Objective To investigate the role of insulin resistance in patients with prostate cancer who received surgical castration. Methods Sixty-seven patients with advanced prostate cancer who received with surgical castration were divided into obesity group [30 cases, BMI (26.85±1.22) kg/m2] and non-obesity group[37 cases, BMI(22.72±1.28) kg/m2]. The fasting blood glucose (FBG) and the fasting serum insulin, while evaluated the insulin resistance index(IRI) were determined before treatment, 6 months after treatment and 12 months after treatment. Results The levels of fasting serum insulin were significantly higher 6 months[(23.21±5.78 )mU/L] and 12 months [(24.34±5.37) mU/L] after treatment than that be-fore treatment[(20.01±4.82) mU/L] in obesity group, but 12 months after treatment [(22.19±6.14) mU/L ]was higher than that before treatment [(17.36±6.01) mU/L] in non-obesity group (P<0.01). The IRI were significantly higher 6 months (2.94±0.79) and 12 months (3.10±0.73) after treatment than that be-fore treatment (2.53±0.64) in obesity group, but 12 months after treatment (2.79±0.75) was higher than that before treatmeat(2.17±0.73) in non-obesity group(P<0.01). Conclusion The current data suggests that the patients with prostate cancer who received surgical castration is at risk for developing insulin resistance, thus leading to increasing risk of cardiovascular disease and type 2 diabetes mellitus.

Objective To apply Nutritional Risk Screening-2002(NRS-2002) to perform primary screening for nutritional risk in patients with esophageal cancer who undergo radiotherapy, and assess their nutritional status, and to investigate the value of NRS-2002 in such patients.Methods A total of 97 patients who were diagnosed with esophageal cancer and underwent radiotherapy in Zhejiang Cancer Hospital from January 2010 to April 2014 were analyzed retrospectively.The Kaplan-Meier method was applied to analyze the difference in survival, and the chi-square test and the Pearson correlation analysis were applied to analyze the correlation between NRS-2002 score and blood parameters.Results Of all patients, 26.8%had nutritional risk before radiotherapy, which gradually increased with the progress of radiotherapy.The 1-year overall survival rates of the patients with NRS-2002scores of ≤3 and ≥4 on admission were 91.1%and 61.9%, respectively (P=0.010).As for the patients with the highest NRS-2002 scores of ≤2 and ≥3 during treatment, the 1-year overall survival rates were 94.2% and 77.5%, respectively (P=0.012).As for the patients with the lowest NRS-2002 scores of ≤3 and ≥4 during treatment, the 1-year overall survival rates were 91.3% and 54.5%, respectively ( P=0.018).The NRS-2002 score was correlated with prealbumin on admission and at week 1 of radiotherapy (P=0.000 and 0.002), and the NRS-2002 score was correlated with albumin at week 3 of radiotherapy (P=0.036).The multivariate analysis showed that the TNM stage of esophageal cancer and the highest NRS-2002 score during treatment were the independent prognostic factors in esophageal cancer (P=0.001 and 0.005).Conclusions The patients with esophageal cancer undergoing radiotherapy have high nutritional risk, and NRS-2002 score is the independent prognostic factor in these patients and can be used as a tool for primary screening for nutritional risk.

OBJECTIVETo analyze the clinical features and prognosis of radiotherapy associated sarcoma (RAS) in the head and neck following radiotherapy for nasopharyngeal carcinoma (NPC).

METHODSThe clinicopathologic data, diagnosis, treatment and follow-up results of 11 patients with RAS diagnosed between January 1995 and December 2011 at Zhejiang Cancer Hospital were analyzed retrospectively. Among these patients, 6 were males and 5 were females. Patients' ages ranged from 33 to 66 years (median 50 years). The latency period for development of the RAS was between 3 years and 23 years (median 7 years) after irradiation. Overall survival rate was calculated using the Kaplan-Meier method and Log rank test.

RESULTSAll cases underwent surgery, of them 6 casesachieved radical resection3 cases left with microscopic positive resection margins and 2 caseshad palliative surgery. Among 11 patients, 4 had re-surgery after recurrence, including 1 case had repeated surgeries followed by chemotherapy and radioactive seed implantation. Follow-up time ranged from 2 to 102 months, andeight patients died The 2-year, 3-year and 5-year cumulative survival rateswere 45.5%, 30.3% and 15.2%, respectively. The median survival time was 15 months. Surgical resection with clear margins achieved significantly better prognosis (P = 0.04).

CONCLUSIONSThe incidence of RAS after radiation of NPC is generally low, but the treatment of RAS is very difficult, with poor prognosis.

Brachytherapy ; Carcinoma ; Female ; Follow-Up Studies ; Humans ; Male ; Nasopharyngeal Neoplasms ; radiotherapy ; Neck ; Neoplasm Recurrence, Local ; diagnosis ; radiotherapy ; Prognosis ; Retrospective Studies ; Sarcoma ; diagnosis ; radiotherapy ; Survival Rate

Objective:To explore a three-dimensional dose distribution prediction method for the left breast cancer radiotherapy planning based on full convolution network (FCN), and to evaluate the accuracy of the prediction model.Methods:FCN was utilized to achieve three-dimensional dose distribution prediction. First, a volumetric modulated arc therapy (VMAT) plan dataset with 60 cases of left breast cancer was built. Ten cases were randomly chosen from the dataset as the test set, and the remaining 50 cases were used as the training set. Then, a U-Net model was built with the organ structure matrix as inputs and dose distribution matrix as outputs. Finally, the model was adopted to predict the dose distribution of the cases in the test set, and the predicted 3D doses were compared with actual planned results.Results:The mean absolute differences of PTV, ipsilateral lung, heart, whole lung and spinal cord for 10 cases were (119.95±9.04) cGy, (214.02±9.04) cGy, (116.23±30.96) cGy, (127.67±69.19) cGy, and (37.28±18.66) cGy, respectively. The Dice similarity coefficient (DSC) of the prediction dose and the planned dose in the 80% and 100% prescription dose range were 0.92±0.01 and 0.92±0.01. The γ rate of 3 mm/3% in the area of 80% and 10% prescription dose range were 0.85±0.03 and 0.84±0.02. Conclusion:FCN can be used to predict the three-dimensional dose distribution of left breast cancer patients undergoing VMAT.