Objective This study was purposed to analyze and summarize the vein temporary cardiac pacing therapy in patients with acute inferior wall myocardial infarction complicated by high degree atrioventricular block (AVB) . Methods One hundred and twelve patients with acute inferior wall myocardial infarction complicated by high degree AVB were selected as observation and research subjects, and they were treated by vein temporary cardiac pacing therapy. The safety, availability of different kinds of this surgical methods and the relationship between these surgical methods and complication were observed. Results Three out of 60 patients who were treated by ordinary temporary pacing electrode catheter were suffering from cardiac tamponade. No serious complications occurred when 52 patients were treated by floating temporary pacing electrode catheter. Conclusion Floating temporary pacing electrode catheter have already proved safe and effective in the treatment of acute inferior wall myocardial infarction complicated by AVB, and it could decrease the incidence of serious complications such as myocardial perforation.

Objective To analyze and summarize the treatment strategies for unstable angina with no-reflow phenomenon after PTCA during early percutaneous interventional procedures.Methods A total of 32 cases with unstable angina were divided into two groups:one group with drug therapy and the other group with drug therapy and thrombus aspiration catheter.The patients were chosen when there was no-reflow phenomenon after PTCA during early percutaneous interventional procedures and their clinical data were compared and analyzed.Blood flow TIMI grade,myocardial perfusion grade (MBG),TIMI myocardial perfusion (TMP) grade and other indexes were observed and recorded.Results The general conditions had no statistical difference between two groups.Compared with the drug therapy group,the proportion of patients with TIMI,MBG and TMP grade 3 was higher in aspiration and drug therapy group (89％ VS 71％ P＜0.05).Conclusion Drug therapy and thrombus aspiration catheter in treatment helps to improve myocardial perfusion level for unstable angina with no no-reflow phenomenon after PTCA during early percutaneous interventional procedures.

Objective To investigate the treatment outcome and failure in patients with primary mediastinal large B-cell lymphoma(PMBL). Methods Between Jan. 1992 and Oct. 2006, a total of 46 patients with pathologically confirmed PMBL were reviewed, including 14 with Ann Arbor Stage I disease, 23 with Stage Ⅱ disease,3 with Stage Ⅲ disease and 6 with Stage Ⅳ disease. Stage Ⅰ+Ⅱ disease was present in 80% of the patients. All patients were treated with chemotherapy ,and 29 also received radiotherapy. Twenty-seven patients(59%) were treated with first generation regimen(CHOP),9(20%) with third generation regimens (MACOP-B, ProMACE/CytaBOM, m-BACOD, or ProMACE-MOPP), and 10(22%) with high-dose chemotherapy (HDCT/APBSCT). Rituximab was administered to 16 patients (35%). For most patients who received radiotherapy,an involved field was used with a median dose of 45 Gy in 23 fractions.Results The rate of complete remission, partial remission and progression disease was 41%, 30% and 24% ,respectively. The 5-year overall survival rate(OS) for all patients was 35%. The 2- and 5-year OS was 79% and 63% for stage Ⅰ+Ⅱ and 51% and 0 for stage Ⅲ+Ⅳ ,respectively(X2=4.35 ,P=0. 037).The 2-year progression free survival rate was 63 % and 11%, respectively (X2=17.77, P=0.1300). The 5-year OS was 80% for the patients with CR,50% for those with PR,and 0 for those with progression disease(X2= 19.58 ,P=0.003 ). With a median follow-up of 22 months, progression disease and relapse occurred in 19 patients. Conclusions Survival of patients with advanced stage PMBL is poor. Further studies areneeded to confirm the optimal treatment. Radiotherapy often plays a pivotal role in local control.

