OBJECTIVETo explore new source of skin for burn wound coverage.

METHODSSplit-thickness consanguineous skin was harvested from New Zealand white rabbit and was soaked in 200 g/L of multi-peptides of Tripterygium wilfordii, 50 g/L of dexamethasonel, on 9 g/L of normal saline solution for 15 - 30 mins, respectively. The consanguineous skin was thereafter grafted onto the whole layer skin defects in filial generation of rabbits with non-consanguineous skin as the control. The survival time and rejection of the grafted skin was observed.

RESULTSThe rejection appeared evidently less intense and survived significantly longer (43 +/- 3.5 days) when the consanguineous skin was pretreated by Tripterygium wilfordii. However the grafted consanguineous skin survived for 30 +/- 2.5 days when it was pretreated by dexamethasone. The grafted skin was quickly rejected and survived only for 11 +/- 1.6 days when the skin was pretreated by normal saline or the skin was non-consanguineous.

CONCLUSIONConsanguineous skin possessed partial compatibility with the recipient due to similar antigen, which was beneficial to the its survival, especially after the skin was pretreated.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Burns ; surgery ; Dexamethasone ; pharmacology ; Female ; Graft Rejection ; Graft Survival ; Male ; Plant Extracts ; pharmacology ; Rabbits ; Skin ; drug effects ; Skin Transplantation ; methods ; Transplantation, Isogeneic ; Tripterygium ; Wound Healing

Objective To study the variation of gross tumor volume (GTV) and clinical target volume (CTV) definition for lung cancer between different doctors.Methods Ten lung cancer patients with PET-CT simulation were selected from January 2008 to December 2009.GTV and CTV of these patients were defined by four professors or associate professors of radiotherapy independently.Results The mean ratios of largest to smallest GTV and CTV were 1.66 and 1.65, respectively.The mean coefficients of variation for GTV and CTV were 0.20 and 0.17, respectively.System errors of CTV definition in three dimension were less than 5 mm, which was the largest in inferior and superior (0.48 cm,0.37 cm,0.32 cm;F=0.40,0.60,0.15,P=0.755,0.618,0.928).Conclusions The variation of GTV and CTV definition for lung cancer between different doctors exist.The mean ratios of largest to smallest GTV and CTV were less than 1.7.The variation was in hilar and mediastinum lymphanode regions.System error of CTV definition was the largest (<5 mm) in cranio-caudal direction.

Objective To analyze the influencing factors of cone-beam CT (CBCT) imagine registration in lung cancer. Methods From Mar. 2007 to Dec. 2007, 20 patients with lung cancer were treated with IGRT. The imagines of CBCT were collected from 6 to 19 fractions during the patients' radiotherapy. To compare the difference of set-up errors between the two groups according to the distance from the lesion in lung to the centrum. At the same time, CBCT imagines from the first, middle and the last fraction of these patients' radiotherapy were registrated in bone and grey methods by four doctors. The difference of set-up errors between different doctors and registrated methods were compared. Results The mean values of set-up errors were ＜2 mm in the two groups without significant difference (x:-1.31mm vs 0. 10 mm (t=0. 07,P=0.554);y:1.24 mm vs 1.37 mm (t=0. 05,P=0. 652);z: - 1.88mm vs -1.26mm (t= -0. 12,P=0.321)). The mean values of set-up errors were ＜ 1.3 mm in four doctors and registrated methods without significant difference, for bone registration,x: -0. 05 mm, -0. 01 mm,0. 05 mm, -0.12 mm and -1.31 mm ( F=-0.01,P=0.887) ;y:0.56 mm,0.35 mm,0.51 mm and 0.43 mm (F= -0.01,P=0.880);z: -1.16 mm, -1.20 mm, -0.88 mm and -1.03 mm (F= -0.04,P=0. 555 ), for grey registration ,x: -0.32 mm, -0.341 mm, -0.395 mm and - 0.37 mm(F=-0.01, P=0.874);y:0.34 mm,0.54 mm, -0.04 mm and 0.27 mm (F= -0.03,P=0.622);x:-1.12 mm,- 1.15 mm, - 1.13 mm and - 1.04 mm (F=0. 00,P=0. 812). Conclusions With the same registrated box and imagine quality, the location of the lesions in lung, registred methods and different doctors are not the influencing factors for CBCT imagine registration.

