Objective To observe the incidence of acute radiation pneumonitis (RP)after intensity modulated radiation therapy,and to explore the relationship between the incidence of RP and the parameters from dose-volume histogram (DVH)in the patients with non-small cell lung cancer (NSCLC).Methods By Pinnacle 7.6c TPS, 46 patients with NSCLC were treated by IMRT.The values of the percentages of the lung volumes receieved 5, 10,20,and 30 Gy radition to the total lung volumes (V5 ,V10 ,V20 ,V30 )and mean lung dose (MLD)were observed,and its correlation with acute RP was analyzed.Results The incidence of acute RP of the patients with NSCLC was 37.0% (17/46),among then there were 29 cases (63.0%)of Grade 0 (non-pneumonitis group), 12 cases (26.1%)of Grade 1,5 cases (10.9%)of Grade 2,and there were no Grade 4 and 5 RP.The values of V5,V10,V20,V30,and MLD of lung were 53.34 %,43.12%,24.15%,15.36 %,and 16.02 Gy.The values of V5,V10,V20,V30,and MLD in pneumonitis group were 57.81%,48.91%,31.34%,17.83%, 21.71 Gy,and they were 49. 81%,39.78%,21.82%,13.12%,and 13.71 Gy in non-pneumonitis group, there were significant differences between two groups (P<0.05).Conclusion The intensity modulated radiation therapy in treatment of NSCLC can protect the lung tissue,and the parameters of DVH such as V5 ,V10 ,V20 , V30 and MLD can predict the occurrence of RP.

Objective To observe the therapeutic effect of Tanreqing Injection in treatment of acute irradiation oropharyngeal mucositis in the patients with head and neck cancer, and to provide reference for its clinical application.Methods Fifty patients with head and neck cancer were randomly divided into treatment group and control group(n=25).The patients in treatment group received concurrently intravenous infusion of Tanreqing Inj ection during irradiation course.The patients in control group received daily regular oral nursing;oropharyngeal mucositis was evaluated according to the protocol proposed by RTOG.Results The patients in treatment group with Ⅰ and Ⅱ oropharyngeal mucosal injury accounted for 76%,and the patients in control group with Ⅲ,Ⅳoropharyngeal mucosal injury accounted for 60%,there was statistically significant difference between two groups (P<0.05).The scores of the patients with oropharyngeal pain in treatment group were 0-3 (mild),in control group they were 4- 6 (moderate).The patients with mild,moderate,and severe oropharyngeal pain in treatment group and control group after radiotherapy accounted for 72%,24%,4% and 12%,64%,24%;there were statistically significant differences between two groups (P<0.05).Conclusion Tanreqing Injection has a good therapeutic effect on acute radiation stomatitis and layngopharyngitis, and it has the effects of relieving oral and pharyngeal mucosa inj ury,anti-inflammatory and analgesic and accelerating wound healing.

Objective To study the setup errors in three-dimensional conformal radiotherapy (3DCRT) for thoracic esophageal carcinoma using electronic portal imaging device(EPID) and calculate the margins from CTV to PTV. Methods Forty-one patients with thoracic esophageal carcinoma who received 3DCRT were continuously enrolled into this study. The anterior and lateral electronic portal images (EPI) were aquired by EPID once a week. The setup errors were obtained through comparing the difference between EPI and digitally reconstructed radiographs(DRR). Then the setup margins from CTV to PTV were calculat-ed. By using self paired design,22 patients received definitive radiotherapy with different margins. Group A: the margins were 10 mm in all the three axes;Group B: the margins were aquired in this study. The differ-ence were compared by Paired t-test or Wilcoxon signed-rank test. Results The margins from CTV to PTV in x,y and z axes were 8.72 mm, 10.50 mm and 5.62 mm, respectively. Between the group A and group B, the difference of the maximum dose of the spinal cord was significant(4638.7 cGy±1449.6 cGy vs. 4310.2 cGy±1528.7 cGy; t=5.48, P=0.000), and the difference of NTCP for the spinal cord was also significant (4.82%±5.99% vs. 3.64%±4.70%;Z=-2.70,P=0.007). Conclusions For patients with tho-racic esophageal carcinoma who receive 3DCRT in author's department,the margins from CTV to PTV in x, y and z axes were 8.72 mm, 10.50 mm and 5.62 mm, respectively. The spinal cord could be better protected by using these setup margins than using 10 mm in each axis.