Objective:To summarize the experience of radiation oncology residency training programs in western coutries, and provide evidence to improve the present Phase-I Radiation Oncology Residency Training Programs in China.Methods:An electronic questionnaire-based survey was conducted among residents and staffs in 6 top cancer centers in China and 5 centers from Europe and North America to collect their feedback regarding the description and comparison of different programs.Results:A total of 70 responses and 4 papers explaining relevant training programs from 26 residents and 23 teachers in Chinese hopsitals and 20 residents and 1 teacher from Europe and North America were received. The Radiation Oncology Residency Training Programs in China were designed into 2 phases, and the results in the current study were involved with the first phase. Program designs were similar in the following aspects: goal, clinical practice-based training, rotation curriculum, interim and final assessment. However, the total timeframe in the investigated Chinese Phase-I programs was shorter than that in western hospitals (2 to 3 years vs. 4 to 5 years). Chinese programs covered major common diseases, whereas rotation design was performed based on each individual disease in western programs. In Chinese programs, the working hours were mainly 40-60 h every week. Although the working hours were commensurate with local workforce regulations, the residents from MSK program had an outstanding longer working time of 60-80 h every week and treated more patients compared with other programs. Conclusions:The investigated Phase-I Radiation Oncology Residency Training Programs in 6 top cancer centers in China share common features in goals, training modes and assessments with western programs. However, our programs have shorter timeframe and less detailed requirements in individual disease than the western programs.

Objective To analyze the outcome and prognostic factors in breast cancer at high-risk of recurrence and evaluate the role of radiotherapy. Methods 381 breast cancer patients treated with mastec-tomy and axillary dissection were retrospectively analyzed. The including criterias were pathologic diagnosis of invasive breast cancer, T_3-T_4 and/or four or more positive axillary nodes. The survival rates was calculat-ed by Kaplan-Meier method, and compared by Logrank test. Cox regression model was used to select poten-tial prognostic variables. Results The median follow up was 48 months. The 5-year overall survival (OS) and locoregional recurrence-free survival (LRFS) rates were 76.8% and 89.7%, respectively. Radiothera-py significantly improved the OS (80.9% vs. 62.3%, χ~2=15.47, P=0.001) and LRFS (93.4% vs. 77.1% χ~2=19.95,P=0.000). The use of ipsilateral chest wall and supraclavicular nodal radiation was associated with increased 5-year chest wall recurrence free survival (96.8% : 86.2%, χ~2= 12.66, P=0.001) and 5-year supraclavicular node recurrence free survival (97.7% : 90.7 %, χ~2= 9.98, P=0.002).However, axillary irradiation had no impact on 5-year axillary recurrence free survival (98.4% : 96.1% ,χ~2=0.74, P=0.389). In multivariate analysis, absence of radiotherapy (χ~2=14.42, P=0.000), 10 or more positive axillary nodes (χ~2=21.60, P=0.000), and T_4 stage (χ~2=10.79, P=0.001) were inde-pendent unfavorable prognostic factors for overall survival. Conclusions Radiotherapy improves the overall survival of breast cancer patients with T_3, T_4 and/or four or more positive axillary nodes. The chest wall and supraclavicular nodal radiation should be given to this group of patients.

erall survival.

Objective To analyze the outcomes and the role of radiotherapy in breast cancer pa-tients with T1-T2 and one to three positive axillary nodes treated with modified radical mastectomy, and to investigate the prognostic factors for loco - regional recurrence in patients without radiotherapy . Methods Three hundred and seventy breast cancer patients with T1-T2 and one to three positive axillary lymph nodes treated with mastectomy and axillary dissection were retrospectively analyzed. Kaplan-Meier method was used to calculate the overall survival (OS) and loco-regional recurrence-free survival (LRFS) rates. The Logrank test was used for the comparison of the survival curves of patients with or without radiotherapy. Univariate analyses of potential prognostic variables for LRFS were performed. Results The 5-year OS and LRFS rates were 85.4% and 91%. Radiotherapy significantly improved the 5-year LRFS rate ( 100% vs. 89.5% ;x2 = 5.17, P=0.023). However, there was no significant difference in overall survival rate between patients with and without radiotherapy. In univariate analyses, T stage, the number of positive axillary nodes, C-erbB-2 and PR status were the significant predictive factors for LRFS. Conclusions For breast cancer pa-tients with T1-T2. and one to three positive axillary nodes, radiotherapy improves the LRFS, but not OS. T stage, the number of positive axillary nodes, C-erbB-2 and PR status are predictive factors for loco-regional recurrence in patients without radiotherapy.

