Objective:To investigate the predictive efficacy of spiral computed tomography(CT)combined with serum fibrinogen(Fbg)detection in the prognosis of patients with locally advanced non-small cell lung cancer(NSCLC)who underwent concurrent radiotherapy and chemotherapy.Methods:From April 2018 to January 2023,a total of 60 patients with locally advanced NSCLC patients,who admitted to Hefei Cancer Hospital of the Chinese Academy of Sciences and underwent the treatment of concurrent radiotherapy and chemotherapy,were selected.They were divided into survival group(50 cases)and endpoint event group(10 cases)according to the prognosis.Before treatment,both two groups were examined by spiral CT,and the average CT values,noise values,and signal to noise ratio(SNR)values of CT related indicators of two groups were counted by using statistical method.The serum Fbg levels of two groups were detected before treatment,and the follow up was conducted until October 2023,and the record of the follow-up time within 9 months were counted by using statistical method.Kaplan-Meier method and Logrank analysis were used to analyze prognosis.The mean CT values,noise values,SNR and Fbg data were included in the binary regression analysis for the receiver operating characteristic(ROC)curve analysis,so as to obtain the efficacy values of each indicator and the combination of the each indicator in predicting prognosis.Results:The average CT value and noise value of the endpoint event group were significantly higher than those of the survival group,while the SNR was significantly lower than that of the survival group,and the serum Fbg level of the endpoint event group was significantly higher than that of the survival group,and the differences were statistically significant(t=5.445,18.323,7.580,78.628,P<0.05),respectively.The area under curve(AUC)values of ROC curve of average CT value,noise value,SNR,Fbg alone and the combination of 4 indicators were 0.665(95%CI:0.493-0.837),0.581(95%CI:0.410-0.752),0.734(95%CI:0.598-0.870),0.668(95%CI:0.533-0.803)and 0.776(95%CI:0.657-0.895)in predicting the prognosis of concurrent radiotherapy and chemotherapy of NSCLC patients,respectively.The ROC curve was adopted to analyze the diagnostic thresholds of the obtained CT value(56.832%),noise value(12.283%),SNR(10.149%)and Fbg(5.102 g/L).Based on the thresholds of each indicator,35 patients with high average CT value and 25 patients with low average CT value were identified.The survival time of patients with high average CT value was significantly lower than that of patients with low average CT value,and the difference was statistically significant(Logrank=25.554,P<0.05).In these patients,37 patients appeared high noise and 23 patients appeared low noise,and the survival time of patients with high noise was significantly lower than that of patients with low noise,and the difference was statistically significant(Logrank=28.109,P<0.05).The survival time of 38 patients with high SNR was significantly higher than that of 22 patients with low SNR,and the difference was statistically significant(Logrank=17.502,P<0.05).The survival time of 26 patients with high Fbg was significantly lower than that of 34 patients with low Fbg,and the difference was significant(Logrank=17.809,P<0.05).Conclusion:The average CT value,noise value and SNR combined with serum Fbg level of the relative indicators of CT scan relate to the prognosis of patients with tumor,and the combined detection of them can predict the prognosis of NSCLC patients undergoing concurrent radiotherapy and chemotherapy.

Objective To provide a reliable and stable animal model for investigating the molecular pathogenesis of radiation-induced liver disease (RILD). Methods Ninety C57BL/6J mice were divided into control, 20 Gy, 25 Gy, 30 Gy and 35 Gy radiation groups. The mice were executed at 4 weeks after radiation and the levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase in the liver serum were measured. HE staining was performed on the pathological liver tissues. Masson staining was performed at 36 weeks after radiation. Results Compared with the control group, the fatality rate was higher in the 30 and 35 Gy radiation groups, and the body weight significantly decreased in the 20 and 25 Gy radiation groups. Compared with the control group, alanine aminotransferase significantly increased in mice exposed to 20 Gy, while aspartate aminotransferase and alanine aminotransferase increased in mice exposed to 25 Gy. No significant changes were observed in the livers of the mice in the 20 and 25 Gy radiation groups, but pathological examination showed liver damage induced by both 20 and 25 Gy radiation. Conclusion A stable and reliable mouse model of RILD was constructed for treatment with linear accelerator. The mouse model of RILD constructed for stereotactic body radiation therapy using linear accelerator has significant research implications for the exploration of RILD.

