In recent years, the incidence of pancreatic cancer shows rising trend and higher mortality. Pancreatic cancer lacks early diagnostic methods with high sensitivity and specificity, and the surgical resection rate is 10 %-20 % with high operation mortality, poor long-term curative effect and less than 5 %survival rate within 5 years. At present, researchers indicate that radiotherapy can improve the quality of life, increase tumor local control rate and prolong the overall survival time of patients with pancreatic cancer in different levels. Diffusion weighted imaging (DWI), as a functional imaging technology of magnetic resonance imaging (MRI), is the only way to react cell levels. This paper will summarize the application of DWI in radiotherapy of pancreatic cancer.

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A general situation on research about the endothelins (ET) such as its synthesis, secretion and the mitogenic activity on vascular smooth muscle cells (VSMC), and its effect on restenosis after percutaneous coronary intervention (PCI) was reviewed by the authors.

A case of multiple keratoacanthoma centrifugum marginatum is first reported in China. A 37-year-old woman was admitted to the hospital for papules and plaques on her face, which had been increasing in number for 4 months. Cutaneous examination revealed dozenes of well-marginated, pale-red or skin-colored crateriform papules of variant size, and plaques in a geographic pattern on her face. The papules presented with a central umbilication filled with grey-brown corneous material. The plaques were surrounded by dyke-like borders, covered with thick, crusted brown corneous material, and partly depressed in the center. Histopathology showed hyperkeratosis, parakeratosis, irregular strip-like extension of epidermis into dermis, keratinous cysts and squamous eddies. The tumor cells had eosinophilic and glassy cytoplasm characteristic of keratoacanthoma.Given both the clinical and histologic evidence, a diagnosis of multiple keratoacanthoma centrifugum marginatum was made. After more than 3 months of treatment with oral acitretin and topical tretinoin, the lesions faded,leaving rugosity scars. No relapse was noted during 3-year follow-up.

80% of low density area in tumor), 10 PR(50%-80%) and 3 NC(0.05). Conclusion For tumor treated with hyperthermia plus radiotherapy, the response evaluation should be based on both the change in the mass size and the percentage of low density area in the tumor.

Objective To preliminarily evaluate the feasibility,therapeutic effect and normal tissue complications of stereotactic γ-ray body radiation therapy for patients with asynchronous bilateral renal cell carcinoma.Methods Nine patients with inoperable asynchronous bilateral renal cell carcinoma with a median time from the resection of the primary focus and discovery of the contralateral focus underwent stereotactic γ-ray body radiotherapy with OUR-QGD stereotactic γ-ray whole body therapeutic planning system.50％ isodose line,as the prescription dose line,was to cover the planning target volume (PTV) and the 70％ isodose line was to cover the gross target volume (GTV).Radiotherapy was delivered,with a single dose of 3-5 Gy per fraction,one fraction per day,5 fractions per week,and totally 10-17 fractions.The PTV edge total dose was 36-51 Gy,and the GTV edge total dose was 60-85 Gy.The patients were followed up for a median time of 24 months to evaluate the local control rate and overall survival rate.Results Of the 9 patients,1 presented complete remission (11.1％) and 4 partial remission (44.5％),with a total effective rate of 55.6％.The 1-,3-,and 5-year local control rates were 64.8％,43.2％,and 43.2％ respectively.The 1-,3-,and 5-year overall survival rates were 66.7％,53.3％,and 35.6％ respectively.Four patients (44.4％) had acute radiation reaction:2 cases with grade l leukocytopenia and 2 cases with grade 1 gastrointestinal reactions.Two patients showed grade 2 late radiation-induced reaction in gastrointestinal system.The Karnofsky score was significantly increased and the renal function was normal after radiotherapy.Conclusions Stereotactic γ-ray body radiation therapy is safe and effective in the treatment of asynchronous bilateral renal cell carcinoma.

Objective To seek a optimization method for lung cancer planning with Helical TomoTherapy for reducing the low dose area of total lung.Methods CT images of thirty patients with unilateral lung cancer were selected.Seven plans (Groups A,B,C,D,E,F and G) were generated for each patient using an identical optimization procedure with the conditions that implemented contralateral lung with unblocked (control group),1/4 directional block,1/2 directional block,directional block,1/4 complete block,1/2 complete block and complete block,respectively.The benefits in different schemes of reducing the low dose area of normal lung tissue were estimated,in order to provide a reference treatment plan scheme in clinical.Results Groups B,C,D and E had less influence on the target than that of group A.And there were no statistical difference between the target dosimetric parameters.The median dose and average dose of group F were increased within 0.5 Gy.The conformal index of group G had great influence on the target.The low dose area of total lung were reduced effectively in Groups C,D,E,F and G,the average decrease of V5 and V10 was 8.06％-45.26％ and 6.21％-33.95％,respectively.The V20 decreased by 1.71％-3.78％ in directional block group,while V20 increased in complete block group (2.07％-5.07％).The single treatment time was increased by 8.51％-79.22％.Conclusions The results showed that the low dose area of total lung was higher for the plan without any block limitation.It could reduce the low dose area of total lung with directional block.We should lengthen the blocking arc of contralateral lung with directional block based on the fractional treatment time and the patient's physical condition.A certain arc of contralateral lung with complete block could effectively reduce low dose area.When complete block was used,it is suggested that the arc was no more than half of the contralateral lung.