Objective To analyze the acute and late toxicities in patients with prostate cancer trea-ted with hypofractionated intensity-modulated radiotherapy (IMRT). Methods Between June 2006 and June 2008, 37 patients with prostate cancer were treated with hypofractionated IMRT. The clinical target vol-ume (CTV) was the prostate, seminal vesicles and pelvic lymph nodes in 24 patients, the prostate and semi-hal vesicles in 12, and only the tumor bed in 1. The dose per fraction was 2.3 - 2.8 Gy, with 2.7 Gy in 26 patients. The minimal dose was 62.5-75.0 Gy to the prostate and seminal vesicles, and 50 Gy to the pelvic lymph nodes. Results The median follow-up was 14 months. None of the patients experienced grade 4 a-cute gastro-intestinal (GI) toxicity. Grade 1, 2 and 3 acute GI toxicity occurred in 24.3%, 35.1% and 2.7% of the patients, respectively. The rectal V50>27% and V55>20% were highly significantly associat-ed with grade ≥1 acute GI toxicity. Grade 1,2 and 3 acute genitourinary (GU) toxicity occurred in 68%, 0% and 3% of the patients, respectively. The bladder V50> 10% was significantly associated with grade ≥1 acute GU toxicity. The incidence of late GI toxicity was low. No grade ≥3 late GI toxicity was observed. The incidence of late grade 1 and 2 GI toxicity was 24% and 5%, respectively. The rectal V65> 10% was highly significantly associated with grade ≥1 late GI toxicity. No late grade 4 GU toxicity was observed. The incidence of grade 1, 2 and 3 late GU toxicity was 49%, 11% and 3%, respectively. Grade ≥2 late GU toxicity was correlated with V40, V50 and mean dose of the bladder. Conclusions Acute and late toxicity of hypofractionated IMRT is acceptable in patients with prostate cancer.

Objective To analyze the clinical features and treatment outcomes of extranodal diffuse large B-cell lymphoma(DLBCL). Methods Ninety-nine consecutively diagnosed patients with extranodal DLBCL were reviewed. All patients were confirmed by a combination of morphologic and immunohistochemi-cal evaluation. The primary sites of extranodal DLBCL were the gastrointestine(n = 32) ,central nerve system (CNS)/testis(n=14) ,and other sites (n = 53). Results Extranodal DLBCL was characterized by a pre-dominance in old males,less frequency of B symptorns,a large proportion of stage Ⅰ-Ⅱ disease and low in-ternational prognostic factor(IP1) score. The 5-year overall survival(OS) rate for all patients was 78.9%. The corresponding OS rate was 82.5% for gastrointestinal origin, 37.0% for CNS and testis origin and 74.6% for other organ origin, respectively. On univariate analysis, performance status, IPI score and more than one extranedal site involvement were the prognostic predictors for 5-year OS. Conclusions Being a heterogeneous group of lymphomas, extranedal DLBCL has good prognosis except those derived from the CNS and testis.

Objective To analyze clinical characteristics of diffuse large B-cell lymphonma(DL BCL) of Waldeyer's ring(WR-DLBCL) comparing with those of nodal DLBCL(N-DLBCL).Methods 181 patients consecutively diagnosed as primary WR-DLBCL(80) or N-DLBCL(101) were retrospectively reviewed.According to Ann Arbor staging system,57,83,26 and 15 patients had stage Ⅰ ,Ⅱ ,Ⅲ and Ⅳ disease,respectively.Patients with stageⅠ-Ⅱ disease were treated with chemotherapy and radiotherapy, whereas patients with stage Ⅲ-Ⅳ disease received primary chemotherapy. Results Comparing with N-DL BCL,pafients with WR-DLBCL presented with more stage Ⅱdiseases,more frequent involvement of adjacent organs and tissues,less B-symptoms,less involvement of spleen and lower lactate dehydrogenase (LDH) and β2-microglobulin(β2M) level.The 5-year overall survival(OS) rate of all patients was 76% for WR-DLBCL and 56% for N-DLBCL(x2 =2.43,P=0.119) ,respectively.The corresponding OS rate for stage Ⅰ and Ⅱ diseases was 78% for WR-DLBCL and 58% for N-DLBCL(X2 = 2.76,P =0.097),respectively.On univa riate analysis,elevated LDH,IPI and elevated β2 M were prognostic predictors for WR-DLBCL patients, whereas elevated β2 M,bulky tumor and IPI were associated with poor OS for N-DLBCL patients.On multiva riate analysis,elevated LDH and β2M were prognostic predictors for all patients. Conclusions Comparing with N-DLBCL,WR-DLBCL represents distinct clinical features and prognosis.