ObjectiveTo evaluate the value of the international union against cancer (UICC)stage,pathologic complete response (pCR),and the estimated treatment response as various means for prognostic stratifying patients after surgery in patients with squamous cell carcinoma of the esophagus who received preoperative radiotherapy (RT).MethodsA retrospective review was performed on 311 patients with esophageal squamous cell carcinoma who received RT before the esophagectomy. Data collected included the demographics,the RT details,the pathologic findings,and the survival.Prognostic survival was analyzed by Kaplan-Meier method and Logrank test.ResultsThe follow-up rate was 96.5％,89 and 43 patients,respectively were followed up more than 5 and 10 years.In univariate analysis,residual disease and the number of positive lymph node were predictors of the overall survival ( T-pCR,x2 =11.53,P =0.001 ;0,1 -3,≥4,x2=42.13,P=0.000,respectively).Further study found the 7th stage system of UICC cannot (can or cannot) entirely predict the prognosis of this group of patients.If categorizing the stages of their lymph nodes into three groups:N0(0),N1 (1-3) and N2(≥4)),and the modified UICC system can accurately distinguish ypStage Ⅰ with ypStage Ⅱ ( T0.3 N 1 M0 + T3 N0 M0 ) ( x2 =11.15,P =0.001 ) and ypStage Ⅱ with ypStage Ⅲ ( T4 N0-1 M0 and T0-3 N2 M0 ) ( x2 =23.39,P =0.000 ).ConclusionsThe pathologic post-radiotherapy T stage and the number of positive lymph node are predictors for esophageal squamous cell carcinoma receiving preoperative radiotherapy.The modified UICC stage system can be a better survival predictor than the 7th UICC stage system.

Objective To compare postoperative three-dimensional conformal radiotherapy (3DCRT) and conventional radiotherapy (CR) in patients with non-small-cell lung cancer (NSCLC). Methods From Nov. 2002 to Mar. 2006,162 patients with stage ⅠB～ⅢB NSCLC receiving postoperative radiotherapy in our department were restrospetcively analyzed. Among them,86 received 3DCRT and 76 re-ceived CR. The survival outcome, pattern of failure and treatment-related side effects in both groups were an-alyzed. Results The median follow-up was 29.4 months in the 3DCRT group and 24 months in the CR group. The 1-,2- and 3-year local-regional free survival was 97.5% ,83.2% and 83.2% in 3DCRT group, and 84.3% ,76.0% and 65.6% in CR group(χ2= 5.46, P = 0.019), respectively. No statistically signifi-cant difference was found in the overall survival, disease-free survival or distant metastasis-free survival be-tween the two groups. The local-regional failure rate was statistically different between the two groups (14.5% vs 33.3% ,χ2 =7.70,P =0.006). The incidence of distant metastasis in the two groups was simi-lar. Radiation pneumonitis of NCI CTC grade 2-3 occurred in 10 patients(11.6%)in 3DCRT group and 18 (23.7%) in CR group,which was statistically different(χ2 =4.10,P=0.043). Conclusions Postopera-tive 3DCRT for NSCLC provides a better local-regional control and lower incidence of radiation pneumonitis compared with CR.

Objective To analyze survival and recurrence rates of patients with Masaoka stage Ⅲ thymoma and to explore the prognostic factors.Methods Between September 1965 and December 2010,a total of 111 patients with stage Ⅲ thymoma treated in our hospital were retrospectively analyzed.Sixty-eight patientsreceived comple te rescction ± radiotherapy,whilc 23 patients received incomplete resection ±radiotherapy and 20 patients received biopsy ± radiotherapy.Eighty-seven patients received postoperative radiotherapy (12 patients received preoperative radiotherapy) while 24 patients received surgery alone.Results The median follow-up time was 66 months (5-540) with a follow-up rate of 92.5％ (111/120).Compared with incomplete resection ± radiotherapy and biopsy ± radiotherapy,the 5-year overall survival (OS) (88％ vs.59％ and 57％,x2 =12.11,P =0.002),disease free survival (DFS) (74％ vs.40％ and 41％,x2 =11.49,P =0.003) and disease specific survival (DSS) (94％ vs.69％ and 60％,x2 =10.95,P =0.004) could be improved with complete resected ± radiotherapy.Compared with surgery alone,postoperative radiotherapy did not improve OS,DFS and DSS (55％ vs.77％ (x2 =1.01,P =0.316),61％vs.61％ (x2 =0.12,P =0.729) and 72％ vs.85％ (x2 =0.27,P =0.601),respectively).For the 68 patients received complete resection,radiotherapy after complete resection (56 patients) did not improve OS,DFS and DSS (82％ vs.89％ (x2 =0.31,P =0.576),72％ vs.81％ (x2 =0.05,P=0.819) and 89％vs.95 ％ (x2 =0.05,P =0.825),respectively) compared with surgery alone (8 patients).Conclusions Stage Ⅲ thymoma patients received complete resection had better outcome than patients received incomplete resection or biopsied only.The role of postoperative radiotherapy is still controversial for stage Ⅲ thymoma,randomized clinical trial is needed