ObjectiveTo evaluate the association between Cyclin D1 G870A polymmphism and risk of colorectal cancer.MethodsExtensive searches of relevant studies on datebase like PubMed,EMCC and CNKI were performed.Case control studies involving unrelated subjects and genotype frequencies in control group consistent with Hardy-Weinberg equilibrium were included for the meta-analysis.Twenty-three case-control studies with 6 344 cases and 9 018 controls were analyzed by the fixed-effect or random-effect meta-analysis method.The metaanalysis was applied with RevMan 5.0 software for heterogeneity test.AA and GA were compared with those with GG genotype.Pooled OR value and 95％ confidence interval (CI) were calculated.ResultsThere were statistical differences between AA & GA and GG.The pooled OR value was 1.10 (95％CI:1.01-1.19,P =0.02).The values were analyzed hierarchically according to different populations.The pooled OR value of Asian was 1.11 (95％ CI:0.98-1.26,P=0.11).The pooled OR value of American was 1.13(95％CI:0.97-1.32,P=0.12).The pooled OR value of European was 1.06(95％CI:0.89-1.25,P =0.52).The pooled OR value of Oceanian was 1.05(95％ CI:0.80-1.38,P=0.73).The values were analyzed hierarchically according to the comparison basis.The pooled OR value of hospital-based was 1.07 (95％ CI:0.95-1.20,P =0.28).The pooled OR value of population-based was 1.13 (95％CI:1.01-1.26,P=0.04).ConclusionThe Cyclin D1 G870A polymorphism is correlated with the susceptibility of colorectal cancer risk at the aggregate level analysis.Analysis by different methods:according to different populations,every group don't support the correlation.According to comparison basis,there has no correlation in hospital-based group,but there has correlation in population-based group.

Objective: To evaluate the effect of tumor shape and location on pulmonary dose-volume parameters by intensity-modulated radiation therapy (IMRT) in patients with non-small cell lung cancer (NSCLC), aiming to provide a reference basis for establishing limits of the pulmonary dose-volume parameters during IMRT. Methods: Clinical data of 208 NSCLC patients undergoing radical IMRT from June 2009 to June 2016 were retrospectively analyzed. According to the tumor shape and location, 208 cases were divided into the vertical bar group (n=127) and the horizontal bar group (n=81), the superior lung group (n=103) and the inferior lung group (n=105). Regression model curve was used to evaluate the effect of tumor shape and location upon the common pulmonary dose-volume parameters(V₅, V₂₀, MLD, AVS₅ and AVS₂₀). Results: In all groups, the fitting curves of V₅, V₂₀ and MLD were manifested in the quadratic equation pattern, and AVS₅ and AVS₂₀ in the logarithmic equation manner. In the vertical bar group, the V₅(P=0.015), V₂₀(P=0.047) and MLD (P=0.012) were significantly higher, whereas the AVS₅(P=0.044) was significantly lower compared with those in the horizontal bar group. No statistical significance was observed in AVS₂₀ between two groups (P=0.490). The tumor location exerted significant effect upon V₅ alone (P=0.009). Conclusions When the tumors presents in the vertical bar shape, the limits of the common lung dose-volume parameters are likely to exceed those of tumors in the vertical bar shape. Lung tumors located in the inferior lobe exerts a more significant effect upon the low-dose region volume compared with the tumors in the superior lobe.

Objective:To explore the effect of constructing WeChat platform and introducing PPT (PowerPoint) optimized by Media studio pro editing technology in the teaching of radiation therapeutics.Methods:Sixty undergraduates of medical imaging technology in Fujian Medical University were randomly divided into experimental group and control group in average. The experimental group set up a WeChat group and acquired the optimized PPT before class; control group received classroom teaching and clinical practice according to the traditional teaching mode. Twenty-four items of MCTQ (Maastricht clinical teaching questionnaire) were selected and translated. A total of 30 teachers majoring in tissue radiation oncology and medical imaging were randomly divided into two groups. The questionnaire was used to evaluate the two teaching models. To examine the academic performance of the two groups of students. SPSS 23.0 software was used for independent sample t-test. Results:By comparing the scores of MCTQ questionnaire between the two groups, it was concluded that the teaching mode of the experimental group had significant advantages in 11 aspects, such as clinical practice, obtaining more learning opportunities and so on ( P < 0.05). The scores of practice [(84.67±7.29) vs. (80.03±8.97)] and final evaluation [(81.53±8.78) vs. (76.77±9.49)] of the students in the experimental group were better than those in the control group ( P < 0.05). Conclusion:The application of optimized PPT by Media studio pro editing technology based on WeChat platform is worth popularizing in the teaching of radiation therapeutics.