OBJECTIVE To establis h and validate a population pharmacokinetic model of docetaxel in malignant tumor patients. METHODS The clinical data of malignant tumor patients treated with chemotherapy regimen containing docetaxel in our hospital from June 2019 to December 2021 were retrospectively collected . According to the results of blood concentration detection ， based on the three -compartment model the nonlinear mixed effect model （NONMEM）was used ；covariates（age，weight，height， body surface area ，Karnofsky performance scale ，total protein ，albumin，total bilirubin ，aspartate aminotransferase ，alanine aminotransferase and serum creatinine ）affecting clearance （CL）were screened by “forward inclusion and backward exclusion ”； the population pharmacokinetic model of docetaxel was established . The model was tested for goodness -of-fit diagnosis and internal validation by Bootstrap . RESULTS A total of 264 measured blood concentrations of 132 patients with malignant tumors during chemotherapy were included . The covariates that had significant effect on CL of docetaxel were serum creatinine and total bilirubin （P＜0.01）. The results of Bootstrap analysis （parameter median values and 95% confidence intervals ）were close to predict results of the established model ；the final model estimated that the population typical value of docetaxel CL was 37.82 L/h. CONCLUSIONS The population pharmacokinetic model of docetaxel in malignant tumor patients is established successfully ， which can be used for the formulation and optimization of clinical individualized regimen .

[Abstract] Objective: To observe the short-term efficacy and safety of Apatinib combined with radiotherapy and concurrent docetaxel and cisplatin chemotherapy in driver-gene-negative non-small cell lung cancer (NSCLC) patients with brain metastases. Methods: A total of 72 NSCLC patients with brain metastases, who were treated in our hospital from June 2018 to June 2019, were enrolled in this study. The driver gene was proved to be negative by next generation sequencing (NGS). The patients were divided into control group (36 cases) and treatment group (36 cases) by Digital random grouping method.The control group received 2 cycles of chemotherapy with docetaxel and cisplatin and concurrent radiotherapy for brain metastases, and the treatment group was given Apatinib anti-angiogenic treatment based on the regimen in control group. Primary study endpoints: confirmed objective response rate (cORR) and disease control rate (DCR); Secondary study endpoints: progression-free survival (PFS), quality of life (QOL) score, serum carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), and incidence of adverse drug events (AE). Results: Compared with the control group, cORR and DCR in treatment group were significantly improved [41.67% (15/36) vs 33.33% (12/36), 80.56% (29/36) vs 69.44% (25/36), all P<0.05], the median PFS was significantly prolonged (5.9 vs 4.6 months, P<0.05), and serum CEA and VEGF levels were significantly reduced [(16.5±2.3) vs (22.9±3.7) ng/ml, (291.6±42.6) vs (479.3±50.2) ng/L, all P<0.05], while the QOL score was slightly increased, but the difference was not statistically significant [(69.5±8.5) points vs (64.1±7.3) points, P>0.05]. There was no statistically significant difference in the incidence of acute brain edema, gastrointestinal reaction, bone marrow suppression, and liver dysfunction between the two groups of patients (all P>0.05); however, the incidences of oral mucositis, hand-foot syndrome, hypertension and proteinuria in the treatment group were significantly higher than those in the control group (all P<0.05). Conclusion: The efficacy of Apatinib combined with radiochemotherapy in driver-negative NSCLC patients with brain metastases is significantly better than that of radiochemotherapy alone, and the adverse reactions can be controlled. It is worthy of clinical recommendation.

