Objective To investigate the intensity modulated radiation therapy (IMRT) planning optimization method to reduce the additional dose resulting from megavoltage cone-beam CT (MVCBCT) imaging for nasopharyngeal carcinoma IMRT treatment. Methods MVCBCT images collection process was simulated using XiO treatment planning system. The mean doses of MVCBCT ( DMVCBCT ) were calculated in gross tumor volume ( GTV), clinical target volume ( CTV ) and risk at organ or tissue using 27. 4 cm× 27.4 cm portal radiation 8 MU,5 MU (A,C) and 27.4 cm× 15.0 cm portal radiation 8 MU,5 MU (B,D). The dose correct factor of MVCBCT (CFMVCBCT) according to IMRT TPS and DMVCBCT ,but CFMVCBCT plus MVCBCT imaging process for radiotherapy planning optimization. The paired t-test was play for A∶ B,C∶ D,A∶ C,B∶ D of DMVCBCT. Results The DMVCBCT and CFMVCBCT of A, B, C, D were 7. 78,5. 78,4. 88,3.55 cGy ( A∶ C, t =24.41,P＜0.01) and 0.993 -0.997 in GTV,with 7.88,6.95,4.88,4.38 cGy (A∶ B,A∶ C,B∶ C,t=3. 85, -31.82, -8.52, all P＜0. 01) and 0.992 -0.996 in CTV1 ,with 8.28,6.67,5. 17,4. 17 cGy (A ∶B,A∶C,B∶C,B∶D,t=6.41 -18.24,all P＜0. 01) and 0.991 -0.996 in CTV2;with 6.88,5.00,4.28,3. 50 cGy ( A∶ B, A∶ C,t = 2. 83,11.03, all P ＜ 0. 05 ) and 0. 989 - 0. 995 in spinal cord, with 7.88,7. 38,4. 95,4. 62 cGy and 0. 984 -0. 990 in left parotid, with 8. 67,0. 28,5. 33,0. 28 cGy and 0. 963 -0. 999 in left optic nerve,with 9. 17,0.22,5.72,0. 17 cGy and 0.821 -0.997 in left eye lens,with 6.95,2. 17,4. 38,1.38 cGy and 0. 987 -0. 997 in brain stem, with 7.78,0.45,4. 95,0. 28 cGy and 0. 978 -0. 999 ( A ∶ B,A∶ C,B∶ C,B∶ D for five organ or tissue,t =5. 06 -335. 16 ,all P ＜0. 01 ) in optic chiasm. Conclusions The MVCBCT imaging process resulted in radiation doses to patient. The impact of MVCBCT image acquired dose on IMRT treatment plan for NPC was eliminated by a compensation method.

Objective To evaluate the desimetrie performances of Seven29TM two-dimensional ion chamber array(2D-array).Methods Seven29TM 2D-array was calibrated by using solid water,IBA Dose 1 dosimeter and RIT 113 film dosimetry system.Tests and verifications were performed to evaluate the preci sion of absolute and relative doses of the 2D-array in solid water.Meanwhile ,the dose linear and energy re sponse of the 2D-array were studied.Results Solid water was a good equivalent phantom of water.For 2D-array,the calibration factor in solid water was 1.007 ,the absolute dose error was less than 2.1% ,the rel ative dose error was less than 3.8% and the errors of dose linear and energy response were hess than 0.2% and 1.2% ,respectively.Conclusions The Seven29TM 2D-array,possessing excellent desimetry perform ances,is a powerful tool for intensity modulated radiotherapy.

