Among the existing radiotherapy technologies, ?(X) stereotatic radiotherapy,especially the whole body ? knife,provides better dose distribution and has advantages in increasing target volume dose and reducing normal tissue damage.The whole body ? knife,patented in China with unique characteristics of dose focusing and dose distribution,could provide higher curative effect and minimal toxicity in the treatment of cancers of the lung,liver,pancreas,etc.It has initiated a new phase of Chinese mode of ?(X) stereotatic radiotherapy and was drawn great attention at home and abroad.In this review,the clinical application criteria,treatment progress,existing problem and expectation of ?(X) stereotatic radiotherapy have been summarized.

Stereotactic body radiation therapy had a history for over 20 years since it was applied in elinical treatment,with promising outcomes in early-stage non-small cell lung cancer (NSCLC) and lung metastases.Air Force General Hospital was one of the earliest institutes which had launched SBRT in China.Our self-developed γ-ray SBRT technology was used to treat early-stage NSCLC and lung metastases.The adverse effects and cost of γ-ray SBRT were less than those for foreign technology.In conclusion,it is suitable for our national situation and worth to be widely introduced.

With the development of imaging techniques of CT , MRI, and PET-CT, the clinical applications of the above-men-tioned imaging modalities have become increasingly mature , which makes early diagnosis rate of pancreatic cancer has been improved to some extent.However, choosing the most effective and economical imaging method need to be addressed in the clinical work .This pa-per will show the research progress of imaging in pancreatic carcinoma detection at home and abroad .

Objective:Total lesion glycolysis (TLG) on PET scans were calculated using custom-designed software, then we analyzed the prognostic utility of PET for patients with locally advanced pancreatic cancer (LAPC) undergoing radiation therapy.Methods: 33 patients with newly diagnosed LAPC who underwent 18F- FDG PET/CT scan for staging before radiation therapy were retrospectively included in this study. Patients were divided into two different groups by the median value of TLG. TLG lower than 55.3 was A group and TLG higher or equal to 55.3 was B group. TLG of tumor tissue were calculated from PET/CT images with the SUV cut-off value of 2.5. We analyzed the relationship between TLG and other clinical factors and prognosis in patients with pancreatic cancer by Kaplan-Meier method and log-rank test.Results: By Log-rank univariate analysis showed that the differences in group A and group B related significantly (r=7.765,P=0.005). And their middle survival time was 15.5 months and 8 months respectively. GTV dose of the patients in two groups and CA19-9 before treatment were also statistically different (x2=7.162, x2=10.476;P=0.05). Multivariate analysis showed that the TLG (P=0.009) were independent risk factors that prevented the long-term survival of the prognosis of patients in this group.Conclusion: The value of CA19-9 and GTV dose before treatment were the risk factors of radiotherapy for patients with locally advanced pancreatic cancer. The parameters of TLG were independent prognostic factors. TLG have a certain clinical value in predicting the prognosis of patients with pancreatic cancer, and can guide clinical diagnosis and treatment planning, and extend the lifespan of patients with pancreatic cancer.

In recent years, the incidence of pancreatic cancer shows rising trend and higher mortality. Pancreatic cancer lacks early diagnostic methods with high sensitivity and specificity, and the surgical resection rate is 10 %-20 % with high operation mortality, poor long-term curative effect and less than 5 %survival rate within 5 years. At present, researchers indicate that radiotherapy can improve the quality of life, increase tumor local control rate and prolong the overall survival time of patients with pancreatic cancer in different levels. Diffusion weighted imaging (DWI), as a functional imaging technology of magnetic resonance imaging (MRI), is the only way to react cell levels. This paper will summarize the application of DWI in radiotherapy of pancreatic cancer.

Objective:To investigate the prognostic value of18F-FDG PET/CT by calculating maximal standard uptake values(SUVmax) in patients with pancreatic carcinoma of TOMO knife radiotherapy.Methods:Sixty five cases of pancreatic carcinoma who underwent18F-FDG PET/CT scan before TOMO radiotherapy were reviewed retrospectively, the18F-FDG uptake of primary tumors was measured with the SUVmax. SUVmax<3.0 was divided into group A(32 cases), SUVmax≥3.0 was divided into group B(33 cases), the relationship of SUVmax and other clinical factors with the survival of the 65 patients were analyzed.Results:By Log-rank univariate analysis showed that the differences in group A(SUVmax<3.0) and group B(SUVmax≥3.0) in patiengts with middle survival time was statistically significant(15.5:7 months)atP=0.001. TNM stages(x2=6.625,P<0.010), CA19-9(x2=10.298,P<0.001) and GTV dose(x2=8.054, P<0.005) were also statistically different at (P<0.05). Multivariate analysis showed that the SUVmax and preoperative serum CA19-9 level were independent risk factors that prevent the long-term survival of the prognosis of patients in this group.Conclusion: SUVmax has a certain clinical value in predicting the prognosis of patients with pancreatic cancer, and can guide clinical diagnosis and treatment planning, and extend the lifespan of patients with pancreatic carcinoma.