Objective To analyze the efficacy and prognostic factors of postoperative radiotherapy for high grade gliomas based on MRI guided target delineation. Methods Retrospective analysis was conducted on 111 patients with high-grade gliomas from October 2010 to December 2015. The patients were treated with IMRT in combination with temozolomide guided by MRI-CT fusion technique after target delineation at preoperation, postoperation ( < 72 h ) and before radiotherapy. The survival rate was calculated by K-M method. The analyses of single factor and multiple factor, ranging from the patients′age, gender, pathological grade, number of lesions, multiple lobes, tumour crossing the midline,epilepsy, the maximum diameter of the lesions, adjuvant chemotherapy and other factors on prognosis were conducted with Log-Rank test and COX regression analysis. Results A total of 111 patients met the criteria for admission, and the overall follow-up rate was 94. 6%. The survival rates of 1-, 2-, 3-, 4-, 5- year were 81. 6%, 54. 2%, 39. 1%, 25. 4%, 15. 5%, respectively. The median survival time was 38 months. The single factor analysis showed that pathological grading (χ2 =5. 549, P<0. 05), age (χ2 =6. 393, P<0. 05), preoperative tumor maximum diameter (χ2 =4. 555, P<0. 05) and adjuvant chemotherapy (χ2 =4. 965, P <0. 05 ) were correlated with on the survival rate, while multivariate analysis showed that pathological grade Ⅲ, younger age, preoperative tumor with size smaller contributed to the good prognosis (Wald=4. 784, 4. 560, 5. 859, P<0. 05). Conclusions High grade gliomas after operation by MRI-CT fusion technique in preoperative and postoperative 72 h and MRI before radiotherapy guided by radiotherapy, for intensity-modulated radiotherapy combined with temozolomide chemotherapy, can obtain better efficacy. The grade Ⅲ of glioma, <50 years old, the maximum diameter of the tumor <6 cm, the adjuvant chemotherapy may have the better prognosis.

Objective: To calculate out the Hausdorff distance based on the scripting in RayStation treatment planning system, which was then applied in measuring the deformation error of brain stem during image automatic registration between CT and MR. Methods: Scripting was edited in RayStation system (version 4.7) by using IronPython. The set of point coordinates on the contour of any two region of interest (ROI) had been found firstly, then the Hausdorff distance between the two point sets was calculated out. A graphical user interface (GUI) was designed by using XAML to acquire the visualized output of Hausdorff distance. GUI appeared when the script was run, where two ROIs was selected, then the corresponding Hausdorff distance and the running time were displayed by pressing the "Calculate" button. Results: The mean Hausdorff distance of brain stem in 20 patients with head and neck neoplasms was 1.20 cm while the mean elapsed time was 11.01s. Conclusions Hausdorff distance of any two ROIs can be calculated out by using the developed method. GUI is designed to realize the visual interaction with RayStation system. Therefore, the RayStation system satisfies the demands of Hausdorff distance calculation in both clinical and research work.

Objective: To retrospectively analyze the efficacy and prognostic factors of postoperative intensity modulated radiotherapy for grade Ⅱ gliomas. Methods: Retrospective analysis was conducted on patients with postoperative grade Ⅱ glioma in our hospital from Jan. 2010 to Dec. 2018. The primary endpoint was progression-free survival, and the secondary endpoint was overall survival. Correlative analyses of prognosis by age, gender, initial resection status, the maximum diameter of the lesions, bi-hemisphere, astrocytoma, chemoradiation, adjuvant chemotherapy were conducted. Results: A total of 109 cases with grade Ⅱ glioma were enrolled. The follow-up rate was 91.75%, including 10 cases dead and 27 relapsed. There were 24 cases (88.9%) of in-field failure, and 3 cases (11.1%) of out-field failure. 14 cases of recurrence occurred in 81 cases of total resection group, accounting for 17.3%, and 13 in 28 cases of subtotal resection group, accounting for 46.4%. The recurrence rate in the subtotal resection group was significantly higher than that in the total resection group (χ ²=9.484, P<0.05). The 1-, 2-, 3-, 4- and 5-year progression-free survival rates were 92.5%, 86.0%, 80.6%, 77.5% and 66.8%, respectively. The 2-, 3-, 4- and 5-year overall survival rates were 97.2%, 90.8%, 87.7% and 84.5%, respectively. Multivariate analysis showed that patients with subtotal resection(HR=3.608, P<0.05) and bi-hemisphere(HR=3.183, P<0.05)were significantly correlated with the progression free survival. Conclusions Postoperative intensity modulated radiotherapy for grade Ⅱ gliomas can achieve a better PFS. Recurrence in the radiation field is the main failure mode. Initial resection status and bi-hemisphere of tumor are important influential factors for PFS of grade Ⅱ gliomas patients.