Objective To evaluate the peripheral dose (PD) from megavoltage cone-beam CT (MVCBCT) imaging for head-and-neck region image-guided radiation therapy,to determine the correlation of PD with monitor unit (MU),and to investigate the impact of imaging field size on the PD.Methods Measurements of PD from MVCBCT were made with a 0.65 cm3 ionization chamber placed in a specially designed phantom at various depths and distances from the field edges.The PD at reference point inside the phantom was measured with the same ionization chamber to investigate the linearity between MU used for MVCBCT and the PD.The homogeneity of PD in the axial plane of the phantom were measured.Results PD from MVCBCT increased with increasing number of MU used for imaging and with increasing the field size.The measured PD in the phantom decreased exponentially as distance from the field edges increased.PD also decreased as the depth from the phantom surface increased.There was a strong linear relationship between PD and MUs used for MVCBCT.The PD was heterogeneous,with higher dose at the anterior than the posterior.Conclusions The PD from MVCBCT depend much on the MVCBCT delivery MU and the scan field size.In clinic,using the smallest number of MU allowable and reducing MVCBCT scanning field size without compromising acquired image quality is an effective method of reducing the PD.

Objective To estimate and compare the equivalent dose between the intensity modula-ted radiotherapy (IMRT) and conventional radiotherapy (CR) for patients with nasopharyngeal carcinoma (NPC). Methods The peripheral equivalent dose of NPC patients was measured by TLD during IMRT and CR. The whole-body equivalent dose was calculated. Results When prescribed tumor dose of 70 Gy was given, the mean number of accelerator output units were 25235 MU and 8575 MU, and the whole-body e-quivalent dose were 73.65 mSy and 15.28 mSy for IMRT and CR, respectively. Conclusion The equiva-lent dose in IMRT is 4.8 times higher than that in CR for patients with nasopharyngeal carcinoma.

Objective To compare the whole-body equivalent doses from volumetric modulated arc therapy (VMAT) and static intensity-modulated radiotherapy (IMRT) for patients with cervical cancer.Methods Nine patients with cervical cancer admitted to our hospital in 2014 were included in this study.Both VMAT and IMRT were planned for each patient.Each patient's personal dose equivalent (Hp (10)) was measured using thermoluminescent dosimeters placed at the xiphoid process and glabella during IMRT and VMAT.The whole-body equivalent doses were estimated based on the results measured at the xiphoid process and compared between the VMAT and IMRT techniques.The paired t test was used for difference analysis.Results The Hp (10) values measured at the xiphoid process and glabella of every patient were lower for VMAT than for IMRT.At a prescribed dose of 50 Gy,if the mean Hp (10) values measured at the xiphoid process were considered to represent the whole-body equivalent doses,the whole-body equivalent doses for VMAT and IMRT were 364 mSv and 538 mSv,respectively.Conclusions VMAT results in a lower whole-body equivalent dose to patients compared with IMRT.The decreased whole-body equivalent dose delivered by VMAT may reduce the likelihood of a radiation-induced secondary malignancy.

Objective To investigate the impact of adopting different dose grid resolution during volumetric modulated arc therapy (VMAT) planning on COMPASS pass rate.Methods A total of 10 patients with cervical cancer were enrolled.Four types of VMAT plans (plan1,plan2,plan3,plan4) were designed for each patient,with dose grid resolution of 0.2 cm × 0.2 cm × 0.2 cm,0.3 cm × 0.3 cm ×0.3 cm,0.4 cm ×0.4 cm ×0.4 cm and 0.5 cm ×0.5 cm ×0.5 cm,respectively.The plans were exported to Linac and conducted,then measured by COMPASS.The discrepancies were analyzed,which were obtained by comparing reconstructed dose from COMPASS and dose from TPS optimization.Results For tumor volume,the mean value of Dmean and D95 were ＜ 0.5％ and ＜ 1.3％ respectively,and the standard deviation were both ＜ 1.0％.For organs at risk (OAR),the max discrepancies were Dmean of femur with-6.7％,-7.0％,-8.0％,-5.8％,and V35 of rectum with 4.9％,-6.3％,-6.1％,-5.7％ in four types of VMAT plans.The γ (3％,3 am) rate of tumor volume was ＞95％ with standard deviation ＜ 2.5％,with no statistically significant difference among the four types of plans (P ＞0.05).The γ (3％,3 mm) rate of OARs were ＞ 98％ except femur (＞ 95％),and the standard deviations were within 1.9％-6.1％,with no statistical significance (P ＞0.05).The average γ rate of tumor volume and OARs were ＜ 0.4 except femur (＞ 0.4),with no statistically significant difference among four types of VMAT plans (P ＞ 0.05).Conclusions COMPASS pass rate was not influenced by the dose grid resolution between 0.2 ～ 0.5 cm for VMAT plan.

