Radiotherapy is the main treatment for head and neck cancer,but it will result in adjacent tissue damage,including radioactive xerostomia,the most common complication.The mechanism of radiation-induced parotid damage injury is unclear.Parotid function test include detection of parotid salivary flow and salivary flow rate,parotid SPECT,CT and MRI,etc.How to protect the parotid glands becomes a hot research in recent years.At present,the main methods of protecting the parotid glands includes selecting patterns of radiotherapy,radiotherapy planning optimization,drugs,stem cell transplantation and gene transduction.

Objective To investigate the clinical effects, the therapy reactions,the living qualities of three treatments in advanced nasopharyngeal carcinoma. Methods From Jan 2001 to Jun 2002, 120 patients pathologically confirmed NPC who firstly underwent radiotherapy were divided into two groups: radiotherapy with concurrent chemotherapy group(RC, n = 60, 5 fractions per week, one time per day, 200 cGy per day to a total dose of 7 000 ～ 8 000 cGy. cisplatin and 5-Fu two cycles in the first and fourth week during radioation); radiotherapy with AiDi injection group(RAD, n = 60, radiotherapy was the same as that of RC. Continuously injecting AiDi for 10 days 50 ml per day was one cycle which was repeated 3 cycles every alternation of 7 days); another 60 patients who contemporaneity reciceved radiotherapy alone (radiotherapy was the same as that of RC) because of some reasons and were comparable in clilical materials were regarded as the third group (R) to compare with the above two groups. The life quality, 3-year survival rate, and acute or chronic radiation reactions in the three groups were observed. Results All patients were followed up for more than 3 years: the 3-year survival rate in RC (73.3%),which was homologous as that in RAD(65.0 %, P =0.347), was higher than that in R group(53.3%,P = 0.028), and the local recurrent was inverse(10.0%,26.7%,P = 0.033 6). The acute and chronic radiation reactions in RC was highest whereas that in RAD group is lowest(P

Objective To analyze the genetic polymorphism of GSTM1 to lung cancer patients in north Sichuan of China and compare with race from other district.Methods PCR-based technique was used to detect the genotypes of GSTM1 in lung cancer patients.Results In local lung cancer patients,the frequency of homozygous deletions(null genotype) for GSTM1 was 58.4 % (73/125).Among the patients,the frequencys of null genotype for GSTM1 were 62.5 % (20/32) in female,56.9 % (53/93) in male,56.1% (32/57)in patients with squamous cell carcinoma and 54.8 % (17/31) in patients with adenocarcinoma,respectively.The frequency of deletions of GSTM1 in lung cancer patients from north Sichuan of China is slightly exceeding those of Europe and Americas (P ＜0.05) and similar to the domestic result (P ＞0.05).Conclusion The genetic polymorphism of GSTM1 to lung cancer patients in north Sichuan of China dosen' t show distinguished feature for this district and race.

Objective To retrospectively analyze the efficacy of radiotherapy on nasal NK/T-cell lymphoma, and to explore the prognostic factors. Methods Between January 2000 and December 2008, 62 patients with nasal NK/T-cell lymphoma were treated with radiotherapy in our hospital. Their clinic data and efficiency were reviewed retrospectively. Kaplan-Meier methods were applied in unifactorial analysis and the COX regression model was applied in multivariate analysis. Results The median overall survival time was 69.7 months (95 % CI, 63.0-78.0 months), and 3, 5-year survival rate was 66.1% and 46.8 %. Metastasis was 61.8 % for the first reason which resulted in failure. The median survival time was 72.6 months in the increased group of numbers of T lymphocyte CD3 and 39.6 months in the decreased group, the difference was significant(x2 =4.9309, P =0.0264). Multivariate analysis confirmed that modified IPI 0-1 (x2 = 7.5266, P =0.0061), the numbers increased for CD3 (x2 =9.0912, P =0.0266), and complete remission(x2 = 9.0912, P =0.0106) were significant favorable prognostic factors for survival. Conclusion The radiotherapy was effective for patients with nasal NK/T-cell lymphoma, but was failure on account of distant metastasis, so systematic therapy still has an important role. modified IP1 0-1, the number increased for CD3 and complete remission were significant favorable prognostic factors for survival.

