Objective To evaluate the diagnostic efficacy of the pulmonary perfusion tomography combined with low dose CT scan (Q SPECT/ CT) in detecting acute pulmonary embolism (PE) by compa-ring with pulmonary ventilation/ perfusion (V/ Q) SPECT imaging. Methods A total of 203 patients sus-pected with acute PE (88 males, 115 females, age range 19-94 years) from January 2013 to December 2015 were enrolled in this retrospective study. All patients underwent V/ Q SPECT and low dose CT scan. Final clinical diagnosis was regarded as the gold standard. The diagnostic consistency and diagnostic efficacy of Q SPECT/ CT were compared with those of V/ Q SPECT. χ2 test was used to compare the differences be-tween the two methods. Kappa analysis was used to analyze the agreement of them. Results The coinci-dence rate of Q SPECT/ CT and V/ Q SPECT was 94.09％(191/ 203), Kappa= 0.882, P<0.001. Among the 12 cases with inconsistent diagnosis, 9 were finally diagnosed as chronic obstructive pulmonary disease (COPD). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Q SPECT / CT in the diagnosis of PE were 95. 12％(78/ 82), 80.99％(98/ 121), 77.23％(78/ 101), 96.08％(98/ 102), 86. 70％ ( 176/ 203). The counterpart parameters of V/ Q SPECT were 95. 12％ ( 78/ 82), 90. 91％(110/ 121), 87.64％ (78/ 89), 96.49％ (110/ 114), 92.61％ (188/ 203). Compared with V/ Q SPECT, Q SPECT/ CT had the same sensitivity but lower specificity (χ2 = 4.928, P = 0.026). The positive predictive value, negative predictive value and accuracy of Q SPECT/ CT were lower than those of V/ Q SPECT, but there was no significant difference (χ2 values: 3.491, 0.000, 3.824, all P>0.05). Conclusion In the majority of patients with suspected acute PE, V/ Q SPECT scan can be replaced by Q SPECT/ CT, but it must be careful to select Q SPECT/ CT for patients with COPD history.

Objective: To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation. Methods: Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results: Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.

Objective To verify the safety and efficacy of IONTRIS particle therapy system ( IONTRIS) in clinical implementation. Methods Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial:31 males and 4 females with a median age of 69 yrs ( range 39?80) . Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non?metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results Twenty?two patients received carbon ion and 13 had proton irradiation. With a median follow?up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression?free survival rate was 93.8％ (15/16). Among the 19 patients with prostate cancer, biological?recurrence free survival was 100％. Particle therapy was well tolerated in all 35 patients. Twenty?five patients (71.4％) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow?up. Six ( 17.1％) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow?up is needed to observe the late toxicity and long term result.

Objective To verify the safety and efficacy of IONTRIS particle therapy system ( IONTRIS) in clinical implementation. Methods Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial:31 males and 4 females with a median age of 69 yrs ( range 39?80) . Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non?metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results Twenty?two patients received carbon ion and 13 had proton irradiation. With a median follow?up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression?free survival rate was 93.8％ (15/16). Among the 19 patients with prostate cancer, biological?recurrence free survival was 100％. Particle therapy was well tolerated in all 35 patients. Twenty?five patients (71.4％) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow?up. Six ( 17.1％) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow?up is needed to observe the late toxicity and long term result.

Objective To investigate the treatment outcome of patients with localized soft tissue sarcoma (STS) and related prognostic factors,with a focus of the role of postoperative radiotherapy in the treatment of STS.Methods A retrospective analysis was performed for the clinical data of 203 STS patients who underwent organ preservation surgery in Fudan University Shanghai Cancer Center from July 2000 to July 2010.Of all the patients,76(37.4％) received adjuvant radiotherapy,which was delivered via anterior-posterior parallel opposed fields at a dose of 45-70 Gy.The Kaplan-Meier method was used to calculate survival rates,the log-rank test was used for survival difference analysis,and the Cox proportional hazards model was used for multivariate analysis.Results The follow-up rate was 100％.The 5-year overall survival (OS) rate,local failure-free survival rate,and distant metastasis-free survival rate were 69.1％,69.2％,and 68.0％,respectively.The multivariate analysis showed that pathological subtype,tumor size,resection margin status,and postoperative radiotherapy were influencing factors for OS.Among these factors,postoperative radiotherapy was associated with a significantly reduced risk of local recurrence in STS patients (HR=0.327,95％ CI 0.177-0.605,P=0.000) and a significantly increased OS rate (HR=0.489,95％ CI 0.266-0.897,P=0.021).Conclusions Postoperative radiotherapy can reduce local recurrence and improve OS in patients with localized STS,and further studies are needed to clarify its role.