Objective To investigate the short-term clinical efficacy and adverse reactions of stereotactic radiotherapy (SRT) in the treatment of locally recurrent non-small cell lung cancer (NSCLC).Methods Clinical data of 120 cases of recurrent NSCLC after radiotherapy admitted to our hospital from October 2009 to October 2015 were retrospectively analyzed.SRT was adopted for further radiotherapy.The prescription dose was 50％ dose curve surrounding the target area.The total dose was 40-50 Gy,with a single dose of 4-5 Gy for 8-12 times.The chest CT was re-examined every 2 months after radiotherapy.The short-term clinical efficacy and adverse reactions were evaluated.The changes of Karnofsky performance score (KPS) and quality of life (QOL) were recorded before and after radiotherapy.Results One patient terminated the radiotherapy due to grade 3 acute radiation-induced pneumonia,25 patients (21.0％) obtained complete remission (CR),61 cases (51.3％) of partial remission (PR),19 cases (16.0％) of stable disease (SD),14 cases (11.8％) of progress disease (PD),86 cases (72.3％) of objective remission rate (CR+PR),and 105 cases (88.2％) of disease control (CR+PR+SD),respectively.Thirty-one patients experienced radiation-induced pneumonia,23 cases of radiation-induced myelosuppression and 1 case of acute radiation-induced heart injury.All these adverse reactions were mitigated after symptomatic treatment.The KPS was significantly increased from 68.16±15.22 before SRT to 78.39± 11.50 after SRT (P＜0.05).The QOL was considerably elevated from 27.58±5.37 prior to SRT to 38.16±8.39 following SRT (P＜0.01).Conclusion SRT is an efficacious and safe treatment of locally recurrent NSCLC,which yields controllable and tolerable adverse reactions and enhances the QOL of patients.

Objective To verify and evaluate the prognostic models for extranodal natural killer/T-cell lymphoma, nasal type (ENKL). Methods ENKL patients in the 105th Hospital of PLA from January 1990 to December 2015 were retrospectively analyzed, and patients were followed to the August 2016 through telephone and medical records. The models were evaluated by C-index, and the prognostic ability of each factor was assessed by survival curves. Results A total of 76 patients met the inclusion criteria, with a median age of 41.9 years old (range, 14-74 years old), all patients received chemotherapy, and 49 received radiation therapy. During the median observation time (37.0 months), 37 patients died in a median of 28.4 months. The prognostic factors of Eastern Cooperative Oncology Group performance status (ECOG PS) score, level of lactate dehydrogenase (LDH) and Ann Arbor staging were the influencing factors of overall survival in the univariate survival analysis (all P<0.05), and only ECOG PS score was significant in the multivariate Cox regression (OR: 4.231, 95 ％ CI 2.172-8.240, P= 0.000). C-index of international prognostic index (IPI) was 0.541 (95 ％ CI 0.534- 0.555), and those of model with ECOG PS score, Ann Arbor staging, primary lesion invasion, LDH and age as the indicators and model with ECOG PS core, Ann Arbor staging, primary lesion invasion, LDH and hemoglobin as the indicators were both 0.726 (95 ％ CI 0.626-0.826). Conclusion Both model with ECOG PS score, Ann Arbor staging, primary lesion invasion, LDH and age as the indicators and model with ECOG PS core, Ann Arbor staging, primary lesion invasion, LDH and hemoglobin as the indicators can accurately predict the prognosis of patients with ENKL and are significantly better than the IPI model.

Objective: : To observe the short-term efficacy and toxicity of apatinib monotherapy as well as docetaxel plus cisplatin in advanced gastric cancer. Method: : According to inclusion and exclusion criteria, 108 patients with advanced gastric cancer in the 105th Hospital of PLA were selected. According to random table grouping method, there were 54 cases in group A and 54 cases in group B. Patients in group A received continuous oral administration of apatinib alone, while group B received docetaxel plus cisplatin chemotherapy, with 3 weeks as a cycle and 4 cycles for a course. The efficacy and side effects were evaluated 3 months later. Results: : In groupA, there were 4 cases of CR, 25 cases of PR, 18 cases of SD and 7 cases of PD; the ORR was 53.7% and DCR was 87%. In group B, there were 2 cases of CR, 19 cases of PR, 21 cases of SD and 12 cases of PD; the ORR was 38.9% and DCR was 77.8%. The ORR and DCR in group A were significantly better than those in group B (P<0.05). The main adverse reactions were gastrointestinal reaction, myelosuppression, hypertension and hand-foot syndrome, all of which were grade 1 to 2; The incidence of bone marrow suppression and gastrointestinal reaction in group A was lower than that in group B (P<0.05), while the incidence of hand-foot syndrome and hypertension in group B was lower than that in group A (P<0.01). Conclusion： ：The short-term efficacy of targeted therapy of apatinib alone was better than that of docetaxel combined with cisplatin chemotherapy, and the toxicity and side effects of both regimens were controllable;Apatinib can be used as the primary regimen for the treatment of advanced gastric cancer.