Objective To study the effect of CT scanning condition on the target position coordinate with WIMRT radiotherapy planning system using the" Z" form localizing frame. Methods The whole Head Phantom containing three metal targets was scanned under the following conditions: localizing frame transver-sally tilting, CT gantry tilting and localizing frame axially tilting. Then the three target coordinates were com-puted respectively and compared with those under the standard condition. Results The height and width of coordinate under the localizing frame transversally tilting condition deviated from those under the standard scanning condition,which was in an angle dependent manner. On the other hand ,a tendency was shown that the greater the absolute height value of the targets coordinate, the greater the width value deviation. And so was the relation between the absolute width value of the coordinate and height value deviation. If CT gantry angle was not zero degree or localizing frame axis is not in the same line with the CT bed moving direction, the calculated longititude value of the targets coordinate was mainly affected. Conclusions CT scanning must be performed strictly under the standard localizing scanning condition by a proficient physicist.

The application of immune checkpoint inhibitors (ICI) has rewritten the current treatment pattern of non-small cell lung cancer. However, single-agent ICI has disadvantages such as small benefit population and slow tumor cytoreduction effect. Therefore, various immunizations combined with other treatment methods are becoming clinical hotspots. Low-dose irradiation shows a significant anti-tumor synergistic effect through activating the body's immune system, and its potential for adjuvant immunotherapy has transformed traditional radiotherapy from local radical treatment to immune adjuvant. This article reviews the current research progress of ICI combined with low-dose irradiation in the treatment of non-small cell lung cancer.

Objective To define the maximum-tolerated dose (MTD) of lobaplatin (LBP) in a weekly regimen combined with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC).Methods A total of 18 cases with stage Ⅲ/Ⅳ A NPC were enrolled.Concurrent chemoradiotherapy was given to all the patients with a dose escalation of LBP.The initial dose of LBP was 15 mg/m2 with an escalating dose of 5 mg/m2.At least 3 patients were assigned into each group.Patients were proceeded into the next dose group if no dose-limiting toxicity (DLT) occurred until the MTD was achieved.Efficacy and toxicity were evaluated regularly.Results Three patients were assigned into the 10 mg/m2,3 into the 15 mg/m2,and 6 into the 20 mg/m2 and 25 mg/m2 groups,respectively.Two patients experienced DLT in the 25 mg/m2 group.Hence,the MTD was determined as 20 mg/m2.At 3 months after corresponding treatment,the remission rate of nasopharyngeal tumors and neck-positive lymph nodes of the patients was 100％.The most common toxicity was reversible bone marrow suppression.Conclusions The MTD of weekly lobaplatin plus concurrent IMRT is 20 mg/m2 for locally advanced NPC.This regimen is reliable and safe,which is worthy of further clinical study.

Objective To investigate the relationship of programmed death ligand-1 (PD-L1) with clinicopathological characteristics,radiosensitivity and prognosis of the patients with esophageal squamous cell carcinoma(ESCC). Methods Ninety ESCC patients who received radical radiotherapy diagnosed by ESCC in Affiliated Hospital of North Sichuan Medical College were enrolled. Twenty cases of normal esophageal mucosa were used as the controls. The expression of PD-L1 was detected by using immunohistochemical SP method. Results The expression of PD-L1 protein was not correlated with age, gender, the maximum diameter of tumor, the length of lesion, the local aggressive of tumor, clinical stage and primary tumor volume (all P> 0.05). However, it was statistically correlated with the lymphatic metastasis (χ2= 4.404, P= 0.036). Meanwhile, PD-L1 positive expression was sensitive to radiation(χ2=4.888, P< 0.05). Single factor analysis showed that the maximum diameter of tumor and radiosensitivity were correlated with progression-free survival (PFS) (χ2=6.239,P =0.013;χ2=6.852,P =0.008; χ2= 6.312, P= 0.012) and overall survival (OS) (χ2=8.170, P = 0.004; χ 2= 4.261, P = 0.039; χ2= 5.003, P= 0.025) of ESCC patients. Multifactor analysis showed that the radiosensitivity and the maximum diameter of tumor affected PFS (OR= 0.512, 95 % CI 0.275-0.954, P= 0.035) and OS (OR= 0.507, 95 % CI 0.266-0.968, P= 0.039) in ESCC patients, respectively.Conclusions The level of PD-L1 expression is increased significantly in ESCC tissues compared with the normal esophageal mucosa tissues. PD-L1 may be a novel biomarker for predicting metastatic potential and radiosensitivity in ESCC patients, rather than the prognosis predictors of ESCC patients treated by radiotherapy.

