Objective To study the security of low dose and half-body irradiation by 60Co ?-rays as a new method of clinical radiotherapy.Methods The simulated manikin was used to simulate human body and two radiation modalities of facing and backing on radioactive source were adopted.Half-body irradiation was done by 60Co ?-rays with doses of 9,10 and 11 cGy.The exposure dose of every layer and important target organs in the simulated manikin were detected,and the security of low dose and half-body irradiation as a therapeutic method was evaluated.Results The exposure dose of every layer and sensitive organs were all within safety margin,when simulated manikin facing or backing on the radioactive source was irradiated by 60Co ?-rays with doses of 9,10 and 11 cGy.Further,the exposure dose of sensitive organs in the simulated manikin backing on the radioactive source was lower than that in those facing the radioacive source.Conclusion The method of low dose and half-body irradiation as a radiotherapeutic method is safe and feasible and the radiation modality of backing on the radioactive source is more safe.

Objective:To collect the imaging data and related materials of the patients with in-stent restenosis (ISR)after coronary artery stent operation with intravascular ultrasound (IVUS),and to analyze the risk factors of ISR,and to propose the reasonable intervention strategies.Methods:Fifty patients with ISR were divided into ISR ≤ 50% drug group (n = 14 )and ISR > 50% drug group (n = 36),including drug-coated balloon therapy group (n=16)and stent treatment group (n=20);IVUS virtual organization technology was used to compare the plaque area,location,tissue composition,thrombus and other factors of the patients in various groups after treatment;the data changes after 6 months of follow-up were analyzed.Results:The IVUS results showed the plaque areas and plaque loads of the ISR patients treated with intervention were significantly reduced compared with before operation (P <0.05);the plaque compression degree of the patients in drug-coated balloon therapy group was lower than that in stent treatment group (P <0.05),but the differences were not found between drug-coated balloon therapy group and stent treatment group in fibrous tissue components and calcified tissue proportion (P >0.05).Conclusion:The ISR rate is higher in the patients with high degree of fiber components,plaque composition heterogeneity and distribution of diffuse tortuous and calcified lesions.ISR has no significant correlation with the plaque wall thickness and lipid content and plaque instability and necrotic tissue proportion.

Objective:To preliminarily evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic tumors from head and neck carcinoma.Methods:Clinical data of 24 patients with pulmonary oligometastasis from head and neck carcinoma undergoing SBRT in Zhejiang Cancer Hospital from January 2014 to May 2019 were retrospectively analyzed. Survival analysis was performed by Kaplan- Meier method. Results:Among the 24 patients, 12 cases were diagnosed with nasopharyngeal origin and 12 cases of non-nasopharyngeal origin. A total of 34 pulmonary metastatic lesions were treated with SBRT. The median follow-up time was 19.5 months. Thirteen cases developed new lesions after SBRT, and 9 of them occurred within 1 year after SBRT treatment. The actual 1-year local control rate was 95%. The median progression-free survival was 15.2 months, and the 1-and 2-year progression-free survival were 59% and 46%, respectively. The 2-and 3-years overall survival rate at were 71% and 51% fter lung metastasis, respectively. Univariate analysis showed that the patients with primary lesions located in nasopharynx and disease-free interval of more than 1 year had survival advantage. No more than grade 3 radiation-induced injury was observed in the whole cohort after SBRT, and the incidence of mild radiation-induced injury was 13%.Conclusions:SBRT is safe and effective in the treatment of pulmonary oligometastatsis from head and neck carcinoma, and it may be more effective for patients with primary tumors located in nasopharynx.

Objective The aim of the present study was to evaluate the efficacy of three different modalities in treatment of lung oligometastases from nasopharyngeal carcinoma ( NPC) after radiotherapy and to identify a more appropriate treatment modality.Methods The clinical data of 87 cases of lung oligometastases from NPC were analyzed retrospectively.Among them, 33 patients underwent local small-field irradiation+/-chemotherapy, 28 underwent whole-lung irradiation+chemotherapy, and 26 underwent simple chemotherapy.The survival rates were calculated using Kaplan-Meier analysis.The differences among the modalities were evaluated using the log-rank test.Cox univariate and multivariate analyses were performed to determine the influencing factors.Results The 3-year lung metastasis survival ( LMS) rates of patients with lung metastasis undergoing the three treatment modalities ( local small-field irradiation +/-chemotherapy, whole-lung irradiation+chemotherapy and chemotherapy alone) were 89.3%, 72.7%, and 72.4%, respectively, showing a significant difference between the groups ( P=0.003 ) .Further subgroup analysis showed that the 5-year LMS rate was significantly higher in the local small-field irradiation+/-chemotherapy group than that in the whole-lung irradiation+chemotherapy group and chemotherapy alone group (P=0.001).The 2y-ear progression -free survival (PFS ) rates of the three groups were 571.%, 25.8%and 3.8%, respectively, showing significant intergroup differences ( P=0.002 and P<0 .001 ) . Multivariate analysis indicated that compared with the whole lung irradiation group and the chemotherapy alone group, the local irradiation+/-chemotherapy is an independent favorable prognostic factor for LMS and PFS (P<0.05). Conclusion Local radiotherapy combined with systemic chemotherapy is the best therapeutic modality for lung oligometastases derived from NPC after radiotherapy, improving the LMS and prolonging the PFS.