Objective To investigate the effects of 5-Aza-2'-deoxycytidine (5-Aza-CdR) on the apoptosis of A549/DDP cells and the expression of hMLH1 gene.Methods A549/DDP cells were treated with 5-Aza-CdR at 0.5,5,50 μmol/L.The growth curve of A549/DDP cells was investigated by MTT assay.The methylation status of hMLH1 gene was detected by methylation specific PCR (MSP).The expression of hMLH1 mRNA was evaluated by FQ-PCR.The apoptosis rate of A549/DDP cells was analyzed by flow cytometry.Results A549/DDP cells treated with 5-Aza-CdR showed a slow growth in comparison with the control cells,and the growth rates were decreased with the increasing of 5-Aza-CdR concentration.The apoptosis rate after treatment was higher than that before treatment in A549/DDP cells (P ＜ 0.05),and had a positive correlation with 5-Aza-CdR dose (P ＜ 0.001).hMLH1 mRNA expression level was increased in a 5-Aza-CdR concentration dependent manner (P ＜ 0.05).hMLH1 promoter in A549/DDP cells was methylated and hMLH1 mRNA was negatively expressed before treatment,but the mRNA was positively expressed after treatment with 5-Aza-CdR.Conclusions 5-Aza-2'-CdR can induce apoptosis of A549/DDP cells by inducing demethylation of hMLH1 promoter and thereby enhancing hMLH1 gene expression and its tumor suppressor function.

Esophageal cancer with eyeball metastasis is scarce,and the clinical diagnosis is based on ul-trasound.The treatment method is surgical removal at present.Our focus is through other local or systemic treat-ment to protect eyeball,protect the integrity intact and facial appearance.One patient's clinical data with esopha-geal eyeball metastasis from the People′s Liberation Army Cancer Center of No.105 Hospital was included.The patient was completed“enucleation of the right side of eyeball” by ultrasound diagnosis.The results of pathologi-cal suggested that poorly differentiated squamous cell carcinoma metastasis in the eye.Eyeball metastases′s opera-tion was received a good recovery after 2 months and there was no recurrence.In the present paper,we discuss e-sophageal eyeball metastases clinical characteristics and methods of diagnosis and treatment combined with the lit-erature.

OBJECTIVETo study the influence of the sequence of three-dimensional conformal radiotherapy (3DCRT) and transcatheter arterial chemoembolization (TACE) on the efficacy and toxicity of treatment in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

METHODSA total of 65 patients who were diagnosed with primary HCC with PVTT were enrolled in the study from November 2008 to March 2012 and were randomly divided into the following two groups:group A,32 patients treated with 3DCRT followed by TACE; group B,33 patients treated with TACE followed by 3DCRT.

RESULTSThe total efficacy rates of groups A and B were 68.8% and 69.7% (x² =0.232, P < 0.793). The survival rates,effective percentage of PVTT and AFP remission rates were not significantly different between group A and group B.The exacerbation rate of liver function was significantly higher for group B than for group A (P < 0.05). No serious complication was found in the follow-up period for either group.

CONCLUSIONThe combination of 3DCRT and TACE is a relatively effective local treatment for patients with primary HCC and PVTT.Compared with TACE followed by 3DCRT, 3DCRT followed by TACE may have a negative influence on liver function.

Arteries ; Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Humans ; Liver Neoplasms ; Portal Vein ; Radiotherapy, Conformal ; Survival Rate ; Thrombosis ; Treatment Outcome