Objective To identify dosimetric predictors for the development of gastrointestinal toxicity in patients with pancreatic adenocarcinoma treated with TOMO radiotherapy .Methods From January 2014 to Janu-ary 2015 ,we analysed the medical records of 68 pancreatic cancer patients who received helical tomotherapy from Air Force General Hospital .The stomach and duodenum were contoured separately to determine their dose volume histogram(DVH)parameters.Chi-square test was employed to analyze the count data .Spearman correlation anal-ysis was used to analyze the relationship between occurrence of gastrointestinal toxicity and clinical and physical factors.Logistic regression models was performed to identify risk factors associated with gastrointestinal toxicity . Results The median follow-up was 9 months(4~16 months).18 patients experienced grade II acute gastroin-testinal toxicity ,1 patient experienced grade Ⅲ acute gastrointestinal toxicity , whereas 17 patients experienced grade II late gastrointestinal toxicity ,1 patient experienced grade Ⅲlate gastrointestinal toxicity .On UVA,the vol-ume,Dmean,D1,D3,D5,D10,V5 to V40,and V5′to V45′of duodenum were significantly associated with GradeⅡor higher gastrointestinal toxicity ( P <0.05 ) .The MVA, V45′of duodenum was independent predictor for gradeⅡor higher gastrointestinal toxicity(P<0.05).The ROC analysis also showed that V45′of 0.5cm3 was the optimal threshold to predict for gastrointestinal toxicity for the entire cohort .Conclusion V45′of duodenum is of greater importance in the judgment of occurrence of hypofractioned radiation -induced gastrointestinal toxici-ty.

80% of low density area in tumor), 10 PR(50%-80%) and 3 NC(0.05). Conclusion For tumor treated with hyperthermia plus radiotherapy, the response evaluation should be based on both the change in the mass size and the percentage of low density area in the tumor.

Tomotherapy plans were produced using a combination of field widths (1 cm, 2.5 cm and 5 cm) and pitches (0.15, 0.30, and 0.45) for seven patients with brain metastases from lung cancer, the plans were compared with dosimetric parameters, protection of organs at risk (OAR) dose and treatment times. All plans were defined that CTV with 30Gy and GTV 50 Gy by ten fraction synchronously. The results showed that the mean dose and CI for GTV was statistical difference (P = 0.002 1, P = 0.012 8), OARs were within the normal range, the treatment time increased inversely proportional to the jaw width, but had lesser impact on the pitch. This study showed plans produced with 5 cm jaw was an effective method for patients with brain metastases from lung cancer.
Aged ; Brain Neoplasms ; diagnostic imaging ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Spiral Computed

Objective To preliminarily evaluate the feasibility,therapeutic effect and normal tissue complications of stereotactic γ-ray body radiation therapy for patients with asynchronous bilateral renal cell carcinoma.Methods Nine patients with inoperable asynchronous bilateral renal cell carcinoma with a median time from the resection of the primary focus and discovery of the contralateral focus underwent stereotactic γ-ray body radiotherapy with OUR-QGD stereotactic γ-ray whole body therapeutic planning system.50％ isodose line,as the prescription dose line,was to cover the planning target volume (PTV) and the 70％ isodose line was to cover the gross target volume (GTV).Radiotherapy was delivered,with a single dose of 3-5 Gy per fraction,one fraction per day,5 fractions per week,and totally 10-17 fractions.The PTV edge total dose was 36-51 Gy,and the GTV edge total dose was 60-85 Gy.The patients were followed up for a median time of 24 months to evaluate the local control rate and overall survival rate.Results Of the 9 patients,1 presented complete remission (11.1％) and 4 partial remission (44.5％),with a total effective rate of 55.6％.The 1-,3-,and 5-year local control rates were 64.8％,43.2％,and 43.2％ respectively.The 1-,3-,and 5-year overall survival rates were 66.7％,53.3％,and 35.6％ respectively.Four patients (44.4％) had acute radiation reaction:2 cases with grade l leukocytopenia and 2 cases with grade 1 gastrointestinal reactions.Two patients showed grade 2 late radiation-induced reaction in gastrointestinal system.The Karnofsky score was significantly increased and the renal function was normal after radiotherapy.Conclusions Stereotactic γ-ray body radiation therapy is safe and effective in the treatment of asynchronous bilateral renal cell carcinoma.