Background and purpose:Human epidermal growth factor receptor-2 (HER-2), a member of epidermal growth factor receptor family, initiates a diverse set of signaling pathways that ultimately affect such fun-damental processes as cell proliferation, cell motility and cell apoptosis. It is reported that HER-2 was associated with epithelial-mesenchymal transition (EMT) process. However, the mechanism needs further investigation. The purpose of this study was to investigate the mechanism of HER-2 on regulating EMT process.Methods:Transwell assay was used to determine the motility of breast cancer cells; Real-time lfuorescence quantitative polymerase chain reaction (RT-FQ-PCR) was employed to determine the expression of genes of interest, and reactive oxygen species production was measured by reactive oxygen species detection kit.Results:HER-2 overexpression in breast cancer cells could promote cell migration and invasion. Mechanistic study showed that HER-2 overexpression could upregulate ZEB1 expression. ZEB1 silencing by siRNA reduced cell motility of HER-2-overexpressing breast cancer cells. Furthermore, reactive oxygen species produced in HER-2-overexpressing breast cancer cells were less than those produced in corresponding control cells.Conclusion:Our study demonstrated that HER-2 overexpression endowed breast cancer cells with EMT related properties by upregulating ZEB1 expression. ZEB1 could be a candidate target for further study of the relation-ship between HER-2 and EMT.

Sentinel lymph node biopsy has been the standard axillary intervention for breast cancer patients with clinical negative axillary lymph nodes.Complete axillary dissection could be omitted for patients with negative sentinel lymph nodes.While, the optimal axillary intervention for patients with 1-2 positive sentinel lymph nodes remained controversial.This review introduced the latest research results of the axillary management for early stage breast cancer patients with 1-2 positive sentinel lymph nodes.

Objective To observe the efficacy of psychological intervention on treatment compliance rate, clinical effect and quality of life in patients with advanced cancer pain.Methods Using a sealed envelope method, 80 patients with advanced cancer pain were randomly divided into two groups: the experimental group (EG) (40 cases) and the control group (CG) (40 cases).All patients were treated with standardized cancer pain treatment, and the patients of EG were treated with positive psychological intervention.The treatment compliance rate, clinical effect and quality of life after intervention by 14 days between two groups were compared.Results In EG and CG, the clinical efficiencies of cancer pain were 95.0 ％ (38/40) and 80.0 ％ (32/40), respectively (P ＜ 0.05).The treatment compliance rates were 87.5 ％ (35/40) and 62.5 ％ (25/40), respectively (P ＜ 0.01), and the improvement rates of quality of life were 80.0 ％ (32/40) and 57.5 ％ (23/40), respectively (P ＜ 0.05).Conclusion Psychological intervention is effective to improve the treatment compliance, clinical effect and quality of life for the patients with advanced cancer pain.

Bone remains the predominant site of metastasis in advanced breast cancer. Bone metastases dramatically decrease the quality of life. Moreover, pathologic fractures and other skeletal-related events (SREs) caused by bone metastases could result in higher mortality risk in patients with breast cancer. Palliative radiotherapy is a crucial element in bone metastases treatment. The present review discusses the emerging evidence in bone metastases of breast cancer, focusing on optimized radiotherapy strategies and multidisciplinary management.

The technique of nipple-areola complex (NAC)-sparing mastectomy (NSM) facilitates the breast reconstruction due to preserving the skin and NAC of breast in the treatment of breast cancer. Key issues still remain controversial in NSM, in terms of the role of radiotherapy combined with NSM and sequence of radiotherapy and NSM, which arise from the consideration of the oncology safety. Some investigations addressed that post-NSM external beam irradiation and intra-operative radiotherapy (IORT) combined with NSM could reduce the local recurrence rate. Based on the appropriate patient selection and good quality of surgery, radiotherapy would be applied in different strategies of combination with NSM according to the risk of local recurrence of the cancer.