Objective The aim of the present study was to evaluate the efficacy of three different modalities in treatment of lung oligometastases from nasopharyngeal carcinoma ( NPC) after radiotherapy and to identify a more appropriate treatment modality.Methods The clinical data of 87 cases of lung oligometastases from NPC were analyzed retrospectively.Among them, 33 patients underwent local small-field irradiation+/-chemotherapy, 28 underwent whole-lung irradiation+chemotherapy, and 26 underwent simple chemotherapy.The survival rates were calculated using Kaplan-Meier analysis.The differences among the modalities were evaluated using the log-rank test.Cox univariate and multivariate analyses were performed to determine the influencing factors.Results The 3-year lung metastasis survival ( LMS) rates of patients with lung metastasis undergoing the three treatment modalities ( local small-field irradiation +/-chemotherapy, whole-lung irradiation+chemotherapy and chemotherapy alone) were 89.3%, 72.7%, and 72.4%, respectively, showing a significant difference between the groups ( P=0.003 ) .Further subgroup analysis showed that the 5-year LMS rate was significantly higher in the local small-field irradiation+/-chemotherapy group than that in the whole-lung irradiation+chemotherapy group and chemotherapy alone group (P=0.001).The 2y-ear progression -free survival (PFS ) rates of the three groups were 571.%, 25.8%and 3.8%, respectively, showing significant intergroup differences ( P=0.002 and P<0 .001 ) . Multivariate analysis indicated that compared with the whole lung irradiation group and the chemotherapy alone group, the local irradiation+/-chemotherapy is an independent favorable prognostic factor for LMS and PFS (P<0.05). Conclusion Local radiotherapy combined with systemic chemotherapy is the best therapeutic modality for lung oligometastases derived from NPC after radiotherapy, improving the LMS and prolonging the PFS.

OBJECTIVETo explore the relationship between positive lymph node number, involved region, positive lymph node ratio and the prognosis of patients with hypopharyngeal cancer.

METHODSClinicopatological data of 81 patients with hypopharyngeal squamous cell carcinoma who underwent hypopharyngectomy and cervical lymph node dissection from January 2000 to December 2005 in our hospital were analyzed retrospectively. The relationship between positive lymph node number, involved region, positive lymph node ratio and the prognosis was analyzed.

RESULTSThe rate of lymph node metastasis was 79.0% (64/81) in the 81 patients with hypopharyngeal cancer. Of which, the rates of unilateral metastasis and bilateral metastasis were 82.9% (53/64) and 17.1% (11/64), respectively. The rate of lymph node metastasis was increasing with advancing tumor stage. The median survival times were 81, 51 and 26 months in the patients with 0, 1-3 and ≥ 4 positive lymph nodes, respectively (P < 0.001), 84, 45 and 23 months in patients with 0, 1-2 and ≥ 3 involved regions, respectively (P < 0.001), and 84, 51 and 17 months in patients with positive lymph node ratio of 0, <10% and ≥ 10%, respectively (P < 0.001). Multivariable analysis showed that positive lymph node ratio, extracapsular infiltration, T classification and treatment modality were independent prognostic factors (P = 0.002).

CONCLUSIONSPositive lymph node ratio is an independent prognostic factor for hypopharyngeal cancer.

Carcinoma, Squamous Cell ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Lymph Node Excision ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; diagnosis ; Prognosis ; Retrospective Studies

PURPOSE: The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification. MATERIALS AND METHODS: The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively. RESULTS: The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn't (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patientswith T4 classificationwere 89.5% and 83.2%,whichwere similarwith the outcomes of patients with T3b classification. CONCLUSION: MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC.
Classification ; Humans ; Incidence ; Joints ; Magnetic Resonance Imaging ; Multivariate Analysis ; Paranasal Sinuses ; Radiotherapy, Intensity-Modulated* ; Retrospective Studies

Objective To explore the impact of oral nutritional supplements in the local advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy. Methods From 2016 to 2018, we prospectively collected 114 patients into our study, including intervention group ( n=58) and control group ( n=56) . Patients in the intervention group were given oral nutritional supplements from the beginning of radiotherapy, while the control group patients were receiving usual diet care. We collected data of weight, hematological index and nutrition related information before, during and after treatments. Results All patients experienced weight loss during radiotherapy. The declining trend was more obvious in intervention group but with no statistical difference ( P>0.05) . Radiotherapy interruption was lower, completion rate of 2 cycles of concurrent chemotherapy was higher( 78% vs 64%, P=0.02) and level of total serum protein and albumin was more stable ( P=0.003, 0.001) in the intervention group. No difference was found in acute toxicities between the two groups ( P>0.05) . During the treatment period, the nutrition risk screening score declined, more patients with NRS 2002 ≥3 in the control group than the intervention group ( P<0.05) , while no statistically significant difference was found in PG-SGA between the two groups ( P>0.05 ) . Conclusions Oral nutritional supplements can improve treatment tolerance and keep the stability of serum protein level, nevertheless, it has no obvious advantage in maintenance of weight and short-term nutritional status