The two-agent chemotherapy regimen of etoposide + platinum has always been the standard treatment modality for extensive-stage small cell lung cancer (ES-SCLC) during the past 30 years. However, the application of radiotherapy in ES-SCLC has not been clarified. Immunotherapy has made significant breakthroughs in ES-SCLC in recent years. Currently, the regimen of immunotherapy combined with basic chemotherapy has become the standard of care for ES-SCLC. As more and more evidence suggests that there is a non-negligible synergistic anti-tumour effect between radiotherapy and immunotherapy, the application value of radiotherapy in ES-SCLC has been reintroduced in the era of immunotherapy. At present, early clinical studies of thoracic radiotherapy (TRT) and brain radiotherapy (BRT) combined with immunotherapy have been initially explored in this regard, and the introduction of low-dose radiotherapy (LDRT) in ES-SCLC has also proposed a new direction of exploration. In this article, the progress in the application of radiotherapy in ES-SCLC was reviewed.

Background and purpose:Radical surgery after neoadjuvant immunotherapy combined with chemotherapy(nICT)in patients with locally advanced esophageal squamous cell carcinoma(LAESCC)has good efficacy and safety,and it can improve the patients'pathological complete remission(pCR)rate,main pathologic response(MPR)rate and R0 resection rate.The prognosis of patients with pCR/MPR after nICT is significantly better compared with patients without pCR.The prognosis of patients achieving pCR/MPR after neoadjuvant therapy has been demonstrated to be significantly better than that of patients with non-pCR/MPR.Therefore,finding predictive factors of pCR/MPR is beneficial for us to screen out the advantageous populations for combination therapy.The aim of this study was to investigate the value of clinical data of patients with LAESCC before and after nICT in predicting the degree of remission of different pathologies after radical surgery following neoadjuvant treatment and to observe the safety of the treatment.Methods:Data of patients with locally LAESCC who underwent radical surgery after nICT from January 2019 to June 2023 at the Affiliated Hospital of Chuanbei Medical College were collected.The clinical data of all patients as well as some blood,inflammation and nutritional indexes of patients before and after neoadjuvant therapy were collected,and the patients were grouped according to the different degrees of pathological remission after neoadjuvant therapy.Data were analyzed by multi-group comparative analysis of variance(ANOVA)and LSD-t post-hoc test.We explored the factors that had an influence on the different degrees of pathological remission,and collected and recorded the patients'adverse reactions during neoadjuvant therapy as well as their eventual surgeries.Results:Data of 62 patients with LAESCC treated with nICT who underwent radical surgery were collected.Only one patient showed grade 4 myelosuppression during neoadjuvant therapy,and the rest of the patients had adverse reactions≤grade 2.The R0 resection rate of the surgery was 98.39%.The present study was compared with the previous studies of LAESCC treated with neoadjuvant chemotherapy followed by radical surgery performed in Affiliated Hospital of Chuanbei Medical College.Compared with the previous studies conducted in our center,no significant difference was observed in terms of operation time,intraoperative bleeding,postoperative hospitalization time and surgical complications.The postoperative pathologic results showed that the pCR rate was 22.58%(14/62),and the MPR rate was 40.32%(25/62).According to the different tumor regression grade(TRG)after surgery,patients were divided into 3 groups of TRG1,TRG2 and TRG3-4,and differences in the platelet distribution width(PDW)before neoadjuvant therapy and the preoperative neutrophil-to-lymphocyte ratio(NLR)after neoadjuvant therapy were statistically significant among the 3 groups(P＜0.05).Further intra-group two-by-two comparisons of PDW before neoadjuvant therapy and NLR before surgery after neoadjuvant therapy were performed for the three groups of patients,respectively,and it was found that the PDW and NLR in the TRG2 group were lower compared with the TRG3-4 group,and the differences were statistically significant(P＜0.05).Conclusion:Radical surgery after nICT treatment in patients with LAESCC can have high R0 resection rate,pCR rate,MPR rate and reliable safety,and the lower PDW of patients before neoadjuvant therapy and the lower NLR of patients before surgery after neoadjuvant therapy predict better pathological remission efficacy.