Objective To observe the effect of preoperative enteral nutritional support combined with modified Ivor-Lewis surgery for esophageal cancer on lung function and mRNA expression of GATA-binding protein 3(GATA3)and forkhead protein P3(Foxp3)in peripheral blood.Methods Sixty esophageal cancer patients who underwent modified Ivor-Lewis surgery in our hospital from January 2022 to October 2023 were selected and divided into two groups by simple random method.The control group was given conventional diet before operation,and the observation group was given enteral nutrition support before operation.The two groups were compared in terms of nutritional support.Results Both groups showed significantly decreases in one-second exertion expiratory volume/exertion lung volume(FEV1/FVC)(P<0.05),FVC(P<0.05),FEV1(P<0.05)and the levels of peripheral blood GATA3(P<0.05),Foxp3 mRNA(P<0.05)expression compared with those at admission(P<0.05),but no significant differences in pulmonary function(P>0.05),peripheral blood GATA3(P>0.05),and Foxp3 mRNA(P>0.05)expression between them at 1 week postoperatively.Both groups exhibited significantly lower levels of albumin,prealbumin,haemoglobin,transferrin,PNI and body mass and body mass index at admis-sion as compared to those at one week after surgery(P<0.05).The observation group showed significantly higher levels of albumin,prealbumin,haemoglobin,transferrin,and PNI at 1 week postoperatively(P<0.05),but no significant differences in ventilation time,defecation time,drain retention time,hospitalisation time,and compli-cation rate as compared to the control group(P>0.05).Conclusion Preoperative enteral nutritional support combined with modified Ivor-Lewis surgery for esophageal cancer improves postoperative nutritional status,and ren-ders less effect on postoperative lung function and peripheral blood GATA3 and Foxp3 mRNA expression.

Objective: To establish the functional occlusal morphology of fixed prostheses by using functional generated path (FGP) technology on a three-dimensional-printed diagnostic crown in order to decrease the chance of occlusal adjustment during try-in procedure of the complete crown, and to avoid the risk of occlusal interference after cementation of prosthesis. Methods: A double-blind clinical trial was performed. Ten subjects (4 males, 6 females) who needed a first molar complete crown restoration were enrolled in Department of Prosthodontics, Peking University School and Hospital of Stomatology from July 2018 to December 2018. The working models with the abutment teeth of the ten participants were scanned to obtain the digital models, then the occlusal surfaces of crown were formed by either FGP technology on a three-dimensional (3D) printed diagnostic crown and then were scanned directly for computer aided design and computer aided manufacture (CAD/CAM) crown fabrication as experiment group, or conventional technology based on database as control group. Then zirconia crowns were fabricated for two groups. During crown try-in of the two groups, preferred crowns of subjects were recorded, the occlusal contact criteria including the occlusal contact area (mm²), the heights of occlusal high spot (mm) before and after the adjustment of crowns were digitally analyzed, and the amount of adjustment (mm and mm³) were calculated on digital models by using a reverse engineering software (Giomagic Sudio & Quality). Differences of values were compared statistically with paired t-test (α=0.05). Results: The amount for occlusal adjustment for crowns in the experiment group [(7.320±4.238) mm³] was statistically less than that in the control group [(20.178±9.650) mm³] (P<0.05), the occlusal contact area of experiment group [(11.430±4.102) mm²] was statistically bigger than that of the control group [(4.808±3.223) mm²] (P<0.05), the heights of occlusal high spots for crowns in the experiment group was (0.043±0.019) mm while it was (0.594±0.201) mm in the control group with statistically significant differences (P<0.05). Conclusions This method could lead to a crown with less adjustment of occlusion, less occlusal high spot and less risk of occlusal interferences.