Thoracic radiotherapy has been a key component of local treatment for the patients with non small cell lung cancer(NSCLC)。Many state of the art technologies, such as conformal radiotherapy, integration of PET imaging into target definition, measures of set-up and movement uncertainties have been used in the clinic and guided the treatment of individual patient. The treatment outcome of postoperative radiotherapy using new techniques has been improved for stage IIIa resected NSCLC. For the patients with inoperable or local advanced NSCLC,the involved field radiotherapy had been used. Dose escalation has become possible in recent years because of improved radiation technology to spare normal tissues. Introduction of risk estimation of normal lung based on dose-volume analysis for dose prescription may further optimise individual treatment

Three-dimensional conformal radiotherapy with intensity-modulated radiation beams significantly enhances the ability to produce sharp dose gradients in the boundaries between a tumor and nearby critical structures.Small uncertainties in the daily repositioning of patients can lead to the overdose of the critical structure and the escape of the target volume.It emphasizes the need to improve the ability to localize the target for treatment. And the image-guided radiotherapy was development.Although steady streams of enhanced new methods of imaging are being introduced to improve treatment guidance and treatment verification,the development of kilovoltage cone-beam CT integrated with the medical linear accelerator for the specific purpose of guiding therapy will permit localization and targeting of soft-tissue structures at the time of treatment.In this review,we focus on the clinical application of CT in the image-guided radiotherapy.

Lung cancer is the most common cause of the death from cancers for both male and female in the world. Surgery remains the most effective method for controlling the primary tumour in most cases, but only 20% primary lesions can be resected. 80% patients should be treated by non-surgical methods. In recent years, radiotherapy has a fast development in the equipment and especially in the theory of radiobiology, but the curability of lung cancer still poor. In this paper we discussed the radiotherapy of lung cancer and how to choose the energe of X-ray, design the fields; the proceeding of irradiation; and it is necessary to find out a new regulation for stages that is available to indicate non-surgical treatment.

It has been a sub - rale in hospital that many doctors and hospitals themselves try every means to get maxinoum interests from patients in many places. Througyh the " Hu Wei Min" case, this essay analyzed the reasons and drawbacks of asking extra money from patients and discussed related social ethical problems and therefore brings out a counter - plans to solue the problem.

Objective To evaluate the impact of different anatomical landmarks on registration in imaging-guided radiation (IGRT) for lung cancer. Methods For 20 patients with non-small cell lung cancer receiving stereotactic body radiotherapy (SBRT) in Fudan University Cancer Hospital, 100 frames of kilo-voltage cone-beam computed tomography scanning were evaluated in this study. The spine, carina and tumor were selected as landmarks for registration, respectively. Results of registration using different landmarks were documented and compared. Results The average set-up errors in the left-right, superiorinferior and anterior-posterior directions were -0. 08 cm ±0. 32 cm, -0. 16 cm ±0. 45 cm and 0. 06 cm ±0. 23 cm with the spine for registration;0. 06 cm ±0. 34 cm, -0. 13 cm ±0. 45 cm and -0. 02 cm±0.23 cm with the carina;and -0. 17 cm ±0.25 cm, 0.03 cm ±0.47 cm and 0. 15 cm ±0.38 cm with tumor. The registration results between using the carina and tumor as landmarks were statistically significant different (q=4.61, P=0. 002 ;q = 2. 23 , P=0. 118;q=3.44, P=0. 017). The registration results were equal when using the spine and tumor as landmarks ( q = 1.85, P = 0. 195; q = 2. 54, P = 0. 075; q = 1.89,P=0. 185), as well as using the carina and tumor as landmarks (q=2.76, P=0. 054;q=0.31, P=0. 826 ;q = 1.55, P = 0. 276). Conclusions For early stage lung cancer, the spine and tumor can be used equally as registration landmarks in imaging-guided SBRT. The carina is not suggested for its poor reproducible position.

Radiomics utilizes the high-throughput extraction of large amounts of quantitative features from radiographic images,giving a comprehensive quantification of tumor phenotype.Thus it can provide complementary and interchangeable information for clinical usage,such as differentiating malignant nodules from benign ones,predicting response to treatment,identifying lymph node metastasis,improving individualized treatment selection and monitoring.The advantages of radiomics give it great potential in precise treatment.But much work needs to be done before it could be used in practice.It is imperative that a standard research procedure is needed to verify its reliability and clinical value via multi-central prospective clinical trials.