OBJECTIVETo analyze the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) for patients with locally advanced non-small-cell lung cancer (LA-NSCLC).

METHODSClinical data of 251 patients with stage III (76 IIIA and 175 IIIB) NSCLC who received CCRT as initial treatment between Jan 2001 and Dec 2010 in our hospital were reviewed. A median total radiotherapy dose of 60 Gy (range, 50-74 Gy) were delivered. 174 patients were treated with IMRT, 51 with 3D-CRT and 26 with 2D-radiotherapy. EP chemotherapy regimen was administered in 112 patients, PC regimen in 99 patients, topotecan regimen in 18 patients and other regimens in the remaining 22 patients. The efficacy and toxicity of CCRT were retrospectively analyzed.

RESULTS244 patients were assessable for response, including 6 (2.5%) patients with CR, 183 (75.0%) with PR, 42 (17.2%) with SD and 13 (5.3%) with PD. At a median follow-up period of 20 months, the 1-, 3-, 5- year OS were 69.2%, 31.2%, 23.2%, respectively, and the median OS was 21 months. The 1-, 3-, 5- year PFS were 40.9%, 22.1%, 17.7%, respectively, and the median PFS was 10 months. Patients with stage IIIA NSCLC achieved better 5-year OS than that with IIIB NSCLC (29.2% vs. 20.7%, χ2=2.254, P=0.133). Failure pattern was assessable in 244 patients, including 61 (25.0%) locoregional progression alone, 55 (22.5%) distant metastasis alone and 77 (31.6%) with both. The rates of grade≥3 radiation pneumonitis, esophagitis and hematologic toxicity were 4.4%, 11.2% and 26.4%, respectively.

CONCLUSIONSCCRT provide stage III NSCLC patients favorable outcome with acceptable toxicity. CCRT is standard therapeutic approach for patients with unresectable locally advanced NSCLC.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; pathology ; therapy ; Chemoradiotherapy ; Cisplatin ; administration & dosage ; Cyclophosphamide ; administration & dosage ; Esophagitis ; etiology ; Humans ; Lung Neoplasms ; pathology ; therapy ; Neoplasm Staging ; Radiation Pneumonitis ; etiology ; Radiotherapy, Conformal ; Retrospective Studies ; Topotecan ; administration & dosage

Objective: The aim of this retrospective study was to evaluate the prognostic significance of pretreatment Neutrophil-to-Lymphocyte Ratio(NLR) in locally advanced non-small cell lung cancer(NSCLC) patients treated with thoracic radiotherapy. Methods: We retrospectively analyze 420 patients who received thoracic radiotherapy alone, sequential chemoraiotherapy or concurrent chemoradiotherapy for locally advanced stage NSCLC from January 2007 to December 2010 of our hospital. The patients were divided into two groups (high NLR group and low NLR group) with appropriate cutoff point using the receiver operating characteristic (ROC) curve method. The survival curve was established by Kaplan-Meier method. The Log-rank test was used to compare the survival of the two NLR groups and the multivariate analysis was carried out by Cox regression model. Results: Among the 420 patients, 99 received radiotherapy alone, 139 received sequential chemoradiotherapy and 182 received concurrent chemoradiotherapy. 345 patients died and 75 were still alive. The median follow-up time was 5.2 years and the median overall survival was 22 months. The cut-off value of pretreatment NLR was 2.1. The 5-year PFS and OS rates in high NLR group and low NLR group were 10.6% vs 15.7% (P=0.033) and 15.5% vs 22.7% (P=0.012). Multivariate analysis confirmed that pretreatment NLR (hazard ratio 1.06, P=0.041) was independent prognostic factor of OS. Conclusions Our study revealed that the pretreatment NLR is the independent prognostic factor of OS in patients with locally advanced stage NSCLC treated with thoracic radiotherapy. However, NLR is still greatly influenced by patient′s condition and treatment which needs further research.