Tomotherapy plans were produced using a combination of field widths (1 cm, 2.5 cm and 5 cm) and pitches (0.15, 0.30, and 0.45) for seven patients with brain metastases from lung cancer, the plans were compared with dosimetric parameters, protection of organs at risk (OAR) dose and treatment times. All plans were defined that CTV with 30Gy and GTV 50 Gy by ten fraction synchronously. The results showed that the mean dose and CI for GTV was statistical difference (P = 0.002 1, P = 0.012 8), OARs were within the normal range, the treatment time increased inversely proportional to the jaw width, but had lesser impact on the pitch. This study showed plans produced with 5 cm jaw was an effective method for patients with brain metastases from lung cancer.
Aged ; Brain Neoplasms ; diagnostic imaging ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Spiral Computed

Objective To study the dose characteristics of Body γ Knife and Tomotherapy treatment plans for hepatocellular carcinoma,and compare their differences between organs at risk (OAR) dose and the range of low dose.Methods CT simulation images of twelve patients with hepatocellular carcinoma were selected,the target volume and OAR were drew by doctor.Body γ Knife and Tomotherapy treatment plans were optimized with their own planning station.The dosimetric characteristics were evaluated by dose volume histograms and were compared.To analyze the difference between the two techniques,the paired t-test was applied.Results The Dmax and Dmean of target with Body γ Knife were higher than Tomotherapy (P =0.002,0.000),but the conformal index of PTV of Tomotherapy was superior to the Body γ Knife (P =0.001).The Dmax of spinal cord and left kidney with Body γ Knife was lower than Tomotherapy (P =0.013,0.012),and it was also in the Dean of stomach and left kidney (P =0.010,0.023).In the volume dose comparison,the V40,V35,V30,V25 and V20 of normal tissue (all Body-PTV) and liver (all liver-GTV) with Body γ Knife were higher than Tomotherapy (P =0.001,0.001,0.001,0.007,0.029),but the V10 and V5 were lower (P =0.019,0.031),the Dmax of stomach,Dmean of right kidney and liver were no statistical difference (P =0.247,0.308,0.401).Conclusions Both treatment plans could meet the clinical dosimetric need,by the same prescription dose,Dmax and Dmean of target of Body γ Knife were higher than Tomotherapy.Tomotherapy had excellent dose-target conformal and could reduce the range of V25-V40 of OAR and normal tissue,but the range of V5-V10 was increased obviously.

ObjectiveTo further evaluate the value of the stereotactic gamma-ray body radiation therapy ( γ-SBRT ) for patients with stage Ⅰ / Ⅱ non-small cell lung cancer ( NSCLC ) basing on the preliminary studies.MethodsTwenty-nine eligible patients with stage Ⅰ / Ⅱ NSCLC who is unable or unwilling to receive surgery underwent treatment prospectively with γ-SBRT (OUR-QGD).Patients were fixed by vacuum bag.Each patient underwent slow CT simulation at 5 s/slide with thickness of 5 mm and interval of 5 mm to take into consideration tumor motion.A total dose of 50 Gy was delivered at 5 Gy/fraction to 50％ isodose line covering 100％ of the PTV,with 60 Gy at 6 Gy/fraction to 60％ isodose line covering 90％ of the CTV,70 Gy at 7 Gy/fraction to 70％ isodose line covering 80％ of the GTV,and 10 times finished in 2 weeks,5 fractions per week.ResultsThe follow-up rate was 97％.The 6 month local tumor response rate was 93％,with CR 86％,and PR 7％.The 1-,2-year local control rates were both 93％.The 1-,2-year overall survival rates for the whole group,stage Ⅰ and stage Ⅱ were 97％ and 89％,100％ and 92％,67％ and 67％,respectively.The 1-,2-year progression-free survival were 90％ and 86％,respectively.34％ of the patients had acute radiation toxicities ( grade 1,2 and 3 in 6,2 and 2patients,respectively),and 38％ late radiation toxicities ( grade 1 and 2 in 10 and 1,patients).Conclusions γ-SBRT is a safe and effective treatment regimen,resulted in promising local control and survival with minor toxicity.