENI or IFI, EC recurrence is usually found in the primary tumor and at distant sites, without survival difference.These data suggest that IFI is feasible in EC patients.

Glioblastoma multiforme (GBM,WHO grade IV) contains some glioma stem cells which have unique self-renewal capacity and multilineage potency.There are numerous neural stem cells in the subventricular zone (SVZ) of adult human brain;it may also act as a storehouse of glioma stem cells that can promote the development and recurrence of a tumor.GBM involving SVZ is prone to early recurrence and intracranial metastasis after resection,so irradiation of the SVZ potentially influences the survival of GBM patients.This review provides a summary of related experimental and clinical studies,and discusses the value of irradiation of the SVZ in GBM patients and the direction of future research.

ObjectiveTo measure the displacement of solitary pulmonary lesion (SPL) using fourdimensional CT (4DCT), and to compare the planning target volume using 4D maximum intensity projection (MIPMIP) ( PTV4DMIP ) with the empirical PTV3D.Methods Data were acquired from 24 consecutive patients with SPL. For each patient, respiration-synchronized 4DCT images and standard axial CT scans were obtained during free breathing.In lung window setting,the 4D technique was used to measure the displacement of SPL in three dimensions. We compared an PTV created using the MIP (PTV4DMIP) to the PTV created from the gross tumor volume (GTV) enlarged isotropically for each spatial direction by 1.0 cm and 1. 5 cm in the PTV3D1.0cm and PTV3D1.5cm. Results The SPL located in the lower lobe showed significant difference with the upper and middle lobe in y axis (0. 44 cm,0. 92 cm, t =2. 87, P =0. 000),but there was no difference in both x and z axis (0. 27 cm,0. 39 cm,t =1.44 ,P =0. 116 and 0. 29 cm,0. 40 cm,t =1.51, P =0. 227). SPL showed significantly greater displacement in y axis than in both x and z axis [0.60 cm and0. 31 cm (t =4.23,P=0.000) ,0.60 cm and 0.32 cm (t =4.65,P=0. 000)], but there was no significant difference between x and z axis (0. 31 cm,0. 32 cm,t =0. 33 ,P =0. 741 ). There was no statistically difference between the peripheral lung cancer and the pulmonary metastasis tumor in three directions ( x axis : 0. 37 cm,0. 32 cm, t =0. 52, P =0. 223 ; y axis : 0. 54 cm, 0. 95 cm, t =- 1.38, P =0.061;z axis:0.42 cm,0.37 cm, t=0.29, P=0.859).Both PTV3D1.0cm and PTV3D1.5cm showed significantly greater volume than PTV4DMIP(46. 73 cm3 ,86. 52 cm3 and 30. 02 cm3 ,t =- 11.35, - 12. 09,P =0. 000,0. 000). ConclusionsThe displacement of SPL in y axis is much greater than x and z axis. The empirical PTV3D is much bigger than PTV4DMIP, which suggests that 4DMIP provide adequate coverage of the moving target and minimize dose to normal tissues.

Objective To compare the clinical features and endoscopic findings of Crohn's disease(CD) and intestinal tuberculosis(ITB) in order to differentiate CD from ITB. Methods The clinical and endoscopic data from 168 patients with CD and 156 patients with ITB between June 2003 and February 2009 were retrospectively analyzed. Results The salient features of CD were male patients in predominance (male : female was 108 :60) and high incidence of colectomy (CD 33.3% vs ITB 10.9%, P<0.01). Diarrhea (66.1%), hematochezia (32.1%), perianal disease (16.1%), intestinal obstruction (28.0%) were more frequent in CD patients than in ITB patients (47.0%, 7.7%, 3.4%, 9.4% respectively, all P values<0.05). The salient features of ITB were night sweating, pulmonary tuberculosis, ascites, hyperglobulin, increased erythrocyte sedimentation rate and the positive serum antibody to mycobacterium. The endoscopic examination showed that the fissure-shape ulcer, grid-shape ulcer, cobblestone sign and intestinal stricture were more frequent in CD patients than in ITB patients (all P values <0.05). Whereas the circular ulcer and involved ileocecal valve with fixed bouche shape were more common in ITB patients (P<0.05). Conclusions The clinical characteristics are different in CD and ITB patients. The endoscopic findings including fissure-shape ulcer, grid-shape ulcer, circular ulcer, cobblestone sign and the status of involved ileocecal valve are important in the differentiation of ITB from CD.