Human epidermal growth factor receptor 2 (HER-2/neu) is an important prognostic predictor and the key predictor of anti-HER-2 therapy of breast cancer. Accurate testing of HER-2 status for breast cancer patients is important in clinical practice. As of this writing, the American Society of Clinical Oncology and the College of American Pathologists recommend three methods for HER-2 detection, namely, immunohistochemistry, fluorescence in situ hybridization, and bright-field in situ hybridization. The abovementioned methods have their own advantages and disadvantages. New methods, such as multiplex ligation-dependent probe amplification, quantitative reverse transcription polymerase chain reaction, and RNA in situ hybridization, are currently applied to detect HER-2 status. New technologies not only make up for the shortcomings of routine methods but also have unique benefits that can meet the demands for HER-2 testing of some breast cancer patients. Thus, these methods are promising for clinical applications and can improve clinical diagnosis and treatment. The characteristics, advantages, and drawbacks of these technologies are introduced and reviewed in this paper.

Purpose:To construct replication-defective adenovirus which was recombinated with Egr-1 promoter and to Smad7, and to study whether it can express exogenous Smad7 protein in cytoplasm.Methods:Based on Adeno-X~(TM) expression system, the CMV promoter of the pShuttle vector was replaced by Egr-1 promoter, and the Smad7 cDNA was subcloned into the MCS(multiple cloning site) of pShuttle. The recombinant pShuttle was then subcloned into the Adeno-X~(TM) genome, which was transformed into E.coli to get recombinant Adeno-X~(TM) plasmid DNA. The recombinant adenovirus was made and amplified in the transfected HEK 293 cells before it was purified and tested for viral titer. Then the Smad7’s location in cells was determined by immunocytochemistry.Results:Identified by restriction endonuclease analysis and PCR, recombinant adenovirus with Egr-1 promoter and Smad7 cDNA was constructed successfully, with a viral titer of 1.0?10~(11) TCID50/ml. Both endogenous and exogenous Smad7 protein was found to be located in cytoplasm of fibroblast cells.Conclusions:With Adeno-X~(TM) expression system, utilizing the techniques of molecular cloning, recombinant adenoviral vector could be quickly and efficiently constructed which could be packaged into replication-defective Adenovirus and amplified in HEK293 cells. The recombinant adenovirus could express exogenous Smad7 protein in fibroblast cells.[

Electronic portal imaging device(EPID) is now been used widely.EPID was initially used for the purpose of checking set-up error.There are two ways to verify set-up errors-on-line and off-line.With advanced knowledge about the dosimetry characteristics of EPID,the use of EPID for dosimetry verification was adapted from the research study to the clinic.EPID plays an important role in quality assurance of radiotherapy accessories including multileaf collimator(MLC)that has been most studied in the past couple of years.This article briefly reviews the clinical use of EPID.

Objective To investigate the advantage of the intensity-modulated radiotherapy treatment (IMRT) by allowing dose heterogeneity in the target volume in esophageal cancer treatment planning.Methods Two sets of 5-field IMRT planning were designed for 10 esophageal cancer patients upon the condition of appropriate clinical tolerance level with the prescription dose of 60 Gy to 95% of the planned target volume (PTV) and the maximum dose of 45 Gy to the spinal cord:the IMRT with rigid restriction of the maximum homogeneous dose to the PTV within 63 Gy prescribing a homogeneous dose ( IMRThom ) and the IMRT allowing dose heterogeneity by loosening the constraints on maximum dose in the PTV to 69 Gy ( IMRTinhom ).Dosimetric comparison was conducted by using dose-volume histograms.Results Compared to IMRThom, the minimum dose (t = -3.37,P =0.012), maximum dose (t = - 23.58,P = 0.000), mean dose ( t = - 4.95, P = 0.002 ), and heterogeneity index ( t = - 11.06, P =0.000) in PTV of the IMRTinhom were all significantly increased, and the values of V5 (t = 6.96, P =0.000), V10(t=5.24,P=0.001) , V15(t=4.73,P=0.002) , V20(t=8.08,P=0.000) , V25(t=8.58,P = 0.000), and mean dose (t = 7.28,P = 0.000) of the normal lungs were all significantly lower.There were no significant differences in all the indexes for the mean dose to the heart and maximum dose to the spinal cord between these 2 set of planning.Conclusions The IMRT plan allowing dose heterogeneity in the PTV escalates the prescription dose and decreases the doses to the lungs.